Proliferative Diabetic Retinopathy (PDR) is a chronic complication of Diabetes and the main cause of blindness among the world’s working population at present. While there have been many studies on the pathogenesis of PDR, its intrinsic molecular mechanisms have not yet been fully elucidated. In recent years, several studies have employed bulk RNA-sequencing (RNA-seq) and single-cell RNA sequencing (scRNA-seq) to profile differentially expressed genes (DEGs) and cellular components associated with PDR. This study adds to this expanding body of work by identifying PDR’s target genes and cellular components by conducting an integrated transcriptome bioinformatics analysis. This study integrately examined two public bulk RNA-seq datasets(including 11 PDR patients and 7 controls) and one single-cell RNA-seq datasets(including 5 PDR patients) of Fibro (Vascular) Membranes (FVMs) from PDR patients and control. A total of 176 genes were identified as DEGs between PDR patients and control among both bulk RNA-seq datasets. Based on these DEGs, 14 proteins were identified in the protein overlap within the significant ligand-receptor interactions of retinal FVMs and Protein-Protein Interaction (PPI) network, three of which were associated with PDR (CD44, ICAM1, POSTN), and POSTN might act as key ligand. This finding may provide novel gene signatures and therapeutic targets for PDR.
PURPOSE: To investigate the effect of wavefront aberrations on night vision problems and mesopic contrast threshold after small incision lenticule extraction (SMILE). METHODS: Forty-two participants (84 eyes) who underwent SMILE were included in this prospective observational study. Visual outcomes including uncorrected distance visual acuity (UDVA), subjective manifest refraction, mesopic contrast threshold (Binoptometer 4P; Oculus Optikgeräte GmbH), and higher order aberrations (HOAs) were analyzed before and 3 months after surgery. The patient's night vision satisfaction was assessed using a questionnaire. RESULTS: The mean spherical equivalent was −5.30 ± 1.38 diopters (D) preoperatively and −0.06 ± 0.15 D postoperatively. UDVA was better than 20/20 in 98.81% of the patients and better than 20/25 in all patients. Scores of night vision satisfaction and glare changed significantly in the postoperative period ( F = 8.463, P = .001; F = 69.518, P < .001, respectively). Preoperative spherical diopters (lower order aberrations) were positively correlated with night vision satisfaction ( r = −0.329, P = .041) and glare score ( r =−0.332, P = .039). Age (odds ratio [OR] = 1.272, 95% CI = 1.019 to 1.589) and preoperative spherical diopter (OR = 0.437, 95% CI = 0.199 to 0.975) were correlated with night vision satisfaction scores by analysis of binary regression. The root mean square value of total HOAs increased 3 months after surgery ( t = −6.873, P < .001) with an increase in horizontal coma (Z 3 1 ) and spherical aberration (Z 4 0 ) ( P < .001). No correlation was observed between glare score and HOAs; however, patients with higher preoperative myopia demonstrated continuously decreasing contrast under mesopic conditions and higher postoperative horizontal coma. CONCLUSIONS: Myopic patients with higher preoperative spherical errors experienced more glare at night after SMILE surgery. Postoperative horizontal coma was associated with worse mesopic contrast thresholds. [ J Refract Surg . 2021;37(7):446–452.]
Abstract Background There are few reports regarding the influence of varying illumination on the compensation effect before and after corneal refractive surgery. We aimed to evaluate the changes in refraction, higher-order aberrations, and aberration compensation between mesopic and photopic illumination before and after small incision lenticule extraction. Methods In this prospective cohort study, only the right eyes of patients who underwent small incision lenticule extraction for the correction of myopia and myopic astigmatism at the Tianjin Eye Hospital were included. Wavefront refraction and higher-order aberrations were measured preoperatively and 3 months postoperatively under mesopic and photopic illumination. Compensation factors were calculated as 1 − (aberration of the whole eye/aberration of the anterior corneal surface). Results Forty patients undergoing small incision lenticule extraction were enrolled. All surgeries were completed without postoperative complications. Preoperatively, the eyes only had a statistically significantly higher ( t = − 4.589, p < .001) spherical refractive error under mesopic vs. photopic illumination (median [interquartile range], − 6.146 [2.356] vs. − 6.030 [2.619] diopters [D]), whereas postoperatively, the eyes also exhibited statistically significantly higher ( t = − 3.013, p = .005) astigmatism (− 0.608 [0.414] vs. − 0.382 [0.319] D). Differences in spherical refraction between the two illuminations were the highest in postoperative eyes (Δ > 0.5 D). Only postoperative eyes exhibited statistically significant elevations ( t ≥ 4.081, p < .001) in higher-order aberrations under mesopic illumination, and only preoperative eyes exhibited statistically significantly enhanced ( χ 2 = 6.373, p = .01 for fourth-order and χ 2 = 11.850, p = .001 for primary spherical aberrations) and decreased ( χ 2 = 13.653, p = .001 for horizontal trefoil) compensation factors under mesopic illumination. Conclusions Exaggerations in higher-order aberrations and myopic shift after small incision lenticule extraction became apparent under mesopic illumination. Slight undercorrection may have an enhanced effect under low illumination and may reduce night vision. The specific changes in compensation effects in preoperative eyes may improve optical quality under mesopic illumination. Postoperative eyes have reduced compensation ability, specifically for spherical aberrations, under mesopic illumination, which may diminish night vision. Further studies that include the measurement of subjective night vision parameters should be conducted.
To compare higher-order aberrations (HOAs) after small incision lenticule extraction (SMILE) in patients with and without intraoperative angle kappa adjustments.This is a retrospective case series. One hundred six eyes of 106 patients who underwent SMILE at Tianjin Eye Hospital (Tianjin Medical University, Tianjin, China) for correction of myopia and myopic astigmatism were divided into 2 groups. The first group consisted of eyes with intraoperative angle kappa adjustment and the second group consisted of eyes without adjustment. Preoperative and postoperative visual outcome, refraction, and HOA measurements at 1 and 3 months were compared.At the pupil size of 6 mm, vertical coma at 1 and 3 months after SMILE for the angle kappa-adjusted group was 0.153 ± 0.107 and 0.157 ± 0.094 μm, which were significantly lower than those of the nonadjusted group (0.204 ± 0.117 and 0.203 ± 0.113 μm, respectively) (P = 0.026 at 1 mo, P = 0.047 at 3 mo). The change in vertical coma between preoperative and postoperative measurements was 0.011 ± 0.136 and 0.023 ± 0.129 μm at 1 and 3 months postoperatively for the angle kappa-adjusted group, which were lower than those of the nonadjusted group (0.082 ± 0.165 and 0.085 ± 0.150 μm, respectively) (P = 0.023 at 1 mo, P = 0.045 at 3 mo). Subgroup analysis for eyes with large angle kappa demonstrated that the vertical coma was significantly less in the angle kappa-adjusted group at both 1 and 3 months (P = 0.009, P = 0.043, respectively). No significant correlation was observed between angle kappa and HOAs in the angle kappa-adjusted group.Adjustment of angle kappa during SMILE resulted in less HOAs. It would provide more insight on how to optimize treatment centration in SMILE.
Purpose: To investigate real-time intraocular pressure (IOP) during small incision lenticule extraction (SMILE) in rabbit eyes for myopia correction.Methods: During SMILE, real-time IOP was measured in the vitreous cavity of rabbit eyes with an optic fiber pressure sensor (OFPS). Two groups (n = 6 for each) underwent surgery, one group for a −2.00 diopter (D) refractive spherical correction and the other for a −6.00 D correction.Results: During surgery, the IOP increased once the glass contact attached to the cornea (Pre-suction), and peaked 83.94 mmHg (SD ± 23.87 mmHg) for the −2.00 D group and 89.17 mmHg (SD ± 22.66 mmHg) for the −6.00 D group, both average values were less than 110 mmHg when suction was initiated to fix the glass contact onto the cornea (Suction on). It then fell to 74.81 mmHg (SD ± 20.64 mmHg) and 76.94 mmHg (SD ± 27.43 mmHg), respectively, and remained stable during lenticule creation (Cutting). After suction stopped (Suction off), IOP fell steeply. During lenticule separation/extraction, the change in IOP was 32.26 mmHg (SD ± 2.91 mmHg). Notably, the average duration of elevated IOP during the surgery was 166.05 s (no longer than 3 min).Conclusions: The IOP fluctuations in the vitreous cavity using an OFPS in a rabbit model during SMILE showed that real-time IOP significantly was increased during Pre-suction, Suction on, Cutting, Suction off, and lenticule separation/extraction compared to baseline IOP, although, peaked at Suction on. Neither the degree of myopic correction nor central corneal thickness significantly affected these changes in IOP.
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