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Nava-Castañeda Á, Garnica-Hayashi L, Santiago-Rea N, González-Mondragón E, Buentello-Volante B, Magaña-Guerrero FS, Garfias Y. The Effect of Amniotic Membrane Transplantation or Conjunctival Autografts on the Tear Mucins MUC5A and MUC2 After Pterygium Resection: A Six-Month Follow-Up. Transl Vis Sci Technol 2024; 13:10. [PMID: 39235403 PMCID: PMC11382966 DOI: 10.1167/tvst.13.9.10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/06/2024] Open
Abstract
Purpose Pterygium is an ocular surface disease characterized by the invasion of fibrovascular tissue from the bulbar conjunctiva to the cornea and is associated with abnormal tear function caused by changes in tear composition and osmolarity. In this study, the effect of two different surgical techniques to remove primary pterygium: conjunctival autograft surgery (CAG) and amniotic membrane transplantation (AMT), on changes in MUC2 and MUC5AC tear mucins concentration were evaluated. Methods Forty-four patients (>18 years old) with primary unilateral pterygium (> 1.0 mm long, measured from the limbus to the apex on the cornea) were randomly enrolled, and assigned to the AMT or CAG group by using the permuted block technique. Patients with systemic inflammatory diseases or other eye comorbidities were excluded from the study. Tear break-up time (TBUT) and best-corrected visual acuity (BCVA) assessments were performed before surgery and at 1, 3, and 6 months after surgery. Tears were collected concurrently with the clinical evaluations, and MUC2 and MUC5AC concentrations were subsequently measured by means of ELISA. Results At 6 months after CAG or AMT, TBUT and BCVA were significantly lower (P < 0.05) in comparison with the baseline values in the study subjects. The tear mucin concentrations of both MUC2 and MUC5AC were significantly higher (P < 0.0001) in patients with pterygium before any surgical procedure than in healthy individuals. The concentration of MUC2 increased at 1 and 3 months after CAG surgery and decreased at 6 months; however, the MUC2 concentration decreased on the AMT group in all time point measurements. Interestingly, the MUC5AC concentration significantly increased at 1 month after AMT or CAG and then decreased at 3 and 6 months after surgery. Finally, an inverse correlation was found between both MUC2 and MUC5AC tear mucins concentration and the TBUT. Conclusions These results suggest that pterygium excision via both CAG or AMT changes the concentrations of the tear mucins MUC2 and MUC5AC during the evaluated times, and these changes could affect tear film stability and clinical recovery after pterygium treatment. Translational Relevance The tear film stability during pterygium excision was evaluated to determine adequate treatments.
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Affiliation(s)
- Ángel Nava-Castañeda
- Research Unit, Instituto de Oftalmología Fundación Conde de Valenciana, IAP, Chimalpopoca #14, Mexico City, México
- Oculoplastic Department, Instituto de Oftalmología Fundación Conde de Valenciana, IAP, Chimalpopoca #14, Mexico City, México
| | - Lilia Garnica-Hayashi
- Oculoplastic Department, Instituto de Oftalmología Fundación Conde de Valenciana, IAP, Chimalpopoca #14, Mexico City, México
| | - Noé Santiago-Rea
- Oculoplastic Department, Instituto de Oftalmología Fundación Conde de Valenciana, IAP, Chimalpopoca #14, Mexico City, México
| | - Edric González-Mondragón
- Oculoplastic Department, Instituto de Oftalmología Fundación Conde de Valenciana, IAP, Chimalpopoca #14, Mexico City, México
| | - Beatriz Buentello-Volante
- Research Unit, Instituto de Oftalmología Fundación Conde de Valenciana, IAP, Chimalpopoca #14, Mexico City, México
| | - Fátima Sofía Magaña-Guerrero
- Research Unit, Instituto de Oftalmología Fundación Conde de Valenciana, IAP, Chimalpopoca #14, Mexico City, México
| | - Yonathan Garfias
- Research Unit, Instituto de Oftalmología Fundación Conde de Valenciana, IAP, Chimalpopoca #14, Mexico City, México
- Department of Biochemistry, Faculty of Medicine, Universidad Nacional Autónoma de México, Mexico City, Mexico
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Marro M, Moccozet L, Vernez D. A model of ocular ambient irradiance at any head orientation. Comput Biol Med 2024; 179:108903. [PMID: 39059211 DOI: 10.1016/j.compbiomed.2024.108903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Revised: 06/06/2024] [Accepted: 07/14/2024] [Indexed: 07/28/2024]
Abstract
Exposure to ambient ultraviolet radiation is associated with various ocular pathologies. Estimating the irradiance received by the eyes is therefore essential from a preventive perspective and to study the relationship between light exposure and eye diseases. However, measuring ambient irradiance on the ocular surface is challenging. Current methods are either approximations or rely on simplified setups. Additionally, factors like head rotation further complicate measurements for prolonged exposures. This study proposes a novel numerical approach to address this issue by developing an analytical model for calculating irradiance received by the eye and surrounding ocular area. The model takes into account local ambient irradiance, sun position, and head orientation. It offers a versatile and cost-effective means of calculating ocular irradiance, adaptable to diverse scenarios, and serves both as a predictive tool and as a way to compute correction factors, such as the fraction of diffuse irradiance received by the eyes. Furthermore, it can be tailored for prolonged durations, facilitating the calculation of radiant dose obtained during extended exposures.
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Affiliation(s)
- Michele Marro
- University of Geneva, Centre Universitaire d'informatique, Battelle, Batiment A, 7 Route de Drize 1227 Carouge (CH), Switzerland.
| | - Laurent Moccozet
- University of Geneva, Centre Universitaire d'informatique, Battelle, Batiment A, 7 Route de Drize 1227 Carouge (CH), Switzerland.
| | - David Vernez
- University of Lausanne, Center for Public Health and Primary Care Medicine (Unisanté), 44 Rue du Bugnon 1011 Lausanne (CH), Switzerland.
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Masoumi A, Esfandiari A, Khalili A, Latifi G, Ghanbari H, Jafari B, Montazeriani Z, Rahimi M, Ghafarian S. Assessment of conjunctival autograft reperfusion after pterygium surgery by optical coherence tomography angiography (OCT-A). Microvasc Res 2024; 157:104734. [PMID: 39218033 DOI: 10.1016/j.mvr.2024.104734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2024] [Revised: 08/24/2024] [Accepted: 08/26/2024] [Indexed: 09/04/2024]
Abstract
PURPOSE To investigate the healing process of conjunctival autografts (CAG) following pterygium surgery using optical coherence tomography angiography (OCTA). METHODS Twenty-one eyes of 21 patients diagnosed with pterygium underwent pterygium excision with CAG without using Mitomycin-C. Over a 12-week follow-up period, changes in vascular density (VD), vascular density index (VDI), and vascular length density (VLD) were assessed at two distinct depths: superficial (<200 μm) and deep (>200 μm) using OCTA. Additionally, the revascularization rate and pattern were evaluated. RESULTS During the first week, the CAG was edematous and no sign of neovascularization was observed. In 4th week edema decreased and early signs of vascular formation appeared. In the 12th week, the deep vasculature demonstrated a greater density of interconnectivity compared to the superficial layers. VD and VLD significantly increased during the follow-up period (P < 0.05). The CAG blood flow signals exhibited a chaotic pattern, deviating from the expected centrifugal vascular pattern in the surrounding normal conjunctiva. CONCLUSION OCTA imaging emerges as a reliable tool for the assessment of CAG vascularization, improving the monitoring of the healing process in the postoperative period. The evaluation of CAG revascularization patterns appears to be promising biomarkers that can predict the potential future recurrence.
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Affiliation(s)
- Ahmad Masoumi
- Department of Ophthalmology, Farabi Eye Hospital, School of medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Amirreza Esfandiari
- Department of Ophthalmology, Farabi Eye Hospital, School of medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Atefeh Khalili
- Department of Ophthalmology, Farabi Eye Hospital, School of medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Golshan Latifi
- Department of Ophthalmology, Farabi Eye Hospital, School of medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Hamidreza Ghanbari
- Department of Ophthalmology, Farabi Eye Hospital, School of medicine, Tehran University of Medical Sciences, Tehran, Iran.
| | - Behzad Jafari
- Department of Ophthalmology, Farabi Eye Hospital, School of medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Zahra Montazeriani
- Department of Medical Physics and Biomedical Engineering, Tehran University of Medical Sciences and Research Center for Science and Technology in Medicine, Tehran, Iran
| | - Masoud Rahimi
- Department of Ophthalmology, Farabi Eye Hospital, School of medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Sadegh Ghafarian
- Department of Ophthalmology, Farabi Eye Hospital, School of medicine, Tehran University of Medical Sciences, Tehran, Iran.
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Nguyen T, Ong J, Masalkhi M, Waisberg E, Zaman N, Sarker P, Aman S, Lin H, Luo M, Ambrosio R, Machado AP, Ting DSJ, Mehta JS, Tavakkoli A, Lee AG. Artificial intelligence in corneal diseases: A narrative review. Cont Lens Anterior Eye 2024:102284. [PMID: 39198101 DOI: 10.1016/j.clae.2024.102284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2024] [Revised: 07/31/2024] [Accepted: 07/31/2024] [Indexed: 09/01/2024]
Abstract
Corneal diseases represent a growing public health burden, especially in resource-limited settings lacking access to specialized eye care. Artificial intelligence (AI) offers promising solutions for automating the diagnosis and management of corneal conditions. This narrative review examines the application of AI in corneal diseases, focusing on keratoconus, infectious keratitis, pterygium, dry eye disease, Fuchs endothelial corneal dystrophy, and corneal transplantation. AI models integrating diverse imaging modalities (e.g., corneal topography, slit-lamp, and anterior segment OCT images) and clinical data have demonstrated high diagnostic accuracy, often outperforming human experts. Emerging trends include the incorporation of biomechanical data to enhance keratoconus detection, leveraging in vivo confocal microscopy for diagnosing infectious keratitis, and employing multimodal approaches for comprehensive disease analysis. Additionally, AI has shown potential in predicting disease progression, treatment outcomes, and postoperative complications in corneal transplantation. While challenges remain such as population heterogeneity, limited external validation, and the "black box" nature of some models, ongoing advancement in explainable AI, data augmentation, and improved regulatory frameworks can serve to address these limitations.
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Affiliation(s)
- Tuan Nguyen
- Weill Cornell/Rockefeller/Sloan-Kettering Tri-Institutional MD-PhD Program, New York City, NY, United States.
| | - Joshua Ong
- Department of Ophthalmology and Visual Sciences, University of Michigan Kellogg Eye Center, Ann Arbor, MI, United States
| | | | | | - Nasif Zaman
- Human-Machine Perception Laboratory, Department of Computer Science and Engineering, University of Nevada, Reno, Reno, NV, United States
| | - Prithul Sarker
- Human-Machine Perception Laboratory, Department of Computer Science and Engineering, University of Nevada, Reno, Reno, NV, United States
| | - Sarah Aman
- Wilmer Eye Institute, Johns Hopkins Medicine, Baltimore, MD, United States
| | - Haotian Lin
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Mingjie Luo
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Renato Ambrosio
- Federal University of the State of Rio de Janeiro, Rio de Janeiro, Brazil; Brazilian Artificial Intelligence Networking in Medicine, Rio de Janeiro and Alagoas, Brazil
| | - Aydano P Machado
- Federal University of Alagoas, Maceió, Brazil; Brazilian Artificial Intelligence Networking in Medicine, Rio de Janeiro and Alagoas, Brazil
| | - Darren S J Ting
- Academic Unit of Ophthalmology, Institute of Inflammation and Ageing, University of Birmingham, United Kingdom; Birmingham and Midland Eye Centre, Birmingham, United Kingdom; Academic Ophthalmology, School of Medicine, University of Nottingham, United Kingdom
| | - Jodhbir S Mehta
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore; Duke-NUS Medical School, National University of Singapore, Singapore
| | - Alireza Tavakkoli
- Human-Machine Perception Laboratory, Department of Computer Science and Engineering, University of Nevada, Reno, Reno, NV, United States
| | - Andrew G Lee
- The Houston Methodist Research Institute, Houston Methodist Hospital, Houston, TX, United States; Departments of Ophthalmology, Neurology, and Neurosurgery, Weill Cornell Medicine, New York, NY, United States; Department of Ophthalmology, University of Texas Medical Branch, Galveston, TX, United States; University of Texas MD Anderson Cancer Center, Houston, TX, United States; Texas A&M College of Medicine, TX, United States; Department of Ophthalmology, The University of Iowa Hospitals and Clinics, Iowa City, IA, United States
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Wu MN, He K, Yu YB, Zheng B, Zhu SJ, Hong XQ, Xi WQ, Zhang Z. Intelligent diagnostic model for pterygium by combining attention mechanism and MobileNetV2. Int J Ophthalmol 2024; 17:1184-1192. [PMID: 39026919 PMCID: PMC11246929 DOI: 10.18240/ijo.2024.07.02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2023] [Accepted: 04/01/2024] [Indexed: 07/20/2024] Open
Abstract
AIM To evaluate the application of an intelligent diagnostic model for pterygium. METHODS For intelligent diagnosis of pterygium, the attention mechanisms-SENet, ECANet, CBAM, and Self-Attention-were fused with the lightweight MobileNetV2 model structure to construct a tri-classification model. The study used 1220 images of three types of anterior ocular segments of the pterygium provided by the Eye Hospital of Nanjing Medical University. Conventional classification models-VGG16, ResNet50, MobileNetV2, and EfficientNetB7-were trained on the same dataset for comparison. To evaluate model performance in terms of accuracy, Kappa value, test time, sensitivity, specificity, the area under curve (AUC), and visual heat map, 470 test images of the anterior segment of the pterygium were used. RESULTS The accuracy of the MobileNetV2+Self-Attention model with 281 MB in model size was 92.77%, and the Kappa value of the model was 88.92%. The testing time using the model was 9ms/image in the server and 138ms/image in the local computer. The sensitivity, specificity, and AUC for the diagnosis of pterygium using normal anterior segment images were 99.47%, 100%, and 100%, respectively; using anterior segment images in the observation period were 88.30%, 95.32%, and 96.70%, respectively; and using the anterior segment images in the surgery period were 88.18%, 94.44%, and 97.30%, respectively. CONCLUSION The developed model is lightweight and can be used not only for detection but also for assessing the severity of pterygium.
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Affiliation(s)
- Mao-Nian Wu
- School of Information Engineering, Huzhou University, Huzhou 313000, Zhejiang Province, China
- Zhejiang Province Key Laboratory of Smart Management and Application of Modern Agricultural Resources, Huzhou University, Huzhou 313000, Zhejiang Province, China
| | - Kai He
- School of Information Engineering, Huzhou University, Huzhou 313000, Zhejiang Province, China
- School of Mathematical Information, Shaoxing University, Shaoxing 312000, Zhejiang Province, China
| | - Yi-Bei Yu
- School of Information Engineering, Huzhou University, Huzhou 313000, Zhejiang Province, China
| | - Bo Zheng
- School of Information Engineering, Huzhou University, Huzhou 313000, Zhejiang Province, China
- Zhejiang Province Key Laboratory of Smart Management and Application of Modern Agricultural Resources, Huzhou University, Huzhou 313000, Zhejiang Province, China
| | - Shao-Jun Zhu
- School of Information Engineering, Huzhou University, Huzhou 313000, Zhejiang Province, China
- Zhejiang Province Key Laboratory of Smart Management and Application of Modern Agricultural Resources, Huzhou University, Huzhou 313000, Zhejiang Province, China
| | - Xiang-Qian Hong
- Shenzhen Eye Institute, Shenzhen Eye Hospital, Jinan University, Shenzhen 518040, Guangdong Province, China
| | - Wen-Qun Xi
- Shenzhen Eye Institute, Shenzhen Eye Hospital, Jinan University, Shenzhen 518040, Guangdong Province, China
| | - Zhe Zhang
- Shenzhen Eye Institute, Shenzhen Eye Hospital, Jinan University, Shenzhen 518040, Guangdong Province, China
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Zhang L, Lyu RH, Wang JR, Shi WJ, Zheng F, Gao YY. Intermittent sliding-lock-knot suture for limbal conjunctival autograft fixation in pterygium surgery: a technique note. Int J Ophthalmol 2024; 17:838-844. [PMID: 38766334 PMCID: PMC11074188 DOI: 10.18240/ijo.2024.05.07] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Accepted: 12/29/2023] [Indexed: 05/22/2024] Open
Abstract
AIM To report a technique used with intermittent sliding-lock-knot (ISLK) fixation for limbal conjunctival autografts in pterygium surgery and compared with those of routine intermittent (RI) fixation. METHODS Consecutive patients with primary pterygium who had undergone pterygium excision combined with limbal conjunctival autograft transplantation between March 2021 and March 2022 at our institute were retrospectively analyzed. Primary outcome measures were mean duration of surgery and suture removal, degree of conjunctival hyperemia on postoperative day 1, pain score at suture removal, postoperative symptoms at 6mo, including conjunctival hyperemia, foreign body sensation, and graft stability. RESULTS Ninety-eight patients underwent monocular surgery and were divided into ISLK (51 eyes) and RI (47 eyes) groups according to the type of conjunctiva autograft fixation method planned. There was no significant difference in mean duration of surgery between the two groups (18.59±2.39min vs 18.15±2.20min, P=0.417); however, compared to the RI group, shorter suture removal times were observed in the ISLK group [0.58min (0.42-0.87) vs 3.00min (2.21-4.15), P<0.001]. The degree of conjunctival hyperemia on postoperative day 1 was milder in the ISLK group (P<0.001). Pain scores at suture removal were lower in the ISLK group than in RI group [1 (0-3) vs 2 (1-4), P<0.001]. Postoperative symptoms at 6mo were comparable between the groups (P=0.487), with no recurrence. CONCLUSION ISLK is an innovative method for limbal conjunctival autograft fixation after pterygium excision. Compared to RI fixation, ISLK facilitates suture removal and reduces discomfort, with comparable surgery duration and less conjunctival hyperemia.
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Affiliation(s)
- Ling Zhang
- Department of Ophthalmology, the Second Affiliated Hospital, Fujian Medical University, Quanzhou 362000, Fujian Province, China
| | - Run-Hua Lyu
- Department of Ophthalmology, the Second Affiliated Hospital, Fujian Medical University, Quanzhou 362000, Fujian Province, China
| | - Jing-Ru Wang
- Department of Ophthalmology, the Second Affiliated Hospital, Fujian Medical University, Quanzhou 362000, Fujian Province, China
| | - Wen-Jian Shi
- Department of Ophthalmology, the Second Affiliated Hospital, Fujian Medical University, Quanzhou 362000, Fujian Province, China
| | - Feng Zheng
- Department of Neurosurgery, the Second Affiliated Hospital, Fujian Medical University, Quanzhou 362000, Fujian Province, China
| | - Ying-Ying Gao
- Department of Ophthalmology, the Second Affiliated Hospital, Fujian Medical University, Quanzhou 362000, Fujian Province, China
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Chang J, Cao Q, Yong J, Ling X, Zhang X, Kang Z, Xue C. The effect of different pterygium surgery techniques on the ocular surface parameters in different durations: a systematic review and meta-analysis. Graefes Arch Clin Exp Ophthalmol 2024; 262:1383-1396. [PMID: 37581652 DOI: 10.1007/s00417-023-06191-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2023] [Revised: 06/24/2023] [Accepted: 07/23/2023] [Indexed: 08/16/2023] Open
Abstract
PURPOSE To evaluate the effects of different pterygium surgery techniques on ocular surface (OS) in different follow-up periods. METHODS PubMed, Cochrane Library, Web of Science, China National Knowledge Infrastructure, Wan Fang, and China Biology Medicine disc were searched for studies reporting pre- and post-operative OS parameters in pterygium. RESULTS A total of 33 articles were finally included. Three OS parameters showed relatively consistent changing trends after surgery including ocular surface disease index (OSDI), tear film break-up time (BUT), and score of corneal fluorescein staining (SCFS). They worsened significantly at 1w post-operation and then gradually improved: OSDI and BUT showed obvious improvement in 1 m post-operation (SMD = - 0.58, 95%CI = [- 1.04, - 0.13]; SMD = 0.42, 95%CI = [0.06, 0.78]); SCFS was restored to preoperative levels in 3 m after surgery (SMD = - 0.54, 95%CI = [- 1.16, 0.07]). Another parameter, Schirmer test without anesthesia (SIT), presented transient increase at 1w post-operation (SMD = 0.87, 95%CI = [0.27, 1.47]) and presented a relatively stable improvement after 1 m post-operation (SMD = 0.52, 95%CI = [0.16, 0.89]). All parameters in amniotic membrane graft (AMT) showed better improvement in early stage and they showed non-inferior improvements in the long term compared with conjunctival autograft (CAG). Limbal-conjunctival autograft (LCAG) made excellent improvement to OS in the long term while pterygium excision (PE) showed the worst OS. The type of pterygium (primary and secondary), diabetes mellitus (DM) status, and fixation method had certain effects on the results. CONCLUSIONS OS of pterygium is deteriorated at 1w post-operation then gradually improved to preoperative levels after 1 m post-operation. Among various surgery techniques, LCAG had the best improvement to OS which especially displayed in the long-term outcomes.
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Affiliation(s)
- Jingyao Chang
- School of Medicine, Southeast University, Nanjing, 210000, Jiangsu, China
- Department of Ophthalmology, Jinling Hospital, Nanjing, 210000, Jiangsu, China
| | - Qian Cao
- Department of Ophthalmology, Jinling Hospital, Nanjing, 210000, Jiangsu, China
| | - Jingyan Yong
- School of Medicine, Southeast University, Nanjing, 210000, Jiangsu, China
- Department of Ophthalmology, Jinling Hospital, Nanjing, 210000, Jiangsu, China
| | - Xinru Ling
- Department of Ophthalmology, Jinling Hospital, Nanjing, 210000, Jiangsu, China
- School of Medicine, Nanjing University, Nanjing, 210000, Jiangsu, China
| | - Xiaoran Zhang
- Department of Ophthalmology, Jinling Hospital, Nanjing, 210000, Jiangsu, China
- School of Medicine, Nanjing University, Nanjing, 210000, Jiangsu, China
| | - Zhen Kang
- Department of Ophthalmology, Jinling Hospital, Nanjing, 210000, Jiangsu, China
- School of Medicine, Nanjing University, Nanjing, 210000, Jiangsu, China
| | - Chunyan Xue
- School of Medicine, Southeast University, Nanjing, 210000, Jiangsu, China.
- Department of Ophthalmology, Jinling Hospital, Nanjing, 210000, Jiangsu, China.
- School of Medicine, Nanjing University, Nanjing, 210000, Jiangsu, China.
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Divandari M, Javadifar A, Moghadam AB, Janatabadi AA. RIPK3 and RIPK1 gene expression in pterygium: unveiling molecular insights into pathogenesis. Mol Biol Rep 2024; 51:524. [PMID: 38630344 DOI: 10.1007/s11033-024-09368-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Accepted: 02/20/2024] [Indexed: 04/19/2024]
Abstract
BACKGROUND Pterygium, characterized by the abnormal proliferation of epithelial cells, matrix remodeling, vascularization, and lesion migration, is a prevalent ocular surface disease involving the growth of fibrovascular tissue on the cornea. Despite the unclear underlying causes of pterygium, numerous investigations have indicated the involvement of cell death pathways in the regulation of cell cycle dynamics. Consequently, the objective of this study was to assess the expression levels of necroptosis markers in individuals diagnosed with pterygium, aiming to shed light on the potential role of necroptosis in the pathogenesis of this condition. METHODS This study aimed to investigate the expression patterns of receptor-interacting serine/threonine kinase 3 (RIPK3) and receptor-interacting serine/threonine kinase 1 (RIPK1) genes in pterygium tissues. 41 patients undergoing pterygium excision surgery were recruited. Resected pterygium samples and normal conjunctival tissues were collected, and RIPK3 and RIPK1 mRNA levels were measured using quantitative real-time PCR. RESULTS Our findings reveal that the expression of RIPK3 is significantly increased in samples obtained from individuals with pterygium. However, no significant alterations were observed in the expression of RIPK1 in these samples. Results showed significantly higher RIPK3 expression in pterygium tissues compared to controls. Moreover, increased RIPK3 levels correlated negatively with pterygium recurrence rates. CONCLUSIONS These findings suggest RIPK3 may play a protective role against pterygium recurrence through necroptosis.
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Affiliation(s)
- Mahnaz Divandari
- Department of Biology, Sabzevar Branch, Islamic Azad University, Sabzevar, Iran
| | - Amin Javadifar
- Immunology Research Center, Inflammation and Inflammatory Diseases Division, Mashhad University of medical sciences, Mashhad, Iran
| | | | - Ali Akbar Janatabadi
- Department of Biology, Sabzevar Branch, Islamic Azad University, Sabzevar, Iran.
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Boroughani M, Tahmasbi Z, Heidari MM, Johari M, Hashempur MH, Heydari M. Potential therapeutic effects of green tea ( Camellia sinensis) in eye diseases, a review. Heliyon 2024; 10:e28829. [PMID: 38601618 PMCID: PMC11004586 DOI: 10.1016/j.heliyon.2024.e28829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 03/08/2024] [Accepted: 03/26/2024] [Indexed: 04/12/2024] Open
Abstract
This review aims to evaluate the therapeutic potential of green tea (GT), scientifically named Camellia sinensis, in treating eye diseases. We provide an overview of the ingredients and traditional use of Camellia sinensis, followed by a detailed discussion of its therapeutic uses in various eye diseases, including ocular surface diseases (allergic diseases, dry eye, pterygium, and infections), cataract, glaucoma, uveitis, retinal diseases, and optic nerve diseases. The pharmacologic activities related to ocular diseases, such as anti-vascular endothelial growth factor, aldose reductase inhibitor activity, anti-bacterial, anti-inflammatory, and antioxidant effects are also explored in this review. The dose and route of administration of GT in various studies are discussed. Safety issues related to the use of GT, such as the side effects associated with high doses and long-term use, are also addressed. The review highlights the potential of GT as a natural therapeutic agent for a variety of ocular diseases. Its various pharmacologic activities make it a promising treatment option. However, more well-designed studies are needed to determine the optimal dose and route of administration and to assess its long-term safety and efficacy. Overall, GT appears to be a promising adjunct therapy for various ocular diseases.
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Affiliation(s)
- Mohadese Boroughani
- Student research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Zahra Tahmasbi
- Student research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | - Mohammadkarim Johari
- Poostchi Ophthalmology Research Center, Department of Ophthalmology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad Hashem Hashempur
- Research Center for Traditional Medicine and History of Medicine, Department of Persian Medicine, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mojtaba Heydari
- Poostchi Ophthalmology Research Center, Department of Ophthalmology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
- Research Center for Traditional Medicine and History of Medicine, Department of Persian Medicine, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
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10
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Zhang X, Han P, Qiu J, Huang F, Luo Q, Cheng J, Shan K, Yang Y, Zhang C. Single-cell RNA sequencing reveals the complex cellular niche of pterygium. Ocul Surf 2024; 32:91-103. [PMID: 38290663 DOI: 10.1016/j.jtos.2024.01.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Revised: 01/26/2024] [Accepted: 01/26/2024] [Indexed: 02/01/2024]
Abstract
PURPOSE Pterygium is a vision-threatening conjunctival fibrovascular degenerated disease with a high global prevalence up to 12 %, while no absolute pharmacotherapy has been applied in clinics. In virtue of single-cell RNA sequencing (scRNA-seq) technique, our study investigated underlying pathogeneses and potential therapeutic targets of pterygium from the cellular transcriptional level. METHODS A total of 45605 cells from pterygium of patients and conjunctiva of normal controls (NC) were conducted with scRNA-seq, and then analyzed via integrated analysis, pathway enrichment, pseudotime trajectory, and cell-cell communications. Besides, immunofluorescence and western blot were performed in vivo and in vitro to verify our findings. RESULTS In brief, 9 major cellular types were defined, according to canonical markers. Subsequently, we further determined the subgroups of each major cell lineages. Several newly identified cell sub-clusters could promote pterygium, including immuno-fibroblasts, epithelial mesenchymal transition (EMT)-epithelial cells, and activated vascular endothelial cells (activated-vEndo). Besides, we also probed the enrichment of immune cells in pterygium. Particularly, macrophages, recruited by ACKR1+activated-vEndo, might play an important role in the development of pterygium by promoting angiogenesis, immune suppression, and inflammation. CONCLUSION An intricate cellular niche was revealed in pterygium via scRNA-seq analysis and the interactions between macrophages and ACKR1+ activated-vEndo might be the key part in the development of pterygia.
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Affiliation(s)
- Xueling Zhang
- Department of Ophthalmology, Eye Ear Nose and Throat Hospital of Fudan University, Shanghai, 200031, China; Department of Ophthalmology, Shanghai Medical College, Fudan University, Shanghai, 200031, China; NHC Key Laboratory of Myopia (Fudan University), Laboratory of Myopia, Chinese Academy of Medical Sciences, China
| | - Peizhen Han
- Department of Head and Neck Surgery, Fudan University Shanghai Cancer Center, Shanghai, China; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Jini Qiu
- Department of Ophthalmology, Eye Ear Nose and Throat Hospital of Fudan University, Shanghai, 200031, China; Department of Ophthalmology, Shanghai Medical College, Fudan University, Shanghai, 200031, China; NHC Key Laboratory of Myopia (Fudan University), Laboratory of Myopia, Chinese Academy of Medical Sciences, China
| | - Feifei Huang
- Department of Ophthalmology, Eye Ear Nose and Throat Hospital of Fudan University, Shanghai, 200031, China; Department of Ophthalmology, Shanghai Medical College, Fudan University, Shanghai, 200031, China; NHC Key Laboratory of Myopia (Fudan University), Laboratory of Myopia, Chinese Academy of Medical Sciences, China
| | - Qiting Luo
- Department of Ophthalmology, Eye Ear Nose and Throat Hospital of Fudan University, Shanghai, 200031, China; Department of Ophthalmology, Shanghai Medical College, Fudan University, Shanghai, 200031, China; NHC Key Laboratory of Myopia (Fudan University), Laboratory of Myopia, Chinese Academy of Medical Sciences, China
| | - Jingyi Cheng
- Department of Ophthalmology, Eye Ear Nose and Throat Hospital of Fudan University, Shanghai, 200031, China; Department of Ophthalmology, Shanghai Medical College, Fudan University, Shanghai, 200031, China; NHC Key Laboratory of Myopia (Fudan University), Laboratory of Myopia, Chinese Academy of Medical Sciences, China
| | - Kun Shan
- Department of Ophthalmology, Eye Ear Nose and Throat Hospital of Fudan University, Shanghai, 200031, China; Department of Ophthalmology, Shanghai Medical College, Fudan University, Shanghai, 200031, China; NHC Key Laboratory of Myopia (Fudan University), Laboratory of Myopia, Chinese Academy of Medical Sciences, China.
| | - Yujing Yang
- Department of Ophthalmology, Eye Ear Nose and Throat Hospital of Fudan University, Shanghai, 200031, China; Department of Ophthalmology, Shanghai Medical College, Fudan University, Shanghai, 200031, China; NHC Key Laboratory of Myopia (Fudan University), Laboratory of Myopia, Chinese Academy of Medical Sciences, China.
| | - Chaoran Zhang
- Department of Ophthalmology, Eye Ear Nose and Throat Hospital of Fudan University, Shanghai, 200031, China; Department of Ophthalmology, Shanghai Medical College, Fudan University, Shanghai, 200031, China; NHC Key Laboratory of Myopia (Fudan University), Laboratory of Myopia, Chinese Academy of Medical Sciences, China.
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11
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Catania F, Vinciguerra P, Di Maria A. Low Rate of Postoperative Pterygium Recurrence in Patients under Treatment with Low-Dose Oral Doxycycline for Chronic Blepharitis: A First Report. Diagnostics (Basel) 2024; 14:715. [PMID: 38611627 PMCID: PMC11012025 DOI: 10.3390/diagnostics14070715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Revised: 03/02/2024] [Accepted: 03/21/2024] [Indexed: 04/14/2024] Open
Abstract
PURPOSE Low doses of systemic doxycycline (LD-SD) inhibit angiogenesis and the expression of matrix metalloproteases, which are determinants of pterygium progression. This study aimed to compare the recurrence rate and visual outcome of pterygium excision in patients undergoing chronic treatment with LD-SD for chronic refractory blepharitis and LD-SD-naive patients. METHODS A retrospective analysis of patients that underwent surgical excision and conjunctival graft apposition was conducted. Patients were divided in a TETRA group (under LD-SD treatment at the moment of surgery) and a control group. The main outcome was the rate of recurrence at 1 year postoperatively. Secondary outcomes were the comparisons of surface regularity, visual quality, and dry-eye symptoms at 6-week, 6-month, and 1-year follow-up in the two groups. RESULTS The TETRA group showed a significantly lower rate of 1-year recurrence both in primary (p = 0.034) and recurrent (p < 0.001) pterygia. The best corrected visual acuity (BCVA), astigmatic error, corneal total root mean square (RMS), and ocular surface disease index (OSDI) significantly reduced during the follow-up in both groups. The surface asymmetry index and high-order aberrations (HOAs) significantly reduced only in the TETRA group. The final BCVA was significantly higher, while the OSDI score and total RMS and HOAs were significantly lower in the TETRA group compared to the control. CONCLUSIONS Patients under treatment with LD-SD showed a lower rate of recurrence at 1-year follow-up compared to controls. These patients also experienced higher BCVA and surface regularity and less dry-eye symptoms.
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Affiliation(s)
- Fiammetta Catania
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20072 Pieve Emanuele, Italy;
- IRCCS Humanitas Research Hospital, via Manzoni 56, 20089 Rozzano, Italy;
| | - Paolo Vinciguerra
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20072 Pieve Emanuele, Italy;
- IRCCS Humanitas Research Hospital, via Manzoni 56, 20089 Rozzano, Italy;
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12
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Marro M, Moccozet L, Vernez D. A numerical model for quantifying exposure to natural and artificial light in human health research. Comput Biol Med 2024; 171:108119. [PMID: 38367446 DOI: 10.1016/j.compbiomed.2024.108119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Revised: 01/24/2024] [Accepted: 02/04/2024] [Indexed: 02/19/2024]
Abstract
Various skin and ocular pathologies can result from overexposure to ultraviolet radiation and blue light. Assessing the potential harm of exposure to these light sources requires quantifying the energy received to specific target tissue. Despite a well-established understanding of the light-disease relationship, the quantification of received energy in diverse lighting scenarios proves challenging due to the multitude of light sources and continuous variation in the orientation of receiving tissues (skin and eyes). This complexity makes the determination of health hazards associated with specific lighting conditions difficult. In this study, we present a solution to this challenge using a numerical approach. Through the implementation of algorithms applied to 3D geometries, we created and validated a numerical model that simulates skin and ocular exposure to both natural and artificial light sources. The resulting numerical model is a computational framework in which customizable exposure scenarios can be implemented. The ability to adapt simulations to different configurations for study makes this model a potential investigative method in human health research.
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Affiliation(s)
- Michele Marro
- University of Geneva, Centre Universitaire d'informatique, Battelle, Batiment A, 7 Route de Drize 1227 Carouge (CH), Switzerland.
| | - Laurent Moccozet
- University of Geneva, Centre Universitaire d'informatique, Battelle, Batiment A, 7 Route de Drize 1227 Carouge (CH), Switzerland.
| | - David Vernez
- University of Lausanne, Center for Public Health and Primary Care Medicine (Unisanté), 44 Rue du Bugnon 1011 Lausanne (CH), Switzerland.
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13
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Liu Y, Xu C, Wang S, Chen Y, Lin X, Guo S, Liu Z, Wang Y, Zhang H, Guo Y, Huang C, Wu H, Li Y, Chen Q, Hu J, Luo Z, Liu Z. Accurate detection and grading of pterygium through smartphone by a fusion training model. Br J Ophthalmol 2024; 108:336-342. [PMID: 36858799 PMCID: PMC10894821 DOI: 10.1136/bjo-2022-322552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2022] [Accepted: 01/06/2023] [Indexed: 03/03/2023]
Abstract
BACKGROUND/AIMS To improve the accuracy of pterygium screening and detection through smartphones, we established a fusion training model by blending a large number of slit-lamp image data with a small proportion of smartphone data. METHOD Two datasets were used, a slit-lamp image dataset containing 20 987 images and a smartphone-based image dataset containing 1094 images. The RFRC (Faster RCNN based on ResNet101) model for the detection model. The SRU-Net (U-Net based on SE-ResNeXt50) for the segmentation models. The open-cv algorithm measured the width, length and area of pterygium in the cornea. RESULTS The detection model (trained by slit-lamp images) obtained the mean accuracy of 95.24%. The fusion segmentation model (trained by smartphone and slit-lamp images) achieved a microaverage F1 score of 0.8981, sensitivity of 0.8709, specificity of 0.9668 and area under the curve (AUC) of 0.9295. Compared with the same group of patients' smartphone and slit-lamp images, the fusion model performance in smartphone-based images (F1 score of 0.9313, sensitivity of 0.9360, specificity of 0.9613, AUC of 0.9426, accuracy of 92.38%) is close to the model (trained by slit-lamp images) in slit-lamp images (F1 score of 0.9448, sensitivity of 0.9165, specificity of 0.9689, AUC of 0.9569 and accuracy of 94.29%). CONCLUSION Our fusion model method got high pterygium detection and grading accuracy in insufficient smartphone data, and its performance is comparable to experienced ophthalmologists and works well in different smartphone brands.
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Affiliation(s)
- Yuwen Liu
- Eye Institute, Xiamen University, Xiamen, Fujian, China
- Xiamen University National Institute for Data Science in Health and Medicine, Xiamen, Fujian, China
| | - Changsheng Xu
- Eye Institute, Xiamen University, Xiamen, Fujian, China
- Institute of Artificial Intelligence, Xiamen University, Xiamen, Fujian, China
| | - Shaopan Wang
- Eye Institute, Xiamen University, Xiamen, Fujian, China
- Institute of Artificial Intelligence, Xiamen University, Xiamen, Fujian, China
| | - Yuguang Chen
- Eye Institute, Xiamen University, Xiamen, Fujian, China
- Institute of Artificial Intelligence, Xiamen University, Xiamen, Fujian, China
| | - Xiang Lin
- Eye Institute, Xiamen University, Xiamen, Fujian, China
- Department of Ophthalmology, Xiang'an Hospital of Xiamen University, Xiamen, China
| | - Shujia Guo
- Eye Institute, Xiamen University, Xiamen, Fujian, China
| | - Zhaolin Liu
- Eye Institute, Xiamen University, Xiamen, Fujian, China
- Department of Ophthalmology, The First Affiliated Hospital of University of South China, Hengyang, Hunan, China
| | - Yuqian Wang
- Eye Institute, Xiamen University, Xiamen, Fujian, China
| | - Houjian Zhang
- Eye Institute, Xiamen University, Xiamen, Fujian, China
| | - Yuli Guo
- Eye Institute, Xiamen University, Xiamen, Fujian, China
| | - Caihong Huang
- Eye Institute, Xiamen University, Xiamen, Fujian, China
| | - Huping Wu
- Eye Institute, Affiliated Xiamen Eye Center of Xiamen University, Xiamen, Fujian, China
| | - Ying Li
- Department of Ophthalmology, Xi'an People's Hospital, Xi'an, Shaanxi, China
| | - Qian Chen
- Eye Institute, Xiamen University, Xiamen, Fujian, China
| | - Jiaoyue Hu
- Eye Institute, Xiamen University, Xiamen, Fujian, China
- Eye Institute, Affiliated Xiamen Eye Center of Xiamen University, Xiamen, Fujian, China
| | - Zhiming Luo
- Department of Artificial Intelligence, Xiamen University, Xiamen, Fujian, China
| | - Zuguo Liu
- Eye Institute, Xiamen University, Xiamen, Fujian, China
- Eye Institute, Affiliated Xiamen Eye Center of Xiamen University, Xiamen, Fujian, China
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14
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Lan G, Fang X, Zhong Y, Luo S, Xiao X, Xie Z, Luo L, Zhang Y, Li H, Lin Y, Wu H. Evaluation of lymphotoxin-alpha in pterygium and diagnostic value in active and inactive pterygium states. Sci Rep 2024; 14:1866. [PMID: 38253817 PMCID: PMC10803762 DOI: 10.1038/s41598-024-52382-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Accepted: 01/18/2024] [Indexed: 01/24/2024] Open
Abstract
To explore the correlation between tear LT-a, pterygium status, and dry eye indicators. We established a diagnostic model to evaluate active pterygium. A retrospective study was conducted between June 2021 and June 2023 on 172 patients, comprising 108 men and 64 women. The study analyzed LT-a and various ocular parameters in all participants. The data was collected using Excel software and analyzed using SPSS 25.0 statistical software and Medcalc. We made a nomogram diagnostic model to different diagnosed the state of pterygium. This study found that pterygium has progressive eye surface damage during the active state. There was no significant difference in dry eye indicators between the two groups. However, the concentration of LT-a in the active group was significantly lower than that in the inactive group (P < 0.001). We observed that increased pterygium grade corresponded to a worse ocular surface condition. In addition, LT-a was significantly positively correlated with disease duration, but negatively correlated with age, pterygium size, active pterygium state, and LLT value. The optimal intercept value for evaluating active pterygium in Lt-a was ≤ 0.49 dg/ml. We screened three variables for evaluating active pterygium through Single and Multiple regression analysis: LT-a grading, pterygium size, and congestion score. Finally, we made a reliable diagnostic nomogram model. Pterygium development triggers immune inflammation. Our model based on LT-a identifies active pterygium for personalized treatment options and new research directions.
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Affiliation(s)
- Guoli Lan
- Xiamen Eye Center and Eye Institute of Xiamen University, Xiamen, China
- Xiamen Clinical Research Center for Eye Diseases, Xiamen, Fujian, China
- Xiamen Key Laboratory of Ophthalmology, Xiamen, Fujian, China
- Fujian Key Laboratory of Corneal and Ocular Surface Diseases, Xiamen, Fujian, China
- Xiamen Key Laboratory of Corneal and Ocular Surface Diseases, Xiamen, Fujian, China
- Translational Medicine Institute of Xiamen Eye Center of Xiamen University, Xiamen, Fujian, China
| | - Xie Fang
- Xiamen Eye Center and Eye Institute of Xiamen University, Xiamen, China
- Xiamen Clinical Research Center for Eye Diseases, Xiamen, Fujian, China
- Xiamen Key Laboratory of Ophthalmology, Xiamen, Fujian, China
- Fujian Key Laboratory of Corneal and Ocular Surface Diseases, Xiamen, Fujian, China
- Xiamen Key Laboratory of Corneal and Ocular Surface Diseases, Xiamen, Fujian, China
- Translational Medicine Institute of Xiamen Eye Center of Xiamen University, Xiamen, Fujian, China
| | - Yanlin Zhong
- Xiamen Eye Center and Eye Institute of Xiamen University, Xiamen, China
- Xiamen Clinical Research Center for Eye Diseases, Xiamen, Fujian, China
- Xiamen Key Laboratory of Ophthalmology, Xiamen, Fujian, China
- Fujian Key Laboratory of Corneal and Ocular Surface Diseases, Xiamen, Fujian, China
- Xiamen Key Laboratory of Corneal and Ocular Surface Diseases, Xiamen, Fujian, China
- Translational Medicine Institute of Xiamen Eye Center of Xiamen University, Xiamen, Fujian, China
| | - Shunrong Luo
- Xiamen Eye Center and Eye Institute of Xiamen University, Xiamen, China
- Xiamen Clinical Research Center for Eye Diseases, Xiamen, Fujian, China
- Xiamen Key Laboratory of Ophthalmology, Xiamen, Fujian, China
- Fujian Key Laboratory of Corneal and Ocular Surface Diseases, Xiamen, Fujian, China
- Xiamen Key Laboratory of Corneal and Ocular Surface Diseases, Xiamen, Fujian, China
- Translational Medicine Institute of Xiamen Eye Center of Xiamen University, Xiamen, Fujian, China
| | - Xianwen Xiao
- Xiamen Eye Center and Eye Institute of Xiamen University, Xiamen, China
- Xiamen Clinical Research Center for Eye Diseases, Xiamen, Fujian, China
- Xiamen Key Laboratory of Ophthalmology, Xiamen, Fujian, China
- Fujian Key Laboratory of Corneal and Ocular Surface Diseases, Xiamen, Fujian, China
- Xiamen Key Laboratory of Corneal and Ocular Surface Diseases, Xiamen, Fujian, China
- Translational Medicine Institute of Xiamen Eye Center of Xiamen University, Xiamen, Fujian, China
| | - Zhiwen Xie
- Xiamen Eye Center and Eye Institute of Xiamen University, Xiamen, China
- Xiamen Clinical Research Center for Eye Diseases, Xiamen, Fujian, China
- Xiamen Key Laboratory of Ophthalmology, Xiamen, Fujian, China
- Fujian Key Laboratory of Corneal and Ocular Surface Diseases, Xiamen, Fujian, China
- Xiamen Key Laboratory of Corneal and Ocular Surface Diseases, Xiamen, Fujian, China
- Translational Medicine Institute of Xiamen Eye Center of Xiamen University, Xiamen, Fujian, China
| | - Lianghuan Luo
- Xiamen Eye Center and Eye Institute of Xiamen University, Xiamen, China
- Xiamen Clinical Research Center for Eye Diseases, Xiamen, Fujian, China
- Xiamen Key Laboratory of Ophthalmology, Xiamen, Fujian, China
- Fujian Key Laboratory of Corneal and Ocular Surface Diseases, Xiamen, Fujian, China
- Xiamen Key Laboratory of Corneal and Ocular Surface Diseases, Xiamen, Fujian, China
- Translational Medicine Institute of Xiamen Eye Center of Xiamen University, Xiamen, Fujian, China
| | - Yiqiu Zhang
- Xiamen Eye Center and Eye Institute of Xiamen University, Xiamen, China
- Xiamen Clinical Research Center for Eye Diseases, Xiamen, Fujian, China
- Xiamen Key Laboratory of Ophthalmology, Xiamen, Fujian, China
- Fujian Key Laboratory of Corneal and Ocular Surface Diseases, Xiamen, Fujian, China
- Xiamen Key Laboratory of Corneal and Ocular Surface Diseases, Xiamen, Fujian, China
- Translational Medicine Institute of Xiamen Eye Center of Xiamen University, Xiamen, Fujian, China
| | - Hanqiao Li
- Xiamen Eye Center and Eye Institute of Xiamen University, Xiamen, China
- Xiamen Clinical Research Center for Eye Diseases, Xiamen, Fujian, China
- Xiamen Key Laboratory of Ophthalmology, Xiamen, Fujian, China
- Fujian Key Laboratory of Corneal and Ocular Surface Diseases, Xiamen, Fujian, China
- Xiamen Key Laboratory of Corneal and Ocular Surface Diseases, Xiamen, Fujian, China
- Translational Medicine Institute of Xiamen Eye Center of Xiamen University, Xiamen, Fujian, China
| | - Yuan Lin
- Xiamen Eye Center and Eye Institute of Xiamen University, Xiamen, China.
- Xiamen Clinical Research Center for Eye Diseases, Xiamen, Fujian, China.
- Xiamen Key Laboratory of Ophthalmology, Xiamen, Fujian, China.
- Fujian Key Laboratory of Corneal and Ocular Surface Diseases, Xiamen, Fujian, China.
- Xiamen Key Laboratory of Corneal and Ocular Surface Diseases, Xiamen, Fujian, China.
- Translational Medicine Institute of Xiamen Eye Center of Xiamen University, Xiamen, Fujian, China.
| | - Huping Wu
- Xiamen Eye Center and Eye Institute of Xiamen University, Xiamen, China.
- Xiamen Clinical Research Center for Eye Diseases, Xiamen, Fujian, China.
- Xiamen Key Laboratory of Ophthalmology, Xiamen, Fujian, China.
- Fujian Key Laboratory of Corneal and Ocular Surface Diseases, Xiamen, Fujian, China.
- Xiamen Key Laboratory of Corneal and Ocular Surface Diseases, Xiamen, Fujian, China.
- Translational Medicine Institute of Xiamen Eye Center of Xiamen University, Xiamen, Fujian, China.
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Desai NR, Adams B. Outcomes of the TissueTuck Surgical Technique for Recurrent Pterygium. Cornea 2024; 43:26-30. [PMID: 36796012 PMCID: PMC10686277 DOI: 10.1097/ico.0000000000003255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Revised: 01/05/2023] [Accepted: 01/12/2023] [Indexed: 02/18/2023]
Abstract
PURPOSE The objective of this study was to evaluate the clinical outcomes of the TissueTuck technique in the treatment of eyes with recurrent pterygium. METHODS A retrospective review was performed on patients with recurrent pterygium who underwent surgical excision, followed by the application of cryopreserved amniotic membrane, using the TissueTuck technique between January 2012 and May 2019. Only patients with at least 3 months of follow-up were included for analysis. Baseline characteristics, operative time, best-corrected visual acuity, and complications were assessed. RESULTS A total of 44 eyes of 42 patients (age 60.5 ± 10.9 yrs) with single-headed (84.1%) or double-headed (15.9%) recurrent pterygium were included for analysis. The average surgical duration was 22.4 ± 8.0 minutes, and mitomycin C was administered intraoperatively in 31 eyes (72.1%). During a mean postoperative follow-up of 24.6 ± 18.3 months, there was only 1 case of recurrence (2.3%). Other complications include scarring (9.1%), granuloma formation (20.5%), and corneal melt in 1 patient with preexisting ectasia (2.3%). Best-corrected visual acuity significantly improved from 0.16 Logarithm of the Minimum Angle of Resolution at baseline to 0.10 Logarithm of the Minimum Angle of Resolution at the last postoperative follow-up ( P = 0.014). CONCLUSIONS TissueTuck surgery with cryopreserved amniotic membrane is safe and effective for recurrent pterygium cases with a low risk of recurrence and complications.
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Affiliation(s)
| | - Bryan Adams
- The Eye Institute of West Florida, Largo, FL
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16
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Shidakova MK, Malozhen SA, Osipyan GA, Krakhmaleva DA. [Current possibilities for the diagnosis and treatment of pterygium]. Vestn Oftalmol 2024; 140:136-142. [PMID: 38739143 DOI: 10.17116/oftalma2024140022136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/14/2024]
Abstract
Pterygium is a common inflammatory-proliferative disease characterized by the invasion of degeneratively altered fibrovascular tissue into the cornea. This literature review analyzes the etiological factors and pathogenetic concepts of its development, describes modern methods of diagnostics and surgical treatment of pterygium, and pays particular attention to the assessment of structural and functional changes in the cornea occurring during the growth of pterygium and after its excision.
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Affiliation(s)
- M Kh Shidakova
- Krasnov Research Institute of Eye Diseases, Moscow, Russia
| | - S A Malozhen
- Krasnov Research Institute of Eye Diseases, Moscow, Russia
| | - G A Osipyan
- Krasnov Research Institute of Eye Diseases, Moscow, Russia
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17
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Guo Q, Han S. The effect on m 6A methylation writer complex by the reduced MATR3 in pterygium. Acta Histochem 2023; 125:152101. [PMID: 37913560 DOI: 10.1016/j.acthis.2023.152101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Revised: 10/05/2023] [Accepted: 10/05/2023] [Indexed: 11/03/2023]
Abstract
Pterygium is a common eye surface disease with high recurrence and unclear pathogenesis. In current study, RNA sequencing was conducted in 6 pairs of human pterygium and conjunctival tissues, and Matr3 as a novel candidate gene was significantly reduced in pterygium compared to control tissues. Moreover, immunoprecipitation was performed to pull down MATR3, and WTAP specially interacting with MATR3 in control but not pterygium was identified by mass spectrum. Immunoprecipitation was performed to validate the interaction between MATR3 and WTAP/METTL3/METTL14 complex. (Methylated) RNA immunoprecipitation was performed to further reveal that the binding affinity of WTAP and MATR3 was lost at 3' UTR of RNA molecules of down-regulated genes in pterygium. Overall, we figured out the loss of intercrossing between MATR3 and N6-methyladenosine methyltransferase complex, as well as indicated the potential impact on transcription of target genes in pterygium.
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Affiliation(s)
- Qianqian Guo
- Department of Ophthalmology Zibo Center Hospital, Zibo, Shandong Province 25500, China
| | - Shichao Han
- Department of Ophthalmology Zibo Center Hospital, Zibo, Shandong Province 25500, China.
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18
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Böhm EW, Buonfiglio F, Voigt AM, Bachmann P, Safi T, Pfeiffer N, Gericke A. Oxidative stress in the eye and its role in the pathophysiology of ocular diseases. Redox Biol 2023; 68:102967. [PMID: 38006824 DOI: 10.1016/j.redox.2023.102967] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 11/10/2023] [Accepted: 11/14/2023] [Indexed: 11/27/2023] Open
Abstract
Oxidative stress occurs through an imbalance between the generation of reactive oxygen species (ROS) and the antioxidant defense mechanisms of cells. The eye is particularly exposed to oxidative stress because of its permanent exposure to light and due to several structures having high metabolic activities. The anterior part of the eye is highly exposed to ultraviolet (UV) radiation and possesses a complex antioxidant defense system to protect the retina from UV radiation. The posterior part of the eye exhibits high metabolic rates and oxygen consumption leading subsequently to a high production rate of ROS. Furthermore, inflammation, aging, genetic factors, and environmental pollution, are all elements promoting ROS generation and impairing antioxidant defense mechanisms and thereby representing risk factors leading to oxidative stress. An abnormal redox status was shown to be involved in the pathophysiology of various ocular diseases in the anterior and posterior segment of the eye. In this review, we aim to summarize the mechanisms of oxidative stress in ocular diseases to provide an updated understanding on the pathogenesis of common diseases affecting the ocular surface, the lens, the retina, and the optic nerve. Moreover, we discuss potential therapeutic approaches aimed at reducing oxidative stress in this context.
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Affiliation(s)
- Elsa Wilma Böhm
- Department of Ophthalmology, University Medical Center, Johannes Gutenberg University Mainz, Langenbeckstrasse 1, 55131, Mainz, Germany.
| | - Francesco Buonfiglio
- Department of Ophthalmology, University Medical Center, Johannes Gutenberg University Mainz, Langenbeckstrasse 1, 55131, Mainz, Germany
| | - Anna Maria Voigt
- Department of Ophthalmology, University Medical Center, Johannes Gutenberg University Mainz, Langenbeckstrasse 1, 55131, Mainz, Germany
| | - Philipp Bachmann
- Department of Ophthalmology, University Medical Center, Johannes Gutenberg University Mainz, Langenbeckstrasse 1, 55131, Mainz, Germany
| | - Tarek Safi
- Department of Ophthalmology, University Medical Center, Johannes Gutenberg University Mainz, Langenbeckstrasse 1, 55131, Mainz, Germany
| | - Norbert Pfeiffer
- Department of Ophthalmology, University Medical Center, Johannes Gutenberg University Mainz, Langenbeckstrasse 1, 55131, Mainz, Germany
| | - Adrian Gericke
- Department of Ophthalmology, University Medical Center, Johannes Gutenberg University Mainz, Langenbeckstrasse 1, 55131, Mainz, Germany.
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Cai Y, Fang F, Zhou T, Shi W, Cai X, Fu Y. Genetic evidence implicating circulating lipids and lipid drug targets in pterygium. Comput Struct Biotechnol J 2023; 21:5506-5514. [PMID: 38022695 PMCID: PMC10663701 DOI: 10.1016/j.csbj.2023.11.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Revised: 11/01/2023] [Accepted: 11/01/2023] [Indexed: 12/01/2023] Open
Abstract
There is limited knowledge about the impact of circulating lipids and lipid-modifying drugs on pterygium development, with conflicting results reported. Our study aimed to address these questions by applying the Mendelian randomization (MR) approach. A two-step MR model was developed. In the first step, bidirectional two-sample MR was employed to establish the causal relationship between circulating lipids and pterygium risk. In the second step, drug-target MR analysis was conducted to assess the causal effect of proprotein convertase subtilisin/kexin type 9 (PCSK9) and 3-hydroxy-3-methylglutaryl-coenzyme A reductase (HMGCR) inhibitors on pterygium outcomes. Genetically predicted low-density lipoprotein cholesterol (LDL-c) levels were found to be significantly associated with an increased risk of pterygium (Inverse variance weighted [IVW] odds ratio [OR] = 2.227; P = 1.53 × 10-4). Similarly, higher total cholesterol (TC) levels exhibited a suggestive association with greater susceptibility to pterygium (IVW OR = 1.806; P = 1.70 × 10-3). Through drug-target MR, a positive causal association was noted between HMGCR-mediated LDL-c levels and pterygium (IVW OR = 6.999; P = 0.016), suggesting that statins may be effective in reducing pterygium risk. The present findings suggest that circulating TC and LDL-c are risk factors for pterygium. Additionally, the results indicate that HMGCR inhibitors, which lower LDL-c levels, have a potential protective effect on pterygium outcomes. Further research is warranted to elucidate the underlying mechanisms involved in pterygium pathogenesis, with a particular focus on cholesterol metabolism.
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Affiliation(s)
- Yuchen Cai
- Department of Ophthalmology, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, China
| | - Fei Fang
- Department of Ophthalmology, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, China
| | - Tianyi Zhou
- Department of Ophthalmology, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, China
| | - Wenjun Shi
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xueyao Cai
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yao Fu
- Department of Ophthalmology, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, China
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20
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Zhang W, He Y, Zhang Y. CircRNA in ocular neovascular diseases: Fundamental mechanism and clinical potential. Pharmacol Res 2023; 197:106946. [PMID: 37797661 DOI: 10.1016/j.phrs.2023.106946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2023] [Revised: 09/29/2023] [Accepted: 10/02/2023] [Indexed: 10/07/2023]
Abstract
Ocular neovascular disease (OND), characterized by the aberrant formation of immature blood vessels, is the leading cause of vision impairment and blindness. It is important to find effective ways to diagnose and treat these diseases. Circular RNA (circRNA) is a group of endogenous non-coding RNA that play a crucial role in regulating different biological processes. Due to their close association with ocular disease and angiogenesis, circRNAs have become a hotspot in OND research. In this review, we intensively investigate the possibility of using circRNAs in the management of ONDs. In general, angiogenesis is divided into five phases. On the basis of these five steps, we describe the potential of using circRNAs by introducing how they regulate angiogenesis. Subsequently, the interactions between circRNAs and ONDs, including pterygium, corneal neovascularization, age-related macular degeneration, diabetic retinopathy, and retinopathy of prematurity, are analyzed in detail. We also introduce the potential use of circRNAs as OND diagnostic biomarkers. Finally, we summarize the prospects of using circRNAs as a potential strategy in OND management. The gaps in recent research are also pointed out with the purpose of promoting the introduction of circRNAs into clinical applications.
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Affiliation(s)
- Wenxin Zhang
- Department of Ophthalmology, 2nd Hospital of Jilin University, Changchun 130041, Jilin, China
| | - Yuxi He
- Department of Ophthalmology, 2nd Hospital of Jilin University, Changchun 130041, Jilin, China
| | - Yan Zhang
- Department of Ophthalmology, 2nd Hospital of Jilin University, Changchun 130041, Jilin, China; Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200080, China.
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21
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Feltrin de Barros G, Susanna BN, Brito L, Lima VL, Moscovici BK. Results of Fibrin Glue Applied Over the Corneal Surface Immediately After Pterygium Surgery: A Novel Pain Relief Technique. Cornea 2023; 42:1327-1331. [PMID: 37267466 DOI: 10.1097/ico.0000000000003317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 04/24/2023] [Indexed: 06/04/2023]
Abstract
PURPOSE The aim of this study was to compare the use of fibrin glue on the corneal epitheliectomy site at the end of pterygium surgery versus conventional eye patch regarding pain levels, need for oral analgesic medications, number of days feeling pain, and awakening due to pain after surgery. METHODS Forty-eight eyes of 24 patients with bilateral primary pterygium were included in this prospective, randomized, double-masked controlled trial. Each eye of the same patient was randomized to the intervention or control group. The intervention group received 2 drops of fibrin glue in the epitheliectomy site at the end of surgery and an eye patch, whereas the control group was only received an eye patch. Patients returned on the first and seventh days after surgery. Pain intensity (measured using the visual pain analog scale), need for oral analgesics, the number of days the pain lasted, and quality of sleep were assessed during follow-up visits and compared between groups. Comparison analysis accounted for sex, age, pterygium grading, and comorbidities. RESULTS Visual analog pain scale after surgery was significantly lower in eyes receiving fibrin glue (-1.58; 95% confidence interval: -2.84 to -0.32; P = 0.014). In addition, the intervention group presented a 73% lower chance of using oral analgesics (OR: 0.27; 95% confidence interval: 0.07-0.95; P = 0.041). No difference in the awakenings at night was noted ( P = 0.240) nor the mean days of ocular pain in the first week after surgery ( P = 0.474). CONCLUSIONS Fibrin glue at the end of pterygium surgery effectively reduces pain and the need for oral analgesics compared with conventional eye patching. This study is the first to describe the results of this strategy.
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Affiliation(s)
| | - Bianca Nicolela Susanna
- Department of Ophthalmology, Faculdade de Medicina do ABC, Santo André, Brazil
- Banco de Olhos de Sorocaba, Sorocaba-Brazil; and
| | - Luiz Brito
- Department of Ophthalmology, Faculdade de Medicina do ABC, Santo André, Brazil
| | - Vagner Loduca Lima
- Department of Ophthalmology, Faculdade de Medicina do ABC, Santo André, Brazil
| | - Bernardo Kaplan Moscovici
- Department of Ophthalmology and Visual Sciences, Paulista School of Medicine/Federal University of São (EPM/UNIFESP), Brazil
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22
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Arish M, Dakkali MS. Evaluating the application of argon laser on pterygium surgery: Report of 30 patients. Oman J Ophthalmol 2023; 16:478-481. [PMID: 38059099 PMCID: PMC10697261 DOI: 10.4103/ojo.ojo_59_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Accepted: 07/14/2023] [Indexed: 12/08/2023] Open
Abstract
BACKGROUND The recurrence rate plays a key role in using various treatments of pterygium. This study assessed the effectiveness of argon laser therapy before the excision of pterygium on the recurrence rate. MATERIALS AND METHODS The eyes (n = 60) of patients (n = 30) were divided into two groups based on the treatment. All eyes had undergone pterygium excision with the bare sclera technique. Three weeks before surgery, an argon laser was applied to 30 eyes. Patients have been followed up for 1 year, and the progression of pterygium has been evaluated at days 1, 7, 14, and 30, and then, every 2 months until month 6 and then every 3 months until month 12. Recurrence was defined as more than 1 mm growth of pterygium from the limbus. RESULTS In the group with adjuvant argon laser therapy, the mean size of pterygium was 3.7 ± 0.47 mm before surgery and 2.3 ± 0.98 after 12 months (P = 0.001). These were 3.8 ± 0.43 mm and 2.4 ± 1 mm in the other group (P = 0.001). The recurrence of the pterygium was 76% (23/30) in the group treated with an argon laser and 90% (27/30) in another group (P = 0.16). There was no correlation between pterygium sizes before surgery and the pterygium recurrence rate in both eyes (P = 0.272 [right] and 0.916 [left]). CONCLUSION Argon laser therapy on pterygium before surgery cannot decrease its recurrence rate, but its application gives a good vision and clarifies the surgery's target area.
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Affiliation(s)
- Mohammed Arish
- Department of Ophthalmology, Zahedan University of Medical Sciences, Zahedan, Iran
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23
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Yang T, Chan SY, Liu J, Chen Z, Yu G, He X, Meng J. Pterygium combined with corneal perforation: a case report. BMC Ophthalmol 2023; 23:363. [PMID: 37641016 PMCID: PMC10463940 DOI: 10.1186/s12886-023-03084-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Accepted: 07/13/2023] [Indexed: 08/31/2023] Open
Abstract
BACKGROUND Pterygium is a common ocular surface disease. Pterygium combined with corneal perforation is rare. CASE PRESENTATION A 28-year-old female patient visited our outpatient clinic due to sudden onset of blurred vision and increased tearing in her left eye. The visual acuity was 1.0 OD and intraocular pressure (IOP) of 19.5 mmHg for the right eye with no significant abnormalities found in the anterior and posterior segments. The visual acuity of her left eye was 0.06, and IOP was 6.2 mmHg. A triangular vascular membranous tissue was seen in her left eye below the nose growing into the cornea and the pupil area was not touched. Slit-lamp examination revealed a tiny round corneal perforation in 8 o'clock position of the lesion area. Hospital diagnosis was given as pterygium combined with corneal perforation. The patient was treated with levofloxacin eye drops and autologous serum-based eye drops. CONCLUSIONS We report a rare case of pterygium combined with corneal perforation. Perforation is a very rare complication of pterygium. This patient received proper treatment and good result was seen. This article aimed to improve clinicians' understanding of pterygium.
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Affiliation(s)
- Tianqi Yang
- Department of Ophthalmology, The First Affiliated Hospital of Jinan University, Guangzhou, 510632, China
| | - Sun Yuet Chan
- Department of Ophthalmology, The First Affiliated Hospital of Jinan University, Guangzhou, 510632, China
| | - Jie Liu
- Department of Ophthalmology, The First Affiliated Hospital of Jinan University, Guangzhou, 510632, China
| | - Zhiwei Chen
- Department of Ophthalmology, The First Affiliated Hospital of Jinan University, Guangzhou, 510632, China
| | - Guocheng Yu
- Department of Ophthalmology, The First Affiliated Hospital of Jinan University, Guangzhou, 510632, China
| | - Xiaojuan He
- Department of Ophthalmology, The First Affiliated Hospital of Jinan University, Guangzhou, 510632, China
| | - Jing Meng
- Department of Ophthalmology, The First Affiliated Hospital of Jinan University, Guangzhou, 510632, China.
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24
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Liu H, Cheng J, Zhuang X, Qi B, Li F, Zhang B. Genomic instability and eye diseases. ADVANCES IN OPHTHALMOLOGY PRACTICE AND RESEARCH 2023; 3:103-111. [PMID: 37846358 PMCID: PMC10577848 DOI: 10.1016/j.aopr.2023.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/19/2022] [Revised: 03/30/2023] [Accepted: 03/30/2023] [Indexed: 10/18/2023]
Abstract
Background Genetic information is stored in the bases of double-stranded DNA. However, the integrity of DNA molecules is constantly threatened by various mutagenic agents, including pollutants, ultraviolet light (UV), and medications. To counteract these environmental damages, cells have established multiple mechanisms, such as producing molecules to identify and eliminate damaged DNA, as well as reconstruct the original DNA structures. Failure or insufficiency of these mechanisms can cause genetic instability. However, the role of genome stability in eye diseases is still under-researched, despite extensive study in cancer biology. Main text As the eye is directly exposed to the external environment, the genetic materials of ocular cells are constantly under threat. Some of the proteins essential for DNA damage repair, such as pRb, p53, and RAD21, are also key during the ocular disease development. In this review, we discuss five ocular diseases that are associated with genomic instability. Retinoblastoma and pterygium are linked to abnormal cell cycles. Fuchs' corneal endothelial dystrophy and age-related macular degeneration are related to the accumulation of DNA damage caused by oxidative damage and UV. The mutation of the subunit of the cohesin complex during eye development is linked to sclerocornea. Conclusions Failure of DNA damage detection or repair leads to increased genomic instability. Deciphering the role of genomic instability in ocular diseases can lead to the development of new treatments and strategies, such as protecting vulnerable cells from risk factors or intensifying damage to unwanted cells.
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Affiliation(s)
- Hongyan Liu
- Eye Institute of Shandong First Medical University, Qingdao Eye Hospital of Shandong First Medical University, Qingdao, China
- School of Ophthalmology, Shandong First Medical University, Qingdao, China
| | - Jun Cheng
- Eye Institute of Shandong First Medical University, Qingdao Eye Hospital of Shandong First Medical University, Qingdao, China
- School of Ophthalmology, Shandong First Medical University, Qingdao, China
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Qingdao, China
| | - Xiaoyun Zhuang
- School of Ophthalmology, Shandong First Medical University, Qingdao, China
- Eye Institute of Shandong First Medical University, Eye Hospital of Shandong First Medical University (Shandong Eye Hospital), Jinan, China
- Department of Ophthalmology, School of Clinical Medicine, Weifang Medical University, Weifang, China
| | - Benxiang Qi
- Eye Institute of Shandong First Medical University, Qingdao Eye Hospital of Shandong First Medical University, Qingdao, China
- School of Ophthalmology, Shandong First Medical University, Qingdao, China
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Qingdao, China
| | - Fenfen Li
- The Eye Hospital of Wenzhou Medical University, Hangzhou, China
| | - Bining Zhang
- Eye Institute of Shandong First Medical University, Qingdao Eye Hospital of Shandong First Medical University, Qingdao, China
- School of Ophthalmology, Shandong First Medical University, Qingdao, China
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Qingdao, China
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25
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Kaur M, Singh M, Singh S. Sliding limbus-conjunctival flaps for minimizing the pterygium recurrence: a prospective tertiary care institute study. Rom J Ophthalmol 2023; 67:244-249. [PMID: 37876502 PMCID: PMC10591434 DOI: 10.22336/rjo.2023.41] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/15/2023] [Indexed: 10/26/2023] Open
Abstract
Objective: To describe the surgical technique and long-term outcomes of sliding limbus-conjunctival flaps to treat primary pterygium. Methods: Our single-center, single-surgeon-based, prospective study (part of the postgraduate thesis) included primary pterygium patients. We included the larger pterygium in bilateral cases for our research. All patients underwent pterygium excision and reconstruction by sliding limbus-conjunctival flaps technique to minimize the recurrence rates. Similar surgical steps and drugs were used for all the enrolled patients. Two ophthalmologists (SS and MK) evaluated all cases for blinding purposes. A minimum follow-up of 12 months was ensured in all cases. Results: Fifty eyes of 50 patients underwent the sliding limbus-conjunctival flaps surgery at a mean age of 50.40 ± 15.05 years. There were 27 (54%) males and 23 (46%) females with nasal pterygium (100%), having an average horizontal size of 2.96 mm. A "with the rule" astigmatism was seen in 44 (88%) eyes with a horizontal keratometry value of 42.00 ± 2.83, which increased significantly to 42.23 ± 2.02 (p>0.05) after surgery. The visual acuity was improved by 1 Snellen's line in 21 cases, 2 lines in 4 cases, and by 3 lines in 1 case. No change in visual acuity was seen in 24 cases. The early minor postoperative complications were self-resolving. At a mean follow-up of 14.5 months, the recurrence was found in 2 patients (4%), one in the 3rd and the other in the 9th month. Conclusion: The sliding limbus-conjunctival flaps technique is a simple, safe, and efficient procedure for primary pterygium cases. Pterygium surgery positively affects the visual acuity and keratometry values in most patients, making it a cosmetic and functional ophthalmic surgical procedure.
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Affiliation(s)
- Manpreet Kaur
- Department of Ophthalmology, Sri Guru Ram Das Institute of Medical Sciences and Research, Amritsar, India
| | - Manpreet Singh
- Department of Ophthalmology, Advanced Eye Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Shakeen Singh
- Department of Ophthalmology, Sri Guru Ram Das Institute of Medical Sciences and Research, Amritsar, India
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26
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Zhang J, Zhang L, Hu H, Sun L, He W, Zhang Z, Wang J, Nie D, Liu X. The influence of pterygium on corneal densitometry evaluated using the Oculus Pentacam system. Front Med (Lausanne) 2023; 10:1184318. [PMID: 37396900 PMCID: PMC10310544 DOI: 10.3389/fmed.2023.1184318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2023] [Accepted: 05/30/2023] [Indexed: 07/04/2023] Open
Abstract
Purpose To assess the effect of pterygium on corneal densitometry (CD) values. Methods One hundred and nine patients (155 eyes) with primary pterygium were divided into a severe pterygium group (79 eyes) and a mild-to-moderate pterygium group (76 eyes) according to pterygium severity. Among them, 63 patients had monocular pterygium; and 25 patients (38 eyes) underwent pterygium excision combined with conjunctival autograft follow-up. A Pentacam anterior segment analyzer was used to obtain the CD values and corneal morphological parameters, including central corneal thickness (CCT), flat-axis keratometry (K1), steep-axis keratometry (K2), corneal astigmatism, irregular astigmatism, and spherical aberration. CD was subdivided into four concentric radial regions based on corneal diameter and three layers according to depth. Results CD values at 0-12 mm of the anterior 120 μm layer, 0-10 mm of the center layer and full thickness, and 2-6 mm of the posterior 60 μm layer were significantly higher in eyes affected by pterygium than in the contralateral unaffected eyes (all P < 0.05). CD values were significantly higher in the severe pterygium group than in the mild to moderate pterygium group (all P < 0.05). Corneal astigmatism, irregular astigmatism, K1, K2, CCT, and spherical aberration correlated with CD values in eyes with pterygium (all P < 0.05). CD values at 6-10, 0-12 mm in the anterior 120 μm layer and full thickness, 10-12 and 0-12 mm in the center layer were significantly decreased 1 month after pterygium surgery compared with those before surgery (all P < 0.05). Conclusion Patients with pterygium had increased CD values, particularly in the anterior and central layers. CD values were correlated with pterygium severity grading and corneal parameters. Pterygium surgery partially reduced the CD values.
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Affiliation(s)
- Jing Zhang
- Shenzhen Eye Hospital, Jinan University, Shenzhen Eye Institute, Shenzhen, Guangdong, China
| | - Liyun Zhang
- Shenzhen Eye Hospital, Jinan University, Shenzhen Eye Institute, Shenzhen, Guangdong, China
- Shenzhen Key Laboratory of Ophthalmology, Shenzhen Eye Hospital, Postgraduate Training Base of Jinzhou Medical University, Shenzhen, Guangdong, China
| | - Huiling Hu
- Shenzhen Eye Hospital, Jinan University, Shenzhen Eye Institute, Shenzhen, Guangdong, China
| | - Liangnan Sun
- Shenzhen Eye Hospital, Jinan University, Shenzhen Eye Institute, Shenzhen, Guangdong, China
| | - Wenling He
- Shenzhen Eye Hospital, Jinan University, Shenzhen Eye Institute, Shenzhen, Guangdong, China
| | - Zhe Zhang
- Shenzhen Eye Hospital, Jinan University, Shenzhen Eye Institute, Shenzhen, Guangdong, China
| | - Jiantao Wang
- Shenzhen Eye Hospital, Jinan University, Shenzhen Eye Institute, Shenzhen, Guangdong, China
| | - Danyao Nie
- Shenzhen Eye Hospital, Jinan University, Shenzhen Eye Institute, Shenzhen, Guangdong, China
| | - Xinhua Liu
- Shenzhen Eye Hospital, Jinan University, Shenzhen Eye Institute, Shenzhen, Guangdong, China
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27
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Okumus S, Ozcan E, Erbagci I. High-throughput screening of cytochrome P450 (CYP) family of genes in primary and recurrent pterygium. Exp Eye Res 2023:109522. [PMID: 37271310 DOI: 10.1016/j.exer.2023.109522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 05/15/2023] [Accepted: 06/01/2023] [Indexed: 06/06/2023]
Abstract
Pterygium is a common degenerative disease characterized fibrovascular outgrowth towards cornea. Around 200 million people have been reported to be affected by the pterygium in the world. Although the risk factors for pterygium are well documented, the molecular pathogenesis of pterygium seems to be very complex and remains highly elusive. However, the common sense for the development of pterygium appears to be deregulation of growth hemostasis due to aberrant apoptosis. In addition, pterygium shares many features with human cancers, including dysregulation of apoptosis, persistent proliferation, inflammation, invasion, and relapse following resection. Cytochrome P450 (CYP) monooxygenases are a superfamily of heme-containing enzymes with a wide range of structural and functional diversity. In the present study, we aimed to identify significant expression signatures of CYP gene in pterygium. For the study, a total number of 45 patients (30 primary and 15 recurrent pterygium) were included. For the high-throughput screening of CYP gene expression, Fluidigm 96.96 Dynamic Array Expression Chip was used and analyzed with BioMark™ HD System Real-Time PCR system. Remarkably, CYP genes were identified to be significantly overexpressed in both primary and recurrent pterygium samples. Most prominent overexpression was observed in CYP1A1, CYP11B2 and CYP4F2 in primary pterygium and CYP11A1 and CYP11B2 in recurrent pterygium. Consequently, present findings suggest the significant involvement of CYP genes in the development and progression of pterygium.
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Affiliation(s)
- Seydi Okumus
- Ophthalmology Clinic, Netgoz Medical Center, Gaziantep, Turkey.
| | - Eyup Ozcan
- Ophthalmology Clinic, Netgoz Medical Center, Gaziantep, Turkey
| | - Ibrahim Erbagci
- Ophthalmology Clinic, Netgoz Medical Center, Gaziantep, Turkey
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28
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He Q, Cai Y, Huang J, He X, Han W, Chen W. Impairment of autophagy promotes human conjunctival fibrosis and pterygium occurrence via enhancing the SQSTM1-NF-κB signaling pathway. J Mol Cell Biol 2023; 15:mjad009. [PMID: 36792067 PMCID: PMC10320757 DOI: 10.1093/jmcb/mjad009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Revised: 11/03/2022] [Accepted: 02/10/2023] [Indexed: 02/17/2023] Open
Abstract
Pterygium is a common ocular disease with a high recurrence rate, characterized by hyperplasia of subconjunctival fibrovascular tissue. Autophagy, an important process to maintain cellular homeostasis, participates in the pathogenic fibrosis of different organs. However, the exact role of autophagy in pterygium pathogenesis remains unknown. Here, we found that autophagic activity was decreased in human pterygium tissues compared with adjacent normal conjunctival tissues. The in vitro model of fibrosis was successfully established using human primary conjunctival fibroblasts (ConFB) treated with transforming growth factor-β1 (TGF-β1), evidenced by increased fibrotic level and strong proliferative and invasive capabilities. The autophagic activity was suppressed during TGF-β1- or ultraviolet-induced fibrosis of ConFB. Activating autophagy dramatically retarded the fibrotic progress of ConFB, while blocking autophagy exacerbated this process. Furthermore, SQSTM1, the main cargo receptor of selective autophagy, was found to significantly promote the fibrosis of ConFB through activating the PKCι-NF-κB signaling pathway. Knockdown of SQSTM1, PKCι, or p65 in ConFB delayed TGF-β1-induced fibrosis. Overexpression of SQSTM1 drastically abrogated the inhibitory effect of rapamycin or serum starvation on TGF-β1-induced fibrosis. Collectively, our data suggested that autophagy impairment of human ConFB facilitates fibrosis via activating the SQSTM1-PKCι-NF-κB signaling cascades. This work was contributory to elucidating the mechanism of autophagy underlying pterygium occurrence.
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Affiliation(s)
- Qin He
- Department of Ophthalmology, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310003, China
| | - Yiting Cai
- Institute of Immunology, School of Medicine, Zhejiang University, Hangzhou 310058, China
| | - Jiani Huang
- Eye Center of the Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310009, China
| | - Xiaoying He
- Eye Center of the Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310009, China
| | - Wei Han
- Eye Center of the Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310009, China
| | - Wei Chen
- Institute of Immunology, School of Medicine, Zhejiang University, Hangzhou 310058, China
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29
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Zhang B, Dong X, Sun Y. Efficacy and safety of anti-vascular endothelial growth factor agents in the treatment of primary pterygium. Front Med (Lausanne) 2023; 10:1166957. [PMID: 37287747 PMCID: PMC10242018 DOI: 10.3389/fmed.2023.1166957] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 05/05/2023] [Indexed: 06/09/2023] Open
Abstract
Purpose To further evaluate the efficacy and safety of anti-vascular endothelial growth factor (VEGF) agents in management of primary pterygium. Methods Randomized controlled trials (RCTs) in databases of PubMed, Web of Science, Embase, and the Cochrane Central Register of Controlled Trials were searched from inception to September 2022. Recurrences and complications were evaluated as the pooled risk ratio (RR) and 95% confidence interval (CI) using random-effects model. Results In total of 1,096 eyes in 19 RCTs were included. Anti-VEGF agents statistically decreased recurrence rate of pterygium following surgery (RR 0.47, 95% CI 0.31-0.74, P < 0.001). Subgroup analysis showed that anti-VEGF as an adjunct to bare sclera (RR 0.34, 95% CI 0.13-0.90, P = 0.03) and conjunctival autograft (RR 0.50, 95% CI 0.26-0.96, P = 0.04) statistically reduced recurrence rate, while the effect was not favorable for conjunctivo-limbo autograft (RR 0.99, 95% CI 0.36-2.68, P = 0.98). Anti-VEGF agents statistically decreased recurrence in White patients (RR 0.48, 95% CI 0.28-0.83, P = 0.008), while didn't in Yellow patients (RR 0.43, 95% CI 0.12-1.47, P = 0.18). Both topical (RR 0.19, 95% CI 0.08-0.45, P < 0.001) and subconjunctival anti-VEGF agents (RR 0.64, 95% CI 0.45-0.91, P = 0.01) had a positive influence on recurrence. There was no statistically significant difference in complications between the groups (RR 0.80, 95% CI 0.52-1.22, P = 0.29). Conclusions As adjuvant treatment, anti-VEGF agents statistically reduced the recurrence following pterygium surgery, especially among White patients. Anti-VEGF agents were well tolerated without increased complications.
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Affiliation(s)
- Bowen Zhang
- Department of Operating Room, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Xingmei Dong
- Department of Pathology, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine (Guangdong Provincial Hospital of Chinese Medicine), Guangzhou, China
| | - Yi Sun
- Department of Ophthalmology, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
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Wang J, Cao K, Li S, Su B, Jin Z, Pan Z, Tian L, Shi W, Jie Y. Epidemiologic characteristics and the change of surgical methods of pterygium and pseudopterygium from 2013 to 2019 in China: A retrospective analysis. Heliyon 2023; 9:e15046. [PMID: 37082637 PMCID: PMC10112034 DOI: 10.1016/j.heliyon.2023.e15046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Revised: 03/23/2023] [Accepted: 03/24/2023] [Indexed: 04/22/2023] Open
Abstract
Introduction Pterygium is a common multifactorial external eye disease, which causes various ocular symptoms and negatively affects appearance. The aim of this study was to analyze the epidemiological characteristics and the change of surgical methods of pterygium and pseudopterygium in China from 2013 to 2019. Materials and methods This study was a hospital-based nationwide retrospective study to estimate the epidemiologic characteristics and the change of surgical methods of pterygium and pseudopteygium in China from 2013 to 2019. The data was extracted from the Hospital Quality Monitoring System (HQMS) database. The diagnosis was based on the tenth revision of the International Classification of Diseases (ICD-10) code. Results Our study included 1,007,800 pterygium and 2,681 pseudopteygium inpatients. From 2013 to 2019, the proportion of pterygium and pseudopterygium patients who underwent surgery, among all ophthalmology inpatients, increased from 3.3% in 2013 to 7.84% in 2019. The male-female ratio of surgically treated pterygium and pseudopterygium is 1:1.8 and 1.6:1 respectively. Among all age groups, the hospitalized pterygium patients who received surgery were mainly 60-69 years old, accounting for 36.53%. The pseudopterygium patients who received surgery were mostly 50-59 years old, accounting for 24.02%. Among the 31 provinces of mainland China, Yunnan Province has the highest proportion of pterygium patients treated surgically (6.40%), while Shanghai has the highest proportion of pseudopterygium patients treated surgically (12.98%). The most common occupation of participants in the study was farmer, accounting for 47.62% and 28.53%, respectively. During the study period, the application of autologous stem cell transplantation increased year by year, and became the first choice for pterygium and pseudopterygium surgery. Discussion This study was the first to describe the epidemiological characteristics and surgical methods of hospitalized pterygium and pseudopterygium patients in China. This study provides important information for better diagnosis, treatment and prevention of pterygium and pseudopterygium.
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Affiliation(s)
- Jingyi Wang
- National Center for Quality Control of Ophthalmic Care, WHO Collaborating Center for the Prevention of Blindness, Dongjiaomin Lane, Beijing, China
- Beijing Institute of Ophthalmology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Kai Cao
- National Center for Quality Control of Ophthalmic Care, WHO Collaborating Center for the Prevention of Blindness, Dongjiaomin Lane, Beijing, China
- Beijing Institute of Ophthalmology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Shang Li
- National Center for Quality Control of Ophthalmic Care, WHO Collaborating Center for the Prevention of Blindness, Dongjiaomin Lane, Beijing, China
- Beijing Institute of Ophthalmology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Bingnan Su
- National Center for Quality Control of Ophthalmic Care, WHO Collaborating Center for the Prevention of Blindness, Dongjiaomin Lane, Beijing, China
- Beijing Institute of Ophthalmology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Zibing Jin
- National Center for Quality Control of Ophthalmic Care, WHO Collaborating Center for the Prevention of Blindness, Dongjiaomin Lane, Beijing, China
- Beijing Institute of Ophthalmology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Zhiqiang Pan
- National Center for Quality Control of Ophthalmic Care, WHO Collaborating Center for the Prevention of Blindness, Dongjiaomin Lane, Beijing, China
- Beijing Institute of Ophthalmology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Lei Tian
- National Center for Quality Control of Ophthalmic Care, WHO Collaborating Center for the Prevention of Blindness, Dongjiaomin Lane, Beijing, China
- Beijing Institute of Ophthalmology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
- Beijing Advanced Innocation Center Fot Big Data-Based Precision Medicine, Beihang University & Capital Medical University, Beijing, China
| | - Weiyun Shi
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Shandong First Medical University & Shandong Academy of Medical Sciences, Qingdao, China
- Shandong Eye Hospital, Jinan, China
- Corresponding author. No.5, Yanerdao Road, Shinan District, 250004, Qingdao, China.
| | - Ying Jie
- National Center for Quality Control of Ophthalmic Care, WHO Collaborating Center for the Prevention of Blindness, Dongjiaomin Lane, Beijing, China
- Beijing Institute of Ophthalmology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
- Corresponding author. No.17, Hougou alley, Dongcheng District, Beijing 100730, China.
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Paganelli B, Sahyoun M, Gabison E. Conjunctival and Limbal Conjunctival Autograft vs. Amniotic Membrane Graft in Primary Pterygium Surgery: A 30-Year Comprehensive Review. Ophthalmol Ther 2023; 12:1501-1517. [PMID: 36961661 PMCID: PMC10164200 DOI: 10.1007/s40123-023-00689-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Accepted: 02/13/2023] [Indexed: 03/25/2023] Open
Abstract
INTRODUCTION The purpose of this study is to compare the "real-life" effectiveness of amniotic membrane graft (AMG) and conjunctival (CAT) or limbal conjunctival (LCA) autograft in the management of primary pterygium. METHODS Human-based studies on primary pterygium surgery that were published between 1993 and 2022 with at least 3 months of follow-up were identified, and only those that were retrospective were included. The global recurrence rate of pterygium was assessed for each surgical technique separately. Specific recurrence rates taking into consideration the fixation technique (glue versus sutures) were also measured. RESULTS 35 real-life retrospective subgroups comprising a total of 3747 eyes were included in the final review. The mean global recurrence rates for CAT, LCA and AMG were 7.61%, 5.50% and 9.0%, respectively. Recurrences were less common for patients who received fibrin glue (5.92%, 2.56% and 3.60%) than for those who received sutures (8.99%, 6.03% and 23.0%) for the three groups, respectively. Surgical techniques combining CAT or LCA with AMG yielded an even lower global recurrence rate (1.83%). CONCLUSION AMG seems like a reasonable option that could be considered in primary pterygium surgery, especially when glued to the underlying sclera. Combining AMG with other treatment modalities such as CAT or LCA seems to offer an interesting alternative in terms of recurrence.
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Affiliation(s)
- Benoît Paganelli
- Fondation Adolphe de Rothschild Hospital, 47Bis rue Manin, 75019, Paris, France
- Necker Hospital, 75006, Paris, France
| | | | - Eric Gabison
- Fondation Adolphe de Rothschild Hospital, 47Bis rue Manin, 75019, Paris, France.
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Cai Y, Zhou T, Chen J, Cai X, Fu Y. Uncovering the role of transient receptor potential channels in pterygium: a machine learning approach. Inflamm Res 2023; 72:589-602. [PMID: 36692516 DOI: 10.1007/s00011-023-01693-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Revised: 01/04/2023] [Accepted: 01/11/2023] [Indexed: 01/25/2023] Open
Abstract
OBJECTIVES We aimed at identifying the role of transient receptor potential (TRP) channels in pterygium. METHODS Based on microarray data GSE83627 and GSE2513, differentially expressed genes (DEGs) were screened and 20 hub genes were selected. After gene correlation analysis, 5 TRP-related genes were obtained and functional analyses of gene ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) were performed. Multifactor regulatory network including mRNA, microRNAs (miRNAs) and transcription factors (TFs) was constructed. The 5 gene TRP signature for pterygium was validated by multiple machine learning (ML) programs including support vector classifiers (SVC), random forest (RF), and k-nearest neighbors (KNN). Additionally, we outlined the immune microenvironment and analyzed the candidate drugs. Finally, in vitro experiments were performed using human conjunctival epithelial cells (CjECs) to confirm the bioinformatics results. RESULTS Five TRP-related genes (MCOLN1, MCOLN3, TRPM3, TRPM6, and TRPM8) were validated by ML algorithms. Functional analyses revealed the participation of lysosome and TRP-regulated inflammatory pathways. A comprehensive immune infiltration landscape and TFs-miRNAs-mRNAs network was studied, which indicated several therapeutic targets (LEF1 and hsa-miR-455-3p). Through correlation analysis, MCOLN3 was proposed as the most promising immune-related biomarker. In vitro experiments further verified the reliability of our in silico results and demonstrated that the 5 TRP-related genes could influence the proliferation and proinflammatory signaling in conjunctival tissue contributing to the pathogenesis of pterygium. CONCLUSIONS Our study suggested that TRP channels played an essential role in the pathogenesis of pterygium. The identified pivotal biomarkers (especially MCOLN3) and pathways provide novel directions for future mechanistic and therapeutic studies for pterygium.
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Affiliation(s)
- Yuchen Cai
- Department of Ophthalmology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhi-Zao-Ju Road, Huangpu District, Shanghai, 200011, China
- Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, China
| | - Tianyi Zhou
- Department of Ophthalmology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhi-Zao-Ju Road, Huangpu District, Shanghai, 200011, China
- Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, China
| | - Jin Chen
- Department of Ophthalmology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhi-Zao-Ju Road, Huangpu District, Shanghai, 200011, China
- Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, China
| | - Xueyao Cai
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhi-Zao-Ju Road, Huangpu District, Shanghai, 200011, China.
| | - Yao Fu
- Department of Ophthalmology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhi-Zao-Ju Road, Huangpu District, Shanghai, 200011, China.
- Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, China.
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Öztürk E, Gündüz A. Double Flip Technique for Graft Transfer in Autograft Pterygium Surgery. Turk J Ophthalmol 2023; 53:67-69. [PMID: 36847636 PMCID: PMC9973206 DOI: 10.4274/tjo.galenos.2022.41387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/01/2023] Open
Abstract
A 50-year-old man with recurrent pterygium and a 46-year-old woman with primary pterygium underwent surgery using a novel autograft transfer technique that facilitates autograft suturing and ensures correct graft orientation. After removing the pterygium, three edges of the autograft were cut. The autograft was flipped first over the uncut edge and secured to the superior margin of the recipient bed with two sutures. Afterward, the fourth side of the graft was cut and the second flip was done over the sutured edge. Thus, the autograft was in correct surface and side orientation and was sutured to the recipient bed. This simple technique provides both easy transfer and correct orientation of the graft in autograft pterygium surgery.
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Affiliation(s)
- Emrah Öztürk
- Malatya Turgut Özal University Faculty of Medicine, Department of Ophthalmology, Malatya, Türkiye
| | - Abuzer Gündüz
- Malatya Turgut Özal University Faculty of Medicine, Department of Ophthalmology, Malatya, Türkiye
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Yin CJ, Bao YL, Zhang QC, Kang SF, Chen GL. Comparison of postoperative recovery of primary pterygium excision combined with either limbal stem cell transplantation or amniotic membrane transplantation: a randomized controlled trial-based meta-analysis. Am J Transl Res 2023; 15:641-652. [PMID: 36915777 PMCID: PMC10006757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Accepted: 01/20/2023] [Indexed: 03/16/2023]
Abstract
OBJECTIVE To compare the postoperative recovery of primary pterygium excision combined with either limbal stem cell transplantation (LSCT) or amniotic membrane transplantation (AMT). METHODS All relevant studies on the primary pterygium excision combined with either LSCT or AMT conducted before August 2022 were extracted from PubMed, EMBASE, Web of Science, and Cochrane Library databases. The main outcomes compared were tear film stability at 1, 3, and 6 months after surgery, postoperative corneal epithelial healing time, recurrence rate, and complications. RESULTS Sixteen randomized controlled trials (RCTs) with 1390 eye cases were included in this meta-analysis. We found that patients of the AMT group improved significantly in the results of the tear break-up time (BUT) and Schirmer I test at 1 month after surgery (BUT: MD=-0.37, 95% CI: -0.62, -0.12, P<0.05; Schirmer I test: MD=-0.32, 95% CI: -0.57, -0.07, P<0.05) compared with those of the LSCT group, suggesting that the early stage of tear film stability after primary pterygium excision combined with AMT was superior to the LSCT combination. However, according to the Schirmer I test result, the patients in the LSCT group showed increased tear production compared to the AMT group at 3 and 6 months after surgery (3 months: MD=0.36, 95% CI: 0.08, 0.64, P<0.05; 6 months: MD=0.33, 95% CI: 0.07, 0.60, P<0.05), suggesting that the LSCT combination was superior to the AMT combination in long-term postoperative tear film stability. As for postoperative corneal epithelial healing time, the LSCT group exhibited shorter time than the AMT group (MD=-1.17, 95% CI: -2.15, -0.19, P<0.05). Furthermore, the recurrence rate was lower in the LSCT group than in the AMT group (RR=0.42, 95% CI: 0.30, 0.59, P<0.05). Lastly, there was no statistical difference in BUT and complication rate at 3 and 6 months after surgery between the LSCT and AMT groups. CONCLUSIONS Our analysis suggests that primary pterygium excision combined with LSCT may be a better choice compared to the combination with AMT in postoperative recovery.
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Affiliation(s)
- Chuan-Jie Yin
- Department of Ophthalmology, The Second Hospital of Shandong University Jinan 250033, Shandong, China
| | - Yin-Lei Bao
- Department of Ophthalmology, Linyi People's Hospital Linyi 276000, Shandong, China
| | - Qi-Chen Zhang
- Department of Ophthalmology, The Second Hospital of Shandong University Jinan 250033, Shandong, China
| | - Sui-Fang Kang
- Department of Ophthalmology, The Second Hospital of Shandong University Jinan 250033, Shandong, China
| | - Guo-Ling Chen
- Department of Ophthalmology, The Second Hospital of Shandong University Jinan 250033, Shandong, China
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Fan J, Wei S, Zhang X, Chen L, Zhang X, Jiang Y, Sheng M, Chen Y. Resveratrol inhibits TGF-β1-induced fibrotic effects in human pterygium fibroblasts. Environ Health Prev Med 2023; 28:59. [PMID: 37866886 PMCID: PMC10613557 DOI: 10.1265/ehpm.23-00020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2023] [Accepted: 09/02/2023] [Indexed: 10/24/2023] Open
Abstract
BACKGROUND Resveratrol is a polyphenolic phytoalexin which has the properties of anti-oxidant, anti-inflammatory and anti-fibrotic effects. The aim of this study was to investigate the anti-fibrotic effects of resveratrol in primary human pterygium fibroblasts (HPFs) and elucidate the underlying mechanisms. METHOD Profibrotic activation was induced by transforming growth factor-beta1 (TGF-β1). The expression of profibrotic markers, including type 1 collagen (COL1), α-smooth muscle actin (α-SMA), and fibronectin, were detected by western blot and quantitative real-time-PCR after treatment with various concentrations of resveratrol in HPFs to investigate the anti-fibrotic effects. Relative signaling pathways downstream of TGF-β1 were detected by Western blot to assess the underlying mechanism. Cell viability and apoptosis were assessed using CCK-8 assay and flow cytometry to evaluate proliferation and drug-induced cytotoxicity. Cell migration and contractile phenotype were detected through wound healing assay and collagen gel contraction assay. RESULTS The expression of α-SMA, FN and COL1 induced by TGF-β1 were suppressed by treatment with resveratrol in dose-dependent manner. The Smad3, mitogen-activated protein kinase (p38 MAPK) and phosphatidylinositol-3-kinase (PI3K) / protein kinase B (AKT) pathways were activated by TGF-β1, while resveratrol attenuated those pathways. Resveratrol also inhibited cellular proliferation, migration and contractile phenotype, and induced apoptosis in HPFs. CONCLUSIONS Resveratrol inhibit TGF-β1-induced myofibroblast activation and extra cellular matrix synthesis in HPFs, at least partly, by regulating the TGF-β/Smad3, p38 MAPK and PI3K/AKT pathways.
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Affiliation(s)
- Jianwu Fan
- Department of Ophthalmology, Yangpu Hospital, School of Medicine, Tongji University, Shanghai 200090, China
- Center for Clinical Research and Translational Medicine, Yangpu Hospital, School of Medicine, Tongji University, Shanghai 200090, China
| | - Shuang Wei
- Department of Ophthalmology, Yangzhi Rehabilitation Hospital, School of Medicine, Tongji University, Shanghai 201600, China
| | - Xiaoyan Zhang
- Department of Ophthalmology, Huashan Hospital, Fudan University, Shanghai 200040, China
| | - Li Chen
- Department of Ophthalmology, Yangpu Hospital, School of Medicine, Tongji University, Shanghai 200090, China
| | - Xin Zhang
- Department of Ophthalmology, Yangpu Hospital, School of Medicine, Tongji University, Shanghai 200090, China
| | - Yaping Jiang
- Department of Ophthalmology, Yangpu Hospital, School of Medicine, Tongji University, Shanghai 200090, China
| | - Minjie Sheng
- Department of Ophthalmology, Yangzhi Rehabilitation Hospital, School of Medicine, Tongji University, Shanghai 201600, China
| | - Yihui Chen
- Department of Ophthalmology, Yangpu Hospital, School of Medicine, Tongji University, Shanghai 200090, China
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Ozturkmen C, Berhuni M. YouTube as a source of patient information for pterygium surgery. Ther Adv Ophthalmol 2023; 15:25158414231174143. [PMID: 37255623 PMCID: PMC10226336 DOI: 10.1177/25158414231174143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Accepted: 04/08/2023] [Indexed: 06/01/2023] Open
Abstract
Background Patients use the YouTube platform to get information about pterygium surgery, and this affects the treatment decisions of the patients. Objectives The purpose of this study was to analyze the quality and reliability of YouTube videos as educational resources about pterygium surgery. Design This is a register-based retrospective study. Methods This was a retrospective, record-based study. A YouTube search was performed using the terms 'pterygium surgery' and 'pterygium eye surgery', resulting in the evaluation of a total of 200 videos. In the end, 122 English-language videos about pterygium surgery were recruited to study. All videos were rated with the DISCERN, the Journal of the American Medical Association (JAMA), and the Global Quality Score (GQS) systems. Results The mean DISCERN, JAMA, and GQS values were 38.9 ± 10.9, 1.8 ± 0.8, and 2.2 ± 1, respectively. The YouTube videos about pterygium surgery had been uploaded by a physician in 63 (51.6%) and non-physicians in 59 (48.4%) cases. There was no significant difference between the two groups in terms of general characteristics and scores. Conclusions Our results show that YouTube videos about pterygium surgery have low quality and credibility and are not sufficient in terms of providing patient information. Registration Not applicable.
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Fang X, Deshmukh M, Chee ML, Soh ZD, Teo ZL, Thakur S, Goh JHL, Liu YC, Husain R, Mehta JS, Wong TY, Cheng CY, Rim TH, Tham YC. Deep learning algorithms for automatic detection of pterygium using anterior segment photographs from slit-lamp and hand-held cameras. Br J Ophthalmol 2022; 106:1642-1647. [PMID: 34244208 PMCID: PMC9685734 DOI: 10.1136/bjophthalmol-2021-318866] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2021] [Accepted: 06/25/2021] [Indexed: 11/04/2022]
Abstract
BACKGROUND/AIMS To evaluate the performances of deep learning (DL) algorithms for detection of presence and extent pterygium, based on colour anterior segment photographs (ASPs) taken from slit-lamp and hand-held cameras. METHODS Referable pterygium was defined as having extension towards the cornea from the limbus of >2.50 mm or base width at the limbus of >5.00 mm. 2503 images from the Singapore Epidemiology of Eye Diseases (SEED) study were used as the development set. Algorithms were validated on an internal set from the SEED cohort (629 images (55.3% pterygium, 8.4% referable pterygium)), and tested on two external clinic-based sets (set 1 with 2610 images (2.8% pterygium, 0.7% referable pterygium, from slit-lamp ASP); and set 2 with 3701 images, 2.5% pterygium, 0.9% referable pterygium, from hand-held ASP). RESULTS The algorithm's area under the receiver operating characteristic curve (AUROC) for detection of any pterygium was 99.5%(sensitivity=98.6%; specificity=99.0%) in internal test set, 99.1% (sensitivity=95.9%, specificity=98.5%) in external test set 1 and 99.7% (sensitivity=100.0%; specificity=88.3%) in external test set 2. For referable pterygium, the algorithm's AUROC was 98.5% (sensitivity=94.0%; specificity=95.3%) in internal test set, 99.7% (sensitivity=87.2%; specificity=99.4%) in external set 1 and 99.0% (sensitivity=94.3%; specificity=98.0%) in external set 2. CONCLUSION DL algorithms based on ASPs can detect presence of and referable-level pterygium with optimal sensitivity and specificity. These algorithms, particularly if used with a handheld camera, may potentially be used as a simple screening tool for detection of referable pterygium. Further validation in community setting is warranted. SYNOPSIS/PRECIS DL algorithms based on ASPs can detect presence of and referable-level pterygium optimally, and may be used as a simple screening tool for the detection of referable pterygium in community screenings.
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Affiliation(s)
- Xiaoling Fang
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore.,Department of Ophthalmology, Shanghai Eye Diseases Prevention and Treatment Center, Shanghai Eye Hospital, Shanghai, China
| | - Mihir Deshmukh
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
| | - Miao Li Chee
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
| | - Zhi-Da Soh
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
| | - Zhen Ling Teo
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
| | - Sahil Thakur
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
| | | | - Yu-Chi Liu
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore.,Ophthalmology and Visual Sciences Academic Clinical Program, Duke-NUS Medical School, Singapore
| | - Rahat Husain
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore.,Ophthalmology and Visual Sciences Academic Clinical Program, Duke-NUS Medical School, Singapore
| | - Jodhbir S Mehta
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore.,Ophthalmology and Visual Sciences Academic Clinical Program, Duke-NUS Medical School, Singapore
| | - Tien Yin Wong
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore.,Ophthalmology and Visual Sciences Academic Clinical Program, Duke-NUS Medical School, Singapore.,Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore
| | - Ching-Yu Cheng
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore.,Ophthalmology and Visual Sciences Academic Clinical Program, Duke-NUS Medical School, Singapore.,Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore
| | - Tyler Hyungtaek Rim
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore.,Ophthalmology and Visual Sciences Academic Clinical Program, Duke-NUS Medical School, Singapore
| | - Yih-Chung Tham
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore .,Ophthalmology and Visual Sciences Academic Clinical Program, Duke-NUS Medical School, Singapore
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Sayadi J, Gouider D, Henchiri M, Choura R, Boujelbene N, Abbes I, Khochtali S, Zghal I, Malek I, Khairallah M, Nacef L. Preoperative Intralesional Bevacizumab Injection in Primary Pterygium in Tunisian Patients: A Randomized Controlled Prospective Study. J Curr Ophthalmol 2022; 34:297-304. [PMID: 36644467 PMCID: PMC9832450 DOI: 10.4103/joco.joco_146_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 07/24/2022] [Accepted: 07/28/2022] [Indexed: 12/09/2022] Open
Abstract
Purpose To assess the efficacy and safety of a single preoperative intralesional bevacizumab injection as an adjuvant treatment before primary pterygium surgery. Methods We conducted a randomized controlled interventional study from January 2019 to December 2020. The study included a total of 60 patients (60 eyes) with primary pterygium. We defined two groups of 30 patients each. Group A received an intralesional injection of bevacizumab (Avastin), 1 month before surgery (lesion excision and conjunctival autograft). Group B (control) had only the surgical treatment. Patients were followed up 7 days (D7), 1 month (M1), 3 months (M3), and 6 months (M6) postoperatively. Pre-, per-, and postoperatively, photographs of the lesions were taken, as well as a histopathological examination. The main outcome measures were the change in functional discomfort following intralesional bevacizumab injection and pterygium recurrence. Recurrence was defined as fibrovascular tissue growth invading the cornea. Therapeutic success was defined as the absence of pterygium recurrence in M6. Results The mean age of the 60 patients was 54.17 ± 10.53. After bevacizumab injection, the preoperative functional discomfort score decreased significantly (P = 0.048). There was a significant improvement in grade and color intensity (P = 0.001). We noted no local nor systemic complications after intralesional injection of bevacizumab. After pterygium excision, the success rate was statistically higher in Group A (P = 0.047). There was no significant difference in either final best-corrected spectral visual acuity or astigmatism between the two groups. We noted a statistically significant association between recurrence and color intensity (P = 0.046), vascular density (P = 0.049), and the degree of elastic tissue degeneration (P = 0.040). Conclusion A single preoperative subconjunctival injection of bevacizumab 1 month before surgery decreases the vascularity of newly formed blood vessels and hence may reduce the recurrence rate.
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Affiliation(s)
- Jihene Sayadi
- Department A, Hedi Raies Institute of Ophthalmology, Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia
| | - Dhouha Gouider
- Department A, Hedi Raies Institute of Ophthalmology, Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia,Address for correspondence: Dhouha Gouider, Department A of Ophthalmology, Hedi Raies Institute, Faculty of Medicine, Beb Saadoun, Tunis, Tunisia. E-mail:
| | - Meher Henchiri
- Department A, Hedi Raies Institute of Ophthalmology, Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia
| | - Racem Choura
- Department A, Hedi Raies Institute of Ophthalmology, Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia
| | - Nadia Boujelbene
- Department of Pathology, Salah Azaiez Institute, Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia
| | - Imen Abbes
- Department of Pathology, Salah Azaiez Institute, Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia
| | - Sana Khochtali
- Department of Ophthalmology, Fattouma Bourguiba University Hospital, Faculty of Medicine, Monastir,Tunisia
| | - Imene Zghal
- Department A, Hedi Raies Institute of Ophthalmology, Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia
| | - Ines Malek
- Department A, Hedi Raies Institute of Ophthalmology, Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia
| | - Moncef Khairallah
- Department of Ophthalmology, Fattouma Bourguiba University Hospital, Faculty of Medicine, Monastir,Tunisia
| | - Leila Nacef
- Department A, Hedi Raies Institute of Ophthalmology, Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia
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Taher NO, Alnabihi AN, Hersi RM, Alrajhi RK, Alzahrani RA, Batais WT, Mofti AH, Alghamdi SA. Amniotic membrane transplantation and conjunctival autograft combined with mitomycin C for the management of primary pterygium: A systematic review and meta-analysis. Front Med (Lausanne) 2022; 9:981663. [DOI: 10.3389/fmed.2022.981663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 10/26/2022] [Indexed: 11/11/2022] Open
Abstract
BackgroundPterygium is a common ocular surface disease. Recurrence is the greatest concern in the treatment of pterygium. Thus, a standardized and effective treatment modality with minimal risk for complications is needed for the management of pterygium. The aim of this systematic review and meta-analysis was to evaluate different tissue grafting options, including conjunctival autograft (CAG) with mitomycin C (MMC), CAG alone, and amniotic membrane transplantation (AMT), for the management of primary pterygium.MethodsWe searched the MEDLINE, EMBASE, and Cochrane Central Register of Controlled Trials databases for relevant studies. We included randomized controlled trials (RCTs) in which CAG + MMC and AMT were compared with surgical excision with CAG alone for the treatment of primary pterygium. The rates of recurrence and adverse events reported in the studies were also evaluated. Risk ratio (RR) was used to represent dichotomous outcomes. The data were pooled using the inverse variance weighting method. The quality of the evidence derived from the analysis was assessed using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach. Risk of bias was assessed using the revised Cochrane risk-of-bias tool for randomized trials.ResultsTwelve RCTs (n = 1144) were deemed eligible and included for analysis. Five RCTs had a low risk of bias, five had some concerns, and two had a high risk of bias. Subgroup analysis showed a statistically significant reduction in the rate of pterygium recurrence after CAG + MMC (RR = 0.12; 95% confidence interval [CI], 0.02–0.63). This outcome was rated as high-quality evidence according to the GRADE criteria. There were insignificant differences between the rates of recurrence after AMT and CAG (RR = 1.51; 95% CI, 0.63–3.65). However, this result was rated as low-quality evidence. Regarding adverse events, patients treated using AMT showed significantly lower rates of adverse events than those treated using CAG (RR = 0.46; 95% CI, 0.22–0.95). However, this finding was rated as low-quality evidence as well. CAG + MMC showed a safety profile comparable to that of surgical excision with CAG alone (RR = 1.81; 95% CI, 0.40–8.31). This result was also rated as low-quality evidence.ConclusionA single intraoperative topical application of 0.02% MMC during excision of pterygium followed by CAG has significantly shown to decrease the rate of pterygium recurrence to 1.4% with no severe complications.
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Yu J, Luo J, Li P, Chen X, Zhang G, Guan H. Identification of the circRNA-miRNA-mRNA Regulatory Network in Pterygium-Associated Conjunctival Epithelium. BIOMED RESEARCH INTERNATIONAL 2022; 2022:2673890. [PMID: 36398070 PMCID: PMC9666032 DOI: 10.1155/2022/2673890] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Revised: 10/12/2022] [Accepted: 10/21/2022] [Indexed: 10/07/2023]
Abstract
To investigate the regulatory mechanism of pterygium formation, we detected differentially expressed messenger RNAs (DE-mRNAs) and differentially expressed circular RNAs (DE-circRNAs) in pterygium-associated conjunctival epithelium (PCE) and normal conjunctival epithelium (NCE). Genome-wide mRNA and circRNA expression profiles of PCE and NCE were determined using high-throughput sequencing. Bioinformatics analyses, including Gene Ontology (GO) analysis, Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis, gene set enrichment analysis (GSEA), and protein-protein interaction (PPI) analysis, were conducted. The microRNAs (miRNAs) interacting with the hub DE-mRNAs and DE-circRNAs were predicted and verified using real-time quantitative PCR (RT-qPCR). The data showed that there were 536 DE-mRNAs (280 upregulated and 256 downregulated mRNAs) and 78 DE-circRNAs (20 upregulated and 58 downregulated circRNAs) in PCE. KEGG enrichment analysis indicated that the DE-mRNAs were mainly involved in the following biological processes: IL-17 signalling pathway, viral protein interaction with cytokine and cytokine receptor, cytokine-cytokine receptor interaction, ECM-receptor interaction, and focal adhesion. The GSEA results revealed that the epithelial mesenchymal transition (EMT) process was significantly enriched in upregulated mRNAs. The pterygium-associated circRNA-miRNA-mRNA network was established based on the top 10 DE-circRNAs, 4 validated miRNAs (upregulated miR-376a-5p and miR-208a-5p,downregulated miR-203a-3p and miR-200b-3p), and 31 DE-mRNAs. We found that miR-200b-3p, as a regulator of FN1, SDC2, and MEX3D, could be regulated by 5 upregulated circRNAs. In addition, we screened out EMT-related DE-mRNAs, including 6 upregulated DE-mRNAs and 6 downregulated DE-mRNAs. The EMT-related circRNA-miRNA-mRNA network was established with the top 10 circRNAs, 8 validated miRNAs (upregulated miR-17-5p, miR-181a-5p, and miR-106a-5p, downregulated miR-124-3p, miR-9-5p, miR-130b-5p, miR-1-3p, and miR-26b-5P), and 12 EMT-related DE-mRNAs. We found that hsa_circ_0002406 might upregulate FN1 and ADAM12 by sponging miR-26b-5p and miR-1-3p, respectively, thus promoting EMT in pterygium. Briefly, the study provides a novel viewpoint on the molecular pathological mechanisms in pterygium formation. CircRNA-miRNA-mRNA regulatory networks participate in the pathogenesis of pterygium and might become promising targets for pterygium prevention and treatment.
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Affiliation(s)
- Jianfeng Yu
- Eye Institute, Affiliated Hospital of Nantong University, Medical School of Nantong University, Nantong 226001, China
| | - Jiawei Luo
- Eye Institute, Affiliated Hospital of Nantong University, Medical School of Nantong University, Nantong 226001, China
| | - Pengfei Li
- Eye Institute, Affiliated Hospital of Nantong University, Medical School of Nantong University, Nantong 226001, China
| | - Xiaojuan Chen
- Eye Institute, Affiliated Hospital of Nantong University, Medical School of Nantong University, Nantong 226001, China
| | - Guowei Zhang
- Eye Institute, Affiliated Hospital of Nantong University, Medical School of Nantong University, Nantong 226001, China
| | - Huaijin Guan
- Eye Institute, Affiliated Hospital of Nantong University, Medical School of Nantong University, Nantong 226001, China
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Soares PVBDS, Colombo-Barboza GN, Colombo-Barboza MN, Moscovici BK. Exérese de pterígio em paciente pós-LASIK com técnica de air bubble. REVISTA BRASILEIRA DE OFTALMOLOGIA 2022. [DOI: 10.37039/1982.8551.20220059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Yoon S, Na M, Eom Y, Kim HM, Song JS. Morphometric Measurement of Pterygium with Anterior Segment Optical Coherence Tomography and Relationship with Astigmatism. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2022. [DOI: 10.3341/jkos.2022.63.8.653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Purpose: We used anterior segment optical coherence tomography (AS-OCT) to measure the pterygial subepithelial invasion length and thickness before and after surgery, and to evaluate the corneal epithelium and the extent of astigmatism.Methods: This was a retrospective study. Ten eyes that underwent pterygial excision surgery were analyzed. We used corneal topographic data to assess astigmatism before surgery and employed AS-OCT to measure corneal epithelial thickness and the length of subepithelial invasion. We measured the relative pterygial length, width, and area on anterior segment photographs. Corneal topographic assessment and AS-OCT were repeated 1 month after surgery. Multiple regression and Pearson correlation analyses were used to analyze the relationships between normalization of astigmatism and the size and thickness of the excised pterygium.Results: The mean With-the-Rule proportion of preoperative astigmatism was 2.9 ± 2.3 D and the mean corneal epithelial thickness 269.60 ± 84.17 µm. The mean thickness of the excised pterygia was 210.73 ± 80.36 µm. Pterygial thickness was significantly associated with the extent of preoperative With-the-Rule astigmatism and the normalized With-the-Rule astigmatism after pterygial excision. These correlations were stronger than those of the relative pterygial length, width, and area. The mean subepithelial invasion length was 595.00 ± 310.32 µm.Conclusions: An increase in pterygial epithelial thickness influenced the extent of With-the-Rule astigmatism to a much greater extent than did the relative pterygial length, width, and area. AS-OCT measurement of the subepithelial invasion length identifies the required excisional area prior to surgery.
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He MX, Zhang JF, Yang L, Qin B, Gu HW, Tang QY, Guan HJ, Shi HH. Doxycycline Suppresses Vasculogenic Mimicry in Human Pterygium Fibroblasts. Curr Eye Res 2022; 47:1381-1388. [PMID: 35923150 DOI: 10.1080/02713683.2022.2108455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
PURPOSE To explore the effect of doxycycline on vasculogenic mimicry (VM) formation and the potential mechanism in human pterygium fibroblasts in order to find novel targets for pterygium therapy. METHODS First, we demonstrate the existence of VM in 73 pterygium specimens by CD31 and periodic acid Schiff (PAS) dual staining. Then we used cell counting kit-8, clone formation assay and flow cytometry to prove the inhibitory effect of doxycycline on cell proliferation and apoptosis. The VM formation was evaluated through wound healing assay, cell transwell assay and three-dimensional cell culture combined with PAS staining. Finally, we used Western blot to testify the correlation of the VM and the factors in protein level preliminarily. RESULTS Our results showed that VM existed in human pterygium specimens exactly. Otherwise, in human pterygium fibroblasts, doxycycline induced a dose-dependent inhibitory effect on cell proliferation and apoptosis induction. Besides, doxycycline significantly suppressed vasculogenic mimicry tube formation, cell migration and invasion. Furthermore, doxycycline impaired the expression of MMP-9, MMP-2 and VEGF which may related to pterygium VM formation. CONCLUSIONS Doxycycline decelerated pterygium progression might be through inhibiting VM formation according to the downregulation of MMP-9, MMP-2 and VEGF, which may provide the basis of further studies involving doxycycline for pterygium treatment.
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Affiliation(s)
- Meng-Xuan He
- Eye Institute, Affiliated Hospital of Nantong University, Nantong, China
| | - Jun-Fang Zhang
- Eye Institute, Affiliated Hospital of Nantong University, Nantong, China
| | - Ling Yang
- Eye Institute, Affiliated Hospital of Nantong University, Nantong, China
| | - Bai Qin
- Eye Institute, Affiliated Hospital of Nantong University, Nantong, China
| | - Hong-Wei Gu
- Eye Institute, Affiliated Hospital of Nantong University, Nantong, China
| | - Qiu-Yang Tang
- Eye Institute, Affiliated Hospital of Nantong University, Nantong, China
| | - Huai-Jin Guan
- Eye Institute, Affiliated Hospital of Nantong University, Nantong, China
| | - Hai-Hong Shi
- Eye Institute, Affiliated Hospital of Nantong University, Nantong, China
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Acupoint Massage plus Recombinant Bovine Basic Fibroblast Growth Factor Ophthalmic Gel and Limbal Stem Cell Transplantation on Visual Quality, Corneal Refraction, and Aesthetic Outcome in Patients with Pterygium. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2022; 2022:7103496. [PMID: 35747376 PMCID: PMC9213128 DOI: 10.1155/2022/7103496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 05/05/2022] [Accepted: 05/23/2022] [Indexed: 11/18/2022]
Abstract
Objective To investigate the clinical study of acupoint massage combined with recombinant bovine basic fibroblast growth factor (rbFGF) ophthalmic gel combined with limbal stem cell transplantation on visual quality, corneal refraction, and aesthetic outcome in patients with pterygium. Methods Sixty patients with pterygium treated in People's Hospital of Lujiang County from March 2018 to May 2021 were randomized into the control group and the research group by the random number table method, with 30 cases in each group. The control group received rbFGF plus limbal stem cell transplantation. The research group was treated with acupoint massage additionally. Results The total clinical effective rate in the study group was higher than that in the control group (P < 0.05); after treatment, the modulation transfer function (MTF) cutoff and Strehl ratio (SR) levels in the study group were significantly higher than those in the control group, and the tear film-related objective scatter index (TF-OSI) was significantly lower than that in the control group (P < 0.05); corneal horizontal curvature and corneal vertical curvature in the study group after treatment were significantly higher than those in the control group, and corneal astigmatism degree (CAD) levels were significantly lower than those in the control group (P < 0.05); the levels of the break-up time (BUT) and Schirmer test (SIT) in the study group were significantly higher after treatment, compared with the control group (P < 0.05); and the incidence of adverse manifestations in the study group was significantly lower than that in the control group (P < 0.05). Conclusion Acupoint massage combined with rbFGF ophthalmic gel combined with limbal stem cell transplantation is effective in clinical treatment of pterygium.
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Auw-Hädrich C, Gasser L, Reinhard T. Bindehautdegenerationen und -neoplasien. AUGENHEILKUNDE UP2DATE 2022. [DOI: 10.1055/a-1488-0383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
ZusammenfassungErhabenheiten der Bindehaut entstehen durch Gewebevermehrung, die entweder degenerativ oder neoplastisch, aber auch entzündlich sein können. In diesem Artikel werden degenerative (Pterygium
und Pinguecula) sowie benigne und maligne neoplastische Bindehautveränderungen (epitheliale, melanozytäre und vaskuläre Tumoren, Choristome sowie Metastasen) bezüglich der Pathogenese,
Symptome, Diagnostik und aktuellem Stand der Behandlung dargestellt.
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Auw-Hädrich C, Gasser L, Reinhard T. [Conjunctival Degeneration and Neoplasia]. Klin Monbl Augenheilkd 2022; 239:823-845. [PMID: 35609810 DOI: 10.1055/a-1831-2648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Conjunctival tumors result from gain of tissue, which can be either degenerative or neoplastic, but also inflammatory. In this article, degenerative (pterygium and pinguecula) as well as benign and malignant neoplastic conjunctival changes (epithelial, melanocytic and vascular tumors, choristomas as well as metastases) are discussed with regard to pathogenesis, symptoms, diagnostics and current status of treatment.
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Wu X, Dong S, Xu Y, Zhu G, Yan M. Evaluation of JUN, FN1 and LAMB1 polymorphisms in pterygium in a Chinese Han population. Ophthalmic Genet 2022; 43:488-495. [PMID: 35445627 DOI: 10.1080/13816810.2022.2065511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
PURPOSE To explore the underlying molecular mechanism of pterygium and identify the key genes regulating the development of pterygium. METHODS Differentially expressed mRNAs were obtained from the Gene Expression Omnibus (GEO) database. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) analyses were performed using the DAVID (http://david.abcc.ncifcrf.gov/). The differential expressions of hub genes were verified using the reverse transcription-real-time fluorescent quantitative PCR (RT-qPCR). The function of the hub genes was further confirmed based on associations between the single nucleotide polymorphisms (SNPs) in hub genes and pterygium. The genotyping results were analyzed using SNPStats online software in five gene models, including codominant, dominant, recessive, overdominant, and log-additive. Five gene models were analyzed using SNPStats. RESULTS We found that 240 genes were significantly differentially expressed. Functional enrichment analysis showed that focal adhesion pathway is extremely meaningful, among which JUN, FN1, and LAMB1 were verified to significantly differentially express in pterygium (P = 0.0011, P = 0.0018, and P = 0.0050, respectively). However, the all nine candidate SNPs (rs11688, rs3748814 in JUN; rs1263, rs1132741, rs1250259 in FN1; rs20556, rs35710474, rs25659, rs4320486 in LAMB1), were not statistically associated with pterygium. CONCLUSION Our results demonstrated that JUN, FN1, and LAMB1 polymorphisms were not associated with susceptibility to pterygium in Chinese Han population. Considering the fact that these three genes are differentially expressed in pterygium, further research is needed to explain its involvement in pterygium.
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Affiliation(s)
- Xiying Wu
- Department of Ophthalmology, Zhongnan Hospital of Wuhan University, Wuhan, Hubei Province, China
| | - Shiqi Dong
- Department of Cataract, Hankou Aier Eye Hospital, Wuhan, Hubei Province, China
| | - Yuting Xu
- Department of Pediatric Ophthalmology, The Affiliated Eye Hospital of Nanjing Medical University, Nanjing, Jiangsu Province, China
| | - Ge Zhu
- Department of Ophthalmology, Zhongnan Hospital of Wuhan University, Wuhan, Hubei Province, China
| | - Ming Yan
- Department of Ophthalmology, Zhongnan Hospital of Wuhan University, Wuhan, Hubei Province, China
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Zhang X, Jiang Y, Wang Q, An W, Zhang X, Xu M, Chen Y. Atypical U3 snoRNA Suppresses the Process of Pterygium Through Modulating 18S Ribosomal RNA Synthesis. Invest Ophthalmol Vis Sci 2022; 63:17. [PMID: 35472218 PMCID: PMC9055567 DOI: 10.1167/iovs.63.4.17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Background The progression and recurrence of pterygium mainly occur due to the abnormal proliferation and migration of stromal pterygium fibroblasts. This research explores the aberrant expression of small nucleolar RNA U3 (U3 snoRNA) in pterygium and elucidates the molecular mechanisms of U3 snoRNA in pterygium development. Methods Primary human conjunctival fibroblasts (HCFs) and human pterygium fibroblasts (HPFs) were separated and cultured from fresh conjunctiva grafts and pterygium tissues. The PLKO.1 lentiviral system and CRISPR/Cas9 recombinant construct were, respectively, used to overexpress and silence U3 snoRNA in HPFs and HCFs for further specific phenotype analysis. RNA-seq and TMT-labeled quantitative protein mass spectrometry were utilized to evaluate the effect of U3 snoRNA on mRNA transcripts and protein synthesis. Results Reduced U3 snoRNA in pterygium promotes HCF or HPF cells’ proliferation, migration, and cell cycle but has no significant effect on apoptosis. U3 snoRNA modulates 18S rRNA synthesis through shearing precursor ribosomal RNA 47S rRNA at the 5′ external transcribed spacer (5′ ETS). Moreover, the altered U3 snoRNA causes mRNA and protein differential expression in HCF or HPF cells. Conclusions The atypical U3 snoRNA regulates the translation of specific proteins to exert a suppressive function in pterygium through modulating the 18S rRNA synthesis. Here, we uncover a novel insight into U3 snoRNA biology in the development of pterygium.
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Affiliation(s)
- Xin Zhang
- Department of Ophthalmology, Yangpu Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Yaping Jiang
- Department of Ophthalmology, Yangpu Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Qian Wang
- Department of Oncology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Weishu An
- Department of Oncology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xiaoyan Zhang
- Department of Ophthalmology, Huashan Hospital, Fudan University, Shanghai, China
| | - Ming Xu
- Department of Oncology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yihui Chen
- Department of Ophthalmology, Yangpu Hospital, School of Medicine, Tongji University, Shanghai, China
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Kate A, Jain N, Jakati S, Basu S. Conjunctival Autograft for Tarsal Keratinization in a Case of Chronic Vernal Keratoconjunctivitis. Cureus 2022; 14:e23089. [PMID: 35464522 PMCID: PMC8996432 DOI: 10.7759/cureus.23089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/06/2022] [Indexed: 11/16/2022] Open
Abstract
This report describes the clinical features and management in a case of vernal keratoconjunctivitis (VKC) with bilateral tarsal conjunctival keratinization. A 32-year-old male presented with VKC since childhood that had exacerbated in the eight years prior to presentation. Examination revealed partial limbal stem cell deficiency in both eyes, with keratinization of the superior tarsal conjunctiva. The corresponding areas of the cornea exhibited punctate keratopathy in both eyes. To address this, the patient underwent excision of the conjunctival keratinization in both eyes. The resultant bare areas were covered with conjunctival autografts (CAGs). Postoperatively, the grafts were well apposed, and there was no recurrence of keratinization observed during the period of follow-up of four years. Resolution of corneal epitheliopathy was also noted. Although keratinization can occur in eyes with VKC, it is usually limited to the bulbar conjunctival areas. This is the first report of tarsal conjunctival keratinization in such cases. Milder cases may be observed or managed with scleral contact lenses. In more severe forms, there is associated corneal epitheliopathy, which may progress to corneal vascularization and scarring. Surgical excision of the lesion is recommended in these eyes. Following excision, several options exist to cover the bare area, which include a CAG, an amniotic membrane, or an oral mucous membrane. Of these, a CAG is an autologous tissue that can be harvested with a simple surgical technique and yields stable long-term results. Thus, tarsal conjunctival keratinization is a rare complication of chronic VKC. Excision of the lesion followed by a CAG is a viable approach for treatment, which reestablishes and maintains a stable ocular surface.
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Zhong Z, Wang J, Tian J, Deng X, Balayan A, Sun Y, Xiang Y, Guan J, Schimelman J, Hwang H, You S, Wu X, Ma C, Shi X, Yao E, Deng SX, Chen S. Rapid 3D bioprinting of a multicellular model recapitulating pterygium microenvironment. Biomaterials 2022; 282:121391. [PMID: 35101743 PMCID: PMC10162446 DOI: 10.1016/j.biomaterials.2022.121391] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Revised: 01/17/2022] [Accepted: 01/23/2022] [Indexed: 12/25/2022]
Abstract
Pterygium is an ocular surface disorder with high prevalence that can lead to vision impairment. As a pathological outgrowth of conjunctiva, pterygium involves neovascularization and chronic inflammation. Here, we developed a 3D multicellular in vitro pterygium model using a digital light processing (DLP)-based 3D bioprinting platform with human conjunctival stem cells (hCjSCs). A novel feeder-free culture system was adopted and efficiently expanded the primary hCjSCs with homogeneity, stemness and differentiation potency. The DLP-based 3D bioprinting method was able to fabricate hydrogel scaffolds that support the viability and biological integrity of the encapsulated hCjSCs. The bioprinted 3D pterygium model consisted of hCjSCs, immune cells, and vascular cells to recapitulate the disease microenvironment. Transcriptomic analysis using RNA sequencing (RNA-seq) identified a distinct profile correlated to inflammation response, angiogenesis, and epithelial mesenchymal transition in the bioprinted 3D pterygium model. In addition, the pterygium signatures and disease relevance of the bioprinted model were validated with the public RNA-seq data from patient-derived pterygium tissues. By integrating the stem cell technology with 3D bioprinting, this is the first reported 3D in vitro disease model for pterygium that can be utilized for future studies towards personalized medicine and drug screening.
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Affiliation(s)
- Zheng Zhong
- Department of NanoEngineering, University of California San Diego, La Jolla, CA, 92093, USA
| | - Jing Wang
- Department of Human Genetics, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, 90095, USA
| | - Jing Tian
- Department of NanoEngineering, University of California San Diego, La Jolla, CA, 92093, USA
| | - Xiaoqian Deng
- Department of Human Genetics, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, 90095, USA
| | - Alis Balayan
- Department of NanoEngineering, University of California San Diego, La Jolla, CA, 92093, USA; School of Medicine, University of California San Diego, La Jolla, CA, 92093, USA
| | - Yazhi Sun
- Department of NanoEngineering, University of California San Diego, La Jolla, CA, 92093, USA
| | - Yi Xiang
- Department of NanoEngineering, University of California San Diego, La Jolla, CA, 92093, USA
| | - Jiaao Guan
- Department of NanoEngineering, University of California San Diego, La Jolla, CA, 92093, USA
| | - Jacob Schimelman
- Department of NanoEngineering, University of California San Diego, La Jolla, CA, 92093, USA
| | - Henry Hwang
- Department of NanoEngineering, University of California San Diego, La Jolla, CA, 92093, USA
| | - Shangting You
- Department of NanoEngineering, University of California San Diego, La Jolla, CA, 92093, USA
| | - Xiaokang Wu
- School of Medicine, University of California San Diego, La Jolla, CA, 92093, USA
| | - Chao Ma
- Stein Eye Institute, University of California Los Angeles, Los Angeles, CA, 90095, USA
| | - Xiaoao Shi
- Department of NanoEngineering, University of California San Diego, La Jolla, CA, 92093, USA
| | - Emmie Yao
- Department of NanoEngineering, University of California San Diego, La Jolla, CA, 92093, USA
| | - Sophie X Deng
- Stein Eye Institute, University of California Los Angeles, Los Angeles, CA, 90095, USA
| | - Shaochen Chen
- Department of NanoEngineering, University of California San Diego, La Jolla, CA, 92093, USA.
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