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Braeu FA, Avril S, Girard MJA. 3D growth and remodeling theory supports the hypothesis of staphyloma formation from local scleral weakening under normal intraocular pressure. Biomech Model Mechanobiol 2024:10.1007/s10237-024-01885-9. [PMID: 39320690 DOI: 10.1007/s10237-024-01885-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2024] [Accepted: 08/10/2024] [Indexed: 09/26/2024]
Abstract
The purpose of this study was to assess whether growth and remodeling (G&R) theory could explain staphyloma formation from a local scleral weakening-as could occur from age-related elastin degradation, myopia progression, or other factors. A finite element model of a healthy eye was reconstructed, including the lamina cribrosa, the peripapillary sclera, and the peripheral sclera. The homogenized constrained mixture model was employed to simulate the adaptation of the sclera to alterations in its biomechanical environment over a duration of 13.7 years. G&R processes were triggered by reducing the shear stiffness of the ground matrix in the peripapillary sclera and lamina cribrosa by 85%. Three distinct G&R scenarios were investigated: (1) low mass turnover rate in combination with transmural volumetric growth; (2) high mass turnover rate in combination with transmural volumetric growth; and (3) high mass turnover rate in combination with mass density growth. In scenario 1, we observed a significant outpouching of the posterior pole, closely resembling the shape of a Type-III staphyloma. Additionally, we found a notable change in scleral curvature and a thinning of the peripapillary sclera by 84%. In contrast, scenario 2 and 3 exhibited less drastic deformations, with stable posterior staphylomas after approximately 7 years. Our proposed framework suggests that local scleral weakening is sufficient to trigger staphyloma formation under a normal level of intraocular pressure. Our model also reproduced characteristics of Type-III staphylomas. With patient-specific scleral geometries (as could be obtained with wide-field optical coherence tomography), our framework could be clinically translated to help us identify those at risks of developing posterior staphylomas.
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Affiliation(s)
- Fabian A Braeu
- Singapore Eye Research Institute (SERI), Singapore National Eye Centre (SNEC), Singapore, Singapore
- Singapore-MIT Alliance for Research and Technology, Singapore, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Stéphane Avril
- Mines Saint-Etienne, Université Jean Monnet, Saint-Etienne, France
| | - Michaël J A Girard
- Singapore Eye Research Institute (SERI), Singapore National Eye Centre (SNEC), Singapore, Singapore.
- Duke-NUS Graduate Medical School, Singapore, Singapore.
- Department of Biomedical Engineering, College of Design and Engineering, National University of Singapore, Singapore, Singapore.
- Department of Ophthalmology, Emory University School of Medicine, Atlanta, GA, USA.
- Department of Biomedical Engineering, Georgia Institute of Technology/Emory University, Atlanta, GA, USA.
- Emory Empathetic AI for Health Institute, Emory University, Atlanta, GA, USA.
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2
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Wen Y, Ren C, Zhu L, Huang L, Qi H, Yu W, Wang K, Zhao M, Xu Q. Unmasking of molecular players: proteomic profiling of vitreous humor in pathologic myopia. BMC Ophthalmol 2024; 24:352. [PMID: 39160465 PMCID: PMC11334356 DOI: 10.1186/s12886-024-03584-6] [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: 03/24/2024] [Accepted: 07/18/2024] [Indexed: 08/21/2024] Open
Abstract
BACKGROUND This study aimed to identify the differentially expressed proteins in the vitreous humor (VH) of eyes with and without pathologic myopia (PM), providing insights into the molecular pathogenesis. METHODS A cross-sectional, observational study was conducted. VH samples were collected from patients undergoing vitrectomy for idiopathic epiretinal membrane (ERM), macular hole (MH), or myopic retinoschisis (MRS). Label-free quantitative proteomic analysis identified differential protein expression, with validation using ELISA. RESULTS The proteomic profiling revealed significantly higher expressions of tubulin alpha 1a (TUBA1A) and eukaryotic translation elongation factor 1 alpha 1 (EEF1A1) in PM groups (MH-PM, MRS-PM) compared to controls (MH, ERM). Conversely, xylosyltransferase 1 (XYLT1), versican core protein (VCAN), and testican-2 (SPOCK2) expressions were lower in PM. ELISA validation confirmed these findings. CONCLUSIONS Our study provides novel insights into the molecular mechanisms of PM. The differentially expressed proteins EEF1A1, TUBA1A, XYLT1, VCAN, and SPOCK2 may play crucial roles in chorioretinal cell apoptosis, scleral extracellular matrix (ECM) synthesis, and scleral remodeling in PM. These proteins represent potential new targets for therapeutic intervention in PM, highlighting the importance of further investigations to elucidate their functions and underlying mechanisms in disease pathogenesis.
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Affiliation(s)
- Yue Wen
- Department of Ophthalmology, Beijing Key Laboratory of Diagnosis and Therapy of Retinal and Choroid Diseases, Peking University People's Hospital, Beijing, China
- College of Optometry, Peking University People's Hospital, Beijing, China
- Eye Disease and Optometry Institute, Beijing, China
- Peking University Health Science Center, No. 11 South Avenue of XiZhiMen, Xi Cheng District, 100044, Beijing, China
| | - Chi Ren
- Department of Ophthalmology, Beijing Key Laboratory of Diagnosis and Therapy of Retinal and Choroid Diseases, Peking University People's Hospital, Beijing, China
- College of Optometry, Peking University People's Hospital, Beijing, China
- Eye Disease and Optometry Institute, Beijing, China
- Peking University Health Science Center, No. 11 South Avenue of XiZhiMen, Xi Cheng District, 100044, Beijing, China
| | - Li Zhu
- Department of Ophthalmology, Beijing Key Laboratory of Diagnosis and Therapy of Retinal and Choroid Diseases, Peking University People's Hospital, Beijing, China
- College of Optometry, Peking University People's Hospital, Beijing, China
- Eye Disease and Optometry Institute, Beijing, China
- Peking University Health Science Center, No. 11 South Avenue of XiZhiMen, Xi Cheng District, 100044, Beijing, China
| | - Lvzhen Huang
- Department of Ophthalmology, Beijing Key Laboratory of Diagnosis and Therapy of Retinal and Choroid Diseases, Peking University People's Hospital, Beijing, China
- College of Optometry, Peking University People's Hospital, Beijing, China
- Eye Disease and Optometry Institute, Beijing, China
- Peking University Health Science Center, No. 11 South Avenue of XiZhiMen, Xi Cheng District, 100044, Beijing, China
| | - Huijun Qi
- Department of Ophthalmology, Beijing Key Laboratory of Diagnosis and Therapy of Retinal and Choroid Diseases, Peking University People's Hospital, Beijing, China
- College of Optometry, Peking University People's Hospital, Beijing, China
- Eye Disease and Optometry Institute, Beijing, China
- Peking University Health Science Center, No. 11 South Avenue of XiZhiMen, Xi Cheng District, 100044, Beijing, China
| | - Wenzhen Yu
- Department of Ophthalmology, Beijing Key Laboratory of Diagnosis and Therapy of Retinal and Choroid Diseases, Peking University People's Hospital, Beijing, China
- College of Optometry, Peking University People's Hospital, Beijing, China
- Eye Disease and Optometry Institute, Beijing, China
- Peking University Health Science Center, No. 11 South Avenue of XiZhiMen, Xi Cheng District, 100044, Beijing, China
| | - Kai Wang
- Department of Ophthalmology, Beijing Key Laboratory of Diagnosis and Therapy of Retinal and Choroid Diseases, Peking University People's Hospital, Beijing, China
- College of Optometry, Peking University People's Hospital, Beijing, China
- Eye Disease and Optometry Institute, Beijing, China
- Peking University Health Science Center, No. 11 South Avenue of XiZhiMen, Xi Cheng District, 100044, Beijing, China
| | - Mingwei Zhao
- Department of Ophthalmology, Beijing Key Laboratory of Diagnosis and Therapy of Retinal and Choroid Diseases, Peking University People's Hospital, Beijing, China.
- College of Optometry, Peking University People's Hospital, Beijing, China.
- Eye Disease and Optometry Institute, Beijing, China.
- Peking University Health Science Center, No. 11 South Avenue of XiZhiMen, Xi Cheng District, 100044, Beijing, China.
| | - Qiong Xu
- Department of Ophthalmology, Beijing Key Laboratory of Diagnosis and Therapy of Retinal and Choroid Diseases, Peking University People's Hospital, Beijing, China.
- College of Optometry, Peking University People's Hospital, Beijing, China.
- Eye Disease and Optometry Institute, Beijing, China.
- Peking University Health Science Center, No. 11 South Avenue of XiZhiMen, Xi Cheng District, 100044, Beijing, China.
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Zhang J, Xiao F, Zou H, Feng R, He J. Self-supervised learning-enhanced deep learning method for identifying myopic maculopathy in high myopia patients. iScience 2024; 27:110566. [PMID: 39211543 PMCID: PMC11359982 DOI: 10.1016/j.isci.2024.110566] [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: 01/08/2024] [Revised: 04/28/2024] [Accepted: 07/18/2024] [Indexed: 09/04/2024] Open
Abstract
Accurate detection and timely care for patients with high myopia present significant challenges. We developed a deep learning (DL) system enhanced by a self-supervised learning (SSL) approach to improve the automatic diagnosis of myopic maculopathy (MM). Using a dataset of 7,906 images from the Shanghai High Myopia Screening Project and a public validation set of 1,391 images from MMAC2023, our method significantly outperformed conventional techniques. Internally, it achieved 96.8% accuracy, 83.1% sensitivity, and 95.6% specificity, with AUC values of 0.982 and 0.999. Externally, it maintained 89.0% accuracy, 71.7% sensitivity, and 87.8% specificity, with AUC values of 0.978 and 0.973. The model's Cohen's kappa values exceeded 0.8, indicating substantial agreement with retinal experts. Our SSL-enhanced DL approach offers high accuracy and potential to enhance large-scale myopia screenings, demonstrating broader significance in improving early detection and treatment of MM.
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Affiliation(s)
- Juzhao Zhang
- Shanghai Eye Disease Prevention & Treatment Center/Shanghai Eye Hospital, School of Medicine, Tongji University, Shanghai, China
- National Clinical Research Center for Eye Diseases, Shanghai, China
- Department of Ophthalmology, Shanghai General Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Diseases, Shanghai, China
| | - Fan Xiao
- School of Computer Science, Shanghai Key Laboratory of Intelligent Information Processing, Fudan University, Shanghai, China
- Academy for Engineering and Technology, Fudan University, Shanghai, China
| | - Haidong Zou
- Shanghai Eye Disease Prevention & Treatment Center/Shanghai Eye Hospital, School of Medicine, Tongji University, Shanghai, China
- National Clinical Research Center for Eye Diseases, Shanghai, China
- Department of Ophthalmology, Shanghai General Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Diseases, Shanghai, China
| | - Rui Feng
- Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Diseases, Shanghai, China
- School of Computer Science, Shanghai Key Laboratory of Intelligent Information Processing, Fudan University, Shanghai, China
- Academy for Engineering and Technology, Fudan University, Shanghai, China
| | - Jiangnan He
- Shanghai Eye Disease Prevention & Treatment Center/Shanghai Eye Hospital, School of Medicine, Tongji University, Shanghai, China
- Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Diseases, Shanghai, China
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Lin Q, Wang X, Han T, Peng X, Zhou X. A novel variant in the keratin 12 gene in a four-generation Chinese family with high myopia. Eye (Lond) 2024:10.1038/s41433-024-03279-8. [PMID: 39095469 DOI: 10.1038/s41433-024-03279-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2023] [Revised: 07/05/2024] [Accepted: 07/22/2024] [Indexed: 08/04/2024] Open
Abstract
BACKGROUND High myopia is a major cause of visual impairment, and genetic factors play crucial roles in the pathogenesis. We performed this study to identify candidate genes for the development of high myopia in a four-generation Chinese family with myopia. METHODS All family members with myopia and 100 healthy participants were included in this study. Data were obtained on demographics, disease history, and ocular examination results. We performed whole exome sequencing of the genomic DNA and Sanger sequencing to verify the variants. Functional analyses of the variant were performed using software programmes. RESULTS Nine of thirteen family members were found to have high myopia, amongst which two members were also diagnosed keratoconus. A missense variant in the keratin 12 gene (KRT12, p.Val410Gly) was detected in all high myopia cases but not in other family members without high myopia or the controls. The variant was predicted to be benign by online software programmes. However, modelling of the three-dimensional structure of the protein clearly revealed conformational changes caused by the mutation. CONCLUSIONS A missense mutation in the KRT12 gene was identified in this Chinese family, which may be associated with the pathogenesis of high myopia.
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Affiliation(s)
- Qinghong Lin
- Department of Ophthalmology, Eye and ENT Hospital of Fudan University, Shanghai, 200000, China
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, 200031, China
- NHC Key Laboratory of Myopia (Fudan University); Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, 200031, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, 200000, China
- Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care (20DZ2255000), Shanghai, 200000, China
- Refractive Surgery Department, Bright Eye Hospital, Fuzhou, 350001, China
| | - Xuejun Wang
- Department of Ophthalmology, Eye and ENT Hospital of Fudan University, Shanghai, 200000, China
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, 200031, China
- NHC Key Laboratory of Myopia (Fudan University); Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, 200031, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, 200000, China
- Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care (20DZ2255000), Shanghai, 200000, China
| | - Tian Han
- Department of Ophthalmology, Eye and ENT Hospital of Fudan University, Shanghai, 200000, China
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, 200031, China
- NHC Key Laboratory of Myopia (Fudan University); Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, 200031, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, 200000, China
- Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care (20DZ2255000), Shanghai, 200000, China
| | - Xiaoliao Peng
- Department of Ophthalmology, Eye and ENT Hospital of Fudan University, Shanghai, 200000, China
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, 200031, China
- NHC Key Laboratory of Myopia (Fudan University); Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, 200031, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, 200000, China
- Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care (20DZ2255000), Shanghai, 200000, China
| | - Xingtao Zhou
- Department of Ophthalmology, Eye and ENT Hospital of Fudan University, Shanghai, 200000, China.
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, 200031, China.
- NHC Key Laboratory of Myopia (Fudan University); Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, 200031, China.
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, 200000, China.
- Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care (20DZ2255000), Shanghai, 200000, China.
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Midorikawa M, Mori K, Torii H, Tomita Y, Zhang Y, Tsubota K, Kurihara T, Negishi K. Choroidal thinning in myopia is associated with axial elongation and severity of myopic maculopathy. Sci Rep 2024; 14:17600. [PMID: 39080368 PMCID: PMC11289249 DOI: 10.1038/s41598-024-68314-w] [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: 04/29/2024] [Accepted: 07/22/2024] [Indexed: 08/02/2024] Open
Abstract
High myopia can lead to pathologic myopia and visual impairment, whereas its causes are unclear. We retrospectively researched high myopia cases from patient records to investigate the association between axial elongation and myopic maculopathy. Sixty-four eyes were examined in patients who visited the department between July 2017 and June 2018, had an axial length of 26 mm or more, underwent fundus photography, and had their axial length measured twice or more. The average axial length was 28.29 ± 1.69 mm (mean ± standard deviation). The average age was 58.3 ± 14.4 years old. Myopic maculopathy was categorized as mild (grades 0 and 1) and severe (grades 2, 3, and 4). The severe group had longer axial lengths than the mild group (P < 0.05). Moreover, the severe group exhibited thinner choroidal thickness than the mild group (P < 0.05). When subjects were grouped by axial elongation over median value within a year, the elongation group showed thinner central choroidal thickness than the non-elongation group (142.1 ± 91.9 vs. 82.9 ± 69.8, P < 0.05). In conclusion, in patients with high myopia, the severity of maculopathy correlated with choroidal thickness and axial length. Thinner choroidal thickness was associated with axial elongation based on the baseline axial length.
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Affiliation(s)
- Momoka Midorikawa
- Department of Ophthalmology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Kiwako Mori
- Department of Ophthalmology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
- Laboratory of Photobiology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Hidemasa Torii
- Department of Ophthalmology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
- Laboratory of Photobiology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Yohei Tomita
- Department of Ophthalmology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
- Laboratory of Photobiology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
- Chorioretinal Biology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Yan Zhang
- Laboratory of Photobiology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Kazuo Tsubota
- Department of Ophthalmology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan.
- Tsubota Laboratory, Inc., 34 Shinanomachi, Shinjuku-ku, Tokyo, 160-0016, Japan.
| | - Toshihide Kurihara
- Department of Ophthalmology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan.
- Laboratory of Photobiology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan.
| | - Kazuno Negishi
- Department of Ophthalmology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan.
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Lin HJ, Huang YT, Liao WL, Huang YC, Chang YW, Weng AL, Tsai FJ. Developing a Polygenic Risk Score with Age and Sex to Identify High-Risk Myopia in Taiwan. Biomedicines 2024; 12:1619. [PMID: 39062192 PMCID: PMC11274619 DOI: 10.3390/biomedicines12071619] [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: 06/06/2024] [Revised: 07/12/2024] [Accepted: 07/15/2024] [Indexed: 07/28/2024] Open
Abstract
Myopia is the leading cause of impaired vision, and its prevalence is increasing among Asian populations. This study aimed to develop a polygenic risk score (PRS) followed by replication to predict myopia in the Taiwanese population. In total, 23,688 participants with cycloplegic autorefraction-measured mean spherical equivalent (SE), genetic, and demographic data were included. The myopia PRS was generated based on genome-wide association study (GWAS) outcomes in a Taiwanese population and previously published GWAS reports. The results demonstrated that the inclusion of age and sex in the PRS had an area under the curve (AUC) of 0.80, 0.78, and 0.73 (p < 0.001) for participants aged >18 years with high (SE < -6.0 diopters (D); n = 1089), moderate (-6.0 D < SE ≤ -3.0 D; n = 3929), and mild myopia (-3.0 D < SE ≤ -1.0 D; n = 2241), respectively. Participants in the top PRS quartile had a 1.30-fold greater risk of high myopia (95% confidence interval = 1.09-1.55, p = 0.003) compared with that in the remaining participants. Further, a higher PRS significantly increased the risk of high myopia (SE ≤ -2.0 D) in children ≤6 years of age (p = 0.027). In conclusion, including the PRS, age, and sex improved the prediction of high myopia risk in the Taiwanese population.
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Affiliation(s)
- Hui-Ju Lin
- Department of Ophthalmology, China Medical University Hospital, Taichung 404327, Taiwan; (H.-J.L.); (Y.-T.H.)
- School of Chinese Medicine, China Medical University, Taichung 404328, Taiwan;
| | - Yu-Te Huang
- Department of Ophthalmology, China Medical University Hospital, Taichung 404327, Taiwan; (H.-J.L.); (Y.-T.H.)
| | - Wen-Ling Liao
- Center for Personalized Medicine, China Medical University Hospital, Taichung 404327, Taiwan;
- Graduate Institute of Integrated Medicine, China Medical University, Taichung 404328, Taiwan
| | - Yu-Chuen Huang
- School of Chinese Medicine, China Medical University, Taichung 404328, Taiwan;
- Genetic Center, Department of Medical Research, China Medical University Hospital, Taichung 404327, Taiwan;
| | - Ya-Wen Chang
- Genetic Center, Department of Medical Research, China Medical University Hospital, Taichung 404327, Taiwan;
| | - Angel L. Weng
- American School in Taichung, Taichung 406051, Taiwan;
| | - Fuu-Jen Tsai
- School of Chinese Medicine, China Medical University, Taichung 404328, Taiwan;
- Department of Medical Genetics, China Medical University Hospital, Taichung 404327, Taiwan
- Children’s Hospital of China Medical University, Taichung 404327, Taiwan
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Wan Q, He P, Wei R, Ma K, Yin H, Tang J, Deng YP. Long-term observation of V4c implantable collamer lenses implantation for moderate to extreme high myopia correction: five years follow-up. Eye (Lond) 2024; 38:1933-1940. [PMID: 38519715 PMCID: PMC11226664 DOI: 10.1038/s41433-024-03046-9] [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: 06/13/2023] [Revised: 03/06/2024] [Accepted: 03/18/2024] [Indexed: 03/25/2024] Open
Abstract
BACKGROUND This study aims to assess the long term effectiveness, safety, predictability and stability of V4c implantable collamer lenses (ICL) for correction of moderate to extreme high myopia. METHODS We reviewed 125 eyes from 64 patients who implanted V4c ICL at the Refractive Surgery Center of West China Hospital in Chengdu, China, between May 2015 and January 2017. The median spherical equivalent was -11.50 D (interquartile range [IQR]: -13.00 to -9.00 D). We followed up with the patients over five years and evaluated several parameters, including uncorrected visual acuity (UDVA), corrected visual acuity (CDVA), axial length, refractive error, endothelial cell density (ECD), intraocular pressure (IOP), white-to-white distance (WTW), and vault. We performed a correlation analysis to explore the potential impacts on vault following implantation. RESULTS The median safety index (postoperative CDVA/preoperative CDVA) during the last follow-up was 1.00 (interquartile range [IQR]: 1.00-1.20), and the efficacy indices (postoperative UDVA/preoperative CDVA) were 1.20 (IQR: 1.00-1.25), 1.20 (IQR: 1.00-1.33), and 0.8 (IQR: 0.65-1.00) at postoperative 1 week, 1 month, and 5 years, respectively. At the five-year mark, 16% of the eyes were within ±0.50 D of expected correction, and 73% were within ±2.00 D. No significant difference in ECD was observed between pre-operative and post-operative measurements. Compared to baseline, we observed a significant increase in IOP at the one-week follow-up, which decreased significantly at the one-month visit. Furthermore, we identified ICL size and spherical equivalent (SE) as independent variables in a multiple linear regression model that accurately predicted the five-year vault after surgery. CONCLUSION In conclusion, V4c ICL implantation is an effective and safe treatment for moderate to extreme high myopia with good predictability and stability over the long-term.
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Affiliation(s)
- Qi Wan
- Department of Ophthalmology, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Peiyuan He
- Department of Ophthalmology, West China Hospital of Sichuan University, Chengdu, Sichuan, China
- Department of Health Management & Institute of Health Management, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, Sichuan, China
| | - Ran Wei
- Department of Ophthalmology, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Ke Ma
- Department of Ophthalmology, West China Hospital of Sichuan University, Chengdu, Sichuan, China.
| | - Hongbo Yin
- Department of Ophthalmology, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Jing Tang
- Department of Ophthalmology, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Ying-Ping Deng
- Department of Ophthalmology, West China Hospital of Sichuan University, Chengdu, Sichuan, China.
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Ge JY, Teo ZL, Chee ML, Tham YC, Rim TH, Cheng CY, Wong TY, Wong EYM, Lee SY, Cheung N. International incidence and temporal trends for rhegmatogenous retinal detachment: A systematic review and meta-analysis. Surv Ophthalmol 2024; 69:330-336. [PMID: 38000699 DOI: 10.1016/j.survophthal.2023.11.005] [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: 03/06/2023] [Revised: 11/15/2023] [Accepted: 11/20/2023] [Indexed: 11/26/2023]
Abstract
We set out to estimate the international incidence of rhegmatogenous retinal detachment (RRD) and to evaluate its temporal trend over time. There is a lack of robust estimates on the worldwide incidence and trend for RRD, a major cause of acute vision loss. We conducted a systematic review of RRD incidence. The electronic databases PubMed, Scopus, and Thomson Reuters' Web of Science were searched from inception through 2nd June 2022. Random-effects meta-analysis model with logit transformation was performed to obtain pooled annual incidence estimates of RRD. Pooled analysis was performed to evaluate the temporal trend of RRD incidence of the 20,958 records identified from the database searches; 33 studies from 21 countries were included for analysis (274,836 cases of RRD in 273,977 persons). Three of the 6 global regions as defined by WHO had studies that met the inclusion and exclusion criteria of the study. The annual international incidence of RRD was estimated to be 12.17 (95% confidence interval [CI] 10.51-14.09) per 100,000 population; with an increasing temporal trend of RRD at 5.4 per 100,000 per decade (p 0.001) from 1997 to 2019. Amongst world regions, the RRD incidence was highest in Europe (14.52 [95% CI 11.79 - 17.88] per 100,000 population), followed by Western Pacific (10.55 [95% CI 8.71-12.75] per 100,000 population) and Regions of Americas (8.95 [95% CI 6.73-11.92] per 100,000 population). About one in 10,000 persons develop RRD each year. There is evidence of increasing trend for RRD incidence over time, with possibly doubling of the current incidence rate within the next 2 decades.
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Affiliation(s)
- Jasmine Yaowei Ge
- Singapore National Eye Centre, Singapore Eye Research Institute, Singapore
| | - Zhen Ling Teo
- Singapore National Eye Centre, Singapore Eye Research Institute, Singapore
| | - Miao Li Chee
- Singapore National Eye Centre, Singapore Eye Research Institute, Singapore
| | - Yih-Chung Tham
- Singapore National Eye Centre, Singapore Eye Research Institute, Singapore; Duke-NUS Medical School, Singapore; Centre for Innovation and Precision Eye Health, Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore
| | | | - Ching-Yu Cheng
- Singapore National Eye Centre, Singapore Eye Research Institute, Singapore; Duke-NUS Medical School, Singapore; Centre for Innovation and Precision Eye Health, Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore
| | - Tien Yin Wong
- Singapore National Eye Centre, Singapore Eye Research Institute, Singapore; Duke-NUS Medical School, Singapore; Tsinghua Medicine, Tsinghua University, Beijing, China
| | | | - Shu Yen Lee
- Singapore National Eye Centre, Singapore Eye Research Institute, Singapore
| | - Ning Cheung
- Singapore National Eye Centre, Singapore Eye Research Institute, Singapore; Duke-NUS Medical School, Singapore.
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9
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Zheng T, Fu W, Jiang S, Yang X. Inverse L-Shaped Association Between Body Mass Index and Myopia in Chinese Schoolchildren: A Pilot Study. J Multidiscip Healthc 2024; 17:1839-1846. [PMID: 38680876 PMCID: PMC11055557 DOI: 10.2147/jmdh.s458978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Accepted: 04/09/2024] [Indexed: 05/01/2024] Open
Abstract
Purpose The prevalence of obesity and myopia in young people is increasing worldwide; however, the association between body mass index (BMI) and myopia remains controversial. This study aimed to assess the association between BMI and myopia in Chinese schoolchildren. Patients and Methods In this study, the open data for analysis were obtained from DATADRYAD website (www.datadryad.org). A total of 3658 children were enrolled in this study. Logistic regression model was used to analyze the relationship between BMI and myopia. Results Compared with individuals with lower BMI Q1 (less than 25 kg/m2), the adjusted odds ratios (ORs) for BMI and myopia were 2.15 (95% confidence interval [CI]: 1.62-2.86) in Q2 (25.0-29.9 kg/m2) and 2.39 (95% CI: 1.37-4.18) in Q3 (30.0 kg/m2 or more). Moreover, the association between BMI and myopia exhibited an inverted L-shaped curve (nonlinear; p < 0.001). When the BMI was <25 kg/m2, an increased BMI was significantly associated with a higher risk of myopia (OR = 1.244 [95% CI: 1.211-1.277], p < 0.001). However, when the BMI was ≥25 kg/m2, the association lost its significance (OR = 1.063 [95% Cl: 0.964-1.171], p = 0.219). Conclusion This study found an inverted L-shaped association between BMI and myopia in Chinese schoolchildren. A higher BMI was associated with a higher risk of myopia reaching 25 kg/m2, after which an increase in BMI was no longer associated with an increased risk of myopia.
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Affiliation(s)
- Tianli Zheng
- School of Biomedical Engineering (Suzhou), Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, People’s Republic of China
- Suzhou Institute of Biomedical Engineering and Technology, Chinese Academy of Science, Suzhou, Jiangsu, People’s Republic of China
| | - Weiwei Fu
- School of Biomedical Engineering (Suzhou), Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, People’s Republic of China
- Suzhou Institute of Biomedical Engineering and Technology, Chinese Academy of Science, Suzhou, Jiangsu, People’s Republic of China
| | - Shuang Jiang
- The Third Affiliated Hospital of Jinzhou Medical University, Jinzhou, Liaoning, People’s Republic of China
| | - Xiaodong Yang
- School of Biomedical Engineering (Suzhou), Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, People’s Republic of China
- Suzhou Institute of Biomedical Engineering and Technology, Chinese Academy of Science, Suzhou, Jiangsu, People’s Republic of China
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Wan C, Fang J, Li K, Zhang Q, Zhang S, Yang W. A new segmentation algorithm for peripapillary atrophy and optic disk from ultra-widefield Photographs 1. Comput Biol Med 2024; 172:108281. [PMID: 38503096 DOI: 10.1016/j.compbiomed.2024.108281] [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: 09/28/2023] [Revised: 03/09/2024] [Accepted: 03/12/2024] [Indexed: 03/21/2024]
Abstract
BACKGROUND AND OBJECTIVE The prevalence of myopia and high myopia is increasing globally, underscoring the growing importance of diagnosing high myopia-related pathologies. While existing image segmentation models, such as U-Net, UNet++, ResU-Net, and TransUNet, have achieved significant success in medical image segmentation, they still face challenges when dealing with ultra-widefield (UWF) fundus images. This study introduces a novel automatic segmentation algorithm for the optic disc and peripapillary atrophy (PPA) based on UWF fundus images, aimed at assisting ophthalmologists in more accurately diagnosing high myopia-related diseases. METHODS In this study, we developed a segmentation model leveraging a Transformer-based network structure, complemented by atrous convolution and selective boundary aggregation modules, to elevate the accuracy of segmenting the optic disc and PPA in UWF photography. The atrous convolution module adeptly manages multi-scale features, catering to the variances in target sizes and expanding the deep network's receptive field. Concurrently, the incorporation of the selective boundary aggregation module in the skip connections of the model significantly improves the differentiation of boundary information between segmentation targets. Moreover, the comparison of our proposed algorithm with classical segmentation models like U-Net, UNet++, ResU-Net, and TransUNet highlights its considerable advantages in processing UWF photographs. RESULTS The experimental results show that, compared to the other four models, our algorithm demonstrates substantial improvements in segmenting the optic disc and PPA in UWF photographs. In PPA segmentation, our algorithm improves by 0.8% in Dice, 1.8% in sensitivity, and 1.3% in intersection over union (IOU). In optic disc segmentation, our algorithm improves by 0.3% in Dice, 0.6% in precision, and 0.4% in IOU. CONCLUSION Our proposed method improves the segmentation accuracy of PPA and optic disks based on UWF photographs, which is valuable for diagnosing high myopia-related diseases in ophthalmology clinics.
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Affiliation(s)
- Cheng Wan
- College of Electronic Information Engineering, Nanjing University of Aeronautics and Astronautics, Nanjing, 211106, China
| | - Jiyi Fang
- College of Electronic Information Engineering, Nanjing University of Aeronautics and Astronautics, Nanjing, 211106, China
| | - Kunke Li
- Shenzhen Eye Institute, Shenzhen Eye Hospital, Jinan University, Shenzhen, 518040, China
| | - Qing Zhang
- The Third Affiliated Hospital of Xinxiang Medical University, Xinxiang Medical University, Xinxiang, 453000, China
| | - Shaochong Zhang
- Shenzhen Eye Institute, Shenzhen Eye Hospital, Jinan University, Shenzhen, 518040, China.
| | - Weihua Yang
- Shenzhen Eye Institute, Shenzhen Eye Hospital, Jinan University, Shenzhen, 518040, China.
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11
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Wang SW, Igarashi-Yokoi T, Mochida S, Fujinami K, Ohno-Matsui K. PREVALENCE AND CLINICAL FEATURES OF RADIAL FUNDUS AUTOFLUORESCENCE IN HIGH MYOPIC WOMEN. Retina 2024; 44:446-454. [PMID: 37948743 DOI: 10.1097/iae.0000000000003981] [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: 05/13/2023] [Accepted: 10/21/2023] [Indexed: 11/12/2023]
Abstract
PURPOSE To determine the prevalence and characteristics of radial fundus autofluorescence (FAF) in highly myopic women. METHODS This was a retrospective, observational case study to determine the prevalence of radial FAF in the ultra-widefield FAF images in women. The clinical characteristics of these patients were evaluated. RESULTS Fifteen of 1,935 (0.78%) highly myopic women were found to have radial FAF. Their mean age was 36.6 ± 25.6 years, and their mean best-corrected visual acuity was 0.3 ± 0.42 logMAR units. The mean axial length (AL) was 28.8 ± 2.8 mm. Among the 15 cases, eight did not have pigmentary changes and seven had pigmentary changes in the ultra-widefield FAF images. The women with the pigmentary changes were significantly older ( P = 0.021), had poorer BCVA ( P = 0.001), and had longer ALs ( P = 0.002). The visual fields and electroretinograms were worse in the eyes with pigmentary changes. CONCLUSION The prevalence of radial FAF was 0.78% in women with high myopia. These patients might have mutations in the RPGR or RP2 genes and can develop high myopia and retinitis pigmentosa. Ultra-widefield FAF images should be examined in all highly myopic patients for early detection of radial FAF, and myopia prevention and genetic counseling for possible genetic therapy are recommended.
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Affiliation(s)
- Shih-Wen Wang
- Department of Ophthalmology and Visual Science, Tokyo Medical and Dental University, Tokyo, Japan
- Department of Ophthalmology, Shuang Ho Hospital, Taipei Medical University, Taiwan, ROC
| | - Tae Igarashi-Yokoi
- Department of Ophthalmology and Visual Science, Tokyo Medical and Dental University, Tokyo, Japan
| | - Shiho Mochida
- Department of Ophthalmology, Tokyo Metropolitan Ohkubo Hospital, Tokyo, Japan; and
| | - Kaoru Fujinami
- National Institute of Sensory Organs, National Hospital Organization, Tokyo Medical Center, Tokyo Japan
| | - Kyoko Ohno-Matsui
- Department of Ophthalmology and Visual Science, Tokyo Medical and Dental University, Tokyo, Japan
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Yang L, Xu Y, Zhou P, Wan G. The SNTB1 and ZFHX1B gene have susceptibility in northern Han Chinese populations with high myopia. Exp Eye Res 2023; 237:109694. [PMID: 37890754 DOI: 10.1016/j.exer.2023.109694] [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: 08/12/2023] [Revised: 10/11/2023] [Accepted: 10/24/2023] [Indexed: 10/29/2023]
Abstract
The aim of this study was to explore the association between SNTB1 and ZFHX1B polymorphisms and high myopia (HM) in a Northern Han Chinese population. This case-control study included 457 HM and 860 healthy subjects from the Northern Han Chinese population. Four single nucleotide polymorphisms (SNPs) (rs7839488, rs4395927, rs4455882, and rs6469937) in SNTB1 and one SNP in ZFHX1B (rs13382811)were selected based on two previous genome-wide association study (GWAS) studies. The allele and genotype distributions of SNPs in SNTB1 and ZFHX1B were compared between the two groups using the chi-square test. The allele results were adjusted for age and sex using Plink software (Plink 1.9). Pairwise linkage disequilibrium (LD) and haplotype analyses were performed using SHEsis software. For HM subjects, the mean age was 44.80 ± 17.11 years, and for the control subjects, it was 44.41 ± 14.26 years. For rs7839488 of the SNTB1 gene, the A allele is a risk allele and the G allele is a wild allele. The A allele had no statistical significance with the HM cases and controls (OR = 0.90, 95% CI = 0.74-1.09, aP = 0.273, Pc = NS). There was a LD in SNTB1 (rs7839488, rs4395927, rs4455882, and rs6469937). The G-C-A-G haplotype frequency was higher in HM subjects than that of the controls (OR = 1.31, 95% CI = 1.07-1.60, P = 0.008). Meanwhile, the A-T-G-A haplotype frequency was slightly lower in the HM group (OR = 0.81, 95% CI = 0.66-0.99, P = 0.048). In the ZFHX1B gene, the frequency of the minor T allele of rs13382811 was significant higher in the HM group than in the control group (OR = 1.34, 95% CI = 1.11-1.61, aP = 0.001, Pc = 0.009). Furthermore, compared to the CC genotype, there were significant differences in the CT genotype (OR = 1.57, 95% CI = 1.23-2.00, aP < 0.001, Pc = 0.002). In conclusion, G-C-A-G is a risk haplotype from the SNTB1 gene in high myopia patients. The minor T-allele of ZFHX1B rs13382811 is a risk factor for high myopia. SNTB1 and ZFHX1B are both risk genes associated with increased susceptibility to high myopia in the Northern Han Chinese population.
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Affiliation(s)
- Lin Yang
- Department of Ophthalmology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, PR China
| | - Youmei Xu
- Department of Ophthalmology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, PR China
| | - Pengyi Zhou
- Department of Ophthalmology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, PR China
| | - Guangming Wan
- Department of Ophthalmology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, PR China.
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Wen K, Zhang L, Cai Y, Teng H, Liang J, Yue Y, Li Y, Huang Y, Liu M, Zhang Y, Wei R, Sun J. Identification and characterization of extrachromosomal circular DNA in patients with high myopia and cataract. Epigenetics 2023; 18:2192324. [PMID: 36945837 PMCID: PMC10038054 DOI: 10.1080/15592294.2023.2192324] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/23/2023] Open
Abstract
To explore the presence of extrachromosomal circular DNA (eccDNA) in the anterior capsule of the lens in the eyes of patients with cataract and with high myopia. Circle-Seq was performed to identify differences in the eccDNA and gene expression between the anterior capsule of the lens of patients with simple nuclear cataract (C, n = 6 cases) and patients with nuclear cataract along with high myopia (HM, n = 6 cases). The expression of eccDNA was confirmed using routine quantitative polymerase chain reaction. The eccDNA ranked in C and HM ranged in length from 0.017 kb - 9.9 Mb with two distinctive peaks detected at 0.2 kb and 0.5 kb, while eccDNA that were differentially expressed ranged in size from 0.05 kb - 57.8 kb with two distinctive peaks observed at 0.1 kb and 0.5 kb. Only 2.5% of the eccDNA in C and 2% in HM were>25 kb in size. The gene-rich chromosomes contributed to more number of eccDNA/Mb, while several well-known high myopia candidate genes, including catenin delta 2 (CTNND2) and ubiquitin-like with PHD, exhibited significantly increased levels of eccDNA in the anterior capsule of the lens in patients with high myopia. This study highlighted the topologic analysis of the anterior capsule of eyes with high myopia, which is an emerging direction for research and clinical applications. These findings suggested that eccDNA was commonly detected in eyes with high myopia and cataracts, and the candidate genes for high myopia identified in previous studies were also observed in the eccDNA.
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Affiliation(s)
- Kai Wen
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital
| | | | - Yang Cai
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital
| | - He Teng
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital
| | - Jingli Liang
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital
| | - Yi Yue
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital
| | - Yaoling Li
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital
| | - Yifang Huang
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital
| | - Ming Liu
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital
| | - Yufeng Zhang
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital
| | - Ruihua Wei
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital
| | - Jing Sun
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital
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Zhao M, Zhang Y, Herold F, Chen J, Hou M, Zhang Z, Gao Y, Sun J, Hossain MM, Kramer AF, Müller NG, Zou L. Associations between meeting 24-hour movement guidelines and myopia among school-aged children: A cross-sectional study. Complement Ther Clin Pract 2023; 53:101792. [PMID: 37595358 DOI: 10.1016/j.ctcp.2023.101792] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 07/24/2023] [Accepted: 08/03/2023] [Indexed: 08/20/2023]
Abstract
BACKGROUND The Canadian 24-hour movement behavior (24-HMB) guidelines recommend an adequate level of physical activity (PA), a limited amount of screen time (ST), and a sufficient sleep duration (SLP) to promote the healthy development of children. Although the positive effects of adhering to the 24-HMB guidelines have been established for several health parameters, less is known about how adherence to the 24-HMB guidelines relates to the myopia risk (i.e., inability to see distant objects properly). Thus, this study investigated associations between meeting 24-HMB guidelines and myopia risk in school-aged children. METHOD Using a questionnaire survey, this cross-sectional study was conducted among parents of school-aged children (5-13 years) in China from 15th September to 15th October 2022, with a total of 1423 respondents with complete data for analysis. Parents reported their child's time spent in moderate-to-vigorous-intensity physical activity (MVPA), SLP, and ST. Multiple logistic regression analyses were performed to examine the associations between measures of PA, ST, and SLP alone and in combination, and the occurrence of myopia. RESULTS A relatively low percentage of the children being included in the current study (4.92%) met all 24-HMB guidelines, while 32.46% had myopia. Girls had a significantly higher risk of myopia compared to boys (OR = 1.3, 1.002 to 1.68, p = 0.049). Children of parents without myopia had a lower risk of myopia (OR = 0.45, 0.34-0.59, p < 0.001). Children who lived in urban areas (OR = 1.83, 95% CI 1.33 to 2.52, p < 0.001) or towns (OR = 1.60, 1.03 to 2.47, p = 0.04) had a significantly higher risk of myopia compared to those living in rural areas. Meeting SLP guidelines (OR = 0.50, 95% CI 0.31 to 0.82, p < 0.01), meeting ST + SLP guidelines (OR = 0.47, 95% CI 0.32-0.69, <0.001), and meeting all three guidelines were associated with significantly lower risk of myopia (OR = 0.40, 95% CI 0.20-0.82, p = 0.01). Meeting more 24-HMB guidelines was associated with a reduced risk of myopia. CONCLUSIONS Our data suggest that adhering to SLP, ST + SLP, and ST + SLP + PA guidelines is associated with the risk of myopia. Future research investigating dose-response associations, and potential mechanisms, is necessary to achieve a more nuanced understanding of the observed associations.
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Affiliation(s)
- Mengxian Zhao
- Body-Brain-Mind Laboratory, School of Physical Education, School of Psychology, Shenzhen University, Shenzhen, 518060, China
| | - Yanjie Zhang
- Physical Education Unit, Chinese University of Hong Kong, Shenzhen, China
| | - Fabian Herold
- Research Group Degenerative and Chronic Diseases, Movement, Faculty of Health Sciences Brandenburg, University of Potsdam, Potsdam, Germany
| | - Jianyu Chen
- Body-Brain-Mind Laboratory, School of Physical Education, School of Psychology, Shenzhen University, Shenzhen, 518060, China
| | - Meijun Hou
- Body-Brain-Mind Laboratory, School of Physical Education, School of Psychology, Shenzhen University, Shenzhen, 518060, China
| | - Zhihao Zhang
- Body-Brain-Mind Laboratory, School of Physical Education, School of Psychology, Shenzhen University, Shenzhen, 518060, China
| | - Yanping Gao
- Body-Brain-Mind Laboratory, School of Physical Education, School of Psychology, Shenzhen University, Shenzhen, 518060, China
| | - Jing Sun
- School of Medicine and Dentistry and Menzies Health Institute Queensland, Institute for Integrated Intelligence and Systems, Griffith University, Australia
| | - M Mahbub Hossain
- Department of Decision and Information Sciences, C.T. Bauer College of Business, University of Houston, TX, 77204, USA; Department of Health Systems and Population Health Sciences, Tilman J. Fertitta Family College of Medicine, University of Houston, TX, 77204, USA
| | - Arthur F Kramer
- Center for Cognitive and Brain Health, Northeastern University, Boston, 02115, MA, United States; Beckman Institute, University of Illinois at Urbana-Champaign, Champaign, 61820, IL, United States
| | - Notger G Müller
- Research Group Degenerative and Chronic Diseases, Movement, Faculty of Health Sciences Brandenburg, University of Potsdam, Potsdam, Germany
| | - Liye Zou
- Body-Brain-Mind Laboratory, School of Physical Education, School of Psychology, Shenzhen University, Shenzhen, 518060, China.
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15
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Chen S, Wu Z, Li M, Zhu Y, Xie H, Yang P, Zhao C, Zhang Y, Zhang S, Zhao X, Lu L, Zhang G, Lei B. FIT-Net: Feature Interaction Transformer Network for Pathologic Myopia Diagnosis. IEEE TRANSACTIONS ON MEDICAL IMAGING 2023; 42:2524-2538. [PMID: 37030824 DOI: 10.1109/tmi.2023.3260990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/19/2023]
Abstract
Automatic and accurate classification of retinal optical coherence tomography (OCT) images is essential to assist physicians in diagnosing and grading pathological changes in pathologic myopia (PM). Clinically, due to the obvious differences in the position, shape, and size of the lesion structure in different scanning directions, ophthalmologists usually need to combine the lesion structure in the OCT images in the horizontal and vertical scanning directions to diagnose the type of pathological changes in PM. To address these challenges, we propose a novel feature interaction Transformer network (FIT-Net) to diagnose PM using OCT images, which consists of two dual-scale Transformer (DST) blocks and an interactive attention (IA) unit. Specifically, FIT-Net divides image features of different scales into a series of feature block sequences. In order to enrich the feature representation, we propose an IA unit to realize the interactive learning of class token in feature sequences of different scales. The interaction between feature sequences of different scales can effectively integrate different scale image features, and hence FIT-Net can focus on meaningful lesion regions to improve the PM classification performance. Finally, by fusing the dual-view image features in the horizontal and vertical scanning directions, we propose six dual-view feature fusion methods for PM diagnosis. The extensive experimental results based on the clinically obtained datasets and three publicly available datasets demonstrate the effectiveness and superiority of the proposed method. Our code is avaiable at: https://github.com/chenshaobin/FITNet.
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Jiang F, Wang D, Yin Q, He M, Li Z. Longitudinal Changes in Axial Length and Spherical Equivalent in Children and Adolescents With High Myopia. Invest Ophthalmol Vis Sci 2023; 64:6. [PMID: 37669064 PMCID: PMC10484013 DOI: 10.1167/iovs.64.12.6] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Accepted: 08/09/2023] [Indexed: 09/06/2023] Open
Abstract
Purpose To investigate longitudinal changes in axial length (AL) and spherical equivalent (SE) in children and adolescents with high myopia and to explore associated risk factors. Methods This was a longitudinal, observational cohort study of highly myopic participants (aged 7-17 years) to evaluate the mean rates of change in AL and SE. Mixed effects regression models were used to explore the risk factors. Results The sample consisted of 293 participants (mean age at the baseline, 13.63 ± 2.66 years; mean AL, 27.03 ± 1.30 mm diopters; mean SE, -8.99 ± 2.30 diopters) who were followed for 7.09 ± 1.64 years. Pathological myopia (PM) was present in 11.95% of the participants at the baseline. Over the follow-up period, the mean AL and SE progression rates were 0.13 mm/y (95% CI, 0.12-0.14) and -0.36 diopters/y (95% CI, -0.39 to -0.34). The multivariate analysis showed that the AL elongation and myopic SE progression decreased significantly after age 11 (β = -0.080, P < 0.001; β = 0.146, P < 0.001), increased with a greater baseline SE (β = -0.006, P = 0.014; β = 0.017, P = 0.005), and accelerated in children and adolescents who had PM at the baseline (β = 0.043, P = 0.011; β = -0.097, P = 0.025). Conclusions A significant association was found between acceleration of AL elongation and myopic SE progression among the children and adolescents with age, especially those younger than 11 years, and the presence of PM.
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Affiliation(s)
- Feng Jiang
- 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
| | - Decai Wang
- 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
| | - Qiuxia Yin
- 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
| | - Mingguang He
- 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
- School of Optometry, The Hong Kong Polytechnic University, Hong Kong, China
- Research Centre for SHARP Vision, The Hong Kong Polytechnic University, Hong Kong, China
- Centre for Eye and Vision Research (CEVR), Hong Kong, China
| | - Zhixi Li
- 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
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Huang X, He S, Wang J, Yang S, Wang Y, Ye X. Lesion detection with fine-grained image categorization for myopic traction maculopathy (MTM) using optical coherence tomography. Med Phys 2023; 50:5398-5409. [PMID: 37490302 DOI: 10.1002/mp.16623] [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: 11/14/2022] [Revised: 06/14/2023] [Accepted: 06/27/2023] [Indexed: 07/26/2023] Open
Abstract
BACKGROUND Myopic traction maculopathy (MTM) are retinal disorder caused by traction force on the macula, which can lead to varying degrees of vision loss in eyes with high myopia. Optical coherence tomography (OCT) is an effective imaging technique for diagnosing, detecting and classifying retinopathy. MTM has been classified into different patterns by OCT, corresponding to different clinical strategies. PURPOSE We aimed to engineer a deep learning model that can automatically identify MTM in highly myopic (HM) eyes using OCT images. METHODS A five-class classification model was developed using 2837 OCT images from 958 HM patients. We adopted a ResNet-34 architecture to train the model to identify MTM: no MTM (class 0), extra-foveal maculoschisis (class 1), inner lamellar macular hole (class 2), outer foveoschisis (class 3), and discontinuity or detachment of foveal outer hyperreflective layers (class 4). An independent test set of 604 images from 173 HM patients was used to evaluate the model's performance. Classification performance was assessed according to the area under the curve (AUC), accuracy, sensitivity, specificity. RESULTS Our model exhibited a high training performance for classification (F1-score of 0.953; AUCs of 0.961 to 0.998). In test set, it achieved sensitivities (91.67%-97.78 %) and specificities (98.33%-99.17%) as good as, or better than, those of experienced clinicians. Heatmaps were generated to provide visual explanations. CONCLUSIONS We established a deep learning model for MTM classification using OCT images. This model performed equally well or better than retinal specialists and is suitable for large-scale screening and identifying MTM in HM eyes.
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Affiliation(s)
- Xingru Huang
- School of Electronic Engineering and Computer Science, Queen Mary University of London, London, UK
| | - Shucheng He
- Center for Rehabilitation Medicine, Department of Ophthalmology, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College), Hangzhou, Zhejiang, China
| | - Jun Wang
- School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Shangchao Yang
- School of Ophthalmology and Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Yaqi Wang
- College of Media Engineering, Communication University of Zhejiang, Hangzhou, Zhejiang, China
| | - Xin Ye
- Center for Rehabilitation Medicine, Department of Ophthalmology, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College), Hangzhou, Zhejiang, China
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Lee CY, Hsia Y, Tsui MC, Wang SW, Huang CJ, Ma IH, Hung KC, Chen MS, Ho TC. Correlation of Visual Acuity and Outer Retinal Thickness in Myopic Atrophic Maculopathy: A Retrospective Review. Ophthalmol Ther 2023; 12:1989-2003. [PMID: 37171558 PMCID: PMC10287860 DOI: 10.1007/s40123-023-00710-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 04/05/2023] [Indexed: 05/13/2023] Open
Abstract
INTRODUCTION Myopic atrophic maculopathy is prevalent among patients with pathologic myopia and frequently leads to relentless vision loss. Several grading systems were established to facilitate the understanding of myopic atrophic maculopathy. However, the anatomical details in different stages of myopic maculopathy are so far not clearly elucidated. This study aims to investigate the visual acuity and retinal sublayer features in highly myopic eyes with varying severities of myopic atrophic maculopathy (MAM). METHODS The clinical records of 111 consecutive patients (158 eyes) with high myopia (refractive error ≤ -6.0 D and axial length ≥ 26.0 mm) were reviewed. Fundus photography, optical coherence tomography (OCT), and best-corrected visual acuity (BCVA) were measured. MAM was graded according to the META-analysis for Pathologic Myopia (META-PM) classification system. Myopic choroidal neovascularization (mCNV) and dome-shaped macula (DSM) were also investigated. RESULTS Among the 158 eyes, 18 (11%), 21(13%), 24 (15%), 25 (16%), 23 (15%), and 24 (15%) had tessellated fundus, diffuse chorioretinal atrophy, diffuse chorioretinal atrophy with DSM, patchy atrophy, patchy atrophy with DSM, and MAM with mCNV, respectively. A total of 23 (15%) eyes had macular atrophy without mCNV. Progressive thinning in the Henle's fiber and outer nuclear layers, myoid and ellipsoid zone (MEZ), outer segment (OS), and interdigitation zone and retinal pigmented epithelium based on the severity of MAM (p-value < 0.001) was found. MEZ and OS were most significantly reduced in thickness (p-value < 0.001). The presence of mCNV demonstrated significant outer retinal layer thinning compared with that of the tessellated fundus (p-value = 0.031). Patchy atrophy with DSM showed statistically poorer BCVA compared with that without (p-value = 0.008). CONCLUSION Visual acuity and outer retinal sublayer characteristics were correlated with the severity of MAM. Outer retinal sublayer analysis by spectrum-domain OCT shed some light on the mechanisms of MAM progression.
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Affiliation(s)
- Cheng-Yung Lee
- Department of Ophthalmology, National Taiwan University Hospital, College of Medicine, National Taiwan University, No 7, Chung-Shan S. Rd., Taipei, 10002, Taiwan
| | - Yun Hsia
- Department of Ophthalmology, National Taiwan University Hospital, College of Medicine, National Taiwan University, No 7, Chung-Shan S. Rd., Taipei, 10002, Taiwan
- Department of Ophthalmology, National Taiwan University Hospital Hsin-Chu, Hsinchu, Taiwan
| | - Mei-Chi Tsui
- Department of Ophthalmology, National Taiwan University Hospital, College of Medicine, National Taiwan University, No 7, Chung-Shan S. Rd., Taipei, 10002, Taiwan
| | - Shih-Wen Wang
- Department of Ophthalmology, National Taiwan University Hospital, College of Medicine, National Taiwan University, No 7, Chung-Shan S. Rd., Taipei, 10002, Taiwan
- Department of Ophthalmology, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
| | - Chien-Jung Huang
- Department of Ophthalmology, National Taiwan University Hospital, College of Medicine, National Taiwan University, No 7, Chung-Shan S. Rd., Taipei, 10002, Taiwan
- Department of Ophthalmology, Fu Jen Catholic University Hospital, New Taipei City, Taiwan
| | - I-Hsin Ma
- Department of Ophthalmology, National Taiwan University Hospital, College of Medicine, National Taiwan University, No 7, Chung-Shan S. Rd., Taipei, 10002, Taiwan
- Department of Ophthalmology, National Taiwan University Hospital Hsin-Chu, Hsinchu, Taiwan
| | - Kuo-Chi Hung
- Department of Ophthalmology, National Taiwan University Hospital, College of Medicine, National Taiwan University, No 7, Chung-Shan S. Rd., Taipei, 10002, Taiwan
- Universal Eye Clinic, Taipei, Taiwan
| | - Muh-Shy Chen
- Department of Ophthalmology, National Taiwan University Hospital, College of Medicine, National Taiwan University, No 7, Chung-Shan S. Rd., Taipei, 10002, Taiwan
- Department of Ophthalmology, Cardinal Tien Hospital, New Taipei City, Taiwan
| | - Tzyy-Chang Ho
- Department of Ophthalmology, National Taiwan University Hospital, College of Medicine, National Taiwan University, No 7, Chung-Shan S. Rd., Taipei, 10002, Taiwan.
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Tang W, Ouyang J, Luo Y. Distribution of the Retinal Microcirculation Based on the Morphology of Peripapillary Atrophy in High Myopia. Ophthalmic Res 2023; 66:1085-1095. [PMID: 37459845 PMCID: PMC10614452 DOI: 10.1159/000531509] [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: 01/14/2023] [Accepted: 06/06/2023] [Indexed: 11/01/2023]
Abstract
INTRODUCTION The objective of this study was to evaluate the retinal microvasculature of the optic nerve head and macula in high myopia (HM), investigate the association between the vascular parameters and peripapillary atrophy (PPA) deformation, and assess and identify the PPA morphology changes during the development of HM. METHODS One hundred sixty-seven right eyes from 167 HM patients were enrolled in this cross-sectional study. Using the optical coherence tomography angiography (OCTA) and fundus camera, we evaluated the following parameters: radian and type of PPA, intrapapillary vascular density (IVD), peripapillary vascular density (PVD), macular vascular density (MVD), and foveal avascular zone (FAZ). Based on the PPA radian, subjects were divided into four groups: the non-PPA, temporal PPA, advanced PPA, and annular PPA. At the same time, the above parameters were compared between the groups using analysis of variance (ANOVA) and least significant difference test. RESULTS Total enrolled patients were divided into the non-PPA group (22 eyes), temporal-PPA group (70 eyes), advanced-PPA group (60 eyes), and annular-PPA group (15 eyes). The results showed that the PVD in the annular-PPA group was smaller than that in the non-PPA group, especially in the superonasal, nasosuperior, nasoinferior, inferotemporal, temporoinferior, and superotemporal directions (F = 4.059, 5.014, 2.830, 4.798, 5.892, 3.439; p < 0.05). Notably, the PVD showcased the highest value in temporal, followed by that in superior and inferior, and the lowest in the nasal. Concerning the fovea deep macular vascular density, FAZ area, and subfoveal choroidal thickness in the annular-PPA group, they were less than those of the rest of the groups (p < 0.05). CONCLUSION The retinal microvasculature differed significantly in HM according to the PPA morphology. In addition to PVD and SFCT, the PPA can also affect FAZ. Finally, we speculated that PVD demonstrated better predictability of myopic progression than MVD.
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Affiliation(s)
- Wenquan Tang
- Department of Ophthalmology, Hunan Children's Hospital, Changsha, China,
| | | | - YuLin Luo
- Department of Ophthalmology, Hunan Children's Hospital, Changsha, China
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20
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Su J, Yuan J, Xu L, Xing S, Sun M, Yao Y, Ma Y, Chen F, Jiang L, Li K, Yu X, Xue Z, Zhang Y, Fan D, Zhang J, Liu H, Liu X, Zhang G, Wang H, Zhou M, Lyu F, An G, Yu X, Xue Y, Yang J, Qu J. Sequencing of 19,219 exomes identifies a low-frequency variant in FKBP5 promoter predisposing to high myopia in a Han Chinese population. Cell Rep 2023; 42:112510. [PMID: 37171956 DOI: 10.1016/j.celrep.2023.112510] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Revised: 12/13/2022] [Accepted: 04/28/2023] [Indexed: 05/14/2023] Open
Abstract
High myopia (HM) is one of the leading causes of visual impairment and blindness worldwide. Here, we report a whole-exome sequencing (WES) study in 9,613 HM cases and 9,606 controls of Han Chinese ancestry to pinpoint HM-associated risk variants. Single-variant association analysis identified three newly identified -genetic loci associated with HM, including an East Asian ancestry-specific low-frequency variant (rs533280354) in FKBP5. Multi-ancestry meta-analysis with WES data of 2,696 HM cases and 7,186 controls of European ancestry from the UK Biobank discerned a newly identified European ancestry-specific rare variant in FOLH1. Functional experiments revealed a mechanism whereby a single G-to-A transition at rs533280354 disrupted the binding of transcription activator KLF15 to the promoter of FKBP5, resulting in decreased transcription of FKBP5. Furthermore, burden tests showed a significant excess of rare protein-truncating variants among HM cases involved in retinal blood vessel morphogenesis and neurotransmitter transport.
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Affiliation(s)
- Jianzhong Su
- School of Ophthalmology & Optometry and Eye Hospital, Wenzhou Medical University, Wenzhou 325027, China; National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou 325027, China; Oujiang Laboratory, Zhejiang Lab for Regenerative Medicine, Vision and Brain Health, Wenzhou 325101, Zhejiang, China; Wenzhou Institute, University of Chinese Academy of Sciences, Wenzhou 325011, China.
| | - Jian Yuan
- School of Ophthalmology & Optometry and Eye Hospital, Wenzhou Medical University, Wenzhou 325027, China; National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou 325027, China
| | - Liangde Xu
- School of Ophthalmology & Optometry and Eye Hospital, Wenzhou Medical University, Wenzhou 325027, China; National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou 325027, China
| | - Shilai Xing
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou 325027, China; Institute of PSI Genomics, Wenzhou 325024, China
| | - Mengru Sun
- Key Laboratory of RNA Biology, Institute of Biophysics, Chinese Academy of Sciences, Beijing 100190, China
| | - Yinghao Yao
- Oujiang Laboratory, Zhejiang Lab for Regenerative Medicine, Vision and Brain Health, Wenzhou 325101, Zhejiang, China; Wenzhou Institute, University of Chinese Academy of Sciences, Wenzhou 325011, China
| | - Yunlong Ma
- School of Ophthalmology & Optometry and Eye Hospital, Wenzhou Medical University, Wenzhou 325027, China; National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou 325027, China
| | - Fukun Chen
- School of Ophthalmology & Optometry and Eye Hospital, Wenzhou Medical University, Wenzhou 325027, China; National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou 325027, China
| | - Longda Jiang
- School of Life Sciences, Westlake University, Hangzhou, Zhejiang 310030, China
| | - Kai Li
- Wenzhou Institute, University of Chinese Academy of Sciences, Wenzhou 325011, China
| | - Xiangyi Yu
- School of Ophthalmology & Optometry and Eye Hospital, Wenzhou Medical University, Wenzhou 325027, China; National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou 325027, China
| | - Zhengbo Xue
- School of Ophthalmology & Optometry and Eye Hospital, Wenzhou Medical University, Wenzhou 325027, China; National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou 325027, China
| | - Yaru Zhang
- School of Ophthalmology & Optometry and Eye Hospital, Wenzhou Medical University, Wenzhou 325027, China; National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou 325027, China
| | - Dandan Fan
- School of Ophthalmology & Optometry and Eye Hospital, Wenzhou Medical University, Wenzhou 325027, China; National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou 325027, China
| | - Ji Zhang
- School of Ophthalmology & Optometry and Eye Hospital, Wenzhou Medical University, Wenzhou 325027, China; National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou 325027, China
| | - Hui Liu
- School of Ophthalmology & Optometry and Eye Hospital, Wenzhou Medical University, Wenzhou 325027, China; National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou 325027, China
| | - Xinting Liu
- School of Ophthalmology & Optometry and Eye Hospital, Wenzhou Medical University, Wenzhou 325027, China; National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou 325027, China
| | - Guosi Zhang
- School of Ophthalmology & Optometry and Eye Hospital, Wenzhou Medical University, Wenzhou 325027, China; National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou 325027, China
| | - Hong Wang
- School of Ophthalmology & Optometry and Eye Hospital, Wenzhou Medical University, Wenzhou 325027, China; National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou 325027, China
| | - Meng Zhou
- School of Ophthalmology & Optometry and Eye Hospital, Wenzhou Medical University, Wenzhou 325027, China; National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou 325027, China
| | - Fan Lyu
- School of Ophthalmology & Optometry and Eye Hospital, Wenzhou Medical University, Wenzhou 325027, China; National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou 325027, China; Oujiang Laboratory, Zhejiang Lab for Regenerative Medicine, Vision and Brain Health, Wenzhou 325101, Zhejiang, China
| | - Gang An
- Institute of PSI Genomics, Wenzhou 325024, China
| | - Xiaoguang Yu
- Institute of PSI Genomics, Wenzhou 325024, China
| | - Yuanchao Xue
- School of Ophthalmology & Optometry and Eye Hospital, Wenzhou Medical University, Wenzhou 325027, China; Key Laboratory of RNA Biology, Institute of Biophysics, Chinese Academy of Sciences, Beijing 100190, China.
| | - Jian Yang
- School of Life Sciences, Westlake University, Hangzhou, Zhejiang 310030, China; Westlake Laboratory of Life Sciences and Biomedicine, Hangzhou, Zhejiang 310024, China.
| | - Jia Qu
- School of Ophthalmology & Optometry and Eye Hospital, Wenzhou Medical University, Wenzhou 325027, China; National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou 325027, China; Oujiang Laboratory, Zhejiang Lab for Regenerative Medicine, Vision and Brain Health, Wenzhou 325101, Zhejiang, China; Wenzhou Institute, University of Chinese Academy of Sciences, Wenzhou 325011, China.
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Tang W, He B, Luo Y, Duan X. Morphology and microcirculation changes of the optic nerve head between simple high myopia and pathologic myopia. BMC Ophthalmol 2023; 23:208. [PMID: 37165324 PMCID: PMC10173470 DOI: 10.1186/s12886-023-02949-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Accepted: 04/26/2023] [Indexed: 05/12/2023] Open
Abstract
PURPOSE To investigate morphological and microcirculation changes of optic nerve head (ONH) in simple high myopia (SHM) and pathologic myopia(PM) to evaluate and identify ONH changes in the development of PM. METHODS A cross-sectional clinical study was used. Medical records from 193 right eyes of 193 patients with high myopia (HM) were included. Using the Topocon swept source optical coherence tomograph (SS-OCT) and fundus camera to detect the parameters, we have assessed the relative position and size of ONH, tilt and rotation of ONH, angle α (Defined as between retinal temporal arterial vascular arcades was measured from the centre of ONH with 250 pixels' radius), size and type of peripapillary atrophy (PPA), the thickness of peripapillary retinal nerve fiber layer (PRNFL), peripapillary choriodal thickness (PCT) and peripapillary scleral thickness (PST), and peripapillary vessel density (PVD). In addition, subjects were grouped as SHM and PM according to retinopathy, and the above parameters were compared between the two groups. RESULTS Patients were divided into the SHM group (138 eyes) and the PM group (55 eyes). Paramters like older age, higher diopter and longer axial length (AL) of the PM were compared to SHM (t=-3.585, -8.808, -11.409, all P<0.05). There were no differences in the smallest diameter and area of ONH, rotation angle and ratio, or PST (all P>0.05). The angle α in PM was smaller than that in SHM (t = 2.728, P<0.01). The disc-fovea distance (DFD), the largest diameter, tilt index and ratio, PPA area and radian in PM were larger than in SHM (t=-3.962, Z=-2.525, t=-2.229, Z=-4.303, Z=-2.834, all P<0.05). The superior and inferior PRNFLs in PM were smaller than in SHM (t = 4.172, 4.263, all P<0.01). The temporoinferior PRNFL was the opposite (t=-2.421, P<0.01). The average PCT in PM (93.82 ± 29.96 μm) was smaller than in SHM (108.75 ± 30.70 μm) (P<0.05). The PVD in each direction of PM was smaller than that in SHM (t = 6.398, 4.196, 4.971, 3.267, 5.029, 5.653, 4.202, 5.146, 2.090, all P<0.05). CONCLUSION Compared with SHM, the PM patients were older, with higher diopter. Their AL and DFD were longer, the angle α was smaller, the tilt index was more extensive, the PPA area and radian were larger, PCT was generally thinner, and PVD was lower. When the PPA area was bigger than the ONH area, this already indicated the presence of PM. Based on these results, we suggest ophthalmologists and myopia patients pay more attention to ONH's morphology and microcirculation changes as there is a possibility that microcirculatory changes precede morphologic changes.
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Affiliation(s)
- Wenquan Tang
- Department of Ophthalmology, Hunan Children's Hospital, Changsha, 410007, China
- College of pharmacy, changsha medical university, Changsha, 410011, China
| | - Bin He
- Department of Ophthalmology, Hunan Children's Hospital, Changsha, 410007, China
| | - YuLin Luo
- Department of Ophthalmology, Hunan Children's Hospital, Changsha, 410007, China.
| | - Xuanchu Duan
- Changsha Aier Eye Hospital, Changsha, 410011, China.
- Aier School of Ophthalmology, Central South University, Changsha, 410011, China.
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Lu H, Xie S, Xiong J, Chen C, Wang Y, Moriyama M, Kamoi K, Uramoto K, Ohno-Matsui K. COMPLEX HEMODYNAMICS OF INTERVORTEX VEIN ANASTOMOSES IN HIGHLY MYOPIC EYES. Retina 2023; 43:723-732. [PMID: 36728124 DOI: 10.1097/iae.0000000000003738] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
PURPOSE To analyze the complex pattern of filling of the intervortex vein (IVV) anastomoses through large trunks in highly myopic eyes based on indocyanine green angiographic (ICGA) videos. METHODS The medical records of 1,060 consecutive highly myopic eyes that had undergone ICGA were studied. IVV anastomoses were identified in the ICGA images, and the ICGA images and videos were analyzed comprehensively to characterize their hemodynamic features. RESULTS Seven eyes with IVV anastomoses through large trunks were analyzed. In the ICGA videos of six eyes, laminar flow was observed in the IVV anastomotic vessels. The laminar flow started in the arterial phase in two eyes, with pulsatile fashion in 1 of them. The flow began in the early arteriovenous transition phase in four eyes. The laminar flow continued for a mean of 12.17 ± 3.06 seconds, and the remaining section was gradually filled slower than the surrounding veins. The anastomotic trunk for the remaining one eye was too narrow to be analyzed. Four eyes had longitudinal ICGA records, and two had significant attenuation and narrowing of the anastomotic vessels. CONCLUSION The very early filling of part of the IVV anastomoses suggests that arteriovenous anastomoses are involved in the IVV of highly myopic eyes. However, this suggestion needs further study. There may be similar pathogenesis for IVV anastomoses either in thick or thin sclera.
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Affiliation(s)
- Hongshuang Lu
- Department of Ophthalmology and Visual Science, Tokyo Medical and Dental University, Tokyo, Japan
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23
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Wolffsohn JS, Whayeb Y, Logan NS, Weng R. IMI-Global Trends in Myopia Management Attitudes and Strategies in Clinical Practice-2022 Update. Invest Ophthalmol Vis Sci 2023; 64:6. [PMID: 37126357 PMCID: PMC10155870 DOI: 10.1167/iovs.64.6.6] [Citation(s) in RCA: 22] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 02/07/2023] [Indexed: 05/02/2023] Open
Abstract
Purpose Surveys in 2015 and 2019 identified a high level of eye care practitioner concern/activity about myopia, but the majority still prescribed single vision interventions to young myopes. This research aimed to provide updated information. Methods A self-administered, internet-based questionnaire was distributed in 13 languages, through professional bodies to eye care practitioners globally. The questions examined awareness of increasing myopia prevalence, perceived efficacy and adoption of available strategies, and reasons for not adopting specific strategies. Results Of the 3195 respondents, practitioners' concern about the increasing frequency of pediatric myopia in their practices differed between continents (P < 0.001), being significantly higher in Asia (9.0 ± 1.5 of 10) than other continents (range 7.7-8.2; P ≤ 0.001). Overall, combination therapy was perceived by practitioners to be the most effective method of myopia control, followed by orthokeratology and pharmaceutical approaches. The least effective perceived methods were single vision distance undercorrection, spectacles and contact lenses, as well as bifocal spectacles. Practitioners rated their activity in myopia control between (6.6 ± 2.9 in South America to 7.9 ± 1.2/2.2 in Australasia and Asia). Single-vision spectacles are still the most prescribed option for progressing young myopia (32.2%), but this has decreased since 2019, and myopia control spectacles (15.2%), myopia control contact lenses (8.7%) and combination therapy (4.0%) are growing in popularity. Conclusions More practitioners across the globe are practicing myopia control, but there are still significant differences between and within continents. Practitioners reported that embracing myopia control enhanced patient loyalty, increasing practice revenue and improving job satisfaction.
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Affiliation(s)
- James S. Wolffsohn
- College of Health & Life Sciences, Aston University, Birmingham, United Kingdom
| | - Yasmin Whayeb
- College of Health & Life Sciences, Aston University, Birmingham, United Kingdom
| | - Nicola S. Logan
- College of Health & Life Sciences, Aston University, Birmingham, United Kingdom
| | - Rebecca Weng
- Brien Holden Vision Institute, Sydney, NSW, Australia
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Wang H, Zhou J, Wang YX, Wang Q, Yan Y, Yang X, Yang J, Zhou W, Nie Z, Shi X, Ji H, Zhang Y, Shi X, Wei WB. Prevalence and associated health and lifestyle factors of myopic maculopathy in northern China: the Kailuan eye study. BMC Ophthalmol 2023; 23:176. [PMID: 37095443 PMCID: PMC10123981 DOI: 10.1186/s12886-023-02896-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Accepted: 03/31/2023] [Indexed: 04/26/2023] Open
Abstract
BACKGROUND To evaluate the prevalence and associated health and lifestyle factors of myopic maculopathy (MM) in a northern Chinese industrial city. METHODS The cross-sectional Kailuan Eye Study included subjects who participated in the longitudinal Kailuan Study in 2016. Ophthalmologic and general examinations were performed on all the participants. MM was graded based on fundus photographs using the International Photographic Classification and Grading System. The prevalence of MM was evaluated. Univariate and multiple logistic regression were adopted to evaluated risk factors of MM. RESULTS The study included 8330 participants with gradable fundus photographs for MM and ocular biometry data. The prevalence of MM was 1.11% (93/8330; 95% confidence interval [CI] 0.89-1.33%). Diffuse chorioretinal atrophy, patchy chorioretinal atrophy, macular atrophy, and plus lesions were observed in 72 (0.9%), 15 (0.2%), 6 (0.007%), and 32 eyes (0.4%), respectively. MM was more common in eyes with longer axial length (OR 4.517; 95%CI 3.273 to 6.235) and in participants with hypertension (OR 3.460; 95%CI 1.152 to 10.391), and older age (OR 1.084; 95%CI 1.036 to 1.134). CONCLUSIONS The MM was present in 1.11% of the northern Chinese individuals 21 years or older and the associate factors include longer axial length, older age, and hypertension.
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Affiliation(s)
- Haiwei Wang
- Beijing Tongren Eye Center, Beijing key Laboratory of Intraocular Tumor Diagnosis and Treatment, Beijing Ophthalmology & Visual Sciences Key Lab, Medical Artificial Intelligence Research and Verification Key Laboratory of the Ministry of Industry and Information Technology, Beijing Tongren Hospital, Beijing Tongren Eye Center, Capital Medical University, Beijing, China
- Department of Ophthalmology, Fuxing Hospital, Capital Medical University, Beijing, China
| | - Jinqiong Zhou
- Beijing Tongren Eye Center, Beijing key Laboratory of Intraocular Tumor Diagnosis and Treatment, Beijing Ophthalmology & Visual Sciences Key Lab, Medical Artificial Intelligence Research and Verification Key Laboratory of the Ministry of Industry and Information Technology, Beijing Tongren Hospital, Beijing Tongren Eye Center, Capital Medical University, Beijing, China
| | - Ya Xing Wang
- Beijing Institute of Ophthalmology, Beijing Key Laboratory of Ophthalmology and Visual Sciences, Beijing Tongren Hospital, Beijing Tongren Eye Center, Capital Medical University, Beijing, China
| | - Qian Wang
- Beijing Tongren Eye Center, Beijing key Laboratory of Intraocular Tumor Diagnosis and Treatment, Beijing Ophthalmology & Visual Sciences Key Lab, Medical Artificial Intelligence Research and Verification Key Laboratory of the Ministry of Industry and Information Technology, Beijing Tongren Hospital, Beijing Tongren Eye Center, Capital Medical University, Beijing, China
| | - Yanni Yan
- Beijing Tongren Eye Center, Beijing key Laboratory of Intraocular Tumor Diagnosis and Treatment, Beijing Ophthalmology & Visual Sciences Key Lab, Medical Artificial Intelligence Research and Verification Key Laboratory of the Ministry of Industry and Information Technology, Beijing Tongren Hospital, Beijing Tongren Eye Center, Capital Medical University, Beijing, China
| | - Xuan Yang
- Beijing Tongren Eye Center, Beijing key Laboratory of Intraocular Tumor Diagnosis and Treatment, Beijing Ophthalmology & Visual Sciences Key Lab, Medical Artificial Intelligence Research and Verification Key Laboratory of the Ministry of Industry and Information Technology, Beijing Tongren Hospital, Beijing Tongren Eye Center, Capital Medical University, Beijing, China
| | - Jingyan Yang
- Beijing Tongren Eye Center, Beijing key Laboratory of Intraocular Tumor Diagnosis and Treatment, Beijing Ophthalmology & Visual Sciences Key Lab, Medical Artificial Intelligence Research and Verification Key Laboratory of the Ministry of Industry and Information Technology, Beijing Tongren Hospital, Beijing Tongren Eye Center, Capital Medical University, Beijing, China
| | - Wenjia Zhou
- Beijing Tongren Eye Center, Beijing key Laboratory of Intraocular Tumor Diagnosis and Treatment, Beijing Ophthalmology & Visual Sciences Key Lab, Medical Artificial Intelligence Research and Verification Key Laboratory of the Ministry of Industry and Information Technology, Beijing Tongren Hospital, Beijing Tongren Eye Center, Capital Medical University, Beijing, China
| | - Zihan Nie
- Beijing Tongren Eye Center, Beijing key Laboratory of Intraocular Tumor Diagnosis and Treatment, Beijing Ophthalmology & Visual Sciences Key Lab, Medical Artificial Intelligence Research and Verification Key Laboratory of the Ministry of Industry and Information Technology, Beijing Tongren Hospital, Beijing Tongren Eye Center, Capital Medical University, Beijing, China
| | - Xuhan Shi
- Beijing Tongren Eye Center, Beijing key Laboratory of Intraocular Tumor Diagnosis and Treatment, Beijing Ophthalmology & Visual Sciences Key Lab, Medical Artificial Intelligence Research and Verification Key Laboratory of the Ministry of Industry and Information Technology, Beijing Tongren Hospital, Beijing Tongren Eye Center, Capital Medical University, Beijing, China
| | - Haixia Ji
- Beijing Tongren Eye Center, Beijing key Laboratory of Intraocular Tumor Diagnosis and Treatment, Beijing Ophthalmology & Visual Sciences Key Lab, Medical Artificial Intelligence Research and Verification Key Laboratory of the Ministry of Industry and Information Technology, Beijing Tongren Hospital, Beijing Tongren Eye Center, Capital Medical University, Beijing, China
| | - Yongpeng Zhang
- Beijing Tongren Eye Center, Beijing key Laboratory of Intraocular Tumor Diagnosis and Treatment, Beijing Ophthalmology & Visual Sciences Key Lab, Medical Artificial Intelligence Research and Verification Key Laboratory of the Ministry of Industry and Information Technology, Beijing Tongren Hospital, Beijing Tongren Eye Center, Capital Medical University, Beijing, China
| | - Xuehui Shi
- Beijing Tongren Eye Center, Beijing key Laboratory of Intraocular Tumor Diagnosis and Treatment, Beijing Ophthalmology & Visual Sciences Key Lab, Medical Artificial Intelligence Research and Verification Key Laboratory of the Ministry of Industry and Information Technology, Beijing Tongren Hospital, Beijing Tongren Eye Center, Capital Medical University, Beijing, China
| | - Wen-Bin Wei
- Beijing Tongren Eye Center, Beijing key Laboratory of Intraocular Tumor Diagnosis and Treatment, Beijing Ophthalmology & Visual Sciences Key Lab, Medical Artificial Intelligence Research and Verification Key Laboratory of the Ministry of Industry and Information Technology, Beijing Tongren Hospital, Beijing Tongren Eye Center, Capital Medical University, Beijing, China.
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Tsui MC, Hsieh YT, Lai TT, Hsia Y, Wang SW, Ma IH, Hung KC, Lin CP, Yang CH, Yang CM, Ho TC. Vitreoretinal Interface Changes After Anti-vascular Endothelial Growth Factor Treatment in Highly Myopic Eyes: A Real-World Study. Ophthalmol Ther 2023; 12:1693-1710. [PMID: 37004698 PMCID: PMC10164047 DOI: 10.1007/s40123-023-00701-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 03/06/2023] [Indexed: 04/04/2023] Open
Abstract
INTRODUCTION To investigate changes in the vitreoretinal interface after anti-vascular endothelial growth factor (anti-VEGF) treatment in highly myopic eyes. METHODS Eyes with myopic choroidal neovascularization (mCNV) treated with intravitreal injection of anti-VEGF in a single-center were retrospectively reviewed. Fundus abnormalities and features of optical computed tomography were studied. RESULTS A total of 295 eyes from 254 patients were recruited to the study. Prevalence of myopic macular retinoschisis (MRS) was 25.4%, and the rates of progression and onset of MRS were 75.9% and 16.2%, respectively. Outer retinal schisis (β = 8.586, p = 0.003) and lamellar macular hole (LMH) (β = 5.015, p = 0.043) at baseline were identified risk factors for progression and onset of MRS, whereas male sex (β = 9.000, p = 0.039) and outer retinal schisis at baseline (β = 5.250, p = 0.010) were risk factors for MRS progression. Progression of MRS was first detected in outer retinal layers in 48.3% of eyes. Thirteen eyes required surgical intervention. Spontaneous improvements of MRS were observed in five eyes (6.3%). CONCLUSION Changes in the vitreoretinal interface, such as progression, onset, and improvement of MRS, were observed after anti-VEGF treatment. Outer retinal schisis and LMH were risk factors of progression and onset of MRS after anti-VEGF treatment. Intravitreal injection of ranibizumab and retinal hemorrhage were protective factors for surgical intervention for vision-threatening MRS.
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Affiliation(s)
- Mei-Chi Tsui
- Department of Ophthalmology, National Taiwan University Hospital, No. 7, Zhongshan S. Rd., Zhongzheng District, Taipei, 10002, Taiwan
- Department of Ophthalmology, An Nan Hospital, China Medical University, Tainan, Taiwan
| | - Yi-Ting Hsieh
- Department of Ophthalmology, National Taiwan University Hospital, No. 7, Zhongshan S. Rd., Zhongzheng District, Taipei, 10002, Taiwan
- Department of Ophthalmology, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Tso-Ting Lai
- Department of Ophthalmology, National Taiwan University Hospital, No. 7, Zhongshan S. Rd., Zhongzheng District, Taipei, 10002, Taiwan
- Department of Ophthalmology, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Yun Hsia
- Department of Ophthalmology, National Taiwan University Hospital, No. 7, Zhongshan S. Rd., Zhongzheng District, Taipei, 10002, Taiwan
- Department of Ophthalmology, National Taiwan University Hospital Hsin-Chu Branch, Hsinchu, Taiwan
| | - Shih-Wen Wang
- Department of Ophthalmology, National Taiwan University Hospital, No. 7, Zhongshan S. Rd., Zhongzheng District, Taipei, 10002, Taiwan
- Department of Ophthalmology, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
| | - I-Hsin Ma
- Department of Ophthalmology, National Taiwan University Hospital, No. 7, Zhongshan S. Rd., Zhongzheng District, Taipei, 10002, Taiwan
- Department of Ophthalmology, National Taiwan University Hospital Hsin-Chu Branch, Hsinchu, Taiwan
| | - Kuo-Chi Hung
- Department of Ophthalmology, National Taiwan University Hospital, No. 7, Zhongshan S. Rd., Zhongzheng District, Taipei, 10002, Taiwan
- Universal Eye Clinic, Taipei, Taiwan
| | - Chang-Pin Lin
- Department of Ophthalmology, National Taiwan University Hospital, No. 7, Zhongshan S. Rd., Zhongzheng District, Taipei, 10002, Taiwan
- Department of Ophthalmology, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Chang-Hao Yang
- Department of Ophthalmology, National Taiwan University Hospital, No. 7, Zhongshan S. Rd., Zhongzheng District, Taipei, 10002, Taiwan
- Department of Ophthalmology, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Chung-May Yang
- Department of Ophthalmology, National Taiwan University Hospital, No. 7, Zhongshan S. Rd., Zhongzheng District, Taipei, 10002, Taiwan
- Department of Ophthalmology, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Tzyy-Chang Ho
- Department of Ophthalmology, National Taiwan University Hospital, No. 7, Zhongshan S. Rd., Zhongzheng District, Taipei, 10002, Taiwan.
- Department of Ophthalmology, College of Medicine, National Taiwan University, Taipei, Taiwan.
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Ye M, Ma Y, Qin YX, Cai B, Ma LM, Ma Z, Liu Y, Jin ZB, Zhuang WJ. Mutational investigation of 17 causative genes in a cohort of 113 families with nonsyndromic early-onset high myopia in northwestern China. Mol Genet Genomics 2023; 298:669-682. [PMID: 36964802 DOI: 10.1007/s00438-023-02003-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Accepted: 02/24/2023] [Indexed: 03/26/2023]
Abstract
High myopia (HM) is a leading cause of visual impairment in the world. To expand the genotypic and phenotypic spectra of HM in the Chinese population, we investigated genetic variations in a cohort of 113 families with nonsyndromic early-onset high myopia from northwestern China by whole-exome sequencing, with focus on 17 known genes. Sixteen potentially pathogenic variants predicted to affect protein function in eight of seventeen causative genes for HM in fifteen (13.3%) families were revealed, including seven novel variants, c.767 + 1G > A in ARR3, c.3214C > A/p.H1072N, and c.2195C > T/p.A732V in ZNF644, c.1270G > T/p.V424L in CPSF1, c.1918G > C/p.G640R and c.2786T > G/p.V929G in XYLT1, c.601G > C/p.E201Q in P4HA2; six rare variants, c.799G > A/p.E267K in NDUFAF7, c.1144C > T/p.R382W in TNFRSF21, c.1100C > T/p.P367L in ZNF644, c.3980C > T/p.S1327L in CPSF1, c.145G > A/p.E49K and c.325G > T/p.G109W in SLC39A5; and three known variants, c.2014A > G/p.S672G and c.3261A > C/p.E1087D in ZNF644, c.605C > T/p.P202L in TNFRSF21. Ten of them were co-segregated with HM. The mean (± SD) examination age of these 15 probands was 14.7 (± 11.61) years. The median spherical equivalent was - 9.50 D (IQ - 8.75 ~ - 12.00) for the right eye and - 11.25 D (IQ - 9.25 ~ - 14.13) for the left eye. The median axial length was 26.67 mm (IQ 25.83 ~ 27.13) for the right eye and 26.25 mm (IQ 25.97 ~ 27.32) for the left eye. These newly identified genetic variations not only broaden the genetic and clinical spectra, but also offer convincing evidence that the genes ARR3, NDUFAF7, TNFRSF21, and ZNF644 contribute to hereditable HM. This work improves further understanding of molecular mechanism of HM.
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Affiliation(s)
- Min Ye
- Third Clinical Medical College, Ningxia Medical University, Yinchuan, China
- Ningxia Eye Hospital, People's Hospital of Ningxia Hui Autonomous Region, Third Clinical Medical College of Ningxia Medical University, Yinchuan, China
| | - Ya Ma
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology and Visual Science Key Laboratory, Beijing, China
| | - Yi-Xuan Qin
- Third Clinical Medical College, Ningxia Medical University, Yinchuan, China
| | - Bo Cai
- Ningxia Eye Hospital, People's Hospital of Ningxia Hui Autonomous Region, Third Clinical Medical College of Ningxia Medical University, Yinchuan, China
| | - Li-Mei Ma
- North Minzu University, Yinchuan, China
| | - Zhen Ma
- Ningxia Eye Hospital, People's Hospital of Ningxia Hui Autonomous Region, Third Clinical Medical College of Ningxia Medical University, Yinchuan, China
| | - Yang Liu
- Ningxia Eye Hospital, People's Hospital of Ningxia Hui Autonomous Region, Third Clinical Medical College of Ningxia Medical University, Yinchuan, China
| | - Zi-Bing Jin
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology and Visual Science Key Laboratory, Beijing, China.
| | - Wen-Juan Zhuang
- Ningxia Eye Hospital, People's Hospital of Ningxia Hui Autonomous Region, Third Clinical Medical College of Ningxia Medical University, Yinchuan, China.
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Hui EKY, Yam JCS, Rahman F, Pang CP, Kumaramanickavel G. Ophthalmic genetic counselling: emerging trends in practice perspectives in Asia. J Community Genet 2023; 14:81-89. [PMID: 36322374 PMCID: PMC9947206 DOI: 10.1007/s12687-022-00616-w] [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: 05/04/2022] [Accepted: 10/18/2022] [Indexed: 11/05/2022] Open
Abstract
Genetic counselling (GC) provides information to the patient and the family to make informed choices. Among the advanced Western countries and a few Asian countries, there are certified or trained professionals who perform GC. The Human Genome Project and next-generation sequencing diagnostics have provided an opportunity for increased genetic testing in the field of ophthalmology. The recent interventional therapeutic research strategies have also generated additional interest to seek GC globally, including in Asia. However, GC has several barriers to practise in the developing countries in Asia, namely, (a) shortage of qualified or trained genetic counsellors, (b) poor knowledge and reluctance in clinical adoption of genomics among the physicians in clinical practice, (c) overstretched public health services, and (d) negligible ophthalmic GC-related research and publications. The GC inadequacy in Asia is glaring in the most populous countries like China and India. Cultural differences, religious beliefs, misogyny, genetic discrimination, and a multitude of languages in Asia create unique challenges that counsellors in the West may only encounter with the immigrant minorities. Since there are currently 500 or more specific Mendelian genetic eye disorders, it is important for genetic counsellors to translate the genetic results at a level that the patient and family understand. There is therefore a need for governmental and healthcare organisations to train genetic counsellors in Asia and especially this practice must be included in the routine comprehensive ophthalmic care practice.
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Affiliation(s)
- Esther K. Y. Hui
- Department of Ophthalmology, University College London, London, UK
| | - Jason C. S. Yam
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Kowloon, Hong Kong
| | - Farhana Rahman
- Department of Pharmacology, Sree Balaji Medical College and Hospital, Bharath Institute of Higher Education and Research (BIHER), Chennai, India.
| | - Chi Pui Pang
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Kowloon, Hong Kong
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Mohd-Ali B, Low YC, Mohamad Shahimin M, Arif N, Abdul-Hamid H, Wan Abdul-Halim WH, Mohidin N. Comparison of vision-related quality of life between wearing Orthokeratology lenses and spectacles in myopic children living in Kuala Lumpur. Cont Lens Anterior Eye 2023; 46:101774. [PMID: 36319519 DOI: 10.1016/j.clae.2022.101774] [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: 07/05/2022] [Revised: 10/08/2022] [Accepted: 10/18/2022] [Indexed: 01/18/2023]
Abstract
PURPOSE There are limited reports available on the impact of wearing Orthokeratology (ortho-K) lenses on the quality of life of Asian children. This study evaluated and compared vision-related quality of life (VRQoL) between myopic children wearing ortho-K lenses and single-vision spectacles (SVSs), living in Kuala Lumpur, using Paediatric Refractive Error Profile (PREP) questionnaires. METHODS This is a cross sectional study. Myopic children who had been wearing ortho-K and SVSs for 12 months were recruited, and the questionnaires were distributed online. The PREP scores were obtained using a summary scoring method. The Shapiro-Wilk test was used to determine data normality. Unpaired t-test was performed for normally distributed data, and the Mann-Whitney test for non-normally distributed data. P < 0.05 was considered significant. RESULTS A total of 70 subjects participated in this study (45 ortho-K and 25 SVSs), with a mean age of 10.86 ± 0.73 years. The mean scores for all the items were higher in ortho-K than SVS wearers (p < 0.05). With regard to symptoms during ortho-K lens wear at night, <10 % of the subjects reported difficulty falling asleep, itch/burning/dry eyes and foreign body sensation after lens insertion. CONCLUSION Ortho-K improves the vision-related quality of life of myopic school children in Kuala Lumpur. Thus, it should be considered by more local optometrists when managing myopic children.
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Affiliation(s)
- Bariah Mohd-Ali
- Optometry and Vision Science Program & Research Centre for Community Health (REACH), Faculty of Health Sciences, Universiti Kebangsaan, Malaysia.
| | - Yu Chen Low
- Optometry and Vision Science Program & Research Centre for Community Health (REACH), Faculty of Health Sciences, Universiti Kebangsaan, Malaysia
| | - Mizhanim Mohamad Shahimin
- Optometry and Vision Science Program & Research Centre for Community Health (REACH), Faculty of Health Sciences, Universiti Kebangsaan, Malaysia
| | - Norlaili Arif
- Optometry and Vision Science Program & Research Centre for Community Health (REACH), Faculty of Health Sciences, Universiti Kebangsaan, Malaysia
| | | | | | - Norhani Mohidin
- Optometry Centre, Faculty of Health Science, Universiti Teknologi MARA
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Tang W, Luo Y, Duan X. Distribution of the Retinal Microcirculation Based on the Morphology of the Optic Nerve Head in High Myopia. Semin Ophthalmol 2023:1-8. [PMID: 36658739 DOI: 10.1080/08820538.2023.2169581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
PURPOSE To explore the retinal microvasculature of the optic nerve head and macula and their associations with the optic nerve head deformation in high myopia. METHODS One hundred sixty-seven eyes from patients with high myopia (HM) were enrolled in a cross-sectional study. We have evaluated and measured characteristics like the tilt ratio of the optic disc, interpupillary vascular density (IVD), peripapillary vascular density (PVD), macular vascular density (MVD), subfoveal choroidal thickness (SFCT) and foveal avascular zone (FAZ). The subjects were classified as a non-tilt group (control group) and a tilt group based on the tilt index. The above parameters were utilized to compare the two groups. In addition, we collected the data from the subjects' right eyes to analyze variance, the Kruskal-Wallis test, and the least significant difference. RESULTS The patients were divided into the non-tilt group of ninety-one eyes and the tilt group of seventy-six eyes. We found that the IVD in the tilt group was more significant than in the non-tilt group (t = -2.794, P = .006). On the other hand, the PVD was less in the tilt group than in the non-tilt, especially in the NS, NI and IN directions (tNS = 3.782; tNI = 3.07; tIN = 2.086; P < .05). Interestingly, the values of PVD were the highest in temporal, second in superior and inferior and lowest in nasal. Concerning the fovea-DMVD (including fovea, parafovea and perifovea), we characterized them as more minor in the tilt group when compared to those in the non-tilt group (P < .05). CONCLUSION Herein, we discovered that the retinal microvasculature differed significantly in patients with HM according to the ONH morphology. In this population, lower PVD and thinner SFCT were associated with higher odds of the tilted optic disc. In addition, the other two characteristics, the IVD and DMVD, were affected by the ONH deformation. Finally, we showed that PVD demonstrated better predictability of rapid myopic progression than MVD.
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Affiliation(s)
- Wenquan Tang
- Department of Ophthalmology, Hunan Children's Hospital, Changsha, China.,College of Pharmacy, Changsha Medical University, Changsha, China
| | - YuLin Luo
- Department of Ophthalmology, Hunan Children's Hospital, Changsha, China
| | - Xuanchu Duan
- Department of refractive, Aier School of Ophthalmology, Central South University, Changsha, China
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Liu J, Lu Y, Huang D, Yang J, Fan C, Chen C, Li J, Wang Q, Li S, Jiang B, Jiang H, Li X, Yang Z, Lan W. The Efficacy of Defocus Incorporated Multiple Segments Lenses in Slowing Myopia Progression: Results from Diverse Clinical Circumstances. Ophthalmology 2023; 130:542-550. [PMID: 36642334 DOI: 10.1016/j.ophtha.2023.01.007] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Revised: 12/30/2022] [Accepted: 01/09/2023] [Indexed: 01/15/2023] Open
Abstract
PURPOSE Defocus incorporated multiple segments (DIMS) spectacle lenses were reported to slow myopia progression significantly in a randomized controlled trial (RCT). The study evaluated their effectiveness in clinical settings. DESIGN Retrospective study. PARTICIPANTS Patient records involving use of DIMS and single-vision (SV) spectacle lenses were collected from subsidiary hospitals of Aier Eye Hospital Group. METHODS The spherical equivalent (SE), determined by subjective refraction, was adopted to assess the myopia progression. The strategy of propensity score matching (PSM) was applied to match the confounding baseline characteristics between the 2 groups. The effectiveness was calculated based on the difference of myopia progression of these 2 approaches. MAIN OUTCOME MEASURES Change in SE. RESULTS Three thousand six hundred thirty-nine patients with DIMS and 6838 patients with SV spectacles were included. The age of the patients was 6 to 16 years (mean ± standard deviation: 11.02 ± 2.53 years). The baseline SE was between 0.00 and -10.00 diopters (D) (mean ± standard deviation: -2.78 ± 1.74 D). After the PSM, data on 2240 pairs with 1-year follow-up and on 735 pairs with 2-year follow-up were obtained. Significantly slower progression was seen in the DIMS group at both the 1-year (DIMS, -0.50 ± 0.43 D; SV, -0.77 ± 0.58 D; P < 0.001) and 2-year (DIMS, -0.88 ± 0.62 D; SV, -1.23 ± 0.76 D; P < 0.001) subdataset. In the 1-year subdataset, 40% and 19% showed myopia progression of no more than 0.25 D for the DIMS and SV groups, respectively (chi-square, 223.43; P < 0.001), whereas 9% and 22% showed myopia progression of more than 1.00 D for the DIMS and SV groups, respectively (chi-square, 163.38; P < 0.001). In the 2-year subdataset, 33% and 20% showed myopia progression of no more than 0.50 D for the DIMS and SV groups, respectively (chi-square, 31.15; P < 0.001), whereas 12% and 29% showed myopia progression of more than 1.50 D for the DIMS and SV groups (chi-square, 65.60; P < 0.001). CONCLUSIONS Although the magnitude was lower than that reported in the previous RCT, this large-scale study with diversity of the data sources confirmed the effectiveness of DIMS spectacles to slow myopia progression in clinical practice. FINANCIAL DISCLOSURE(S) Proprietary or commercial disclosure may be found after the references.
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Affiliation(s)
- Jiaxin Liu
- Aier School of Ophthalmology, Central South University, Changsha, China
| | - Yiqiu Lu
- Aier School of Ophthalmology, Central South University, Changsha, China
| | - Dan Huang
- Changsha Aier Eye Hospital, Beijing, China
| | - Jiwen Yang
- Shenyang Aier Eye Hospital, Shenyang, China
| | - Chunlei Fan
- Beijing Aier Intech Eye Hospital, Beijing, China
| | - Chunmei Chen
- Chongqing Aier-Mega Eye Hospital, Chongqing, China
| | - Jianhua Li
- Guangzhou Aier Eye Hospital, Jinan University, Guangzhou, China
| | | | - Shan Li
- Shenzhen Aier Eye Hospital, Huzhou, China
| | | | | | - Xiaoning Li
- Aier School of Ophthalmology, Central South University, Changsha, China; School of Stomatology and Ophthalmology, Xianning Medical College, Hubei University of Science and Technology, Xianning, China; Hunan Province Optometry Engineering and Technology Research Center, Changsha, China; Hunan Province International Cooperation Base for Optometry Science and Technology, Changsha, China
| | - Zhikuan Yang
- Aier School of Ophthalmology, Central South University, Changsha, China; School of Stomatology and Ophthalmology, Xianning Medical College, Hubei University of Science and Technology, Xianning, China; Hunan Province Optometry Engineering and Technology Research Center, Changsha, China; Hunan Province International Cooperation Base for Optometry Science and Technology, Changsha, China
| | - Weizhong Lan
- Aier School of Ophthalmology, Central South University, Changsha, China; Guangzhou Aier Eye Hospital, Jinan University, Guangzhou, China; School of Stomatology and Ophthalmology, Xianning Medical College, Hubei University of Science and Technology, Xianning, China; Hunan Province Optometry Engineering and Technology Research Center, Changsha, China; Hunan Province International Cooperation Base for Optometry Science and Technology, Changsha, China.
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31
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Girard MJA, Panda S, Tun TA, Wibroe EA, Najjar RP, Aung T, Thiéry AH, Hamann S, Fraser C, Milea D. Discriminating Between Papilledema and Optic Disc Drusen Using 3D Structural Analysis of the Optic Nerve Head. Neurology 2023; 100:e192-e202. [PMID: 36175153 DOI: 10.1212/wnl.0000000000201350] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Accepted: 08/19/2022] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND AND OBJECTIVES The distinction of papilledema from other optic nerve head (ONH) lesions mimicking papilledema, such as optic disc drusen (ODD), can be difficult in clinical practice. We aimed the following: (1) to develop a deep learning algorithm to automatically identify major structures of the ONH in 3-dimensional (3D) optical coherence tomography (OCT) scans and (2) to exploit such information to robustly differentiate among ODD, papilledema, and healthy ONHs. METHODS This was a cross-sectional comparative study of patients from 3 sites (Singapore, Denmark, and Australia) with confirmed ODD, those with papilledema due to raised intracranial pressure, and healthy controls. Raster scans of the ONH were acquired using OCT imaging and then processed to improve deep-tissue visibility. First, a deep learning algorithm was developed to identify major ONH tissues and ODD regions. The performance of our algorithm was assessed using the Dice coefficient. Second, a classification algorithm (random forest) was designed to perform 3-class classifications (1: ODD, 2: papilledema, and 3: healthy ONHs) strictly from their drusen and prelamina swelling scores (calculated from the segmentations). To assess performance, we reported the area under the receiver operating characteristic curve for each class. RESULTS A total of 241 patients (256 imaged ONHs, including 105 ODD, 51 papilledema, and 100 healthy ONHs) were retrospectively included in this study. Using OCT images of the ONH, our segmentation algorithm was able to isolate neural and connective tissues and ODD regions/conglomerates whenever present. This was confirmed by an averaged Dice coefficient of 0.93 ± 0.03 on the test set, corresponding to good segmentation performance. Classification was achieved with high AUCs, that is, 0.99 ± 0.001 for the detection of ODD, 0.99 ± 0.005 for the detection of papilledema, and 0.98 ± 0.01 for the detection of healthy ONHs. DISCUSSION Our artificial intelligence approach can discriminate ODD from papilledema, strictly using a single OCT scan of the ONH. Our classification performance was very good in the studied population, with the caveat that validation in a much larger population is warranted. Our approach may have the potential to establish OCT imaging as one of the mainstays of diagnostic imaging for ONH disorders in neuro-ophthalmology, in addition to fundus photography.
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Affiliation(s)
- Michaël J A Girard
- From the Ophthalmic Engineering & Innovation Laboratory (M.J.A.G., S.P.), Singapore Eye Research Institute (T.A.T., R.P.N., T.A., D.M.), Singapore National Eye Centre; Duke-NUS Graduate Medical School (M.J.A.G., T.A.T., R.P.N., T.A., D.M.), Singapore; Institute for Molecular and Clinical Ophthalmology (M.J.A.G.), Basel, Switzerland; Department of Ophthalmology (E.A.W., S.H.), Rigshospitalet, University of Copenhagen, Denmark; Yong Loo Lin School of Medicine (R.P.N., T.A.), and Department of Statistics and Applied Probability (A.H.T.), National University of Singapore; and Save Sight Institute (C.F.), Faculty of Health and Medicine, The University of Sydney, New South Wales, Australia.
| | - Satish Panda
- From the Ophthalmic Engineering & Innovation Laboratory (M.J.A.G., S.P.), Singapore Eye Research Institute (T.A.T., R.P.N., T.A., D.M.), Singapore National Eye Centre; Duke-NUS Graduate Medical School (M.J.A.G., T.A.T., R.P.N., T.A., D.M.), Singapore; Institute for Molecular and Clinical Ophthalmology (M.J.A.G.), Basel, Switzerland; Department of Ophthalmology (E.A.W., S.H.), Rigshospitalet, University of Copenhagen, Denmark; Yong Loo Lin School of Medicine (R.P.N., T.A.), and Department of Statistics and Applied Probability (A.H.T.), National University of Singapore; and Save Sight Institute (C.F.), Faculty of Health and Medicine, The University of Sydney, New South Wales, Australia
| | - Tin Aung Tun
- From the Ophthalmic Engineering & Innovation Laboratory (M.J.A.G., S.P.), Singapore Eye Research Institute (T.A.T., R.P.N., T.A., D.M.), Singapore National Eye Centre; Duke-NUS Graduate Medical School (M.J.A.G., T.A.T., R.P.N., T.A., D.M.), Singapore; Institute for Molecular and Clinical Ophthalmology (M.J.A.G.), Basel, Switzerland; Department of Ophthalmology (E.A.W., S.H.), Rigshospitalet, University of Copenhagen, Denmark; Yong Loo Lin School of Medicine (R.P.N., T.A.), and Department of Statistics and Applied Probability (A.H.T.), National University of Singapore; and Save Sight Institute (C.F.), Faculty of Health and Medicine, The University of Sydney, New South Wales, Australia
| | - Elisabeth A Wibroe
- From the Ophthalmic Engineering & Innovation Laboratory (M.J.A.G., S.P.), Singapore Eye Research Institute (T.A.T., R.P.N., T.A., D.M.), Singapore National Eye Centre; Duke-NUS Graduate Medical School (M.J.A.G., T.A.T., R.P.N., T.A., D.M.), Singapore; Institute for Molecular and Clinical Ophthalmology (M.J.A.G.), Basel, Switzerland; Department of Ophthalmology (E.A.W., S.H.), Rigshospitalet, University of Copenhagen, Denmark; Yong Loo Lin School of Medicine (R.P.N., T.A.), and Department of Statistics and Applied Probability (A.H.T.), National University of Singapore; and Save Sight Institute (C.F.), Faculty of Health and Medicine, The University of Sydney, New South Wales, Australia
| | - Raymond P Najjar
- From the Ophthalmic Engineering & Innovation Laboratory (M.J.A.G., S.P.), Singapore Eye Research Institute (T.A.T., R.P.N., T.A., D.M.), Singapore National Eye Centre; Duke-NUS Graduate Medical School (M.J.A.G., T.A.T., R.P.N., T.A., D.M.), Singapore; Institute for Molecular and Clinical Ophthalmology (M.J.A.G.), Basel, Switzerland; Department of Ophthalmology (E.A.W., S.H.), Rigshospitalet, University of Copenhagen, Denmark; Yong Loo Lin School of Medicine (R.P.N., T.A.), and Department of Statistics and Applied Probability (A.H.T.), National University of Singapore; and Save Sight Institute (C.F.), Faculty of Health and Medicine, The University of Sydney, New South Wales, Australia
| | - Tin Aung
- From the Ophthalmic Engineering & Innovation Laboratory (M.J.A.G., S.P.), Singapore Eye Research Institute (T.A.T., R.P.N., T.A., D.M.), Singapore National Eye Centre; Duke-NUS Graduate Medical School (M.J.A.G., T.A.T., R.P.N., T.A., D.M.), Singapore; Institute for Molecular and Clinical Ophthalmology (M.J.A.G.), Basel, Switzerland; Department of Ophthalmology (E.A.W., S.H.), Rigshospitalet, University of Copenhagen, Denmark; Yong Loo Lin School of Medicine (R.P.N., T.A.), and Department of Statistics and Applied Probability (A.H.T.), National University of Singapore; and Save Sight Institute (C.F.), Faculty of Health and Medicine, The University of Sydney, New South Wales, Australia
| | - Alexandre H Thiéry
- From the Ophthalmic Engineering & Innovation Laboratory (M.J.A.G., S.P.), Singapore Eye Research Institute (T.A.T., R.P.N., T.A., D.M.), Singapore National Eye Centre; Duke-NUS Graduate Medical School (M.J.A.G., T.A.T., R.P.N., T.A., D.M.), Singapore; Institute for Molecular and Clinical Ophthalmology (M.J.A.G.), Basel, Switzerland; Department of Ophthalmology (E.A.W., S.H.), Rigshospitalet, University of Copenhagen, Denmark; Yong Loo Lin School of Medicine (R.P.N., T.A.), and Department of Statistics and Applied Probability (A.H.T.), National University of Singapore; and Save Sight Institute (C.F.), Faculty of Health and Medicine, The University of Sydney, New South Wales, Australia
| | - Steffen Hamann
- From the Ophthalmic Engineering & Innovation Laboratory (M.J.A.G., S.P.), Singapore Eye Research Institute (T.A.T., R.P.N., T.A., D.M.), Singapore National Eye Centre; Duke-NUS Graduate Medical School (M.J.A.G., T.A.T., R.P.N., T.A., D.M.), Singapore; Institute for Molecular and Clinical Ophthalmology (M.J.A.G.), Basel, Switzerland; Department of Ophthalmology (E.A.W., S.H.), Rigshospitalet, University of Copenhagen, Denmark; Yong Loo Lin School of Medicine (R.P.N., T.A.), and Department of Statistics and Applied Probability (A.H.T.), National University of Singapore; and Save Sight Institute (C.F.), Faculty of Health and Medicine, The University of Sydney, New South Wales, Australia
| | - Clare Fraser
- From the Ophthalmic Engineering & Innovation Laboratory (M.J.A.G., S.P.), Singapore Eye Research Institute (T.A.T., R.P.N., T.A., D.M.), Singapore National Eye Centre; Duke-NUS Graduate Medical School (M.J.A.G., T.A.T., R.P.N., T.A., D.M.), Singapore; Institute for Molecular and Clinical Ophthalmology (M.J.A.G.), Basel, Switzerland; Department of Ophthalmology (E.A.W., S.H.), Rigshospitalet, University of Copenhagen, Denmark; Yong Loo Lin School of Medicine (R.P.N., T.A.), and Department of Statistics and Applied Probability (A.H.T.), National University of Singapore; and Save Sight Institute (C.F.), Faculty of Health and Medicine, The University of Sydney, New South Wales, Australia
| | - Dan Milea
- From the Ophthalmic Engineering & Innovation Laboratory (M.J.A.G., S.P.), Singapore Eye Research Institute (T.A.T., R.P.N., T.A., D.M.), Singapore National Eye Centre; Duke-NUS Graduate Medical School (M.J.A.G., T.A.T., R.P.N., T.A., D.M.), Singapore; Institute for Molecular and Clinical Ophthalmology (M.J.A.G.), Basel, Switzerland; Department of Ophthalmology (E.A.W., S.H.), Rigshospitalet, University of Copenhagen, Denmark; Yong Loo Lin School of Medicine (R.P.N., T.A.), and Department of Statistics and Applied Probability (A.H.T.), National University of Singapore; and Save Sight Institute (C.F.), Faculty of Health and Medicine, The University of Sydney, New South Wales, Australia
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Observation of macular hole associated with retinoschisis in patients with high myopia. Graefes Arch Clin Exp Ophthalmol 2023; 261:57-65. [PMID: 35867147 DOI: 10.1007/s00417-022-05766-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2022] [Revised: 06/24/2022] [Accepted: 07/09/2022] [Indexed: 01/04/2023] Open
Abstract
PURPOSE To observe the characteristics of highly myopic macular holes (HMMHs) with macular retinoschisis (MRS) by optical coherence tomography (OCT) and explore the possible relationship between HMMHs and different types of MRS. METHODS We consecutively reviewed the clinical data and OCT images of the patients with HMMHs from June 2015 to February 2021. Then we picked eyes with MRS from these HMMHs for analysis. The minimum linear diameter (MLD), basal diameter (BD), and height (H) of HMMHs were measured. HMMHs were grouped according to the extent or layer involvement of the concomitant MRS and the characteristics were compared among groups. The impact of MRS on the MLD of macular hole was analyzed with multivariable linear regression. RESULTS We included 127 patients with MRS from 168 HMMHs (75.5%) for analysis. According to the different classification systems, the most frequent type of MRS in HMMHs was S3 (foveal but not entire macular area MRS) (62.2%) and both inner- and outer- (I/O-MRS) involved types. In our study, HMMHs with more extensive MRS had larger MLD, larger BD, larger H, and poorer best-corrected visual acuity (BCVA). Meanwhile, HMMHs with outer layer-involved MRS (outer MRS and I/O-MRS) had larger BD than HMMH with only inner layer-involved MRS. (All P < 0.05) Multivariable linear regression further illustrated only the extent of MRS was significantly associated with the MLD of HMMH, while there was no significant correlation between the involved retinal layers and the MLD of HMMH. CONCLUSION HMMH with MRS presented as a predominant type in HMMHs. The MRS was always with a relatively large extent and involved both inner and outer layers. MLD of HMMH was mainly affected by the extent of MRS.
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Yao W, Xu J, She X, Yu J, Liang Z, Ye X, Tao J, Wu S, Mao J, Chen Y, Zhang Y, Shen L. Perforating scleral vessels adjacent to myopic choroidal neovascularization achieved a poor outcome after intravitreal anti-VEGF therapy. Front Med (Lausanne) 2022; 9:1065397. [PMID: 36582283 PMCID: PMC9792597 DOI: 10.3389/fmed.2022.1065397] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2022] [Accepted: 11/21/2022] [Indexed: 12/15/2022] Open
Abstract
Background This study aimed to summarize the features of perforating scleral vessels (PSVs) in patients with myopic choroidal neovascularization (CNV) (mCNV) using optical coherence tomography angiography (OCTA) and to identify the associations with the response after intravitreal anti-vascular endothelial growth factor (anti-VEGF) therapy. Methods A consecutive series of naïve patients who had mCNV and received intravitreal anti-VEGF therapy with a follow-up duration of 12 months or more were enrolled. The prevalence, location, and branches of PSVs were analyzed. Projection-resolved OCTA (PR-OCTA) was used to analyze the neovascular signals between CNV and PSVs. Best corrected visual acuity (BCVA) and central macular thickness (CMT) were measured. The proportion of CMT change relative to baseline was used to assess therapeutic response. Results A total of 44 eyes from 42 patients with mCNV were enrolled. PSVs were identified in 41 out of 44 eyes. Branches were identified in the PSVs of 24 eyes (57.14%), and 20 eyes did not have PSV branches (47.62%). In eight eyes (18.18%), PSVs were adjacent to mCNV, and in 36 eyes (81.82%), PSVs were not adjacent to mCNV. After anti-VEGF therapy for mCNV, BCVA increased (F = 6.119, p < 0.001) and CMT decreased (F = 7.664, p < 0.001). In the eyes where PSVs were adjacent to mCNV, BCVA improvements (F = 7.649, p = 0.009) were poor, and changes in CMT were small. Conclusion The eyes with PSVs adjacent to mCNV showed poor therapeutic responses after intravitreal anti-VEGF therapy.
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Affiliation(s)
- Wangjing Yao
- Department of Vitreous and Retinal Center, Affiliated Eye Hospital of Wenzhou Medical University, Hangzhou, China
| | - Jiawen Xu
- Zhejiang Chinese Medical University Affiliated Jiaxing TCM Hospital, Jiaxing, China
| | - Xiangjun She
- Department of Vitreous and Retinal Center, Affiliated Eye Hospital of Wenzhou Medical University, Hangzhou, China
| | - Jiangxin Yu
- Hwa Mei Hospital, University of Chinese Academy of Sciences (Ningbo No.2 Hospital), Ningbo, China
| | - Zhi Liang
- Department of Vitreous and Retinal Center, Affiliated Eye Hospital of Wenzhou Medical University, Hangzhou, China
| | - Xin Ye
- Department of Vitreous and Retinal Center, Affiliated Eye Hospital of Wenzhou Medical University, Hangzhou, China
| | - Jiwei Tao
- Department of Vitreous and Retinal Center, Affiliated Eye Hospital of Wenzhou Medical University, Hangzhou, China
| | - Sulan Wu
- Department of Vitreous and Retinal Center, Affiliated Eye Hospital of Wenzhou Medical University, Hangzhou, China
| | - Jianbo Mao
- Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College), Hangzhou, China
| | - Yiqi Chen
- Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College), Hangzhou, China
| | - Yun Zhang
- Department of Vitreous and Retinal Center, Affiliated Eye Hospital of Wenzhou Medical University, Hangzhou, China
| | - Lijun Shen
- Department of Vitreous and Retinal Center, Affiliated Eye Hospital of Wenzhou Medical University, Hangzhou, China,Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College), Hangzhou, China,*Correspondence: Lijun Shen
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Zhang F, Liu X, Wang Y, Wang Q, Zheng M, Chang F, Mao X. Characteristics of the optic disc in young people with high myopia. BMC Ophthalmol 2022; 22:477. [PMID: 36482327 PMCID: PMC9730557 DOI: 10.1186/s12886-022-02719-x] [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: 06/11/2022] [Accepted: 11/30/2022] [Indexed: 12/13/2022] Open
Abstract
PURPOSE This study aimed to investigate the characteristics of the optic disc in adolescents and young adults with high myopia by applying optical coherence tomography angiography. METHODS A total of 112 patients with high myopia (spherical equivalent refraction (SER) ≤ -6.00 D) aged 12 to 30 years old were enrolled in this cross-sectional study. Parapapillary atrophy (PPA) and ovality index from scanning laser ophthalmoscopy images and the degree of optic disc tilt from the optic nerve head (ONH) OCT B-scans were analysed using ImageJ and MATLAB software. Peripapillary retinal nerve fibre layer thickness (pRNFLT) and radial peripapillary capillary vessel density (RPC VD) around the optic disc were obtained from the images of the optic disc angiography scan. RESULTS In young high myopia patients, the PPA area was positively correlated with age, axial length (AL) and pRNFLT (all p < 0.05) and negatively correlated with SER (r = -0.222, p = 0.020). The degree of the optic disc tilt was associated with increasing AL and pRNFLT (all p < 0.05). The disc area was positively correlated with AL, pRNFLT, and RPC VD (all p < 0.05). In the multivariate regression analysis, PPA area was independently associated with the degree of optic disc tilt and disc area. The degree of optic disc tilt was affected by AL and PPA area while the change of disc area was influenced by PPA area and pRNFLT (all p < 0.05). CONCLUSION In young patients with high myopia, PPA area, the degree of optic disc tilt and disc area increased with AL and pRNFLT, while decreased with SER. The association between these factors was slightly different in the adolescent and young adult groups. The degree of the optic disc tilt was more associated with AL and SER in the adolescent group while disc area showed more correlated with AL and SER in the young adult group.
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Affiliation(s)
- Fen Zhang
- grid.268099.c0000 0001 0348 3990School of Ophthalmology and Optometry, Wenzhou Medical University, 325000 Wenzhou, Zhejiang China ,grid.417279.eDepartment of Ophthalmology, General Hospital of the Central Theater Command of the People’s Liberation Army of China, 430070 Wuhan, Hubei China
| | - Xinting Liu
- grid.268099.c0000 0001 0348 3990School of Ophthalmology and Optometry, Wenzhou Medical University, 325000 Wenzhou, Zhejiang China
| | - Yanli Wang
- grid.268099.c0000 0001 0348 3990School of Ophthalmology and Optometry, Wenzhou Medical University, 325000 Wenzhou, Zhejiang China
| | - Qian Wang
- grid.268099.c0000 0001 0348 3990School of Ophthalmology and Optometry, Wenzhou Medical University, 325000 Wenzhou, Zhejiang China
| | - Miaoran Zheng
- grid.268099.c0000 0001 0348 3990School of Ophthalmology and Optometry, Wenzhou Medical University, 325000 Wenzhou, Zhejiang China
| | - Feng Chang
- grid.417279.eDepartment of Ophthalmology, General Hospital of the Central Theater Command of the People’s Liberation Army of China, 430070 Wuhan, Hubei China
| | - Xinjie Mao
- grid.268099.c0000 0001 0348 3990School of Ophthalmology and Optometry, Wenzhou Medical University, 325000 Wenzhou, Zhejiang China
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Xiong J, Du R, Xie S, Lu H, Chen C, lgarashi-Yokoi T, Uramoto K, Onishi Y, Yoshida T, Kamoi K, Ohno-Matsui K. Papillary and Peripapillary Hemorrhages in Eyes With Pathologic Myopia. Invest Ophthalmol Vis Sci 2022; 63:28. [DOI: 10.1167/iovs.63.12.28] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Affiliation(s)
- Jianping Xiong
- Department of Ophthalmology Visual Science, Tokyo Medical and Dental University, Tokyo, Japan
| | - Ran Du
- Department of Ophthalmology Visual Science, Tokyo Medical and Dental University, Tokyo, Japan
| | - Shiqi Xie
- Department of Ophthalmology Visual Science, Tokyo Medical and Dental University, Tokyo, Japan
| | - Hongshuang Lu
- Department of Ophthalmology Visual Science, Tokyo Medical and Dental University, Tokyo, Japan
| | - Changyu Chen
- Department of Ophthalmology Visual Science, Tokyo Medical and Dental University, Tokyo, Japan
| | - Tae lgarashi-Yokoi
- Department of Ophthalmology Visual Science, Tokyo Medical and Dental University, Tokyo, Japan
| | - Kengo Uramoto
- Department of Ophthalmology Visual Science, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yuka Onishi
- Department of Ophthalmology Visual Science, Tokyo Medical and Dental University, Tokyo, Japan
| | - Takeshi Yoshida
- Department of Ophthalmology Visual Science, Tokyo Medical and Dental University, Tokyo, Japan
| | - Koju Kamoi
- Department of Ophthalmology Visual Science, Tokyo Medical and Dental University, Tokyo, Japan
| | - Kyoko Ohno-Matsui
- Department of Ophthalmology Visual Science, Tokyo Medical and Dental University, Tokyo, Japan
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Bai JX, Zheng WY, Zhu XQ, Peng XY. Re-vitrectomy for recurrent retinal detachment in post-vitrectomy eyes of rhegmatogenous retinal detachment. BMC Ophthalmol 2022; 22:439. [DOI: 10.1186/s12886-022-02665-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Accepted: 11/01/2022] [Indexed: 11/17/2022] Open
Abstract
Abstract
Background
Recurrent retinal detachment (Re-RD) usually affects the prognosis of surgery for rhegmatogenous retinal detachment (RRD). Previous clinical studies of Re-RD were not specific. This study aimed to analyze the clinical characteristics of Re-RD in post-vitrectomy eyes with RRD and surgical outcomes after revitrectomy without combining it with retinectomy or scleral buckling.
Methods
This is a retrospective case series analyzed the ocular characteristics of 20 recurrent and contralateral eyes, evaluated the significance of the associations between variables before reoperation and the final best-corrected visual acuity (BCVA), and calculated the outcome of revitrectomy.
Results
Patients with phakic eyes, those undergoing only one surgery, and those with more than one break had better final BCVA. The final BCVA was negatively correlated with the axial length and positively correlated with the preoperative BCVA. Among the 12 eyes with no break detected before surgery, 11 (92%) were found to have a small crevice-like break beside the pigment scar of a large number of original laser spots. The single-operation complete retinal reattachment rate was 75%, the complete retinal reattachment rate was 80%, and the final incomplete retinal reattachment rate was 90%. The BCVA improved from 1.2 ± 0.6LogMAR (0.06 ± 0.25) before surgery to 0.8 ± 0.7LogMAR (0.15 ± 0.2) at the last follow-up. The BCVA of 16 patients with complete retinal reattachment improved from 1.0 ± 0.5LogMAR (0.1 ± 0.3) to 0.6 ± 0.4LogMAR (0.25 ± 0.4). In the contralateral eyes, 15% already had vision-damaging disease, and the incidence of eyesight-threating lesions was 5.9% during follow-up.
Conclusions
Revitrectomy without retinectomy or scleral buckling can effectively treat Re-RD in post-vitrectomy eyes. In Re-RD patients with no definite retinal break detected preoperatively, the retinal hole usually shows small crevice-like changes alongside a large number of original laser pigment scars.
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Wu W, Gong Y, Hao H, Zhang J, Su P, Yan Q, Ma Y, Zhao Y. Choroidal layer segmentation in OCT images by a boundary enhancement network. Front Cell Dev Biol 2022; 10:1060241. [PMID: 36438560 PMCID: PMC9691264 DOI: 10.3389/fcell.2022.1060241] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Accepted: 10/25/2022] [Indexed: 12/23/2023] Open
Abstract
Morphological changes of the choroid have been proved to be associated with the occurrence and pathological mechanism of many ophthalmic diseases. Optical Coherence Tomography (OCT) is a non-invasive technique for imaging of ocular biological tissues, that can reveal the structure of the retinal and choroidal layers in micron-scale resolution. However, unlike the retinal layer, the interface between the choroidal layer and the sclera is ambiguous in OCT, which makes it difficult for ophthalmologists to identify with certainty. In this paper, we propose a novel boundary-enhanced encoder-decoder architecture for choroid segmentation in retinal OCT images, in which a Boundary Enhancement Module (BEM) forms the backbone of each encoder-decoder layer. The BEM consists of three parallel branches: 1) a Feature Extraction Branch (FEB) to obtain feature maps with different receptive fields; 2) a Channel Enhancement Branch (CEB) to extract the boundary information of different channels; and 3) a Boundary Activation Branch (BAB) to enhance the boundary information via a novel activation function. In addition, in order to incorporate expert knowledge into the segmentation network, soft key point maps are generated on the choroidal boundary, and are combined with the predicted images to facilitate precise choroidal boundary segmentation. In order to validate the effectiveness and superiority of the proposed method, both qualitative and quantitative evaluations are employed on three retinal OCT datasets for choroid segmentation. The experimental results demonstrate that the proposed method yields better choroid segmentation performance than other deep learning approaches. Moreover, both 2D and 3D features are extracted for statistical analysis from normal and highly myopic subjects based on the choroid segmentation results, which is helpful in revealing the pathology of high myopia. Code is available at https://github.com/iMED-Lab/Choroid-segmentation.
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Affiliation(s)
- Wenjun Wu
- Ningbo Cixi Institute of Biomedical Engineering, Ningbo Institute of Materials Technology and Engineering, Chinese Academy of Sciences, Ningbo, China
- University of Chinese Academy of Sciences, Beijing, China
| | - Yan Gong
- The Affiliated Ningbo Eye Hospital of Wenzhou Medical University, Ningbo, China
| | - Huaying Hao
- Ningbo Cixi Institute of Biomedical Engineering, Ningbo Institute of Materials Technology and Engineering, Chinese Academy of Sciences, Ningbo, China
| | - Jiong Zhang
- Ningbo Cixi Institute of Biomedical Engineering, Ningbo Institute of Materials Technology and Engineering, Chinese Academy of Sciences, Ningbo, China
| | - Pan Su
- School of Control and Computer Engineering North China Electric Power University, Baoding, China
| | - Qifeng Yan
- Ningbo Cixi Institute of Biomedical Engineering, Ningbo Institute of Materials Technology and Engineering, Chinese Academy of Sciences, Ningbo, China
| | - Yuhui Ma
- Ningbo Cixi Institute of Biomedical Engineering, Ningbo Institute of Materials Technology and Engineering, Chinese Academy of Sciences, Ningbo, China
| | - Yitian Zhao
- Ningbo Cixi Institute of Biomedical Engineering, Ningbo Institute of Materials Technology and Engineering, Chinese Academy of Sciences, Ningbo, China
- Zhejiang Engineering Research Center for Biomedical Materials, Ningbo Cixi Institute of Biomedical Engineering, Ningbo Institute of Materials Technology and Engineering, Chinese Academy of Sciences, Ningbo, China
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Du R, Xie S, Lu H, Chen C, Xiong J, Uramoto K, Takahashi H, Onishi Y, Kamoi K, Nakao N, Fang Y, Ohno-Matsui K. Hospital-Based Study of Risk Factors Associated with Development of Myopic Macular Neovascularization in Highly Myopic Eyes. Ophthalmic Res 2022; 66:293-300. [PMID: 36260976 DOI: 10.1159/000527183] [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: 04/17/2022] [Accepted: 09/20/2022] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Myopic macular neovascularization (MNV) is the most common cause of a reduction of central vision in eyes with pathologic myopia, and it can progress to macular atrophy in the long term. The aim of this study was to determine the risk factors associated with the development of MNVs. METHODS There were 17,198 follow-up records from 5,409 eyes of 2,784 highly myopic patients that were reviewed. The general information and ophthalmic information in the records were studied. The significance of the correlations of factors associated with the development and predicting the development of myopic MNV were determined. RESULTS Being a woman (odds ratio [OR] = 0.727, p < 0.001), having a longer axial length (OR = 0.948, p < 0.001), having a poorer baseline best-correct visual acuity (BCVA, OR = 2.098, p < 0.001), having severe myopic maculopathy (overall: p < 0.001), prior myopic MNV in the fellow eye (OR = 4.105, p < 0.001), presence of patchy atrophy (overall p < 0.001), lacquer cracks (OR = 1.718, p < 0.001), prior foveal retinal detachment (RD, OR = 3.269, p < 0.001), prior macular hole (MH, OR = 0.641, p < 0.001), prior macular retinoschisis (OR = 1.533, p < 0.001), and prior macular edema (OR = 1.508, p < 0.001) were significantly correlated with the development of myopic MNV. Eyes with MNV and patchy atrophy would require an intensive follow-up examination for myopic patients as the fellow eye would have a risk of >70% for the development of myopic MNV in 3 years and nearly 80% in 5 years. CONCLUSIONS Clinicians need to pay special attention to eyes with severe grades of myopic maculopathy, prior myopic MNV in the fellow eye, presence of patchy atrophy, and prior foveal retinal detachment to determine the onset of myopic MNV.
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Affiliation(s)
- Ran Du
- Department of Ophthalmology and Visual Science, Tokyo Medical and Dental University, Tokyo, Japan,
| | - Shiqi Xie
- Department of Ophthalmology and Visual Science, Tokyo Medical and Dental University, Tokyo, Japan
| | - Hongshuang Lu
- Department of Ophthalmology and Visual Science, Tokyo Medical and Dental University, Tokyo, Japan
| | - Changyu Chen
- Department of Ophthalmology and Visual Science, Tokyo Medical and Dental University, Tokyo, Japan
| | - Jianping Xiong
- Department of Ophthalmology and Visual Science, Tokyo Medical and Dental University, Tokyo, Japan
| | - Kengo Uramoto
- Department of Ophthalmology and Visual Science, Tokyo Medical and Dental University, Tokyo, Japan
| | - Hiroyuki Takahashi
- Department of Ophthalmology and Visual Science, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yuka Onishi
- Department of Ophthalmology and Visual Science, Tokyo Medical and Dental University, Tokyo, Japan
| | - Koju Kamoi
- Department of Ophthalmology and Visual Science, Tokyo Medical and Dental University, Tokyo, Japan
| | - Noriko Nakao
- Department of Ophthalmology and Visual Science, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yuxin Fang
- Beijing Tongren Eye Center, Beijing Key Laboratory of Ophthalmology and Visual Science, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Kyoko Ohno-Matsui
- Department of Ophthalmology and Visual Science, Tokyo Medical and Dental University, Tokyo, Japan
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Zhang Y, Jeong H, Mori K, Ikeda SI, Shoda C, Miwa Y, Nakai A, Chen J, Ma Z, Jiang X, Torii H, Kubota Y, Negishi K, Kurihara T, Tsubota K. Vascular endothelial growth factor from retinal pigment epithelium is essential in choriocapillaris and axial length maintenance. PNAS NEXUS 2022; 1:pgac166. [PMID: 36714840 PMCID: PMC9802415 DOI: 10.1093/pnasnexus/pgac166] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Accepted: 08/16/2022] [Indexed: 06/18/2023]
Abstract
Myopia, which prevalence is rapidly increasing, causes visual impairment; however, the onset mechanism of pathological axial length (AL) elongation remains unclear. A highly vascularized choroid between the retinal pigment epithelium (RPE) and sclera not only maintains physiological activities, but also contributes to ocular development and growth regulation. Vascular endothelial growth factor (VEGF) secreted from the RPE to the choroid is essential for retinal function and maintenance of the choriocapillaris. Herein, we demonstrated that the loss of VEGF secreted from the RPE caused abnormal choriocapillaris development and AL elongation, with features similar to those of the lens-induced myopia (LIM) mouse model, whereas VEGF overexpression by knocking-out von Hippel-Lindau (VHL) specific to the RPE expands the choriocapillaris and shortens the AL. Additionally, LDL Receptor Related Protein 2 (LRP2) deletion in the RPE downregulated VEGF expression and leads to pathological AL elongation. Furthermore, high-myopia patients without choriocapillaris demonstrated longer ALs than did those with preserved choriocapillaris. These results suggest that physiological secretion of VEGF from the RPE is required for proper AL development by maintaining the choriocapillaris. The pinpoint application of VEGF to the choriocapillaris may become a potential intervention for the prevention and treatment of axial myopia progression.
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Affiliation(s)
- Yan Zhang
- Laboratory of Photobiology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
- Department of Ophthalmology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
| | - Heonuk Jeong
- Laboratory of Photobiology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
- Department of Ophthalmology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
| | - Kiwako Mori
- Laboratory of Photobiology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
- Department of Ophthalmology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
| | - Shin-Ichi Ikeda
- Laboratory of Photobiology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
- Department of Ophthalmology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
| | - Chiho Shoda
- Laboratory of Photobiology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
- Department of Ophthalmology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
- Department of Ophthalmology, Nihon University School of Medicine, 30-1 Oyaguchikamicho, Itabashi City, Tokyo 173-8610, Japan
| | - Yukihiro Miwa
- Laboratory of Photobiology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
- Department of Ophthalmology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
- Aichi Animal Eye Clinic, 3 Chome-17-3 Honjitori, Minami Ward, Nagoya, Aichi 457-0074, Japan
| | - Ayaka Nakai
- Laboratory of Photobiology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
- Department of Ophthalmology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
- Department of Ophthalmology, Nihon University School of Medicine, 30-1 Oyaguchikamicho, Itabashi City, Tokyo 173-8610, Japan
| | - Junhan Chen
- Laboratory of Photobiology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
- Department of Ophthalmology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
| | - Ziyan Ma
- Laboratory of Photobiology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
- Department of Ophthalmology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
| | - Xiaoyan Jiang
- Laboratory of Photobiology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
- Department of Ophthalmology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
| | - Hidemasa Torii
- Laboratory of Photobiology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
- Department of Ophthalmology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
| | - Yoshiaki Kubota
- Department of Anatomy, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
| | - Kazuno Negishi
- Department of Ophthalmology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
| | - Toshihide Kurihara
- Laboratory of Photobiology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
- Department of Ophthalmology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
| | - Kazuo Tsubota
- Department of Ophthalmology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
- Tsubota Laboratory Inc., 34 Shinanomachi, 304 Toshin Shinanomachi Ekimae Building, Shinjuku-ku, Tokyo 160-0016, Japan
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Liu YL, Jhang JP, Hsiao CK, Tsai TH, Wang IJ. Influence of parental behavior on myopigenic behaviors and risk of myopia: analysis of nationwide survey data in children aged 3 to 18 years. BMC Public Health 2022; 22:1637. [PMID: 36038863 PMCID: PMC9426005 DOI: 10.1186/s12889-022-14036-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Accepted: 08/17/2022] [Indexed: 11/24/2022] Open
Abstract
Background Preventive parental behavior may play an important role in the outcomes of children’s myopia. We investigated associations between parental behavior and children’s myopia status and daily activities using data from the most recent myopia survey in Taiwan. Methods In total, 3845 children aged 3 to 18 years who completely responded to the questionnaire were included (total score ranging from 0 to 75). A score of ≥ 50 was considered to indicate beneficial parental behavior. Time allocation data for near-work activities, using electronic devices, and outdoor activities were collected using a separate self-reported questionnaire. Associations between beneficial parental behavior and children’s myopia status and activity patterns were analyzed and stratified by school level. Results Beneficial parental behavior was positively associated with children’s myopia in the overall samples [adj. odds ratio (OR): 1.31, 95% confidence interval (CI): 1.08–1.59, p = 0.006)] and at the elementary school level (adj. OR: 1.43, 95% CI: 1.11–1.83, p = 0.005). However, a negative association with high myopia was observed in the overall samples (adj. OR: 0.71, 95% CI: 0.50–0.99, p = 0.049) and high school level (adj. OR: 0.62, 95% CI: 0.41–0.92, p = 0.02). Beneficial parental behavior was associated with less time spent on near work (≥ 180 min/day) and electronic device use (≥ 60 min/day), but not with outdoor activities. Conclusion In Taiwan, children’s myopia is associated with higher rate of parents’ beneficial behaviors, which suggests that regular vision surveillance is necessary to promote better parental behavior toward children’s eye care. Certain parental practices may influence children’s behavior pattern and reduce the risk of children’s high myopia development in the long run. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-14036-5.
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Affiliation(s)
- Yao-Lin Liu
- Department of Ophthalmology, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan.,Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Jia-Pang Jhang
- Department of Ophthalmology, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Chuhsing Kate Hsiao
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Tzu-Hsun Tsai
- Department of Ophthalmology, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan.
| | - I-Jong Wang
- Department of Ophthalmology, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan
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Wang Y, Liu L, Lu Z, Qu Y, Ren X, Wang J, Lu Y, Liang W, Xin Y, Zhang N, Jin L, Wang L, Song J, Yu J, Zhao L, Ma X, Zhang L. Rural-urban differences in prevalence of and risk factors for refractive errors among school children and adolescents aged 6-18 years in Dalian, China. Front Public Health 2022; 10:917781. [PMID: 36106164 PMCID: PMC9465045 DOI: 10.3389/fpubh.2022.917781] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Accepted: 08/08/2022] [Indexed: 01/22/2023] Open
Abstract
Purpose To assess the prevalence of refractive errors (REs) in school children aged 6-18 years in urban and rural settings in Dalian, Northeast of China. Methods This is a school-based cross-sectional survey using multi-stage randomization technique. Six- to eighteen-year-old school children from elementary schools, junior and senior high schools from a rural area and an urban area in Dalian were included in December 2018. All subjects underwent a comprehensive questionnaire and eye examination. Results A total of 4,522 school children with 6-18 years of age were investigated. The age, gender-adjusted prevalence of myopia, and anisometropia were 82.71 and 7.27% among the urban students as compared to 71.76% and 5.41% among the rural ones (OR = 1.80, 95 % CI = 1.53 - 2.11, P < 0.001; OR = 1.29, 95 % CI = 1.00-1.67, P = 0.049), respectively. The hyperopia was less common in urban students than in rural ones (5.63 vs. 10.21%; OR = 0.54, 95 % CI: 0.43-0.67, P < 0.001). However, there was no significant difference in prevalence of astigmatism between urban (46.07%) and rural (44.69%) participants (OR = 0.96, 95 % CI: 0.84-1.10, P = 0.559). The differences on prevalence of REs were attributed to different social-demographic and physiologic factors. Conclusions The students from urban settings are more likely to have myopia and anisometropia but less likely to have hyperopia than their rural counterparts. Although considerable attention had been paid to controlling REs, it is necessary to further consider the urban-rural differences in REs.
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Affiliation(s)
- Yachen Wang
- Department of Ophthalmology, The Third People's Hospital of Dalian, Dalian, China,Department of Ophthalmology, Dalian Third People's Hospital Affiliated to Dalian Medical University, Dalian, China
| | - Lei Liu
- Department of Ophthalmology, Guangdong Eye Institute, Guangdong Provincial People's Hospital, Guangzhou, China,Lei Liu
| | - Zhili Lu
- Department of Ophthalmology, The First Affiliated Hospital of Dalian Medical University, Dalian, China
| | | | - Xianlong Ren
- Beijing Center for Diseases Prevention and Control, Beijing, China
| | - Jiaojiao Wang
- Department of Ophthalmology, The Third People's Hospital of Dalian, Dalian, China,Department of Ophthalmology, Dalian Third People's Hospital Affiliated to Dalian Medical University, Dalian, China
| | - Yan Lu
- Department of Ophthalmology, The First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Wei Liang
- Department of Ophthalmology, The Third People's Hospital of Dalian, Dalian, China,Department of Ophthalmology, Dalian Third People's Hospital Affiliated to Dalian Medical University, Dalian, China
| | - Yue Xin
- Department of Ophthalmology, The Third People's Hospital of Dalian, Dalian, China,Department of Ophthalmology, Dalian Third People's Hospital Affiliated to Dalian Medical University, Dalian, China
| | - Nan Zhang
- Department of Ophthalmology, The Third People's Hospital of Dalian, Dalian, China,Department of Ophthalmology, Dalian Third People's Hospital Affiliated to Dalian Medical University, Dalian, China
| | - Lin Jin
- Department of Ophthalmology, The Third People's Hospital of Dalian, Dalian, China,Department of Ophthalmology, Dalian Third People's Hospital Affiliated to Dalian Medical University, Dalian, China
| | - Lijing Wang
- Department of Ophthalmology, The Third People's Hospital of Dalian, Dalian, China,Department of Ophthalmology, Dalian Third People's Hospital Affiliated to Dalian Medical University, Dalian, China
| | - Jian Song
- Department of Ophthalmology, The Third People's Hospital of Dalian, Dalian, China,Department of Ophthalmology, Dalian Third People's Hospital Affiliated to Dalian Medical University, Dalian, China
| | - Jian Yu
- Department of Ophthalmology, The Third People's Hospital of Dalian, Dalian, China,Department of Ophthalmology, Dalian Third People's Hospital Affiliated to Dalian Medical University, Dalian, China
| | - Lijun Zhao
- Department of Ophthalmology, The Third People's Hospital of Dalian, Dalian, China,Department of Ophthalmology, Dalian Third People's Hospital Affiliated to Dalian Medical University, Dalian, China
| | - Xiang Ma
- Department of Ophthalmology, The First Affiliated Hospital of Dalian Medical University, Dalian, China,Xiang Ma
| | - Lijun Zhang
- Department of Ophthalmology, The Third People's Hospital of Dalian, Dalian, China,Department of Ophthalmology, Dalian Third People's Hospital Affiliated to Dalian Medical University, Dalian, China,*Correspondence: Lijun Zhang
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Lian P, Zhao X, Song H, Tanumiharjo S, Chen J, Wang T, Chen S, Lu L. Metabolic characterization of human intraocular fluid in patients with pathological myopia. Exp Eye Res 2022; 222:109184. [PMID: 35820467 DOI: 10.1016/j.exer.2022.109184] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2022] [Revised: 05/31/2022] [Accepted: 07/05/2022] [Indexed: 11/18/2022]
Abstract
Pathological myopia (PM) and its associated complications can lead to permanent vision loss. However, the cellular mechanisms underlying PM development remain unclear. To identify the metabolic alterations that may contribute to the pathophysiology of PM, we performed non-targeted metabolomics analysis using ultra-high-performance liquid chromatography with tandem mass spectrometry in age- and sex-matched patients with PM (n = 30) and individuals without myopia as controls (n = 30). Targeted metabolomics and insulin microarray were used to validate the results. We identified 508 metabolites in the aqueous humour (AH) and 601 in the vitreous humour (VH). Statistical evaluation revealed that 104 metabolites in AH and 114 metabolites in VH were significantly different between the two groups (variable important for the projection >1, fold change >1.5, or < 0.667, and P < 0.05). The four metabolic pathways enriched in both AH and VH identified to be associated with PM were: bile secretion, insulin secretion, thyroid hormone synthesis, and cGMP-PKG signaling pathway. The concentration of 10 amino acids was significantly higher in the PM than in the controls. Insulin microarray analysis showed that insulin, insulin-like growth factor 2 (IGF-2), IGF-2R, insulin-like growth factor binding protein 1 (IGFBP-1), IGFBP-2, IGFBP-3, IGFBP-4, and IGFBP-6 levels were significantly higher in PM patients compared to that in the controls. Thus, this study identified potential metabolite biomarkers for PM and provided novel insights into the mechanisms underlying this disorder.
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Affiliation(s)
- Ping Lian
- 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, 510060, China
| | - Xiujuan Zhao
- 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, 510060, China
| | - Huiying Song
- 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, 510060, China
| | - Silvia Tanumiharjo
- 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, 510060, China
| | - Jing Chen
- 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, 510060, China
| | - Tong Wang
- 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, 510060, China
| | - Shida Chen
- 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, 510060, China
| | - Lin Lu
- 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, 510060, China.
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Khezri R. Covid-19 pandemic and risk of Myopia. Ann Med Surg (Lond) 2022; 79:103944. [PMID: 35747306 PMCID: PMC9212979 DOI: 10.1016/j.amsu.2022.103944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Accepted: 06/02/2022] [Indexed: 11/17/2022] Open
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Zhang M, Sun Z, Zhu X, Zhang H, Zhu Y, Yan H. Sports and Myopia: An Investigation on the Prevalence and Risk Factors of Myopia in Young Sports-Related Groups in Tianjin, China. Invest Ophthalmol Vis Sci 2022; 63:27. [PMID: 35758907 PMCID: PMC9248751 DOI: 10.1167/iovs.63.6.27] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Objective To explore the relationship between sports and the prevalence of myopia in young sports-related groups in Tianjin, China. Methods In this cross-sectional study, a cluster sampling method was used to survey professional athletes in Tianjin, students at Tianjin University of Sport, and Tianjin Vocational College of Sports. All participants completed epidemiological questionnaires and ophthalmic examinations. Multivariable logistic regression models were used to explore the potential risk factors of myopia. Results This study recruited 1401 participants. The prevalence of myopia was 50.18%. The prevalence of low, moderate, and high myopia were 52.63%, 37.41%, and 9.96%, respectively. There were no sex-related differences in the prevalence of myopia. The odds of having myopia was 1.788 times higher in the indoor sports group than the outdoor sports group (the adjusted odds ratio [OR], 95% confidence interval [CI], 1.391–2.297). Training time of more than 4 h/d (4–6 h/d: OR, 0.539; 95% CI, 0.310–0.938; >6 h/d: OR, 0.466; 95% CI, 0.257–0.844) resulted in a lower risk of myopia. Participants who often used the electronic screen (OR, 1.406; 95% CI, 1.028–1.923) and/or had a family history of myopia (OR, 2.022; 95% CI, 1.480–2.763) were more likely to suffer from myopia. Conclusions Outdoor sports do not necessarily guarantee to insulate against myopia. Youngsters engaged in outdoor sports had a lower prevalence of myopia than those participating in indoor sports. Electronic screen use, training time, and family history of myopia were also associated with the prevalence of myopia in young sports-related groups.
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Affiliation(s)
- Mingxue Zhang
- Department of Ophthalmology, Tianjin Medical University General Hospital, Heping District, Tianjin, China
| | - Zhiyong Sun
- Department of Ophthalmology, Tianjin Medical University General Hospital, Heping District, Tianjin, China
| | - Xinlei Zhu
- Department of Ophthalmology, Tianjin Medical University General Hospital, Heping District, Tianjin, China.,Shandong Eye Institute, Shandong First Medical University & Shandong Academy of Medical Sciences, Shinan District, Qingdao, China
| | - Haokun Zhang
- Department of Ophthalmology, Tianjin Medical University General Hospital, Heping District, Tianjin, China
| | - Yun Zhu
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Heping District, Tianjin, China
| | - Hua Yan
- Department of Ophthalmology, Tianjin Medical University General Hospital, Heping District, Tianjin, China.,Laboratory of Molecular Ophthalmology, Basic Medical Research Center, Tianjin Medical University, Heping District, Tianjin, China.,School of Medicine, Nankai University, Nankai District, Tianjin, China
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Tang J, Yuan M, Tian K, Wang Y, Wang D, Yang J, Yang Z, He X, Luo Y, Li Y, Xu J, Li X, Ding D, Ren Y, Chen Y, Sadda SR, Yu W. An Artificial-Intelligence-Based Automated Grading and Lesions Segmentation System for Myopic Maculopathy Based on Color Fundus Photographs. Transl Vis Sci Technol 2022; 11:16. [PMID: 35704327 PMCID: PMC9206390 DOI: 10.1167/tvst.11.6.16] [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: 12/05/2022] Open
Abstract
Purpose To develop deep learning models based on color fundus photographs that can automatically grade myopic maculopathy, diagnose pathologic myopia, and identify and segment myopia-related lesions. Methods Photographs were graded and annotated by four ophthalmologists and were then divided into a high-consistency subgroup or a low-consistency subgroup according to the consistency between the results of the graders. ResNet-50 network was used to develop the classification model, and DeepLabv3+ network was used to develop the segmentation model for lesion identification. The two models were then combined to develop the classification-and-segmentation–based co-decision model. Results This study included 1395 color fundus photographs from 895 patients. The grading accuracy of the co-decision model was 0.9370, and the quadratic-weighted κ coefficient was 0.9651; the co-decision model achieved an area under the receiver operating characteristic curve of 0.9980 in diagnosing pathologic myopia. The photograph-level F1 values of the segmentation model identifying optic disc, peripapillary atrophy, diffuse atrophy, patchy atrophy, and macular atrophy were all >0.95; the pixel-level F1 values for segmenting optic disc and peripapillary atrophy were both >0.9; the pixel-level F1 values for segmenting diffuse atrophy, patchy atrophy, and macular atrophy were all >0.8; and the photograph-level recall/sensitivity for detecting lacquer cracks was 0.9230. Conclusions The models could accurately and automatically grade myopic maculopathy, diagnose pathologic myopia, and identify and monitor progression of the lesions. Translational Relevance The models can potentially help with the diagnosis, screening, and follow-up for pathologic myopic in clinical practice.
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Affiliation(s)
- Jia Tang
- Department of Ophthalmology, Peking Union Medical College Hospital, Beijing, China.,Key Laboratory of Ocular Fundus Diseases, Chinese Academy of Medical Sciences, Beijing, China
| | - Mingzhen Yuan
- Department of Ophthalmology, Peking Union Medical College Hospital, Beijing, China.,Key Laboratory of Ocular Fundus Diseases, Chinese Academy of Medical Sciences, Beijing, China
| | - Kaibin Tian
- AI and Media Computing Lab, School of Information, Renmin University of China, Beijing, China
| | - Yuelin Wang
- Department of Ophthalmology, Peking Union Medical College Hospital, Beijing, China.,Key Laboratory of Ocular Fundus Diseases, Chinese Academy of Medical Sciences, Beijing, China
| | - Dongyue Wang
- Department of Ophthalmology, Peking Union Medical College Hospital, Beijing, China.,Key Laboratory of Ocular Fundus Diseases, Chinese Academy of Medical Sciences, Beijing, China
| | - Jingyuan Yang
- Department of Ophthalmology, Peking Union Medical College Hospital, Beijing, China.,Key Laboratory of Ocular Fundus Diseases, Chinese Academy of Medical Sciences, Beijing, China
| | - Zhikun Yang
- Department of Ophthalmology, Peking Union Medical College Hospital, Beijing, China
| | - Xixi He
- Vistel AI Lab, Visionary Intelligence, Beijing, China
| | - Yan Luo
- Department of Ophthalmology, Peking Union Medical College Hospital, Beijing, China
| | - Ying Li
- Department of Ophthalmology, Peking Union Medical College Hospital, Beijing, China
| | - Jie Xu
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology and Visual Science Key Laboratory, Beijing, China
| | - Xirong Li
- AI and Media Computing Lab, School of Information, Renmin University of China, Beijing, China.,Key Laboratory of Data Engineering and Knowledge Engineering, Renmin University of China, Beijing, China
| | - Dayong Ding
- Vistel AI Lab, Visionary Intelligence, Beijing, China
| | - Yanhan Ren
- Chicago Medical School, Rosalind Franklin University of Medicine and Science, North Chicago, IL, USA
| | - Youxin Chen
- Department of Ophthalmology, Peking Union Medical College Hospital, Beijing, China.,Key Laboratory of Ocular Fundus Diseases, Chinese Academy of Medical Sciences, Beijing, China
| | - Srinivas R Sadda
- Doheny Eye Institute, Los Angeles, CA, USA.,Department of Ophthalmology, University of California, Los Angeles, Los Angeles, CA, USA
| | - Weihong Yu
- Department of Ophthalmology, Peking Union Medical College Hospital, Beijing, China.,Key Laboratory of Ocular Fundus Diseases, Chinese Academy of Medical Sciences, Beijing, China
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Yang K, Li J, Zhang W, Liu Z, Song C, Zhao Y. Comparison of pre-chop technique using a reverse chopper and classic stop-and-chop technique in the treatment of high myopia associated with nuclear cataract. BMC Surg 2022; 22:206. [PMID: 35643561 PMCID: PMC9148448 DOI: 10.1186/s12893-022-01658-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Accepted: 05/17/2022] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND To evaluate the safety and efficacy of the pre-chop technique using a novel reverse chopper vs. the classic stop-and-chop technique in phacoemulsification for patients with high myopia and associated grade III-IV nuclear cataracts. METHODS In this prospective cohort study, a total of 44 consecutive patients (44 eyes) with grade III-IV nuclear cataracts who were admitted to our hospital for cataract surgery between March 2018 and September 2018 were enrolled. All patients had ocular axial length > 27 mm and myopic refraction more than -10 diopters. Patients were randomly divided into a pre-chop group and stop-and-chop group using a randomization table. Nucleus splitting was performed surgically in both groups using either the pre-chop technique with reverse chopper or the classic stop-and-chop technique. RESULTS Postoperative visual acuity was significantly improved in both groups compared with preoperative values. Significantly better visual acuity, lower degree of corneal edema and lower rates of corneal endothelial cell loss were observed in the pre-chop group compared to those in the classic stop-and-chop group. No complications were reported in either group. CONCLUSIONS In treating patients with high myopia associated with grade III-IV cataracts, the pre-chop technique using a reverse chopper reduces damage to corneal endothelial cells and improves visual acuity better than the classic stop-and-chop technique.
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Affiliation(s)
- Ke Yang
- Beijing Tongren Eye Center, Beijing Key Laboratory of Ophthalmology and Visual Science, Beijing Tongren Hospital, Capital Medical University, Dongjiaominxiang 1st, Dongcheng District, Beijing, 100730, China
| | - Jiaxin Li
- Medical School, Pingdingshan University, Pingdingshan, 467000, China
| | - Weihua Zhang
- Liaocheng People's Hospital, Liaocheng, 252000, China
| | - Zhanjiang Liu
- Chaoyang Central Hospital, Chaoyang City, 122000, Liaoning Province, China
| | - Chenjie Song
- Beijing Tongren Eye Center, Beijing Key Laboratory of Ophthalmology and Visual Science, Beijing Tongren Hospital, Capital Medical University, Dongjiaominxiang 1st, Dongcheng District, Beijing, 100730, China
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Anomalies of choroidal venous structure in highly myopic eyes. Retina 2022; 42:1655-1664. [DOI: 10.1097/iae.0000000000003529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Berhane MA, Demilew KZ, Assem AS. Myopia: An Increasing Problem for Medical Students at the University of Gondar. Clin Ophthalmol 2022; 16:1529-1539. [PMID: 35615078 PMCID: PMC9126289 DOI: 10.2147/opth.s365618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Accepted: 05/10/2022] [Indexed: 11/23/2022] Open
Abstract
Purpose The purpose of this study was to assess the prevalence and associated factors of myopia among medical students at the University of Gondar College of Medicine and Health Sciences, Northwest Ethiopia. Patients and Methods Institution-based cross-sectional study was conducted at the University of Gondar College of Medicine and Health Sciences from June 20 to August 15, 2021. A simple random sampling technique with proportional allocation was used to select 492 students. Interviewer-administered questionnaire, Snellen acuity chart, pinhole, retinoscope and direct ophthalmoscope were used to collect the data. The data were entered to EpiData version 4.6 and exported to SPSS version 25 for analysis. Descriptive statistics were summarized by measures of central tendency. Variables with p-value ≤0.2 in bivariable regression were entered into a multivariable logistic regression model. Adjusted odds ratio with 95% confidence interval was used and variables with p-values <0.05 were considered as statistically significant. Results A total of 492 respondents participated giving a response rate of 98.3%. The prevalence of myopia was found to be 16.7% (95% CI = 12.8–19.4%). Urban residents (AOR = 1.56; 95% CI: 1.28–6.21), family history of myopia (AOR = 2.31; 95% CI: 1.33–4.54), near-work activity of 5–7 hours (AOR = 2.41; 95% CI: 1.31–5.76) and ≥8 hours (AOR = 4.35; 95% CI: 1.96–9.66), outdoor activity for <3 hours (AOR = 1.65 95% CI: (1.14–4.53), were significantly associated with myopia. Conclusion The prevalence of myopia among medical students at the University of Gondar College of Medicine and Health Sciences was high. Urban residency, positive family history, longer time spent on near-work activities and less outdoor activity were positively associated with myopia.
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Affiliation(s)
- Michael Assefa Berhane
- Department of Ophthalmology, St. Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - Ketemaw Zewdu Demilew
- Department of Optometry, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
- Correspondence: Ketemaw Zewdu Demilew, Department of Optometry, College of Medicine and Health Sciences, University of Gondar, PO Box 196, Gondar, Ethiopia, Tel +251-918150629, Email
| | - Abel Sinshaw Assem
- Department of Optometry, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Zhang XF, Li XX, Xin C, Kline B, Kang MT, Li M, Qiao LY, Wang NL. Refractive Lens Exchange Surgery in Early-Onset High Myopia Patients With Partial Cataract. Front Med (Lausanne) 2022; 9:739197. [PMID: 35492336 PMCID: PMC9051036 DOI: 10.3389/fmed.2022.739197] [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] [Received: 07/10/2021] [Accepted: 03/08/2022] [Indexed: 12/04/2022] Open
Abstract
Purpose By reporting clinical characteristics and retinal image quality before and after refractive lens replacement surgery in early-onset high myopia (eoHM) patients presenting with partial cataract, we emphasized the need for an objective way to grade the severity of partial cataracts. Methods This retrospective, consecutive case series included six Chinese patients (nine eyes). Analysis of previous medical records, visual acuity, optometry, retinal image quality, and axial length (AXL) before surgery and after surgery was performed. Results Five females and one male (nine eyes) with a mean (± SD) age of 11.6 ± 7.9 years (range: 4–25 years) were included in this study. The preoperative spherical power ranged from −7.5 to −42 D. The mean follow-up time was 36 months (range: 24–48 months). Phacoemulsification was followed by in-the-bag implantation of intraocular lens. For patients who were under 6 years old, posterior capsulotomy + anterior vitrectomy were performed simultaneously. All surgeries were uneventful and no postoperative complications occurred during the entire follow-up period. All patients’ uncorrected visual acuity improved by ≥2 lines postoperatively(Snellen acuity). LogMAR best-corrected visual acuity was improved at 24-month (P = 0.042) and endpoint (P = 0.046) follow-ups. Modulation transfer function cutoff frequency (MTFcutoff) and objective scatter index (OSI) was significantly improved at 12-month (P = 0.025, P = 0.038), 24-month (P = 0.005, P = 0.007) and endpoint (P = 0.005, P = 0.008) follow-ups. Postoperative AXL remained stable during 2–4 year follow-ups (P > 0.05). Conclusion Refractive lens replacement surgery is safe and effective for improving functional vision in eoHM patients presenting with partial cataract. Retinal image quality could provide a useful and objective way to facilitate partial cataract severity evaluation and surgery decision making.
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Affiliation(s)
- Xi-Fang Zhang
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology and Visual Sciences Key Laboratory, Beijing, China
| | - Xiao-Xia Li
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology and Visual Sciences Key Laboratory, Beijing, China
| | - Chen Xin
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology and Visual Sciences Key Laboratory, Beijing, China
| | - Brad Kline
- Department of Ophthalmology, University of California, San Francisco, San Francisco, CA, United States
| | - Meng-Tian Kang
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology and Visual Sciences Key Laboratory, Beijing, China
| | - Meng Li
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology and Visual Sciences Key Laboratory, Beijing, China
| | - Li-Ya Qiao
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology and Visual Sciences Key Laboratory, Beijing, China
- *Correspondence: Li-Ya Qiao,
| | - Ning-Li Wang
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology and Visual Sciences Key Laboratory, Beijing, China
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Li J, Wang L, Gao Y, Liang Q, Chen L, Sun X, Yang H, Zhao Z, Meng L, Xue S, Du Q, Zhang Z, Lv C, Xu H, Guo Z, Xie G, Xie L. Automated detection of myopic maculopathy from color fundus photographs using deep convolutional neural networks. EYE AND VISION (LONDON, ENGLAND) 2022; 9:13. [PMID: 35361278 PMCID: PMC8973805 DOI: 10.1186/s40662-022-00285-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Accepted: 03/09/2022] [Indexed: 02/07/2023]
Abstract
BACKGROUND Myopic maculopathy (MM) has become a major cause of visual impairment and blindness worldwide, especially in East Asian countries. Deep learning approaches such as deep convolutional neural networks (DCNN) have been successfully applied to identify some common retinal diseases and show great potential for the intelligent analysis of MM. This study aimed to build a reliable approach for automated detection of MM from retinal fundus images using DCNN models. METHODS A dual-stream DCNN (DCNN-DS) model that perceives features from both original images and corresponding processed images by color histogram distribution optimization method was designed for classification of no MM, tessellated fundus (TF), and pathologic myopia (PM). A total of 36,515 gradable images from four hospitals were used for DCNN model development, and 14,986 gradable images from the other two hospitals for external testing. We also compared the performance of the DCNN-DS model and four ophthalmologists on 3000 randomly sampled fundus images. RESULTS The DCNN-DS model achieved sensitivities of 93.3% and 91.0%, specificities of 99.6% and 98.7%, areas under the receiver operating characteristic curves (AUC) of 0.998 and 0.994 for detecting PM, whereas sensitivities of 98.8% and 92.8%, specificities of 95.6% and 94.1%, AUCs of 0.986 and 0.970 for detecting TF in two external testing datasets. In the sampled testing dataset, the sensitivities of four ophthalmologists ranged from 88.3% to 95.8% and 81.1% to 89.1%, and the specificities ranged from 95.9% to 99.2% and 77.8% to 97.3% for detecting PM and TF, respectively. Meanwhile, the DCNN-DS model achieved sensitivities of 90.8% and 97.9% and specificities of 99.1% and 94.0% for detecting PM and TF, respectively. CONCLUSIONS The proposed DCNN-DS approach demonstrated reliable performance with high sensitivity, specificity, and AUC to classify different MM levels on fundus photographs sourced from clinics. It can help identify MM automatically among the large myopic groups and show great potential for real-life applications.
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Affiliation(s)
- Jun Li
- Qingdao Eye Hospital of Shandong First Medical University, 5 Yanerdao Road, Qingdao, 266071, China.,State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Shandong First Medical University & Shandong Academy of Medical Sciences, Qingdao, 266071, China
| | - Lilong Wang
- Ping An Healthcare Technology, 9F Building B, PingAn IFC, No. 1-3 Xinyuan South Road, Beijing, 100027, China
| | - Yan Gao
- Qingdao Eye Hospital of Shandong First Medical University, 5 Yanerdao Road, Qingdao, 266071, China.,State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Shandong First Medical University & Shandong Academy of Medical Sciences, Qingdao, 266071, China
| | - Qianqian Liang
- Qingdao Eye Hospital of Shandong First Medical University, 5 Yanerdao Road, Qingdao, 266071, China.,State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Shandong First Medical University & Shandong Academy of Medical Sciences, Qingdao, 266071, China
| | - Lingzhi Chen
- Ping An Healthcare Technology, 9F Building B, PingAn IFC, No. 1-3 Xinyuan South Road, Beijing, 100027, China
| | - Xiaolei Sun
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Shandong First Medical University & Shandong Academy of Medical Sciences, Qingdao, 266071, China.,Shandong Eye Hospital of Shandong First Medical University, Jinan, 250021, China
| | | | | | - Lina Meng
- Qilu Hospital of Shandong University (Qingdao), Qingdao, 266035, China
| | - Shuyue Xue
- Qingdao Eye Hospital of Shandong First Medical University, 5 Yanerdao Road, Qingdao, 266071, China.,State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Shandong First Medical University & Shandong Academy of Medical Sciences, Qingdao, 266071, China
| | - Qing Du
- Qingdao Eye Hospital of Shandong First Medical University, 5 Yanerdao Road, Qingdao, 266071, China.,State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Shandong First Medical University & Shandong Academy of Medical Sciences, Qingdao, 266071, China
| | - Zhichun Zhang
- Qingdao Eye Hospital of Shandong First Medical University, 5 Yanerdao Road, Qingdao, 266071, China.,State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Shandong First Medical University & Shandong Academy of Medical Sciences, Qingdao, 266071, China
| | - Chuanfeng Lv
- Ping An Healthcare Technology, 9F Building B, PingAn IFC, No. 1-3 Xinyuan South Road, Beijing, 100027, China
| | - Haifeng Xu
- Qingdao Eye Hospital of Shandong First Medical University, 5 Yanerdao Road, Qingdao, 266071, China.,State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Shandong First Medical University & Shandong Academy of Medical Sciences, Qingdao, 266071, China
| | - Zhen Guo
- Qingdao Eye Hospital of Shandong First Medical University, 5 Yanerdao Road, Qingdao, 266071, China.,State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Shandong First Medical University & Shandong Academy of Medical Sciences, Qingdao, 266071, China
| | - Guotong Xie
- Ping An Healthcare Technology, 9F Building B, PingAn IFC, No. 1-3 Xinyuan South Road, Beijing, 100027, China. .,Ping An Healthcare and Technology Company Limited, Shanghai, 200030, China. .,Ping An International Smart City Technology Company Limited, Shenzhen, 518000, China.
| | - Lixin Xie
- Qingdao Eye Hospital of Shandong First Medical University, 5 Yanerdao Road, Qingdao, 266071, China. .,State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Shandong First Medical University & Shandong Academy of Medical Sciences, Qingdao, 266071, China.
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