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Chrząszcz M, Pociej-Marciak W, Żuber-Łaskawiec K, Romanowska-Dixon B, Sanak M, Michalska-Małecka K, Petrovič MG, Karska-Basta I. Changes in Plasma VEGF and PEDF Levels in Patients with Central Serous Chorioretinopathy. MEDICINA (KAUNAS, LITHUANIA) 2021; 57:medicina57101063. [PMID: 34684100 PMCID: PMC8540423 DOI: 10.3390/medicina57101063] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Revised: 09/27/2021] [Accepted: 09/30/2021] [Indexed: 12/05/2022]
Abstract
Background and Objectives: Retinal pigment epitheliopathy and hyperpermeability of choroidal vessels were postulated to be involved in the pathogenesis of central serous chorioretinopathy (CSC). Imbalanced levels of vascular endothelial growth factor (VEGF) and pigment-epithelium–derived factor (PEDF) were previously implicated in the development of chorioretinal diseases characterized by increased vascular permeability. We aimed to compare the plasma levels of proangiogenic VEGF and antiangiogenic PEDF for 26 patients with acute CSC, 26 patients with chronic CSC, and 19 controls. Materials and Methods: VEGF and PEDF levels were measured using a multiplex immunoassay or enzyme-linked immunosorbent assay. Correlations with disease duration were assessed. Results: VEGF levels differed between groups (p = 0.001). They were lower in patients with acute CSC (p = 0.042) and chronic CSC (p = 0.018) than in controls. PEDF levels were similar in all groups. The VEGF-to-PEDF ratio was lower in CSC patients than in controls (p = 0.04). A negative correlation with disease duration was noted only for PEDF levels in the group with chronic CSC (rho = −0.46, p = 0.017). Discussion: Our study confirmed that patients with CSC have imbalanced levels of VEGF and PEDF. This finding may have important implications for the pathogenesis of CSC. VEGF-independent arteriogenesis rather than angiogenesis may underlie vascular abnormalities in these patients.
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Affiliation(s)
- Michał Chrząszcz
- Clinic of Ophthalmology and Ocular Oncology, Department of Ophthalmology, Faculty of Medicine, Jagiellonian University Medical College, 31-501 Kraków, Poland; (M.C.); (W.P.-M.); (K.Ż.-Ł.); (B.R.-D.)
| | - Weronika Pociej-Marciak
- Clinic of Ophthalmology and Ocular Oncology, Department of Ophthalmology, Faculty of Medicine, Jagiellonian University Medical College, 31-501 Kraków, Poland; (M.C.); (W.P.-M.); (K.Ż.-Ł.); (B.R.-D.)
| | - Katarzyna Żuber-Łaskawiec
- Clinic of Ophthalmology and Ocular Oncology, Department of Ophthalmology, Faculty of Medicine, Jagiellonian University Medical College, 31-501 Kraków, Poland; (M.C.); (W.P.-M.); (K.Ż.-Ł.); (B.R.-D.)
| | - Bożena Romanowska-Dixon
- Clinic of Ophthalmology and Ocular Oncology, Department of Ophthalmology, Faculty of Medicine, Jagiellonian University Medical College, 31-501 Kraków, Poland; (M.C.); (W.P.-M.); (K.Ż.-Ł.); (B.R.-D.)
| | - Marek Sanak
- Molecular Biology and Clinical Genetics Unit, Department of Internal Medicine, Faculty of Medicine, Jagiellonian University Medical College, 31-501 Kraków, Poland;
| | | | - Mojca Globočnik Petrovič
- Eye Hospital University Medical Centre, Faculty of Medicine, University of Ljubljana, 1000 Ljubljana, Slovenia;
| | - Izabella Karska-Basta
- Clinic of Ophthalmology and Ocular Oncology, Department of Ophthalmology, Faculty of Medicine, Jagiellonian University Medical College, 31-501 Kraków, Poland; (M.C.); (W.P.-M.); (K.Ż.-Ł.); (B.R.-D.)
- Correspondence:
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García-Gen E, Penadés M, Mérida S, Desco C, Araujo-Miranda R, Navea A, Bosch-Morell F. High Myopia and the Complement System: Factor H in Myopic Maculopathy. J Clin Med 2021; 10:jcm10122600. [PMID: 34204630 PMCID: PMC8231207 DOI: 10.3390/jcm10122600] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Revised: 06/06/2021] [Accepted: 06/07/2021] [Indexed: 12/25/2022] Open
Abstract
High myopia (HM) is both a medical problem and refractive error of the eye owing to excessive eyeball length, which progressively makes eye tissue atrophic, and is one of the main causes for diminishing visual acuity in developed countries. Despite its high prevalence and many genetic and proteomic studies, no molecular pattern exists that explain the degenerative process underlying HM, which predisposes patients to other diseases like glaucoma, cataracts, retinal detachment and chorioretinal atrophy that affect the macular area. To determine the relation between complement Factors H (CFH) and D (CFD) and the maculopathy of patients with degenerative myopia, we studied aqueous humor samples that were collected by aspiration from 122 patients during cataract surgery. Eyes were classified according to eyeball axial length as high myopia (axial length > 26 mm), low myopia (axial length 23.5–25.9 mm) and control (axial length ˂ 23.4 mm). The degree of maculopathy was classified according to fundus oculi findings following IMI’s classification. Subfoveal choroid thickness was measured by optical coherence tomography. CFH and CFD measurements were taken by ELISA. CFH levels were significantly high in the high myopia group vs. the low myopia and control groups (p ˂ 0.05). Significantly high CFH values were found in those eyes with choroid atrophy and neovascularization (p ˂ 0.05). In parallel, the CFH concentration correlated inversely with choroid thickness (R = −0.624). CFD levels did not correlate with maculopathy. All the obtained data seem to suggest that CFH plays a key role in myopic pathology.
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Affiliation(s)
- Enrique García-Gen
- Departamento Ciencias Biomédicas, Universidad CEU Cardenal Herrera, CEU Universities, 46115 Valencia, Spain; (E.G.-G.); (M.P.); (S.M.); (C.D.); (A.N.)
| | - Mariola Penadés
- Departamento Ciencias Biomédicas, Universidad CEU Cardenal Herrera, CEU Universities, 46115 Valencia, Spain; (E.G.-G.); (M.P.); (S.M.); (C.D.); (A.N.)
- Thematic Cooperative Health Network for Research in Ophthalmology (Oftared), Carlos II Health Institute, 28029 Madrid, Spain
| | - Salvador Mérida
- Departamento Ciencias Biomédicas, Universidad CEU Cardenal Herrera, CEU Universities, 46115 Valencia, Spain; (E.G.-G.); (M.P.); (S.M.); (C.D.); (A.N.)
| | - Carmen Desco
- Departamento Ciencias Biomédicas, Universidad CEU Cardenal Herrera, CEU Universities, 46115 Valencia, Spain; (E.G.-G.); (M.P.); (S.M.); (C.D.); (A.N.)
- Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunidad Valenciana (FISABIO), 46020 València, Spain;
| | - Rafael Araujo-Miranda
- Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunidad Valenciana (FISABIO), 46020 València, Spain;
| | - Amparo Navea
- Departamento Ciencias Biomédicas, Universidad CEU Cardenal Herrera, CEU Universities, 46115 Valencia, Spain; (E.G.-G.); (M.P.); (S.M.); (C.D.); (A.N.)
- Thematic Cooperative Health Network for Research in Ophthalmology (Oftared), Carlos II Health Institute, 28029 Madrid, Spain
| | - F. Bosch-Morell
- Departamento Ciencias Biomédicas, Universidad CEU Cardenal Herrera, CEU Universities, 46115 Valencia, Spain; (E.G.-G.); (M.P.); (S.M.); (C.D.); (A.N.)
- Thematic Cooperative Health Network for Research in Ophthalmology (Oftared), Carlos II Health Institute, 28029 Madrid, Spain
- Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunidad Valenciana (FISABIO), 46020 València, Spain;
- Correspondence:
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He M, Chen H, Wang W. Refractive Errors, Ocular Biometry and Diabetic Retinopathy: A Comprehensive Review. Curr Eye Res 2020; 46:151-158. [PMID: 32589053 DOI: 10.1080/02713683.2020.1789175] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Purpose: To summarize the association between diabetic retinopathy and refractory status as well as ocular biometric parameters; To review the theories of the protective effect of high myopia against diabetic retinopathy. Methods: A comprehensive literature search on MEDLINE, EMBASE, Web of Science and Scopus databases as well as reference list search, and systematic review of relevant publications. Results: Myopia may delay the onset and progression of diabetic retinopathy. Increased axial length in myopia is associated with reduced risk of any diabetic retinopathy and vision-threatening diabetic retinopathy. The possible mechanisms for the protective effect of myopia against diabetic retinopathy may include posterior vitreous detachment, change in retinal blood flow and oxygen demand, choroidal thinning and altered cytokine profiles. Conclusions: High myopia may be a protective factor against the onset and progression of diabetic retinopathy. Further studies about the mechanisms of how myopia, axial length and ocular biometrics influence the onset and progression of DR are needed.
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Affiliation(s)
- Miao He
- Department of Ophthalmology, Guangdong General Hospital, Guangdong Academy of Medical Sciences , Guangzhou, People's Republic of China
| | - Haiying Chen
- The Royal Melbourne Hospital , Melbourne, Victoria, Australia
| | - Wei Wang
- Zhongshan Ophthalmic Center, State Key Laboratory of Ophthalmology, Sun Yat-Sen University , Guangzhou, People's Republic of China
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Pigment Epithelium-Derived Factor as a Possible Treatment Agent for Choroidal Neovascularization. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2020; 2020:8941057. [PMID: 32215180 PMCID: PMC7079215 DOI: 10.1155/2020/8941057] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Accepted: 02/28/2020] [Indexed: 02/06/2023]
Abstract
Choroidal neovascularization (CNV) is a sight-threatening disease and is characterized by the formation of pathological neovascularization in the choroid which extends into the subretinal space. Exudative age-related macular degeneration (AMD) is the formation of CNV in the macular area which leads to irreversible blindness. Continuous leakage and hemorrhage of the CNV lesion may eventually result in scarring or later fibrosis, which could result in photoreceptor cell atrophy. The current strategy for treating CNV is the use of antivascular endothelial growth factor (VEGF) agents. Many studies have demonstrated the efficacy of intravitreal anti-VEGF therapy. Other studies have also reported the side effects of single anti-VEGF treatment. And long-term inhibition of a single system may result in collateral damage to other visual elements. Pigment epithelium-derived factor (PEDF) is a 50 kDa protein that was first isolated from the conditioned medium of human RPE cells. PEDF has both antiangiogenesis and neuroprotective functions for photoreceptor cells. It may be a potential ocular antiangiogenic agent. This review outlines the distribution of PEDF in the eye, the mechanism of antiangiogenesis, the protective effect on the retina, and the relationship between PEDF and VEGF.
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Chen Q, He J, Hu G, Xu X, Lv H, Yin Y, Zou H, Zhu J, Fan Y, Xu X. Morphological Characteristics and Risk Factors of Myopic Maculopathy in an Older High Myopia Population-Based on the New Classification System (ATN). Am J Ophthalmol 2019; 208:356-366. [PMID: 31351050 DOI: 10.1016/j.ajo.2019.07.010] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2019] [Revised: 07/16/2019] [Accepted: 07/16/2019] [Indexed: 02/08/2023]
Abstract
PURPOSE To investigate the characteristics, mergers, and risk factors of different types of myopic maculopathy (MM) in a highly myopic population. DESIGN Population-based, cross-sectional study. METHODS A total of 1086 eyes (762 patients) were enrolled. Each participant underwent detailed ocular examinations. Combining the fundus photographs and optical coherence tomography images, types of MM were assessed as myopic atrophy maculopathy (MAM), myopic tractional maculopathy (MTM), or myopic neovascular maculopathy (MNM) according to the ATN classification system. Peripapillary atrophy (PPA) area, tilt ratio, and macular choroidal thickness (mChT) were measured individually. RESULTS Eyes with larger PPA area were more likely to have MAM (odds ratio [OR], 1.220; P = .037 per 1-mm2 increase) and MNM (OR, 1.723; P < .001 per 1-mm2 increase), and eyes with thicker mChT were less likely to have MAM (OR, 0.740; P < .001 per 10-μm increase) and MNM (OR, 0.784; P < .001 per 10-μm increase), whereas eyes with higher tilt ratio were less likely to have MTM (OR, 0.020; P < .001 per 1 increase). The severity of MTM and MNM was not precisely consistent with that of MAM. CONCLUSIONS Different types of MM have different risk factors; larger PPA area and thinner mChT are risk factors for MAM and MNM, whereas lower tilt ratio is a risk factor for MTM. Our results indicate that the pathogenesis of MTM is different from that of MAM and MNM, and a tractional component should be considered as a possible component to the myopic macular classification.
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Chen W, Zhang H, Zhang Y, Wang Q, Wang Y, Li ZW. Relationship between Aquaporin-1 Protein Expression and Choroidal Thickness during the Recovery of Form-deprivation Myopia in Guinea Pigs. Curr Eye Res 2019; 45:705-712. [PMID: 31697570 DOI: 10.1080/02713683.2019.1689275] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Purpose: The purpose of this study was to investigate the relationship between aquaporin-1 (AQP-1) protein expression in the choroid and choroid thickness (CT) during the recovery of form-deprivation (FD) myopia in guinea pigs.Materials and Methods: Seventy-two guinea pigs were randomly assigned to the normal control (NC) group, FD 21 group (animals wore a latex facemask in the right eye for 21 days to induce FD myopia) and four recovery (REC) groups. Guinea pigs in the REC groups also wore the facemask for 21 days to induce myopia; then, the facemask was removed, and the eye was re-exposed to the normal environment for 12 hours (REC ½ group), 1 day (REC 1 group), 2 days (REC 2 group), and 7 days (REC 7 group). All animals underwent biometric measurements (refraction, axial length, and CT), and the protein expression of AQP-1 in the choroid was determined using western blotting.Results: The protein expression of AQP-1 and CT were significantly decreased in the FD 21 group as compared with those in the NC group (p = .007 and p < .001). Both AQP-1 protein expression and CT gradually increased and peaked in the REC 2 group. Additionally, there were significant differences in AQP-1 protein expression and CT between the REC 2 group and all other groups (all p < .05). We observed a complete recovery in the in REC 7 group as compared with the NC group (p > .05). AQP-1 protein expression was significantly associated with CT (p = .001) in all groups; however, there was a significant negative correlation (p = .029) between AQP-1 protein expression and axial length in the REC groups.Conclusions: AQP-1 protein expression in the choroid was upregulated following recovery of FD myopia in guinea pigs, and these changes correlated with alterations in CT and axial length.
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Affiliation(s)
- Wei Chen
- Tianjin Key Laboratory of Ophthalmology and Visual Science, Tianjin Eye Hospital, Nankai University Affiliated Eye Hospital, Clinical College of Ophthalmology, Tianjin Medical University, Tianjin Eye Institute, Tianjin, China
| | - Hongyuan Zhang
- Department of Gynaecology, Tianjin Central Hospital of Gynecology and Obstetrics, Tianjin, China
| | - Yue Zhang
- Tianjin Key Laboratory of Ophthalmology and Visual Science, Tianjin Eye Hospital, Nankai University Affiliated Eye Hospital, Clinical College of Ophthalmology, Tianjin Medical University, Tianjin Eye Institute, Tianjin, China
| | - Qimiao Wang
- Tianjin Key Laboratory of Ophthalmology and Visual Science, Tianjin Eye Hospital, Nankai University Affiliated Eye Hospital, Clinical College of Ophthalmology, Tianjin Medical University, Tianjin Eye Institute, Tianjin, China
| | - Yan Wang
- Tianjin Key Laboratory of Ophthalmology and Visual Science, Tianjin Eye Hospital, Nankai University Affiliated Eye Hospital, Clinical College of Ophthalmology, Tianjin Medical University, Tianjin Eye Institute, Tianjin, China
| | - Zhi Wei Li
- Department of Ophthalmology, Shandong Provincial Hospital Affilliated to Shandong University, Jinan, China
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Wong CW, Yanagi Y, Tsai ASH, Shihabuddeen WA, Cheung N, Lee SY, Jonas JB, Cheung CMG. Correlation of axial length and myopic macular degeneration to levels of molecular factors in the aqueous. Sci Rep 2019; 9:15708. [PMID: 31673022 PMCID: PMC6823508 DOI: 10.1038/s41598-019-52156-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2019] [Accepted: 07/22/2019] [Indexed: 02/06/2023] Open
Abstract
To elucidate the molecular processes associated with the development of myopic macular degeneration (MMD), we measured the intraocular concentrations of molecular factors in emmetropic and myopic eyes. This is a retrospective clinic-based case-control study that included eyes undergoing routine cataract surgery whereby aqueous humour samples were obtained. We measured the concentrations of pigment epithelium derived factor(PEDF), matrix metalloproteinase 2(MMP-2), tissue inhibitor of metalloproteinase(TIMP-2), vascular endothelial growth factor isoform A(VEGF-A), interleukin 8(IL-8), interleukin 6(IL-6), C-reactive protein(CRP), angiopoietin 2(Ang2), and amphiregulin. 38 eyes (axial length (AL): 22.4–32.4 mm), including 12 highly myopic (HM) eyes (AL ≥ 26.5 mm) without MMD and 12 HM eyes with MMD but without neovascularization were included. Eyes with MMD were found to have significantly lower VEGF-A levels (p = 0.007) and higher MMP-2 levels (p = 0.02) than control eyes after adjusting for age and gender. MMP-2 levels correlated positively (r = 0.58, p = 0.002), while VEGF-A levels correlated negatively with longer axial length (r = −0.75, p < 0.001). Both the concentrations of VEGF-A (P = 0.25) and MMP-2 (P = 0.69) were not significantly associated with MMD after adjusting for AL. These findings suggest that the predominant mechanism underlying the development of non-neovascular MMD may be axial elongation, driven in part by MMP-2 related mechanisms.
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Affiliation(s)
- Chee Wai Wong
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore.,Ophthalmology and Visual Sciences Academic Clinical Program, Duke-NUS Medical School, National University of Singapore, Singapore, Singapore
| | - Yasuo Yanagi
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore.,Ophthalmology and Visual Sciences Academic Clinical Program, Duke-NUS Medical School, National University of Singapore, Singapore, Singapore
| | - Andrew Shih Hsiang Tsai
- Department of Ophthalmology, Medical Faculty Mannheim of the Ruprecht-Karls-University, Mannheim, Germany
| | | | - Ning Cheung
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore.,Ophthalmology and Visual Sciences Academic Clinical Program, Duke-NUS Medical School, National University of Singapore, Singapore, Singapore
| | - Shu Yen Lee
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore.,Ophthalmology and Visual Sciences Academic Clinical Program, Duke-NUS Medical School, National University of Singapore, Singapore, Singapore
| | - Jost B Jonas
- Department of Ophthalmology, Medical Faculty Mannheim of the Ruprecht-Karls-University, Mannheim, Germany
| | - Chui Ming Gemmy Cheung
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore. .,Ophthalmology and Visual Sciences Academic Clinical Program, Duke-NUS Medical School, National University of Singapore, Singapore, Singapore.
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Chen W, Li L, Zhang H, Li Y, Chen X, Zhang Y. Macular choroidal thickness in highly myopic women during pregnancy and postpartum: a longitudinal study. BMC Pregnancy Childbirth 2018; 18:220. [PMID: 29884130 PMCID: PMC5994060 DOI: 10.1186/s12884-018-1865-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2016] [Accepted: 05/29/2018] [Indexed: 12/05/2022] Open
Abstract
Background High myopia, a cause of serious visual impairment, is a significant global public health concern. We investigate longitudinal changes in macular choroidal thickness (CT) during pregnancy and 6-months postpartum in women with high myopia (HM). Methods A prospective longitudinal study was conducted in HM-pregnant women during the course of pregnancy (n = 42 eyes, 42 patients) and 6 months postpartum (n = 40 eyes, 40 patients, two cases lost).Macular CT was measured via enhanced-depth imaging (EDI)-optical coherence tomography (OCT) (EDI-OCT). Intraocular pressure (IOP), axial length (AL), refractive error, mean arterial pressure (MAP), mean ocular perfusion pressure (MOPP), and body mass index (BMI) were also measured. Results Macular CTs of HM pregnant women (214.3 ± 52.3 μm) had increased significantly during the third trimester of pregnancy compared with postpartum women (192.7 ± 51.9 μm, p = 0.014). No significant differences in AL, refractive error, or MAP were found between pregnant and postpartum groups (p > 0.05 for all parameters).During pregnancy, macular CT was negatively correlated with AL (first trimester: p = 0.010; second trimester: p = 0.013; and third trimester: p = 0.008) and positively correlated with refractive error (first trimester: p = 0.038; second trimester: p = 0.024; and third trimester: p = 0.010). No correlations between macular CT and age, IOP, MOPP, MAP, or BMI were found. Conclusions Our study revealed the presence of a significantly thicker choroid during the third trimester of pregnancy compared with 6-mo postpartum in HM women. Macular CT positively correlated with refractive error and negatively correlated with AL during pregnancy, but did not correlate with gestational age, MOPP, IOP, MAP, or BMI.
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Affiliation(s)
- Wei Chen
- Clinical College of Ophthalmology, Tianjin Medical University, No.4, Gansu Road, Tianjin City, People's Republic of China
| | - Li Li
- Clinical College of Ophthalmology, Tianjin Medical University, No.4, Gansu Road, Tianjin City, People's Republic of China
| | - Hongyuan Zhang
- Tianjin Central Hospital of Gynecology and Obstetrics, Tianjin, China
| | - Yan Li
- Clinical College of Ophthalmology, Tianjin Medical University, No.4, Gansu Road, Tianjin City, People's Republic of China
| | - Xu Chen
- Tianjin Central Hospital of Gynecology and Obstetrics, Tianjin, China
| | - Yue Zhang
- Clinical College of Ophthalmology, Tianjin Medical University, No.4, Gansu Road, Tianjin City, People's Republic of China.
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