Uveal effusion and transient myopia as the initial presentation of systemic lupus erythematosus patient with pulmonary arterial hypertension: case report

Gut microbiome and plasma metabolome alterations in myopic mice

Background

Myopia is one of the most common eye diseases leading to blurred distance vision. Inflammatory diseases could trigger or exacerbate myopic changes. Although gut microbiota bacteria are associated with various inflammatory diseases, little is known about its role in myopia.

Materials and methods

The mice were randomly divided into control and model groups, with the model group being attached-30D lens onto the eyes for 3 weeks. Then, mouse cecal contents and plasma were collected to analyze their intestinal microbiota and plasma metabolome.

Results

We identified that the microbial composition differed considerably between the myopic and non-myopic mice, with the relative abundance of Firmicutes phylum decreased obviously while that of Actinobacteria phylum was increased in myopia. Furthermore, Actinobacteria and Bifidobacterium were positively correlated with axial lengths (ALs) of eyeballs while negatively correlated with refractive diopters. Untargeted metabolomic analysis identified 141 differentially expressed metabolites, and Kyoto Encyclopedia of Genes and Genomes pathway enrichment analysis revealed considerable enrichment mainly in amino acid metabolism pathways. Notably, pathways involved glutamate metabolism including "Glutamine and D-glutamate metabolism" and "Alanine, aspartate and glutamate metabolism" was changed dramatically, which presented as the concentrations of L-Glutamate and L-Glutamine decreased obviously in myopia. Interestingly, microbiome dysbiosis and metabolites alternations in myopia have a disrupting gut barrier feature. We further demonstrated that the gut barrier function was impaired in myopic mice manifesting in decreased expression of Occludin, ZO-1 and increased permeation of FITC-dextran.

Discussion

Myopic mice had obviously altered gut microbiome and metabolites profiles compared to non-myopic mice. The dysbiosis and plasma metabolomics shift in myopia had an interrupting gut barrier feature. Our study provides new insights into the possible role of the gut microbiota in myopia and reinforces the potential feasibility of microbiome-based therapies in myopia.

A case of severe choroidal detachment in both eyes due to systemic lupus erythematosus

Purpose

We report a case of severe choroidal detachments (CDs) in both eyes caused by systemic lupus erythematosus (SLE).

Observations

The patient was a 50-year-old woman who presented with conjunctival edema in both eyes, visual dysfunction, and generalized fatigue. At the first visit, the best corrected visual acuity (BCVA) was 20/70 OD and 20/70 OS, and the intraocular pressure (IOP) was 22 mmHg OD and 27 mmHg OS. She had serous retinal detachments (SRDs), CDs, ciliary dissections, and a shallow anterior chamber with partial angle closure in both eyes. Systemic findings included hypoalbuminemia, pleural fluid, generalized fatigue, and brown papules on the back and both legs. First, we suspected Vogt-Koyanagi-Harada disease and administered two courses of methylprednisolone pulse therapy, but the CDs in both eyes gradually deteriorated and worsened to the extent that the optic nerve in both eyes could not be observed, and the BCVA deteriorated to 20/200 OD and 6/200 OS. Further multidisciplinary evaluations for diagnosing collagen diseases revealed vasculitis in the skin histopathology examination, positive results for anti-double stranded DNA antibody and anti-SS-A antibody, and hypocomplementemia in the blood examination, and she was diagnosed with severe SLE in the dermatology department. After administration of high dose intravenous γ-globulin therapy, albumin infusion, and intravenous cyclophosphamide pulse therapy, the SRDs and severe CDs improved along with improvement in hypoalbuminemia, pleural fluid, and generalized fatigue. Moreover, the shallow anterior chamber and high IOP improved to normal in both eyes. The CDs and SRDs completely disappeared, and the BCVA improved to 20/13 OU 6 months after the SLE therapy.

Conclusion and importance

In patients with observed SRDs and CDs accompanying hypoalbuminemia, it is necessary to consider collagen diseases such as SLE.

Association between MMP/TIMP Levels in the Aqueous Humor and Plasma with Axial Lengths in Myopia Patients

Purpose

The present study investigated the profiles of matrix metalloproteinases (MMPs) and tissue inhibitors of metalloproteinases (TIMPs) of the aqueous humor (AH) and plasma (PL) in myopia patients, to determine whether there was an association between these levels with their axial length (AL) and to investigate if MMPs/TIMPs were regulated locally or systemically.

Methods

A cross-sectional study was conducted. Thirty-nine patients (78 eyes) diagnosed with high myopia were recruited. The AL was measured using IOL Master. And the patients were divided into three groups based on their AL, Group A (AL ≤ 26 mm), Group B (26 < AL ≤ 28 mm), and Group C (AL > 28 mm). The AH in both eyes and blood samples were collected before the patients underwent implantable collamer lens surgery. In all, 78 samples of the AH and 39 samples of the PL were analyzed using MILLIPLEX map assays, followed by statistical analyses of the results.

Results

There were 8 patients (16 eyes) in Group A, 22 patients (44 eyes) in Group B, and 9 patients (18 eyes) in Group C. MMP-1 (p = 0.014, Β = 0.118), MMP-2 (p ≤ 0.001, Β = 0.278), MMP-9 (p ≤ 0.001, Β = 0.019), and TIMP-1 (p = 0.014, Β = 0.062) in the AH were positively associated with the AL. MMP-1 (p = 0.004, Β = 0.001) and TIMP-1 (p = 0.030, Β = 1.171) concentrations in the PL increased linearly with longer ALs. No concentration-dependent relationship was found between MMP-2 in the PL and AL.

Conclusions

There was a consistent relationship between MMP-2 in the AH and AL. AL was not consistently or substantially affected by MMP-2 in the PL, indicating myopia formation was possibly a localized process. Associations among MMP-1, MMP-9, and TIMP-1 in the AH and AL were also observed.