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Zhong T, Yi H, Gou J, Li J, Liu M, Gao X, Chen S, Guan H, Liang S, He Q, Lin R, Long Z, Wang Y, Shi C, Zhan Y, Zhang Y, Xing L, Zhong J, Xue X. A wireless battery-free eye modulation patch for high myopia therapy. Nat Commun 2024; 15:1766. [PMID: 38409083 PMCID: PMC10897479 DOI: 10.1038/s41467-024-46049-6] [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: 08/13/2023] [Accepted: 02/12/2024] [Indexed: 02/28/2024] Open
Abstract
The proper axial length of the eye is crucial for achieving emmetropia. In this study, we present a wireless battery-free eye modulation patch designed to correct high myopia and prevent relapse. The patch consists of piezoelectric transducers, an electrochemical micro-actuator, a drug microneedle array, μ-LEDs, a flexible circuit, and biocompatible encapsulation. The system can be wirelessly powered and controlled using external ultrasound. The electrochemical micro-actuator plays a key role in precisely shortening the axial length by driving the posterior sclera inward. This ensures accurate scene imaging on the retina for myopia eye. The drug microneedle array delivers riboflavin to the posterior sclera, and μ-LEDs' blue light induces collagen cross-linking, reinforcing sclera strength. In vivo experiments demonstrate that the patch successfully reduces the rabbit eye's axial length by ~1217 μm and increases sclera strength by 387%. The system operates effectively within the body without the need for batteries. Here, we show that the patch offers a promising avenue for clinically treating high myopia.
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Affiliation(s)
- Tianyan Zhong
- School of Physics, University of Electronic Science and Technology of China, Chengdu, 611731, China
| | - Hangjin Yi
- School of Medicine, University of Electronic Science and Technology of China, Chengdu, 610054, China
- Department of Ophthalmology, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China
| | - Jiacheng Gou
- School of Information and Communication Engineering, University of Electronic Science and Technology of China, Chengdu, 611731, China
| | - Jie Li
- Department of Ophthalmology, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China
| | - Miao Liu
- Department of Ophthalmology, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China
| | - Xing Gao
- Department of Ophthalmology, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China
| | - Sizhu Chen
- Department of Ophthalmology, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China
| | - Hongye Guan
- School of Physics, University of Electronic Science and Technology of China, Chengdu, 611731, China
| | - Shan Liang
- School of Physics, University of Electronic Science and Technology of China, Chengdu, 611731, China
| | - Qianxiong He
- School of Medicine, University of Electronic Science and Technology of China, Chengdu, 610054, China
| | - Rui Lin
- School of Physics, University of Electronic Science and Technology of China, Chengdu, 611731, China
| | - Zhihe Long
- Department of Mechanical Engineering, City University of Hong Kong, Hong Kong SAR, 999077, China
| | - Yue Wang
- School of Information and Communication Engineering, University of Electronic Science and Technology of China, Chengdu, 611731, China
| | - Chuang Shi
- School of Information and Communication Engineering, University of Electronic Science and Technology of China, Chengdu, 611731, China
| | - Yang Zhan
- Brain Cognition and Brain Disease Institute, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, 518055, China
| | - Yan Zhang
- School of Physics, University of Electronic Science and Technology of China, Chengdu, 611731, China
| | - Lili Xing
- School of Physics, University of Electronic Science and Technology of China, Chengdu, 611731, China
| | - Jie Zhong
- School of Medicine, University of Electronic Science and Technology of China, Chengdu, 610054, China.
- Department of Ophthalmology, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China.
| | - Xinyu Xue
- School of Physics, University of Electronic Science and Technology of China, Chengdu, 611731, China.
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Akgöz H, Fındık H, Aslan MG. Evaluation of tear parameters and meibomian gland morphology in keratoconus patients after epithelial-on corneal cross-linking. Eur J Ophthalmol 2022; 33:11206721221118740. [PMID: 35929885 DOI: 10.1177/11206721221118740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE To evaluate the variations in tear parameters and meibomian gland morphology after epithelial-on (epi-on) corneal collagen cross-linking (CXL) in keratoconus (KC) patients. METHODS This prospective observational study included 38 KC eyes that underwent epithelium-on CXL. Thirty-three eyes of 33 stable KC patients with no prior CXL treatment formed the KC group and 35 eyes of 35 healthy volunteers were recruited as the control group. All participants were evaluated by Schirmer I test, first and average noninvasive tear break-up time (NITBUT), ocular surface disease index (OSDI) questionnaire, and meibography scores. The CXL patients were evaluated preoperatively and at the 1st, 3rd, and 6th months, and participants without any intervention (KC and control groups) were evaluated initially, at 1st, 3rd, and 6th months. RESULTS The KC patients had significantly lower average NITBUT, higher OSDI scores, and impaired meibomian gland morphology than healthy individuals (NITBUT(seconds): KC, 12.8(2.4-17.6), healthy group (HG), 17.1(6.8-17.6); p = 0.012, OSDI: KC, 27.5(0.0-87.5), HG, 7.5(0.0-55.0); p < 0.001, p < 0.001, respectively). A significant difference was found in Schirmer values of the CXL group at 0-1st months, first NITBUT values at 1-6 months, and average NITBUT values at 1-3 and 1-6 months (p = 0.003, p = 0.001, p = 0.003, p = 0.001, respectively). All meibography parameters remained unchanged after CXL over a 6-month follow-up compared to initial measurements. CONCLUSIONS Even though the KC patients had lower NITBUT, higher OSDI scores, and increased meibomian gland disfunction, the CXL treatment did not significantly affect tear quantity, dry eye symptoms, and meibomian gland morphology.
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Affiliation(s)
- Hasan Akgöz
- 175650Recep Tayyip Erdoğan University, Merkez/Rize, Turkey
| | - Hüseyin Fındık
- 175650Recep Tayyip Erdoğan University, Merkez/Rize, Turkey
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Németh J, Tapasztó B, Aclimandos WA, Kestelyn P, Jonas JB, De Faber JTHN, Januleviciene I, Grzybowski A, Nagy ZZ, Pärssinen O, Guggenheim JA, Allen PM, Baraas RC, Saunders KJ, Flitcroft DI, Gray LS, Polling JR, Haarman AEG, Tideman JWL, Wolffsohn JS, Wahl S, Mulder JA, Smirnova IY, Formenti M, Radhakrishnan H, Resnikoff S. Update and guidance on management of myopia. European Society of Ophthalmology in cooperation with International Myopia Institute. Eur J Ophthalmol 2021; 31:853-883. [PMID: 33673740 PMCID: PMC8369912 DOI: 10.1177/1120672121998960] [Citation(s) in RCA: 64] [Impact Index Per Article: 21.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Accepted: 02/04/2021] [Indexed: 12/13/2022]
Abstract
The prevalence of myopia is increasing extensively worldwide. The number of people with myopia in 2020 is predicted to be 2.6 billion globally, which is expected to rise up to 4.9 billion by 2050, unless preventive actions and interventions are taken. The number of individuals with high myopia is also increasing substantially and pathological myopia is predicted to become the most common cause of irreversible vision impairment and blindness worldwide and also in Europe. These prevalence estimates indicate the importance of reducing the burden of myopia by means of myopia control interventions to prevent myopia onset and to slow down myopia progression. Due to the urgency of the situation, the European Society of Ophthalmology decided to publish this update of the current information and guidance on management of myopia. The pathogenesis and genetics of myopia are also summarized and epidemiology, risk factors, preventive and treatment options are discussed in details.
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Affiliation(s)
- János Németh
- Department of Ophthalmology, Semmelweis University, Budapest, Hungary
| | - Beáta Tapasztó
- Department of Ophthalmology, Semmelweis University, Budapest, Hungary
- Faculty of Health Sciences, Semmelweis University, Budapest, Hungary
| | | | | | - Jost B Jonas
- Department of Ophthalmology, Heidelberg University, Mannheim, Germany
| | | | | | - Andrzej Grzybowski
- Department of Ophthalmology, University of Warmia and Mazury, Olsztyn, Poland
- Institute for Research in Ophthalmology, Foundation for Ophthalmology Development, Poznan, Poland
| | - Zoltán Zsolt Nagy
- Department of Ophthalmology, Semmelweis University, Budapest, Hungary
| | - Olavi Pärssinen
- Gerontology Research Centre and Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | | | - Peter M Allen
- Vision and Hearing Sciences Research Centre, Anglia Ruskin University, Cambridge, UK
| | - Rigmor C Baraas
- National Centre for Optics, Vision and Eye Care, University of South-Eastern Norway, Kongsberg, Norway
| | - Kathryn J Saunders
- Centre for Optometry and Vision Science research, Ulster University, Coleraine, UK
| | - Daniel Ian Flitcroft
- Temple Street Children’s Hospital, Dublin, Ireland
- Centre for Eye Research Ireland (CERI) Technological University Dublin, Ireland
| | | | - Jan Roelof Polling
- Department of Ophthalmology and Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands
- Department of Optometry and Orthoptics, Hogeschool Utrecht, University of Applied Science, Utrecht, The Netherlands
| | - Annechien EG Haarman
- Department of Ophthalmology and Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - J Willem L Tideman
- Department of Ophthalmology and Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - James Stuart Wolffsohn
- Optometry and Vision Science, College of Health and Life Sciences, Aston University, Birmingham, UK
| | - Siegfried Wahl
- Institute for Ophthalmic Research, University Tübingen, Tübingen, Germany
- Carl Zeiss Vision International GmbH, Tübingen, Germany
| | - Jeroen A Mulder
- Department of Optometry and Orthoptics, Hogeschool Utrecht, University of Applied Science, Utrecht, The Netherlands
| | | | - Marino Formenti
- Department of Physics, School of Science, University of Padova, Padova, Italy
| | | | - Serge Resnikoff
- School of Optometry and Vision Science, University of New South Wales, Sydney, Australia
- Brien Holden Vision Institute, Sydney, Australia
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Han D, He MN, Zhu Y, Zhang Y, Wei RH. Protective effects of riboflavin-UVA-mediated posterior sclera collagen cross-linking in a guinea pig model of form-deprived myopia. Int J Ophthalmol 2021; 14:333-340. [PMID: 33747806 DOI: 10.18240/ijo.2021.03.01] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Accepted: 12/21/2020] [Indexed: 01/17/2023] Open
Abstract
AIM To evaluate the effect of posterior sclera collagen cross-linking induced by riboflavin-ultraviolet A (UVA) on form-deprived myopia in guinea pigs. METHODES Twenty-five pigmented guinea pigs of 3-week-old were randomly assigned into 4 groups that included normal control (NOR, n=7), form-deprived (FDM, n=7), normal with riboflavin-UVA cross-linking (NOR+CL, n=5) and form-deprived with cross-linking (FDM+CL, n=6). The NOR+CL group and the FDM+CL group received the riboflavin-UVA induced cross-linking at day 0. FDM was induced by monocularly deprived with facemask in the right eyes. The refraction, axial length and corneal curvature were measured by retinoscopy, A-scan and keratometer respectively in scheduled time points (day 0 and 1, 2, 3, 4wk after form-deprivation). At the end of 4 weeks' experiment, stress-strain tests of sclera were measured and morphological changes of sclera and retina were examined. RESULTS After 4wk, the interocular difference of refractive error were -0.11±0.67, -2.93±0.56, 1.10±0.58, and -1.63±0.41 D in the NOR, FDM, NOR+CL, and FDM+CL groups respectively. Mixed-effect linear model revealed significant effect of FDM (P<0.01) and CL (P<0.001). Also, after 4wk, the interocular difference of axial length were 0.01±0.04, 0.29±0.07, -0.13±0.06, and 0.11±0.05 mm in the NOR, FDM, NOR+CL, and FDM+CL group. Mixed-effect linear model revealed significant effect of FDM (P<0.001) and CL (P<0.01). As for corneal curvature, significant interocular difference have not found between any of the two groups. At the end of this experiment, the ultimate stress and elastic modulus were found significantly increased in both CL groups. But no difference was found in the groups without cross-linked. There was no abnormality observed in the retina and RPE cells of the treated eyes. CONCLUSION The posterior sclera collagen cross-linking induced by riboflavin-UVA can slow down the progress of myopia and increase the sclera biomechanical strength in the guinea pig model of form-deprived myopia.
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Affiliation(s)
- Ding Han
- Tianjin Key Laboratory of Retinal Functions and Diseases, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin 300384, China
| | - Mei-Nan He
- Tianjin Key Laboratory of Retinal Functions and Diseases, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin 300384, China
| | - Ying Zhu
- Tianjin Key Laboratory of Retinal Functions and Diseases, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin 300384, China
| | - Yan Zhang
- Tianjin Key Laboratory of Retinal Functions and Diseases, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin 300384, China
| | - Rui-Hua Wei
- Tianjin Key Laboratory of Retinal Functions and Diseases, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin 300384, China
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Hopping GC, Somani AN, Vaidyanathan U, Liu H, Barnes JR, Ronquillo YC, Hoopes PC, Moshirfar M. Myopic regression and recurrent Salzmann nodule degeneration after laser in situ keratomileusis in Ehlers Danlos Syndrome. Am J Ophthalmol Case Rep 2020; 19:100729. [PMID: 32426553 PMCID: PMC7225616 DOI: 10.1016/j.ajoc.2020.100729] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2019] [Revised: 12/18/2019] [Accepted: 04/27/2020] [Indexed: 11/18/2022] Open
Abstract
PURPOSE We describe the first case of Ehlers Danlos Syndrome (EDS) reported in the English language ophthalmic literature to have undergone Laser In Situ Keratomileusis (LASIK) surgery. OBSERVATIONS We review our patient's specific postoperative complications of myopic regression, Salzmann nodular degeneration, and dry eye syndrome, as well as the risks and consequences of performing LASIK on patients with this collagen disorder. CONCLUSIONS AND IMPORTANCE Refractive errors may prompt EDS patients to seek laser vision correction, placing them at increased risk for complications such as myopic regression, keratectasia, and dry eye syndrome. Aberrant wound healing and collagen dysfunction may have influenced our patient's myopic regression and Salzmann nodule degeneration post-LASIK. Currently, EDS is considered a relative contraindication in LASIK due to a presumed higher risk of postoperative keratectasia; however, we believe it is possible that not all forms of EDS need to be an absolute contraindication to LASIK. More research is warranted to determine preoperative risk stratification for laser vision surgery in each subtype of EDS.
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Affiliation(s)
- Grant C. Hopping
- McGovern Medical School at the University of Texas Health Science Center at Houston, 6431 Fannin St, Houston, TX, 77030, USA
| | - Anisha N. Somani
- McGovern Medical School at the University of Texas Health Science Center at Houston, 6431 Fannin St, Houston, TX, 77030, USA
| | - Uma Vaidyanathan
- McGovern Medical School at the University of Texas Health Science Center at Houston, 6431 Fannin St, Houston, TX, 77030, USA
| | - Harry Liu
- McGovern Medical School at the University of Texas Health Science Center at Houston, 6431 Fannin St, Houston, TX, 77030, USA
| | - James R. Barnes
- Virginia Commonwealth University School of Medicine, VCU Medical Center, 1201 E, Marshall St #4-100, Richmond, VA, 23298, USA
| | - Yasmyne C. Ronquillo
- Hoopes Durrie Rivera Research Center, Hoopes Vision; 11820 State St, Draper, UT, 84020, USA
| | - Phillip C. Hoopes
- Hoopes Durrie Rivera Research Center, Hoopes Vision; 11820 State St, Draper, UT, 84020, USA
| | - Majid Moshirfar
- Hoopes Durrie Rivera Research Center, Hoopes Vision; 11820 State St, Draper, UT, 84020, USA
- Utah Lions Eye Bank; 6056 Fashionsquare Drive Suite 200, Murray, UT, 84107, USA
- John A. Moran Eye Center, Department of Ophthalmology and Visual Sciences, University of Utah School of Medicine; 65 Mario Capecchi Drive Salt Lake City, UT, 84132, USA
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