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Zhang XJ, Chen XN, Tang FY, Szeto S, Ling XT, Lin ZX, Tham CC, Pang CP, Chen LJ, Yam JC. Pathogenesis of myopic choroidal neovascularization: A systematic review and meta-analysis. Surv Ophthalmol 2023; 68:1011-1026. [PMID: 37517683 DOI: 10.1016/j.survophthal.2023.07.006] [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: 03/30/2023] [Revised: 07/19/2023] [Accepted: 07/24/2023] [Indexed: 08/01/2023]
Abstract
Myopic choroidal neovascularization (CNV) is a vision-threatening complication of high myopia. Here, we systematically review cohort, case-control, and cross-sectional studies in PubMed, Embase, and Web of Science, and summarize the associated factors of myopic CNV using meta-analysis where applicable. Among 1,333 records assessed, 50 were found eligible, all having a low-to-moderate risk of bias. Highly myopic eyes with CNV had a higher risk of lacquer cracks (odds ratio = 2.88) and patchy chorioretinal atrophy (odds ratio = 3.43) than those without. The mean posterior staphyloma height (µm) was greater in myopic CNV eyes than in highly myopic eyes without CNV (mean difference = 82.03). The thinning of choroidal thickness (µm) between myopic eyes with and without CNV differed significantly (mean difference = -47.76). The level of vascular endothelial growth factor (pg/ml) in the aqueous humor of myopic CNV eyes was significantly higher than in highly myopic eyes without CNV (mean difference = 24.98), the same as interleukin-8 (IL-8) (pg/ml, mean difference = 7.73). Single-nucleotide polymorphisms in the vascular endothelial growth factor, complement factor I, and collagen type VIII alpha 1 genes were associated with myopic CNV. We found that myopic CNV eyes have a higher ratio of lacquer cracks and patchy chorioretinal atrophy, thinner choroid, greater posterior staphyloma height, and a higher level of vascular endothelial growth factor and IL-8 in aqueous. Structural predisposing lesions, hemodynamic, genetic, and systemic factors are also associated with myopic CNV.
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Affiliation(s)
- Xiu Juan Zhang
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong; Joint Shantou International Eye Center of Shantou University and The Chinese University of Hong Kong, Shantou, China
| | - Xiu Nian Chen
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong
| | - Fang Yao Tang
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong
| | - Simon Szeto
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong; Department of Ophthalmology and Visual Sciences, Prince of Wales Hospital, Hong Kong
| | - Xiang Tian Ling
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong
| | - Zi Xuan Lin
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong
| | - Clement C Tham
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong; Joint Shantou International Eye Center of Shantou University and The Chinese University of Hong Kong, Shantou, China; Department of Ophthalmology and Visual Sciences, Prince of Wales Hospital, Hong Kong; Hong Kong Eye Hospital, Hong Kong; Hong Kong Hub of Paediatric Excellence, The Chinese University of Hong Kong, Hong Kong; Department of Ophthalmology, Hong Kong Children's Hospital, Hong Kong
| | - Chi Pui Pang
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong; Joint Shantou International Eye Center of Shantou University and The Chinese University of Hong Kong, Shantou, China; Hong Kong Hub of Paediatric Excellence, The Chinese University of Hong Kong, Hong Kong
| | - Li Jia Chen
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong; Joint Shantou International Eye Center of Shantou University and The Chinese University of Hong Kong, Shantou, China; Department of Ophthalmology and Visual Sciences, Prince of Wales Hospital, Hong Kong; Hong Kong Hub of Paediatric Excellence, The Chinese University of Hong Kong, Hong Kong.
| | - Jason C Yam
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong; Joint Shantou International Eye Center of Shantou University and The Chinese University of Hong Kong, Shantou, China; Department of Ophthalmology and Visual Sciences, Prince of Wales Hospital, Hong Kong; Hong Kong Eye Hospital, Hong Kong; Hong Kong Hub of Paediatric Excellence, The Chinese University of Hong Kong, Hong Kong; Department of Ophthalmology, Hong Kong Children's Hospital, Hong Kong.
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González-Iglesias E, López-Vázquez A, Noval S, Nieves-Moreno M, Granados-Fernández M, Arruti N, Rosa-Pérez I, Pacio-Míguez M, Montaño VEF, Rodríguez-Solana P, del Pozo A, Santos-Simarro F, Vallespín E. Next-Generation Sequencing Screening of 43 Families with Non-Syndromic Early-Onset High Myopia: A Clinical and Genetic Study. Int J Mol Sci 2022; 23:4233. [PMID: 35457050 PMCID: PMC9031962 DOI: 10.3390/ijms23084233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Accepted: 04/04/2022] [Indexed: 02/01/2023] Open
Abstract
Early-onset high myopia (EoHM) is a disease that causes a spherical refraction error of ≥-6 diopters before 10 years of age, with potential multiple ocular complications. In this article, we report a clinical and genetic study of 43 families with EoHM recruited in our center. A complete ophthalmological evaluation was performed, and a sample of peripheral blood was obtained from proband and family members. DNA was analyzed using a customized next-generation sequencing panel that included 419 genes related to ophthalmological disorders with a suspected genetic cause, and genes related to EoHM pathogenesis. We detected pathogenic and likely pathogenic variants in 23.9% of the families and detected variants of unknown significance in 76.1%. Of these, 5.7% were found in genes related to non-syndromic EoHM, 48.6% in genes associated with inherited retinal dystrophies that can include a syndromic phenotype, and 45.7% in genes that are not directly related to EoHM or retinal dystrophy. We found no candidate genes in 23% of the patients, which suggests that further studies are needed. We propose a systematic genetic analysis for patients with EoHM because it helps with follow-up, prognosis and genetic counseling.
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Affiliation(s)
- Eva González-Iglesias
- Section of Molecular Ophthalmology, Medical and Molecular Genetics Institute (INGEMM) IdiPaz, La Paz University Hospital, 28046 Madrid, Spain; (E.G.-I.); (V.E.F.M.); (P.R.-S.)
| | - Ana López-Vázquez
- Department of Ophthalmology, La Paz University Hospital, 28046 Madrid, Spain; (A.L.-V.); (S.N.); (M.N.-M.); (M.G.-F.); (N.A.); (I.R.-P.)
| | - Susana Noval
- Department of Ophthalmology, La Paz University Hospital, 28046 Madrid, Spain; (A.L.-V.); (S.N.); (M.N.-M.); (M.G.-F.); (N.A.); (I.R.-P.)
| | - María Nieves-Moreno
- Department of Ophthalmology, La Paz University Hospital, 28046 Madrid, Spain; (A.L.-V.); (S.N.); (M.N.-M.); (M.G.-F.); (N.A.); (I.R.-P.)
| | - María Granados-Fernández
- Department of Ophthalmology, La Paz University Hospital, 28046 Madrid, Spain; (A.L.-V.); (S.N.); (M.N.-M.); (M.G.-F.); (N.A.); (I.R.-P.)
| | - Natalia Arruti
- Department of Ophthalmology, La Paz University Hospital, 28046 Madrid, Spain; (A.L.-V.); (S.N.); (M.N.-M.); (M.G.-F.); (N.A.); (I.R.-P.)
| | - Irene Rosa-Pérez
- Department of Ophthalmology, La Paz University Hospital, 28046 Madrid, Spain; (A.L.-V.); (S.N.); (M.N.-M.); (M.G.-F.); (N.A.); (I.R.-P.)
| | - Marta Pacio-Míguez
- Biomedical Research Center in the Rare Diseases Network (CIBERER), Carlos II Health Institute (ISCIII), 28029 Madrid, Spain; (M.P.-M.); (A.d.P.); (F.S.-S.)
- Section of Neurodevelopmental Disorders, Medical and Molecular Genetics Institute (INGEMM) IdiPaz, La Paz University Hospital, 28046 Madrid, Spain
| | - Victoria E. F. Montaño
- Section of Molecular Ophthalmology, Medical and Molecular Genetics Institute (INGEMM) IdiPaz, La Paz University Hospital, 28046 Madrid, Spain; (E.G.-I.); (V.E.F.M.); (P.R.-S.)
- Biomedical Research Center in the Rare Diseases Network (CIBERER), Carlos II Health Institute (ISCIII), 28029 Madrid, Spain; (M.P.-M.); (A.d.P.); (F.S.-S.)
| | - Patricia Rodríguez-Solana
- Section of Molecular Ophthalmology, Medical and Molecular Genetics Institute (INGEMM) IdiPaz, La Paz University Hospital, 28046 Madrid, Spain; (E.G.-I.); (V.E.F.M.); (P.R.-S.)
| | - Angela del Pozo
- Biomedical Research Center in the Rare Diseases Network (CIBERER), Carlos II Health Institute (ISCIII), 28029 Madrid, Spain; (M.P.-M.); (A.d.P.); (F.S.-S.)
- Section of Clinical Bioinformatics, Medical and Molecular Genetics Institute (INGEMM) IdiPaz, La Paz University Hospital, 28046 Madrid, Spain
| | - Fernando Santos-Simarro
- Biomedical Research Center in the Rare Diseases Network (CIBERER), Carlos II Health Institute (ISCIII), 28029 Madrid, Spain; (M.P.-M.); (A.d.P.); (F.S.-S.)
- Section of Clinical Genetics, Medical and Molecular Genetics Institute (INGEMM) IdiPaz, La Paz University Hospital, 28046 Madrid, Spain
| | - Elena Vallespín
- Section of Molecular Ophthalmology, Medical and Molecular Genetics Institute (INGEMM) IdiPaz, La Paz University Hospital, 28046 Madrid, Spain; (E.G.-I.); (V.E.F.M.); (P.R.-S.)
- Biomedical Research Center in the Rare Diseases Network (CIBERER), Carlos II Health Institute (ISCIII), 28029 Madrid, Spain; (M.P.-M.); (A.d.P.); (F.S.-S.)
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Llorente‐González S, Hernandez M, González‐Zamora J, Bilbao‐Malavé V, Fernández‐Robredo P, Saenz‐de‐Viteri M, Barrio‐Barrio J, Rodríguez‐Cid MJ, Donate J, Ascaso FJ, Gómez‐Ramírez AM, Araiz J, Armadá F, Ruiz‐Moreno Ó, Recalde S, García‐Layana A, Alonso E, Salinas‐Alamán Á, Bezunartea J, Abraldes MJ, Díez‐Sotelo M, Sarandeses‐Díez MT, Taboada‐Gago MD, Asorey MK, Valverde‐Megías A, Felipe‐Marquez G, Honrubia‐Grijalbo A, Núñez‐Benito ME, Escobar‐Barranco JJ, Pina‐Marín B, Fernández‐Bonet M, Jadraque‐Ruíz Y, Crespi J, García‐Parès E, Mingorance‐Moya E, Bassaganyas‐Vilarrassa F, Sambricio J, de‐Lucas‐Viejo B, Arias‐Barquet L, Badia‐Vera M, Gili‐Manzanaro P, Lloreda‐Martín L, Azevedo González‐Oliva M, Cobo‐Soriano R, Zarallo‐Gallardo J, Lozano‐Escobar I, Cidad‐Betegón MDP, Coca‐Robinot J, D’Anna‐Mardero O, Méndez‐Martínez S, Pardiñas‐Barón N, Gil‐Ruiz MR, Udaondo P, Catalá‐Gregori AI, Ramos‐González L, Vila‐Arteaga J, Gómez‐Ledesma I, Zarranz‐Ventura J, Sala‐Puigdollers A, Sabater‐Cruz N, Bernal‐Morales C, Figueras‐Roca M, Marín‐Méndez JJ, Sayar O. The role of retinal fluid location in atrophy and fibrosis evolution of patients with neovascular age-related macular degeneration long-term treated in real world. Acta Ophthalmol 2022; 100:e521-e531. [PMID: 34085771 DOI: 10.1111/aos.14905] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 04/21/2021] [Accepted: 04/22/2021] [Indexed: 12/24/2022]
Abstract
PURPOSE To assess the effect of clinical factors on the development and progression of atrophy and fibrosis in patients with neovascular age-related macular degeneration (nAMD) receiving long-term treatment in the real world. METHODS An ambispective 36-month multicentre study, involving 359 nAMD patients from 17 Spanish hospitals treated according to the Spanish Vitreoretinal Society guidelines, was designed. The influence of demographic and clinical factors, including the presence and location of retinal fluid, on best-corrected visual acuity (BCVA) and progression to atrophy and/or fibrosis were analysed. RESULTS After 36 months of follow-up and an average of 13.8 anti-VEGF intravitreal injections, the average BCVA gain was +1.5 letters, and atrophy and/or fibrosis were present in 54.8% of nAMD patients (OR = 8.54, 95% CI = 5.85-12.47, compared to baseline). Atrophy was associated with basal intraretinal fluid (IRF) (OR = 1.87, 95% CI = 1.09-3.20), whereas basal subretinal fluid (SRF) was associated with a lower rate of atrophy (OR = 0.40, 95% CI = 0.23-0.71) and its progression (OR = 0.44, 95% CI = 0.26-0.75), leading to a slow progression rate (OR = 0.34, 95% CI = 0.14-0.83). Fibrosis development and progression were related to IRF at any visit (p < 0.001). In contrast, 36-month SRF was related to a lower rate of fibrosis (OR = 0.49, 95% CI = 0.29-0.81) and its progression (OR = 0.50, 95% CI = 0.31-0.81). CONCLUSION Atrophy and/or fibrosis were present in 1 of 2 nAMD patients treated for 3 years. Both, especially fibrosis, lead to vision loss. Subretinal fluid (SRF) was associated with good visual outcomes and lower rates of atrophy and fibrosis, whereas IRF yields worse visual results and a higher risk of atrophy and especially fibrosis in routine clinical practice.
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Affiliation(s)
- Sara Llorente‐González
- Department of Ophthalmology Clínica Universidad de Navarra Madrid Spain
- Retinal Pathologies and New Therapies Group, Experimental Ophthalmology Laboratory Department of Ophthalmology Clínica Universidad de Navarra Pamplona Spain
- Thematic Network of Cooperative Health Research in Eye Diseases (Oftared) Health Institute Carlos III Department of Ophthalmology Clínica Universidad de Navarra Pamplona Spain
| | - Maria Hernandez
- Retinal Pathologies and New Therapies Group, Experimental Ophthalmology Laboratory Department of Ophthalmology Clínica Universidad de Navarra Pamplona Spain
- Thematic Network of Cooperative Health Research in Eye Diseases (Oftared) Health Institute Carlos III Department of Ophthalmology Clínica Universidad de Navarra Pamplona Spain
- Navarra Institute for Health Research IdiSNA Pamplona Spain
| | | | - Valentina Bilbao‐Malavé
- Department of Ophthalmology Clínica Universidad de Navarra Madrid Spain
- Department of Ophthalmology Clínica Universidad de Navarra Pamplona Spain
| | - Patricia Fernández‐Robredo
- Retinal Pathologies and New Therapies Group, Experimental Ophthalmology Laboratory Department of Ophthalmology Clínica Universidad de Navarra Pamplona Spain
- Thematic Network of Cooperative Health Research in Eye Diseases (Oftared) Health Institute Carlos III Department of Ophthalmology Clínica Universidad de Navarra Pamplona Spain
- Navarra Institute for Health Research IdiSNA Pamplona Spain
| | - Manuel Saenz‐de‐Viteri
- Retinal Pathologies and New Therapies Group, Experimental Ophthalmology Laboratory Department of Ophthalmology Clínica Universidad de Navarra Pamplona Spain
- Thematic Network of Cooperative Health Research in Eye Diseases (Oftared) Health Institute Carlos III Department of Ophthalmology Clínica Universidad de Navarra Pamplona Spain
- Department of Ophthalmology Clínica Universidad de Navarra Pamplona Spain
| | - Jesús Barrio‐Barrio
- Thematic Network of Cooperative Health Research in Eye Diseases (Oftared) Health Institute Carlos III Department of Ophthalmology Clínica Universidad de Navarra Pamplona Spain
- Navarra Institute for Health Research IdiSNA Pamplona Spain
- Department of Ophthalmology Clínica Universidad de Navarra Pamplona Spain
| | | | - Juan Donate
- Thematic Network of Cooperative Health Research in Eye Diseases (Oftared) Health Institute Carlos III Department of Ophthalmology Clínica Universidad de Navarra Pamplona Spain
- Hospital Clínico San Carlos Madrid Spain
| | - Francisco J. Ascaso
- Department of Ophthalmology, Hospital Clínico Universitario Lozano Blesa and Instituto de Investigación Sanitaria de Aragón (IIS Aragón) Zaragoza Spain
| | | | - Javier Araiz
- Thematic Network of Cooperative Health Research in Eye Diseases (Oftared) Health Institute Carlos III Department of Ophthalmology Clínica Universidad de Navarra Pamplona Spain
- Hospital San Eloy Bilbao Spain
| | | | - Óscar Ruiz‐Moreno
- Hospital Universitario Miguel Servet IIS Aragón and Grupo de Investigación e Innovación Miguel Servet Oftalmología (GIMSO) Zaragoza Spain
| | - Sergio Recalde
- Retinal Pathologies and New Therapies Group, Experimental Ophthalmology Laboratory Department of Ophthalmology Clínica Universidad de Navarra Pamplona Spain
- Thematic Network of Cooperative Health Research in Eye Diseases (Oftared) Health Institute Carlos III Department of Ophthalmology Clínica Universidad de Navarra Pamplona Spain
- Navarra Institute for Health Research IdiSNA Pamplona Spain
| | - Alfredo García‐Layana
- Retinal Pathologies and New Therapies Group, Experimental Ophthalmology Laboratory Department of Ophthalmology Clínica Universidad de Navarra Pamplona Spain
- Thematic Network of Cooperative Health Research in Eye Diseases (Oftared) Health Institute Carlos III Department of Ophthalmology Clínica Universidad de Navarra Pamplona Spain
- Navarra Institute for Health Research IdiSNA Pamplona Spain
- Department of Ophthalmology Clínica Universidad de Navarra Pamplona Spain
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Liu S, Miyaji M, Hosoya O, Matsuo T. Effect of NK-5962 on Gene Expression Profiling of Retina in a Rat Model of Retinitis Pigmentosa. Int J Mol Sci 2021; 22:ijms222413276. [PMID: 34948073 PMCID: PMC8703378 DOI: 10.3390/ijms222413276] [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: 10/25/2021] [Revised: 12/03/2021] [Accepted: 12/06/2021] [Indexed: 11/18/2022] Open
Abstract
Purpose: NK-5962 is a key component of photoelectric dye-coupled polyethylene film, designated Okayama University type-retinal prosthesis (OUReP™). Previously, we found that NK-5962 solution could reduce the number of apoptotic photoreceptors in the eyes of the Royal College of Surgeons (RCS) rats by intravitreal injection under a 12 h light/dark cycle. This study aimed to explore possible molecular mechanisms underlying the anti-apoptotic effect of NK-5962 in the retina of RCS rats. Methods: RCS rats received intravitreal injections of NK-5962 solution in the left eye at the age of 3 and 4 weeks, before the age of 5 weeks when the speed in the apoptotic degeneration of photoreceptors reaches its peak. The vehicle-treated right eyes served as controls. All rats were housed under a 12 h light/dark cycle, and the retinas were dissected out at the age of 5 weeks for RNA sequence (RNA-seq) analysis. For the functional annotation of differentially expressed genes (DEGs), the Metascape and DAVID databases were used. Results: In total, 55 up-regulated DEGs, and one down-regulated gene (LYVE1) were found to be common among samples treated with NK-5962. These DEGs were analyzed using Gene Ontology (GO) term enrichment, Kyoto Encyclopedia of Genes and Genomes (KEGG), and Reactome pathway analyses. We focused on the up-regulated DEGs that were enriched in extracellular matrix organization, extracellular exosome, and PI3K–Akt signaling pathways. These terms and pathways may relate to mechanisms to protect photoreceptor cells. Moreover, our analyses suggest that SERPINF1, which encodes pigment epithelium-derived factor (PEDF), is one of the key regulatory genes involved in the anti-apoptotic effect of NK-5962 in RCS rat retinas. Conclusions: Our findings suggest that photoelectric dye NK-5962 may delay apoptotic death of photoreceptor cells in RCS rats by up-regulating genes related to extracellular matrix organization, extracellular exosome, and PI3K–Akt signaling pathways. Overall, our RNA-seq and bioinformatics analyses provide insights in the transcriptome responses in the dystrophic RCS rat retinas that were induced by NK-5962 intravitreal injection and offer potential target genes for developing new therapeutic strategies for patients with retinitis pigmentosa.
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Affiliation(s)
- Shihui Liu
- Department of Ophthalmology, Graduate School of Interdisciplinary Science and Engineering in Health Systems, Okayama University, Okayama City 700-8558, Japan;
| | - Mary Miyaji
- Department of Medical Neurobiology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama City 700-8558, Japan; (M.M.); (O.H.)
| | - Osamu Hosoya
- Department of Medical Neurobiology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama City 700-8558, Japan; (M.M.); (O.H.)
| | - Toshihiko Matsuo
- Department of Ophthalmology, Graduate School of Interdisciplinary Science and Engineering in Health Systems, Okayama University, Okayama City 700-8558, Japan;
- Correspondence:
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Leng L, Zhang J, Xie S, Ding W, Ji R, Tian Y, Long K, Yu H, Guo Z. Effect of Sunshine Duration on Myopia in Primary School Students from Northern and Southern China. Int J Gen Med 2021; 14:4913-4922. [PMID: 34483681 PMCID: PMC8409785 DOI: 10.2147/ijgm.s328281] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Accepted: 08/13/2021] [Indexed: 11/23/2022] Open
Abstract
Background To assess the current myopia prevalence rate and evaluate the effect of sunshine duration on myopia among primary school students in the north and south of China. Methods This prospective cross-sectional study pooled data from 9171 primary school students (grades from 1 to 6) from four cities in the north and south of China. National Geomatics Center of China (NGCC) and China Meteorological Administration provided data about altitude, latitude, longitude, average annual temperature, and average annual sunshine duration. Non-cycloplegic refraction was recorded, and prevalence rates in primary school students and factors associated with myopia were analyzed. Univariate and multivariate logistic regression models were used to determine the independent association of risk factors of myopia. Results The overall myopia prevalence was 28.0%, from 7.5% to 50.6% for first and sixth grades, respectively. Low, moderate and high myopia significantly increased with school grades from 7.30% to 35.0%, 0.3% to 13.60% and 0.00% to 1.9%, respectively. Multiple regression analysis revealed that longer average cumulative daylight hours were connected to lower myopia prevalence in primary school students (OR, 0.721; 95% CI, [0.593–0.877]; P=0.001), whereas girls and higher grade was independently associated with higher myopia prevalence (girls: β=0.189; OR, 1.208; 95% CI, [1.052–1.387]; P=0.007; higher grade: β=0.502; OR, 1.652; 95% CI, [1.580–1.726]; P<0.001). Conclusion This study demonstrated that myopia was highly prevalent in southern Chinese cities over northern ones, linked to shorter light exposure, higher education level, and female gender. Such findings reinforced the beneficial impact of daylight exposure with a protective role against myopia development.
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Affiliation(s)
- Lin Leng
- Department of Ophthalmology, Qingdao Eye Hospital of Shandong First Medical University, 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, Shandong Province, People's Republic of China
| | - Jiafan Zhang
- Department of Ophthalmology, Qingdao Eye Hospital of Shandong First Medical University, 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, Shandong Province, People's Republic of China
| | - Sen Xie
- Department of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, 510000, Guangdong Province, People's Republic of China
| | - Wenzhi Ding
- Department of Ophthalmology, Qingdao Eye Hospital of Shandong First Medical University, 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, Shandong Province, People's Republic of China
| | - Rongyuan Ji
- Department of Ophthalmology, Qingdao Eye Hospital of Shandong First Medical University, 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, Shandong Province, People's Republic of China
| | - Yuyin Tian
- Department of Ophthalmology, Qingdao Eye Hospital of Shandong First Medical University, 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, Shandong Province, People's Republic of China
| | - Keli Long
- Department of Ophthalmology, Qingdao Eye Hospital of Shandong First Medical University, 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, Shandong Province, People's Republic of China
| | - Hongliang Yu
- Department of Ophthalmology, Shenyang Eye Docloud Internet Hospital, Shenyang, 110000, Liaoning Province, People's Republic of China
| | - Zhen Guo
- Department of Ophthalmology, Qingdao Eye Hospital of Shandong First Medical University, 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, Shandong Province, People's Republic of China
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Nieves-Moreno M, Noval S, Peralta J, Palomares-Bralo M, del Pozo A, Garcia-Miñaur S, Santos-Simarro F, Vallespin E. Expanding the Phenotypic Spectrum of PAX6 Mutations: From Congenital Cataracts to Nystagmus. Genes (Basel) 2021; 12:genes12050707. [PMID: 34065151 PMCID: PMC8151272 DOI: 10.3390/genes12050707] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2021] [Revised: 05/04/2021] [Accepted: 05/05/2021] [Indexed: 12/15/2022] Open
Abstract
Background: Congenital aniridia is a complex ocular disorder, usually associated with severe visual impairment, generally caused by mutations on the PAX6 gene. The clinical phenotype of PAX6 mutations is highly variable, making the genotype–phenotype correlations difficult to establish. Methods: we describe the phenotype of eight patients from seven unrelated families with confirmed mutations in PAX6, and very different clinical manifestations. Results: Only two patients had the classical aniridia phenotype while the other two presented with aniridia-related manifestations, such as aniridia-related keratopathy or partial aniridia. Congenital cataracts were the main manifestation in three of the patients in this series. All the patients had nystagmus and low visual acuity. Conclusions: The diagnosis of mild forms of aniridia is challenging, but these patients have a potentially blinding hereditary disease that might present with a more severe phenotype in future generations. Clinicians should be aware of the mild aniridia phenotype and request genetic testing to perform an accurate diagnosis.
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Affiliation(s)
- Maria Nieves-Moreno
- Department of Ophthalmology, Hospital Universitario La Paz, 28046 Madrid, Spain; (S.N.); (J.P.)
- Correspondence:
| | - Susana Noval
- Department of Ophthalmology, Hospital Universitario La Paz, 28046 Madrid, Spain; (S.N.); (J.P.)
| | - Jesus Peralta
- Department of Ophthalmology, Hospital Universitario La Paz, 28046 Madrid, Spain; (S.N.); (J.P.)
| | - María Palomares-Bralo
- Department of Molecular Developmental Disorders, Medical and Molecular Genetics Institue (INGEMM) IdiPaz, CIBERER, Hospital Universitario La Paz, 28046 Madrid, Spain;
| | - Angela del Pozo
- Department of Bioinformatics, Medical and Molecular Genetics Institue (INGEMM) IdiPaz, CIBERER, Hospital Universitario La Paz, 28046 Madrid, Spain;
| | - Sixto Garcia-Miñaur
- Department of Clinical Genetics, Medical and Molecular Genetics Institue (INGEMM) IdiPaz, CIBERER, Hospital Universitario La Paz, 28046 Madrid, Spain; (S.G.-M.); (F.S.-S.)
| | - Fernando Santos-Simarro
- Department of Clinical Genetics, Medical and Molecular Genetics Institue (INGEMM) IdiPaz, CIBERER, Hospital Universitario La Paz, 28046 Madrid, Spain; (S.G.-M.); (F.S.-S.)
| | - Elena Vallespin
- Department of Molecular Ophthalmology, Medical and Molecular Genetics Institue (INGEMM) IdiPaz, CIBERER, Hospital Universitario La Paz, 28046 Madrid, Spain;
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Galvis V, Tello A, Rey JJ, Serrano Gomez S, Prada AM. Estimation of ocular axial length with optometric parameters is not accurate. Cont Lens Anterior Eye 2021; 45:101448. [PMID: 33975785 DOI: 10.1016/j.clae.2021.101448] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Revised: 03/30/2021] [Accepted: 04/21/2021] [Indexed: 12/17/2022]
Abstract
Myopia is a worldwide major public concern, aside from the visual disturbance needing optical correction, myopia may be associated with open angle glaucoma, retinal detachment and myopic maculopathy. The higher the myopia the higher the risk for retinal associated comorbidities, and the axial length is the more important measure to estimate risk of visual impairment. Recently a formula to predict axial length using spherical equivalent and keratometry was proposed, with the intention of categorizing the risk of visual impairment with Tideman et al. classification. PURPOSE To evaluate the accuracy of an axial length prediction formula in a Colombian population 8-17 years old. METHODS Children from MIOPUR study with optical biometer axial length measure (AL), manifest refraction and keratometry were included in the analysis. Predicted axial length (PAL) was calculated with the prediction formula. A Bland-Altman assessment was conducted, and the concordance correlation coefficient was measured. Proposed classification of AL to establish risk of visual loss was used with measured AL and with PAL. The percentage of eyes misclassified was then established. RESULTS A total of 2129 eyes were included in the analysis. Mean difference of axial length (actual AL minus PAL) was -0.516 mm (-1.559 mm - 0.528 mm). Concordance correlation coefficient (CCC) of 0.656 (IC95 0.636-0.675) was found between the real AL and PAL. PAL differed from measured AL by 1 mm or more in 16.58 %, and by 2 mm or more, in 0.61 % of the eyes. In myopic eyes, PAL was in average 0.426 mm longer than the AL actually measured with CCC of 0.714 (IC95 0.666-0.761). PAL differed from measured AL by 1 mm or more in 21.92 %, and by 2 mm or more, in 0.45 % of the myopic eyes. The study revealed that 15.03 % of all eyes, and 29.81 % of myopic eyes, were misclassified when PAL was used. CONCLUSIONS The proposed axial length prediction formula was not accurate, and it did not adequately classify risk of visual impairment in myopic eyes in a group of Colombian children. We consider that it is not possible to predict the axial length based only on optometric data, such as the corneal radius of curvature and the spherical equivalent. This is very possibly related to the variability of crystalline lens power within a population.
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Affiliation(s)
- V Galvis
- Centro Oftalmologico Virgilio Galvis, Floridablanca, Colombia; Fundacion Oftalmologica de Santander, Floridablanca, Colombia; Department of Ophthalmology, Universidad Autonoma de Bucaramanga, Floridablanca, Colombia
| | - A Tello
- Centro Oftalmologico Virgilio Galvis, Floridablanca, Colombia; Fundacion Oftalmologica de Santander, Floridablanca, Colombia; Department of Ophthalmology, Universidad Autonoma de Bucaramanga, Floridablanca, Colombia
| | - Juan J Rey
- School of Medicine, Universidad Autonoma de Bucaramanga, Bucaramanga, Colombia
| | | | - A M Prada
- Centro Oftalmologico Virgilio Galvis, Floridablanca, Colombia; Department of Ophthalmology, Universidad Autonoma de Bucaramanga, Floridablanca, Colombia.
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