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Purpose To determine the feasibility and safety of bilateral simultaneous vitreoretinal surgery in pediatric patients. Design International, multicenter, interventional, retrospective case series. Participants Patients 17 years of age or younger from 24 centers worldwide who underwent immediate sequential bilateral vitreoretinal surgery (ISBVS)—defined as vitrectomy, scleral buckle, or lensectomy using the vitreous cutter—performed in both eyes sequentially during the same anesthesia session. Methods Clinical history, surgical details and indications, time under anesthesia, and intraoperative and postoperative ophthalmic and systemic adverse events were reviewed. Main Outcome Measures Ocular and systemic adverse events. Results A total of 344 surgeries from 172 ISBVS procedures in 167 patients were included in the study. The mean age of the cohort was 1.3±2.6 years. Nonexclusive indications for ISBVS were rapidly progressive disease (74.6%), systemic morbidity placing the child at high anesthesia risk (76.0%), and residence remote from surgery location (30.2%). The most common diagnoses were retinopathy of prematurity (ROP; 72.7% [ P < 0.01]; stage 3, 4.8%; stage 4A, 44.4%; stage 4B, 22.4%; stage 5, 26.4%), familial exudative vitreoretinopathy (7.0%), abusive head trauma (4.1%), persistent fetal vasculature (3.5%), congenital cataract (1.7%), posterior capsular opacification (1.7%), rhegmatogenous retinal detachment (1.7%), congenital X-linked retinoschisis (1.2%), Norrie disease (2.3%), and viral retinitis (1.2%). Mean surgical time was 143±59 minutes for both eyes. Higher ROP stage correlated with longer surgical time ( P = 0.02). There were no reported intraoperative ocular complications. During the immediate postoperative period, 2 eyes from different patients demonstrated unilateral vitreous hemorrhage (0.6%). No cases of endophthalmitis, choroidal hemorrhage, or hypotony occurred. Mean total anesthesia time was 203±87 minutes. There were no cases of anesthesia-related death, malignant hyperthermia, anaphylaxis, or cardiac event. There was 1 case of reintubation (0.6%) and 1 case of prolonged oxygen desaturation (0.6%). Mean follow-up after surgery was 103 weeks, and anatomic success and globe salvage rates were 89.8% and 98.0%, respectively. Conclusions This study found ISBVS to be a feasible and safe treatment paradigm for pediatric patients with bilateral vitreoretinal pathologic features when repeated general anesthesia is undesirable or impractical. [ABSTRACT FROM AUTHOR]

Purpose: To examine the optical components and spectral-domain optical coherence tomography (OCT) findings in children with a history of retinopathy of prematurity (ROP) and to identify any associations between the OCT findings and the visual acuities of the patients. Design: Prospective, case-controlled study. Participants and Controls: Children who were between 6 and 14 years of age were divided into the following 4 groups: Patients with a history of threshold ROP who had been treated using laser therapy or cryotherapy (group 1), patients with regressed ROP who had not received any treatment (group 2), patients who were born prematurely but who had no history of ROP (group 3), and normal full-term children (group 4). The posterior poles of the eyes of all of the patients seemed to be normal. Methods: Visual acuities, optical components, and macular thicknesses were measured in 4 groups of patients, and comparisons between the groups were made. Macular thicknesses were measured using OCT. Main Outcome Measures: Visual acuity (VA), optical components, and OCT findings. Results: We enrolled 133 patients in the study. Patients in group 1 had significantly thicker foveas than the other patients, as demonstrated by OCT, and this finding was negatively correlated with gestational age. The incidence of abnormal foveal contours among patients in group 1 was significantly higher than among the rest of the patients. Retention of the inner retinal layers was noted in group 1 patients; however, the structure of the outer retina remained intact. Greater degrees of myopic shift and astigmatism, steeper corneal curvatures, shallower anterior chamber depths, and thicker lenses were noted in previously treated ROP patients. These findings corresponded with poor VA and high refractive errors in group 1 patients. Conclusions: Patients with a history of threshold ROP are more likely to show abnormal foveal development and have a poorer visual prognosis than other patient groups despite a fundus with no macular dragging, disc dragging, or retinal detachment. A steeper corneal curvature, shallower anterior chamber, and greater lens thickness are the main changes in the optical components in these patients. Financial Disclosure(s): The authors have no proprietary or commercial interest in any of the materials discussed in this article. [Copyright &y& Elsevier]

Purpose: To investigate the effects and complications of the anti-vascular endothelial growth factor agent bevacizumab in the treatment of retinopathy of prematurity (ROP) in Taiwanese patients. Design: A multicenter, retrospective case series study. Participants: Twenty-seven patients (49 eyes) from 4 medical centers across Taiwan. Methods: This study included patients receiving intravitreal injections of bevacizumab (IVB) (0.625 mg) for the treatment of ROP between 2007 and 2009 at 4 major medical centers in Taiwan. The effects and complications associated with this treatment were analyzed. Patients were followed for at least 6 months after bevacizumab injection. Main Outcome Measures: Regression of ROP and the complications associated with the injection of bevacizumab. Results: Forty-nine eyes of 27 patients (18 male and 9 female) were included in the study. Mean gestational age and birth weight were 26.0±2.4 weeks and 971.6±589.6 g, respectively. There were 41 eyes (23 patients) with stage 3 ROP, 6 eyes (3 patients) with stage 4A ROP, and 2 eyes (1 patient) with stage 5 ROP. All of the eyes received only a single injection of IVB. The mean injection time was 36.8±2.6 weeks postmenstrual age for eyes with stage 3 ROP. A total of 37 of 41 eyes (90%) with stage 3 ROP regressed after bevacizumab injection only. Four eyes (10%) required additional laser treatment to regress the ROP. Of 6 eyes (3 patients) with stage 4A ROP, 2 eyes (1 patient; 33%) regressed after bevacizumab injection and 4 eyes (67%) regressed after bevacizumab injection and subsequent vitrectomy. The 2 eyes with stage 5 ROP exhibited decreased vascular tortuosity after bevacizumab injection, but the retina failed to reattach after vitrectomy surgeries. Major complications included vitreous or pre-retinal hemorrhage in 4 eyes (8%) and transient vascular sheathing in 2 eyes (4%). Conclusions: Bevacizumab injection seems effective and well tolerated in some cases of ROP, especially in stage 3 ROP. Ocular complications could result from the injection of bevacizumab in pediatric eyes. Financial Disclosure(s): The author(s) have no proprietary or commercial interest in any materials discussed in this article. [Copyright &y& Elsevier]

Purpose: To review our experience with plasmin-assisted vitrectomy surgery for the treatment of pediatric macular holes. Design: Retrospective, interventional case series. Methods: Thirteen pediatric patients aged one to 15 years with a traumatic macular hole underwent surgical repair. All patients underwent surgery between February 1997 and March 2005 with autologous plasmin enzyme-assisted vitrectomy. After induction of posterior vitreous detachment (PVD), vitrectomy with membrane peeling and gas or silicone oil injection were performed followed by prone positioning for seven days. Main outcome measures included anatomic closure rate, visual outcome, and ocular complications. Results: The macular hole was closed successfully in 12 (92%) of 13 cases. Of the 12 patients for whom vision could be measured, 11 patients (92%) had visual acuity improvement of 2 or more lines and six patients (50%) achieved vision of 20/50 or better; all of the patients achieved vision better than 20/200. The visual improvement was statistically significant (P = .005, Wilcoxon signed-rank test). Surgical complications included cataract formation in one patient and retinal detachment in one patient. Conclusions: Autologous plasmin enzyme may be a helpful adjunct when performing vitrectomy for traumatic macular holes. [Copyright &y& Elsevier]

Purpose: To describe ischemic retinopathy in a patient with tetralogy of Fallot. Design: Interventional case report. Testing: Clinical and imaging evaluation. Main Outcome Measures: Clinical, imaging, and laboratory findings in a patient with tetralogy of Fallot. Results: A 20-year-old female patient with tetralogy of Fallot had progressive visual loss of 3 weeks duration. Bilateral examination revealed dilated, tortuous, conjunctival vessels; prominent anterior chamber reaction; iris neovascularization; posterior synechia; retinal vascular tortuosity in both eyes; and inferior exudative retinal detachment. Fluorescein angiography revealed delayed retinal and choroidal filling. The working diagnosis was ischemic retinopathy with uveitis. The patient was treated for 6 months with a high-dose oral corticosteroid combined with a topical corticosteroid, a topical mydriatic, and panretinal photocoagulation. Conjunctival, vascular congestion subsided with a decrease in anterior chamber reaction. The inferior, exudative retinal detachment resolved, and vision was restored. Conclusions: Retinal ischemic syndrome combined with uveitis can develop in patients with tetralogy of Fallot. Treatment can restore vision in such patients. [Copyright &y& Elsevier]

Purpose: To examine whether whole blood prevents indocyanine green (ICG) toxicity on in vitro retinal pigment epithelium (RPE) and prevents RPE staining in ICG-assisted macular hole (MH) surgery. Design: In vitro study and prospective case series. Participants: In vitro study and 20 patients who underwent ICG-assisted MH surgery (20 eyes). Methods: In the in vitro study, cultured human RPE cells were covered with balanced saline solution (BSS), heparinized whole blood, plasma, or packed red blood cells, then exposed to various concentrations of ICG. One cohort was incubated in the dark; the other cohort was exposed to light. Indocyanine green toxicity was evaluated by mitochondrial dehydrogenase assay. In the clinical study, a prospective noncomparative review of 20 consecutive patients (20 eyes) with stage 3 to stage 4 MH who underwent surgery with ICG to stain the internal limiting membrane (ILM) was performed. Indocyanine green solution (0.5 mg/ml) was used to stain the ILM after autologous whole blood covered the macular hole area. Postoperative staining of ICG on RPE was detected by an infrared-sensitive camera. Main Outcome Measures: Cultured human RPE cell viability, macular hole closure rate, median visual acuity preoperatively and postoperatively, postoperative ICG staining, and retinal changes. Results: Cultured human RPE cells covered by whole blood or plasma showed no decrease of mitochondrial dehydrogenase even in 5.0 mg/ml concentration of ICG for 20 minutes with or without light exposure. Conversely, those exposed to ICG and covered with BSS demonstrated a significant decrease of mitochondrial dehydrogenase after incubation in 5, 2.5, and 1.0 mg/ml for 20 minutes in the dark and in 5 to 0.05 mg/ml with light. Clinically, no postoperative staining on RPE was detected. No atrophic RPE changes or other retinal changes were observed in the previous MH area that was covered by autologous whole blood in all 20 eyes on average follow-up of 10.6 months. The hole closed in 19 eyes (95%) on first surgery. Visual acuity improved in 17 eyes (85%) on most recent follow-up. Conclusions: Whole blood prevents ICG toxicity in RPE cell culture and prevents staining of RPE in surgery of MH when the ILM is stained with ICG. [Copyright &y& Elsevier]

Retinotomy refers to "cutting" or "incising" the retina, whereas retinectomy denotes "excising" the retina. Retinotomies and retinectomies aid in tackling traction and retinal shortening that persist following membrane dissection and scleral buckling. We performed a literature search using Google Scholar and PubMed, followed by a review of the references procured. All relevant literature was studied in detail and summarized. We discuss the indications of retinotomies and retinectomies for relaxing retinal stiffness, accessing the subretinal space for choroidal neovascular membrane, hemorrhage and abscess clearance, drainage retinotomies to allow retinal flattening, radial retinotomies to release circumferential traction, harvesting free retinal grafts, and prophylactic chorioretinectomies in trauma. [ABSTRACT FROM AUTHOR]

Graphical abstract Highlights • A facile approach has been developed to modify oligochitosan on the protein vector. • Two proteins, namely zein and ovalbumin, were modified with oligochitosan for gene delivery. • The protein moiety in the vectors modulates their internalization pathway and the transfection efficiency. Abstract Oligochitosan-modified proteins have gained attention as efficient non-viral vectors for gene delivery. However, little information exists if protein moieties can serve as an important role for internalization and endosome escape ability of the genetic material. To explore this issue, we designed two cationic oligochitosan-modified vectors that consist of different proteins, namely a hydrophobic plant protein (zein) and a hydrophilic animal protein (ovalbumin (OVA)) to deliver pDNA to epithelial cell line CHO-K1 and HEK 293 T. These cationic vectors were systematically characterized by molecular weight, infrared (IR) structural analysis, transmission electron microscopy (TEM) morphology, and surface charge. A remarkable impact of protein moieties was observed on physiochemical properties of the developed vectors. Oligochitosan-modified zein containing hydrophobic protein exhibited high buffering capacity and excellent DNA binding ability compared to the oligochitosan-modified OVA. The data on transfection in the presence of endocytic inhibitors indicated that the caveolae-mediated pathway (CvME) played a key role in the internalization of the zein-based polyplex. However, the OVA-based polyplex was internalized in CHO-K1 cells via CvME and in HEK 293 T cells via the lipid-mediated pathway. Moreover, oligochitosan-modified zein exhibited lower cytotoxicity, greater lysosomal escape ability, better plasmid stability, and better transfection efficiency than the oligochitosan-modified OVA. This study offers a facile procedure for the synthesis of cationic vectors and elucidates the relationship that exists between protein moieties and transfection activity, thus providing an alternative, non-viral platform for the gene delivery. [ABSTRACT FROM AUTHOR]

Chitosan and its derivatives have shown to be potential gene carriers with biocompatiblility and safety. However, their practical delivery is far from being ideal because of the low transfection efficiency. The present work describes the potential of a natural protein, bovine serum albumin (BSA), conjugated with a natural oligosaccharide, oligochitosan (OC), as a considerable promising approach for a safe and efficient non-viral gene delivery vector. The FTIR spectra proved the effective conjugation of BSA with OC through covalent bond. The condensation ability of plasmid DNA (pDNA) with a BSA-OC biopolymer was analyzed by gel retardation assay, competition binding assay, and dynamic light scattering used to measure the nanoparticle size. In addition, the BSA-OC biopolymer showed the protection of pDNA from enzymatic degradation by DNase I and showed good stability when exposed to 50% fetal bovine serum. The transfection efficiency was evaluated in the presence of 10% serum-supplemented media or serum-free media on three kinds of mammalian cells. Our results showed that the BSA-OC biopolymer is a good non-viral vehicle for gene delivery. We investigated the parameters such as the pDNA payload, temperature, incubating duration, and biopolymer/pDNA ratio on the transfection efficiency. This hybrid vehicle had the ability to transfect 90% of cells and to maintain 80% of cell viability. The aforementioned results suggest that the facile synthesis of the BSA-OC biopolymer could overcome the cytotoxicity problem and transfection barriers during in vitro gene delivery. [ABSTRACT FROM AUTHOR]

Intraocular angiogenesis mediated by vascular endothelial growth factor (VEGF) and the related ocular disease, age-related macular degeneration (AMD), is the leading cause of loss of vision worldwide. Though anti-VEGF antibodies are used to control AMD, administration of high doses or frequent dosing, and poor ocular retention of the drug adversely affect the patient outcomes. Herein, we report the synthesis of anti-angiogenic carbon nanovesicles (CNVs) through one-step mild carbonization of Brij L76 for loading and sustained release of anti-VEGF antibody [bevacizumab (Avastin)] to treat VEGF-induced angiogenesis. Compared to liposomes and polymersomes, the preparation of CNVs is relatively quick, straightforward, and cost-effective. The bevacizumab loading efficiency of the CNVs is 24.4%, with an encapsulation efficiency of 56.4%. With negligible cytotoxicity toward human umbilical vein endothelial cells and retinal pigment epithelial cells, the bevacizumab-loaded CNVs (BVZ@CNVs) effectively inhibit VEGF-induced cell proliferation and suppress HUVEC migration. In vivo studies show that BVZ@CNVs has superior efficacy to bevacizumab in treating pathological angiogenesis of rabbit eyes as a result of increased bioavailability of the drug through sustained release combined with the anti-angiogenic effect of CNVs. Our findings indicate that BVZ@CNVs hold great potential as a therapeutic anti-angiogenic agent for clinical AMD treatment. [Display omitted] • Anti-angiogenic carbon nanovesicles (CNVs) were synthesized for loading and sustainable release of bevacizumab (BVZ). • BVZ@CNVs inhibit the VEGF-induced cell proliferation and suppress migration of HUVECs. • BVZ@CNVs relieve the symptoms of VEGF-induced angiogenesis in vivo in a rabbit model. • A combined therapeutic effect of CNVs and long-term release of BVZ has been demonstrated. [ABSTRACT FROM AUTHOR]

To evaluate the neurodevelopmental and ocular developmental outcomes in premature children who have undergone intravitreal bevacizumab injection (IVB) for treatment of type 1 retinopathy of prematurity (ROP). Prospective case-control study. We enrolled 3 groups of premature patients: premature children who had no history of ROP (group 0), premature children with history of ROP without treatment (group 1), and premature children with ROP who had received a single IVB (0.625 mg; group 2). Ocular developmental assessment, including cycloplegic refractometry, axial length, Cardiff acuity, and neurodevelopmental assessment via the Bayley Scales of Infant and Toddler Development, Third Edition (Bayley III), were performed at 1 to 3 years of age and were compared between groups. Ocular developmental outcomes and Bayley III scores. A total of 148 patients (85 boys and 63 girls) were included. The mean age at assessment was 1.49±0.59 years. Group 0 patients demonstrated significantly higher gestational age (GA), birth weight, and Apgar scores compared with group 1 and 2 patients. There were no significant differences between groups 1 and 2 in demographics or systemic risk factors except for lower GA in group 2. The cylindrical power was significantly larger in groups 1 and 2 compared with group 0. The spherical equivalent was significantly more myopic and the Cardiff acuity was significantly poorer in group 2 than in group 0. There were no significant differences between groups 1 and 2 in refractive status, axial length, or Cardiff acuity. Neurodevelopmental assessment using Bayley III showed no significant difference among the 3 groups in any aspect after adjusting for GA and other systemic risk factors. The risks for poor neurodevelopmental outcomes also were not significantly different. At the mean age of 1.5 years, children with prior history of IVB (group 2) showed similar refractive and visual outcomes and similar neurodevelopmental outcomes compared with premature patients with ROP without requirement of treatment (group 1), although there is a possibility that a small but clinically significant difference may not have been detected in the current study. [ABSTRACT FROM AUTHOR]

Purpose To investigate the surgical results of macular hole retinal detachment (MHRD) repaired using vitrectomy combined with inverted internal limiting membrane repositioning (ILMR) and autologous blood clot (ABC) in highly myopic eyes. Design Retrospective, interventional case series. Participants Twenty-seven cases of MHRD. Methods Twenty-seven cases of highly myopic eyes with MHRD in 27 patients who underwent a vitrectomy combined with ILMR and ABC and were followed up over 6 months were reviewed. The anatomic outcomes of MHRD were evaluated by fundus examinations and optical coherence tomography. The preoperative and postoperative best-corrected visual acuities (BCVAs) were compared as the functional outcome. Main Outcome Measures Retinal reattachment, macular hole (MH) closure, and BCVA before and after surgery. Results In total, women accounted for 85% (23/27) of the MHRD patients. The mean age was 59.1±10.6 years. The mean axial length was 29.37±1.92 mm. Type 1 MHRD was present in 9 eyes, and type 2 MHRD was present in 18 eyes. After a single surgery, the retina was attached and the hole was closed in 26 eyes (96%), and 100% retinal attachment was achieved by another vitrectomy for rhegmatogenous retinal detachment that occurred 3 months after the initial surgery. A parafoveal unclosed hole was found in 1 eye (4%) during the follow-up period, and the patient did not undergo further treatment. Three eyes with a closed hole showed persistent subretinal fluid (SRF) after gas absorption. In 2 of these cases, the fluid absorbed completely during the follow-up period, but 1 eye exhibited persistent SRF, which was resolved progressively during the 12 months of follow-up. The surgery significantly improved the BCVAs {from 1.8±0.7 logarithm of the minimum angle of resolution units to 1.3±0.7 logarithm of the minimum angle of resolution units ( P = 0.001)} at 3 and 6 months and at the last visit after surgery. Seven patients underwent cataract surgery during the follow-up period. Conclusions A vitrectomy combined with ILMR and ABC is effective for closing MHs and reattaching the retina and significantly improves the postoperative BCVA in MHRD patients. [ABSTRACT FROM AUTHOR]

The incidence of retinopathy of prematurity (ROP) continues to rise due to the improved survival of very low birth weight infants in developed countries. This epidemic is also fueled by increased survival of preterm babies with variable use of oxygen and a lack of ROP awareness and screening services in resource-limited regions. Improvements in technology and a basic understanding of the disease pathophysiology have changed the way we screen and manage ROP, educate providers and patients, and improve ROP awareness. Advancements in imaging techniques, expansion of telemedicine services, and the potential for artificial intelligence-assisted ROP screening programs have created opportunities to improve ROP care in areas with a shortage of ophthalmologists trained in ROP. To address the gap in provider knowledge regarding ROP, the Global Education Network for Retinopathy of Prematurity (GEN-ROP) created a web-based tele-education training module that can be used to educate all providers involved in ROP, including non-physician ROP screeners. Over the past 50 years, the treatment of severe ROP has evolved from limited treatment modalities to cryotherapy and laser photocoagulation. More recently, there has been growing evidence to support the use of anti-vascular endothelial growth factor (VEGF) agents for the treatment of severe ROP. However, VEGF is known to be important in organogenesis and microvascular maintenance, and given that intravitreal anti-VEGF treatment can result in systemic VEGF suppression over a period of at least 1-12 weeks, there are concerns regarding adverse effects and long-term ocular and systemic developmental consequences of anti-VEGF therapy. Future research in ophthalmology to address the growing burden of ROP should focus on cost-effective fundus imaging devices, implementation of artificial intelligence platforms, updated treatment algorithms with optimal use of anti-VEGF and careful investigation of its long-term effects, and surgical options in advanced ROP. Addressing these unmet needs will aid the global effort against the ROP epidemic and optimize our understanding and treatment of this blinding disease. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the efficacy of autologous heparinized whole blood in assisting internal limiting membrane (ILM) peeling by coating the ILM for macular hole (MH) repair. Design: Prospective, interventional case series. Participants: Twenty-nine patients (32 eyes) who underwent blood-assisted ILM peeling for MH repair. Methods: Patients in whom stage 2–4 idiopathic MHs had developed and who desired surgery were enrolled in this study. After core vitrectomy, autologous heparinized whole blood was applied to cover the macula and to coat the surface of the macular area in the fluid-filled vitreous cavity. The redundant blood was removed and only a very thin film of blood was left on the macular area. The blood-coated ILM was removed by forceps in a circular fashion. To confirm the removed membrane was the ILM, the first 10 specimens were examined by electron microscopy (EM). Main Outcome Measures: The MH closure rate, the interval mean visual acuity (before and after surgery), retinal changes, and the EM results of the ILM specimens. Results: All 32 eyes in 29 patients completed 12 months of follow-up. The ILM were coated by autologous heparinized whole blood, removed without difficulty, and confirmed by EM. The whole blood highlighted the contrast of the coated and noncoated areas during the ILM peeling procedure. The MHs were closed in all surgical eyes with a single surgery (100%). Compared with study entry, the mean logMAR best-corrected visual acuity 12 months after surgery improved significantly (1.02 and 0.53, respectively; P<0.001). At 12 months of follow-up, 31 eyes (96.9%) had stable or improved vision. No toxic fundus changes were observed during follow-up. Conclusions: Autologous heparinized whole blood coated the ILM and facilitated visibility during ILM peeling. Autologous heparinized whole blood is a cost-effective and useful tool for assisting MH surgery. Financial Disclosure(s): The author(s) have no proprietary or commercial interest in any materials discussed in this article. [Copyright &y& Elsevier]

Purpose: To describe clinical features, predisposing factors, and surgical outcomes of retinal detachment in different age groups in a pediatric population. Design: Retrospective, noncomparative, interventional case series. Participants: A total of 296 eyes from 278 children younger than 18 years of age underwent the first surgical procedure for rhegmatogenous retinal detachment between 1983 and 2003. They were divided into 3 age groups: 38 eyes in group 1 (0–10 years), 107 eyes in group 2 (11–15 years), and 151 eyes in group 3 (16–18 years). Methods: Predisposing factors for retinal detachment were classified into 4 categories: (1) high myopia, (2) trauma, (3) congenital or developmental structural ocular abnormalities, and (4) previous intraocular surgery. Main Outcome Measurements: Visual acuity and retinal reattachment. Results: The mean age of the patients was 14.6 years; 73.7% were boys. The mean follow-up period was 51 months. At least 1 predisposing factor could be identified in 282 (95%) of study eyes. High myopia was most common in 111 eyes (38%). Thirty-one percent of eyes experienced trauma, 17% had structural abnormalities, and 5% underwent previous intraocular surgery. Macular involvement was found in 237 eyes (80%). The initial surgery was scleral buckling alone in 224 eyes (76%). Retinal reattachment was achieved in 214 eyes (72%) after the first operation and in 250 eyes (85%) at the end of intervention. Features seen in patients with a poor surgical outcome included congenital anomaly (P<0.001), previous intraocular surgery (P = 0.007), proliferative vitreoretinopathy grade C or worse (P<0.001), macula off (P = 0.001), total retinal detachment (P<0.001), and use of silicone oil (P<0.001). Conclusions: Myopia is one of the important predisposing factors of pediatric retinal detachment in East Asians. The predisposing factors, clinical features, timing of diagnosis, and frequency of proliferative vitreoretinopathy of retinal detachment are somewhat different in the 3 age groups considered. Because of higher proportions of congenital anomaly, total retinal detachment, proliferative vitreoretinopathy, and a low success rate with poor postoperative compliance, patients in group 1 experienced the lowest final reattachment rate and the worst visual recovery. [Copyright &y& Elsevier]

The pumping function of corneal endothelial cells (CECs) plays a pivotal role in the maintenance of corneal water homeostasis. Corneal endothelial dysfunction (CED) leads to corneal edema and opacity, but with the exception of keratoplasty, no optimal therapeutic strategies have been established for CED. In this study, we aimed to investigate the ameliorative effect of ascorbic acid (AA) on CED and the underlying mechanism of action in the corneal endothelium. Rabbit corneal endothelial damage was induced by anterior chamber injection of benzalkonium chloride (BAK). AA was topically administered to the corneal surface, and the transparency and thickness of the cornea were assessed by external eye photography, slit-lamp photography, and ultrasonic pachymetry. To further analyze the mechanism, rabbit CECs and immortalized human CECs (B4G12 cells) were cultured. A ferric reducing/antioxidant and AA (FRASC) assay was performed to measure the AA concentration. Cell proliferation was evaluated by cell counting and bromodeoxyuridine (BrdU) labeling assays, and protein expression was examined by liquid chromatography–mass spectrometry (LC/MS) and immunoblotting. The involvement of glucose transporter 1 (GLUT1) and phospho-ERK was evaluated via GLUT1-siRNA and phospho-ERK inhibitor (PD98059) treatment. We observed that topical AA ameliorates BAK-induced rabbit corneal endothelial damage. Furthermore, we demonstrated that AA is transported into B4G12 cells via GLUT1, and afterward, AA increases ERK phosphorylation and promotes cell proliferation. Our findings indicate that CEC proliferation stimulated via the noncanonical AA-GLUT1-ERK axis contributes to AA-enhanced healing of CED. [ABSTRACT FROM AUTHOR]

• A highly sensitive magneto immunosensor developed for parathyroid hormone detection. • The immunosensors only need small volume, minor wash steps, and low detection limit. • Magnetic beads-based immunosensors may be implementing for point-of-care testing. Using magnetic beads (MBs) in electrochemical immunosensors has been shown to improve their sensitivity, reduce analysis time, and minimize reaction volume. The antigen–antibody interaction can be improved with the correct orientation of the antibody using aminophenyl boronic acid (APBA) as the immobilized ligand. In this work, a highly sensitive magneto immunosensor to detect parathyroid hormone (PTH) was reported. The analysis was based on the immobilization of anti-PTH antibodies onto MBs followed by immunocapture, voltammetric and impedimetric assay. We introduce a facile two-step method to detect PTH by using MBs modified by APBA and antibody-peroxidase complex. Immunocapture of PTH by the antibodies takes place on the modified MBs, and the immunocomplexes are separated by a magnet on a screen-printed electrode. Electrochemical detection was performed by measuring the catalytic current and impedance. The APBA coating, antibody-peroxidase ratio, MB characterization, and electrochemical parameters were systematically investigated in this study. The PTH immunosensor exhibited a linear range between 10 and 300 pg mL−1, with a limit of detection of 11.56 pg mL−1 by voltammetry and 49.30 pg mL−1 by impedance spectroscopy. A magneto immunosensor was successfully prepared by using modified MBs and a disposable electrode, which can be applied to analyze PTH quickly as a point of care device. [ABSTRACT FROM AUTHOR]

Purpose: To compare the macular choroidal thickness in 2 types of early dry-type myopic maculopathy. Design: Prospective, observational, comparative study. Methods: Patients with a refractive error of less than −8 diopters were included and were classified into 2 groups. Group 1 consisted of 24 eyes with a tessellated fundus, and group 2 consisted of 33 eyes with diffuse chorioretinal atrophy, but not to the extent of patchy chorioretinal atrophy. These 2 groups were compared with regard to their clinical characteristics, refractive error, axial length, macular choroidal thickness, and best-corrected visual acuity (BCVA). Linear regression was used to evaluate the explanatory variables in terms of macular choroidal thickness and BCVA. Results: Patients in group 1 were significantly younger and had better BCVA, less myopia, shorter axial length, and less staphyloma than those in group 2. Refractive error, axial length, and BCVA correlated significantly with macular choroidal thickness in group 2. However, no such significant correlations were observed in group 1. Multiple linear regression analysis showed that age and macular choroidal thickness were the variables that associated most strongly with BCVA, whereas neither refractive error nor axial length was a significant predictor of BCVA. In group 2, eyes with lacquer cracks showed worse BCVA and thinner macular choroidal thickness than eyes without lacquer cracks. Conclusions: Macular choroidal thickness is an important factor in myopic maculopathy and can be a better indicator of its severity. These findings suggest that BCVA reduction in eyes with dry-type myopic maculopathy can be related to a thinner macular choroidal thickness and to the development of lacquer cracks. [Copyright &y& Elsevier]