Smartphone fundoscopy for retinopathy of prematurity

PurposeThe utility of digital fundus images in retinopathy of prematurity (ROP) screening has been established. A smartphone can be a device available to most ophthalmologists to capture digital fundus photographs. In this study, fundus images were captured with original camera settings for ROP documentation.MethodsThe examination was performed under topical anesthesia. An assistant held a glass stick against the eye movement if infants moved their eyes too frequently. A hand-held smartphone and a 30D lens were used to record the fundus in video mode. A continuous flash was turned on to provide almost constant coaxial illumination. Fundus photographs were captured from the video film.ResultsFundus photographs can be captured successfully with a smartphone and a 30D lens under original camera settings.ConclusionFundus photographs of acceptable diagnostic quality can be obtained in ROP patients conveniently and inexpensively using a portable hand-held smartphone. It might be a useful tool in documentation, education, consultation, and telemedicine in ROP.     

Visual function with blue light filter IOLs

BACKGROUND: Recently, intraocular lenses (IOLs) with a blue light filter have been introduced to protect the retina from age-related macular degeneration (AMD) after cataract extraction. A reduction of longitudinal chromatic aberration by filtering blue light may enhance patient's visual function. In this study we compared subjective and objective parameters of visual function following implantation of blue light filter (yellow) IOLs and IOLs of the same design without filter. PATIENTS AND METHODS: 21 patients (21 eyes) underwent implantation of an IOL with a blue light filter (AF-1 UY, Hoya, Japan), 22 patients (22 eyes) received an IOL without blue light filter (AF-1 UV, Hoya, Japan). Patients were examined three months postoperatively for uncorrected and best corrected spectacle visual acuity, mesopic and photopic contrast sensitivity, colour vision and subjective quality of vision by a standard questionnaire. RESULTS: Eyes with blue light filter IOLs did not show any significant difference in any parameter analysed when compared to eyes without the blue light filter IOL. Subjective quality of vision was considered to be high by all patients and no significant difference was observed between the two IOL groups. CONCLUSION: The visual function of patients with blue filter IOLs is not significantly different to those without blue light filter IOLs. Since blue light filter IOLs did not show any functional disadvantage, but potentially protect the macula from AMD, blue light filter IOLs may be considered as a reasonable alternative to traditional IOLs, especially in eyes with a high risk for the development of macular degeneration.     

蓝光对人视网膜色素上皮细胞增殖的影响和机制研究

目的:研究蓝光对人视网膜色素上皮细胞增殖能力的影响,并初步探讨其可能机制.方法:利用35W白色冷光灯加用蓝色滤光片建立蓝光损伤体外培养的RPE细胞模型,蓝光控制波长在470~520nm,光照强度控制为2000Lx左右,光照时间控制为24~96h,利用CCK-8法检测RPE细胞的增殖能力,利用real-time PCR技术检测RPE细胞中miR-103的含量.结果:与对照组相比,蓝光照射组的RPE细胞的增殖能力减弱;蓝光照射组的RPE细胞内的miR-103含量较对照组增加;miR-103过表达时,RPE细胞的增殖能力减退,降低miR-103的表达时,细胞增殖能力增强;降低miR-103的表达能够减弱蓝光对RPE细胞增殖的抑制作用.结论:蓝光通过上调miR-103抑制RPE细胞的增殖,miR-103可能成为治疗年龄相关性黄斑变性等视网膜变性疾病治疗的新靶点.     

A novel approach to anterior segment imaging with smartphones in the COVID-19 era

Purpose:To report a novel, telemedicine-friendly, smartphone-based, wireless anterior segment device with instant photo-documentation ability in the COVID-19 era.Methods:Anterior Imaging Module (AIM) was constructed based on a 50/50 beam splitter design, to match the magnification drum optics of slit-lamps with a three-step or higher level of magnification. The design fills the smartphone sensor fully at the lowest magnification and matches the fixed focus of the slit-lamp. It comes with a smartphone for instant photo-documentation, an in-built software application for data-management and secure HIPAA compliant cloud storage, and a Bluetooth trigger for a one-tap image capture. The construction of the device is explained, and the optical resolution measured using U.S. air-force resolution test. AIM’s performance was characterized with traceability to internationally relevant performance standards for digital slit-lamps after image quality assessment through a pilot study.Results:Clinically useful anterior segment images were obtained with both diffuse and slit illumination at different magnification settings with the highest magnification (40X) resolution of 359 lines per cm and the lowest magnification (16X) resolution of 113 lines per cm.Conclusion:AIM is a novel, wireless, telemedicine-enabled design that digitizes existing, analog slit lamps with at least three-step magnification. The settings ensure the focus is determined purely by the position of the slit-lamp. Hence, the image viewed and captured on the smartphone is exactly what the clinician sees through the eyepiece. This helps in maintaining distance from the patient in the ongoing COVID-19 pandemic, as well.     

CCK-8法检测蓝光和白光对ARPE-19细胞增殖的影响

目的：探讨蓝光和白光分别光照不同时间对人视网膜色素上皮(ARPE-19)细胞增殖的影响,为进一步检测光照损伤过程中相关因子的变化情况,研究光照损伤过程中的信号转导机制奠定基础。

方法：收集生长状态良好的ARPE-19 细胞进行实验,制作CCK-8标准曲线,确定实验合适的ARPE-19细胞密度及CCK-8试剂的反应时间。将细胞分为避光组、蓝光组、白光组,分别光照 3、6、9h,再避光培养12h后采用CCK-8 法检测不同光源光照不同时间对ARPE-19细胞增殖率的影响。

结果：通过CCK-8标准曲线选择每孔细胞数量为20 000个,CCK-8溶液作用4h后测量相应吸光度值。CCK-8检测结果示,避光组、蓝光组、白光组三组细胞光照不同时间细胞增殖率比较,差异有统计学意义(P<0.01)。蓝光组细胞光照3、6、9h,各时间点细胞增殖率比较,差异有统计学意义(P<0.001),且随着光照时间的延长,细胞增殖率逐渐降低。白光组细胞光照3、6、9h,各时间点细胞增殖率比较,差异有统计学意义(P<0.05),其中光照3h和6h细胞增殖率比较,差异有统计学意义(P<0.05),而光照9h分别与光照3、6h细胞增殖率比较,差异均无统计学意义(P=0.253、0.120)。白光光照3～6h细胞增殖率呈下降趋势,而光照6～9h细胞增殖率呈现上升趋势。相同光照时间,蓝光组和白光组细胞增殖率均低于避光组,且蓝光组细胞增殖率均低于白光组,差异均有统计学意义(P<0.05)。

结论：光照能抑制ARPE-19细胞的增殖,其中蓝光光照细胞增殖率明显低于白光,且随光照时间的增长,细胞增殖率进一步降低。     

Selective photoreceptor damage in albino rats using continuous blue light

Purpose: To develop a retinal degeneration model with selective photoreceptor loss and RPE sparing, to be used as recipient for evaluating retinal transplants. Methods: Albino rats were exposed to blue light, continuously, for 1–7 days (24–168 h) in a specially designed cage. Eyes were histologically analyzed at periods between 2 h and 8 months after the light exposure. Electroretinograms (ERGs) were recorded from some rats at 12–216 days after exposure. Using behavioral methods, visual thresholds of some rats were determined before exposure and re-measured between 18 and 52 days following exposure. Results: Apoptotic nuclei appeared exclusively in the photoreceptor layer after 1–5 days exposure to blue light. Light microscopy revealed that 2–4 days of light exposure reduced the outer nuclear layer (normally eight to ten rows) to 1 row of cells in the central retina and to two to three rows in the periphery, both in the superior and the inferior retina. Average ERG a- and b-wave amplitudes of light-damaged rats were both reduced by about 98%. Visual performance in the behavioral test was substantially impaired. Conclusions: Continuous exposure of albino rats to moderate blue light for 2–5 days selectively eliminates most of the photoreceptors while leaving the RPE initially intact. Received: 27 September 1999 Revised: 14 December 1999 Accepted: 3 February 2000     

Blood-retinal barrier dysfunction at the pigment epithelium induced by blue light.

Exposure to low-intensity white light can induce dysfunction of the blood-retinal barrier (BRB) at the retinal pigment epithelium (RPE). To determine whether the shorter wavelengths white light are responsible for this dysfunction, rabbit retinas were exposed to blue light (400-520 nm) or yellow light (510-740 nm). The permeability of the BRB, a parameter for the integrity of the barrier, was quantified with vitreous fluorophotometry. Morphologically, the barrier at the RPE was visualized on light and electron microscopy using horseradish peroxidase (HRP) as a tracer. Seventeen pigmented rabbits were exposed to blue light and 11 were exposed to yellow light. Vitreous fluorescein leakage increased with the exposure energy according to a power function (correlation coefficient > 0.79). The threshold energy for an increase in BRB permeability was 50 J/cm2 (0.014 W/cm2 for 1 hr) after blue and 1600 J/cm2 after yellow light. HRP tracing demonstrated that after blue light exposure, a significant fluorescein leakage on fluorophotometry corresponded to the presence of HRP in the RPE cells and in the subretinal space. After yellow light exposures of < 3700 J/cm2 and in rabbits with no significant fluorescein leakage, the HRP was limited to the choroidal capillaries and Bruch's membrane. These results demonstrate that the blue component of white light causes dysfunction of the BRB at the RPE 30 times more effectively than the longer wavelength fraction of white light. As a result, a blue light blocking filter should be used in ocular surgery on humans when an operating microscope is being used (light power 0.1-0.9 W/cm2).     

A smartphone lens attachment improves the quality of referrals to eye casualty

Background/objectivesIn recent years, eye casualty clinics have seen significant increases in patient numbers with reduced capacity. COVID-19 has exacerbated this issue and demonstrated the potential of telemedicine as a solution. Our study evaluated the potential benefit of a smartphone-based lens attachment to improve the referral pathway for anterior segment related complaints in eye casualty.Subjects/methodsFifty-four consecutive patients with anterior segment complaints were recruited. A questionnaire was completed with each patient to simulate the history from the point of referral. White light and cobalt blue photos were captured using a smartphone lens. The clinician reviewing the patient was asked to document the actual diagnosis and the appropriate time-frame within which they felt the patient could safely have been seen within; both with and without the option of management advice at the time of triage. The subsequent images and questionnaires were reviewed by a single consultant Ophthalmologist who was independent to the data collection process. The assessor was asked to make a diagnosis and management plan based upon the questionnaire (‘History’), and the questionnaire with the photo (‘History with Image’), as well as rate their clinical confidence on a 1–5 scale.ResultsDiagnostic accuracy was significantly higher in “History with Image” (98.2%), when compared to “History” only (48.2%). “History with Image” prevented significantly more appointments when compared to “History” alone, at similar levels to retrospective clinic review. Preventable appointments were increased if clinical advice was possible. Timeframe of appointments between ‘History with Image’ and ‘Clinic’ appointments was similar. Clinical’Confidence was significantly higher at 4.5 with ‘History with Image’ when compared to 2.37 with ‘History Only’.ConclusionA low-cost smartphone lens attachment, alongside a standardised clinical questionnaire, can improve the referral pathway to the hospital eye service by reducing unnecessary appointments, while improving clinical confidence and diagnostic accuracy during triage. Further work to evaluate referral pathways, including the development of systems that allow for secure image transmission are needed to understand the feasibility for the widespread adoption of this technology.Subject terms: Physical examination, Health services     

AcrySof Natural filter decreases blue light-induced apoptosis in human retinal pigment epithelium

Purpose The effect of AcrySof filter (UV light-filtering chromophore; Alcon) and AcrySof Natural filter (UV- and blue light-filtering chromophores) on blue light-induced apoptosis in human retinal pigment epithelial (RPE) cells was evaluated. Design Laboratory investigation Clinical relevance Acrysof Natural filter reduces the blue-light toxicity in RPE cells and may have a positive impact on age-related macular degeneration (AMD). Methods RPE cells were exposed to blue light (430–450 nm) in the presence of either the AcrySof (UV only) filter or Acrysof Natural (UV and blue light) filter for 10 days. The rate of apoptosis was analyzed. Results Blue light induced significant apoptosis in RPE cells. AcrySof Natural filter significantly reduced the blue light-induced apoptosis when compared to AcrySof filter. The amount of blue-light energy reaching the cells with the AcrySof filter was 4.25 mW/cm² and with the AcrySof Natural filter was 2.5 mW/cm². Conclusions AcrySof Natural filter significantly reduced blue light-induced apoptosis. This was most likely due to its filtering effect on blue wavelength light, which reduces the energy that reaches the cells. In patients with cataract who are at a high risk for AMD, the implantation of a blue light-filtering intraocular lens may be considered. Supported in part by Alcon Laboratories and Research to Prevent Blindness. None of the authors have a proprietary interest.     

不同波长的蓝光对人视网膜色素上皮细胞的影响

目的：探讨不同波长的蓝光对人视网膜色素上皮细胞(RPE)的影响。

方法：将体外培养的ARPE-19细胞随机分为对照组、447nm蓝光组、456nm蓝光组、468nm蓝光组,对照组细胞于常规条件下培养,蓝光组细胞使用光强为200Lx的OLED蓝光背光源照射72h,利用细胞活/死染色实验、CCK-8实验、Real-time PCR等方法比较不同波长的蓝光对细胞形态、细胞活性、增殖能力及视循环功能指标和炎症指标mRNA表达的影响。

结果：蓝光照射后,ARPE-19细胞的形态发生变化,细胞融合减少。蓝光波长越短,对细胞增殖抑制作用越明显,细胞内增殖标志物Ki-67 mRNA表达越少,视循环功能指标卵磷脂视黄醇酰基转移酶(LRAT)、视黄醛结合蛋白(CRALBP)、视黄醛脱氢酶(RDH)、光受体视黄醇类结合蛋白(IRBP)mRNA表达下调越明显,细胞内炎症因子单核细胞趋化因子(MCP-1)、白介素-6(IL-6)mRNA表达水平上调越明显。

结论：不同波长蓝光对RPE细胞均有损害作用,且蓝光波长越短,其损害作用越大。     

智能手机照相功能在裂隙灯显微摄影中的应用

目的探讨智能手机附带的照相功能在裂隙灯显微镜显微摄影中应用的价值。方法利用易获取的材料自制转接环,将智能手机的照相机与裂隙灯显微镜目镜接驳,在自制辅助照明光和弥散光配合下,进行裂隙灯显微镜眼前段摄影,对采集的图片进行数据库管理、利用互联网进行交流。结果自制接口能够精确接驳于裂隙灯显微镜的光学系统,能使智能手机附带的照相机顺利成像。所获得的照片清晰度、色彩还原度、对比度均较好。能够较为清晰地显示组织细节、病变特点。结论500～800万像素的智能手机采集的裂隙灯显微镜照片,在影像质量上可满足临床需求,能够丰富客观临床资料,有助于方便快捷地进行同行交流,直观地进行医患交流,在眼外伤方面,可为法医和医保鉴定提供图像资料。自制转接环成本低廉、易于普及。     

Foldscope: A smartphone based diagnostic tool for fungal keratitis

Purpose:Smartphone-based microscopy tool like foldscope (FS) may serve the purpose of a low-cost diagnostic alternative to the compound light microscope especially in areas with limited resources. The purpose of this study was to detect fungal pathogens causing keratitis on direct smear by smartphone-mounted FS and to evaluate the efficacy of FS against routine compound light microscope (CLM).Methods:The prospective study was conducted at a tertiary eye care center from September 2019 to March 2020. The study included 60 smear examinations (Gram stain [GM] n = 30, Lactophenol Cotton Blue [LCB] n = 30) to detect fungal pathogens from corneal scraping material of clinically suspected fungal keratitis (FK) cases. The diagnostic utility of FS was compared with CLM for both GM and LCB wet mount. Data collected were used to quantify the agreement using Cohen’s kappa between CLM and FS imaging.Results:Forty-six samples out of 60 were positive for fungi using CLM. GM stain and LCB showed 22/30 (73.33%) and 24/30 (80%) positive results with CLM, respectively. Moderate agreement (0.49) was observed between CLM and FS with the smartphone method. LCB mount showed high specificity of 1.00 over 0.87 of GM stain for FS with the smartphone.Conclusion:Direct smear can be an early and sensitive measure to diagnose FK other than clinical suspicion. The smartphone-mounted FS has limited sensitivity as an alternative to CLM, but excellent specificity in the present study for FK. The FS as a smartphone-based diagnostic tool is simple, portable, and inexpensive in resource-constrained rural or remote clinical and public health settings in the absence of CLM and other higher diagnostic modalities.     

枸杞多糖对蓝光损伤的视网膜色素上皮细胞的保护作用

目的:研究不同浓度的枸杞多糖对蓝光诱导损伤的体外培养人视网膜色素上皮(human retinal pigment epithelium,hRPE)细胞的保护作用。方法:通过蓝光诱导建立hRPE细胞光损伤模型,分别用不同浓度的枸杞多糖(分别为0.01,0.1,1mg/mL)对体外培养的hRPE细胞进行干预,通过流式细胞仪检测各实验组的细胞线粒体活性氧和凋亡率。实验组分为正常对照组、光照损伤组以及不同浓度枸杞多糖(0.01,0.1,1mg/mL)干预组。结果:线粒体活性氧检测:正常对照组荧光强度最小;蓝光损伤组荧光强度最大,不同浓度枸杞多糖处理组荧光度与蓝光损伤组强度相比,荧光强度差异有统计学意义(P<0.05)。Annexin V-FITC/PI凋亡检测显示不同浓度枸杞多糖干预组凋亡细胞数量与蓝光损伤组凋亡细胞相比差异均有统计学意义(P<0.05);1mg/mL枸杞多糖干预组凋亡细胞数量与对照组凋亡数量相比差异无统计学意义(P>0.05)。结论:枸杞多糖能抑制蓝光诱导损伤的hRPE细胞的凋亡,1mg/mL枸杞多糖抑制蓝光诱导的hRPE细胞凋亡的作用更强,其作用机制可能与抑制细胞线粒体产生活性氧有关。     

Eye damage control by reduced blue illumination

The aim of this study was to demonstrate that a blue light and ultraviolet cut-off filter (blue filter) could reduce short-wavelength retina/RPE damage threshold by a continuous spectrum source. Sixteen normal eyes of two rhesus monkeys and six cynomolgus monkeys were subjected to macular irradiation of 20, 24, 27.4, 30, 35, 45, 50 and 60 J/cm² energy densities. The values of energy density were measured before the blue filter. Lesions were measured before and at 2 and 30 days after irradiation of a 2.8 mm diameter region within the macular arcade. Measures were fundoscopy, fluorescein angiography and long wavelength scanning by the Heidelberg Retinal Tomograph (HRT) unit. The lesions, which were produced, were scored and compared to irradiant energy density of the blue LED (NSPB500S, Nichia, Tokushima, Japan). The exposure at the 20 J/cm² produced no detectable result at 2 or 30 days. Exposure at 35 J/cm² showed definite lesion production without blue filter. With the filter added there was one indication of minor change. At 60 J/cm² there was extensive heavy, enduring damage without the filter and with the filter damage was present but was significantly attenuated. These results strongly support the conclusion that the blue filter attenuation reduces the frequency of damage by exposure. This experimental system is a useful model for normal human eye aging and continuous spectrum environment irradiance.     

Properties of Corneas Reconstructed with Cultured Human Corneal Endothelial Cells and Human Corneal Stroma

Purpose

To examine the properties of corneas tissue-engineered with cultured human corneal endothelial cells (HCEC) and human corneal stroma.

Methods

Primary HCEC cultures were established from endothelial cell layer explants and propagated on culture dishes coated with bovine corneal endothelial extracellular matrix. A cell suspension of HCEC at the fifth passage was transferred onto human corneal stroma deprived of endothelial cells, and the corneas were gently centrifuged to enhance cell attachment. The cell density of the tissue-engineered corneas was examined after staining with alizarin red and trypan blue. The tissue-engineered corneas were histologically examined by light and electron microscopy. The pump function of the tissue-engineered corneas was measured using an Ussing chamber.

Results

The mean endothelial cell density of four tissue-engineered corneas was 2380 ± 264 cells/mm² (mean ± SD). HCEC on the tissue-engineered corneas had a morphology similar to HCEC in vivo. The pump function parameters of the tissue-engineered corneas were 55%–75% of those of normal corneas.

Conclusions

HCEC on the tissue-engineered corneas have morphology and cellular density similar to HCEC in vivo, whereas the pump function of the tissue-engineered corneas was lower than in normal corneas. Jpn J Ophthalmol 2005;49:448–452 © Japanese Ophthalmological Society 2005     

Functional results after intraocular lens implantation with or without blue light filter: an intraindividual comparison

BACKGROUND: The new generation of intraocular lenses (IOL) with an additional blue light filter has a slight yellowish colour (compared to the IOLs with only a UV filter) due to its different light transmitting properties. This could have an effect on contrast sensitivity and subjective visual perception. PATIENTS AND METHODS: In this intraindividual prospective comparative study including 14 cataract patients without further ocular pathology, a blue light filtering IOL (SN60AT, Alcon) was implanted in one eye and 1 month later a conventional single-piece IOL (SA60AT, Alcon) was fitted into the fellow eye. The visual acuity and the clinical findings were assessed at one day and four weeks post-operatively. Contrast sensitivity was tested under defined mesopic (6 cd/m(2)) and high mesopic (18.8 cd/m(2)) light conditions in the Ginsburg Box using the Functional Acuity Contrast Test (F.A.C.T.). Furthermore, subjective differences in the visual perception of both eyes were noted. RESULTS: The contrast sensitivity testing 1 day and 1 month postoperatively, revealed no statistically significant differences (P > 0.008) between both IOL types for all spatial frequencies (1.5/3/6/12/18 cpd) and light levels. 13 patients (85 %) reported no differences in the colour perception of both eyes, and none had visual disturbances. CONCLUSION: This intraindividual comparison revealed no relevant differences concerning mesopic contrast sensitivity and the subjective visual perception after implantation of one IOL with or without a blue light filter.     

Observation of ultrastructural changes in cultured retinal pigment epithelium following exposure to blue light

· Background: The retina can be damaged by light even when levels of energy are well below the threshold for thermal damage, and the experimental damage of the retinal pigment epithelium (RPE) may be induced more easily by blue light than by longer wavelengths of visible light. The present study demonstrates the ultrastructural damage produced by exposure to blue light in cultured RPE. · Methods: Long-Evans rats were enucleated 8–10 days after birth for primary culture. One week after seeding, the monolayer culture of RPE cells was exposed to a cool blue light (wavelength = 440±10 nm) for 36 h (12 h/day, 3 days) at 2.0 mW/cm². Transmission electron microscopy was used to compare the exposed RPE with the control. The entire experiment was repeated 3 times independently. · Results: The cytoplasm of the exposed RPE exhibited degenerative changes, such as large whorls of membrane, lamellar whorls and whorled inclusions. · Conclusion: The RPE cells can be damaged directly by blue light after excluding the possible influence of phagosomes. This primary culture of RPE can also serve as an in vitro model for the study of light damage to the RPE. Received: 10 Ocotober 1997 Revised version received: 3 December 1997 Accepted: 19 January 1998     

White light confocal microscopy of preserved human corneas from an eye bank

PURPOSE: To verify the possibility of using a commercially available ophthalmologic white light confocal microscope for imaging optical sections of donated corneas preserved at 4 degrees C, especially for endothelial evaluation. METHODS: Sixteen corneas donated to the Warsaw Eye Bank but excluded from use in surgery for serological or morphologic reasons were examined using a ConfoScan 3 confocal scanning microscope (Nidek Technologies, Padova, Italy) and a Konan Eye Bank KeratoAnalyzer specular microscope (Konan Medical, Inc.; Hyogo, Japan). Images of corneal structures were obtained, including epithelium, corneal nerves, stroma, and endothelium. The endothelial cell density was calculated for both microscopes, and the results were compared. RESULTS: For images obtained with the specular microscope, mean (+/- SD) endothelial cell density was 2168.6 +/- 404.0 cells/mm; for confocal microscope images, mean +/- SD was 2090.9 +/- 369.1 cells/mm. There was no significant difference between the methods. CONCLUSIONS: White light confocal microscopy can be used for high-magnification imaging of corneas preserved in an eye bank with the 4 degrees C method, and images obtained permit evaluation of endothelium. Although the quality of confocal microscopy images of eye bank corneas is generally lower than that achieved with in vivo examinations, and although technical adaptations are needed for easier and safer application to corneas intended for transplantation, confocal microscopy is a promising new tool for evaluation of collected corneas.     

Telemedicina en retinopatía del prematuro: Atravesando fronteras en la salud visual pediátrica. Estudio TELEROP

General objectiveTo evaluate the accuracy and validity of images with smartphone compared to the RetCam® system for the diagnosis of retinopathy of prematurity (ROP).MethodologyObservational, longitudinal and masked study carried out at the Dr. Elías Santana hospital. Infants with birth weight ≤ 1500 g, gestational age ≤ 30 weeks and/or patients exposed to risk factors or complications linked to ROP were included. These subjects were screened using images with smartphone or RetCam®, both compared to conventional fundoscopy. The ICROP classification was used for staging. The main results analyzed were sensitivity, specificity, positive predictive values and kappa index.Results915 images (n = 121) were obtained, distributed in smartphone group (50.4%) and RetCam® group (49.6%) between August 2020 and March 2021. Subjects with ROP had lower gestational age (30.2 sem ± 2.8), birth weight (1361 g ± 398), and greater exposure to oxygen therapy (12.8 days ± 11.3). The RetCam® group presented sensitivity = 80%, specificity = 78%, positive predictive value = 90% and kappa index = 0.70. The smartphone group presented sensitivity = 88%, specificity = 90%, positive predictive value = 93.75% and kappa index = 0.81.ConclusionsBoth diagnostic methods were accurate to identify ROP. The smartphone group obtained superior results with excellent resolution, representing a cost-effective method to create a global impact on reducing preventable blindness in the pediatric population.     

蓝光诱导视网膜色素上皮细胞铁死亡的机制研究

目的:探讨蓝光诱导人视网膜色素上皮(ARPE)细胞铁死亡的发生及可能机制。方法:体外培养的ARPE-19细胞接受405nm蓝光50mW/cm²辐照度照射不同时间,分为对照组、16.3J/cm²组、32.6J/cm²组和65.2J/cm²组;将65.2J/cm²组定为高能量蓝光照射组,进一步分为对照组、高能量蓝光照射组和高能量蓝光照射+铁死亡抑制剂组,CCK-8检测细胞活力,试剂盒检测细胞内谷胱甘肽(GSH)含量、二价铁离子浓度及丙二醛(MDA)含量,Western blot法检测细胞内GPX4和xCT蛋白相对表达量。结果:蓝光照射导致ARPE-19细胞活力下降呈剂量依赖性,高能量蓝光照射导致细胞内GSH含量下降,二价铁离子浓度和MDA含量上升(均P<0.05);加入铁死亡抑制剂可部分恢复蓝光照射组细胞活力和GSH含量,减少MDA含量,降低二价铁离子浓度(均P<0.05);蓝光照射组GPX4和xCT蛋白相对表达量显著下降,加入铁死亡抑制剂后蛋白表达量不同程度恢复(P&...