Gene Expression Signatures of Contact Lens-Induced Myopia in Guinea Pig Retinal Pigment Epithelium

PurposeTo identify key retinal pigment epithelium (RPE) genes linked to the induction of myopia in guinea pigs.MethodsTo induce myopia, two-week-old pigmented guinea pigs (New Zealand strain, n = 5) wore −10 diopter (D) rigid gas-permeable contact lenses (CLs), for one day; fellow eyes were left without CLs and served as controls. Spherical equivalent refractive errors (SE) and axial length (AL) were measured at baseline and one day after initiation of CL wear. RNA sequencing was applied to RPE collected from both treated and fellow (control) eyes after one day of CL-wear to identify related gene expression changes. Additional RPE-RNA samples from treated and fellow eyes were subjected to quantitative real-time PCR (qRT-PCR) analysis for validation purposes.ResultsThe CLs induced myopia. The change from baseline values in SE was significantly different (P = 0.016), whereas there was no significant difference in the change in AL (P = 0.10). RNA sequencing revealed significant interocular differences in the expression in RPE of 13 genes: eight genes were significantly upregulated in treated eyes relative to their fellows, and five genes, including bone morphogenetic protein 2 (Bmp2), were significantly downregulated. The latter result was also confirmed by qRT-PCR. Additional analysis of differentially expressed genes revealed significant enrichment for bone morphogenetic protein (BMP) and TGF-β signaling pathways.ConclusionsThe results of this RPE gene expression study provide further supporting evidence for an important role of BMP2 in eye growth regulation, here from a guinea pig myopia model.     

Role of amniotic membrane transplantation in treating acute ocular manifestations in Steven–Johnson syndrome and its long-term impact

Background:Steven–Johnson syndrome (SJS) is a serious disorder affecting the skin and mucous membrane, causing multiple flaccid bullae and purpuric rashes with sheet-like epithelial detachment including the ocular surface. The long-term outcomes following SJS are dismal and manifest as corneal vascularization, lid-wiper keratopathy, and severe dry eyes. The disease course can be modified if amniotic membrane graft is performed at the first week of disease, and the above-said complications can be avoided. This procedure thus not only decreases the morbidity but also improves the quality of life.Purpose:This video discusses the long-term sequelae of SJS which can be modified with timely intervention during the acute stage and thus significantly decreases morbidity.Synopsis:The video demonstrates the simple technique of amniotic membrane transplantation in the acute stage in SJS and its impact in long run.Highlights:There should be a low threshold for doing early amniotic membrane transplantation in patients with SJS with ocular surface involvement. Early intervention can change the disease course and decrease disease morbidity significantly.Video link: https://youtu.be/qgIiVcW56Oo     

Short-term safety and efficacy of Preserflo™ Microshunt in glaucoma patients: a multicentre retrospective cohort study

Background/aimsTo evaluate 1-year success rates and safety profile of Preserflo™ Microshunt in glaucoma patients.MethodsRetrospective multicentre cohort study of 100 consecutive eyes (91 patients) from four tertiary-referral glaucoma centres. Four intraocular pressure (IOP) criteria were defined: A: IOP ≤ 21 mmHg+IOP reduction ≥20% from baseline; B: IOP ≤ 18 mmHg+IOP reduction ≥20%; C: IOP ≤ 15 mmHg+IOP reduction ≥25%; D: IOP≤12 mmHg+IOP reduction ≥30%. Success was defined as qualified or complete based on whether reached with or without medication. Primary outcome was success according to the above criteria. Secondary outcomes included: IOP, best-corrected visual acuity (BCVA), medication use, complications, postoperative interventions, and failure-associated factors.ResultsQualified and complete success rates (95% CI) at 12 months were 74%(66–83%) and 58%(49–69%) for criterion A, 72%(63–82%) and 57%(48–68%) for B, 52%(43–63%) and 47%(38–58%) for C, 29%(21–40%) and 26%(19–36%) for D. Overall median (interquartile range (IQR)) preoperative IOP decreased from 21.5(19–28) mmHg to 13(11–16) mmHg at 12 months. BCVA was not significantly different up to 12 months (p = 0.79). Preoperative median (IQR) number of medications decreased from 3 (2–3) to 0 (0–1) at 12 months. Twelve eyes underwent needling, five surgical revision and one device removal due to corneal oedema. There were no hypotony-related complications. Non-Caucasian ethnicity was the only risk factor consistently associated with increased failure.ConclusionsPreserflo™ Microshunt is a viable surgical option in glaucoma patients, with reasonable short-term success rates, decreased medications use, excellent safety profile, smooth postoperative care, and rapid learning curve. Success rates for the most stringent IOP cutoffs were modest, indicating that it may not be the optimal surgery when very low target IOP is required.Subject terms: Outcomes research, Optic nerve diseases     

Association between the Dietary Inflammatory Index and Gastric Disease Risk: Findings from a Korean Population-Based Cohort Study

Evidence suggests that diets with high pro-inflammatory potential may play a substantial role in the origin of gastric inflammation. This study aimed to examine the association between the energy-adjusted dietary inflammatory index (E-DII^TM) and gastric diseases at baseline and after a mean follow-up of 7.4 years in a Korean population. A total of 144,196 participants from the Korean Genome and Epidemiology Study_Health Examination (KoGES_HEXA) cohort were included. E-DII scores were computed using a validated semi-quantitative food frequency questionnaire. Multivariate logistic regression and Cox proportional hazards regression were used to assess the association between the E-DII and gastric disease risk. In the prospective analysis, the risk of developing gastric disease was significantly increased among individuals in the highest quartile of E-DII compared to those in the lowest quartile (HR_quartile4vs1 = 1.22; 95% CI = 1.08–1.38). Prospective analysis also showed an increased risk in the incidence of gastritis (HR_quartile4vs1 = 1.19; 95% CI = 1.04–1.37), gastric ulcers (HR_quartile4vs1 = 1.47; 95% CI = 1.16–1.85), and gastric and duodenal ulcers (HR_quartile4vs1 = 1.46; 95% CI = 1.17–1.81) in the highest E-DII quartile compared to the lowest quartile. In the cross-sectional analysis, the E-DII score was not associated with the risk of gastric disease. Our results suggest that a pro-inflammatory diet, indicated by high E-DII scores, is prospectively associated with an increased risk of gastric diseases. These results highlight the significance of an anti-inflammatory diet in lowering the risk of gastric disease risk in the general population.     

Evaluation of a New Smartphone Powered Low-cost Pulse Oximeter Device

BackgroundMeasurement of blood oxygen saturation is a vital part of monitoring coronavirus 2019 (COVID-19) patients. Pulse oximetry is commonly used to measure blood oxygen saturation and pulse rate for appropriate clinical intervention. But the majority of direct-to-consumer grade pulse oximeters did not pass through in-vivo testing, which results in their accuracy being questionable. Besides this, the ongoing COVID-19 pandemic exposed the limitations of the device in resource limited areas since independent monitoring is needed for COVID-19 patients. The purpose of this study was to perform an in-vivo evaluation of a newly developed smartphone powered low-cost pulse oximeter.MethodsThe new prototype of a smartphone powered pulse oximeter was evaluated against the standard pulse oximeter by taking measurements from fifteen healthy volunteers. The accuracy of measurement was evaluated by calculating the percentage error and standard deviation. A repeatability and reproducibility test were carried out using the ANOVA method.ResultsThe average accuracy for measuring spot oxygen saturation (SPO2) and pulse rate (PR) was 99.18% with a standard deviation of 0.57 and 98.78% with a standard deviation of 0.61, respectively, when compared with the standard pulse oximeter device. The repeatability and reproducibility of SPO2 measurements were 0.28 and 0.86, respectively, which is in the acceptable range.ConclusionThe new prototype of smartphone powered pulse oximeter demonstrated better performance compared to the existing low-cost fingertip pulse oximeters. The device could be used for independent monitoring of COVID-19 patients at health institutions and also for home care.     

Deleterious effects of whole‐body vibration on the spine: A review of in vivo,ex vivo,and in vitro models

Occupational exposure to whole‐body vibration is associated with the development of musculoskeletal, neurological, and other ailments. Low back pain and other spine disorders are prevalent among those exposed to whole‐body vibration in occupational and military settings. Although standards for limiting exposure to whole‐body vibration have been in place for decades, there is a lack of understanding of whole‐body vibration‐associated risks among safety and healthcare professionals. Consequently, disorders associated with whole‐body vibration exposure remain prevalent in the workforce and military. The relationship between whole‐body vibration and low back pain in humans has been established largely through cohort studies, for which vibration inputs that lead to symptoms are rarely, if ever, quantified. This gap in knowledge highlights the need for the development of relevant in vivo, ex vivo, and in vitro models to study such pathologies. The parameters of vibrational stimuli (eg, frequency and direction) play critical roles in such pathologies, but the specific cause‐and‐effect relationships between whole‐body vibration and spinal pathologies remain mostly unknown. This paper provides a summary of whole‐body vibration parameters; reviews in vivo, ex vivo, and in vitro models for spinal pathologies resulting from whole‐body vibration; and offers suggestions to address the gaps in translating injury biomechanics data to inform clinical practice.