PURPOSE: Refractive surgery may exacerbate the existing dry eye symptoms in patients with dry eye syndrome. Therefore, we explore the therapeutic and protective effects of using optimal intense pulsed light (IPL) therapy...PURPOSE: Refractive surgery may exacerbate the existing dry eye symptoms in patients with dry eye syndrome. Therefore, we explore the therapeutic and protective effects of using optimal intense pulsed light (IPL) therapy combined with meibomian gland expression (MGX) before and after surgery on post-laser corneal refractive surgery dry eyes. METHODS: This was a prospective, self-controlled, single-center clinical trial. Using optimal IPL therapy and MGX, a total of 68 patients with mild-to-moderate evaporative dry eye or meibomian gland dysfunction who underwent refractive surgery received 2 sessions of treatment. The treatment was administered once a week preoperatively and once a week postoperatively. Baseline measurements were taken before optimal IPL therapy and MGX, and the parameters were assessed at 1 week and 1 month after surgery. RESULTS: Out of 68 patients, 54 patients received small-incision lenticule extraction (SMILE), while 14 patients received femtosecond laser-assisted keratomileusis (FS-LASIK) (results primarily reflect SMILE outcomes due to sample imbalance). In the SMILE group, significant improvement was already observed in uncorrected/corrected distance visual acuity ( = 1.42 × 10), meibomian gland expressibility score (MGYSS) ( = 0.01), and meibum yielding secretion score (MGS) ( = 5.39 × 10) between 1 week before and after the surgery. First noninvasive breakup time (NIBUTf) ( = 8.98 × 10), average noninvasive breakup time (NIBUTav) ( = 2.30 × 10), and meibomian gland dropout score (bottom) ( = 9.05 × 10) were observed to have significant improvement till 1 month after the surgery. Patients in the FS-LASIK group exhibited a comparable trend of change. CONCLUSION: IPL treatment combined with MGX may improve ocular discomfort and dry eye symptoms in MGYSS, MGS, NIBUTf, NIBUTav, and meibomian gland dropout score (bottom) for patients with post-laser corneal refractive surgery dry eyes in short term.
PURPOSE: Ambroxol is a high-potency inhibitor of voltage-gated sodium channels Nav1.7 and Nav1.8 responsible for nociceptive and neuropathic pain. This study investigated the analgesic property of ambroxol on corneal pai...PURPOSE: Ambroxol is a high-potency inhibitor of voltage-gated sodium channels Nav1.7 and Nav1.8 responsible for nociceptive and neuropathic pain. This study investigated the analgesic property of ambroxol on corneal pain in rats as well as its toxicity on human corneal epithelial cells. METHODS: Inhibition of corneal sensation (CS) by ambroxol hydrochloride (AH) in Sprague-Dawley rats was assessed by Cochet-Bonnet esthesiometer. Rat corneal pain was induced by administering 5 M NaCl drops to the eyes, and eye wiping rates were recorded to reflect pain intensity. Subsequently, a rat neuropathic corneal pain (NCP) model was created by first removing the corneal epithelium and then provoking pain with 2 M NaCl. The analgesic property of 0.5% AH eye drop was assessed in rats by reductions in eye wiping rates. In cultured human corneal epithelial cells, the adverse effects of AH on cell migration and viability were studied by cell scratch and Cell Counting Kit-8 tests. RESULTS: It was noted that 0.5% AH could significantly inhibit CS, and 0.5% AH is efficacious in suppressing rat corneal pain as well as heightened nociceptor sensitivity from repetitive stimulation from irritants. At concentrations up to 30 μM, AH does not affect corneal epithelial cell migration, cell proliferation, and viability. CONCLUSIONS: Selective blockage of key nociceptors of the cornea by ambroxol is effective in suppressing corneal pain and heightened nociceptor excitability, leading to modulation of NCP. Sparing certain CS could translate into more protection to the ocular surface. No overt toxicity of ambroxol was seen in cultured human corneal epithelial cells in this study.
PURPOSE: Pharmacological treatment strategies for dry eye disease (DED) have evolved significantly, incorporating a range of therapeutic interventions targeting underlying inflammation and tear production deficits. Nonst...PURPOSE: Pharmacological treatment strategies for dry eye disease (DED) have evolved significantly, incorporating a range of therapeutic interventions targeting underlying inflammation and tear production deficits. Nonsteroidal anti-inflammatory drugs and tumor necrosis factor-alpha inhibitors, such as adalimumab, are increasingly used to manage severe cases of DED, showing efficacy in reducing symptoms and improving ocular surface integrity. METHODS: This review will comprehensively evaluate the use of platelet-rich plasma (PRP) in the treatment of dry eye (DE) and its possible mechanism of action. RESULTS: Novel immunotherapy targets and gene therapy methodologies are developing, showcasing significant progress in the inhibition of reactive aldehyde species and the application of CRISPR-Cas9 technology to modulate immune responses and promote tissue repair. PRP, abundant in growth factors, is increasingly acknowledged as an efficacious therapy, especially for persistent epithelial defects and severe DED. PRP has demonstrated advantages in expediting wound healing and tissue regeneration owing to its powerful biological constituents, such as transforming growth factor-β, vascular endothelial growth factor, and platelet-derived growth factor. CONCLUSION: Recent research underscores the variations in preparation techniques for PRP, with formulations like E-PRP (eye-specific PRP) used for ocular surface therapies. Moreover, the increasing application of autologous serum and plasma rich in growth factors for the treatment of DED is substantiated by data indicating their capacity to enhance corneal epithelialization and mitigate DE symptoms. This review highlights the increasing significance of new therapeutic modalities, such as PRP, as essential for controlling DED, offering effective alternatives with improved clinical results.
PURPOSE: To investigate the protective effect of Qiming granules on diabetic retinopathy (DR). METHODS: The diabetic model was established by intraperitoneal injection of streptozotocin. Histopathological alterations in...PURPOSE: To investigate the protective effect of Qiming granules on diabetic retinopathy (DR). METHODS: The diabetic model was established by intraperitoneal injection of streptozotocin. Histopathological alterations in the rat retina were examined using hematoxylin and eosin techniques. The TUNEL assay was utilized to identify apoptosis in retinal cells. Western blotting was used to investigate the expression of tight junction proteins and the phosphatidylinositol 3-kinase (PI3K/Protein Kinase B (Akt) signaling pathway within retinal tissues. TUNEL assay, immunofluorescence, and Western blot analysis were employed to examine cellular apoptosis, tight junction protein expression, and proteins related to the PI3K/Akt signaling pathway. RESULTS: After Qiming intervention, it was alleviated compared with the model group. TUNEL staining showed an increase in the apoptosis rate of cells in retinal tissue. Western blotting analysis revealed that the Qiming group exhibited a marked upregulation in the expression levels of occludin, zonula occludens-1, p-PI3K/PI3K, and p-Akt/Akt proteins ( < 0.05). The results from the experiments indicated that the rate of apoptosis declined following Qiming intervention ( < 0.05). There was a noted reduction in the expression levels of B-cell lymphoma-2-associated X protein (Bax)/B-cell lymphoma-2 (Bcl-2) and cleaved Caspase-3 proteins, with the decrease being statistically significant ( < 0.05). CONCLUSION: Qiming granules offered protection against damage to the blood-retinal barrier by preventing apoptosis, which in turn slowed the progression of DR. Its mode of action might be associated with modulating the PI3K/Akt signaling pathway.
PURPOSE: This study aimed to evaluate the neuroprotective effects of cutamesine (SA4503), a potent sigma-1-receptor agonist (S1R-agonist), in rat models of retinal degeneration induced by elevated intraocular pressure (I...PURPOSE: This study aimed to evaluate the neuroprotective effects of cutamesine (SA4503), a potent sigma-1-receptor agonist (S1R-agonist), in rat models of retinal degeneration induced by elevated intraocular pressure (IOP) using the Detection of Apoptosing Retinal Cells (DARC) technology. A secondary aim was to test its effect in a rat retinal oxidative stress model. METHODS: Ocular hypertension (OHT) model was induced in Dark Agouti rats via episcleral vein injection of hypertonic saline, while a retinal oxidative stress was induced in Sprague-Dawley rats by intravitreal rotenone injection. In the OHT model, cutamesine (10 nmol) and recombinant human nerve growth factor [rh-NGF (positive control); 0.09 nmol] were intravitreally administered. Their effects were evaluated using DARC technology and RNA-binding protein with multiple splicing (RBPMS) immunohistochemistry. In the oxidative stress model, cutamesine (10 and 300 nmol) was coadministered with rotenone, and neurofilament light chain (Nfl) gene expression was measured by RT-PCR. RESULTS: OHT induced a significant elevation of IOP over 3 weeks, peaked at day 1 ( < 0.001), and gradually decreased by day 21. Cutamesine significantly reduced the number of DARC spots ( < 0.05) and preserved retinal ganglion cells labeled with RBPMS ( < 0.01), similar to rh-NGF ( < 0.01). In the oxidative stress model, cutamesine preserved retinal Nfl expression levels in a dose-dependent manner. CONCLUSIONS: Cutamesine demonstrated significant neuroprotective activity in rat models of OHT and oxidative stress using DARC and RBPMS labeling techniques. These findings provide further evidence that S1R-agonists possess substantial neuroprotective potential and may be beneficial for patients with OHT/glaucoma.
PURPOSE: This study evaluated the efficacy and safety of 3 mitomycin C (MMC) delivery methods in trabeculectomy for uncontrolled primary open-angle glaucoma (POAG): preoperative subconjunctival injection, intraoperative...PURPOSE: This study evaluated the efficacy and safety of 3 mitomycin C (MMC) delivery methods in trabeculectomy for uncontrolled primary open-angle glaucoma (POAG): preoperative subconjunctival injection, intraoperative subconjunctival injection, and conventional soaked sponges. METHODS: In this randomized controlled pilot study, 25 patients were assigned to 3 groups: Group A received a preoperative subconjunctival injection of 0.1 mL MMC 0.002% 2 weeks before surgery; Group B received an intraoperative subconjunctival injection of 0.1 mL MMC 0.01%; and Group C received MMC 0.02% via soaked sponges during surgery. Patients were followed for 6 months. Primary outcome was surgical success-complete [intraocular pressure (IOP) 5-21 mm Hg with ≥30% reduction from baseline without medications] or qualified (with medications). Secondary outcomes included IOP, medication use, best-corrected visual acuity, and complications. RESULTS: At 6 months, complete success rates were 75.0% (Group A), 66.7% (Group B), and 50.0% (Group C) ( = 0.54). Mean baseline IOP was 17.40 ± 4.43 mm Hg with 3.64 ± 0.70 medications. Postoperative IOPs were 9.88 ± 2.70, 10.67 ± 4.06, and 10.38 ± 5.04 mm Hg in Groups A, B, and C, respectively ( 0.92). Medication use postoperatively was lowest in Group A (0 ± 0), compared to Groups B (0.7 ± 1.0) and C (0.4 ± 1.1) ( 0.30). Visual outcomes and complication rates were similar across groups. CONCLUSIONS: In this pilot study, all MMC delivery methods demonstrated comparable success rates, IOP reduction, and safety outcomes. Subconjunctival MMC injections show promise as a viable alternative to the conventional sponge application. However, due to the small sample size, further larger-scale studies are warranted to validate these findings.
J Ocul Pharmacol Ther
· 2026 · PMID 41111434
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PURPOSE: Carbofuran (CF) exposure causes ocular injury, but the underlying mechanism remains elusive. This study examined CF's cytotoxicity and autophagy modulation in human cornea using and organ culture models. METHO...PURPOSE: Carbofuran (CF) exposure causes ocular injury, but the underlying mechanism remains elusive. This study examined CF's cytotoxicity and autophagy modulation in human cornea using and organ culture models. METHODS: Healthy human cadaver corneas were used for generating primary corneal stromal fibroblasts (hCSFs) and organ culture. Dose-dependent CF (0-200 µM) cytotoxicity was evaluated using phase-contrast microscopy, live/dead, MTT, PrestoBlue, and Cyto-Tox-Glo assays. The half-maximal inhibitory concentration (IC) was determined via regression analysis. The messenger RNA (mRNA) and protein expression of autophagy genes, , , and , were analyzed by quantitative real-time PCR and immunofluorescence. Transmission electron microscopy evaluated ultrastructural features. RESULTS: Carbofuran reduced hCSFs' viability in a dose-dependent manner. Cytotoxicity was not detected at ≤10 µM concentrations, whereas a significant progressive cytotoxicity was observed at concentrations ≥10 µM ( < 0.01, < 0.001). Morphological changes corroborated with cytotoxicity assays. The IC of CF was 58.6 µM to 24 h. Significant alterations in mRNA ( < 0.01, < 0.001, or < 0.0001) and protein levels of , and were noted in hCSFs at two tested concentrations. The semiquantitative immunofluorescence analysis of LC3, BECN1, and SQSTM1 proteins was consistent with the changes in the transcript levels. Topical CF (IC) to human corneal tissues resulted in no remarkable loss of corneal clarity but significantly upregulated , , and expression ( < 0.01) in human cornea . CF-exposed human cornea in organ culture revealed higher autophagosomes and electron-dense vesicles in stromal keratocytes than naive corneas in transmission electron microscopy. CONCLUSION: Carbofuran cytotoxicity to human cornea encompasses autophagy modifications and .
PURPOSE: The apelin/APJ system represents a promising VEGF-independent therapeutic target for treating retinopathy of prematurity (ROP), given its selective upregulation in pathological retinal neovasculature. We aimed t...PURPOSE: The apelin/APJ system represents a promising VEGF-independent therapeutic target for treating retinopathy of prematurity (ROP), given its selective upregulation in pathological retinal neovasculature. We aimed to identify clinically translatable APJ antagonists that suppress pathological neovascularization without VEGF-related side effects. METHODS: We employed a hypoxia-induced zebrafish ROP model to recapitulate pathological neovascularization, combined with structure-based virtual screening of 2,506 FDA-approved drugs targeting the APJ receptor (PDB ID: 6KNM). Lead compounds were evaluated through angiogenesis assays (human umbilical vascular endothelial cells [HUVEC] tube formation, migration, and invasion) and efficacy testing. RESULTS: Among 21 initial hits, octreotide () showed the most potent anti-angiogenic activity, with an IC of 0.016 µM in HUVECs. Mechanistically, selectively downregulated APJ expression without altering VEGF/VEGFR levels. Functional assays confirmed its ability to suppress endothelial tube formation, migration, and invasion. CONCLUSIONS: Our findings identified octreotide as a novel APJ antagonism with high translational potential, offering a dual advantage-targeting pathological neovascularization while preserving physiological VEGF signaling. These findings support its repurposing as a precision therapy for ROP and other ocular neovascular disorders.
PURPOSE: To investigate the mechanisms underlying the protective effects of piperine on retinal pigment epithelium (RPE) cells under high-glucose and hypoxic conditions. METHODS: A model of diabetes was established by tr...PURPOSE: To investigate the mechanisms underlying the protective effects of piperine on retinal pigment epithelium (RPE) cells under high-glucose and hypoxic conditions. METHODS: A model of diabetes was established by treating D407 cells with high glucose (25 mM) and hypoxia (5% O for 24 h). The mRNA and protein expression levels of the long noncoding RNA (lncRNA), plasmacytoma variant translocation 1 (PVT1), miR-128, pigment epithelium-derived factor (PEDF), and vascular endothelial growth factor C (VEGFC) were assessed by RT-qPCR, western blotting, and immunofluorescence staining. Wound-healing assays were performed to evaluate cell migration. The role of PVT1 was explored using siRNA-mediated knockdown, and the interactions among lncRNA PVT1, miR-128, and VEGFC were predicted and validated by dual-luciferase reporter assays. RESULTS: Under high-glucose and hypoxic conditions, lncRNA PVT1 and VEGFC mRNA transcription were upregulated, whereas miR-128 and PEDF mRNA expression were downregulated. VEGFC protein levels were increased, PEDF protein levels were decreased, and cell migration was impaired. Treatment with piperine or knockdown of lncRNA PVT1 via siRNA partially reversed these effects. Dual-luciferase reporter assays further confirmed the interactions among PVT1, miR-128, and VEGFC. CONCLUSION: Piperine may protect RPE cells by modulating the lncRNA PVT1/miR-128 signaling pathway and promoting PEDF expression.
OBJECTIVE: To analyze the differential expression of inflammatory proteins in the tear fluid of patients with polypoidal choroidal vasculopathy (PCV) or neovascular age-related macular degeneration (nAMD). METHODS: A tot...OBJECTIVE: To analyze the differential expression of inflammatory proteins in the tear fluid of patients with polypoidal choroidal vasculopathy (PCV) or neovascular age-related macular degeneration (nAMD). METHODS: A total of 19 patients with PCV, 17 patients with nAMD, and 18 normal controls (NC) aged ≥50 years were enrolled. Tear samples were collected, and the expression levels of 92 inflammatory proteins were quantified using Olink technology. Differentially expressed proteins (DEPs) among the groups were analyzed, with particular attention to consistency with previous findings from aqueous humor studies. RESULTS: Olink analysis revealed extensive DEPs among PCV, nAMD, and NC groups. Compared with NC, the PCV group exhibited significant upregulation of VEGFA, Interleukin (IL) -18, IL-1α, IL-8, IL-7, Monocyte chemotactic protein (MCP)-2, and Neurturin (NRTN), along with downregulation of Tumor necrosis factor (TNF) and IL-10. The nAMD group showed a more pronounced pro-inflammatory profile, with upregulation of VEGFA, IL-18, IL-8, IL-1α, IL-7, Fibroblast growth factor (FGF)-19, MCP-1, Matrix metalloproteinase (MMP)-10, NRTN, Stem cell factor (SCF), Osteoprotegerin (OPG), Eukaryotic translation initiation factor 4E-binding protein 1 (4E-BP1), MMP-1, MCP-2, Fms-related tyrosine kinase 3 ligand (Flt3L), Tumor Necrosis Factor - like Weak Inducer of Apoptosis (TWEAK), Caspase (CASP)-8, and Tumor necrosis factor receptor superfamily member 9 (TNFRSF9), and downregulation of IL-10 and IL-12β. Comparison between PCV and nAMD indicated that IL-12β and Hepatocyte growth factor (HGF) were specifically upregulated in PCV, whereas SCF, VEGFA, Flt3L, OPG, MCP-1, T-cell surface glycoprotein CD8α (CD8α), Cystatin D (CST5), MMP-1, TNFRSF9, Transforming growth factor-α (TGF-α), 4E-BP1, and CASP-8 were significantly downregulated in PCV relative to nAMD. Boxplot analysis confirmed that Flt3L, IL-18, IL-1α, IL-7, IL-8, MCP-1, MMP-1, OPG, SCF, and VEGFA were specifically elevated in nAMD compared with both PCV and NC groups, while IL-10 was specifically suppressed in PCV. CONCLUSIONS: Tear fluid analysis represents a feasible and noninvasive approach to investigate the pathogenesis of PCV and nAMD.
Al-Dwairi R, Ahmad AA, Aleshawi A
… +9 more, Al-Bataineh QM, Bani-Salameh AA, Aljarrah IA, Sharayah A, Tashtoush M, Al Qudah M, Al Beiruti S, Alqudah A, Abu Serhan H
PURPOSE: Silicone oil has several uses and indications in the ophthalmical field. This study aims to determine how the clinical, surgical, and patient factors influence the optical, physical, and chemical properties of s...PURPOSE: Silicone oil has several uses and indications in the ophthalmical field. This study aims to determine how the clinical, surgical, and patient factors influence the optical, physical, and chemical properties of silicone oil extracted from vitrectomized eyes and how these changes predispose to emulsification. METHODS: A prospective laboratory-based analysis was adopted. A total of 35 silicone oil samples were obtained from 35 patients who underwent pars plana vitrectomy (PPV) for rhegmatogenous retinal detachment (RRD; 18 eyes) or non-RRD indications (17 eyes). Ultraviolet-visible-infrared (UV-Vis-IR) spectrometry, micro-viscometry, Fourier-transform infrared (FTIR) spectroscopy, and proton nuclear magnetic resonance (H-NMR) spectroscopy were performed. Demographic and clinical parameters, including patient age, sex, tamponade duration, PPV indication, lens status, associated cataract surgery, argon laser exposure, and postoperative glaucoma, were obtained and correlated. RESULTS: Compared with control silicone oil (5,000 cSt viscosity, 77.5% visible-light transmittance), extracted samples exhibited a lower mean viscosity (4,670.3 cSt) and reduced visible-light transmittance (71.8%). Non-RRD eyes showed lower transmittance but higher viscosity (4,857.5 vs. 4,493.5 cSt; < 0.05) than RRD eyes. Argon laser exposure significantly reduced transmittance ( < 0.05) without affecting viscosity. FTIR indicated more chemical bond cleavage in non-RRD eyes. CONCLUSIONS: Non-RRD eyes exhibited reduced transmittance, increased viscosity, and chemical bond disruption, which may indicate increased emulsification. Furthermore, argon laser exposure appeared to exacerbate optical clarity loss. Strategic timing of silicone oil removal and careful surgical planning may help mitigate emulsification. Further studies are required to explore more secrets of silicone oil physics.
Baicalein, a flavonoid from , demonstrates multi-target therapeutic effects in ocular diseases through anti-inflammatory, antioxidant, and antiangiogenic mechanisms, primarily via modulation of nuclear factor kappa B, ph...Baicalein, a flavonoid from , demonstrates multi-target therapeutic effects in ocular diseases through anti-inflammatory, antioxidant, and antiangiogenic mechanisms, primarily via modulation of nuclear factor kappa B, phosphatidylinositol 3-kinase/protein kinase B, and hypoxia-inducible factor-1α/vascular endothelial growth factor pathways. This review highlights its efficacy in treating corneal diseases, glaucoma, uveitis, cataracts, and retinal/optic nerve disorders, supported by evidence from both traditional Chinese medicine formulations and modern pharmacological studies. Key advancements in delivery systems (e.g., nanocarriers, intravitreal hydrogels) address its solubility challenges and enhance bioavailability. Despite promising preclinical results, clinical translation requires optimization of dosing regimens and validation through rigorous trials. Baicalein's multifaceted action positions it as a potent natural candidate for managing inflammation, oxidative stress, and vascular pathologies in ophthalmology, warranting further research to bridge mechanistic insights with therapeutic applications.
Lantyer-Araujo NL, Park S, Hisey EA
… +7 more, Thomasy SM, Murphy CJ, Albert DM, O'Neill CA, Gadek TR, Parikh AN, Leonard BC
J Ocul Pharmacol Ther
· 2026 · PMID 40986539
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PURPOSE: This preliminary study sought to determine the pharmacodynamic effect and tolerability of a novel rabbit-derived nonpolar lipid (rNPL593) on tear film breakup time (TFBUT) in healthy beagle dogs as a potential t...PURPOSE: This preliminary study sought to determine the pharmacodynamic effect and tolerability of a novel rabbit-derived nonpolar lipid (rNPL593) on tear film breakup time (TFBUT) in healthy beagle dogs as a potential therapy for patients with evaporative dry eye disease. METHODS: In phase 1, two healthy beagle dogs received a single dose of rNPL593 at concentrations ranging from 0.1 to 10 mg/mL, and TFBUT was measured at different intervals post-dose in both eyes. In phase 2, five dogs received vehicle, 1 or 3 mg/mL rNPL593 once in both eyes, and TFBUT was measured at 6- and 24-h post-dose. In phase 3, three dogs received multiple doses of 3 mg/mL rNPL593 over 4 days, and TFBUT was performed 6 and 80 h after the final dose. Semiquantitative preclinical ocular toxicology scoring was performed in all phases to determine tolerability. RESULTS: In phase 1, topical treatment with 3 mg/mL rNPL593 resulted in a dose-dependent increase in TFBUT, assessed as the preferred concentration. In phase 2, the concentration of 3 mg/mL was superior to 1 mg/mL by creating a more pronounced and sustained increase in TFBUT over 24 h. In phase 3, there was an increase in TFBUT measured at 6-h post-dose that returned to baseline levels at 80-h post-dose. The topical rNPL593 was well tolerated in all phases with all doses. CONCLUSIONS: Treatment with rNPL593 was well tolerated at all doses tested and resulted in an increased TFBUT that was most pronounced with the 3 mg/mL concentration at 6- and 24-h post-dose.
UNLABELLED: We extend Li et al.'s investigation of aqueous humor (AH) metabolomics in sequential cataract surgery by referencing our prior study on interocular symmetry/asymmetry in AH metabolomic profiles from simultane...UNLABELLED: We extend Li et al.'s investigation of aqueous humor (AH) metabolomics in sequential cataract surgery by referencing our prior study on interocular symmetry/asymmetry in AH metabolomic profiles from simultaneous bilateral cataract surgery in emmetropic patients, which demonstrated similar AH compositions in fellow eyes. We also illustrate variability with 2 sequential-surgery cases and highlight the most and least variable metabolites across 6 biochemical classes. Taken together with Li et al., these observations support careful attribution of second-eye changes to surgery versus biology. PURPOSE: To extend the findings of Li et al. on AH metabolomics in sequential cataract surgery by incorporating reference data on interocular symmetry/asymmetry in AH metabolomic profiles and illustrating variability in sequential cases. METHODS: We drew on our prior study of simultaneous bilateral cataract surgery in emmetropic patients, which demonstrated high interocular similarity, and examined AH metabolomic variability in 2 patients undergoing sequential cataract surgery. RESULTS: Baseline interocular comparisons highlight metabolic symmetry in the AH among patients undergoing simultaneous cataract surgery. In 2 additional cases, we identified the most and least variable metabolites across 6 biochemical classes among patients undergoing sequential cataract surgery, complementing the observations of Li et al.Conclusion:Our reference data help contextualize Li et al.'s results. Although based on limited cases, our findings emphasize the need for caution when interpreting AH metabolomics in sequential surgery to distinguish true intra- and inter-individual biological variability from potential surgical effects on the second eye. Multimodal approaches integrating metabolomic and vascular metrics may improve biomarker selection and inform surgical timing.
PURPOSE: This study aims to evaluate the effects of brimonidine eye drops and intravitreal administration in guinea pigs with form-deprivation myopia (FDM) and to analyze the ocular pharmacokinetics and irritation. METHO...PURPOSE: This study aims to evaluate the effects of brimonidine eye drops and intravitreal administration in guinea pigs with form-deprivation myopia (FDM) and to analyze the ocular pharmacokinetics and irritation. METHODS: The experimental guinea pigs were randomized to the normal control, FDM, FDM brimonidine topical eye drops, and FDM intravitreal injection groups. The experiment period was 13 days. Changes in ocular refraction and axial length were monitored regularly. The ocular pharmacokinetics of brimonidine and its metabolite brimonidine-2,3-dione were analyzed using ultra-performance liquid chromatography-tandem mass spectrometry. Ocular irritation was assessed by the Draize test, corneal fluorescein staining, and hematoxylin and eosin staining. RESULTS: Two administration methods of brimonidine equally inhibited the increase in refraction and axial length in FDM guinea pigs ( < 0.05). Pharmacokinetic analysis revealed significant and sustained accumulation of brimonidine in the iris and choroid. Brimonidine was preferentially distributed to the cornea, conjunctiva, and sclera when administered topically, and preferentially to the retina and vitreous when administered intravitreally. The total area under the curve values for retinal and scleral tissues demonstrated that continuous topical administration was 1.95 times and 1.36 times that of intravitreal administration, respectively. The concentration of brimonidine-2,3-dione was significantly lower than that of brimonidine. Brimonidine topical eyedrops had less ocular irritation. CONCLUSIONS: At the drug concentrations in this study, both topical and intravitreal brimonidine achieved sufficient ocular exposure to exert similar myopia-suppressing effects. Continuous topical administration can maintain higher drug concentrations in the retinal and scleral tissues with less eye irritation.
OBJECTIVE: This network meta-analysis (NMA) of randomized controlled trials (RCTs) evaluates the long-term efficacy and feasibility of treatments for macular edema (ME) secondary to retinal vein occlusion (RVO). Comparis...OBJECTIVE: This network meta-analysis (NMA) of randomized controlled trials (RCTs) evaluates the long-term efficacy and feasibility of treatments for macular edema (ME) secondary to retinal vein occlusion (RVO). Comparisons between different alternatives remain unclear. METHODS: We used a Bayesian framework to perform an NMA of treatments for ME secondary to RVO. We searched for relevant RCTs with at least 12 months of follow-up in PubMed, Scopus, Web of Science, and Cochrane databases. Efficacy outcomes included changes in best-corrected visual acuity and central macular thickness, while feasibility outcomes focused on the mean number of injections and dropout rates. RESULTS: We included 3,431 patients from 21 RCTs. We compared 8 treatment modalities: aflibercept, ranibizumab 0.3, ranibizumab 0.5 mg, bevacizumab, dexamethasone, dexamethasone plus anti- Vascular Endothelial Growth Factor (VEGF), laser, and anti-VEGF plus laser. Dexamethasone combined with anti-VEGF treatment was found to be the most effective and feasible. Aflibercept was the top option when used alone, followed by bevacizumab and ranibizumab. Laser alone, dexamethasone alone, and laser combined with anti-VEGF treatment showed the lowest long-term effectiveness and feasibility. CONCLUSION: Dexamethasone plus anti-VEGF is a potential long-term option for effectiveness. Despite the need for repeated injections, aflibercept stands out as a leading choice.