Hypertension is the leading risk factor of cardiovascular disease and has profound effects on both the structure and function of the microvasculature. Abnormalities of the retinal vasculature may reflect the degree of microvascular damage due to hypertension, and these changes can be detected with fundus photographs. This study aimed to use deep learning technique that can detect subclinical features appearing below the threshold of a human observer to explore the effect of hypertension on morphological features of retinal microvasculature. We collected 2012 retinal photographs which included 1007 from patients with a diagnosis of hypertension and 1005 from normotensive control. By method of vessel segmentation, we removed interference information other than retinal vasculature and contained only morphological information about blood vessels. Using these segmented images, we trained a small convolutional neural networks (CNN) classification model and used a deep learning technique called Gradient-weighted Class Activation Mapping (Grad-CAM) to generate heat maps for the class “hypertension”. Our model achieved an accuracy of 60.94%, a specificity of 51.54%, a precision of 59.27%, and a recall of 70.48%. The AUC was 0.6506. In the heat maps for the class “hypertension”, red patchy areas were mainly distributed on or around arterial/venous bifurcations. This indicated that the model has identified these regions as being the most important for predicting hypertension. Our study suggested that the effect of hypertension on retinal microvascular morphology mainly occurred at branching of vessels. The change of the branching pattern of retinal vessels was probably the most significant in response to elevated blood pressure.

Purpose: Diquafosol ophthalmic solution (DQS) stimulates P2Y2 receptors on the ocular surface, which enhances mucin secretion from goblet cells. Therefore, tear film stability and hydration of the ocular surface can be achieved independent from lacrimal gland function. Methods: This prospective, open-label pilot study included 60 eyes of 30 diabetic patients diagnosed with dry eye disease (DED) and were randomly assigned to either DQS ( n = 30 eyes) or hyaluronate (HA) group ( n = 30 eyes). Participants in the DQS group received 3% diquafosol ophthalmic solution, whereas HA group received 0.1% sodium HA preservative-free artificial tears. The dosage for both drugs was 1 drop, 6 times per day for 4 weeks. Tear film lipid layer (TFLL), noninvasive breakup time (NITBUT), corneoconjunctival staining (CS) score, meibomian gland (MG), conjunctival hyperemia [redness score (RS)], ocular surface disease index (OSDI) was assessed and compared at baseline, day 14, and day 28. Results: Comparing baseline and day 28 measurements revealed that both groups found significant improvements in NITBUT, CS, MG quality, MG expressibility, and OSDI scores significantly ( P < 0.05), in addition TFLL improvements were only found in the DQS group. At day 28, the magnitude of change in mean NITBUT was 1.74 (DQS) versus 0.31 (HA), 1.16 (DQS) versus 0.37 (HA) point grade reduction in corneoconjunctival staining score and 9.80 (DQS) versus 4.80 (HA) point grade in mean OSDI score. Conclusion: Three percent diquafosol ophthalmic solution treatment demonstrated the ability to improve the tear film dry eye parameters and clinically reduced sign and symptoms of DED in diabetic dry eye patients. Clinical Trials.gov ID: NCT04980144.

Introduction Laser in situ keratomelieusis (LASIK) is one of the most frequently performed refractive treatments. Dry eye (DE) is common in patients after LASIK and can be bothersome postoperatively. Therapies such as intense pulsed light (IPL), sodium hyaluronate (SH) and heated eye mask (HEM) have been reported to improve signs and symptoms of DE . Aim The purpose of this prospective study was to evaluate and compare the effects of IPL and 0.1% SH (IPL group, 50 eyes) and IPL in combination with 0.1% SH and HEM (IPL + group, 50 eyes) in participants with persistent post-LASIK DE. Methods The final analysis included 100 patients (100 eyes) who had LASIK for myopic correction and had been experiencing moderate to severe DE following LASIK for over a year. Participants were randomly assigned to either the IPL group (2 IPL sessions) or IPL + group (2 IPL sessions and daily HEM for 4 weeks), and both groups continued the use of daily 0.1% SH (HYLO-COMOD®) preservative-free eye drops. Non-invasive tear break-up time (NITBUT), tear film lipid layer (TFLL), lower tear meniscus height (LTMH), meibomian gland quality (MGQ), meibomian gland expressibility (MGEx), corneal fluorescein staining (CFS), ocular surface disease index (OSDI) and artificial tear usage (ATU) survey were assessed at baseline (BL) and follow-up at 2 (F1) and 4 weeks (F2). Results Following the treatment protocol, all dry eye (DE) parameters assessed in this study improved significantly (P < 0.05) in both groups at F2 compared with their respective BL measurements. Inter-group comparison at F2 found significant differences in their NITBUT (IPL: 6.06 ± 0.59 vs. IPL +: 6.67 ± 0.86, P < 0.001), TFLL (IPL: 1.90 ± 0.65 vs. IPL +: 1.60 ± 0.64, P = 0.021), LTMH (IPL: 0.186 ± 0.053 vs. 0.204 ± 0.034, P = 0.003), MGQ (IPL: 1.48 ± 0.54 vs. IPL +: 1.26 ± 0.56, P = 0.026), MGEx (IPL: 1.62 ± 0.53 vs. IPL +: 1.44 ± 0.50, P = 0.038) and OSDI (IPL: 32.54 ± 6.85 vs. IPL +: 29.76 ± 4.74, P = 0.001), while CFS score (IPL: 4.02 ± 0.65 vs. IPL +: 3.96 ± 0.73, P = 0.652) and ATU (IPL: 1.88 ± 0.63 vs. IPL +: 1.72 ± 0.50, P = 0.159) showed no significant difference. Conclusion Post-LASIK DE signs and symptoms can be improved by combining therapies such as IPL, HEM and 0.1% SH. Increased TFLL due to a combination of IPL, 0.1% SH and HEM had a greater positive impact on the subjective and objective DE measurements in participants with persistent post-LASIK DE.

Background: Retinal degeneration causes irreversible blindness. Human retinal progenitor cells (hRPCs) have the potential to treat retinal diseases. The vitreous cavity is a relatively immune-privileged site that is suitable for stem cell transplantation in the treatment of retinal diseases. This study aimed to evaluate the therapeutic efficacy and safety of intravitreal injection of hRPCs in retinal degeneration therapy. Material/Methods: hRPCs were primary-cultured and injected into the vitreous cavity of RCS rats. To determine whether hRPCs formed teratomas in immune-deficient mice, hRPCs at different passages were transplanted into BALB/c-nu mice. The visual function was detected by electroretinography recording. Changes in the outer nuclear layer (ONL) were analyzed by histological testing and cell counting. The protective mechanism was further assessed by cytokine antibody array. Results: Intravitreal transplantation of hRPCs maintained retinal function and preserved retinal morphology. Importantly, grafted cells in the vitreous cavity were well tolerated, with no adverse effects. Teratoma was not formed in BALB/c-nu mice after hRPCs transplantation. The number of hRPCs-injected eyes and thickness of ONL in the hRPCs-treated group were higher than those in the untreated group and HBSS injection group. The cytokine antibody array revealed that hRPCs expressed GDF-15, PDGF-AA, EGF, and NT-4. Conclusions: Our findings show that intravitreal injection of hRPCs is effective and safe in protecting photoreceptor cells in RCS rats, but were no longer effective at 12 weeks after transplantation. Moreover, hRPCs released multiple neurotrophic factors that may be involved in treating retinal disease.

Background . Dry eye disease (DED) is a multifactorial and one of the most common problems treated in an ophthalmic outpatient clinic. Due to the variability in presentation, diagnosis of DED consists of a combination of subjective and objective clinical tests. The purpose of this study was to assess the effectiveness of a handheld smartphone‐based infrared thermal (IRT) camera for screening symptomatic evaporative DED. Methods . This observational sex‐matched control study assessed IRT images of 184 right eyes (46 normal and 138 DED) of 184 participants. Evaporative DED was assessed using noninvasive tear breakup time, fluorescein staining, and the Chinese version of the ocular surface disease index (C‐OSDI) questionnaire and categorized into their respective dry eye symptomology group (none, mild, moderate, or severe). The ocular surface temperature (OST) at 8 anatomical regions of interest (ROI) (nasal conjunctiva, nasal limbus, nasal cornea, central cornea, inferior cornea, temporal limbus, temporal cornea, and temporal conjunctiva) were measured and compared using a handheld smartphone‐based IRT camera. The effectiveness of these 8 ROIs OST in detecting varying severity of DED was evaluated in terms of correlations with severity of DED and their area under the curve (AUC). Results . OST at the 8 anatomical ROI was significantly higher in DED participants than in the non‐DED group ( p < 0.05) except for inferior cornea, temporal limbus, and temporal conjunctival regions (>0.05). Analyzing 8 anatomical ROIs revealed that the nasal limbus had the highest Pearson correlation with the severity of DED (0.64, p < 0.001). Additionally, the nasal limbus ROI achieved the highest AUC of 0.79 (CI: 0.73–0.85; p < 0.05), sensitivity, and specificity (0.96 and 0.91) when comparing its ability to discriminated DED vs. non‐DED eyes. Conclusions . Rather than a diagnostic tool, handheld smartphone‐based IRT images can be considered as a rapid, noninvasive, and hygienic screening tool in discriminating DED and non‐DED and potentially alleviating inconvenience experienced during conventional tests.

Human umbilical cord mesenchymal stem cells (hUC-MSCs) have considerable potential in cell therapy. Cryopreservation represents the gold standard in cell storage, but its effect on hUC-MSCs is still not well understood. The aim of this study was to investigate the effect of one year of cryopreservation and thawing on the biological characteristics of hUC-MSCs from the same donors. Fresh hUC-MSCs were cryopreserved in commercial freezing medium (serum-free CellBanker 2) at passage 2. After one year of cryopreservation, the hUC-MSCs were thawed and subcultured to passage 4. The comparison was performed in terms of followings: cell count, viability, morphology, proliferation capacity, differentiation potential and chromosomal stability. The total cell count and viability of hUC-MSCs before and after one year of cryopreservation were 1 × 10⁷ and 96.34% and 0.943 × 10⁷ and 93.81%, respectively. Cryopreserved and fresh hUC-MSCs displayed a similar cell doubling times, expressed the markers CD73, CD90, CD105 and were negative for the markers CD34, CD45, and HLA-DR. Karyotypes were found to be normal after one year of cryopreservation. The trilineage differentiation properties were maintained after cryopreservation. However, when compared to freshly isolated hUC-MSCs from the same donor, cryopreserved hUC-MSCs exhibited decreased expression of osteogenesis- and chondrogenesis-related genes including Runx2, Sox9, and Col1a1, and increased expression of adipogenesis-related genes. These results demonstrated that cryopreservation did not affect cell morphology, surface marker expression, cell viability, proliferative capacity, or chromosomal stability. However, the osteogenic and chondrogenic differentiation capacities of cryopreserved hUC-MSCs were slightly reduced compared with those of fresh cells from the same donor. Graphical