Fang Tian

Background: Diabetes increases the risk of cataract formation fivefold. Immune-mediated inflammation has been reported to play a role in this process; however, whether alterations in the immune landscape are involved remains unknown. Therefore, we conducted a multi-omics analysis to evaluate the impact of immune inflammation on the lens. Methods: Bulk RNA sequencing was performed on peripheral blood mononuclear cells (PBMCs) from diabetic patients and lens tissues from diabetic rats. Single-cell RNA sequencing was utilized to characterize intercellular interactions. Key gene and protein expressions were validated via laboratory assays. Results: An integrated RNA-seq analysis revealed a disruption of the blood–aqueous barrier integrity in the diabetic group, enhanced monocyte migration and adhesion, increased differentiation from classical to non-classical monocytes, and the upregulation of TNF and IFN-γ signaling pathways. The transcriptomic profiling of rat lenses revealed an increased proportion of monocytes and the activation of apoptotic pathways in lens epithelial cells. Immunohistochemistry and immunofluorescence staining demonstrated elevated caspase-3 and IL-6 levels in lens epithelial cells and increased immune cell infiltration in the diabetic group. The qRT-PCR and ELISA confirmed elevated levels of the pro-inflammatory cytokines IL-6 and IFN-γ, alongside reduced anti-inflammatory cytokine IL-10 in the peripheral blood and aqueous humor of diabetic patients. Conclusions: Diabetes alters the peripheral immune microenvironment and disrupts the blood–aqueous barrier, promoting intraocular inflammation and lens epithelial cell apoptosis, thereby accelerating cataract development.

Meibomian gland carcinoma (MGC) is a highly aggressive eyelid malignancy with a poor prognosis. MicroRNA‑3907 (miR‑3907) is upregulated in MGC, where it promotes tumor progression by suppressing thrombospondin 1 (THBS1). The present study aimed to assess the downstream regulatory mechanisms of THBS1 in MGC. Utilizing 4D label‑free quantitative proteomics, chitobiosyldiphosphodolichol β‑mannosyltransferase 1 (ALG1) was identified as the most significantly differentially expressed downstream protein following lentivirus‑mediated overexpression of THBS1, with results corroborated by consistent sequencing data. Protein‑protein docking models predicted a stable interaction between THBS1 and ALG1, mediated by hydrogen bonds involving key amino acid residues such as ASN‑991 and MET‑58. Co‑immunoprecipitation and immunofluorescence assays confirmed the physical interaction and co‑localization of THBS1 and ALG1 in MGC cells. Notably, ALG1 mRNA levels were significantly elevated in MGC cells compared with in normal meibomian gland cells. Functional assays revealed that ALG1 knockdown markedly suppressed malignant cellular behaviors and modulated the expression of genes associated with epithelial‑mesenchymal transition, a key process in tumor metastasis. Conversely, ALG1 overexpression enhanced these malignant traits. Together, these findings highlight ALG1 as a critical downstream effector in the miR‑3907/THBS1/ALG1 regulatory axis and suggest its potential as a biomarker for targeted diagnosis and therapy in MGC. The present study provides new insights into the molecular mechanisms underlying MGC and offers a basis for developing personalized therapeutic strategies.

AIM: To assess and compare the variations and agreements across different ocular biometric parameters using swept-source optical coherence tomography (SS-OCT) and Scheimpflug tomography in patients diagnosed with cataract. METHODS: This prospective case series was conducted at Tianjin Medical University Eye Hospital. In total, 212 eyes from 212 patients scheduled for phacoemulsification were included. Eyes were evaluated preoperatively using two SS-OCT devices (IOLMaster700 and CASIA2) and Scheimpflug tomography (Pentacam). Central corneal thickness (CCT), anterior chamber depth (ACD), aqueous depth (AQD), white-to-white distance (WTW), flat simulated keratometry (Kf), steep simulated keratometry (Ks), mean keratometry (Km), and total corneal keratometry (TKm) were measured. Intraclass correlation coefficient (ICC), 95% confidence intervals (CI) and limits of agreement (LoA) widths were conducted to assess differences and correlations between devices. RESULTS: All parameters, except for Ks, were significantly different. Pairwise comparison revealed no significant differences between keratometry obtained by IOLMaster 700 and Pentacam. LoA widths of all paired comparisons for Ks were >0.80 D. Except for WTW between IOLMaster 700 and CASIA2 and between CASIA2 and Pentacam, other Pearson’s coefficients between devices showed a strong correlation (all r>0.95). The ICC of WTW (ICC=0.438, 95%CI 0.167-0.625) showed poor reliability. The reliability of CCT, ACD, and AQD was excellent (all ICC>0.95), whereas that of TKm was good (ICC=0.827, 95%CI 0.221-0.939). A significant linear correlation was also observed among devices. CONCLUSION: The ocular parameters derived from the use of IOLMaster700, CASIA2, and Pentacam exhibit significant discrepancies; as such, measurements from these devices should not be deemed as interchangeable.

A retrospective cohort study was conducted to observe the correction effect of Toric intraocular lens (IOL) implantation in cataract eyes with specific types of irregular corneal astigmatism. Thirty-four eyes with either the "asymmetric bow-tie" pattern (Type I) or the "angled bow-tie" pattern (Type II) were included. Corneal topography was assessed using Pentacam HR, and changes in preoperative corneal astigmatism, visual acuity, manifest refraction, and objective visual quality were measured and compared. The average uncorrected distance visual acuity improved significantly from 0.86 ± 0.40 logMAR to 0.22 ± 0.15 logMAR (P < 0.001). Preoperative corneal astigmatism of 2.05 ± 0.90 D was corrected to a postoperative residual astigmatism of 0.78 ± 0.57 D (P < 0.001), with 32% of eyes within 0.50 D. The residual astigmatism prediction errors in Type I and Type II cases were (0.97 ± 0.68 D) and (0.66 ± 0.37 D), respectively (P = 0.100). The mean spherical equivalent prediction error in Type II cases (0.07 ± 0.36 D) was significantly smaller than that in Type I cases (− 0.29 ± 0.52 D) (P = 0.030). This study concludes that Toric IOL implantation effectively corrects specific types of irregular corneal astigmatism in cataract surgery. Eyes with the "angled bow-tie" pattern show higher accuracy in refractive predictions compared to eyes with the "asymmetric bow-tie" pattern.

Purpose: To assess the differences and similarities in the corneal curvature obtained by two swept-source optical coherence tomography (SS-OCT) devices, Scheimpflug imaging system and one ray tracing aberrometer in patients with cataracts. Moreover, this study aimed to compare the differences in posterior corneal (PK), total corneal (TK) and true net power (TNP) measurements among the IOLMaster 700, CASIA2, and Pentacam. Methods: A total of 200 eyes of 200 patients (116 female, 58%) were enrolled in this study, with a mean age of 65.9 ± 9.5 years. The flattest (Kf), steepest (Ks), and mean cornal powers (Km), J₀, and J₄₅ were obtained using two SS-OCT-based biometric devices, one rotating camera system and one ray-tracing aberrometer. The PK, TK and TNP values were also measured using these devices. To evaluate the differences and similarities between the devicves, the Friedman test, Pearson correlation coefficient (r), intraclass coefficient correlation (ICC) and Bland‒Altman plots with 95% limits of agreement (LoA) were used, and boxplots and stacked histograms were generated to describe the distributions of the data. Results: There were no significant differences between the IOLMaster 700 and Pentacam for any of the keratometry values. Additionally, there were no significant differences between the IOLMaster 700 and iTrace in evaluating J₀ and J₄₅. Bland‒Altman plots revealed relatively wide LoA widths, almost larger than 1 diopter for the keratometry values and almost larger than 0.5 diopter for J₀ and J₄₅ values among the four devices. In terms of PK and TK values, significant differences and low ICCs were found among the three devices. Conclusions: Although strong correlations and good agreement were found among the IOLMaster700, CASIA2, Pentacam and iTrace for Kf, Ks, Km and J₀, J₄₅, it seems that the measurements should not be used interchangeably because of the wide LoA widths and the presence of significant differences among the devices. Similarly, due to significant differences and low ICCs, the PK, TK and TNP values obtained by IOLMaster 700, CASIA2, and Pentacam should not be used interchangeably.

Purpose: To evaluate and compare the accuracy of iTrace and CASIA2 in measuring the postoperative orientation of toric intraocular lens (IOL) without mydriasis. Setting: Tianjin Medical University Eye Hospital, Tianjin, China. Design: Prospective cohort study. Methods: Patients with SN6AT toric IOLs implanted after cataract surgery were enrolled. 1 month after surgery, the toric IOL orientation were measured by iTrace and CASIA2 in non-mydriatic, semi-dark conditions. Then, the toric axis was directly reviewed using the slit-lamp under full mydriasis. Axis measurement differences between each of the 2 devices and the slit-lamp, described as their relative differences (RDs), were calculated and compared. The percentage of RDs within 5 degrees, within 10 degrees and greater than 30 degrees were analyzed. Results: 77 eyes of 70 patients were included. Generally, the mean toric axis measurement RDs of CASIA2 and iTrace were 9.24 ± 10.53 degrees and 13.89 ± 15.47 degrees respectively (P = .04). For CASIA2 (72 eyes), 54.17% (39), 72.22% (52), and 4.17% (3) of eyes had RDs within 5 degrees, within 10 degrees and greater than 30 degrees, compared with 40.00% (28), 61.43% (43) and 12.86% (9) for iTrace (70 eyes). The 95% limits of agreements of CASIA2 with slit-lamp was narrower than that of iTrace with slit-lamp. The median RD of CASIA2 was significantly smaller in eyes with pupil ≥4 mm under dark condition compared with eyes with pupil 4 mm.