Background: Worldwide application of hyaluronic acid has brought about severe complications, including central retinal arterial occlusion, which leads to a deleterious effect on vision. The current study explored the efficacy of superselective arterial hyaluronidase thrombolysis in rabbit retinal artery occlusion induced by hyaluronic acid. Methods: Occlusion of the internal/external ophthalmic artery in New Zealand White rabbits was induced with superselective injection of hyaluronic acid. Superselective subtraction angiography and fundus examination were conducted to confirm and evaluate the artery embolism. After 30 minutes of embolism, hyaluronidase was injected in the occluded artery through superselective arterial intubation. Results: Compared with preoperative and contralateral eyes, the postoperative eyes showed the symptoms of central retinal arterial occlusion and embolization, confirmed by digital subtraction angiography. After intraarterial hyaluronidase thrombolysis, the embolization failed to dissolve as shown on funduscopic and angiographic examinations. Conclusions: Superselective ophthalmic artery intervention could accurately and successfully establish the animal models of retinal artery occlusion induced by hyaluronic acid. The precise occlusion site of the retinal artery and complete embolism were confirmed by ophthalmologic examinations. Intraarterial hyaluronidase thrombolysis might not be an effective method to treat retinal artery occlusion induced by hyaluronic acid.
Purpose: The study is to evaluate the effect of demodex mite infection on the ocular surface characteristics changes of patients with dry eye disease (DED) using non-invasive instruments. Methods: 127 patients with DED and 52 normal control subjects were enrolled in this study. All DED patients were divided into demodex negative group and demodex positive group based on the result of the demodex mite infection under microscope. Non-invasive tear break-up time (NIBUT), tear meniscus height (TMH), ocular redness, meibomian gland secretions (MGS), morphology of palpebral margin, meibomian gland loss score (MGLS), and cornea fluorescence staining (CFS) were evaluated under oculus corneal topography and slit-lamp. Results: The demodex positive group showed longer NIBUT (P=0.003), lower TMH(P=0.021), worse morphology of palpebral margin (P<0.001) and worse MGS (P=0.007) than demodex negative group. The score of ocular redness in patients with DED were higher than in the control group (P<0.05). In demodex positive group, age had a positive correlation with the degree of palpebral margin morphological damage (rs=0.332 P<0.05) and a negative correlation with the severity of meibomian gland loss (rs=-0.345 P<0.05). Conclusion: A significant association between demodex mite infection and abnormal morphology of the palpebral margin, a lower meibomian gland quality, and lacrimal gland hyposecretion in patients with DED. Prompt recognition of the possible co-occurrence of demodex mite infection in patients with DED is crucial for optimal management and improved patient comfort and prognosis.
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