Recent progress in whole genome sequencing has revealed that animals have various kinds of opsin genes for photoreception. Among them, most opsin genes have introns in their coding regions. However, it has been known for a long time that teleost retinas express intron-less rhodopsin genes, which are presumed to have been formed by retroduplication from an ancestral intron-containing rhodopsin gene. In addition, teleosts have an intron-containing rhodopsin gene (exo-rhodopsin) exclusively for pineal photoreception. In this study, to unravel the evolutionary origin of the two teleost rhodopsin genes, we analyzed the rhodopsin genes of non-teleost fishes in the Actinopterygii. The phylogenetic analysis of full-length sequences of bichir, sturgeon and gar rhodopsins revealed that retroduplication of the rhodopsin gene occurred after branching of the bichir lineage. In addition, analysis of the tissue distribution and the molecular properties of bichir, sturgeon and gar rhodopsins showed that the abundant and exclusive expression of intron-containing rhodopsin in the pineal gland and the short lifetime of its meta II intermediate, which leads to optimization for pineal photoreception, were achieved after branching of the gar lineage. Based on these results, we propose a stepwise evolutionary model of teleost intron-containing and intron-less rhodopsin genes.

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BACKGROUND: Incomitant exotropia is one of ocular complication that has been reported after intranasal surgery. This case report aims to describe the causes of exotropia in a patient with a history of nasal polyp surgery.CASE PRESENTATION: A 50-years-old male, came with the main complaint of double vision 1 month after nasal polyp surgery. He also complained his right eye turned outward. The visual acuity on the right eye was 6/7.5 with his head turn to the left. On the examination, the Hirschberg test was XT 45°, and the Krimsky test > 95 ∆BI. Duction and version test on the right eye were -4 adduction. There was no shifting on the cover-uncover test. Ishihara test was within normal limit, and there was suppression on the right eye in WFDT. On force generation test, we found limited adduction on the right eye and no restriction in force duction test. Head MRI showed atrophy of medial recti on the right eye, 2.2 mm in size. The patient underwent vertical muscle transposition procedure surgery, and it was found atrophy of medial recti without any rupture. Two months after surgery, the double vision was decreased, the result of the Hirschberg test was XT 30° and Krimsky test 65°∆BI. DISCUSSION: Nasal polyp surgery-related incomitant exotropia mostly caused by extraocular muscles rupture. In this case, we found no rupture. Therefore, we suspected the abnormalities of muscles vascularisation, supported by the atrophy of medial recti.

BACKGROUND: The coronavirus disease 2019 (COVID-19) is an infectious disease characterized by severe acute respiratory syndrome caused by the coronavirus 2. The implementation of lockdown and social distancing is the efforts made by the government to prevent the spread of this virus. The COVID-19 pandemic has affected the incidence rate of ocular trauma in several means. AIM: This study aimed to evaluate the factors that can cause ocular trauma, from the patient’s characteristics, clinical presentation, etiology, and mechanism of ocular trauma of patients who came to the emergency unit of Sanglah Central General Hospital (RSUP) during the COVID-19 pandemic. METHODS: This study is an observational analytic study with simple random sampling method to evaluate the characteristics of patients with ocular trauma from March 2020 to March 2021. The secondary data were obtained from the medical records including age, gender, address, examination data (visual acuity, duration between trauma and time of seeking medical care, diagnosis, trauma etiology, trauma mechanism, and surgery performed on the patient). RESULTS: In this study the most common was the presence of corpus alienum/foreign body in the cornea, chemical trauma, corneal erosion, canaliculi rupture, and keratitis which are usually caused by photoelectric injury. During the COVID-19 pandemic, new regulations were implemented including patient screening, COVID-19 test before undergoing surgery, patient treatment, and also the use of personal protective equipment for the examiners. Moreover, there were behavioral changes of the people caused by the enforcement of lockdown system and also people’s fear of going to the hospital, especially to a COVID-19 referral hospital such as Sanglah General Hospital; therefore, some patients delayed seeking medical treatment and refused to have surgery at Sanglah General Hospital. CONCLUSION: Our study concluded that the trend of ocular trauma in the COVID-19 era tends to occur in the male population and involves trauma to the cornea, with the most common etiology is caused by the presence of foreign bodies such as gram, wood, or metal. Our finding also showed that despite the implementation of social distancing policies in the COVID-19 pandemic situation, ocular trauma can still be found related to the implementation of the lockdown that has been relaxed during this research.