Background: Studies of local anatomic characteristics of primary acquired nasolacrimal duct obstruction (PANDO) are important for understanding the etiology of PANDO and guiding surgical treatment. The purpose of this study was to review computed tomography (CT) scans to identify the anatomic differences in the obstructed and unobstructed sides of PANDO patients as well as in control patients in a Chinese population. Methods:In this retrospective comparative observational study, the CT scans of 126 PANDO patients were reviewed. A total of 76 patients who underwent CT examinations for eyeball atrophy or an intraocular foreign body but had a healthy lacrimal drainage system and orbit structure were enrolled as controls. The nasolacrimal canal (NLC) widths, lacrimal sac fossa structures, and nasal abnormalities in the obstructed and unobstructed sides in patients and both sides in controls were evaluated.Results: Both obstructed and unobstructed sides in PANDO patients showed significant differences to the sides of controls in NLC width (obstructed: 3.

Background: Punctal/intracanalicular plugs on the market nowadays are all designed before clinical use in treating dry eye disease (DED). To provide an individualized lacrimal drainage system occlusion method and reduce the complications, we developed a “liquid plug” strategy by intracanalicular injection of hydroxybutyl chitosan (HBC) solution, a thermosensitive, phase-changing biomaterial. This study evaluated the efficacy and safety of the HBC plug in treating dry eye disease by comparing it with the VisiPlug absorbable intracanalicular plug.Methods: A monocenter, randomized, controlled clinical trial was performed. Fifty patients with DED were randomized 1:1 to undergo either the HBC injection treatment or the VisiPlug treatment. Ocular Surface Disease Index (OSDI) questionnaire, tear break-up time (TBUT), corneal fluorescence staining (CFS), tear meniscus height (TMH), and phenol red thread test were evaluated at Day 0 (baseline, before treatment) and Weeks 1, 4, and 12.Results: The two groups had a balanced baseline of age, gender, and DED-related characteristics. Both occlusion methods could relieve the symptoms and signs of DED. Significant improvement was found in OSDI, phenol red thread test, and tear meniscus height (P < 0.05 compared to baseline) but not in corneal fluorescence staining and tear break-up time (P > 0.05). There is no statistically significant difference between HBC injection and VisiPlug at Weeks 1 and 4 (P > 0.05). However, at week 12, the HBC injection was not as effective as the VisiPlug in maintaining phenol red thread test (HBC: 5.35 ± 3.22 mm, VisiPlug: 8.59 ± 4.35 mm, P = 0.009) and tear meniscus height (HBC: 206.9 ± 47.95 μm, VisiPlug: 242.59 ± 60.30 μm, P = 0.041). The numbers of ocular adverse events were relatively low in both groups.Conclusions: The HBC injection showed similar efficacy and safety compared to VisiPlug. The intracanalicular injection of HBC solution proves to be a promising, individualizing method to treat DED.Clinical Trial Registration: This study is registered with the Chinese Clinical Trial Registry (https://www.chictr.org.cn/enindex.aspx), Identifier: ChiCTR1800016603.

Background. Benign essential blepharospasm (BEB) is a form of focal dystonia that causes excessive involuntary spasms of the eyelids. Currently, the pathogenesis of BEB remains unclear. This study is aimed at investigating the serum metabolites profiles in patients with BEB and healthy control and to identify the mechanism and biomarkers of this disease. Methods. 30 patients with BEB and 33 healthy controls were recruited for this study. We conducted the quantitative and nontargeted metabolomics analysis of the serum samples from 63 subjects by using liquid chromatography and Orbitrap mass spectrometry (LC-Orbitrap MS). Multivariate statistical analysis was performed to detect and identify different metabolites between the two groups. The Kyoto Encyclopedia of Genes and Genomes (KEGG) and receiver operating characteristic (ROC) curve analysis of the altered metabolites were performed. Results. A total of 134 metabolites were found and identified. The metabolites belonged to several metabolic pathways including phenylalanine metabolism, phenylalanine, tyrosine and tryptophan biosynthesis, arginine biosynthesis, linoleic acid metabolism, tryptophan metabolism, aminoacyl-tRNA biosynthesis, sphingolipid metabolism, glycosphingolipid biosynthesis, leucine and isoleucine biosynthesis, and vitamin B6 metabolism. Eight metabolites were identified as the potential biomarkers. Conclusions. These results demonstrated that serum metabolic profiling of BEB patients was significantly different from healthy controls based on LC-Orbitrap MS. Besides, metabolomics might provide useful information for a better understanding of BEB.

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Background: Whether to choose nasolacrimal duct intubation or dacryocystorhinostomy (DCR) for primary acquired nasolacrimal duct obstruction (PANDO) therapy is an important question in clinic practice. The purpose of this study is to find the potential lacrimal sac characteristics which can be used for the predictors of unsuccessful intubation for PANDO based on computed tomography-dacryocystography (CT-DCG). Methods: In this retrospective comparative observational study, we included PANDO patients who had a history of failed intubation for nasolacrimal duct obstruction as intubation failure group, and PANDO patients without intubation history as control group. We analyzed the lacrimal sac height, lacrimal sac width and obstruction site based on CT-DCG, all measured based on several reference levels on axial sections (upper, intermediate, lower level, common canaliculus level and lowermost contrast level), which were defined according to the contrast and the bony structure. Results: A total of 114 sides of PANDO were studied, including 36 sides in intubation failure group the other 78 sides in control group. The intubation failure group showed smaller lacrimal sac height (11.69±4.59 mm) and width (2.28±1.97 mm, intermediate level) than control group (14.13±2.92 mm, 3.32±2.02 mm, P = 0.005 and 0.012, respectively). Intubation failure group showed higher obstruction site than control group (P = 0.009). Conclusions: A small lacrimal sac and a high obstruction site are predictors of nasolacrimal duct intubation failure for PANDO. For PANDO patients with small lacrimal sac or high obstruction position, DCR is more recommended than intubation.