Abstract:Abstract OBJECTIVE: To observe the clinical efficacy of 0.05% cyclosporine eye drops combined with sodium vitrate in the treatment of moderate to severe dry eye related to type 2 diabetes. METHODS: From January 2024 to September 2024, 120 patients with type 2 diabetes-related moderate to severe dry eye who visited the Endocrinology and Ophthalmology Departments of Xuzhou Medical University Affiliated Hospital were selected. They were randomly assigned into two groups: a 0.05% cyclosporine eye drop (CsA) combination group and a sodium hyaluronate eye drop (HA) control group, with 60 patients in each group. The HA group received treatment with 0.3% sodium hyaluronate eye drops, while the combination group received additional treatment with 0.05% cyclosporine eye drops. Assessments were performed at baseline and at 1 month, 2 months, and 3 months post-treatment, including Ocular Surface Disease Index (OSDI), non-invasive tear meniscus height (NITMH), first non-invasive tear breakup time (NIBUTf), meibomian gland dropout score, lipid layer thickness grade, conjunctival grading, and corneal fluorescein sodium staining score (FL). Additionally, changes in tear inflammatory factors were observed at 3 months post-treatment, and corneal nerve fiber morphology and density changes in the sub basal nerve plexus (SBN) were analyzed using in vivo confocal microscopy (IVCM). RESULTS: NITMH, NIBUTf, and lipid layer thickness grading increased in both groups after 1mo, 2mo, and 3mo of treatment compared to baseline, with statistically significant differences (P<0.05), and the increase in the combined group was greater than that in the control group, with intergroup variability (P<0.05); OSDI scores, FL scores, and conjunctival grades scores decreased compared to baseline, with statistically significant differences (P<0.05), and the magnitude of decrease in the combined group was greater than that in the control group, with intergroup variability (P<0.05); there was no significant improvement in the blepharospasmal deficiency score of the two groups of patients compared with the baseline (P>0.05); the inflammatory factors in the tear fluid of the patients in the two groups, IL-6 and MMP-9, decreased from the baseline after 3mo of treatment, with statistically significant differences (P<0.05), and the magnitude of decrease in the combined group was greater than that in the control group, with intergroup variability (P<0.05). In the control group, the difference was statistically significant (P<0.05); after 3mo of treatment, the number of branch nerves and corneal nerve density in the combined group increased from baseline, and the nerve curvature score and dendritic cell(DC) density decreased from baseline, with statistically significant differences (P<0.05), and there was no significant change in the control group from the baseline comparison (P>0.05). CONCLUSION: The combination of 0.05% cyclosporine eye drops with sodium hyaluronate eye drops is effective in treating moderate to severe dry eye associated with type 2 diabetes, significantly controlling ocular surface inflammation, improving corneal nerve morphology and density, and with no observed severe complications.

Abstract:[Abstract] Objective This study aimed to evaluate whether Wnt pathway-related genes previously implicated in high myopia (HM) could serve as candidate genes for HM in the Chinese Han population and to identify risk loci associated with HM susceptibility. Mthods A case-control association analysis was conducted involving 530 HM patients and 1087 healthy controls. The test efficacy was estimated using Quanto software. Peripheral blood DNA was extracted using the magnetic bead method, and seven candidate single nucleotide polymorphisms (SNPs) were genotyped using the Sequenom MassARRAY system. The SNPs analyzed were HIVEP3 rs17365632, rs35134694, rs11210537; TNNB1 rs13072632; CAMK2NA rs10753502; Wnt7B rs73175083; and TCF4 rs41396445. Differences in allele and genotype frequencies between the HM and control groups were compared using the chi-square test under dominant, recessive, and additive inheritance models. Haplotype analysis was performed using SHEsis online software. Statistical significance was set at Pc < 0.05 after Bonferroni correction. Results All seven SNPs had a genotyping detection rate exceeding 90% and were in Hardy-Weinberg equilibrium (P > 0.05). The test efficacy of the sample size was above 90.13%, indicating that the samples were representative of the population. In the HM group, the AA genotype frequency of HIVEP3 rs11210537 was significantly reduced (Pc = 0.003，OR = 0.889). Conversely, the GG genotype frequency was significantly elevated (Pc = 0.003，OR = 1.176). In an additive genetic model (AA vs GG), the AA genotype frequency was significantly lower than the GG genotype frequency (Pc = 0.003, OR = 0.583). Additionally, the frequency of the CCA haplotype of rs17365632, rs35134694, and rs11210537 in HIVEP3 was decreased in the HM group compared to the control group (Pc = 0.008, OR = 0.791). Conclusions The SNP locus rs11210537 in the HIVEP3 gene is associated with genetic susceptibility to HM in the Chinese Han population, with the G allele and GG genotype identified as risk genetic markers. The CCA haplotype of rs17365632, rs35134694, and rs11210537 in the HIVEP3 gene represents a risk haplotype for HM.

Abstract:Abstract Objective: To assess the impact of optimized pulsed technology (OPT) on the morphological and functional changes of meibomian glands in patients with meibomian gland dysfunction (MGD). Methods: This prospective case-control study enrolled 60 MGD patients (60 eyes, right eye) treated at Weifang Eye Hospital from September 2023 to February 2024. Patients were categorized into mild, moderate, and severe groups based on the extent of meibomian gland loss, with 20 individuals per group. Treatments consisted of bilateral OPT combined with meibomian gland massages, administered biweekly over four sessions. We monitored ocular surface function indicators including the ocular surface disease index (OSDI), corneal fluorescein staining (CFS), non-invasive average tear break-up time (NIBUTav), and non-invasive tear meniscus height (NITMH), as well as meibomian gland function scores (MGES and MGYSS). Cellular-level assessments using in vivo confocal microscopy (IVCM) examined meibomian gland acinar unit density (MGAUD), inflammatory cell density (ICD), and acinar dimensions (MGALD and MGASD). Results: At baseline, no significant differences were found in NITMH across groups (P>0.05). Significant disparities were observed in NIBUTav, MGES, MGYSS, MGAUD, MGALD, and MGASD (P<0.05). Compared to the mild group, the moderate and severe groups showed significant differences in OSDI, CFS, and ICD (P<0.05), though no significant differences existed between moderate and severe groups (P>0.05). After three months of treatment, all groups showed no significant differences in NITMH (P>0.05). All parameters improved significantly in the mild group (P<0.05); all but MGASD improved in the moderate group (P>0.05 for MGASD); significant improvements were noted in OSDI, CFS, and NIBUTav in the severe group (P<0.05), while MGES and MGYSS did not differ significantly (P>0.05). IVCM parameters (MGAUD, ICD, MGALD, and MGASD) showed no significant change in the severe group post-treatment (P>0.05). Conclusion: OPT effectively enhances various ocular surface functions and improves gland expressibility and secretion quality in mild to moderate MGD cases, while also positively impacting certain cellular parameters. In severe cases, where most acinar functions are lost and structural reversibility is limited, OPT can still mitigate MGD symptoms and decelerate disease progression.

Abstract:Objective: To investigate the expression and clinical diagnostic value of Toll like receptor 4 (TLR4) and nuclear factor-κB (NF-κB) in conjunctival epithelial cells and tears of patients with dry eye syndrome. Methods: From January 2023 to June 2024, 104 dry eye patients (disease group) who visited our hospital and 100 healthy individuals (control group) who underwent physical examination were selected. The changes of TLR4 and NF-κB in conjunctival epithelial cells and tears were analyzed. Pearson analysis was applied to analyze the correlation between TLR4 and NF-κB expression in conjunctival epithelial cells and tears. Logistic analysis was applied to analyze the factors that affected dry eye syndrome. ROC was applied to analyze the diagnostic value of TLR4 and NF-κB expression in conjunctival epithelial cells and tears for dry eye syndrome. Results: The expression levels of TLR4 and NF-κB in conjunctival epithelial cells and tears in the disease group were obviously higher than those in the control group (P<0.05). There was a positive correlation between TLR4 and NF-κB in conjunctival epithelial cells and tears (r=0.392, 0.348, P<0.05). The differences in the use of eye drops, BUT value, SIT value, TFT, and CFS scores between the disease group and the control group were statistically significant (χ2/t=9.525, 29.069, 38.498, 21.722, 27.487, P<0.05). Frequent use of eye drops, CFS score, TLR4, and NF-κB were risk factors for dry eye syndrome (OR=2.153, 3.183, 1.578, 2.452, P<0.05), while BUT value, SIT value, and TFT value were protective factors for dry eye syndrome (OR=0.654, 0.755, 0.276, P<0.05). The sensitivity, specificity, and AUC of TLR4 combined with NF-κB in conjunctival epithelial cells in the diagnosis of dry eye were 86.54%, 81.00%, and 0.889%, respectively. The combination of TLR4 and NF-κB in conjunctival epithelial cells had higher diagnostic value for dry eye than alone diagnosis (Z combination - TLR4=3.506, P=0.001, Z combination - NF-κB=3.165, P=0.002). The sensitivity, specificity, and AUC of TLR4 combined with NF-κB in tears for diagnosing dry eye syndrome were 82.69%, 70.00%, and 0.818, respectively. The combination of TLR4 and NF-κB in tears had higher diagnostic value for dry eye syndrome than alone diagnosis (Z combination - TLR4=3.117, P=0.002, Z combination - NF-κB=2.363, P=0.018). Conclusion: The expression levels of TLR4 and NF-κB in conjunctival epithelial cells and tears of patients with dry eye syndrome are elevated. TLR4 and NF-κB are related to the development of dry eye syndrome, and The increase in both can increase the risk of developing dry eye syndrome. The combination of TLR4 and NF-κB has certain diagnostic significance for dry eye syndrome.

Abstract:Objective: To investigate the influence of relevant inflammatory markers in peripheral blood on the progression of neovascular glaucoma (NVG) secondary to diabetic retinopathy (DR) among patients. Methods: A retrospective case-control study was conducted, categorizing patients into two groups based on the presence or absence of NVG: those with proliferative diabetic retinopathy (PDR) alone (PDR group, n=148) and those with NVG secondary to PDR (NVG secondary to PDR group, n=142). Peripheral blood inflammatory markers were evaluated, including white blood cell-related indices, neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), monocyte-to-lymphocyte ratio (MLR), and systemic immune-inflammation index (SII). Analyze the distinctions in peripheral blood inflammatory markers between the two groups of patients and the relationships these bear to NVG secondary to PDR. Results: No statistically significant differences were observed in baseline characteristics between the two groups, confirming their comparability. However, significant differences were found in eosinophil percentage and monocyte-to-lymphocyte ratio (MLR) between the PDR group and the NVG secondary to PDR group (P< 0.05), with both values being significantly higher in the NVG secondary to PDR group.Multivariate logistic regression analysis revealed that the eosinophil percentage and the monocyte - to - lymphocyte ratio were factors influencing the development of neovascular glaucoma (NVG) secondary to proliferative diabetic retinopathy (PDR) in patients. Conclusion: Eosinophil percentage and MLR may be associated with the progression of PDR to NVG and could serve as potential predictive markers for NVG development in PDR patients. Keywords:diabetic retinopathy； neovascular glaucoma； eosinophils； monocyte to lymphocyte ratio； inflammatory indicators

Abstract:Purpose: To conduct a CiteSpace-based visualization and analysis of the literature on Traditional Chinese Medicine (TCM) treatment of Diabetic Retinopathy (DR) from January 2014 to January 2024. Methods: The literature was retrieved from the China National Knowledge Infrastructure (CNKI) database. Co-occurrence, clustering, and emergence analyses of annual publications, authors, research institutions, and keywords were performed using Note Express and CiteSpace software to generate knowledge maps. Results: A total of 643 Chinese-language articles were included. The annual publication trend was characterized by fluctuations. The primary research institutions were Liaoning University of Traditional Chinese Medicine and Eye Hospital China Academy of Chinese Medicine Sciences. Twenty high-frequency keywords were identified, including "diabetes,""TCM," and "review," along with 12 emergent terms such as "Qiming granules" and "data mining." The research focus in 2014 was on exploring therapeutic methods and the efficacy of proprietary Chinese medicines. From 2016 to 2017, the research perspective expanded to include symptoms and multi-factorial analysis. Between 2018 and 2020, there was an in-depth investigation into evidence types and disease stages. After 2019, the emphasis shifted towards TCM-specific therapies and patient-centered concepts. From 2022 to 2024, innovation in research methods and the theory of TCM complexes emerged as new hotspots. Conclusion: The research on TCM treatment for DR is still in an ascending phase. The primary research hotspot currently centers on Qiming granules. Future trends are likely to focus on the efficacy and mechanisms of action. The combined application of different therapies and long-term follow-up experimental research could provide a more robust basis for evidence-based medicine, unearth the potential of TCM, and promote its development.

Abstract:The excessive accumulation of advanced glycosylation end products (AGEs), the end products of non-enzymatic glycosylation reactions, can be involved in the pathological processes of various ocular diseases through mechanisms such as oxidative stress, inflammatory responses and apoptosis. In this paper, we systematically reviewed the key role of AGEs in diabetic keratopathy, cataract, glaucoma, age-related macular degeneration (AMD) and diabetic retinopathy (DR). It was found that AGEs activate signalling pathways such as NADPH oxidase, MAPK and NF-κB by binding to the receptor RAGE, leading to reactive oxygen species (ROS) generation, release of inflammatory factors, and vascular endothelial dysfunction, which in turn induces delayed corneal healing, cross-linking of lens proteins, optic nerve degeneration, formation of choroidal neovascularisation (CNV), and blood-retinal barrier (BRB) disruption. disruption. For example, in diabetic keratopathy, AGEs delay wound healing via the ROS/NLRP3 inflammatory vesicle axis; in cataract, ascorbic acid-mediated cross-linking of lens proteins due to AGEs directly impairs lens transparency; and in DR, AGEs exacerbate microvascular damage by regulating VEGF expression and pericyte apoptosis. In addition, this article discusses the advances and limitations of AGEs detection techniques, such as the potential application of lens AGEscan fluorescence assay in screening for diabetic complications, and the need to develop tissue-specific assays for atrial fluid and vitreous. For therapeutic strategies, the research directions of inhibiting AGEs production, blocking RAGE signalling pathway and developing anti-glycosylation drugs are proposed to emphasise their clinical value in delaying disease progression. This review not only integrates the molecular mechanisms and clinical associations of AGEs in ocular diseases, but also provides a theoretical basis for targeted interventions, which is of great significance in exploring novel diagnostic and therapeutic strategies.

Abstract:Retinal displacement refers to the strong fluorescent lines parallel to the retinal vessels that are detected through autofluorescence examination after rhegmatogenous retinal detachment (RRD) surgery. Actually, even if patients with RRD achieve macroscopic structural reattachment after the operation, the visual function of some patients remains suboptimal. This is associated with the incomplete recovery of retinal function, and retinal displacement is one of the critical influencing factors. This paper reviews the related concepts of retinal displacement and systematically summarizes the incidence of retinal displacement after retinal reattachment surgery and its impact on function, the possible mechanisms of retinal displacement, and the influence of various factors on the occurrence of retinal displacement in the recent five years. It is conducive to enabling surgeons to conduct better design and planning for retinal reattachment surgeries, then achieve higher integrity of retinal function recovery, and enable patients to obtain better postoperative visual function.

Abstract:Rhegmatogenous retinal detachment (RRD) is a common blinding ophthalmic dis-ease that has always received significant attention in clinical treatment. The foldable capsular buckle (FCB), as a new method for extraocular treatment of RRD, offers "Five Noes" advantages over traditional treatments such as scleral buckling (SB), pars plana vitrectomy (PPV), and pneumatic retinopexy (PR) - no retrobulbar anes-thesia, no muscle traction, no scleral fluid release, no intraoperative positioning, and no cryotherapy. This effectively reduces postoperative complications in RRD pa-tients and shortens the operation time. This review aims to investigate the develop-ment process and treatment principle of foldable capsule buckle, and focus on its therapeutic advantages, indication selection, efficacy and safety for rhegmatogenous retinal detachment. It is expected to play a more important role in the treatment of a variety of retinal diseases through technological innovation and application field ex-pansion.

Abstract:Objective To investigate the correlation between serum leucine-rich α-2 glycoprotein 1 (LRG1) and fibroblast growth factor 21 (FGF-21) levels and neovascular glaucoma (NVG). Methods A total of 110 patients with NVG admitted to the ophthalmology department from September 2020 to September 2022 were selected as the NVG group (23 patients of grade II, 44 patients of grade III, 43 patients of grade IV), 90 cataract patients matched with sex and age were the control group. The levels of LRG1, FGF-21, VEGF, PEDF and TNF-α in serum were detected by ELISA; Pearson correlation analysis was used to analyze the correlation between serum LRG1, FGF-21 levels and Teich grade, VEGF, PEDF, TNF-α levels. Results The levels serum LRG1, FGF-21, VEGF, PEDF and TNF-α in NVG group were obviously higher than those in control group (P<0.05). With the increase of Teich grading, the levels of serum LRG1, FGF-21, VEGF, PEDF and TNF-α in NVG patients increased obviously in turn, and there was a statistically obvious difference between the subgroups (P<0.05). Correlation analysis showed that the levels of LRG1 and FGF-21 in serum of NVG patients were positively correlated with the levels of VEGF, PEDF and TNF-α (P<0.05). Conclusion The levels of LRG1 and FGF-21 in serum of patients with NVG are obviously increased, which are positively correlated with the levels of VEGF, PEDF and TNF-α, and may cooperate with VEGF, PEDF and TNF-α to induce the occurrence and development of NVG.