Abstract:Objective: To construct a risk nomogram prediction model of ME based on the risk factors of macular edema (ME) after phacoemulsification in diabetes cataract (DC) patients. Method: A retrospective collection of data was conducted on 1751 DC patients who underwent cataract phacoemulsification surgery in the hospital from January 2022 to December 2024. Based on whether they developed ME after surgery, the patients were divided into the ME group (n=138) and the N-ME group (n=1613). By conducting univariate and Logistic multiple regression analysis, the risk factors for postoperative ME in DC patients undergoing phacoemulsification were identified. A column chart risk prediction model was constructed, and the receiver operating characteristic (ROC) curve, calibration curve, Hosmer-Lemeshow goodness of fit test were plotted to evaluate the discrimination and calibration of the model. The decision curve was used to evaluate the clinical return on investment of the model. Results: Age, duration of diabetes, proportion of insulin treatment, proportion of retinopathy, best corrected visual acuity, CSMT, macular volume, HbA1c and VEGF in ME group were all higher than those in N-ME group (P<0.05). Multivariate Logistic regression analysis showed that diabetes course, retinopathy, BCVA, CSMT, macular volume, HbA1c and VEGF were the risk factors for ME after phacoemulsification in DC patients (P<0.05). A column chart risk prediction model was constructed based on risk factors, and the ROC curve suggested good model differentiation [AUC of training set was 0.998 (95%CI: 0.997-1.000), and AUC of validation set was 0.999 (95%CI: 0.997-1.000). 0.997-1.000)], the calibration curve and Hosmer-Lemeshow goodness of fit test indicated that the model had a high fit (training set: R2=0.917, x2=0.806, P=0.999. Verification set: R2=0.900, x2=0.675, P=1.000). The decision curve showed that the model had a high net return rate within the probability range of 0.00-1.00 threshold. Conclusion: Diabetes course, retinopathy, BCVA, CSMT, macular volume, HbA1c and VEGF are risk factors for ME after cataract phacoemulsification in DC patients. The risk prediction model based on this construction has good differentiation and consistency in predicting the risk of ME after cataract phacoemulsification in DC patients.

Abstract:Abstract Objective To investigate the distribution characteristics and correlations of ocular biometric parameters in adolescents aged 8-18 years with mild to moderate myopia. Methods A total of 447 eyes from adolescents aged 8-18 years consecutively enrolled for orthokeratology lens fitting at the Fifth Affiliated Hospital of Zhengzhou University between 2021 and 2023 were included. Biometric measurements under scotopic conditions assessed axial length (AL), corneal radius of curvature (CR), and AL/CR ratio. Cycloplegic refraction determined spherical equivalent (SE), classifying eyes into mild or moderate myopia groups. Statistical analyses compared groups. Results A statistically significant difference in myopia severity was observed between the 8-12-year-old and 13-18-year-old age groups (P < 0.001). In the mild myopia group (216 eyes), median SE was -2.25 D, mean AL was 24.48 mm, and mean AL/CR was 3.11. In the moderate myopia group (231 eyes), median SE was -4.29 D, mean AL was 25.18 mm, and mean AL/CR was 3.20. Significant differences in SE, AL, and AL/CR were found between groups (P < 0.05). Linear regression revealed significant negative correlations between SE and AL (r = -0.531, P < 0.0001) and between SE and AL/CR (r = -0.598, P < 0.0001). The areas under the ROC curve (AUC) for predicting moderate myopia were: AL/CR combined with gender and age (AUC = 0.812, 95% CI: 0.773-0.852), AL/CR alone (AUC = 0.800, 95% CI: 0.759-0.841), AL alone (AUC = 0.726, 95% CI: 0.680-0.773), and CR alone (AUC = 0.548, 95% CI: 0.494-0.601). The optimal AL/CR cut-off value for predicting moderate myopia was 3.189 (sensitivity: 73.2%, specificity: 85.2%), suggesting its potential as a clinical threshold. Conclusion In adolescents with non-high myopia, AL/CR, AL, and SE exhibit significant negative correlations. The combination of AL/CR with gender and age demonstrated the highest diagnostic accuracy for SE. AL/CR shows independent predictive value for myopia severity in adolescents, irrespective of refractive status.

Abstract:Objective: To evaluate the effect of defocus incorporated multiple segments(DIMS) lenses on the myopic development and progression of the unilateral myopia children. Methods:In this retrospective case group study,we reviewed the medical records of unilateral myopia children in Hankou Aier Eye Hospital from october 2020 to october 2022 , who had been wearing DIMS lens(n=52) and single-vision(SV) spectacle lenses(n=49) for 1 year.The spherical degree of myopia eyes ranged from -4.00D to -0.50 D and the nonmyopic eyes 0 to +1.00D,astigmatism in all eyes was ≤2.00 D.The DIMS lens group was classified into DIMS-myopia group(the myopic eyes) and DIMS-nonmyopia group(the nonmyopic eyes). The SV lens group was also divided into SV-myopia group and SV-nonmyopia group. T-test were used to compare the changes of axial length (AL), spherical equivalent refraction(SER). Results: After 1 year, the changes of SER in the DIMS-myopic group and the DIMS-nonmyopic group were (-0.41±0.44) D and (-0.26±0.54) D, respectively, and the changes of AL were (0.18±0.20) mm and (0.15±0.15) mm, respectively. SER changes were (-0.74±0.63) D and (-0.70±0.68) D in SV-myopic group and SV-nonmyopic group ,and AL changes were (0.30±0.28) mm and (0.31±0.28) mm. The changes of SER and axis of eyes in DMS-myopic and non-myopic groups were slower than those in SV group (P < 0.05). Compared with SV lenses, wearing DIMS lenses delayed SER by 44.6% in myopia eyes, SER by 62.9% in non-myopia eyes, AL delayed by 40.0% in myopia eyes and 51.6% in non-myopia eyes. The percentage of 1-year AL change ≤0.2mm in DIMS-myopic group and non-myopic group was 53.9% and 65.4%, respectively, higher than that in SV myopic group (34.7% and 42.9%, P < 0.05). The percentage of AL change > 0.4mm in DIMS-myopic group and nonmyopic group was 17.3% and 7.7%, respectively, lower than that in SV myopic group (32.7% and 28.6%, P < 0.05). There was no significant correlation between the change of AL and age and baseline AL in the DIMS-myopic and non-myopic groups after 1 year of lens wearing (r =-0.214,P =0.128; r =-0.111,P =0.435; r =-0.254,P =0.070; r =-0.145,P =0.306); The change of AL in SV-myopic group and non-myopic group was negatively correlated with age (r =-0.446,P =0.001; r =-0.312,P =0.029). Conclusion: DIMS lens has a good effect on myopia control and prevention in both myopia and non-myopia children with monocular myopia. Children with early pre-myopia can wear multi-point defocus lens to prevent myopia.

Abstract:【Abstract】Objective: To explore the effect of bilateral lateral rectus recession in the treatment of basic intermittent exotropia, and to construct a logistic regression model to analyze its influencing factors.Methods:A prospective study was conducted on 104 patients with basic intermittent strabismus admitted to our hospital from October 2022 to October 2023,Patients were randomly divided into a study group of 52 cases and a control group of 52 cases using a random number ranking method. The control group received treatment with one eye retraction and one section surgery, while the study group received treatment with bilateral lateral rectus muscle retraction surgery,Compare the differences in surgical success rate, postoperative strabismus, and postoperative lateral drift between two groups, and analyze the factors affecting surgical success rate.Results:There was no statistically significant difference between the two groups at 1 day, 1 month, 3 months, and 6 months after surgery (P>0.05).The strabismus in the 6m and 33cm eye positions at 1, 3, and 6 months after surgery were lower than those at 1 day after surgery (P<0.05). However, there was no statistically significant difference in the strabismus in the 6m and 33cm eye positions between the two groups at 1, 1, 3, and 6 months after surgery (P>0.05).The results of repeated measures ANOVA showed that there were statistically significant differences in the timing, inter group, and interaction effects of postoperative lateral drift between the two groups (P<0.05). The lateral drift of both groups increased at 3 and 6 months after surgery compared to 1 month after surgery, and the lateral drift at 6 months after surgery was greater than that at 3 months after surgery (P<0.05). However, the lateral drift of the study group at 3 and 6 months after surgery was lower than that of the control group (P<0.05).Binary logistic regression analysis showed that near stereo vision, far stereo vision, and recent postoperative far eye position (0~+10) ° were protective factors affecting surgical success (P<0.05).Conclusion:Bilateral lateral rectus recession surgery has a good success rate in treating basic intermittent exotropia and can effectively reduce the postoperative exotropic deviation, with good long-term stability. Near stereopsis, distance stereopsis, and postoperative recent far eye position (0~+10) are factors influencing surgical success.

Abstract:Ketone body metabolism plays a significant role in the development and progression of Diabetic Retinopathy (DR). Previous research has established a close relationship between dyslipidemia and DR progression. Ketone bodies, comprising β-hydroxybutyrate, acetoacetate, and acetone, are metabolic products generated from fat breakdown when glucose metabolism is impaired. Studies have revealed that ketone body metabolism is intricately linked to multiple pathophysiological processes in DR, including oxidative stress, inflammatory responses, and neurodegeneration within retinal cells. This article provides a review exploring the impact of ketone body metabolism on the pathogenesis of DR.

Abstract:Objective To investigate the changes and clinical significance of miR-34a and miR-29b levels in lens epithelial cells of age-related cataracts (ARC). Methods Sixty-five age-related cataract patients (study group) and fifty-three cases of clear lens anterior capsulorhexis (control group) who visited our hospital from February 2023 to February 2024 were gathered. Pearson was applied to test the correlation between miR-34a and miR-29b. Multiple factor logistic regression equation was applied to determine the factors affecting the occurrence of ARC. Results Compared with the expression levels of miR-34a and miR-29b in lens epithelial cells of control group, the expression levels of miR-34a and miR-29b in lens epithelial cells of research group showed a great decrease trend (P<0.05). There was a positive correlation between miR-34a and miR-29b in the lens epithelial cells of ARC patients, with r=0.472 (P<0.05). The proportion of research group with a history of hypertension was greatly higher than that of control group. MiR-34a, and miR-29b were protective factors for ARC (P<0.05). Conclusion The levels of miR-34a and miR-29b in lens epithelial cells of ARC patients are greatly lower than those in lens epithelial cells of patients without cataracts. MiR-34a and miR-29b are associated with the development of ARC.

Abstract:Objective To explore the efficacy and safety of repeated low-energy red light irradiation (RLRL) combined with visual training for the treatment of adolescent myopia based on vision and tear film function. Methods A total of 104 adolescent myopic patients (208 eyes) from The second hospital of Hebei medical university. from January 2022 to July 2023 were selected and randomly divided into two groups by random number table method, with 52 cases (104 eyes) in the control group and 52 cases (104 eyes) in the study group. Both groups were treated with orthokeratology lenses, while the control group received visual training and the study group received RLRL treatment on top of visual training. Follow-up for 1 year. The improvement of vision, changes in the choroid, tear film function, adverse events, and visual acuity growth after 1 year were compared between the two groups before and after treatment. Results The uncorrected visual acuity and axial length in the treatment group at 6 months and 1 year were lower than those in the control group, and the differences were statistically significant (P<0.05). The thickness of the choroid under the center recess and the density of choroidal capillary blood flow were higher in the study group than in the control group at 6 months and 1 year of treatment, and the differences were statistically significant (P<0.05), the thickness of the lipid layer of the tear film and the time of tear film rupture in the two groups at different time points were not statistically significant when compared between the two groups (P>0.05), and the incidence of adverse events during the treatment period of the two groups was not statistically significant (P>0.05). After 1 year of treatment and 2 weeks of removing the orthokeratology lens, there was no significant difference in the uncorrected visual acuity between the study group and the control group before treatment (P>0.05). The naked visual acuity of the control group increased compared with that before treatment, and the difference was statistically significant (P<0.05). Conclusion RLRL combined with visual training can effectively improve the choroid, control the growth of the axial length, effectively correct the vision of the cornea, and does not affect the tear film function, with high safety.

Abstract:Ferroptosis, an iron-dependent form of programmed cell death characterized by lipid peroxidation, oxidative stress, and dysregulated iron metabolism, plays a significant role in the pathogenesis of glaucoma.This review systematically summarizes the fundamental mechanisms of ferroptosis, the involvement of oxidative stress and ferroptosis in glaucoma, the relationship between ferroptosis and glaucomatous neurodegeneration, and the potential therapeutic strategies targeting ferroptosis in glaucoma.Studies have shown that ferroptosis-regulating factors play a crucial role in mitigating oxidative damage and preserving cellular function.However, the complexity of their regulatory mechanisms not only hinders a comprehensive understanding of their roles but also impedes clinical translation.Although ferroptosis inhibitors have demonstrated promising neuroprotective effects in animal models, their clinical application remains challenged by issues such as drug safety and target specificity. Therefore, the development of more targeted and low-toxicity therapeutic strategies is essential to advance personalized and precise treatment for glaucoma.

Abstract:Retinal diseases (mainly include retinal vascular diseases, extraretinal diseases such as outer retina, retinal pigment epithelium and subchoroidal diseases) are the leading causes of visual impairment and blindness worldwide, that affect human health and quality of life severely. In recent years, artificial intelligence (AI) technology, especially the applications of deep learning model are widespread. Innovations and new tools such as Convolutional Neural Networks (CNNs), Generative Adversarial Networks (GANs), Transformer architectures, show outstanding application value in early diagnosis, precise treatment, training and learning of ophthalmic diseases. Besides this, multimodal fusion models provides new ideas and tools for full-cycle management of ophthalmic diseases and related systemic diseases. This review aims to explore the application of AI or deep learning in the diagnosis of retinal diseases, and to discuss the current research status, progress, challenges and developments in future.

Abstract:AIM: To investigate the role of serum high-sensitivity C-reactive protein (hsCRP) in the pathogenesis and progression of diabetic retinopathy (DR) in patients with type 2 diabetes mellitus (T2DM). METHODS: A nested case-control study was conducted involving 187 T2DM patients (187 eyes) who attended at Beijing Tongren Hospital from June 2017 to October 2024. Patients were categorized into three groups: the diabetes mellitus (DM) group, non-proliferative DR (NPDR) group, and proliferative DR (PDR) group. Baseline information was collected, including age, sex, duration of DM, and duration of hypertension. All patients underwent fasting biochemical tests and comprehensive ophthalmic examinations. RESULTS: After adjusting for confounding factors, multivariable logistic regression identified hsCRP as a significant risk factor for DR (OR=2.67, 95% CI 1.19-5.96, P=0.017). A positive correlation was observed between hsCRP and fasting blood glucose (FBG) (P=0.004) and glycated hemoglobin A1c (HbA1c) (P=0.048) by Spearman’s rank correlation coefficient analysis. CONCLUSION: Serum hsCRP is positively correlated with FBG and HbA1c and can serve as an important predictor of the severity of DR.