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International Eye Science—IES (Guoji Yanke Zazhi, ISSN:1672-5123) is a Chinese-English-mixed Ophthalmological publication indexed in Scopus, EMBASE, CA, IC, WPRIM of WHO, Chinese Core Journals, and China Core Periodical of Science and Technology. Its CST JCR IF in 2019 is 1.628, monthly.

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Clinical analysis of 0.05% cyclosporine eye drops combined with sodium hyaluronate in the treatment of moderate to severe dry eye associated with type 2 diabetes

shicancan, liuxinshu, chenshuwen, zhaoyingyi, yuxiaofan, wanghe, limingxin

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.
Association study of polymorphisms in Wnt signal pathway-related genes with high myopia in Chinese Han population

xiepeipei, pengjie, anguangqi, duliping

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.
Effect of Optimal pulse technology on meibomian gland morphology and function in patients with meibomian gland dysfunction

ZhouYiFan, ZhangPengFei, LiuLiFeng, HanXinHong, WangChao, LiuLiMei

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.
The expression and clinical significance of TLR4 and NF-κB in conjunctival epithelial cells and tears of patients with dry eye syndrome

liuguoying

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.
The Impact of Peripheral Blood Inflammatory Markers on Neovascular Glaucoma Secondary to Diabetic Retinopathy

Wang Mingfang, Zhu Wenwen, Xia Deyu, Xu Dengrui, Shi Yawen, Fu Hongchen, Zhao Qian, Li Xiuyun

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
CiteSpace-based Visualization and Analysis of the Knowledge Map of Traditional Chinese Medicine for Diabetic Retinopathy

Ma Xiaohua, Luo Xiangxia, Zhuang Jiayuan, Kang Li

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.
Research progress on the role of advanced glycosylation end products in ocular diseases

GONG Xiaoqi, FENG Jiaojiao, HAN Yibo, SONG Jike, BI Hongsheng

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.
Advancement on the Mechanism and Clinical Impact of Retinal Displacement after Rhegmatogenous Retinal Detachment Surgery

Li shengnan, Wang li, Yi xiaojing, Wang hua, Ren hui

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.
Research progress of foldable capsule buckle in the treatment of rhegmatogenous retinal detachment

Zhang Yingqing, Feng Meiyan

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.
A study of the correlation between serum LRG1 and FGF-21 levels and neovascular glaucoma

luozhong

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.
Study on specific imaging of choroidal melanoma cells by novel functionalized upconversion nanomaterials

Zhao Bingxin, Fu Aicun, Li Xiuhong, Wei Li, Wang Weiqun

Abstract:

Abstract ·AIM：To prepare a new functionalized upconversion nanomaterial UCNPs-PEG-Tf through an improved method and observe its specific imaging phenomenon to choroidal melanoma cells (OCM-1). ·METHODS：Prepared NaYF4:Yb/Er (Up-conversion nanoparticles, UCNPs) and did plasma treatment to carboxylate the surface; then respectively loaded amino polyethylene glycol and transferrin (Tf) to prepare UCNPs-PEG-Tf. Characterized them accordingly. Tested their biocompatibility. Detected the specific fluorescence phenomenon to OCM-1 using a fluorescence spectrophotometer and inverted fluorescence microscope. ·RESULTS：Characterization confirmed successful synthesis of UCNPs, UCNPs-PEG, and further loading of Tf to form UCNPs-PEG-Tf. UCNPs-PEG-Tf exhibited excellent biocompatibility and emitted significant green fluorescence. Under the same conditions, fluorescence intensity measurement and observations from the inverted fluorescence microscope both demonstrated its significant specificity in imaging to OCM-1 cells. ·CONCLUSION：We have synthesized a novel functionalized UCNPs-PEG-Tf nanocomposite, which can exhibit good biocompatibility and can achieve specific imaging to OCM-1 cells. ·KEYWORDS：Up-conversion nanoparticles; Plasma; Choroidal melanoma; Transferrin; Specific imaging
Comparison of myopia progression before and after discontinuation of low-concentration atropine in children wearing orthokeratology lenses

Wang Yaozeng

Abstract:

Objective: To compare the progression of myopia in children wearing orthokeratology lenses combined with low-concentration atropine before and after drug withdrawal, to determine the rebound effect of drug withdrawal in orthokeratology lens wearers, and to analyze its causes based on changes in pupil diameter. Methods: A prospective case-control study was conducted to collect 80 children with myopia who were treated with orthokeratology lenses combined with 0.01% atropine ophthalmic gel at the First Hospital of Xi'an from January 2022 to June 2022. One year later, they were divided into a drug withdrawal group (Group A, 40 cases) and a continuous medication group (Group B, 40 cases) based on whether they stopped taking the medication. The progression of myopia before and after drug withdrawal was observed by analyzing changes in axial length (AL) and spherical equivalent (SE) in Group B children within one year before and after drug withdrawal. The changes in AL, pupil diameter (PD), and SE were compared between Group A and Group B children over two years, and the correlation between PD and AL growth was analyzed. Independent sample t-test, paired t-test, and linear regression correlation analysis were performed on the data. Results: In Group A, the axial length increased by (0.16±0.21) mm and (0.29±0.18) mm at 0.5 and 1 year after drug withdrawal, respectively, which were both greater than before drug withdrawal (t=3.651, 2.983, P<0.001). There was no statistically significant difference in SE growth between the two time points (t=5.479, P>0.05). There were no statistically significant differences in AL, PD, and SE changes between Group A and Group B at baseline, 0.5 years, and 1 year during combined medication. At 1.5 years, the increase in AL in Group A was greater than that in Group B [(0.16±0.21) mm vs. (0.11±0.14) mm, t=4.803, P<0.001], and the PD was smaller than that in Group A [(3.67±2.19) mm vs. (4.53±1.72) mm, t=-5.946, P<0.001]. At 2 years, the increase in AL in Group A was greater than that in Group B [(0.27±0.18) mm vs. (0.17±0.14) mm, t=2.706, P=0.016<0.05], and the PD was smaller than that in Group B [(3.78±2.60) mm vs. (4.42±2.07) mm, t=-3.493, P<0.001]. There was no statistically significant difference in SE changes between the two groups (t=7.416, P>0.05). Correlation analysis at 0.5-year and 1-year follow-ups over two years showed a negative correlation between PD and AL progression (R = -0.156, R= -0.190, P<0.001). Conclusion: After stopping low-concentration atropine in children wearing orthokeratology lenses, AL increased more rapidly than before drug withdrawal, PD decreased, and SE changed little. Compared with continuous medication, discontinuation of medication led to faster progression of axial length with little change in diopter, and the larger the pupil diameter during orthokeratology lens wear, the slower the progression of axial length.
Effect of Qi Jing Mingmu decoction combined with artificial tears on Th17 related cytokines in tears of conjunctivochalasis with Liver-kidney Yin deficiency type

Yong-Yi Sha, Yi Zhao, Shao-Hua Tu, Xue-Qing Kong, Cheng-Long Yi, Ni-Xia Tao, Min-Hong Xiang

Abstract:

AIM: To observe the changes of Th17-related cytokines in tears of patients with Liver-kidney Yin deficiency type conjunctivochalasis（CCH）treated with traditional Chinese medicine Qi Jing Mingmu decoction combined with artificial tears. METHODS: 56 cases of 56 eyes CCH patients with Liver-kidney Yin deficiency type CCH of grade Ⅱ to Ⅲ were collected and randomly divided into treatment group (treated with Qi Jing Mingmu decoction combined with artificial tears) of 26 patients (26 eyes) and the control group (purely treated with artificial tears) of 30 cases (30 eyes). The treatment course was one month, and international ocular surface disease index (OSDI), tear film break-up time (BUT), tear meniscus height (TMH) and conjunctival congestion index of the patients were observed before and after treatment. The patients' tears were collected before and after treatment, and Th17-related cytokines in tears were detected by flow cytometry immunofluorescence luminescence method. All the results were statistically analyzed by SPSS. RESULTS: After one month of treatment, the OSDI, BUT and conjunctival congestion index of CCH patients in the treatment group and control group were significantly improved compared to before treatment, and the differences were statistically significant (all p < 0.05). After one month treatment, the TMH of CCH patients in the treatment group was significantly reduced compared to before treatment (p <0.05), while there was no statistically significant difference in TMH of the control group before and after treatment (p =0.41). After one month treatment, the expression levels of Th17-related cytokines IL-17A, IL-17F, IL-6, IL-22, TNF-α, IFN-γ and IL-1β in tears of CCH patients in the treatment group were significantly decreased compared to before treatment (all p < 0.05), while the expression levels of Th17-related cytokines in tears of control group were not statistically significant (all p > 0.05). CONCLUSION: Qi Jing Mingmu decoction combined with artificial tears can effectively improve the ocular surface microenvironment, enhance tear film stability, and inhibit ocular surface inflammation in CCH patients with Liver-kidney Yin deficiency type. This may be related to its reduction in the secretion of Th17-related cytokines in tears. KEYWORDS: conjunctivochalasis; Liver-kidney Yin deficiency type; Qi Jing Mingmu decoction; Th17; IL-17
The clinical diagnostic value of 18 MHz color Doppler ultrasonography for epimacular membrane

ZHAO Jun

Abstract:

Objective: Exploring the Diagnostic Value of 18 MHz Color Doppler Ultrasound in the Premacular Membrane. Methods: From January 2020 to January 2022, 44 patients (80 eyes) with suspected cataract and vitreous opacity underwent fundus examination in our hospital were collected. The affected eyes were examined using OCT and 18 MHz color Doppler ultrasound, respectively. The differences in sensitivity, specificity, and accuracy between 18 MHz color Doppler ultrasound and OCT in the diagnosis of macular membrane were compared. Results: 80 eyes were examined by 18MHz color Doppler ultrasound in 62 patients with macular membrane, 18 patients with non macular membrane, 54 patients with macular membrane confirmed by OCT, and 13 patients with non macular membrane. The consistency between 18 MHz color Doppler ultrasound and OCT diagnosis was high (Kappa=0.892, P<0.05); The sensitivity and specificity of 18 MHz color Doppler ultrasound in detecting the macular membrane were 91.52%, 61.90%, 8.47%, 38.09%, and 83.75%, respectively; Compared with OCT detection, the specificity, accuracy, positive prediction accuracy, and negative prediction accuracy of 18 MHz color Doppler ultrasound detection decreased, while the misdiagnosis rate increased (P<0.05). There was no statistically significant difference in diagnostic sensitivity and missed diagnosis rate (P>0.05). Conclusion: 18MHz color Doppler ultrasound has a certain value in identifying macular epidermal lesions, and it is consistent with the OCT test.
Role and Research Progress of Gut Microbiota in Uveitis

lin ying cheng, hu qiu ming, zhou ming, liu jin qing

Abstract:

Uveitis is a blinding inflammatory disease involving multiple structures of the eye, posing a severe threat to patients" vision and psychological well-being.Currently,treatments for uveitis primarily consist of glucocorticoids and immunosuppressants,which are plagued by side effects,frequent recurrence and high costs.Recent research also indicates that dysbiosis of gut microbiota may plays a role in the development of uveitis by the gut-eye axis, with related metabolites exerting significant effects on disease progression.The modulation of gut microbiota or related metabolites may represent a novel approach for treating uveitis. The associations between gut microbiota and various types of uveitis-related diseases,as well as the research progress in utilizing gut microbiota for uveitis treatment are reviewed.Aiming to promote the development of new therapies targeting uveitis-specific microbial communities and related genetic markers, thus advancing precision medicine.
Research hotspot and evolution trend analysis of ocular surface flora based on bibliometrics

yangyang, zhang ting, li shuangle, cao wenhzai

Abstract:

Background In recent years, the ocular surface microflora has garnered significant interest from researchers worldwide.Although China's foray into this domain has been relatively late, it is crucial to leverage the findings of international studies to foster advancements in the field of ocular surface microbiology. Such insights are instrumental in propelling the development of related disciplines and enhancing our understanding of the complex interactions within the ocular microenvironment. Objective Using bibliometric methods, we analyze the current state, research hotspots, and development trends of ocular surface microbiota studies internationally Methods Leveraging the Web of Science database, we conducted a targeted literature search on ocular surface flora. The retrieved data were meticulously screened and weighted to enhance relevance. Our bibliometric analysis delved into publication trends, authorship patterns, institutional collaborations, and pivotal research themes. Employing CiteSpace software, we visually dissected the landscape of institutional and national partnerships, citation impact, keyword co-occurrences, keyword clustering dynamics, and the emergence of new research trends. Results A total of 3,884 publications were ultimately included, with an overall upward trend in the number of publications in the field of ocular surface microbiota from 2003 to 2023, with the most rapid growth occurring from 2019 to 2023. The top three regions/countries by publication volume are the United States (1,039 papers), China (570 papers), and India (302 papers). The top three authors by publication volume are Willcox, Mark (48 papers), Sharma, Savitri (33 papers), and Fleiszig, Suzanne M.J (27 papers). The top three institutions by publication volume, all from the United States, are the University of California (109 papers), L. V. Prasad Eye Institute (79 papers), and Harvard University (73 papers). The citation network map of the literature includes 801 nodes and 1,508 connections, with the most frequently cited document being "Temporal Stability and Composition of the Ocular Surface Microbiome." The top 5 keywords by frequency of occurrence are, in order, "keratitis," "bacterial flora," "identification," "inflammation," and "endophthalmitis." The keyword clustering analysis yielded a total of 8 clusters, which are specifically reflected in three aspects: ocular-related diseases, the relationship between ocular surface microbiota and ocular surface structures, and detection methods for ocular surface microbiota. The keyword with the highest burst strength is "ciprofloxacin." Keywords that have emerged in recent years and continue to the present include "diversity," "gut microbiome," and "ocular surface microbiome." Conclusion Currently, the study of ocular surface microflora is gaining momentum globally, with a particular focus on the diversity of microflora, the composition of the core microbiome, and its impact on ocular diseases. In the future, research should concentrate on elucidating the functional metabolism of the ocular surface microflora and further investigate the causality and mechanisms by which changes in the ocular surface microflora are related to diseases.
Review of the ocular manifestations that related to gout and hyperuricemia

Xiu-Ying Jiang, Hu-Cheng Duan

Abstract:

Gout is a systemic inflammatory disease and one of the most common forms of arthritis worldwide. Hyperuricemia is the leading risk factor for gout, with a high incidence rate. Gout etiology involves the deposition of urate crystals, secondary inflammation, and oxidative stress. These inflammatory and oxidative activities contribute to the pathophysiology of a variety of ocular disorders. Numerous studies have found a correlation between gout and hyperuricemia and ocular diseases, such as direct urate crystal deposition in ocular structures, dry eye syndrome, corneal endothelial damage, scleritis and uveitis, glaucoma, age-related macular degeneration, diabetic retinopathy, and certain metabolic diseases like thyroid-related eye diseases. Furthermore, because of its antioxidant effect, uric acid levels have been linked to a variety of neuropathies, including multiple sclerosis-related optic neuritis and neuromyelitis optica. Although the correlation between uric acid levels and ocular diseases has been reported, many aspects remain unresolved. To gain a more thorough understanding of the association between gout, hyperuricemia, and ocular illnesses, this review will delve into their pathophysiology and disease characteristics, aiming to increase knowledge about gout and hyperuricemia and serving as a reference for future studies.
Research progress on the effects of different myopia prevention and control methods on choroid

zhangshangzhu, wangjiawei, xiruijie, chaisong

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In recent years, there has been a significant surge in the prevalence of myopia at younger ages in China.Numerous studies have investigated methods for preventing and controlling myopia, including orthokeratology, low-concentration atropine eye drops, light therapy, posterior scleral reinforcement, and traditional Chinese medicine. These approaches can modulate choroidal thickness, blood flow, and target various molecular mechanisms. Orthokeratology and low-concentration atropine demonstrate a thickening effect on the choroid and regulate choroidal blood flow.However,further large-scale studies are necessary to explore their long-term effects on the choroid.The ues of multi-point defocus control lenses also shows promise in thickening the choroid but requires additional research to understand its impact on choroidal blood flow. The influence of light and light feeding therapy on myopia prevention and control is also reflected in the choroidal thickness and blood flow.Nevertheless, more research is needed to assess their safety and potential side effects.Nowadays,traditional Chinese medicine has shown good prospect in influencing the microstructure of the choroid for myopia prevention and control,further investigation into the changes within choroidal molecular biology is essential for exploring. This article provides an overview of various methods used to regulate the choroid and prevent myopia.The mechanisms by which these interventions act on the choroid are described to provide new insights and identity novel clinical strategies for myopia management.
The era of artificial intelligence: Thinking about the key issues in the development of intelligent ophthalmology

yangweihua, xuyanwu, chiwei

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The rapid development of intelligent ophthalmology research in recent years still faces some challenges in its clinical application or clinical translation process. Two important issues that urgently need to be addressed in the development of intelligent ophthalmology are: promoting clinical application and maintaining medical equity. In response to the aforementioned issues, this article analyzes the reasons and current situation of the insufficient promotion of clinical application and the potential challenges of medical equity, and proposes that promoting clinical application and maintaining medical equity are key issues in the development of intelligent ophthalmology. At the same time, it systematically proposes corresponding specific measures to promote the development of intelligent ophthalmology.

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Virtual reality technology in ocular trauma teaching for medical students

Zheng Chao, Ma Jiyuan, Zhang Guoheng, Fei Fei, Sun Jiaxing, Zhang Shuai, Zhou Jian, Dou Guorui

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AIM：To explore the application effect of Virtual Reality (VR) technology in the teaching of ocular trauma for medical students. METHODS：In this study, 90 medical students who participated in the teaching practice of Ophthalmology between November 2022 and April 2024 were included as trainee subjects. Using a test-control method, 45 students in the test group participated in traditional classroom ocular trauma theory lectures combined with VR virtual simulation experiments, and 45 students in the control group participated in traditional classroom ocular trauma theory lectures only. After the teaching practice, the two groups were compared in terms of their theoretical assessment scores, learning ability (Self-Directed Learning Rating Scale evaluated), questionnaire surveys on satisfaction with the quality of teaching, and statistical analyses using t-test or chi-square test. RESULTS：The theoretical knowledge and case analysis scores of the trainees in the test group were significantly higher than those of the control group, and the differences were statistically significant [theoretical knowledge scores, (57.27±2.78) versus (53.91±3.20), and case analysis scores, (35.71±3.73) versus (32.67±5.52), both P<0.05]. The self-directed learning scale scores of the participants in the test group were higher than those of the control group (P<0.05), and the satisfaction with teaching quality of the participants in the test group was higher than that of the control group (P<0.05). CONCLUSION：VR-enabled teaching of ocular trauma can effectively improve medical students" mastery of basic knowledge and practical skills, enhance students" self-directed learning ability and improve teaching satisfaction.

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Clinical analysis of 112 cases of giant papillary conjunctivitis in contact lenses wearers

Rui-Bo Zhao, Jian-Jun Li

Abstract: (17197) HTML (0) PDF (225.96 KKB) (1687)

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AIM:To investigate giant papillary conjunctivitis patients who can not be divorced from contact lenses change to frequent replacement type contact lenses and rigid gas permeable contact lenses and observe the condition of giant papillary conjunctivitis with or without changes.And to investigate the efficacy of desensitizing agents at the same time.METHODS:Totally 112 cases(208 eyes) who were diagnosed with giant papillary conjunctivitis in our center were randomly divided into four groups:Group 1(Ⅰ group) of 68 eyes were treated with frequent replacement type contact lenses combined with mingmuqing eye drops;Group 2(Ⅱ group)of 56 eyes were treated with frequent replacement type contact lenses combined with desensitizer eye drops;Group 3(Ⅲ group) of 52 eyes were treated with rigid gas permeable contact lenses combined with mingmuqing eye drops;Group 4(Ⅳ group)of 32 eyes were treated with rigid gas permeable contact lenses combined with desensitizer eye drops.RESULTS:Condition of giant papillary conjunctivitis patients in all the 4 groups were significantly improved,data of 4 groups were no statistically significant difference(P>0.05).CONCLUSION:The giant papillary conjunctivitis caused by contact lenses wearing can get effective control and cure of the disease without affecting wearing of contact lenses if the replacement of rigid gas permeable contact lenses or frequent replacement type contact lenses can be introduced timely.
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Effect of anti-vascular endothelial growth factor therapy on intraocular inflammatory cytokine levels in the treatment of proliferative diabetic retinopathy

Jin-Xiu Luo, Zi-Zhong Hu, Qing-Huai Liu, Yuan Fang

Abstract: (16673) HTML (0) PDF (537.47 KKB) (1229)

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AIM: To explore the effects of anti-vascular endothelial growth factor(VEGF)agents(Conbercept)before pars plana vitrectomy(PPV)on inflammatory cytokine levels of patients with proliferative diabetic retinopathy(PDR).
METHODS: A total of 49 patients(49 eyes)who diagnosed with PDR at the First Affiliated Hospital with Nanjing Medical University from June 2017 to January 2018 were recruited and randomly divided into two groups. A total of 25 cases(25 eyes)who did not receive intravitreal injection before PPV were included in no-intravitreal injection of Conbercept(IVC)group, and 24 cases(24 eyes)who received IVC 5～7d before PPV were included in IVC group. The vitreous samples were collected from all the patients at the start of PPV. Levels of VEGF-A, monocyte chemotactic protein-1(MCP-1)and inflammatory cytokines in the vitreous humor were measured using Luminex technology.
RESULTS: Compared with the no-IVC group, the level of VEGF-A decreased significantly(P<0.001), the concentration of IL-6(P=0.004), IL-8(P=0.002), IL-18(P=0.04)and TNF-α(P=0.03)increased remarkably in the IVC group. The other inflammatory cytokines in the vitreous humor showed no significant difference between the IVC and no-IVC groups.
CONCLUSION: IVC before PPV can effectively decrease the concentration of VEGF-A, but had limited influence on the level of inflammatory cytokines in the vitreous humor of patients with PDR.
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Selection of intraocular lens calculation formula for cataract surgery in glaucoma patients

He-Lin Zhu, Jian Zhang, Hong Yan

Abstract: (15363) HTML (0) PDF (465.56 KKB) (1182)

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Glaucoma and cataracts are the leading causes of blindness, and surgery is an important treatment option. Patients with glaucoma have clinical characteristics such as high intraocular pressure, shallow anterior chamber and short axial length, and the ocular structure is often altered after anti-glaucoma surgery like trabeculectomy. These changes also lead to differences in the accuracy of intraocular lens(IOL)refractive calculation between cataract surgery after anti-glaucoma surgery or combined glaucoma and cataract surgery and alone cataract surgery. Meanwhile glaucoma patients' individual clinical characteristics and structural changes caused by anti-glaucoma surgery have shown differences in the impact on the predictive accuracy of IOL diopters and the type of refractive drift. This article reviews the latest research advances in the causes of refractive error(RE), the characteristics of refractive drift, and the selection of the most appropriate IOL formula for glaucoma patients undergoing cataract surgery or cataract surgery after anti-glaucoma surgery or combined glaucoma and cataract surgery.
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Current situation and prospect of minimally invasive glaucoma surgery in childhood glaucoma

Xiao-Jie Zhou, Ren-Yi Wu

Abstract: (12790) HTML (0) PDF (480.93 KKB) (1509)

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Childhood glaucoma is a kind of refractory glaucoma. Minimally invasive glaucoma surgery(MIGS)provides a safe and effective treatment option for childhood glaucoma. Most of the published studies tend to be with circumferential ab interno trabeculotomy, showing that its safety and effectiveness in the treatment of childhood glaucoma are comparable to non-MIGS circumferential ab externo trabeculotomy. Studies on KDB, trabectome and Xen-gel stent are relatively limited, but they may have advantages in some specific cases. While considering the advantages of each MIGs operation, it is also necessary to weigh the long-term effect of each operation method. In addition, more prospective and comparative researches, larger sample size and longer follow-up time are needed to verify the safety and effectiveness of MIGs in the treatment of childhood glaucoma.
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Clinical efficacy of femtosecond laser-assisted cataract surgery combined with PanOptix trifocal intraocular lens implantation

Lei Guo, Xian-Jun Liang, Xi-Qiao Zhang, Yan-Xue Xu, Ying-Jie Lin

Abstract: (12731) HTML (0) PDF (551.33 KKB) (1182)

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AIM: To evaluate the clinical efficacy of femtosecond laser-assisted cataract surgery combined with PanOptix trifocal intraocular lens implantation.
METHODS:The retrospective study enrolled 22 cases(26 eyes)of cataract patients who underwent femtosecond laser-assisted cataract surgery combined with PanOptix trifocal intraocular lens implantation from August 2020 to August 2021. Follow-up to 3mo after surgery, the changes of far, intermediate and near visual acuity, aberration, Strehl ratio(SR)and modulation transfer function cutoff(MTF-cutoff)frequency were compared. Defocus curve at 1mo postoperatively was made, and the visual quality and satisfaction were evaluated after 3mo of surgery.
RESULTS: The visual acuity of all patients was better than 0.1(LogMAR)at the far, intermediate and near distance at 1d, 1wk, 1 and 3mo postoperatively, and it was significantly improved compared with those before surgery(all P<0.01). The defocus curve transitioned smoothly between +0.5 and -3.0D at 1mo after surgery, and visual acuity was better than 0.63. The total aberration and spherical aberration in the whole eye were significantly lower after surgery than before, and the SR and MTF-cutoff were significantly improved at 1d and 1wk after surgery(all P<0.05). With high satisfaction and good visual quality, patients could watch at far, intermediate and near distance without wearing glasses at 3mo after surgery.
CONCLUSION: Femtosecond laser-assisted cataract surgery combined with PanOptix trifocal intraocular lens implantation gave patients a comfortable and satisfactory full-course vision.
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Pars plana vitrectomy combined with inverted internal limiting membrane flap technique for treating macular hole retinal detachment in high myopia

Wen-Kui Zhu, Wen-Shuai Li, Pei-Shan Xu

Abstract: (12098) HTML (0) PDF (435.98 KKB) (1159)

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AIM: To investigate the clinical efficacy of pars plana vitrectomy(PPV)combined with inverted internal limiting membrane flap technique in the treatment of macular hole retinal detachment(MHRD)in high myopia.
METHODS: A retrospective clinical study was conducted. A total of 63 patients(64 eyes)with high myopia and MHRD who treated at our hospital from October 2017 to October 2021 were selected as research subjects. They were divided into two groups according to different surgery, with 34 cases(35 eyes)who received PPV combined with inverted internal limiting membrane flap technique in group A, and 29 cases(29 eyes)received PPV combined with internal limiting membrane peeling in group B. The patients were followed up for 6mo. The two groups were compared in terms of the hole closure rate, the reduction rate of retinal detachment and best corrected visual acuity(BCVA)before operation and at 1wk, 1, 3 and 6mo after operation, and the postoperative complications were recorded.
RESULTS: The hole closure rate within 6mo after operation was significantly higher in group A than in group B(P<0.05), but there was no statistically significant difference in the reduction rate of retinal detachment(P>0.05). The BCVA of the two groups was significantly improved over time after operation(P<0.05). There was no statistically significant difference in BCVA between the two groups before operation and at 1wk, 1, 3 and 6mo after operation(P>0.05). Complications were observed in the two groups, but there was no statistically significant difference in the incidence of complications between the two groups(P<0.05).
CONCLUSION: PPV combined with inverted internal limiting membrane flap technique is safe and effective in the treatment of MHRD in high myopia, which can effectively improve the patients' BCVA and the hole closure rate without influence on intraocular pressure.
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Risk factors associated with neovascular glaucoma after vitrectomy for proliferative diabetic retinopathy

Xue Zu, Guang-Zheng Dai, Tie-Zhu Lin

Abstract: (11871) HTML (0) PDF (1.96 MKB) (1167)

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AIM: To investigate the risk factors associated with neovascular glaucoma(NVG)after pars plana vitrectomy(PPV)for proliferative diabetic retinopathy(PDR).
METHODS: The PDR patients who received 23G PPV treatment at Shenyang He Eye Specialist Hospital from October 2015 to September 2020 and were followed up for at least 12mo with complete data were retrospectively collected. The patients were divided into two groups according to the occurrence of NVG during follow-up. The preoperative and intraoperative variables between two groups were compared. The cumulative hazard ratio for NVG was evaluated.
RESULTS: A total of 151 PDR patients(169 eyes)with a mean follow-up of 18.07±12.55(1～79)mo were included, of which 30(17.8%)eyes developed NVG, the mean time of occurrence was 6.27±4.01(1～17)mo, and 50%(15 eyes)of NVG occurred within 5mo after vitrectomy. The cumulative hazard ratios of NVG at postoperative 3, 6 and 12mo were 4.8%, 12.6% and 18.1%, respectively. Multivariate logistic regression analysis showed that preoperative best corrected visual acuity(OR=3.077, 95%CI: 1.203～7.869, P=0.019), preoperative iris rubeosis(OR=7.897, 95%CI: 1.313～47.498, P=0.024), and contralateral NVG(OR=22.108, 95%CI: 1.562～312.861, P=0.022)were risk factors with the occurrence of NVG, while the number of intraoperative retinal laser photocoagulation(OR=0.772, 95%CI: 0.666～0.893, P=0.001)was the protective factor with the occurrence of NVG.
CONCLUSIONS: The incidence of NVG in PDR eyes after PPV was 17.8%, of which 50% occurred within 5mo after surgery. PDR eyes with poor baseline visual acuity, iris rubeosis, and contralateral NVG are prone to postoperative NVG, and sufficient intraoperative retinal laser photocoagulation has a certain protective effect. PDR eyes after PPV should be closely followed up for 1a.
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Expression of CTRP9 in serum of patients with diabetic retinopathy and diabetic macular edema

Hai-Xia Jing, Shu Zhang, Hui-Ling Bai, Qin Liu, Xiao-Yan Zhu

Abstract: (11775) HTML (0) PDF (498.90 KKB) (1249)

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AIM: To investigate the expression and correlation of C1q/tumor necrosis factor related protein 9(CTRP9)levels in the serum of patients with different stages of diabetic retinopathy(DR)and diabetic macular edema(DME).METHODS: A total of 135 patients with type 2 diabetes who were admitted to Gansu Provincial Hospital from April 2021 to April 2022 were selected as the experimental group. According to the results of non-mydriatic fundus photography, they were divided into non-DR(NDR)group(n=45), non-proliferative DR(NPDR)group(n=45), proliferative DR(PDR)group(n=45); according to the results of optical coherence tomography, DR patients were divided into DME group(n=51), non-DME group(n=39). In addition, other 45 healthy subjects who matched the age and sex of the experimental group were selected as normal control group. The clinical data and biochemical index test results of subjects in each group were recorded and compared, the correlation between serum CTRP9 level and other biochemical indexes was analyzed, and the risk factors affecting the occurrence of DR and DME were explored.RESULTS: There were significant differences in serum CTRP9 levels among subjects in normal control group, NDR group, NPDR group and PDR group(P&#x003C;0.001), and normal control group &#x003E; NDR group &#x003E; NPDR group &#x003E; PDR group. There was significant difference in serum CTRP9 level between DME group and non-DME group(P&#x003C;0.001), and non-DME group &#x003E; DME group. Spearman rank correlation analysis showed that the level of serum CTRP9 in DR patients was negatively correlated with the course of diabetes(rs=-0.251, P&#x003C;0.05), the level of serum CTRP9 in DME patients was negatively correlated with fasting blood glucose(FBG)(rs=-0.370, P&#x003C;0.05)and glycosylated hemoglobin(HbA1c)(rs=-0.421, P&#x003C;0.05). Logistic multivariate regression analysis showed that the course of diabetes(OR=1.194, 95%CI: 1.068～1.335,P=0.002)and the level of serum CTRP9(OR=0.936, 95%CI: 0.907～0.966,P&#x003C;0.001)were risk factors for DR. The level of serum CTRP9 was a risk factor affecting the occurrence of DME(OR=0.838, 95%CI: 0.778～0.903, P&#x003C;0.001).CONCLUSION: The reduction of CTRP9 level is a risk factor for the occurrence of DR and DME, which may be of great significance to the risk assessment of both DR and DME.
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Surgery management and progress of familial exudative vitreoretinopathy associated retinal detachment

Zi-Wei Zhao, Jie Peng, Pei-Quan Zhao

Abstract: (11127) HTML (0) PDF (475.18 KKB) (1306)

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Familial exudative vitreoretinopathy(FEVR)is a hereditary disorder of retinal angiogenesis, of which the most typical clinical feature is the peripheral avascular area. The progression of the disease can lead to retinal detachment(RD), followed by secondary complications such as cataracts, glaucoma, corneal opacification, and even bulbi phthisis. As one of the main reasons for the RD in Asian children and juvenile, FEVR-associated retinal detachment(FEVR-RD)is mainly treated by surgery, including pars plana vitrectomy, scleral bucking, and combined with retinal photocoagulation or anti-vascular endothelial grouth factor(VEGF)sometimes. The surgery of FEVR-RD requires careful pre/intra-operative evaluation to determine the best surgical procedure and its outcome, including the nature of the affected eye, the stage, the fibrosis of fiber proliferation and the anterior complications, and the anatomy and prognosis of eyes in different stages vary greatly. Adult patients with rhegmatogenous RD have a higher rate of post-operative retina reattachment compared to young patients with tractional RD. In young or advanced patients, surgery is difficult and the prognosis is less optimistic, thus the surgery strategy is controversial. This article reviews the surgical outcomes and progress of FEVR-associated RD.
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Femtosecond laser-assisted cataract phacoemulsification combined with Toric intraocular lenses implantation in correction of high myopia cataract and corneal astigmatism

Wei Fan, Guang-Bin Zhang

Abstract: (9940) HTML (0) PDF (433.14 KKB) (1072)

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AIM: To measure the indexes including postoperative distance, middle, near visual acuity and near stereopsis vision of patients with high myopia cataract and corneal astigmatism by femtosecond laser, which can quantify the diameter of capsulorhexis opening, and to evaluate the availability and necessity of Toric intraocular lenses(IOL)in high myopia.
METHODS: Prospective case-control study. Patients with binocular high myopia cataract and corneal astigmatism who undergone femtosecond laser-assisted cataract surgery in our hospital were selected, and they were divided into two groups, with 20 cases(40 eyes)in group A(Toric IOL)and 20 cases(40 eyes)in group B(IQ IOL). Indexes, including preoperative corneal astigmatism and spherical equivalent and best-corrected distance visual acuity, uncorrected middle visual acuity, uncorrected near visual acuity, residual refractive astigmatism, near stereopsis acuity, total high-order aberration and total spherical aberration, were measured postoperatively at 7d, 1 and 3mo.
RESULTS: The uncorrected middle and near visual acuity, Titmus near stereopsis acuity and residual astigmatism at 7d, 1 and 3mo after surgery were significantly improved in the Toric IOL group than the non-Toric group(all P<0.05). The dependence on glasses was reduced. The postoperative best-corrected distance visual acuity, total high-order aberration and total spherical aberration of the two groups showed no statistically significant differences(all P>0.05).
CONCLUSIONS: The implantation of Toric IOL in patients with high myopia cataract and corneal astigmatism can effectively correct corneal astigmatism, improve postoperative uncorrected middle and near visual acuity and near stereopsis visual function, reduce postoperative dependence on glasses and enhance binocular stereopsis visual function.
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Application value of new assistive technology in keratopathy-associated cataract surgery

Zhen-Bo Zhao, Li-Wei Ma, Kai-Li Tang, Yu-Xi Ding, Dong Han, Jing Wang

Abstract: (9726) HTML (0) PDF (493.57 KKB) (1511)

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Keratopathy-associated cataract, that is, on the basis of corneal disease, and later the development of lens opacity, seriously damage visual quality. In order to avoid corneal transplantation for some patients, partial visual quality can be restored. A comprehensive and accurate evaluation of the effect of corneal opacity on visual function is of great improtance for determining cataract surgery alone. Due to the opacity of the cornea, the operation is very difficult and challenging. Therefore, it is of clinical value to develop and use new assistive technologies, including capsule staining, endoillumination, pupil dialation technology, femtosecond laser assisted technology, etc., avoiding problems such as limited visibility and decreased light flow caused by corneal opacity and facilitating cataract surgery. This article reviews progress of assistive technologies for keratopathy-associated cataract, hoping to guide clinical application.
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Research progress on optical coherence tomography imaging indicators of macular edema secondary to retinal vein occlusion

Mei Sun, Xiao-Feng Hao, Li-Ke Xie, Qi Jin

Abstract: (8802) HTML (0) PDF (470.25 KKB) (1304)

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Retinal vein occlusion(RVO)is the second most common cause of visual loss classified under retinal vascular disorders after diabetic retinopathy, and its complication, macular edema(ME), is the leading cause of vision loss. Currently, the first-line treatment for RVO-ME is the intravitreal injection of anti-vascular endothelial growth factor drugs, which can improve retinal morphology and patients' vision. Optical coherence tomography(OCT)can clearly image retinal structures, and some specific imaging features found by OCT have become biomarkers for evaluating the prognosis of RVO patients. The recent findings of biomarkers are reviewed, such as central retinal thickness, choroidal thickness, disorganization of retinal inner layers, hyperreflective foci, integrity of external limiting membrane and ellipsoid zone, central macular volume, prominent middle limiting membrane, paracentral acute middle maculopathy, highly reflective line, to provide references for selecting the best treatment for RVO.
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Recent advances in treatment of retinitis pigmentosa

Ming Ai, Ming Sun, Dai Li

Abstract: (8711) HTML (0) PDF (412.02 KKB) (1738)

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Retinitis pigmentosa(RP) is a group of inherited retinal disorders characterized by the progressive photoreceptor and pigment epithelial cells dysfunction.It is the common cause of blindness in the whole worldwide.Until now it is not clear about its exact pathogenesis and etiology,so effective treatments are still little.This paper looks back on lots of the recent domestic and abroad related documents,eapecially abroad,and then reviews research advances in treatment of RP.
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Applicability comparison between Chinese dry eye questionnaire and ocular surface disease index questionnaire among college students

Ruo-Jun Geng, Jing-Jing Wei, Kai-Li Yang, Shao-Pei Wang, Sheng-Wei Ren

Abstract: (8645) HTML (0) PDF (1.17 MKB) (1530)

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AIM: To evaluate the applicability of Chinese dry eye questionnaire in college students using the ocular surface disease index(OSDI)questionnaire as a reference.
METHODS: Cross-sectional study. A total of 711 college students from Nanyang Medical College were enrolled in the study and assessed for dry eye condition using OSDI questionnaire and Chinese dry eye questionnaire. The response rate of each question in the two questionnaires was counted. Cronbach α was calculated to evaluate the internal consistency of both questionnaires. Correlation between the total scores of the two questionnaires was analyzed to evaluate the criterion validity. Based on OSDI scores, the discriminant validity of Chinese dry eye questionnaire was evaluated; receiver operating characteristic(ROC)curves was plotted for Chinese dry eye questionnaire scores, area under the ROC curve(AUC)was calculated, and diagnostic thresholds and corresponding sensitivity and specificity were also analyzed.
RESULT: The response rates of the 12 questions on the OSDI questionnaire were 33.2%-100.0%, while it was 100.0% for each question on the Chinese dry eye questionnaire. The Cronbach α values of OSDI questionnaire and Chinese dry eye questionnaire were 0.905 and 0.789, respectively. The Chinese dry eye questionnaire score was positively correlated with the OSDI score(r_s=0.712, P<0.001). According to OSDI questionnaire scores, dry eye severity was divided into normal group, mild dry eye group, moderate dry eye group and severe dry eye group. The scores of Chinese dry eye questionnaire in these groups were 4.00(2.00, 6.00), 9.00(7.00, 11.00), 12.00(9.00, 14.00)and 16.00(13.50, 22.00), respectively, which increased with the severity of dry eye, and the overall difference was statistically significant(P<0.001), as well as pairwise comparison between groups(P<0.05). The AUCs of Chinese dry eye questionnaire in distinguishing normal population from dry eye population, mild dry eye from moderate dry eye, moderate dry eye from severe dry eye were 0.862, 0.661 and 0.769, respectively, and the diagnostic thresholds were 6.5, 11.5 and 14.5, respectively.
CONCLUSION:Chinese dry eye questionnaire has an equivalent reliability, validity, discriminant ability and better response rate for dry eye screening and epidemiological survey among college students in China compared with OSDI questionnaire.
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Diquafosol sodium combined with intense pulsed light in the treatment of meibomian gland dysfunction dry eye after corneal refractive surgery

Mei-Mei Zhang, Shen Wang, Jing Zhang, Chen Li, Shan-Shan Ge, Jia Yu, Yue-Hua Zhou

Abstract: (8638) HTML (0) PDF (1.47 MKB) (1416)

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AIM: To observe the therapeutic effect of the diquafosol sodium combined with intense pulsed light(IPL)on meibomian gland dysfunction(MGD)dry eye after refractive surgery.
METHODS:A total of 64 patients(128 eyes)with MGD dry eye diagnosed within 6mo after laser corneal refractive surgery in our hospital from March 2021 to December 2021 were selected. They were randomly divided into control group and experimental group. A total of 33 patients(66 eyes)in the control group were treated with sodium hyaluronate combined with IPL, and 31 patients(62 eyes)in the experimental group were treated with diquafosol sodium combined with IPL. Ocular symptom scores were performed before each IPL treatment in both groups to examine non-invasive tear breakup time(NIBUT), tear meniscus height, lipid layer grade of tear film, meibomian gland deletion rate and uncorrected visual acuity.
RESULTS:After IPL treatment, ocular symptom scores and meibomian gland deletion rate score of two groups were decreased continuously. NIBUT, tear meniscus height and lipid layer grade of tear film were increased continuously, and there was no significant change in uncorrected visual acuity. NIBUT of patients in the experimental group was better than that in the control group before the third IPL treatment(6.24±0.27s vs. 5.51±0.24s, P=0.046).
CONCLUSIONS:Both diquafosol sodium and sodium hyaluronate combined with IPL showed good therapeutic effect on MGD dry eye, but there was no significant difference in the short-term efficacy between the two groups.
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Relationship among fasting plasma glacose coefficient of variation and macular morphology and microcirculation in patients with nonproliferative diabetic retinopathy

Shu-Ying Fu, Yan-Min Dong

Abstract: (8625) HTML (0) PDF (1.78 MKB) (1106)

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AIM: To investigate the relationship among the fasting plasma glucose coefficient of variation(FPG-CV)and macular morphology and microcirculation in patients with nonproliferative diabetic retinopathy(NPDR).
METHODS: A retrospective analysis of 82 cases(82 eyes)with NPDR admitted to our hospital from February 2018 to June 2022 was the research object, and another 82 cases(82 eyes)of non-diabetic retinopathy(NDR)patients during the same period were selected as the control group, and the clinical data of the two groups of patients were analyzed. Multivariate Logistic regression was used to analyze the risk factors affecting the incidence of NPDR, and the back propagation(BP)neural network model was established and evaluated. Pearson correlation was used to analyze the correlation among FPG-CV and macular morphology and microcirculation in patients.
RESULTS: The results of multivariate Logistic regression analysis showed that the disease duration ≥7.2a, glycated hemoglobin A1c(HbA1c)≥7.7%, triglyceride(TG)≥1.9 mmol/L, microalbuminuria(MALB)≥24.5 mg/L, FPG-CV ≥9.8%, superficial capillary plexus-vessel density(SCP-VD)<27.6%, deep capillary plexus-vessel density(DCP-VD)<47.7%, foveal avascular zone(FAZ)area ≥0.38 mm², central retinal thickness(CRT)≥197.7 μm and subfoveal choroidal thickness(SFCT)<227.7 μm were risk factors for NPDR(P<0.05). The number of hidden layer nodes is 5, and the receiver operating characteristic(ROC)curve, calibration curve and clinical decision curve show that the prediction model has good discrimination, accuracy and validity. The results of Pearson correlation analysis showed that FPG-CV was negatively correlated with SCP-VD, DCP-VD and SFCT(P<0.05); FPG-CV was positively correlated with FAZ area and CRT(P<0.05).
CONCLUSION: The course of disease, HbA1c, TG, MALB, FPG-CV, SCP-VD, DCP-VD, FAZ area, CRT and SFCT are all related to the pathogenesis of NPDR. With the increase of FPG-CV, the indexes of macular morphology and microcirculation changed. FPG-CV was negatively correlated with SCP-VD, DCP-VD and SFCT and positively correlated with FAZ area and CRT.
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Evaluation of macular microvasculature alterations in patients with proliferative diabetic retinopathy after vitrectomy by swept-source optical coherence tomography angiography

Feng-Tao Ji, Hui Wang, Ke Wei, Yong-Rong Li, Wei Dai, Zhi-Min Wang, Rong-Feng Liao

Abstract: (8611) HTML (0) PDF (936.23 KKB) (1397)

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AIM: To investigate the changes in retinal and choroidal blood flow after pars plana vitrectomy(PPV)for proliferative diabetic retinopathy(PDR).
METHODS: A cross-sectional study was conducted on 35 patients(35 eyes)who were diagnosed as monocular PDR and received 23GPPV in ophthalmology department of the Second People's Hospital of Hefei between September 2020 and July 2022. All eyes underwent swept-source optical coherence tomography angiography(SS-OCTA)examination. Retinal and choroidal vascular parameters within 3mm×3mm of macular zone were measured by built-in analyzer, and its correlation with postoperative best corrected visual acuity(BCVA)was analyzed.
RESULTS: The follow-up was 1～22(average 9.72±6.67)mo. At the last follow-up, flow area(FA)of intermediate capillary plexus(ICP)layer in paranasal foveal region was significantly reduced in PPV eyes(0.31±0.06mm²)compared with contralateral eyes(0.38±0.05mm²), and FA of deep capillary plexus(DCP)in temporal foveal region was significantly lower in PPV eyes(0.19±0.08mm²)than contralateral eyes(0.27±0.07mm²; all P<0.05). Choroidal vascularity index(CVI)were lower in PPV eyes than contralateral eyes in parafoveal subregions except temporal region(P<0.05). After PPV, BCVA had a certain correlation with the density and FA of middle and deep retinal vessels.
CONCLUSIONS: Eyes with severe PDR may be prone to having a decrease in the DCP and parafoveal choroidal perfusion in the parafoveal regions after PPV than contralateral eyes.
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Suture guided gonioscopy-assisted transluminal trabeculotomy combined with phacoemulsification in the treatment of primary open angle glaucoma

Shan Zhong, Hui Yang, Shi He, Wen-Jing He

Abstract: (8600) HTML (0) PDF (467.79 KKB) (1381)

Abstract:

AIM: To investigate the clinical efficacy of suture-guided gonioscopy-assisted transluminal trabeculotomy(GATT)combined with phacoemulsification in the treatment of primary open angle glaucoma(POAG).
METHODS: A total of 84 patients(84 eyes)with POAG and cataract who underwent surgery in our hospital from January 2021 to July 2022 were selected and randomly divided into two groups. There were 43 cases(43 eyes)in the combined group who underwent suture-guided GATT combined with phacoemulsification, and 41 cases(41 eyes)in the simple group who underwent suture-guided GATT. The two groups were followed up for 3mo to compare the surgical success rate, intraocular pressure, topical intraocular pressure-lowering drugs, visual acuity and postoperative complications.
RESULTS: There was no significant difference in overall success rate between the combination and simple groups at 3 mo after surgery(88% vs. 85%, P>0.05). The intraocular pressure levels and topical intraocular pressure-lowering drugs at 1wk, 1 and 3mo after surgery in the two groups were significantly lower than those before surgery(all P<0.05), but there was no significant difference between the two groups(all P>0.05). The visual acuity at 1wk, 1 and 3mo after surgery of patients in the combined group was significantly better than that in the simple group(P<0.01). During the follow-up period, the incidence of anterior chamber hemorrhage and transient hypertension in the combined group was significantly lower than that in the simple group(P<0.05).
CONCLUSION: Both suture-guided GATT combined with cataract phacoemulsification and suture-guided GATT are effective treatment for POAG, however, suture-guided GATT combined with phacoemulsification has a lower incidence of anterior chamber hemorrhage and transient ocular hypertension.
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Research advances in contact lens associated bacterial keratitis

Yu-Lin Yan, Yan-Ning Yang, Shan-Shan Wan

Abstract: (8516) HTML (0) PDF (512.03 KKB) (1350)

Abstract:

Contact lens(CL)is currently one of the most common methods of vision correction, with more than 140 million users worldwide and the demand is rising yearly as constantly development of materials and features. Wearing CL can lead to a variety of complications such as dry eye, corneal abrasions, giant papillary conjunctivitis, and infectious keratitis is one of the most severe complications. According to research, bacteria account for 80%～95% of the pathogens that cause CL-associated infective keratitis, it may have been related to the bacterial composition, virulence mechanism, biofilm formation and the combined effect of the lens itself and the process of use, which is prone to introducing pathogens, reducing antimicrobial capacity of the cornea and tears and causing ocular surface hypoxia and ocular surface inflammation. Overnight and prolonged lens wear, irregular lens purchase, use and care procedures can also be risk factors for bacterial infections. This article reviews the studies on the pathogenesis, risk factors, diagnosis, treatment and prevention of CL-related bacterial keratitis.
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Research progress on corneal nerves and substance P in viral keratitis

Yi Mu, Hong Zhang

Abstract: (8464) HTML (0) PDF (490.87 KKB) (1161)

Abstract:

Diseases like viral keratitis can harm corneal nerves, which are necessary for maintaining the health and functionality of the cornea. Recent research has shown that corneal nerve pathology affects the infected eye as well as the contralateral one, and that aberrant changes in sympathetic nerves can be seen, with the exception of sensory nerves that correspond to corneal sensation. However, apart from in vivo confocal microscopy and corneal sensation, there have been no additional prognostic indicators that allow clinicians to assess the severity of corneal nerve damage. While multiple functions of corneal nerves are mediated by neuropeptides, substance P, the first topical neuropeptide used in ocular clinical practice, was proved to regulate the process of viral infections, and it is involved in bilateral corneal pathologies through pro-inflammatory and neurotrophic functions in viral keratitis, so it may be used as a diagnostic biomarker or a therapeutic target. Therefore, this review summarized the changes and roles of corneal nerves as well as substance P in viral keratitis, which may serve as a reference for further study into associated mechanisms and clinical applications.
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