Volume 18,2025 Issue 10

Basic Research

• N-acylethanolamine acid amidase inhibitor-loaded polymeric micelles in the treatment of dry eye disease

  Yang Zhao, Pan Zhou, Bang-Yan Zhou, Wen-Xuan Zeng, Qi-Yue Du, Fang-Yu Chen, Jie Ren, Hong-Wei Fu, Yan Qiu

  2025,18(10):1815-1822 ,DOI: 10.18240/ijo.2025.10.01

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  AIM: To investigate F96, a N-acylethanolamine acid amidase (NAAA) inhibitor, as a novel drug for treating dry eye disease (DED) and to enhance its corneal retention time by utilizing nanometer micelles to improve therapeutic efficacy. METHODS: The study compared nanomicelles encapsulating doxorubicin with an aqueous solution of doxorubicin to assess the ability of the nanomicelles to prolong drug retention on the ocular surface. Dry eye was induced in mice through subcutaneous injections of scopolamine hydrobromide. The efficacy of F96 was evaluated using various clinical assessments, including the phenol red cotton test, Oregon green dextran staining, periodic acid-Schiff (PAS) staining, and Terminal dUTP Nick-End Labeling (TUNEL) assay. RESULTS: Doxorubicin micelles exhibited significantly prolonged retention compared to the aqueous solution. By 15min, the corneal fluorescence intensity of the micelle group was markedly higher than that of theaqueous solution group (P<0.05), and this enhanced effect persisted for at least 4h. Furthermore, mice treated with F96 demonstrated superior outcomes in tear production, corneal staining, and goblet cell density compared to the control groups. Specifically, F96-mPPP significantly increased tear secretion (3.35±0.45 vs 1.85±0.51 mm in the vehicle group, P<0.001), restored conjunctival goblet cell density (54.5±4.5 vs 31.3±3.0, P<0.01), and reduced corneal fluorescein staining scores (3.4±0.32 vs 6.5±0.72, P<0.001). Additionally, F96-mPPP treatment markedly decreased TUNEL-positive cells in the corneal epithelium, indicating suppression of apoptosis. CONCLUSION: F96 nanometer micelles have the potential to serve as a promising novel approach for effectively alleviating ocular surface damage in the treatment of dry eye disease.

• Single subconjunctival injection formulation with a 5-fluorouracil-poly(lactic) acid controlled-release system for glaucoma filtration surgery

  Jing-Jing Zhang, Feng Gao, Kai-Xin Deng, Wen-Xue Guan, Yao-Yao Sun

  2025,18(10):1823-1833 ,DOI: 10.18240/ijo.2025.10.02

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  AIM: To develop a 5-fluorouracil (5-FU) mesoporous poly(lactic) acid (PLA) delivery system for glaucoma filtration surgery suitable for a single subconjunctival implantation. METHODS: The 5-FU was infiltration-loaded into mesoporous PLA. In vitro and in vivo release experiments and ocular toxicology evaluation of the formulation were performed. The antiproliferative effect of this 5-FU-PLA tablet after glaucoma filtration surgery in rabbits was evaluated. Pathology, immunohistochemistry, and Western blot were used to further validate the inhibitory effect of this sustained release system. RESULTS: Various drug formulations were tested, and two 5-FU-PLA tablets, namely 1.5P15 (5-FU 1.5 mg+PLA 15 000 Da) and 2.5P15 (5-FU 2.5 mg+PLA 15 000 Da), had the most suitable release profiles in vitro. Further in vivo studies confirmed the safety and sustained-release profiles of both drugs. Both 5-FU-PLA tablets, relative to the free drugs, significantly inhibited tissue proliferation after glaucoma filtration and improved surgical success. Western blot showed that transforming growth factor-β (TGF-β) and connective tissue growth factor (CTGF) were inhibited by 5-FU after filtration surgery, with the effects of the 5-FU-PLA tablets being more lasting. CONCLUSION: The tested 5-FU-PLA tablets provide a sustained release of 5-FU, which may be used for a single subconjunctival implantation to inhibit proliferation after filtration surgery.

• Promotion of human choroidal melanoma cell metastases by FOXP3 via Wnt5a/CaMKII signaling pathway

  Ying-Ying Yuan, Yi-Chong Liu, Qian Zhang, Xiao-Di Gao, Yuan-Zhang Zhu, Kuan Cheng, Han Zhao, Wei-Wei Fu, Ke Lei, Ai-Hua Sui, Wen-Juan Luo

  2025,18(10):1834-1845 ,DOI: 10.18240/ijo.2025.10.03

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  AIM: To investigate the role of Forkhead box protein P3 (FOXP3) in choroidal melanoma (CM) metastases and elucidate its underlying mechanisms. METHODS: FOXP3 protein expression was analyzed in CM clinical specimens and cell lines. A stable FOXP3 knockout cell line and a transient FOXP3-overexpressing cell line were established, with transfection efficiencies confirmed by Western blotting (WB). Functional assays, including monoclonal formation, cell counting kit-8 (CCK-8) proliferation, migration, invasion, and in vivo tumorigenesis assays in nude mice, were performed to assess the biological effects of FOXP3. Additionally, WB was employed to evaluate epithelial-mesenchymal transition (EMT) markers and the activation of the Wnt5a/CaMKII signaling pathway. RESULTS: FOXP3 expression was significantly elevated in both CM clinical specimens and cell lines. Functional analyses revealed that FOXP3 enhanced CM cell proliferation, migration, and invasion in vitro and promoted tumorigenesis in vivo. Mechanistically, FOXP3 upregulated EMT-related proteins and activated the Wnt5a/CaMKII signaling pathway. Rescue experiments further confirmed that the oncogenic effects of FOXP3 were mediated via modulation of the Wnt5a/CaMKII axis. CONCLUSION: This study identifies FOXP3 as an oncogenic driver in CM, promoting tumor progression through the Wnt5a/CaMKII signaling pathway. These findings provide new insights into the molecular mechanisms of CM pathogenesis and highlight FOXP3 as a potential therapeutic target.

Clinical Research

• Evaluation of conjunctival flora in congenital ptosis

  Mehmet Balbaba, Fatih Ulaş, Mehmet Canleblebici, Ozan Güven, Zülal Aşcı Toraman, Hakan Yıldırım, Murat Erdağ

  2025,18(10):1846-1850 ,DOI: 10.18240/ijo.2025.10.04

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  AIM: To assess and compare the conjunctival bacterial flora in patients with congenital ptosis (CP) to that of healthy individuals. METHODS: The study included 38 patients with CP and 42 healthy control subjects. Conjunctival cultures were collected using a cotton-tipped swab applied to the inferior conjunctival fornix. The samples were inoculated into blood agar, eosin methylene blue agar, chocolate agar for bacteria, and Sabouraud dextrose agar medium for fungi. RESULTS: The culture positivity rate was 68.4% in CP and 47.6% in the control group (P<0.001). Additionally, there was a significant difference in culture positivity between the eyes of patients with unilateral ptosis (P=0.039). In the CP group, the most common found microorganism was Staphylococcus epidermidis at 23.67%, followed by Haemophilus species at 21.04%, and Corynebacterium species at 15.78%. In the control group, Staphylococcus epidermidis and Corynebacterium species were both the most commonly isolated microorganisms, each accounting for 19.04%. More than one species of bacteria was grown in the cultures of 36.84% and 23.80% of the CP and control subjects, respectively. Gram-negative bacteria were more common in CP than in control subjects (P=0.031). CONCLUSION: Culture positivity is significantly higher in the ptotic eyes of CP. Potentially pathogenic microorganisms are more frequently isolated from the CP group compared with the healthy control group.

• Predictive analysis of dry eye diagnosis and digital screen usage: a cross-sectional study

  Rekha Ghimire, Raju Kaiti, Ranjila Shyangbo, Santosh Paudel, Youbraj Neupane

  2025,18(10):1851-1855 ,DOI: 10.18240/ijo.2025.10.05

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  AIM: To characterize the ocular surface characteristics in the Nepalese population across all age groups who have used digital screens for extended durations over several years. METHODS: In a cross-sectional, observational study, 144 digital screen users were assessed for dry eye disease (DED) using subjective and objective measures. The Ocular Surface Disease Index (OSDI) Questionnaire evaluated symptoms, followed by clinical assessments, including slit lamp biomicroscopy, tear breakup time (TBUT), Oxford Scheme grading, and Schirmer I test. DED was diagnosed if a patient had an OSDI score over 13 and at least two clinical signs (OSDI, Schirmer I test, or ocular staining). The prevalence of DED was calculated based on the proportion of patients meeting these criteria. RESULTS: Of the 144 participants (mean age: 34.6±15.2y), 78 (54.2%) were female. The use of digital screens varied between 2-8h (mean duration: 4.1±2.7h) per day. The mean OSDI score, TBUT score, and the Schirmer I scores were 22.7±10.5 (max-min: 24.4-20.9), 6.8±4.2s (max-min: 7.5-6.1), and 12.3±4.6 mm (max-min: 13.1-11.5) respectively with 95% confidence interval (β=1.96), and a two-tailed statistical significance level of 5% (α=0.05). With increased screen use, TBUT shortened and OSDI scores increased significantly (P<0.01), though Schirmer I scores were unaffected (P>0.05). The prevalence of DED ranged from 6.3% to 22.9% in those using screens for more than 2h, with an overall prevalence of 67.4% among digital screen users. CONCLUSION: There is a significant association between prolonged use of digital screens and clinical markers of dry eye signs and symptoms.

• Corneal endothelial characteristics and biometric parameters in microcornea

  Xiang-Zheng Zhang, Li Pei, Jia-Ning Shi, Xi Lu, Ran-Yi Ding, Xiao-Wei Zhong, Xin Wang, Du-Lei Zou, Wei-Yun Shi, Can Zhao, Ting Wang

  2025,18(10):1856-1863 ,DOI: 10.18240/ijo.2025.10.06

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  AIM: To assess the corneal biometric parameters and endothelial cell characteristics in microcornea patients, and exploring their correlations. METHODS: This cross-sectional study included 28 patients of microcornea with uveal coloboma (MCUC), 13 patients of microcornea without coloboma (MCNC), and 30 age-matched healthy individuals (the control group). Corneal biometric parameters such as axial length (AL), anterior chamber depth (ACD), and white-to-white corneal diameter (WTW) were measured using the IOL Master. The corneal endothelial cell density (ECD), percentage of hexagonal cells (6A), average cell area (AVE), maximum cell area (MAX), minimum cell area (MIN), cell area standard deviation (SD), and coefficient of variation (CV) were collected by specular microscopy. RESULTS: This study included MCUC and MCNC patients with age- and sex-matched controls. All patients exhibited significantly reduced WTW (MCUC: 8.51±0.71 mm; MCNC: 9.08±0.42 mm) and worse logMAR BCVA (MCUC 0.62±0.43; MCNC 0.46±0.28) compared to controls (both P<0.001). The ECD was 3106.32±336.80 cells/mm² in the MCUC group and 2906.92±323.53 cells/mm² in the MCNC group, both significantly higher than the control group (2647.43±203.06 cells/mm², P<0.05). In contrast, the CV, AVE, SD, and ACD in the MCUC and MCNC groups were significantly lower compared to controls (P<0.01). In patients with microcornea, the WTW was negatively correlated with the ECD and 6A, but positively with the CV, MAX, AVE, and SD. The ACD was negatively linked to the ECD, but positively to the AVE. CONCLUSION: The corneal ECD and 6A are increased, while the CV is decreased in patients with microcornea, particularly in those accompanied by uveal coloboma. The ECD and morphology demonstrate close correlations with the WTW and ACD.

• Comparison of toric implantable collamer lens alignment accuracy: VERION image-guided system versus manual marking

  Xiao-Ying He, Jun Wang, Min-Jie Yuan, Zi-Xuan Yang, Wei Han

  2025,18(10):1864-1874 ,DOI: 10.18240/ijo.2025.10.07

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  AIM: To compare the accuracy of manual marking versus an image-guided system for toric implantable collamer lens (TICL) implantation and evaluate the short-term postoperative rotational stability of TICL and corneal surgically induced astigmatism vector (SIA). METHODS: Retrospective analysis was conducted on eyes with TICL alignment achieved through manual marking (n=75) or VERION image-guided system-assisted marking (n=83). Each group was further classified into horizontal and vertical subgroups based on implant orientation. Additionally, patients were categorized into superior and temporal incision subgroups according to the position of main corneal incision. The misalignment and rotational stability of TICL were analyzed using slit-lamp anterior segment photography. Surgical predictability, efficacy, safety, and corneal SIA were also evaluated. RESULTS: In general, the TICL implantation with manual and digital image-guided systems all achieved robust predictability, efficacy, and safety. The misalignment of TICL was comparable between the manual and VERION groups (0.16°±3.97° vs 0.52°±5.59°, P=0.633), while a significant difference was observed in the absolute misalignment of TICL between the two groups (3.02°±2.55° vs 4.28°±3.61°, P=0.043). There were no significant differences in the distribution of TICL misalignment between the manual and VERION groups or between horizontal and vertical implant orientation groups (P>0.05). Furthermore, different orientations of TICL placement did not show statistically significant differences in rotational stability (P=0.46). Statistically significant differences were found in anterior corneal SIA between the manual and VERION groups (0.46±0.27 vs 0.33±0.21 D, P=0.001), especially for superior incision position (0.60±0.27 vs 0.35±0.23 D, P<0.0001). The anterior SIA exhibited a significant difference between superior and temporal incisions in the manual group (0.60±0.27 vs 0.35±0.20 D, P<0.0001). CONCLUSION: Compared with the conventional manual marking method, this study indicates that the digital image-guided system with VERION is safe and effective in TICL implantation. The digital system offers the advantage of minimizing corneal SIA compared to the manual method.

• Comparison of outcomes after early congenital cataract surgery in eyes with/without microcornea

  Fan Zhang, Zhang-Liang Li, Jia-Ying Wu, Yun-E Zhao

  2025,18(10):1875-1879 ,DOI: 10.18240/ijo.2025.10.08

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  AIM: To find out intraoperative and postoperative outcomes of congenital cataract surgery in eyes with microcornea. METHODS: This retrospective consecutive case series study compared outcomes after congenital cataract surgery in eyes with/without microcornea. Infants (<1 year old) who underwent lensectomy surgery left aphakic were included. Microphthalmos was defined as an eye that has a horizontal corneal diameter less than or equal to 9.0 mm. RESULTS: There were 40 infants (54 eyes) in the microcornea group and 58 (87 eyes) in the control group. The two groups were age- and sex-matched. The microcornea group showed significantly smaller corneal diameter (P<0.001), steeper corneal keratometry (P=0.001), thinner lens thickness (P<0.001), and shorter axial length (AL, P<0.001). And microcornea increased the incidence of poor pupil dilation (P<0.01). The two groups showed no significant differences in postoperative intraocular pressure (IOP), best-corrected visual acuity, central corneal thickness (CCT), AL, and the incidence of strabismus and nystagmus at the last follow-up. CONCLUSION: Although microcornea have different features from normal ones, the one-year follow-up after surgery has shown that early surgical intervention for congenital cataracts in eyes with microcornea can result in favourable outcomes with an acceptable rate of postoperative complications. Regular follow-up and timely management of postoperative complications are crucial for successful outcomes.

• Visual and health-related quality of life in cataract patients versus healthy controls

  Aryan Miraftab, Leila Ghiasian, Masood Naseripour

  2025,18(10):1880-1887 ,DOI: 10.18240/ijo.2025.10.09

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  AIM: To compare health-related quality of life and vision-related quality of life between patients with cataracts and healthy controls. METHODS: This research was carried out as a cross-sectional study. Participants were selected from Rasoul Akram Hospital in Tehran, Iran, comprised of two groups: healthy individuals and those diagnosed with cataracts, using a simple random sampling technique. Following the interviews, participants completed the SF-36 health-related quality of life questionnaire and the VFQ-25 vision-related quality of life questionnaire. Comprehensive optometric and ophthalmic assessments, were conducted for all participants. RESULTS: This research involved a selection of 130 healthy individuals and 154 cataract patients who were candidates for cataract surgery. The average ages of the healthy individuals and cataract patients were 69.7±3.5 and 69.5±6.5y, respectively (P=0.837), with 42.3% of the healthy individuals and 44.8% of the cataract male patients (P=0.672). According to the SF-36 questionnaire, the quality of life regarding physical functioning, role limitations due to physical health, social functioning, pain, and general health were significantly worse among cataract patients. The composite physical index for cataract patients and healthy individuals was 70.7±9.08 and 78.53±8.17, respectively (P<0.001; effect size=0.90, 95%CI: 0.66-1.15), while the mental index showed no significant difference between the two groups (P=0.112; effect size=0.19, 95%CI: -0.04-0.42). All aspects of the VFQ-25 questionnaire were notably lower in cataract patients, with the mean final VFQ-25 scores being 56.49±14.81 for cataract patients and 92.9±4.64 for healthy individuals (P<0.001; effect size=3.21, 95%CI: 2.85-3.56). The VFQ-25 questionnaire indicated that the most significant effect size was associated with role difficulties and distance activities. More components from both questionnaires exhibited a substantial correlation with best-corrected visual acuity in cataract patients. CONCLUSION: Patients suffering from cataracts exhibit a significantly reduced health-related quality of life, especially concerning physical health and vision-related quality of life, compared to those without cataracts. Timely surgical treatment for these individuals can improve their overall quality of life.

• Staged surgical treatment of complicated initial cataract in patients with advanced proliferative diabetic retinopathy

  Karina I. Konovalova, Michael M. Shishkin, Rinat R. Faizrakhmanov, Dilara B. Babaeva

  2025,18(10):1888-1893 ,DOI: 10.18240/ijo.2025.10.10

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  AIM: To evaluate the efficacy of second-stage phacoemulsification (PE) of complicated initial cataract after vitreoretinal surgery (VRS) in patients with advanced proliferative diabetic retinopathy (PDR). METHODS: Totally 216 patients with PDR and complicated initial cataract who underwent surgery were included. These patients were divided into four groups according to their management. In the 1st group patients were subjected to a two–step surgical procedure: VRS with silicone oil tamponade was performed as the first step, followed by the second step, PE+intraocular lens (IOL) implantation+silicone oil removal. In the 2nd group PE was performed simultaneously with VRS and silicone oil tamponade. The second step differed in the removal of silicone oil from the vitreous cavity. Patients Ia (n=17) and IIa (n=17) subgroups had their tear liquid samples being examined before surgery and on the 2nd day after the 1st phase. In subgroups Ib and IIb, an angiogenesis inhibitor was implanted 10-14d before VRS at a dose of 0.5 mg once. In the 3rd group patients were subjected to a two–step surgical procedure: VRS with gas tamponade performed as the 1st step in their treatment; followed by the 2nd step, PE and the IOL implantation. In the 4th group PE performed simultaneously with VRS with gas tamponade. RESULTS: Patients in subgroup Ia and group III had better functional results than those in subgroup IIa and group IV, respectively (P<0.001). More marked inflammatory response (2-3 points) was statistically significant in patients of the IIa subgroup (P<0.001) and group IV (P<0.001) in comparison with the patients in the Ia and group III respectively. The IIa subgroup (n=9; 14.5%) showed higher incidence of neovascular glaucoma (NVG) than the Ia (n=2; 3.2%), P=0.027. There also was a higher rate of NVG in group IV (n=6; 19.3%) compared to group III (n=1; 3.1%), P=0.04. Subgroup IIa revealed a 2 to 2.5 times higher concentration of interleukin 8 (IL-8), monocyte chemoattractant protein 1 (MCP-1), and inter-cellular adhesion molecule 1 (ICAM-1) compared to subgroup Ia. CONCLUSION: PE of initial cataract at the second stage after VRS in patients with advanced PDR provides a sparing approach to surgical treatment in this category of patients and allows to improve anatomical and functional results of VRS. In addition, it contributes to reduction of number and severity of postoperative complications.

• Intermediate impacts of COVID-19 lockdowns on surgical glaucoma cases in Quebec, Canada: insights from a tertiary eye center

  Huixin Anna Zhang, Sarah McIntyre, Yosra Er-reguyeg, Andrew Toren

  2025,18(10):1894-1900 ,DOI: 10.18240/ijo.2025.10.11

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  AIM: To assess the effect of the coronavirus disease 2019 (COVID-19) pandemic on the wait times and severity of surgical glaucoma cases in a single tertiary referral center in Quebec, Canada. METHODS: Preoperative severity data included mean visual field (VF) deficit, intraocular pressure (IOP), the number of topical glaucoma medication classes, and preoperative best corrected visual acuity (BCVA). The times from referral to procedure (referral time) and from listing date to procedure (waitlisting time) were calculated. RESULTS: This retrospective cohort study involved 181 eyes of patients undergoing glaucoma surgery from March 1 to June 30, 2019 (pre-pandemic period), and 201 eyes in the same timeframe in 2021 (pandemic period) at Saint-Sacrement Hospital in Quebec City. There was no significant difference in the severity data of surgical glaucoma across both periods (VF deficit: P=0.48; IOP: P=0.14; BCVA: P=0.24; topical medication classes: P=0.27). The number of patients referred with oral glaucoma medication increased slightly from 45 to 70 in 2019 and 2021 respectively (P=0.08). Delay data were also comparable. Mean referral time was 122±120d in 2019 versus 144±136d in 2021 (P=0.09), whereas waitlisting time before the pandemic was 43±44.5 versus 39±41.8d in 2021 (P=0.13). CONCLUSION: Despite North America’s strictest pandemic restrictions, limited negative impact is observed on waitlisting delays and the severity of glaucoma cases presenting at our center. A larger subset of patients is treated with oral medications indicating a possible increase in advanced glaucoma.

• Clinical outcomes and safety profile of glaucoma drainage device Ahmed ClearPath® 250 mm2: a tertiary center experience

  Afonso Murta, Edgar Lopes, Patrícia Silva, Catarina Barão, Maria Elisa Luís, Joana Cardigos, Teresa Gomes

  2025,18(10):1901-1907 ,DOI: 10.18240/ijo.2025.10.12

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  AIM: To present the clinical outcomes in efficacy and safety of the Ahmed ClearPath® (ACP) 250 mm2 model as well as our surgical technique. METHODS: Single-center prospective interventional study of uncontrolled glaucoma eyes undergoing ACP implantation, as a standalone procedure or in combination with cataract phacoemulsification. Intraocular pressure (IOP) was evaluated prior to surgery and 1wk, 1, 3, 6mo and 1y postoperatively. In addition, the number of antiglaucoma drugs and intra and postoperative complications were assessed. RESULTS: A total of 30 eyes of 28 patients were included in the study. The patients were on average 72.8 (13.4) years old and 53.6% were male. Totally 40% of the eyes had primary open angle glaucoma, 16.7% had neovascular glaucoma, 16.7% had pseudoexfoliative glaucoma, 10% had glaucoma secondary to pars plana vitrectomy with silicone oil tamponade, 6.7% had aphakic glaucoma, 6.7% had primary congenital glaucoma and 3.3% had pigmentary glaucoma. Before surgery mean IOP was 26.1 (10.8) mm Hg and mean glaucoma medication use was 3.7 (0.5). At 1, 3, 6 and 12mo mean IOP was 16.1, 11.7, 11.8 and 11.5 mm Hg, respectively. Mean glaucoma medication use was 1.9, 1.5, 1.2 and 1.2, respectively. At 1y, complete surgical success was found in 46.7% patients (n=14) and qualified success in 53.3% (n=16). There were no intraoperative complications. Postoperative complications include choroidal effusion (n=5), transient hyphema (n=2), early hypotony with shallow anterior chamber (n=2) and late hemorrhagic choroidal detachment (n=1). CONCLUSION: The ACP appears to be an efficient surgical option for treating refractory glaucoma, achieving good IOP control and decreasing medication burden. The results obtained at 6mo are an important prognostic factor for long-term outcomes.

• Correlations between inflammatory biomarkers in peripheral blood and branch retinal vein occlusion

  Xiao-Juan Lai, Song-Yue Yang, Chun-Yan Lei, Rui-Han Xiao, Mei-Xia Zhang

  2025,18(10):1908-1913 ,DOI: 10.18240/ijo.2025.10.13

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  AIM: To investigate the possible relationship between inflammatory biomarkers in the peripheral blood of patients with branch retinal vein occlusion (BRVO). METHODS: A total of 63 BRVO patients were enrolled in this cross-sectional observational study. Meanwhile, 63 age- and gender-matched cataract patients were included as controls. Complete blood count and biochemical tests were performed, and inflammatory biomarkers including platelet to lymphocyte ratio (PLR), red blood cell distribution width to albumin ratio (RAR), neutrophil to lymphocyte ratio (NLR), systemic immune inflammation index (SII), and monocyte to high density lipoprotein cholesterol ratio (MHR) were compared between the two groups. RESULTS: There were no significant differences between the two groups in terms of age, sex, and prevalence of diabetes mellitus. Compared with the controls, patients with BRVO had a higher prevalence of hypertension and higher body mass index (BMI). Red blood cell distribution width (RDW), triglycerides, MHR, NLR, and RAR were elevated, whereas lymphocyte count and high-density lipoprotein were decreased in the BRVO group. Multivariate logistic regression analysis revealed that NLR (adjusted OR=1.686, 95%CI 1.075-2.646), RAR (adjusted OR=8.930, 95%CI 1.911-41.730), and body mass index (BMI; adjusted OR=1.174, 95%CI 1.010-1.365) were significantly associated with the risk of BRVO. In the receiver operating characteristic analysis, the area under the curve for NLR, RAR, and BMI were 0.602, 0.630, and 0.603, respectively. The sensitivity and specificity were 61.9% and 60.3%, 38.1% and 82.5%, and 61.9% and 57.1%, respectively. CONCLUSION: Peripheral blood inflammatory biomarkers are elevated in BRVO patients, suggesting systemic inflammation involvement. NLR, RAR, and BMI are positively correlated with BRVO. Monitoring NLR and RAR and strict weight control may be beneficial for the prevention and treatment of BRVO.

• Clinical manifestation and multimodal images of Chinese acute zonal occult outer retinopathy patients

  Shu-Lin Liu, Xin-Yu Zhao, Jing-Yuan Yang, You-Xin Chen

  2025,18(10):1914-1921 ,DOI: 10.18240/ijo.2025.10.14

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  AIM: To comprehensively examine the clinical presentations, multimodal images, and long-term follow-up of Chinese patients with acute zonal occult outer retinopathy (AZOOR), a rare inflammatory disorder. METHODS: This was a retrospective study. A total of 20 patients (32 eyes) were included. The medical records and multimodal imaging, including wide-field fundus photography, wide-field fundus autofluorescence (FAF), and swept-source optical coherence tomography (SS-OCT) were analyzed. RESULTS: The study included 20 patients with a mean age of 38.2±10.9y, and females accounted for 60%. Lesions could involve peripapillary areas, macular region, and peripheral retina. The mean best-corrected visual acuity (BCVA) at presentation was 0.38±0.60 logMAR, with no significant difference in visual acuity between acute cases (within 6mo of onset) and chronic cases (beyond 6mo of onset; P=0.390). There was no statistically significant difference in visual acuity between eyes of acute case (within 6mo of onset) and the chronic case (beyond 6mo of onset). In some chronic case, FAF examination revealed the presence of a hyperautofluorescent (hyperAF) ring around the macular area (6/18), a phenomenon not observed in the acute case (P=0.024). A higher proportion of chronic cases showed predominantly hypoautofluorescent (hypoAF) lesions compared to the acute case (13/18 vs 2/14, P=0.0016). SS-OCT examination showed that both acute and chronic cases exhibited hyperreflective dots above the retinal pigment epithelium (RPE), and ellipsoid zone (EZ) and RPE damage. In the chronic case, eyes with hyperreflective dots above the RPE were more likely to exhibit EZ and RPE damage in the macular region compared to those without these dots. CONCLUSION: Multimodal imaging plays a crucial role in the follow-up of patients with AZOOR. In chronic cases of AZOOR, the presence of hyperreflective dots above the RPE indicates a higher likelihood of outer retinal involvement in the macular region. This study provides critical insights into the complex presentation and progression of AZOOR.

• Visual function in the diagnosis of multiple sclerosis and optic neuritis

  Bardia Behnia, Ameer Mohammed Hadi Layedh, Hassan Hashemi, Alireza Jamali, Abbasali Yekta, Navidreza Zamani, Raheleh Moravej, Mehdi Khabazkhoob

  2025,18(10):1922-1928 ,DOI: 10.18240/ijo.2025.10.15

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  AIM: To determine the diagnostic ability of various visual functions in patients with multiple sclerosis (MS) with and without optic neuritis (ON). METHODS: In this cross-sectional study, we assessed and compared refractive error, visual acuity (VA), and contrast sensitivity (CS) between patients with MS and a matched control group of healthy individuals. The MS patients were further categorized into those with ON and those without. RESULTS: A total of 133 eyes from 133 participants were assessed, including 66 individuals diagnosed with MS. The mean ages for the MS group and the healthy control group were 37.5±4.27y and 38.45±4.60y, respectively (P=0.346). Among the 66 patients with MS, 18 had ON. The presence of MS was associated with a decrease in best-corrected visual acuity (BCVA) and spherical component of refractive error (P<0.05), whereas ON did not lead to any further decline in these parameters (P>0.05). MS was linked to decreased CS at spatial frequencies of 6 and 18 cycles per degree (CPD; P<0.05), while ON in MS patients resulted in an additional decrease in CS at 3 CPD (P=0.03). The most significant sensitivity for distinguishing MS patients from healthy individuals as well as MS patients with ON from those without ON was found with cylindrical component [associated criterion (AC) >-0.75 D; 71.21%] and CS at spatial frequency of 6 CPD (AC ≤1.56; 72.22%), respectively. Conversely, the highest specificity for these diagnostic measures was associated with BCVA (AC >0 logMAR; 97.01%) and CS at a spatial frequency of 12 CPD (AC ≤0.60; 93.75%), respectively. CONCLUSION: MS significantly affects refractive error and CS, with ON further reducing CS. Assessing these visual parameters can improve MS monitoring and management.

• Comprehensive evaluation of ocular surface parameters in patients with moderate-to-high myopia

  Bing-Qing Sun, Xiao-Jun Hu, Bing Qin, Xing-Tao Zhou, Mei-Yan Li

  2025,18(10):1929-1935 ,DOI: 10.18240/ijo.2025.10.16

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  Abstract:

  AIM: To investigate the ocular surface parameters in patients with moderate to high myopia. METHODS: This prospective study was conducted in May 2023, enrolling patients with moderate to high myopia (spherical equivalent refraction ≤-3.0 D). After completing the Ocular Surface Disease Index (OSDI) questionnaire, refractive parameters and non-invasive tear film parameters were measured, followed by the Schirmer I test and fluorescein sodium staining. The diagnosis of dry eye disease was based on OSDI score, non-invasive tear breakup time (NIBUT), Schirmer I test, and fluorescein sodium staining results, according to the 2020 Chinese Expert Consensus on Dry Eye. The Mann-Whitney U test was used to compare ocular surface parameters between moderate and high myopia, as well as between patients with and without dry eye. Pearson correlation analysis was employed to assess the relationship between the lipid/muco-aqueous layers and tear film parameters. A general linear mixed model (GLMM) was used to analyze the impact of refractive parameters on ocular surface parameters after adjusting for age and sex. RESULTS: A total of 35 eyes with moderate to high myopia (12 males; mean age, 30.30±5.45y) were included in the study. Among them, 26 eyes were classified as normal and 9 as dry eye. Of the 9 dry eye cases, 7 were observed in the high myopia group (n=18) and 2 in the moderate myopia group (n=17). Among the enrolled patients, those with high myopia demonstrated significantly higher OSDI scores than those with moderate myopia (P=0.0417). Patients with dry eye exhibited significantly shorter interblink intervals (P=0.0081) and higher OSDI scores (P=0.0001) than those without dry eye. Pearson correlation analysis revealed a significant positive correlation between lipid layer thickness (LLT) and tear meniscus height (r=0.395, P=0.023), and a significant negative correlation between the muco-aqueous layer thickness change rate (MALTR) and OSDI score (r=-0.466, P=0.016). After adjusting for age and sex using the GLMM, spherical refraction (SPH, β=-1.802, P=0.048) and axial length (AL, β=2.784, P=0.048) significantly impacted OSDI score. Corneal front astigmatism significantly influenced Schirmer I test results (β=8.377, P=0.024). The difference between central corneal thickness and the thinnest corneal thickness significantly affected LLT (β=-2.294, P=0.026). White-to-white diameter significantly impacted MALTR (β=-81.758, P=0.037). CONCLUSION: In moderate to high myopia, higher SPH and AL correlate with increased dry eye symptoms, which are associated with muco-aqueous and lipid layer alterations. Corneal regularity and diameter also affect tear film dynamics.

• Retinal vessel density alteration after FS-LASIK for myopia with different axial lengths

  Cai-Yun Fu, Yan Zheng, Chang-Bin Zhai, Hou-Bin Huang, Xi Chen, Yi-Ran Dong, Ya-Bin Hu, Wen Xu, Jing Liu, Yan Huang, Ning Sun, Xue-Yin Chen

  2025,18(10):1936-1943 ,DOI: 10.18240/ijo.2025.10.17

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  Abstract:

  AIM: To compare the effects of different types of negative pressure suction on the macular and optic disc retinal vessel density (VD) in myopic patients with different axial lengths (ALs) undergoing femtosecond laser-assisted excimer laser in situ keratomileusis (FS-LASIK) by optical coherence tomography angiography (OCTA). METHODS: A prospective, nonrandomized, controlled study. Participants underwent FS-LASIK surgery were divided into the short AL group (SAL, 22≤AL<26 mm) and the long AL group (LAL, 26≤AL<28 mm) according to the different ALs. Further, the two groups were divided into subgroups according to the corneal flap using VisuMax or WaveLight FS200 femtosecond laser (FS) platform. All patients underwent OCTA before the surgery and 1-day/1-week/1-month after the surgery. ANOVA statistically analyzed data with two-factor repeated measurement in SPSS. RESULTS: Totally 108 participants (108 eyes, 18–35y) were divided into SAL group [22 patients (4 males and 18 females) were treated with VisuMax, and 24 (3 males and 21 females) were treated with WaveLight FS200] and LAL group [34 patients (4 males and 30 females) were treated with VisuMax, and 28 patients (6 males and 22 females) were treated with WaveLight FS200]. In the LAL group, there was no significant difference in macular superficial capillary plexuses vessel density (SCP-VD) in the fovea and perifovea region, but compared with the VisuMax subgroup, SCP-VD in the parafoveal region (t=2.647, P=0.010) and the whole area (t=2.030, P=0.047) in WaveLight FS200 subgroup decreased at one day after the operation and increased to a preoperative level at 1-week and 1-month after operation. There was no significant difference between SCP-VD in the two SAL subgroups, neither of deep capillary plexuses vessel density (DCP-VD) and optic nerve head vessel density (ONH-VD) in the SAL and LAL groups. CONCLUSION: With the increase of AL and suction intensity, a transient decrease of SCP-VD in the macular region is observed at 1d postoperatively during FS-LASIK, and it increases to preoperative level at 1-week and 1-month postoperatively. However, the AL and suction intensity do not affect the macular DCP-VD and ONH-VD.

• Impact of LED exposure on contrast sensitivity and protective efficacy of blue-blocking lenses

  Dolvin Monterio, Elizebeth Olive Akansha Manoj Kumar, Mousumi Ghosh, Radhika Poojary, Judy Jose, Judith Shefali Jathanna, Manasa Bhandarkar, Nagarajan Theruveethi

  2025,18(10):1944-1948 ,DOI: 10.18240/ijo.2025.10.18

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  Abstract:

  AIM: To measure the contrast sensitivity (CS) using computer-based Chart2020 software pre- and post-white light exposure with and without blue-blocking lenses (BBLs). METHODS: The study included participants aged 18 to 25y (n=30 eyes), where baseline CS was measured before the experiment. Following this, the participants were exposed to two white light-emitting diodes (LEDs; 450 lx each), placed at a 45-degree angle from the participant’s eye and 80 cm from the light source. All participants were randomly divided into three groups (BBL1- Placebo lens, BBL2- Crizal Prevencia, BBL3- Duravision) by sequential randomisation, which was double-blinded. Post-light exposure, the CS was measured monocularly with a calibrated computer-based CS Chart-2020 software at different log units. RESULTS: CS measured using Chart-2020 software at 0.8, 1.5, 6, 12, and 18 cpd pre- and post-white LED exposure with and without BBLs showed a significant difference (P<0.05) in contrast threshold and log contrast at 6 cpd and 18 cpd (P<0.05) and showed no significant differences in 0.8, 1.5, 12 cpd (P>0.05). CONCLUSION: This study shows that exposure to white LEDs can diminish CS, while BBLs may ameliorate these negative effects.

• Ocular findings of the patients with congenital leptin deficiency under long-term leptin replacement therapy

  Ozlem Candan, Sevde Nur Fırat

  2025,18(10):1949-1957 ,DOI: 10.18240/ijo.2025.10.19

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  Abstract:

  AIM: To analyze the ocular findings of patients who received lifelong leptin therapy due to congenital leptin deficiency (CLD), an extremely rare condition. METHODS: A prospective, cross-sectional comparative study was performed on six patients with CLD and 13 healthy age- and sex-matched controls. The central corneal thickness (CCT), anterior chamber depth (ACD), axial length (AL), keratometry (K1, K2), optical coherence tomography (OCT), and OCT angiography parameters were compared between the leptin and control groups at the baseline visit. The change in these measurements in leptin patients over a two-year period was analyzed. RESULTS: CLD patients had lower mean AL, ACD, and CCT (P≤0.012 for all). Mean K1, K2 (P≤0.047 for both), choroidal thickness (P≤0.001), and central ganglion cell layer (GCL) thickness (P=0.029) were higher in the leptin group. Perifoveal superficial capillary plexus (SCP) density was decreased in all quadrants except the temporal region (P<0.05), and parafoveal deep capillary plexus (DCP) density was decreased in the superior hemisphere, temporal quadrant (P≤0.036 for both) and nasal quadrant (P=0.048) in the leptin group. During the two-year follow-up, no changes in anterior and posterior segment measurements were observed in the leptin patients, except for subfoveal choroidal thickness (P<0.001). CONCLUSION: CLD patients exhibit structural alterations in both the anterior and posterior segments of the eye, including notable changes in retinal and choroidal vasculature. However, there is limited evidence concerning the influence of leptin therapy on the eye.

Investigation

• Eyelid disorders and morphologies among older individuals: a cross-sectional survey in China

  Yan-Yan Lin, Hai-Rui Jiao, Ya-Qi Peng, Xi Chen, Fan Lyu, Xin-Ting Liu

  2025,18(10):1958-1963 ,DOI: 10.18240/ijo.2025.10.20

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  Abstract:

  AIM: To investigate the prevalence and types of eyelid disorders among an elderly population in China, underscoring the significance of eyelid health for the aging demographic. METHODS: A cross-sectional epidemiological survey was conducted on 3038 individuals over the age of 50, all of whom were evaluated at the community health center. Each participant underwent routine ophthalmic examinations and eyelid morphology evaluations by an ophthalmologist. Eyelid disorders and morphology were assessed through slit-lamp examination and direct visual inspection. The study analyzed the characteristics of common eyelid disorders, including blepharoptosis, dermatochalasis, eyelid tumors, entropion, lower eyelid retraction (LER) and ectropion, as well as eyelid morphologies such as sunken and bulging eyelids. Descriptive statistics were used for demographic data, Chi-square test analyzed gender distribution differences, and logistic regression calculated odds ratios for blepharoptosis (P<0.05 considered significant). RESULTS: The study revealed that eyelid disorders were present in 1250 (41%) individuals, with blepharoptosis being the most common disorder (25%), followed by severe dermatochalasis (16%), eyelid tumors (9.3%), LER and ectropion (11%), and entropion (1.2%). Sunken eyelids were more prevalent in men (26%) than in women (17%). The study found significant associations between the presence of blepharoptosis and sunken upper eyelids [P=0.01, odds ratio (OR)=1.33], as well as male gender (P=0.038, OR=1.22). Additionally, the prevalence of blepharoptosis increased with age. CONCLUSION: Eyelid disorders are highly prevalent in older people and increase steeply with age. This study highlights the need for increased awareness of eyelid health among older individuals at risk for eyelid disorders and the importance of ophthalmic examination for early diagnosis and management of these disorders.

• Prevalence and risk factors of myopia among school-aged children and adolescents in Xi’an, China

  Yi-Ming Guo, Guan-Chen Liu, Jun-Han Wei, Jia-Qi Wang, Jie-Jing Bi, Juan Huang, Dang-Xia Zhou, Lu Ye

  2025,18(10):1964-1970 ,DOI: 10.18240/ijo.2025.10.21

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  Abstract:

  AIM: To evaluate the prevalence of myopia and identify its associated risk factors among children and adolescents in Xi’an, China. METHODS: In a school-based cross-sectional design, students ranging from kindergarten to high school across Xi’an were enrolled. Ophthalmic examinations were performed to assess refractive status via non-cycloplegic refraction. Myopia was defined as SE≤-0.5 D, with stratification into mild (SE: ≤-0.5 to >-3.0 D), moderate (SE: ≤-3.0 to >-6.0 D), and high myopia (SE≤-6.0 D). Data on potential risk factors such as age, gender, and educational level were obtained through structured questionnaires. RESULTS: The study included 156 416 participants, with 81 389 boys (52.0%) and 75 027 girls (48.0%). The prevalence rates of myopia were 65.67% for boys and 68.83% for girls. Data collection occurred over two consecutive years, 2021 and 2022, with 78 849 and 77 567 participants, respectively. The prevalence of myopia was 67.65% in 2021 and decreased slightly to 66.71% in 2022. The high myopia rates were 3.85% and 3.43% for these years, respectively. Analysis revealed significant risk factors including gender, age, and educational level, with a distinct positive correlation between increased educational level and higher myopia prevalence. Notably, both genders exhibited a significant decrease in moderate myopia over the study period, with reductions of 1.7% and 1.2%. CONCLUSION: This comprehensive study underscores the substantial prevalence of myopia among school-aged children and adolescents in Xi’an, marking it as a significant public health concern. The correlation with higher educational levels suggests the need for targeted interventions aimed at myopia prevention and management. These findings contribute critically to the body of knowledge necessary for formulating effective public health strategies in Xi’an and potentially other similar regions.

Mendelian Randomization

• Assessment of causality between circulating inflammatory proteins and subtypes of diabetic retinopathy

  Min Dong, Ning-Zhi Zhang, Wen-Ye Cao, Xiao-Xi Deng, Wen-Xi Zhang, Yi-Qiao Xing, Ning Yang

  2025,18(10):1971-1979 ,DOI: 10.18240/ijo.2025.10.22

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  Abstract:

  AIM: To explore the causal links among circulating inflammatory proteins (CIPs) and the varying severities of diabetic retinopathy (DR). METHODS: This research utilized a two sample Mendelian randomization (MR) approach to explore the causal relationships between 91 CIPs and various severities of DR: background DR (BDR) or non-proliferative DR (NPDR), and proliferative DR (PDR). Single-nucleotide polymorphisms (SNPs) related to the 91 CIPs as exposure factors were identified. These SNPs were selected from an extensive genome-wide association study (GWAS) analyzing large genomic datasets. Genetic variation data of various DR phenotypes provided by the FinnGen collaboration were utilized as outcomes. Inverse-variance weighting (IVW) was used as the main MR analysis. Robustness of study results was evaluated through a series of sensitivity analyses, employing the MR-pleiotropy-test and mendelian randomization pleiotropy residual sum and outlier (MR-PRESSO) to confirm the absence of pleiotropy. RESULTS: In a bidirectional MR analysis, we uncovered a complex relationship between CIPs and DR. Elevated levels of tumor necrosis factor ligand superfamily member 14 (TNFSF14), latency associated peptide transforming growth factors beta-1 (LAP-TGF-beta1), interleukin-10 (IL-10), and vascular endothelial growth factor A (VEGF-A) were associated with a reduced risk of NPDR. Conversely, elevated levels of fibroblast growth factor 23 (FGF-23) were associated with an increased risk of NPDR. Concentrations of adenosine deaminase (ADA), matrix metalloproteinase-10 (MMP-10), eotaxin, and IL-10 showed elevated levels and were linked to a reduced risk of NPDR. On the other hand, the levels of oncostatin-M, beta-nerve growth factor (β-NGF), and interleukin-7 (IL-7) were elevated and associated with an increased risk of SNPDR. Elevated levels of ADA, MMP-10, and macrophage colony-stimulating factor 1 (CSF1) were linked to a lower likelihood of PDR. Conversely, elevated levels of Caspase 8 and glial cell line-derived neurotrophic factor (GDNF) were associated with an increased risk of PDR. In reverse MR analysis, DR affected the expression of these factors. CONCLUSION: Our research demonstrates evidence supporting a potential causal link between key inflammatory factors and the risk and prognosis of various DR phenotypes. These findings emphasize the regulation of inflammatory factors responses as a strategic approach for preventing and managing DR. Altogether, our results validate the pathogenic role of inflammatory factors dysregulation in DR and support the rationale for exploring immunotherapeutic targets further.

Meta-Analysis

• Micropulse laser therapy at 532, 577, and 810 nm for chronic central serous chorioretinopathy: a systematic review and Meta-analysis

  Raphaela M. Fuganti, Danielle M. Cadide, Maikon V. Fuganti, Dillan Cunha Amaral, Ricardo Noguera Louzada, Antonio M. Casella

  2025,18(10):1980-1989 ,DOI: 10.18240/ijo.2025.10.23

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  Abstract:

  AIM: To evaluate the effectiveness of 532, 577, and 810 nm lasers as an initial treatment for non-resolving central serous chorioretinopathy (CSC). METHODS: Following the Cochrane Collaboration Handbook and Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines, randomized clinical trials (RCTs), non-randomized cohorts, observational studies, and case series (>10 cases) assessing these lasers for non-resolving CSC with ≥3mo of follow-up were included. Non-resolving CSC was defined as persistent subretinal fluid (SRF) for >3-6mo. Searches were conducted in PubMed, the Cochrane Library, and Embase (January 17, 2025). Two authors independently performed data extraction and assessed the risk of bias. The primary outcome was SRF resolution on optic cherence tomography (OCT) at 3-6mo. Central retinal thickness (CRT) and best-corrected visual acuity (BCVA) were secondary outcomes. A random-effects model was employed to calculate pooled proportions with 95% confidence intervals (CIs), and heterogeneity was assessed using I² and Q statistics. RESULTS: Twenty-four studies (3 RCTs, 21 non-RCTs) involving 829 non-resolving CSC eyes (77.6% male, mean age 45.36y) were included. SRF resolution was 59% (95%CI: 0.51-0.67; I2=72.6%), showing no significant difference between lasers. Trim-and-fill adjustment raised SRF resolution to 65% (95%CI: 0.44-0.81). CRT significantly decreased by 126.32 µm (95%CI: 95.99-156.65; P<0.0001; I2=95.7%), with the largest reduction noted for the 810 nm laser. BCVA change was 0.10 logMAR (95%CI: -0.03 to 0.22; P=0.13; I2=96.6%), indicating no significant visual improvement. CONCLUSION: This Meta-analysis supports the use of 532, 577, and 810 nm subthreshold micropulse lasers as equally effective in resolving SRF in non-resolving CSC.

Review Article

• Systematic review of retinal toxicity after injection of cefuroxime during cataract surgery

  Shan-Shan Wang, Bi-Jun Zhu, Jian-Nan Huang, Bao-Jiang Li, Ying-Yan Ma, Hai-Dong Zou

  2025,18(10):1990-1999 ,DOI: 10.18240/ijo.2025.10.24

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  Abstract:

  This review is to elucidate the retinal toxicity following intraocular injections of cefuroxime, including possible risk factors, clinical manifestations, visual prognosis and treatment. Refereed publications were retrieved from PubMed, the Cochrane Library, and EMBASE databases, using the search terms cefuroxime, retina, macular edema, serous retinal detachment, toxic, cataract surgery. The screening was not limited by publication date, country or study type. We screened out 51 articles out of which 32 met the inclusion criteria for this systematic review. Data regarding sample size calculation reporting and trial characteristics were extracted for each trial. Retinal toxicity can be caused by both high and standard doses of cefuroxime injections in different ethnic groups, with risk factors including overdose, blood-retinal barrier disruption, anterior and posterior chamber connection. The typical clinical manifestations of retinal toxicity are cystoid macular edema and extensive serous retinal detachment, mainly involving the outer nuclear and outer plexiform layers, with a good prognosis for visual acuity in most cases, but in a small number of cases, the prognosis is not satisfactory. In conclusion, though the current use of intracameral injection antibiotics in cataract surgery is gradually increasing, the potential risks should not be ignored. Unexplained poor vision on the first day after cataract surgery can be supplemented with macular optical coherence tomography to rule out cefuroxime-related retinal toxicity.

• Ocular manifestations in autism spectrum disorder

  Ning-Yu Wang, Zi-Yu Zhu, Zi-Yun Jiao, Nai-Rong Pan, Mirza Mohammed Ismail Baig, Ao-Wang Qiu, Wei-Wei Zhang

  2025,18(10):2000-2006 ,DOI: 10.18240/ijo.2025.10.25

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  Abstract:

  Autism spectrum disorder (ASD) represents a neurodevelopmental disorder that has been the focus of numerous studies on the central nervous system (CNS). The embryological origin of the brain and retina is shared, with the axons of retinal ganglion cells (RGC) developing into the optic nerves that enter the brain through the dorsal lateral geniculate nucleus (LGN) of the thalamus, LGN, and other visual cortices. Given the evidence that individuals with ASD exhibit impairments in the visual mechanisms, including deficits in emotional face recognition, and difficulty in maintaining gaze control as well as eye contact, some studies have documented retinal alterations in individuals with ASD. These have been identified through ophthalmic assessments, including optical coherence tomography (OCT), optical coherence tomography angiography (OCTA), and electroretinography (ERG). With the improvements in ASD animal models, it is possible to obtain a better understanding of vision dysfunction in ASD by analyzing the molecular mechanisms of retinal function and structure abnormalities. This review aims to provide a summary of the recent research on ocular alterations in ASD patients and animal models, intending to contribute to further investigation of the eye-brain connection and communication.

Letter to the Editor

• Pulmonary hypertension causing uveal effusion syndrome: a case report

  Qian Ma, Hong-Lei Liu, Wei-Wei Wang

  2025,18(10):2007-2010 ,DOI: 10.18240/ijo.2025.10.26

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  Abstract:

• Algorithm of automatic identification of diabetic retinopathy foci based on ultra-widefield scanning laser ophthalmoscopy

  Jie Wang, Su-Zhen Wang, Xiao-Lin Qin, Meng Chen, Heng-Ming Zhang, Xin Liu, Meng-Jun Xiang, Jian-Bin Hu, Hai-Yu Huang, Chang-Jun Lan

  Abstract:

  ● AIM: To propose an algorithm for automatic detection of diabetic retinopathy (DR) lesions based on ultra-widefield scanning laser ophthalmoscopy (SLO). ● METHODS: The algorithm utilized the FasterRCNN (Faster Regions with CNN features)+ResNet50 (Residua Network 50)+FPN (Feature Pyramid Networks) method for detecting hemorrhagic spots, cotton wool spots, exudates, and microaneurysms in DR ultra-widefield SLO. Subimage segmentation combined with a deeper residual network FasterRCNN+ResNet50 was employed for feature extraction to enhance intelligent learning rate. Feature fusion was carried out by the feature pyramid network FPN, which significantly improved lesion detection rates in SLO fundus images. ● RESULTS: By analyzing 1076 ultra-widefield SLO images provided by our hospital, with a resolution of 2600×2048 dpi, the accuracy rates for hemorrhagic spots, cotton wool spots, exudates, and microaneurysms were found to be 87.23%, 83.57%, 86.75%, and 54.94%, respectively. ● CONCLUSION: The proposed algorithm demonstrates intelligent detection of DR lesions in ultra-widefield SLO, providing significant advantages over traditional fundus color imaging intelligent diagnosis algorithms.

• The relationship of blood cell-associated inflammatory indices and diabetic retinopathy: a Meta-analysis and systematic review

  Wen-Juan Luo, Wen-Fang Zhang

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  Abstract:

  AIM: To explore the correlation between several blood cell-associated inflammatory indices including mean platelet volume (MPV), platelet distribution width (PDW), neutrophil to lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR), and the presence and severity of diabetic retinopathy (DR). METHODS: We searched for eligible studies from PubMed, EMBASE, Web of Science and CNKI up to December 13, 2017. Standardized mean difference (SMD) calculated with confidence interval (CI) of 95% was used to estimate the values of those indices. RESULTS: A total of 31 studies were included in the present Meta-analysis. As compared with type 2 diabetes mellitus (T2DM) patients without DR, the values of MPV, PDW, NLR, and PLR were higher in patients with DR (SMD=0.67; 95%CI: 0.36 to 0.98; SMD=0.51; 95%CI: 0.27 to 0.75; SMD=0.77; 95%CI: 0.49 to 1.05 and SMD=1.18; 95%CI: 0.07 to 2.28). Additionally, it was also observed that MPV was closely correlated with the severity of DR. CONCLUSION: MPV, PDW, NLR, and PLR could be recommended as diagnostic biomarkers for DR, and MPV could be applied to assess the severity of DR.

  • 1
• Surgical outcome of 21 patients with congenital upper eyelid coloboma

  Arshad Ali Lodhi, Sameen Afzal Junejo, Mahtab Alam Khanzada, Imran Akram Sahaf, Zahid Kamal Siddique

  Abstract: (60260) HTML (0) PDF (420.04 KKB) (1838)

  Abstract:

  AIM: To evaluate the surgical outcome of congenital upper eyelid coloboma repair. · METHODS: All patients underwent complete ophthalmic and general examination before going to surgery, and then examination under anesthesia was performed to assess the site and size of eyelid defect, conjunctival involvement. The status of cornea and ocular motility with forced duction test was also being noted. The surgical procedure was performed according to the size of defect. · RESULTS: Out of 21 cases of congenital upper eyelid coloboma, 18 occurred in isolation with upper eyelid medial defect, 13 were bilateral and 5 were unilateral. Others were associated with Goldenhar syndrome and CHARGE syndrome with bilateral upper lid medial defects. All patients were presented for surgical corrections during age of 2.5-4.0 years except one that presented at 25 years of age. Cosmetically surgical results were acceptable, except one that was already presented with opaque corneal. · CONCLUSION: In this study, overall surgical results were satisfactory except one that was presented late with compromised cornea.

  • 1
• Safety of intravitreal quinupristin/dalfopristin in an animal model

  Veronica E. Giordano, Sergio E. Hernandez-Da Mota, Tania N. Adabache-Guel, Armando Castillejos-Chevez, Sonia Corredor-Casas, Samantha M. Salinas-Longoria, Rafael Romero-Vera, Juan M. Jimenez-Sierra, Jose L. Guerrero-Naranjo, Virgilio Morales-Canton

  Abstract: (51032) HTML (725) PDF (594.71 KKB) (1135)

  Abstract:

  AIM: To determine whether different intravitreal doses of quinupristin/dalfopristin lead to electroretinographic or histological changes in the rabbit retina over one month period after injection. METHODS: Eighteen New Zealand white rabbits were divided into three treatment groups (groups 1 to 3) and different intravitreal doses of quinupristin/dalfopristin were tested in each group. The right eye was injected with the drug and the left eye received intravitreal injection of 5% dextrose water and served as control eye. The doses delivered to each group were 0.1 mg/0.1 mL, 1 mg/0.1 mL and 10 mg/0.1 mL. Simultaneous, bilateral, dark-adapted electroretinography and clinical images of both eyes were obtained in all groups before injection (baseline) and after 7, 14, 21 and 28d, followed by enucleation for histological examination. RESULTS: Subjects in the group 1 showed no signs of toxicity in the electroretinogram when compared with groups 2 and 3 (Kruskall-Wallis test, P=0.000). By day 7, no electrical response to light stimuli was recorded in the treated eyes in groups 2 and 3, consistent with severe damage due to retinal toxicity. Light microscopy revealed no significant histopathological changes in the group 1, while rabbits in groups 2 and 3 had signs of granulomatous inflammation in most cases. CONCLUSION: Intravitreal 0.1 mg/0.1 mL doses of quinupristin/dalfopristin do not lead to electroretinographic or histological signs of retinal toxicity compared with 1 mg/0.1 mL and 10 mg/0.1 mL in this rabbit model.

  • 1
• Ocular manifestation and their associated factors among HIV/AIDS patients receiving highly active antiretroviral therapy in Southern Ethiopia

  Anteneh Amsalu, Kindie Desta, Demiss Nigussie, Demoze Delelegne

  Abstract: (50546) HTML (757) PDF (338.44 KKB) (1131)

  Abstract:

  AIM: To assess the pattern of ocular manifestation and associated factors among human immunodeficiency virus (HIV) /acquired immunodeficiency syndrome (AIDS) patients on highly active antiretroviral therapy (HAART) at Hawassa University Referral Hospital, Southern Ethiopia. METHODS: A cross sectional study was conducted from January 2014 to April 2015. After obtaining informed written consent, 240 adult HIV/AIDS patients on HAART were randomly selected regardless of their ophthalmic symptoms, WHO status or CD4 count. Data were collected using structured questionnaires and ophthalmologic clinical examination. Data were entered and analyzed using SPSS version 20.0 software. RESULTS: The mean duration of HAART was 62.5mo. The prevalence of HIV related ocular manifestation was 14.2%. Seborrheic blepharitis (5%) was the most common ocular manifestation, followed by squamoid conjunctival growth (3.8%). The rate of ocular manifestation was significantly higher among study participants who had CD4+ count <200 cells/μL (AOR=3.83; 95%CI: 1.315-11.153), low duration of HAART (AOR=3.0; 95%CI: 1.305-6.891) and who had primary school education [odds ratio (OR) =2.8; 95%CI: 1.105-7.099]. Prevalence of visual impairment and blindness was 10.9% and 5.8%, respectively. CONCLUSION: HAART may be the reason for the decline in the prevalence of ocular manifestation in HIV/AIDS patients in the study area. Ophthalmologic screening of HIV/AIDS patients, especially those with CD4 counts of <200/μL cells and in the first five years of HAART follow-up is recommended to reduce visual impairment and/or blindness.

  • 1
• Research progress about the effect and prevention of blue light on eyes

  Zhi-Chun Zhao, Ying Zhou, Gang Tan, Juan Li

  Abstract: (14056) HTML (804) PDF (290.71 KKB) (3288)

  Abstract:

  In recent years, people have become increasingly attentive to light pollution influences on their eyes. In the visible spectrum, short-wave blue light with wavelength between 415 nm and 455 nm is closely related to eye light damage. This high energy blue light passes through the cornea and lens to the retina causing diseases such as dry eye, cataract, age-related macular degeneration, even stimulating the brain, inhibiting melatonin secretion, and enhancing adrenocortical hormone production, which will destroy the hormonal balance and directly affect sleep quality. Therefore, the effect of Blu-rays on ocular is becoming an important concern for the future. We describe blue light’s effects on eye tissues, summarize the research on eye injury and its physical prevention and medical treatment.

  • 1
• Proteomic analysis of anti-angiogenic effects by conbercept in the mice with oxygen induced retinopathy

  Ji Jin, Lei Chen, Gao-Qin Liu, Pei-Rong Lu

  Abstract: (10528) HTML (0) PDF (2.76 MKB) (1205)

  Abstract:

  AIM: To analyze the retinal proteomes with and without conbercept treatments in mice with oxygen-induced retinopathy (OIR) and identify proteins involved in the molecular mechanisms mediated by conbercept. METHODS: OIR was induced in fifty-six C57BL/6J mouse pups and randomly divided into four groups. Group 1: Normal17 (n=7), mice without OIR and treated with normal air. Group 2: OIR12/EXP1 (n=14), mice received 75% oxygen from postnatal day (P) 7 to 12. Group 3: OIR17/Control (n=14), mice received 75% oxygen from P7 to P12 and then normal air to P17. Group 4: Lang17/EXP2 (n=21), mice received 75% oxygen from P7 to P12 with intravitreal injection of 1 μL conbercept at the concentration of 10 mg/mL at P12, and then normal air from P12 to P17. Liquid Chromatography-Mass Spectrometry (LC-MS)/MS data were reviewed to find proteins that were up-regulated after the conbercept treatment. Gene ontology (GO) analysis was performed of conbercept-mediated changes in proteins involved in single-organism processes, biological regulation, cellular processes, immune responses, metabolic processes, locomotion and multiple-organism processes. RESULTS: Conbercept induced a reversal of hypoxia-inducible factor 1 signaling pathway as revealed by the Kyoto Encyclopedia of Genes and Genomes (KEGG) analysis and also induced down-regulation of proteins involved in blood coagulation and fibrin clot formation as demonstrated by the Database for Annotation, Visualization and Integrated Discovery (DAVID) and the stimulation of interferon genes studies. These appear to be risk factors of retinal fibrosis. Additional conbercept-specific fibrosis risk factors were also identified and may serve as therapeutic targets for fibrosis. CONCLUSION: Our studies reveal that many novel proteins are differentially regulated by conbercept. The new insights may warrant a valuable resource for conbercept treatment.

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• Achromatopsia caused by novel missense mutations in the CNGA3 gene

  Xi-Teng Chen, Hui Huang, Yan-Hua Chen, Li-Jie Dong, Xiao-Rong Li, Xiao-Min Zhang

  Abstract: (9545) HTML (0) PDF (771.47 KKB) (1180)

  Abstract:

  AIM:To identify the genetic defects in a Chinese family with achromatopsia.METHODS:A 2.5-year-old boy, who displayed nystagmus, photophobia, and hyperopia since early infancy, was clinically evaluated. To further confirm and localize the causative mutations in this family, targeted region capture and next-generation sequencing of candidate genes, such as CNGA3, CNGB3, GNAT2, PDE6C, and PDE6H were performed using a custom-made capture array.RESULTS:Slit-lamp examination showed no specific findings in the anterior segments. The optic discs and maculae were normal on fundoscopy. The unaffected family members reported no ocular complaints. Clinical signs and symptoms were consistent with a clinical impression of autosomal recessive achromatopsia. The results of sequence analysis revealed two novel missense mutations in CNGA3, c.633T>A (p.D211E) and c.1006G>T (p.V336F), with an autosomal recessive mode of inheritance.CONCLUSION: Genetic analysis of a Chinese family confirmed the clinical diagnosis of achromatopsia. Two novel mutations were identified in CNGA3, which extended the mutation spectrum of this disorder.

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• Tests for malingering in ophthalmology

  Ali Ihsan Incesu

  Abstract: (9194) HTML (0) PDF (281.98 KKB) (1716)

  Abstract:

  Simulation can be defined as malingering, or sometimes functional visual loss (FVL). It manifests as either simulating an ophthalmic disease (positive simulation), or denial of ophthalmic disease (negative simulation). Conscious behavior and compensation or indemnity claims are prominent features of simulation. Since some authors suggest that this is a manifestation of underlying psychopathology, even conversion is included in this context. In today’s world, every ophthalmologist can face with simulation of ophthalmic disease or disorder. In case of simulation suspect, the physician’s responsibility is to prove the simulation considering the disease/disorder first, and simulation as an exclusion. In simulation examinations, the physician should be firm and smart to select appropriate test(s) to convince not only the subject, but also the judge in case of indemnity or compensation trials. Almost all ophthalmic sensory and motor functions including visual acuity, visual field, color vision and night vision can be the subject of simulation. Examiner must be skillful in selecting the most appropriate test. Apart from those in the literature, we included all kinds of simulation in ophthalmology. In addition, simulation examination techniques, such as, use of optical coherence tomography, frequency doubling perimetry (FDP), and modified polarization tests were also included. In this review, we made a thorough literature search, and added our experiences to give the readers up-to-date information on malingering or simulation in ophthalmology.

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• Therapeutic effects of mesenchymal stem cells administered at later phase of recurrent experimental autoimmune uveitis

  Ping-Ting Zhao, Ling-Jun Zhang, Hui Shao, Ling-Ling Bai, Bo Yu, Chang Su, Li-Jie Dong, Xun Liu, Xiao-Rong Li, Xiao-Min Zhang

  Abstract: (8816) HTML (0) PDF (2.01 MKB) (1111)

  Abstract:

  AIM: To test the therapeutic effects of delayed treatment of mesenchymal stem cells (MSCs) in recurrent experimental autoimmune uveitis (rEAU). METHODS: The efficacy of different regimens of MSC administration in rEAU were tested by evaluation of clinical and pathological intraocular inflammation, as well as retinal structural and functional integrity using optical coherence tomography (OCT) and electroretinogram (ERG). The retinal sections were also immunostained with antibodies to glial fibrillary acidic protein (GFAP) and rhodopsin (RHO). RESULTS: Delayed treatment of MSCs effectively alleviated the severity of intraocular inflammation with relative intact of outer retinal structure and function. Moreover, double therapies with longer interval led to an even better clinical evaluation, as well as a trend of decrease in relapse and amelioration of retinal function. MSC therapies also effectively reduced GFAP expression and increased RHO expression in the retina. CONCLUSION: MSC administration can effectively treat developed diseases of rEAU, and multiple therapies can provide additional therapeutic benefits.

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• Rapamycin ameliorates experimental autoimmune uveoretinitis by inhibiting Th1/Th2/Th17 cells and upregulating CD4+CD25+ Foxp3 regulatory T cells

  Li-Fei Yuan, Guang-Da Li, Xin-Jun Ren, Hong Nian, Xiao-Rong Li, Xiao-Min Zhang

  Abstract: (8071) HTML (0) PDF (871.51 KKB) (1061)

  Abstract:

  AIM:To determine the effects of rapamycin on experimental autoimmune uveoretinitis (EAU) and investigate of role of rapamycin on T cell subsets in the disease. METHODS:EAU was induced in rats using peptides 1169 to 1191 of the interphotoreceptor binding protein (IRBP). Rapamycin (0.2 mg/kg/d) was administrated by intraperitoneal injection for a consecutive 7d after immunization. Th1/Th2/Th17 cytokines, TGF-β1, and IL-6 produced by lymphocyteswere measured by ELISA, while Th17 cells and CD4+CD25+ regulatory T cells (Tregs) from rat spleen were detected by flow cytometry. RESULTS: Intraperitoneal treatment immediately after immunization dramatically ameliorated the clinical course of EAU. Clinical responses were associated with reduced retinal inflammatory cell infiltration and tissue destruction. Rapamycin induced suppression of Th1/Th2/Th17 cytokines, including IFN-γ, IL-2, IL-17, IL-4, and IL-10 release from T lymphocytes of EAU rats, in vitro. Rapamycin also significantly increased TGF-β1 production but had no effect on IL-6 productionof T lymphocytes from EAU rats in vitro. Furthermore, rapamycin decreased the ratio of Th17 cells/CD4+T cells and upregulated Tregs in EAU, as detected by flow cytometry. CONCLUSION: Rapamycin effectively interferes with T cell mediated autoimmune uveitis by inhibiting antigen-specific T cell functions and enhancing Tregs in EAU. Rapamycin is a promising new alternative as an adjunct corticosteroid-sparing agent for treating uveitis.

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• Superglue injuries of the eye

  Sagili Chandrasekhara Reddy

  Abstract: (7909) HTML (0) PDF (669.75 KKB) (1782)

  Abstract:

  AIM: To report various ocular lesions caused by accidental instillation of superglue.METHODS: Three cases of ocular injuries are described in children aged 6 years, 3 years and 8 months, following accidental instillation of superglue in the eye.RESULTS: In the first case there was sticking of eyelashes in the medial 1/3 of eyelids in both eyes. In the second case sticking of eye lashes was present in the lateral 1/3 of eyelids in the left eye. In the third case, superglue was present on the right cheek, above the right ear and sticking of eyelids in medial 1/3 in right eye. The eyelids were separated by pulling the lid margins with fingers in the first case and later on superglue was removed by trimming the eyelashes; and by direct trimming the eyelashes in second and third cases. There was no injury to other structures of anterior segment in the first two cases. However, removal of the superglue on the cornea resulted in corneal abrasion in the third case which healed with medical treatment and patching of the right eye.CONCLUSION: Accidental instillation of superglue is possible because of the appearance of the tube like eye ointment tube. Immediate medical aid will prevent ocular morbidity.

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• A near-vision chart for children aged 3-5 years old:new designs and clinical applications

  Yang-Qing Huang, He Huang, Rong-Zhi Huang

  Abstract: (6881) HTML (0) PDF (963.79 KKB) (1302)

  Abstract:

  AIM:To introduce a new near-vision chart for children aged 3-5 years old and its clinical applications.METHODS:The new near-vision chart which combined the Bailey-Lovie layout with a newly devised set of symmetry symbols was designed based on Weber-Fechner law. It consists of 15 rows of symmetry symbols, corresponding to a visual acuity range from 1.3 to 0.1 logMAR. The optotypes were red against a white background and were specially shaped four basic geometric symbols:circle, square, triangle，and cross, which matched the preschool children''s cognitive level. A regular geometric progression of the optotype sizes and distribution was employed to arrange in 15 lines. The progression rate of the optotype size between two lines was 1.2589 and two smaller groups of optotypes ranging from 0.7 to -0.1 logMAR were included for repetitive testing. A near visual acuity was recorded in logMAR or decimal, and the testing distance was 25 cm.RESULTS:This new near-vision chart with pediatric acuity test optotypes which consists of 4 different symbols (triangle, square, cross, and circle) met the national and international eye chart design guidelines. When performing the near visual acuity assessment in preschoolers (3-5 years old). It overcame an inability to recognize the letters of the alphabet and difficulties in designating the direction of black abstract symbols such as the tumbling ''E'' or Landolt ''C'', which the subjects were prone to lose interest in. Near vision may be recorded in different notations:decimal acuity and logMAR. These two notations can be easily converted each other in the new near-vision chart. The measurements of this new chart not only showed a significant correlation and a good consistency with the Chinese national standard logarithmic near-vision chart (r=0.932, P<0.01), but also indicated good test-retest reliability (89% of retest scores were within 0.1 logMAR units of the initial test score) and a high response rate.CONCLUSION:The results of this study support the validity and reliability of near visual acuity measurements using the new near-vision chart in children aged 3-5y over a wide range of visual acuities, and the new eye chart was especially suitable for the detection of amblyopia risk factors and low vision examination in children (3-5y of age). It can be applied in routine clinical practice.

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• Malingering or simulation in ophthalmology-visual acuity

  Ali Ihsan Incesu, Güng?r Sobac?

  Abstract: (6513) HTML (0) PDF (320.40 KKB) (1568)

  Abstract:

  Simulation can be defined as malingering, or sometimes functional visual loss (FVL). It manifests as either simulating an ophthalmic disease (positive simulation), or denial of ophthalmic disease (negative simulation). Conscious behavior and compensation or indemnity claims are prominent features of simulation. Since some authors suggest that this is a manifestation of underlying psychopathology, even conversion is included in this context. In today's world, every ophthalmologist can face with simulation of ophthalmic disease or disorder. In case of simulation suspect, the physician's responsibility is to prove the simulation considering the disease/disorder first, and simulation as an exclusion. In simulation examinations, the physician should be firm and smart to select appropriate test(s) to convince not only the subject, but also the judge in case of indemnity or compensation trials. Almost all ophthalmic sensory and motor functions including visual acuity, visual field, color vision and night vision can be the subject of simulation. Examiner must be skillful in selecting the most appropriate test. Apart from those in the literature, we included all kinds of simulation in ophthalmology. In addition, simulation examination techniques, such as, use of OCT (optical coherence tomography), frequency doubling perimetry (FDP), and modified polarization tests were also included. In this review, we made a thorough literature search, and added our experiences to give the readers up-to-date information on malingering or simulation in ophthalmology.

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• Prevalence of vitreous floaters in a community sample of smartphone users

  Blake F. Webb, Jadon R. Webb, Mary C. Schroeder, Carol S. North

  Abstract: (6321) HTML (0) PDF (202.26 KKB) (1516)

  Abstract:

  AIM: To estimate the prevalence and risk factors for vitreous floaters in the general population.METHODS: An electronic survey was administered through a smartphone app asking various demographic and health questions, including whether users experience floaters in their field of vision. Multivariate logistic regression analysis was used to determine risk factors.RESULTS:A total of 603 individuals completed the survey, with 76% reporting that they see floaters, and 33% reporting that floaters caused noticeable impairment in vision. Myopes were 3.5 times more likely (P=0.0004), and hyperopes 4.4 times more likely (P=0.0069) to report moderate to severe floaters compared to those with normal vision. Floater prevalence was not significantly affected by respondent age, race, gender, and eye color.CONCLUSION:Vitreous floaters were found to be a very common phenomenon in this non-clinical general population sample, and more likely to be impairing in myopes and hyperopes.

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• Comparison of fibrin glue and suture technique in pterygium surgery performed with limbal autograft

  Bora Yüksel, Sultan Kaya ünsal, Sevgi Onat

  Abstract: (6264) HTML (0) PDF (165.03 KKB) (1642)

  Abstract:

  AIM: To compare the efficiency and safety of fibrin glue to suture technique in pterygium surgery performed with limbal autograft. METHODS: A prospective randomised clinical trial was carried out in 58 eyes of 58 patients operated for primary nasal pterygium. Autologous conjunctival graft taken from the superotemporal limbus was used to cover the sclera after pterygium excision. In 29 eyes, the transplant was attached to the sclera with a fibrin tissue adhesive (Beriplast P) and in 29 eyes with 8-0 Virgin silk sutures. The Mann-Whitney U test was used for statistical analysis. Postoperative patient discomfort (pain, stinging, watering) and biomicroscopic findings (hyperemia, edema) were graded. Patients were followed up at least for six months. RESULTS: Subconjunctival hemorrhage occured under the graft in one patient in group 1. In seven cases of group 2, sutures were removed at the 15th day because of granulomatous tissue reaction. Patient symptoms were significantly less and biomicroscopic findings were better in group 1. Pterygium recurrence was seen in one case of group 1, and 2 cases of group 2. Average surgery cost was higher (P<0.05) and surgery time was shorter (P<0.05) in fibrin group. CONCLUSION: Using fibrin glue for graft fixation in pterygium surgery causes significantly less postoperative pain and shortens surgery time significantly.

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• Photobiomodulation for the treatment of retinal diseases: a review

  Ivayla I. Geneva

  Abstract: (6226) HTML (0) PDF (331.95 KKB) (1694)

  Abstract:

  Photobiomodulation (PBM), also known as low level laser therapy, has recently risen to the attention of the ophthalmology community as a promising new approach to treat a variety of retinal conditions including age-related macular degeneration, retinopathy of prematurity, diabetic retinopathy, Leber’s hereditary optic neuropathy, amblyopia, methanol-induced retinal damage, and possibly others. This review evaluates the existing research pertaining to PBM applications in the retina, with a focus on the mechanisms of action and clinical outcomes. All available literature until April 2015 was reviewed using PubMed and the following keywords: “photobiomodulation AND retina”, “low level light therapy AND retina”, “low level laser therapy AND retina”, and “FR/NIR therapy AND retina”. In addition, the relevant references listed within the papers identified through PubMed were incorporated. The literature supports the conclusion that the low-cost and non-invasive nature of PBM, coupled with the first promising clinical reports and the numerous preclinical-studies in animal models, make PBM well-poised to become an important player in the treatment of a wide range of retinal disorders. Nevertheless, large-scale clinical trials will be necessary to establish the PBM therapeutic ranges for the various retinal diseases, as well as to gain a deeper understanding of its mechanisms of action.

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• Cod liver oil: a potential protective supplement for human glaucoma

  Wen-Bin Huang, Qian Fan, Xiu-Lan Zhang

  Abstract: (6109) HTML (0) PDF (246.01 KKB) (1493)

  Abstract:

  Glaucoma is one of the leading causes of visual impairment and blindness. Improved knowledge of the pathogenesis of this disease has allowed the exploration of new therapeutic methods. In general, elevated intraocular pressure (IOP), oxidative stress, and vascular insufficiency are accepted as the major risk factors for the progression of glaucoma. Many natural compounds have been found beneficial for glaucoma. Nutritional therapies are now emerging as potentially effective in glaucomatous therapy. One nutritional supplement with potential therapeutic value is cod liver oil, a dietary supplement that contains vitamin A and omega-3 polyunsaturated fatty acids (PUFAs). Vitamin A is important for preserving normal vision and it is a well-known antioxidant that prevents the oxidative damage that contributes to the etiology and progression of glaucoma. Vitamin A is also a crucial factor for maintaining the integrity of conjunctival and corneal ocular surfaces, and preventing the impairment of ocular epithelium caused by topical antiglaucomatous drugs. Omega-3 fatty acids are beneficial for glaucoma patients as they decrease IOP, increase ocular blood flow, and improve optic neuroprotective function. In this article, we propose that cod liver oil, as a combination of vitamin A and omega-3 fatty acids, should be beneficial for the treatment of glaucoma. However, further studies are needed to explore the relationship between cod liver oil and glaucoma.

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• Epidemiology and molecular genetics of congenital cataracts

  Jun Yi, Jun Yun, Zhi-Kui Li, Chang-Tai Xu, Bo-Rong Pan

  Abstract: (6078) HTML (0) PDF (570.98 KKB) (1859)

  Abstract:

  · Congenital cataract is a crystallin severe blinding disease and genetic factors in disease development are important. Crystallin growth is under a combination of genes and their products in time and space to complete the coordination role of the guidance. Congenital cataract-related genes, included crystallin protein gene (CRYAA, CRYAB, CRYBA1/A3, CRYBA4, CRYBB1, CRYBB2, CRYBB3, CRYGC, CRYGD, CRYGS), gap junction channel protein gene (GJA1, GJA3, GJA8), membrane protein gene (GJA3, GJA8, MIP, LIM2), cytoskeletal protein gene (BF-SP2), transcription factor genes (HSF4, MAF, PITX3, PAX6), ferritin light chain gene (FTL), fibroblast growth factor (FGF) and so on. Currently, there are about 39 genetic loci isolated to which primary cataracts have been mapped, although the number is constantly increasing and depends to some extent on definition. We summarized the recent advances on epidemiology and genetic locations of congenital cataract in this review.

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• Aniridia rings implantation for treatment of congenital aniridia combined with cataract surgery: a case report

  Juan-Juan Li, Yun-Peng Li, Zhu-Lin Hu

  Abstract: (5831) HTML (0) PDF (87.46 KKB) (1582)

  Abstract:

  We describe the successful treatment in a patient with bilateral congenital aniridia and cataract by insertion of capsular tension rings and IOL.

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• Prevention of exposure keratopathy in intensive care unit

  Hua Shan, Du Min

  Abstract: (5783) HTML (0) PDF (107.88 KKB) (1530)

  Abstract:

  AIM: To compare the efficacy for preventing exposure keratopathy of three forms of eye care (artificial tear, moist chamber and polyethylene covers) for intensive care patients. METHODS: Eighty-four patients in Intensive Care Unit (ICU) were randomized to three treatment groups, including artificial tears group, moist chambers group and polyethylene film group. Patients of artificial tear group received two drops of carboxymethylcellulose drops to each eye every 2 hours. The moist chambers and the polyethylene were changed every 12 hours or as needed if they became unclean or torn. The corneal fluorescein stains were performed daily. RESULTS: No of 28 patients (0%) in the polyethylene group and one of the 27 patients (3.70%) in the moist chamber group had exposure keratopathy, compared to 8 of the 29 patients (27.59%) in the artificial tear group. There were statistical significance between the artificial tear group and the moist chamber group (P=0.02), and the artificial tear group and the polyethylene group (P =0.003). The time on eye care every day of the artificial tear group, the moist chamber group and the polyethylene group was 26.69±2.39 minutes, 35.33±2.63 minutes and 7.48±0.87 minutes, respectively. The eye care of the polyethylene group were statistically more time-save than that of the artificial tear group (P<0.001) and the moist chamber group (P<0.001). CONCLUSION: Polyethylene covers are more effective and more time-saving in reducing the incidence of corneal damage in intensive care patients

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