Abstract:

Abstract:In vivo confocal microscopy of the cornea is a non-invasive, rapid, and comprehensive technique for real-time, dynamic observation of all layers of the cornea. Confocal microscopy allows the examination of the morphology and cell density in the different layers of the cornea through direct visualization. With the increasing prevalence of diabetes, ocular complications have become common and have garnered more interest and in-depth research from clinical and scientific communities. This paper provides a comprehensive review of research progress made using in vivo confocal microscopy to observe various layers of cornea tissue in diabetic patients.

Abstract:AIM:To establish a nomogram model to predict the effect of serum ferritin on diabetic retinopathy and evaluate the model.

METHODS:A total of 21 variables, including ferritin, were screened by univariate and multivariate regression analysis to determine the risk factors of diabetic retinopathy. A nomogram prediction model was established for evaluation and calibration.

RESULTS:Ferritin, duration of diabetes, hemoglobin, urine microalbumin, regularity of medication and body mass index were included in the nomogram model. The consistency index of the prediction model with serum ferritin was 0.813(95%CI: 0.748-0.879). The calibration curves of internal and external verification showed good performance, and the probability of the threshold suggested by the decision curve was in the range 10% to 90%. The model had a high net profit value.

CONCLUSIONS:Serum ferritin is an important risk factor for diabetic retinopathy. A new nomogram model, which includes body mass index, duration of diabetes, ferritin, hemoglobin, urine microalbumin and regularity of medication, has a high predictive accuracy and could provide early prediction for clinicians.

Abstract:AIM:To identify transcriptional differences between the ocular surface ectoderm(OSE)and surface ectoderm(SE)using RNA-seq, and elucidate the OSE transcriptome landscape and the regulatory networks involved in its development.

METHODS:OSE and SE cells were differentiated from human embryonic stem(hES)cells. Differentially expressed genes(DEGs)between OSE and SE were analyzed using RNA-seq. Based on the DEGs, we performed gene ontology(GO)analysis, Kyoto Encyclopedia of Genes and Genomes(KEGG)pathway enrichment analysis, and protein-protein interaction(PPI)network analysis. Transcription factors(TFs)and hub genes were screened. Subsequently, TF-gene and TF-miRNA regulatory networks were constructed using the NetworkAnalyst platform.

RESULTS:A total of 4 182 DEGs were detected between OSE and SE cells, with 2 771 up-regulated and 1 411 down-regulated genes in OSE cells. GO-BP analysis revealed that up-regulated genes in OSE were enriched in the regulation of ion transmembrane transport, axon development, and modulation of chemical synaptic transmission. Down-regulated genes were primarily involved in nuclear division, chromosome segregation, and regulation of cell cycle phase transition. KEGG analysis indicated that up-regulated genes in OSE cells were enriched in signaling pathways such as cocaine addiction, axon guidance, and amphetamine addiction, while down-regulated genes were enriched in proteoglycans in cancer, ECM-receptor interaction, protein digestion and absorption, and cytokine-cytokine receptor interaction. Additionally, compared with SE, 204 TFs(including FOS, EGR1, POU5F1, SOX2, and PAX6)were up-regulated, and 80 TFs(including HAND2, HOXB6, HOXB5, HOXA5, and HOXB8)were down-regulated in OSE cells. Furthermore, we identified 6 up-regulated and 9 down-regulated hub genes in OSE cells, and constructed TF-gene and TF-miRNA regulatory networks based on these hub genes.

CONCLUSIONS:The transcriptome characteristics of OSE and SE cells were elucidated through RNA-seq analysis. These findings may provide a novel insight for studies on the development and in vitro directed induction of OSE and corneal epithelial cells.

Abstract:AIM: To explore the synthesis of thermo-sensitive poly N-isopropylacry-lamide(PNIPAAm)and the petri dish grafted with PNIPAAm hydrogels by the electron accelerator, as well as the growth conditions and the biological characteristics of rabbit corneal stromal cells on thermo-sensitive PNIPAAm hydrogels, and the cell sheets obtained from the PNIPAAm hydrogels.

METHODS: NIPAAm monomer was dissolved in 2-propanol at concentrations of 55% with 0.5% N,N'-Methylenebisacry-lamide(MBA). Solution(70 μL)was added and spread uniformly over 35 mm petri dish. These dishes were immediately subjected to irradiation. After follow-up treatment, rabbit corneal stromal cells were cultured on thermo-sensitive petri dish in vitro.

RESULTS: According to the monomer formula and radiation synthesis scheme in this experiment, PNIPAAm can be synthesized on the surface of the petri dish. Rabbit corneal stromal cells grew well in the thermo- sensitive surface and can be separated into sheets.

CONCLUSION: The single and multilayer carrier-free cell sheets can be obtained from the use of thermo-sensitive petri dish.

Abstract:AIM: To evaluate the clinical efficacy of Mongolian medicine Mingmu-11 Pills combined with conbercept in the treatment of wet age-related macular degeneration(wARMD).

METHODS: Prospective study. All cases in this study were wARMD patients(72 cases, 72 eyes)admitted to the Ophthalmology Department of Affiliated Hospital of Inner Mongolia University from November 2020 to December 2021. They were randomly divided into a combined treatment group and a control group, each with 36 eyes, and the control group received intravitreal injection of conbercept 0.05 mL for 3 consecutive months. The combined treatment group was given Mingmu-11 Pills twice a day after surgery, with 3 wk as a course of treatment, a total of 3 courses, and the control group was not given Mongolian medicine treatment. The best corrected visual acuity(BCVA), changes in central macular thickness(CMT)in the macular area, and changes in N1, P1 wave amplitude density and latency were observed after treatment in both groups.

RESULTS:The BCVA(letter number)of the two groups were improved(P<0.05), and the CMT were decreased(P<0.05). The improvement of BCVA(letter number)in the combined treatment group was better than that in the control group at 3 mo(17.42±3.29 vs 14.61±3.14, P<0.001)and 5 mo(19.75±3.25 vs 16.81±2.77, P<0.001)after treatment; compared with the control group, CMT of the combined treatment group was thinner than that of the control group at 3 mo(304.58±53.34 vs 351.94±52.99 μm, P<0.001)and 5 mo(274.17±62.26 vs 321.78±63.22 μm, P<0.05)after treatment. The amplitude density of N1 and P1 wave in mfERG in both groups at 3 mo after treatment was higher than that before treatment(P<0.05), and r1-r3 latency of P1 wave was shorter than that before treatment(P<0.05), with no differences in the r1-r3 latency of N1 wave(P>0.05). In addition, the amplitude density of N1 and P1 wave in the combined treatment group was higher than that in the control group at 3 mo after treatment(P<0.05), the latency of P1 wave in the treatment group was significantly shorter than that in the control group(P<0.05), and there was no significant difference in the latency of N1 wave between the two groups(P>0.05).

CONCLUSIONS:Mingmu-11 Pills combined with intravitreal injection of conbercept in the treatment of wARMD has obvious efficacy in improving vision and reducing macular edema.

Abstract:AIM: To compare the efficacy of intravitreal injection of ranibizumab(IVR)and intravitreal injection of conbercept(IVC)in children with retinopathy of prematurity(ROP).

METHODS: Retrospective study. A total of 1 100 eyes with ROP treated with intravitreal anti-VEGF at our hospital from January 2015 to June 2023 were included. According to the different therapeutic drugs, the children were divided into two groups: IVR group and IVC group. According to the degree of ROP, the patients were divided into three groups: aggressive ROP(A-ROP), Zone Ⅰ type 1 ROP and Zone Ⅱ type 1 ROP. The reactivation and retreatment between the two groups were compared after propensity score matching(PSM)analysis, and they were followed-up for at least 3 mo after surgery.

RESULTS: In Zone Ⅱ type 1 ROP, there was a statistically significant difference in the rates of reactivation and retreatment between the IVR and IVC groups(P<0.05); however, in A-ROP and Zone I type 1 ROP, there were no statistically significant differences in the rates of reactivation and retreatment between the two groups(P>0.05). The risk of reactivation and retreatment of Zone I type 1 ROP was higher than the Zone II type 1 ROP. Furthermore, the use of drugs and corrected gestational age of first treatment were influencing factors of lesion recurrence and retreatment.

CONCLUSION: There is a significant difference in the initial cure effect between the two drugs in Zone II type 1 ROP, with the reactivation and retreatment rates of the IVC group being much lower than those of the IVR group.

Abstract:AIM: To understand the publication status, research trends, and cutting-edge and hot topics in this field by conducting a bibliometrics analysis of relevant literatures on the pathogenesis of primary open angle glaucoma(POAG)in the past 30 a.

METHODS:A total of 986 relevant literatures on the pathogenesis of POAG published on the core databases of China National Knowledge Infrastructure(CNKI)and Web of Science(WOS)from 1 September 1993 to 1 September 2023 were retrieved. CiteSpace(6.2.R.4)and VOSviewer(1.6.18)software were used to conduct knowledge graph analysis on the retrieved literature, including publication volume, author, research institution, country/region, and keywords.

RESULTS:The United States(243 articles)has the highest number of publications, followed by China(121 articles). The foreign institution with the highest number of publications is Harvard University(37 articles), while domestic institutions such as Zhongshan Ophthalmic Center, Sun Yat-sen University, ophthalmology department of Xuanwu Hospital of Capital Medical University, and Peking University First Hospital tied for the highest number of publications. Louis R. Pasquale(21 articles)is the most prolific English author. Wang Ningli is the most active Chinese researcher in this field. Keywords include trabecular meshwork, intraocular pressure, aqueous humor, glucocorticoid, hemorheology, etc.

CONCLUSION: The research on the pathogenesis of POAG is in a period of vigorous development. The United States has the largest number of publications in this field, and Harvard University is a leading institution in this field. The research focus in the field of POAG has shifted from the structural aspect to the genetic level, and gene research and traditional Chinese medicine treatment have broad application prospects in this field.

Abstract:AIM: To explore the current status, research hotspots, and trends of global uveitis research to provide a theoretical basis and references for researchers in the field of uveitis, and promote further development in this area.

METHODS: Relevant literatures on uveitis were retrieved from the China National Knowledge Infrastructure(CNKI)database, Wanfang database, and Web of Science core collection database since their establishment until 24 August 2023. The country/publishing institutions, research authors, high-frequency keywords, and burst keywords were visual analyzed by using software such as GraphPad Prism 9, CiteSpace 6.2. R2, and VOSviewer.

RESULTS: Research teams for uveitis have been formed in various countries globally. The top three countries in terms of publications are the United States of America(7 585 papers), the United Kingdom(2 412 papers)and Germany(1 679 papers). The top three foreign institutions in terms of publications are Harvard University, Oregon Health & Science University, and Moorfields Eye Hospital, while the top three domestic institutions are Affiliated Eye Hospital of Shandong University of Traditional Chinese Medicine, Chongqing Medical University, and Zhongshan Ophthalmic Center, Sun Yat-sen University. The analysis of high-frequency keywords and burst keywords in Chinese and English shows that research hotspots mainly focus on exploring pathogenesis and different treatment methods for uveitis. The research hotspots related to uveitis treatment are transitioning to molecular biology-related research topics, such as molecular biological signaling pathways(NF-κB signaling pathway with a strength value of 22.89), biological agents(adalimumab with a strength value of 32.21), and tumor necrosis factor(with a strength value of 48.44). Related research is also expanding to basic experiments on relevant rats.

CONCLUSIONS: In recent years, the research hotspots and trends of global uveitis mainly focus on precise diagnosis, pathogenesis, and more effective treatment methods. It is important for more scholars to dedicate themselves to uveitis-related research in the future to make breakthroughs and progress in the field. More large-scale and multicenter clinical studies on uveitis can provide high-quality research evidence.

Abstract:Non-infectious uveitis, an autoimmune disease that can cause severe visual impairment, can be difficult to treat. According to the prevailing hypothesis, the immune-mediated imbalance that contributes to non-infectious uveitis is primarily driven by CD4⁺T cells. However, recent research has shown that B cells also play a significant role in this process, participating in various ways such as antibody production, antigen presentation, and cytokine secretion in both human uveitis and experimental autoimmune uveitis models. Therapies targeting B cells have been used extensively in various autoimmune diseases. Rituximab, a B-cell inhibitor, is effective in treating noninfectious uveitis that is unresponsive to conventional corticosteroid and immunosuppressive therapy. This paper provides an overview of the involvement of B cells in non-infectious uveitis and their potential use in cellular therapies, aiming to further investigate the mechanisms and develop more effective strategies for prevention and treatment.

Abstract:Charles Bonnet syndrome(CBS)refers to hallucinations resulting from visual pathway damage in individuals without neuropsychiatric disorders. CBS patients typically have insight into the unreality of their hallucinations, and the disorder may be episodic, periodic, or chronic. The condition's prevalence varies from 0.4% to 30% due to the absence of agreed diagnostic criteria for CBS and some patients' reluctance to acknowledge hallucinations. Massive studies have demonstrated an association between CBS and ocular diseases, such as age-related macular degeneration and glaucoma. Additionally, there have been reports of CBS occurring after ophthalmic surgery or medication. Therefore, clinicians should be vigilant in diagnosing CBS promptly and reassuring patients. There is a lack of literature on CBS in ophthalmology, and further research is needed to explore its pathogenesis and diagnostic and therapeutic options. This article reviews some of the studies related to CBS in recent years.

Abstract:In medical research,predictive models have been widely used to predict disease progression and identify high-risk populations in advance, especially in the prevention and diagnosis of chronic diseases. In ophthalmology, the predictive and diagnostic models for fundus diseases such as age-related macular degeneration and diabetic retinopathy have demonstrated expert-level accuracy. However, the application of predictive models is still in the exploratory stage as for myopia prevention and control. The establishment of a predictive model is helpful to identify the high-risk myopic children in advance, so that preventive measures such as adequate outdoor activities and reducing near work can be taken in time, which is of great significance to prevent or slow down the occurrence and development of myopia. Because the mechanism of myopia has not been fully elucidated, there are still challenges and limitations in the selection of application objects, predictors and predictive outcomes. This paper reviews the research progress of different types of myopia predictive models in order to provide reference for further development and improvement.

Abstract:Diabetic retinopathy(DR)represents the primary cause of blindness among the global working-age population, and the disruption of the blood-retinal barrier is a crucial factor. Research in recent years has elucidated that DR transcends the scope of a mere microvascular disorder into a complex interplay of retinal glial cells and neurodegeneration microvascular pathology. Neuronal damage may precede vascular endothelial changes in the retinal neurovascular unit(RNVU)in the early stage of DR, and glial cell activation further exacerbates vascular barrier dysfunction. Retinal microglia are immune cells that reside in the retina and are involved in chronic inflammatory responses induced by long-term exposure to high glucose levels. Microglia secrete various inflammatory factors in response to high glucose levels, which can lead to the destruction of the blood-retinal barrier structure, increased neuronal apoptosis, and altered gliosis of Muller cells, thus affecting the retina's homeostatic balance. The RNVU has received increasing attention in recent years as a unitary structural study, and the mechanism of microglia in the RNVU and the progress of the study are reviewed.

Abstract:Idiopathic epiretinal membrane(IERM)is a kind of epiretinal membrane without any other known ocular conditions, which occurs mostly in the middle-aged and elderly people over the age of 50. As IERM worsens, the structure and function of the retina in the macular region are altered, leading to symptoms like reduced vision and metamorphopsia. The pathogenesis of IERM remains unclear, and surgery is the primary treatment option. However, there is no consensus on the best time to have surgery, and there are differences in how well patients recover their vision following surgery. Optical coherence tomography(OCT)and OCT angiography(OCTA), as non-invasive and rapid diagnostic tools to observe retinal microstructure and blood flow changes in the macula, have been extensively utilized in clinical settings. The use of OCT and OCTA parameters to predict postoperative visual acuity has emerged as a hot topic in IERM research. This article provides a comprehensive review of current research on the correlation between various OCT and OCTA parameters and the prediction of postoperative visual acuity in IERM, aiming to assist clinicians in determining the optimal timing for surgery and balancing the benefits and risks involved.

Abstract:Diabetic macular edema(DME)is a complication of diabetic retinopathy(DR), and is also the main cause of vision loss and blindness in DR patients. Optical coherence tomography(OCT)and optical coherence tomography angiography(OCTA)serve as the principal methods for the non-invasive assessment of microstructural and microvascular pathological changes in the retina. They are widely-used methods for detecting and evaluating DME. As OCT and OCTA technologies advance, various parameters have assumed the role of biomarkers, such as central subfield thickness(CST), cube average thickness(CAT), cube volume(CV), disorganization of retinal inner layers(DRIL), hyperreflective foci(HRF)and subfoveal neuroretinal detachment(SND). OCT and OCTA are widely used in clinical practice. OCT can visually show the layer changes and subtle structures of the retina and choroid in the macular area, while OCTA is more often used to detect microvascular changes. In this article, the role of OCT and OCTA-related biomarkers in prognosis and monitoring in DME is described, while the biomarkers visible in the test results can provide new ideas for monitoring and treatment strategies in DME, and provide new insights into the pathogenesis of DR and DME.

Abstract:Central serous chorioretinopathy(CSC)is a common macular degeneration that primarily affects young patients. While the disease may resolve on its own to some extent, delayed or inadequate treatment can result in recurrence and progression to chronic CSC. This can lead to complications such as retinal pigment epithelium(RPE)atrophy and choroidal neovascularization, ultimately causing irreversible damage to central vision. Subthreshold micropulse laser photocoagulation(SMLP)is a type of laser therapy that differs from traditional lasers in that it does not cause damage or thermal injury to RPE cells and photoreceptors. SMLP has become widely used in clinical treatment of CSC due to its effectiveness, safety, and reproducibility, particularly in cases where verteporfin is not available in photodynamic therapy(PDT). The purpose of this review is to explain the mechanism of SMLP in CSC and summarize the effector cells, cytokines, and mechanisms of action involved in its treatment. This will provide a theoretical basis for promoting and rationalizing the use of SMLP in clinical practice.

Abstract:Laser photocoagulation is one of the important methods for treating retinal diseases, and retinal laser technology continues to advance. For decades, researchers have been striving to find a laser treatment that can minimize tissue damage while achieving optimal results. With low toxicity, low scattering light, strong penetrating power, small compared with the traditional laser damage, light reaction and no pain, the 577 nm subthreshold micropulse laser(SML)turns this goal into reality and ushers in a new era of laser treatment for fundus diseases. This article reviews the concept, mechanism, related parameters and clinical application progress of 577 nm SML in a variety of retinal diseases, aiming to provide references for clinical treatments.

Abstract:Retinoblastoma is a kind of malignant eye tumor commonly seen in children, which is one of the main causes threatening children's vision and life. The diagnosis and evaluation of retinoblastoma has always been a hot topic in clinic. In the past few years, the application of artificial intelligence(AI)technology has made significant progress in the medical field, providing new opportunities and challenges for the diagnosis and treatment of retinoblastoma, for example, the use of AI algorithms to analyze massive clinical data, which can help doctors diagnose the disease more accurately and provide personalized treatment plans. In addition, AI technology also plays an important role in medical image analysis, genomics research and other aspects, which can help the development of new drugs and improve patient prognosis. This article reviews the application progress of AI in retinoblastoma.

Abstract:As society advances and living standards improve, there is a growing emphasis on the impact of mental health on illness and the interaction between them. Diabetes mellitus is one of the most common underlying diseases, and it is often accompanied by depression and anxiety. There are also many complications of diabetes, such as diabetic retinopathy(DR). DR is the leading cause of vision loss in diabetes. Vision loss inevitably increases anxiety and/or depression, which in turn may directly or indirectly affect the treatment or progression of patients with DR. This article reviews how to determine the anxiety and depression status of patients with DR, related assessment tools and methods, and their interaction with the treatment of DR. The interaction of anxiety-depressive states with DR treatment was also discussed. This review aims to raise awareness of the mental health of patients with DR, enhance doctor-patient communication and build doctor-patient trust, thus enhancing treatment adherence and clinical efficacy for individuals with DR and helping them to improve the quality of life.

Abstract:Ferroptosis is a unique and new mode of cell death, which is driven by iron-dependent lipid peroxidation and mainly characterized by the accumulation of reactive oxygen species in cytoplasm and lipids. Ferroptosis plays an important role in the pathogenesis of many ocular fundus diseases, such as retinitis pigmentosa, age-related macular degeneration, diabetic retinopathy, retinal detachment, retinoblastoma and so on. The use of ferroptosis-related inhibitors or activators can regulate the course of the disease and provide new ideas for the research, prevention and treatment of ophthalmic diseases.

Abstract:Thyroid-associated ophthalmopathy(TAO)is a rare organ-specific autoimmune disease with an unclear pathogenesis. At present, the treatment still relies mainly on glucocorticoids and traditional immunosuppressants. However, some patients respond poorly to these drugs and experience treatment-related adverse reactions, highlighting the urgent need for novel drugs for TAO treatment. In recent years, with the deepening of research on the pathogenesis of TAO, a multitude of biologics targeting specific targets have emerged. Among them, teprotumumab, which targets the insulin-like growth factor-I receptor(IGF-IR), has been approved by the Food and Drug Administration for the treatment of TAO, and several other biologics are currently in clinical trials. This review provides the latest reference for the clinical prevention, treatment, and research of TAO by summarizing the current clinical research status of biologics targeting IGF-IR, neonatal Fc receptor(FcRn), thyroid-stimulating hormone receptor(TSHR), B cells, cytokines, and other biological agents in TAO and analyzing their impact on clinical treatment and future research trends.

Abstract:The incidence of myopia among Chinese adolescents is progressively rising, indicating a distinct trend toward younger age onset.This paper aims to comprehensively review the impact of various visual performance on myopia and its progression, with a specific emphasis on accommodative function, convergence function, and ocular position. A meticulous exploration of accommodation function, encompassing accommodative amplitude, accommodative facility, accommodative response, positive relative accommodation, and negative relative accommodation, has been undertaken to elucidate its contributory role in myopia progression. Concurrently, an exhaustive analysis of convergence function has been conducted including esotropia and exotropia, convergence insufficiency and convergence excess, fusional function vergence, divergence insufficiency, and excess, providing a nuanced understanding of convergence's implications for myopia advancement. Furthermore, the influence of ocular position on myopia progression, along with other factors affecting perceptual ocular position and intermittent exotropia, is discussed. The primary objective of this article is to unveil the multifaceted visual performance influencing myopia and its progression, elucidating the paramount significance of accommodative function, convergence function, and ocular position in this context.

Abstract:Etiological research is necessary for understanding the occurrence and epidemiological patterns of diseases, and is also a prerequisite for the diagnosis, prevention and treatment of clinical diseases. Mendelian randomization(MR), a method of research that combines genetics and epidemiology, has the advantage of exploring the causal relationship between exposure and disease genetically as well as avoiding confounding factors and reverse causation. Thus, it has been extensively utilized in the etiological study of diseases. This paper reviews the implementation of MR in the research of ocular diseases and provides ideas and approaches for the investigation of related mechanisms as well as the development of intervention strategies.

Abstract:AIM: To investigate the clinical efficacy of the compound anisodine combined with retinal laser photocoagulation in the treatment of severe non-proliferative diabetic retinopathy(NPDR).

METHODS: According to the retrospective study, totally 120 eyes of patients with severe NPDR who admitted to Daxing Teaching Hospital Affiliated to Capital Medical University from May 2023 to July 2023 were selected. The patients were divided into the observation group and the control group according to treatment methods, with 60 eyes in each group. The observation group was treated with panretinal photocoagulation combined with the compound anisodine injection. The control group was only treated with panretinal photocoagulation. The optical coherence tomography angiography(OCTA)and optical coherence tomography(OCT)were used to quantitatively analyze the fundus retinal structure and blood flow. Furthermore, the best corrected visual acuity(BCVA), superficial vascular density(SVD), deep vascular density(DVD), choroidal blood flow density and central macular foveal retinal thickness(CMT)were compared before treatment and at 1 d, 1 and 2 mo after treatment.

RESULTS:At 2 mo postoperatively, the rate of visual improvement and the BCVA in the observation group of patients were significantly better than those of the control group, and the incidence of macular edema in the observation group was significantly lower than the control group(P<0.05). The BCVA at 1 and 2 mo after treatment were significantly higher than those before treatment in both groups(P<0.05). The SVD in the observation group was better than the control group at 1 d, 1 and 2 mo after treatment(all P<0.05). The DVD and choroidal flow density in the observation group were better than those of the control group at 1 d after treatment(all P<0.05). The CMT of the observation group was smaller than that of the control group at 1 d after treatment(P<0.05).

CONCLUSION:Compound anisodine can effectively improve the fundus microcirculation after panretinal photocoagulation and reduce the incidence of macular edema, thus promoting the visual function.

Abstract:AIM: To understand the current status and differences in visual acuity of children of the same age from different regions of Xi'an, and to take an effective basis for the prevention of children's myopia.

METHODS: Random stratified sampling was used to select the uncorrected distance visual acuity and computed dioptric data of 41 285 children aged 6-12 from 6 towns, 10 urban and rural areas and 112 country schools screened by Xi'an Central Hospital in December 2022.

RESULTS: The myopia detection rate in different regions of Xi'an is 47.16% in towns, 38.59% in urban and rural areas, and 32.29% in the country, and the total myopia rate is 37.50%. The myopia rate of 6-12 years old in towns is higher than that in urban and rural areas, and that of urban and rural areas is higher than that of country; the myopia rate of girls is higher than that of boys; myopia rate increases with age; mild myopia: the myopia rate in towns is significantly higher than that of the urban and rural areas and the country; high myopia: the myopia rate in the country is significantly higher than that of the towns and the urban and rural areas. The total rate of deficient hyperopia reserves in different regions of Xi'an is 92.08% in towns, 93.67% in urban and rural areas, and 90.92% in the country, and the total rate of deficient hyperopia reserves is 92.09%. The rate of deficient hyperopia reserves at the age of 6-12 is higher in the urban and rural areas than in the towns, and higher in the towns than in the country; the total rate of deficient hyperopia reserve is higher in girls than in boys; it is the peak period of the development of hyperopia reserve rate before the age of 8.

CONCLUSION: The total myopia rate and the total vision reserve deficiency rate of 6-12 years old in different regions of Xi'an are different, and 8-9 years old is the accelerated period of myopia development, and the peak of deficient hyperopia reserve is before the age of 8 years old. With the growth of age, the myopia rate shows a certain growth trend, and the rate of deficient hyperopia reserve shows a decreasing trend after reaching the peak. The total myopia rate and insufficient acuity reserve rate of girls are higher than those of boys.

Abstract:AIM: To compare the clinical outcomes of trabeculectomy combined with phacoemulsification intraocular lens implantation with suture-guided penetrating Schlemm canaloplasty combined with phacoemulsification intraocular lens implantation for the treatment of primary open angle glaucoma(POAG).

METHODS: A retrospective case-control study was conducted on 53 cases(53 eyes)with advanced-stage POAG and cataract that received surgery at our hospital from June 2021 to June 2022, among which 26 eyes underwent trabeculectomy combined with phacoemulsification and intraocular lens implantation(group A), and 27 eyes underwent suture-guided penetrating Schlemm canaloplasty combined with phacoemulsification and intraocular lens implantation(group B). The best-corrected visual acuity(BCVA), intraocular pressure, and the number of intraocular pressure lowering drugs were compared between the two groups. Furthermore, the intraoperative and postoperative complications and success rate of surgery were recorded.

RESULTS: The intraocular pressure of two groups of patients at 1 wk, 1, 3 and 6 mo after surgery were lower than that before preoperatively(all P<0.017). There was a notable disparity in the frequency of anterior chamber hemorrhage between the two groups(P<0.05), but there was no significant variance in the occurrence of superficial anterior chamber and choroid detachment(all P>0.05). There was no significant difference in BCVA(LogMAR)between the two groups at 6 mo after surgery(group A: 1.29±1.19, group B: 0.78±1.01, P=0.098), and there was no significant difference in the number of anti-glaucoma drugs \〖group A: 0(0, 2.75), group B: 0(0, 1), P=0.209\〗. Additionally, there was no significant difference in the success rate of surgery between the two groups at 6 mo postoperatively(Z=0.448, P=0.654).

CONCLUSIONS: Suture-guided penetrating Schlemmcanaloplasty is a safe and effective treatment for advanced-stage POAG, with a success rate comparable to that of trabeculectomy.

Abstract:AIM: To compare the outcome of C₃F₈ versus silicone oil tamponade after pars plana vitrectomy(PPV)and inverted internal limiting membrane(ILM)for the treatment of highly myopic macular hole retinal detachment(MHRD).

METHODS: Retrospective clinical study. Totally 45 patients(45 eyes)with highly myopic MHRD who visited our hospital between January 2019 and August 2022 were selected as the research subjects. The patients were divided into two groups according to different intraocular tamponade agents: C₃F₈(22 eyes)and silicone oil(23 eyes)groups. All patients underwent conventional three-incision PPV, ILM was tamped, a venous blood clot was placed on the tamped ILM, and 15% C₃F₈ and silicone oil were used as tamponade, respectively. The best corrected visual acuity(BCVA), multifocal electroretinogram(mfERG), the closure of the macular hole, retinal reattachment and the complications were observed.

RESULTS: The macular hole closure rate was 77% in the C₃F₈ group and 83% in the silicone oil group, respectively(P>0.05), and retinal reattachment rates were 95% and 96%, respectively(P>0.05). The visual acuity of the two groups significantly improved, which was 0.99±0.34 and 1.22±0.37, respectively, and the C₃F₈ group was better than that of the silicone oil group(t=-2.156, P=0.037). After operation, the response density of the first ring of P1 wave in the first order kernel in mfERG was 114.27±26.37 nV/deg² for the C₃F₈ group and 98.08±24.36 nV/deg² for the silicone oil group, and the response density of the second ring of P1 wave was 80.45±14.94 nV/deg² for the C₃F₈ group and 67.73±15.33 nV/deg² for the silicone oil group, all of which were significantly higher compared to pre-operation \〖the response density of the first ring of P1 wave: 58.13±13.96 nV/deg² for the C₃F₈ group and 55.30±10.48 nV/deg² for the silicone oil group, the response density of the second ring of P1 wave: 51.18±8.19 nV/deg² for the C₃F₈ group and 47.43±11.97 nV/deg² for the silicone oil group\〗(all P<0.05). It was found that the response density of the first ring of P1 wave was lower in the silicone oil group than in the C₃F₈ group(P<0.05). There was no statistically significant difference in the incidence of complications between the two groups(P>0.05).

CONCLUSION: Silicone oil tamponade or C₃F₈ tamponade after PPV combined with ILM can both promote retinal reattachment and macular hole closure in patients with MHRD, and the C₃F₈ tamponade was superior to silicone oil in visual function recovery.

Abstract:AIM: To assess the repeatability and agreement of higher-order aberration obtained by adaptive optics visual simulator(VAO)compared with OPD-Scan Ⅲ.

METHODS: A cross-sectional study was conducted from August to September 2023, including a total of 204 patients(204 eyes)with myopia whose right eyes were measured. The examinations were performed by the same skilled examiner using both devices separately. The VAO device was used to measure higher order aberrations of orders 3 to 6 at a pupil diameter of 4.5 mm, while both the VAO and OPD-Scan Ⅲ devices were utilized to measure total higher-order aberration(tHOA), spherical aberration(SA), coma aberration(Coma), and trefoil aberration(Trefoil)of the entire eye at pupil diameters ranging from 3 to 6 mm. Furthermore, the repeatability of whole eye aberration measurements obtained with the VAO device was evaluated and the agreement of the two devices was assessed.

RESULTS: The whole-eye higher-order aberrations measured by VAO demonstrated excellent repeatability(0.767≤ICC≤0.941, S_w<0.01 μm, TRT<0.1 μm). There was no statistically significant difference in Coma measured by VAO or OPD-Scan Ⅲ for pupil diameters ranging from 4 to 6 mm(P>0.05), while a statistically significant difference was observed in whole-eye tHOA of other pupil diameters(all P<0.05). The agreement of aberration measurements for each order between VAO and OPD-Scan Ⅲ for 3 mm pupil diameters, SA at 4 and 5 mm pupil diameter and Coma at 4 mm pupil diameter showed a 95% limit of agreement(LoA)<0.1, indicating good agreement; however, poor agreement was found for the remaining aberration measurements at different pupil diameters, with a 95%LoA>0.1, and there were significant differences in higher-order aberrations measured by two devices under a pupil diameter of 3 mm(r=0.218-0.317, P<0.01), 4 mm(r=0.406-0.672, P<0.01), 5 mm(r=0.538-0.839, P<0.01 and r=0.030-0.109, P>0.01)and 6 mm(r=0.369-0.766, P<0.01).

CONCLUSION: The VAO demonstrates favorable repeatability when assessing whole-eye higher order aberration under pupil diameters of 3-6 mm. However, there is inadequate agreement and interchangeability in whole-eye higher order aberration at 3-6 mm pupil diameter between VAO and OPD-Scan Ⅲ for clinical purposes.

Abstract:AIM:To compare the differences of ocular biometric parameters of age-related cataract between Tibetan and Han ethnic groups, and to analyze the distribution characteristics of ocular biometric parameters in Tibetan cataract patients.

METHODS:Retrospective cohort study. A total of 661 patients(1 030 eyes)with age-related cataract confirmed in the hospital between January 2019 and December 2020 were enrolled. The parameters of axial length, anterior chamber depth, keratometry, corneal astigmatism and astigmatic axis were measured by IOL Master 500 in 483 cases(739 eyes)of Tibetan age-related cataract patients and 178 cases(291 eyes)of Han patients.

RESULTS:The axial length, anterior chamber depth and corneal astigmatism of the Tibetan patients with age-related cataract were 23.33(22.81, 23.86)mm, 3.04(2.79, 3.30)mm and 0.73(0.47, 1.07)D. The mean keratometry was 43.89±1.35 D. The results indicated that Tibetan cataract patients had shorter axial lengths and smaller keratometry compared to Han patients(all P<0.05). Age in Tibetan patients was negatively correlated with axial length and anterior chamber depth, and positively correlated with keratometry(all P<0.05). Tibetan male patients had longer axial lengths, deeper anterior chambers, and flatter corneas compared to female patients(all P<0.05).

CONCLUSION:There were differences in ocular biometric parameters between age-related cataract patients of Tibetan and Han ethnicities. The distribution of ocular biometric parameters in Tibetan cataract patients varied across different age groups and gender groups.

Abstract:AIM: To observe the outcome of intravitreal balanced salt solution(BSS)injection to increase intraocular pressure(IOP)after extrascleral subretinal fluid drainage, then scleral buckling(SB)to treat superior bullous retinal detachment(SBRD), and compare it with the effect of conventional surgery(without any intravitreal filling)and postoperative air filling.

METHODS: Retrospective case-control study. A total of 72 patients(73 eyes)who underwent SB for SBRD from January 2018 to December 2022 in ophthalmology department of Xijing Hospital were included. The extrascleral subretinal fluid drainage was performed in all eyes. According to whether intravitreal injection was performed and different injections, patients were divided into three groups: with 24 cases(24 eyes)in the conventional group(no intravitreal injection), 23 cases(23 eyes)in the air group(sterile air was injected after surgery), and 25 cases(26 eyes)in the BSS group(BSS was injected during extrascleral subretinal fluid drainage). All patients were followed up until subretinal fluid was absorbed completely. The average surgery time, postoperative IOP, retinal reattachment rate, subretinal fluid absorption, visual acuity(LogMAR)and major complications were compared.

RESULTS: All surgeries were completed successfully. The average surgery time of the conventional group, air group and BSS group were 63.17±13.22, 61.65±15.55 and 57.30±11.70 min, respectively. There had no significant difference among these groups(F=0.825, P=0.443). On the first post-operative day, the average IOP of the conventional group, air group and BSS group were 13.69±2.69, 16.40±2.86 and 18.35±2.88 mmHg, respectively. The average IOP of the air group and the BSS group were significant higher than that of the conventional group(F=17.18, P<0.001). Primary reattachment rates were 88%, 96%, and 100%, respectively. The postoperative BCVA was 0.71±0.42, 0.59±0.44, and 0.91±0.50, respectively, which were significantly higher than those before operation(all P<0.05), but there was no significant difference among groups(F=3.046, P>0.05). The main complications included subretinal hemorrhage in 1 eye from the conventional group and 1 eye from the air group, and a new retinal tear in 1 eye from the air group, resulting in localized retinal detachment.

CONCLUSIONS: For SBRD patients with hypotony during SB surgery, intravitreal injection of BSS to properly increase the IOP and then complete the surgery can improve the reattachment rate and reduce postoperative complications. This method is safe and effective for selected SBRD patients.

Abstract:AIM: To investigate the efficacy of modified silicone oil removal combined with scleral buckling in the treatment of patients with retinal detachment under silicone oil tamponade.

METHODS:The retrospective study included a total of 14 patients(14 eyes)who underwent treatment for retinal detachment with silicone oil tamponade at our hospital between January 2021 and February 2023. The modified silicon oil extraction combined with scleral buckling procedure was employed. A self-made 23-gauge suction device was applied in the silicon oil extraction, which involved removing the needle from a disposable blood transfusion set, trimming it to 2.5-3.0 mm near the beveled end, and connecting the other end to a 10 mL syringe without the plunger. The opposite end of the syringe was connected to the negative pressure system of the vitreous cutter to accomplish the silicon oil removal. Scleral compression blocks in scleral buckling surgery using a homemade composite device. No additional silicon oil was injected after the procedure. Follow-up was conducted for 6 mo, assessing retinal reattachment, best-corrected visual acuity(BCVA), intraocular pressure, and complications.

RESULTS: At the 6 mo follow-up, the retina was completely reset in 13 eyes, with a retinal reset rate of 93%, and an improvement in BCVA(LogMAR)compared with the preoperative period(0.95±0.18 vs 1.15±0.21, P=0.002). Transient high IOP occurred in 6 eyes at 1 d postoperatively and returned to normal after medication control. There were no intraoperative complications such as retinal hemorrhage, retinal incarceration, or iatrogenic retinal breaks, and no postoperative complications such as endophthalmitis or choroidal detachment.

CONCLUSIONS:Modified silicone oil removal combined with scleral buckling can effectively treat retinal detachment in the silicone oil tamponade and induce retinal reattachment.

Abstract:AIM: To explore the correlation between neonatal retinal hemorrhage(RH)and changes in umbilical artery blood gas analysis.

METHODS: A total of 312 full-term neonates born in our obstetrics department from January 2019 to December 2021 were selected as the study subjects. According to the RetCam III fundus examination results, 245 neonates who did not experience RH were included in the control group, while 67 cases with RH were found to be included in the RH group. In addition, neonates were grouped into I degree group(n=20), II degree group(n=29), and III degree group(n=18)based on the degree of RH. General clinical data and umbilical artery blood gas analysis indicators between the RH group and the control group were compared; the levels of umbilical artery blood gas analysis indicators in neonates with different degrees of RH, the relationship between pH and RH degree, and the influencing factors of neonatal RH were analyzed.

RESULTS: There was no obvious difference in maternal age, average gestational week, fetal gender, parity, gestational diabetes, fetal birth weight, and amniotic fluid between the RH group and the control group(all P>0.05), while there were obvious differences in delivery methods, gestational hypertension, forceps assisted delivery, neonatal asphyxia, and umbilical cord around the neck(all P<0.05). The pH value, arterial blood sample partial pressure(PaO₂)and base excess(BE)values of the RH group were obviously lower than those of the control group(all P<0.01), while the arterial carbon dioxide partial pressure(PaCO₂)was obviously higher than that of the control group(P<0.01). There were obvious differences in umbilical artery blood gas analysis indicators among children with different degrees of RH(P<0.05), and with the increase of the degree of RH, pH value, PaO₂ and BE gradually decreased(P<0.05), and PaCO₂ gradually increased(P<0.05). There was a negative correlation between the degree of RH and the pH of umbilical artery blood gas analysis(r_s=-0.593, P<0.05). The results of multivariate Logistic regression analysis showed that delivery method, gestational hypertension, forceps assisted delivery, neonatal asphyxia, umbilical cord entanglement, pH, PaO₂, PaCO₂, and BE were all influencing factors for the occurrence of neonatal RH.

CONCLUSION: There is a close correlation between neonatal RH and changes in umbilical artery blood gas analysis, and umbilical artery blood gas analysis can be used for the diagnosis of neonatal RH, which can be used to guide clinical treatment.