Abstract:Objective：This study aims to investigate the relationship between scotopic pupil and optical zone on short-term subjective and objective visual quality following small incision lenticule extraction (SMILE). Methods：In this prospective cohort study, 98 patients (196 eyes) who underwent SMILE surgery from September 2021 to June 2022 were included. Participants were divided into two groups based on the ratio of scotopic pupil diameter to optical zone diameter: Group A (ratio > 1, 70 eyes), and Group B (ratio ≤ 1, 126 eyes). We assessed uncorrected visual acuity (UCVA), spherical equivalent (SE), subjective visual quality via a questionnaire, and total corneal high-order aberrations (corn-tHOA), as well as corneal spherical (corn-SA), coma (corn-COMA), and trefoil (corn-Tre) aberrations. The objective scatter index (OSI) was measured with central diameters of 4mm, 6mm and 8mm. Data were recorded preoperatively and at one month, three months postoperatively. The differences in refractive status, visual quality indexes between groups at various time points were analyzed and compared. Results：No significant differences in UCVA and SE were observed between the two groups at one month and three months postoperatively. Significant differences were noted in total corneal high-order aberrations at one month, as well as in total corneal high-order aberrations and spherical aberrations at three months. At three months after surgery, the most commonly reported symptoms in Group A were glare , starburst , hazy vision , and halo . In Group B, the most common symptoms were hazy vision, halo, starburst , and glare. Statistically signigicant differences were observed in the severity of glare and fluctuation between groups before and three months after surgery. However, there were no significant differences in the severity of halo, starburst, blurred vision, double vision, or focusing difficulty. Conclusion：When the diameter of dark pupils exceeds the optical region, SMILE may augment the postoperative corneal aberration, which is manifested in the increase of high-order corneal Aberrations within the postoperative cornea-centered 8mm range, the elevated incidence of postoperative glare, the severity of glare and visual fluctuation symptoms. However, the symptoms are mild and fall within the safe range.

Abstract:Abstract Objective: To observe the defocus state and myopia control in myopic children wearing single-vision, defocus, and orthokeratology lenses using a multispectral refraction topography (MRT). Methods: This clinical retrospective study involved 290 myopic patients aged 8–14 years old with an equivalent spherical lens (SE) of ?7.00D to ?0.50D, treated at the Aier Eye Hospital of Chengdu from June 2022 to December 2023. Patients who volunteered for the study, were assigned to three groups A total of 97 patients were provided with single-vision spectacle lenses (SVL group), 95 received individualized ocular refraction customization (IORC group), and 98 orthokeratology lenses (OK group). Simultaneously, the three groups were further categorized into low (?3.00D to ?0.50D), moderate (?6.00D to ?3.25D), and high myopia (?7.00D to ?6.25D) groups according to their degree of SE (the right eye was selected as test eye). We used a multispectral refraction topography (MRT) to compare the defocus changes of the retina in four quadrants (upper, lower, nasal, temporal quadrants (RDV-S, RDV-I, RDV-N, RDV-T) and three eccentric regions (0~15o, 15o~30o, 30o~45o, RDV-15, RDV-30, RDV-45) in the three groups. A one-way analysis of variance was used for intergroup comparisons and a paired t-test was used for intragroup comparisons. Univariate and multivariate linear regression analyses were used to analyze the factors related to changes in the AL at one year after intervention. Results: There was a significant difference in 1-year equivalent spherical lens and axial length growth among patients in the SVL, IORC, and OK groups before and after intervention (P < 0.05). The pairwise comparison of 1-year equivalent spherical lens and the difference of ocular axis growth in patients with low myopia was significantly different among SVL, IORC, and OK groups (P <0.05); however, there was no significant difference between the IORC and OK mirror groups (P >0.05). Further, there were significant differences between moderate myopia treatment 1 a (P < 0.05), and high myopia (HM) interval treatment 1 a, OK lens group compared with the IORC and SVL groups, (P < 0.05), whereas the IORC and SVL groups showed no significant differences (P > 0.05). In addition, there were significant differences in the four quadrants and three eccentric regions RPRE among myopia groups (P < 0.05). Pin-wise comparison of the growth difference of 1 a eccentric D-RDV-15 in low myopia group showed significant differences between the SVL, IORC, and OK groups (P < 0.05), but no significant differences between the IORC and OK groups (P > 0.05). Moderate myopia interval treatment 1a eccentric D-RDV-30 in the SVL group was compared with that of IORC and OK groups. The difference was statistically significant (P < 0.05).Further the IORC and OK groups showed no significant differences (P > 0.05); the high myopia treatment 1 a eccentric D-RDV-15, there was a significant difference among OK, IORC, and SVL groups (P < 0.05) but there was no significant difference between the IORC and SVL groups (P > 0.05). Univariate and multivariate linear regression model analysis showed that the changes in D-TRVD, D-RDV-45, RDV-N, and D-RDV-I correlated with the increase in the difference in 1a AL. Conclusion: MRT can be used to guide the clinical control of myopia. Myopia development is related to the peripheral retinal defocus state, and the difference of defocus quantity in the inferior nasal side at 30o~45o eccentricity may be a factor regulating the rapid progression of myopia.

Abstract:Objective: To investigate the risk factors for dry eye syndrome secondary to type 2 diabetes mellitus (T2DM) and to develop a nomogram model for early risk prediction.Methods: A total of 347 T2DM patients treated in our hospital between March 2020 and April 2024 were enrolled and randomly divided into training and validation sets at a 7:3 ratio. Demographic data, glycemic parameters, and clinical treatments were compared between non-dry eye syndrome (control group) and dry eye syndrome to type 2 diabetes mellitus (dry eye group) in the training set. Statistically significant indicators were incorporated into multivariate logistic regression to identify independent predictor for secondary dry eye. These factors were then used to construct a nomogram model using R software, which was subsequently validated using the validation set. Results: The percentage of patients with secondary dry eye syndrome in 242 cases of T2DM was 64.46% (156/242). Multifactorial logistic regression revealed that blood glucose variability, glycosylated serum protein, retinopathy, meibomian gland functional status, duration of T2DM, and meibomian gland opening blockage belonged to the independent predictor for secondary dry eye (OR > 1, P < 0.05). A column-line graph prediction model was constructed based on the above six indicators, and the area under the ROC curve was verified to be 0.994 (95% CI:0.989~0.999) and 0.990 (95% CI:0.977~0.999), respectively. The slopes of the calibration curves were similar, as tested by the Hosmer-Lemeshow test χ2 = 1.461, 1.566, P = 0.993, 0.992. The column-line graphical model could provide good utility for clinical decision-making.Conclusion: Glycemic variability, glycated serum protein, retinopathy, meibomian gland dysfunction, T2DM duration, and meibomian gland orifice obstruction significantly increase the risk of dry eye secondary to T2DM. The constructed nomogram model serves as a valuable tool for early risk assessment and intervention, potentially improving patient outcomes. Future studies should validate this model across diverse populations and clinical settings.

Abstract:With the application and popularization of the polymerase chain reaction, many ocular diseases with unknown etiology in the past have been confirmed to be related to viral infections; From the classic herpes simplex keratitis to the cytomegalovirus intraocular infection which is gradually recognized by people at present, various viral ocular diseases have received increasing clinical attention. Ocular viral infections are complicated with various types of viruses causing different clinical manifestations. Since it is difficult to obtain corresponding tissue specimens from patients with viral ocular diseases, establishing an effective animal model is a crucial foundation for studying the characteristics of the disease course, the pathogenesis, and the pre-clinical evaluation of drugs. Based on the literature on animal models related to viral ocular diseases in recent years, this paper comprehensively summarizes the animal models of various diseases from the anterior segment to the posterior segment of the eye caused by different viruses and introduces in detail the types of viruses, viral loads, and the methods of virus challenge on various models; Besides, it conducts a comparative evaluation from multiple dimensions such as the model stability, advantages and disadvantages of the models, and their application situations, so as to provide a basis for subsequent basic research on related diseases and drug transformation.

Abstract:Myopia has become a common eye disease in China and around the world. The myopia rate among children and adolescents in China has been continuously increasing, and it shows the characteristics of younger age and higher severity, seriously threatening eye health. According to recent studies, myopia is closely related to the axial length of the eye. During the progression of myopia, the excessively long eye axis would lead to changes in ocular structure like the sclera, retina, and choroid etc., thereby increasing the onset risk of diseases such as posterior staphyloma of the sclera and retinal detachment, and ultimately resulting in severe vision impairment. By reviewing the related literature at home and abroad in recent years, the paper systematically sorted out the relationship between the changes in axial length of the eye and fundus damage, discussed deeply the interacting mechanisms of the two, aiming at providing reference for the prevention and treatment of myopia in children and adolescents, with the expectation of reducing the occurrence of complications of myopic fundus lesions, which has important practical significance for protecting the eye health of children and adolescents.

Abstract:Apparent accommodation originates from the residual accommodation function after the absence of classic lens accommodation, serving as a critical theoretical framework in the study of visual function after refractive cataract surgery. Different from Von Helmholtz’s theory, which focuses on lens deformation, it evaluates the overall accommodation capability of the eye excluding the lens, with its mechanisms remaining debated. Apparent accommodation refers to the character that pseudophakic eyes retain a certain degree of refractive accommodation after natural lens removal or intraocular lens (IOL) implantation, despite the loss of physiological accommodation. Integrating both subjective and objective examination methods is crucial for understanding apparent accommodation, which not only advances the study of depth perception but also provides insights into binocular visual coordination in pseudophakic eyes. This paper systematically reviews the historical development of apparent accommodation and the advances in assessment techniques, which have gradually contributed to the re-evaluation and expansion of classical theories of physiological accommodation. Recent studies attempt to decipher the synergistic effects between pupil, corneal, and central cognitive processing by integrating optical parameter measurements with neural adaptation. This reflects a shift in the field from a singular anatomical explanation to a more interdisciplinary and multi-dimensional model.

Abstract:Objective: This study aimed to investigate the specific molecular mechanism of Yinqiao Powder in affecting macrophage polarization in herpes simplex keratitis (HSK) through the cyclic GMP-AMP synthetase (cGAS)-stimulator of interferon genes (STING)-Interferon regulatory factor 3 (IRF3) molecular pathway. Methods: Human corneal epithelial cells (HCE-T) were divided into control, HSK, and HSK + Yinqiao Powder groups. Cell viability was detected by MTT assay, and apoptosis was detected by TUNEL assay. M0 macrophages were grouped as Ctrl, HSV-1, HSV-1 + oe-cGAS, HSV-1 + Yinqiao Powder, and HSV-1 + oe-cGAS + Yinqiao Powder. ELISA was used to detect the concentrations of Arg-1 and iNOS in cell supernatants, and Western blotting was used to detect the relative protein expressions of cGAS, STING, and IRF3. Conditional medium (CM) from each group of M0 macrophages was collected to intervene in HCE-T cells and divided into Ctrl-CM, HSV-1-CM, HSV-1 + oe-cGAS-CM, and HSV-1 + Yinqiao Powder-CM groups. MTT assay was used to detect cell viability, and TUNEL assay was used to detect apoptosis. Balb/c mice were divided into control, model, and drug groups. The model and drug groups were inoculated with HSV-1 on the cornea of Balb/c mice using the corneal scratch method to construct an HSK mouse model, and the drug group was treated with Yinqiao Powder. The incidence and mortality of the three groups were compared on days 1, 3, 5, 7, and 14 after modeling. ELISA was used to detect the levels of Arg-1 and iNOS in the serum of the three groups, and Western blotting was used to detect the protein expressions of cGAS, STING, and IRF3 in corneal tissues. Results: Compared with the control group, the HCE-T cell viability in the HSK group was decreased but apoptosis was increased, which was reversed by Yinqiao Powder intervention. Compared with the Ctrl group, the Arg-1 concentration in the cell supernatant of the HSV-1 group was decreased, the iNOS concentration was increased, and the protein expressions of cGAS, STING, and IRF3 were decreased. Compared with the HSV-1 group, the Arg-1 concentration was increased, the iNOS concentration was decreased, and the protein expressions of cGAS, STING, and IRF3 were enhanced in the HSV-1 + oe-cGAS group and the HSV-1 + Yinqiao Powder group, and the same results were obtained in the HSV-1 + oe-cGAS + Yinqiao Powder group. Compared with the Ctrl-CM group, the HCE-T cell viability was decreased and apoptosis was increased in the HSV-1-CM group, which was reversed by overexpressing cGAS in macrophages or intervening with Yinqiao Powder. In vivo experiments found that Yinqiao Powder intervention could improve the pathological progression of keratitis. Conclusion: Yinqiao Powder inhibits M1 polarization of macrophages through the cGAS-STING-IRF3 molecular pathway, thereby delaying the progression of HSK.