Abstract:Objective: To explore the effectiveness and safety of multi-zone positive optical defocus glasses in the progression of myopia among adolescents, and to provide a theoretical basis for clinical treatment. Methods: This was a retrospective study. From January 2019 to January 2022, 180 cases of myopic children aged 8 to 13 years who were treated in our hospital and wore focus incorporated multiple segment lenses (DIMS), 182 cases who wore orthokeratology lenses (OK), and 198 cases who wore single-vision spectacle lenses (SV ) were collected. The changes in spherical equivalent refraction and axial length of the myopic children in the DIMS group, OK lens group, and SV group were observed at 1 year and 2 years respectively. Then, the patients were further grouped according to the degree of myopia (Group A: spherical equivalent refraction ≤ -3.00 D and Group B: -3.00 D < spherical equivalent refraction ≤ -6.00 D) and age (Group I: 8 to 10 years old and Group II: 11 to 13 years old) to further analyze the influence of the degree of myopia and age on the treatment effect. Results: 1.At 1 year and 2 years after wearing the glasses, there was a statistically significant difference in spherical equivalent refraction between the DIMS group and the SV group (P < 0.05). There were statistically significant differences in axial length among the DIMS group, OK lens group, and SV group (F = 21.791, P < 0.05; F = 3.576, P < 0.05). 2.At 1 year and 2 years after wearing the glasses, there were statistically significant differences in the changes of spherical equivalent refraction between the DIMS group and the SV group in both Group A and Group B (P < 0.05); there were statistically significant differences in the axial length growth among the DIMS group, OK lens group, and SV group (P < 0.05). 3.At 1 year and 2 years after wearing the glasses, there were statistically significant differences in the changes of spherical equivalent refraction between the DIMS group and the SV group in both Group I and Group II (P < 0.05); there were statistically significant differences in the axial length growth among the DIMS group, OK lens group, and SV group (P < 0.05). In Group II patients, there was no statistically significant difference in the change of axial length between the DIMS group and the OK lens group, and the curative effects of the two in myopia prevention and control were similar. The DIMS glasses could delay the progression of myopia in older adolescents, and the curative effect was enhanced. Conclusion: Compared with SV glasses, both DIMS glasses and OK lenses can effectively slow down the progression of myopia in adolescents. The overall myopia control effect of DIMS glasses is slightly worse than that of OK lenses, but with the increase of the patient's age and refractive error, the effect of DIMS glasses in delaying the progression of myopia is enhanced. Keywords: Multi-zone positive optical focus incorporated multiple segmentt; Orthokeratology; Single-vision frame glasses; Myopia; Axial length; Spherical equivalent refraction

Abstract:[Abstract] Objective To investigate the relationship between aqueous humor apelin (Apelin) and δ-like ligand 4 (DLL4) expression levels in patients with neovascular glaucoma (NVG) and clinical stage and efficacy. Methods 96 NVG patients who were admitted to our hospital from January 2022 to March 2024 (NVG group) and 96 cataract patients who underwent cataract surgery in our hospital during the same period (control group) were selected, NVG patients were divided into stage I group (22 cases), stage II group (47 cases) and stage III group (27 cases) according to the clinical stage, patients were divided into ineffective group (20 cases) and effective group (76 cases) according to efficacy. Aqueous humor Apelin and DLL4 levels were detected by enzyme-linked immunosorbent assay. The influencing factors of the efficacy of NVG patients were analyzed by multivariate unconditional Logistic regression analysis, the evaluation efficacy of aqueous humor Apelin and DLL4 levels on the efficacy of NVG patients was analyzed by receiver operating characteristic (ROC) curve. Results Compared with control group, aqueous humor Apelin and DLL4 levels in NVG group were increased (P<0.05). Aqueous humor Apelin and DLL4 levels in stage I group, stage II group and stage III group increased in turn (P<0.05). The effective rate of 96 NVG patients was 79.17% (76/96), compared with effective group, aqueous humor Apelin and DLL4 levels in ineffective group increased (P<0.05). Clinical stage III, high intraocular pressure, high Apelin and high DLL4 were independent risk factors for ineffective treatment in NVG patients (P<0.05). The area under the curve of the combined evaluation of aqueous humor Apelin and DLL4 levels in evaluating the efficacy of NVG patients was 0.874, which was greater than 0.790 and 0.786 of aqueous Apelin and DLL4 levels alone (P<0.05). Conclusion Aqueous humor Apelin and DLL4 levels in NVG patients increase, which are relate to the increase of clinical stage and poor efficacy, the combination of aqueous humor Apelin and DLL4 levels is more effective in evaluating the efficacy of NVG patients.

Abstract:Objective：To explore the efficacy of 0.05% cyclosporine A combined with olopatadine eye drops to treat patients with dry eye disease associated with allergic conjunctivitis. Methods：63 patients(63 eyes) with dry eye disease associated with allergic conjunctivitis in the People’s Hospital of Guangxi Zhuang Autonomous Region from August 2022 to April 2023 were enrolled and randomly divided into control group (n =33) and observation group(n=30). The patients of control group used 0.1% olopatadine eye drops and 0.3% sodium hyaluronate eye drops, while the observation group used 0.1% olopatadine eye drops and 0.05% cyclosporine A eye drops. The ocular surface disease index(OSDI), total ocular symptom score(TOSS), conjunctival congestion score, conjunctival papillae and follicle score, Schirmer I test (SⅠt), tear meniscus height (TMH), meibomian gland secretion ability and property score, meibomian gland loss area score, corneal fluorescein staining (CFS), tear film break-up time (BUT), noninvasive first tear film break-up time (NIBUTf), noninvasive average tear film break-up time (NIBUTav) before and after treatment and the drug safety during the treatment period were evaluated. Results：After treatment, OSDI, TOSS, conjunctival congestion score, conjunctival papillae and follicle score, SⅠt, TMH, meibomian gland secretion ability score, meibomian gland secretion property score, CFS, BUT, NIBUTf, and NIBUTav of the observation group patients showed improvements compared with those before treatment (all P＜0.017). Among these, OSDI, TOSS, conjunctival congestion score, conjunctival papillae and follicle score, BUT, NIBUTf, and NIBUTav demonstrated more significant improvement compared with the control group (all P＜0.05). There was no statistically significant difference in meibomian gland loss area score between the two groups before and after treatment (P＞0.05). During the treatment period, there were no local or systemic adverse reactions. Conclusion：The combined use of 0.05% cyclosporine A and olopatadine eye drops can significantly improve ocular discomfort symptoms of patients with dry eye disease associated with allergic conjunctivitis, such as red eyes, itchy eyes and foreign body sensation, promote tear film stability and have high safety.

Abstract:Objective To preliminarily investigate the protective effects of soy isoflavones on retinal ganglion cells (RGC) damage in diabetic rats and related mechanisms. Methods Fourty male SD rats(80eyes) aged 4-6 weeks were randomly divided into a control group (Con group), a diabetic group (Mod group), a soy isoflavone low-dose-treated group and a soy isoflavone high-dose-treated group, with 10 rats in each group. Among them, the control group was fed with normal chow,the diabetic group,the soy isoflavone low-dose-treated and the soy isoflavone high-dose-treated group were fed with high-fat chow . After 8 weeks of feeding, rats in the diabetic group, the soy isoflavone low-dose-treated group and high-dose treatment groups were injected intraperitoneally with STZ at a dose of 50 mg·kg-1 to establish a diabetic model, and rats in the control group were given the same volume of sodium citrate buffer acid. The soy isoflavone low-dose-treated was given 360 mg·kg-1 of soy isoflavones by daily gavage to the diabetic model

Abstract:AIM To evaluate the application value of artificial intelligence-assisted systems in diagnosing diabetic retinopathy (DR) by Meta-analysis. Methods PubMed, Web of Science, Embase, Cochrane Library, CBM, CNKI, WanFang Data and VIP database were searched to collect relevant literature on the diagnostic value of artificial intelligence-assisted systems for DR from January 2019 to September 2024. The QUADAS-2 tool was used to evaluate the quality of the included studies, and meta-analysis was performed using Stata 17.0 and Meta Disc 1.4 software. Results：A total of 23 studies were included. The results of meta-analysis showed that the pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, diagnostic odds ratio and area under the SROC curve (AUC) were 0.92 (95%CI: 0.89, 0.94), 0.94 (95%CI: 0.91, 0.96), 15.6 (95%CI: 10.6, 22.9), 0.09 (95%CI: 0.07, 0.12), 174 (95%CI: 112, 271) and 0.97(95%CI: 0.96，0.98).Meta-regression and subgroup analyses indicated that the heterogeneity of the studies originated from study type, patient type, patient source, and AI algorithm type. Deeks’ funnel plot test suggested no significant publication bias (P = 0.15 > 0.05), indicating that the results were robust. Conclusions：The artificial intelligence-assisted system demonstrates high diagnostic value for DR and can be widely implemented in the early screening and diagnosis of DR.

Abstract:Objective: To investigate the efficacy of pars plana vitrectomy (PPV) with or without inner limiting membrane (ILM) peeling on refractory macular edema in diabetes. Methods: Eighty patients with refractory macular edema in diabetes were retrospectively selected and assigned into groups according to the treatment method. Among them, 38 patients treated with PPV were included as group A, and 42 patients treated with PPV combined with ILM peeling were included as group B. The relevant data of patients in the two groups were collected and the efficacy of the two groups was compared. Results: At 1, 3, and 6 months after surgery, the best corrected visual acuity (BCVA), central macular retinal thickness (CMT), and severity of macular edema in group B were all superior to those in group A (P<0.05). After surgery, the incidence of complications in group B was 11.90%, with no prominent difference compared to group A's 18.42% (P>0.05). Conclusion: PPV combined with or without ILM peeling can improve visual function and relieve macular edema in patients with refractory macular edema in diabetes. However, the combination of PPV and ILM peeling is superior to PPV alone in improving vision and relieving macular edema, and does not increase postoperative complications.

Abstract:Objective: To explore the changes in serum trefoil factor 1 (Tff1) and bone morphogenetic protein 4 (BMP4) levels in patients with type 2 diabetes retinopathy and the diagnostic value of both for type 2 diabetes retinopathy. Methods: From January 2022 to January 2024, 186 patients with type 2 diabetes were selected as the study group. According to whether they had retinopathy, they were assigned into a retinopathy group of 52 cases and a non retinopathy group of 134 cases. Another 186 volunteers who underwent health check ups were selected as the control group. Enzyme linked immunosorbent assay (ELISA) was applied to detect the expression levels of Tff1 and BMP4 in all serum samples. Pearson method was applied to analyze the correlation between serum Tff1, BMP4 levels and clinical data. Multifactor Logistic method was used to analyze the influencing factors of retinopathy in type 2 diabetes patients. ROC curve was drawn to analyze the diagnostic value of serum Tff1 and BMP4 levels for retinopathy in type 2 diabetes patients. Results: Compared with the control group, the serum Tff1 expression level decreased and BMP4 expression level increased in the study group (non retinopathy group and retinopathy group) patients (P<0.05); and the serum Tff1 expression level in the retinopathy group was lower than that in the non retinopathy group, while the BMP4 expression level was higher than that in the non retinopathy group (P<0.05). Pearson analysis showed that the expression level of Tff1 in type 2 diabetes patients was negatively correlated with the duration of type 2 diabetes, glycosylated hemoglobin level, and triglyceride level, while BMP4 was positively correlated (P<0.05). Multivariate logistic analysis showed that the duration of type 2 diabetes, glycosylated hemoglobin, triglyceride, Tff1, BMP4 were the influencing factors of retinopathy in type 2 diabetes patients (P<0.05). ROC curve results showed that the area under the curve (AUC) value of the combination of serum Tff1 and BMP4 in the diagnosis of retinopathy in type 2 diabetes patients was 0.901, which was greatly higher than that of Tff1 (Z=2.069, P=0.039) and BMP4 (Z=2.072, P=0.038) separately. Conclusion: The expression level of serum Tff1 in patients with type 2 diabetes retinopathy decreases, while the expression level of BMP4 increases. The combination of the two has high diagnostic value for type 2 diabetes retinopathy.

Abstract:Purtscher retinopathy is an occlusive retinal microangiopathy typically associated with trauma. It is characterized by a series of retinal pathological manifestations, such as cotton wool spots, multiple gray plaques (Purtscher spots) in the posterior pole, and intraretinal hemorrhage. Notably, there is no history of direct ocular trauma, as this condition is commonly observed in cases of severe crush injuries to the head, chest, abdomen, limbs, and other regions. Purtscher-like retinopathy, on the other hand, describes extensive retinopathy occurring in the absence of trauma, often associated with conditions such as pancreatitis and connective tissue diseases.With advancements in imaging-assisted ultrastructure research, the understanding of the pathogenesis of this retinopathy has evolved. Initially, it was attributed to trauma-induced injury and the subsequent cascade of damage repair processes. However, current theories suggest that systemic lesions involving lipase, free fatty acids, or complement activation play a significant role in inducing endothelial damage to small retinal blood vessels, ultimately leading to vascular occlusion. The pathogenesis of distant retinopathy is not isolated; it is now widely believed to involve anterior capillary arteriole embolism resulting from changes in retinal microvascular permeability. In addition to embolization, other mechanisms such as retinal vascular-lymphatic extravasation, vasospasm, endothelial injury, and complement activation are also considered crucial contributors to the development of this condition.This paper starts from the inflammation and vascular cascade reaction in the pathological process of trauma and non-trauma, and expounds the pathological mechanism of the disease so as to guide the clinical diagnosis and treatment, in order to find new ideas of diagnosis and treatment in the research of rare diseases.

Abstract:Gene therapy research for retinal diseases has made significant progress recently, offering new hope for refractory ocular conditions. This review summarizes the latest developments, evaluates challenges, and explores future trends. We focus on gene therapy for inherited retinal diseases, including commercialized RPE65-LCA therapy, clinical advances in RP subtypes and Stargardt disease, and the "bilateral effect" in LHON therapy. We also discuss strategies for complex disorders like AMD and DR, and analyze advances in delivery systems including engineered AAV vectors, non-viral vectors, and CRISPR/Cas9 applications. The review addresses major challenges including safety, immunogenicity, long-term efficacy, and personalized approaches. Research indicates retinal gene therapy is transitioning from proof-of-concept to clinical application. With continued innovation and experience, it promises to provide precise treatment options, significantly improving visual outcomes for patients.

Abstract:The retina has a complex and delicate function and structure, containing a large number of neuronal cells with extremely limited regenerative capacity, which are susceptible to damage and apoptosis under pathological conditions such as ischemia and hypoxia, resulting in irreversible vision loss. Retinal diseases are very common, such as retinitis pigmentosa (RP), age-related macular degeneration (AMD), diabetic retinopathy (DR), and glaucoma. Most of the diseases in this category are treated symptomatically, which is effective but has some limitations in neuroprotection. Vascular endothelial growth factor (VEGF)-B is functionally relatively inert in the VEGF family, and unlike pro-angiogenic VEGF-A, VEGF-B shows functional inertia in angiogenesis but exhibits significant neuroprotective effects.VEGF-B is a potent anti apoptotic, antioxidant factor that can regulate the expression of apoptotic genes and enhance the expression of glutamic acid decarboxylase 1 by binding to VEGFR-1 to activate the ERK1/2 or Akt pathway, in addition to decreasing the expression of glutamate, resulting in retinal neurocytoprotective effects. In this article, we review the protective effect of VEGF-B on retinal neuronal cells to provide new ideas for the treatment of retina-associated diseases.