Volume 26,2026 Issue 9

Articles in English

• Longitudinal observation of ocular biometric parameters after intravitreal ranibizumab injection for retinopathy of prematurity

  Yang Jing, Wang Qian, Li Conghui, Zhang Le

  2026,26(9):1501-1505 ,DOI: 10.3980/j.issn.1672-5123.2026.9.01

  Abstract: (58) HTML (0) PDF (406.48 KKB)(43)

  Abstract:

  AIM:To assess the longitudinal changes in ocular biometric parameters after intravitreal ranibizumab(IVR)injection for the treatment of retinopathy of prematurity(ROP)in premature infants during the first year of life.

  METHODS:A longitudinal observational and comparative study was conducted on premature infants diagnosed with type 1 ROP, with a one-year follow-up. In treatment group, patients were administered with ranibizumab injection. The control group was set up without any intervention. All the patients were examined by A-scan ultrasound biometry at 0(40 gestational wk), 3, 6, and 12 mo of corrected gestational age(GA). Anterior chamber depth(ACD), lens thickness(LT), vitreous chamber depth(VCD), and axial length(AL)were measured. Anterior segment(AST)was calculated by summing up the ACD and LT.

  RESULTS:A total of 60 premature infants(60 eyes)were enrolled in this study, with a mean postmenstrual age of 36.80±2.86 wk, including 30 cases(30 eyes)in the treatment group and 30 cases(30 eyes)in the control group. The mean birth weight was 1157.50±232.12 and 1327.00±432.92 g, and the mean GA was 28.46±1.70 and 30.25±2.12 wk in treatment and control groups, respectively. No significant differences were found in all parameters at baseline(P>0.05). However, after correcting GA by 3, 6, and 12 mo, ACD was significantly greater than that of the control group at the 3^rd, 6^th, and 12^th mo. LT was significantly thinner in the treatment group at the 3^rd and 6^thmo, but no statistically significant difference was observed between the two groups by the 12^th mo. Throughout the follow-up period, AST, VCD, and AL were no significant differences in two groups(all P>0.05).

  CONCLUSION:Ranibizumab administered for the treatment of ROP only affected on ACD and LT. No significant effects are observed on AST, VCD, and AL during the first year of life.

• Clinical ophthalmic evaluation of post-traumatic carotid-cavernous fistula

  Viona Viona, Yunita Mansyur, Batari Todja Umar, Ashari Bahar

  2026,26(9):1506-1516 ,DOI: 10.3980/j.issn.1672-5123.2026.9.02

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  Abstract:

  AIM: To identify clinical and fundoscopic predictors of visual outcomes in post-traumatic carotid-cavernous fistula(CCF)and report the relationship between diagnostic delay, angiographic closure rates, and functional prognosis.

  METHODS: This retrospective case series reports patients with post-traumatic CCF confirmed by digital subtraction angiography between January 2024 and October 2025. Comprehensive ophthalmic evaluation included visual acuity, intraocular pressure(IOP), fundoscopy, relative afferent pupillary defect(RAPD), and color vision. Clinical presentation patterns, fundoscopic findings, and visual outcomes were systematically documented and analyzed descriptively.

  RESULTS: Eight patients(5 males, 3 females, mean age 28.5±13.2 y)were included; 7 cases(88%)from motor vehicle accidents. Mean diagnostic delay was 2.6±1.6 mo; 7 cases(88%)presented beyond 6 wk. Secondary glaucoma developed in 5 cases(63%). Bilateral signs and symptoms occurred in 3 cases(38%)despite unilateral fistulas. Type A direct CCF predominated(7 cases, 88%). Fundoscopic examination revealed three presentations: normal disc(2 cases, 25%), optic disc edema(3 cases, 38%), and optic atrophy(3 cases, 38%). Despite complete angiographic closure in only 3 cases(38%), visual outcomes seemed more closely associated with baseline fundoscopic findings than closure rates. Patients with optic atrophy(n=3)demonstrated poor visual prognosis(final visual acuity ranging no light perception to 20/30), while those with normal fundus(n=2)achieved excellent recovery(final visual acuity 20/20-20/25). Patients with disc edema(n=3)showed variable outcomes depending on disease severity, ranging from complete recovery to persistent visual loss. One patient experienced contralateral visual decline(20/20 to 20/150)following partial embolization.

  CONCLUSION: With 88% of patients presenting beyond the critical six-week therapeutic window, early recognition of post-traumatic CCF remains a major challenge in resource-limited settings. Visual outcomes corresponded with baseline fundoscopic findings rather than angiographic closure rates. Patients with established optic atrophy(38%)demonstrated minimal visual recovery regardless of treatment success, while those with preserved disc architecture achieved favorable outcomes. In settings where advanced imaging is unavailable, systematic neuro-ophthalmic examination—particularly RAPD testing and fundoscopy—enables both early diagnosis and prognostic assessment.

Experimental Article

• Long non-coding RNA MALAT1 in apoptosis and oxidative stress of human lens epithelial cells

  Dong Xiaoming, Liu Yuxuan, Wang Yifei, Li Dong, Zhang Jinsong, Wang Jing

  2026,26(9):1517-1523 ,DOI: 10.3980/j.issn.1672-5123.2026.9.03

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  Abstract:

  AIM:To clarify the expression characteristics and regulatory role of the long non-coding RNA(lncRNA)metastasis-associated lung adenocarcinoma transcript 1(MALAT1)in oxidative stress and apoptosis of H₂O₂-induced human lens epithelial cell line HLE-B3.

  METHODS: HLE-B3 cells were divided into Control group and H₂O₂ group(cultured with 200 μmol/L H₂O₂ for 24 h). Levels of reactive oxygen species(ROS)and cell apoptosis rates were detected by flow cytometry. Activities of superoxide dismutase(SOD)and catalase(CAT)were measured using kits, MALAT1 expression was quantified by real-time quantitative PCR, and its cellular localization was determined by fluorescence in situ hybridization. After selecting the Si-MALAT1 sequence with the highest silencing efficiency, the groups were established as Control, H₂O₂, H₂O₂+Si-NC, and H₂O₂+Si-MALAT1. Immunofluorescence staining was employed to detect the apoptosis marker TUNEL and Nrf2 nuclear translocation.

  RESULTS:Compared with the Control group, the H₂O₂group exhibited significantly elevated ROS levels, markedly decreased SOD and CAT activities(both P<0.001), and a significantly increased apoptosis rate(P<0.01). MALAT1 expression was upregulated(P<0.01)and localized in the nucleus. After silencing MALAT1, H₂O₂-induced cell apoptosis was significantly inhibited(P<0.01).

  CONCLUSION: H₂O₂-induced oxidative stress can increase the expression of MALAT1, and silencing MALAT1 reduces oxidative stress damage and apoptosis, providing a potential target for preventing and treating cataracts.

Clinical Article

• Development of a nomogram model for risk factors of pre-myopia in school-aged children and the myopia control efficacy of plano defocus lenses

  Du Juan, Lin Ping, Zhao Yijia, Yao Dayong

  2026,26(9):1524-1530 ,DOI: 10.3980/j.issn.1672-5123.2026.9.04

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  Abstract:

  AIM: To analyze the risk factors for pre-myopia among school-aged children, develop a nomogram model based on these factors, and explore the efficacy of plano defocus lenses on myopia prevention and control.

  METHODS: A prospective randomized controlled clinical trial. School-aged children receiving physical examinations in the hospital between July 2024 and January 2025 were enrolled. All subjects were divided into the experimental group(children with pre-myopia)and the control group(children with normal refraction)according to the results of cycloplegic refraction and axial length measurement. Clinical data of the two groups were collected. Logistic regression analysis was adopted to identify the risk factors for pre-myopia, and a corresponding nomogram model was constructed. The children in the experimental group were further assigned to Group A(standard behavioral intervention+plano defocus lenses)and Group B(standard behavioral intervention alone)via the random number method. Ocular biological parameters and refractive indices before and after intervention were compared between groups.

  RESULTS: A total of 236 school-aged children were enrolled in this study, including 80 children in the experimental group(40 cases in group A and 40 cases in group B)and 156 children in the control group. The age of children in the experimental group was 8.88±1.11 y, with 27 males and 53 females. The age of children in the control group was 8.92±1.05 y, with 91 males and 65 females. Group A had an average age of 8.79±1.22 y(14 males and 26 females), and group B had an average age of 8.91±1.07 y(13 males and 27 females). Multivariate Logistic regression analysis revealed that parental myopia history, pencil-grip posture and duration of electronic device use were risk factors for pre-myopia among school-aged children(all P<0.05); daily outdoor activity duration and daily sleep duration were protective factors(all P<0.05). The nomogram model yielded an AUC of 0.970(95%CI: 0.951-0.990), with a sensitivity of 0.900 and specificity of 0.942. The calibration curve indicated nearly perfect linear calibration and good fitting performance. Decision curve analysis demonstrated high clinical applicability. SHAP summary plots showed that daily outdoor activity duration was the most critical factor affecting the onset of pre-myopia in school-aged children. After intervention with plano defocus spectacles, the axial length elongation in group A was significantly lower than that in group B(P<0.05). Choroidal thickness and cycloplegic spherical refraction were significantly higher, and uncorrected distance visual acuity(LogMAR)was significantly lower in group A compared with group B(all P<0.05).

  CONCLUSION: Parental myopia history, pencil-grip posture, and duration of electronic device use are risk factors for pre-myopia in school-aged children, while daily outdoor activity duration and daily sleep duration are protective factors. The nomogram constructed based on the above factors exhibits favorable predictive accuracy and can be applied for early screening of high-risk children. Plano defocus spectacles can slow axial length progression, stabilize refractive status, and exert positive effects on myopia prevention in school-aged children with pre-myopia.

• Efficacy of defocus rigid gaspermeable contact lenses versus highly aspherical lenslets for moderate-to-high myopia control

  Tang Jingjing, Li Zhanyuan, Quan junming, Lin Jiang

  2026,26(9):1531-1535 ,DOI: 10.3980/j.issn.1672-5123.2026.9.05

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  Abstract:

  AIM:To compare the clinical efficacy of defocus rigid gas permeable contact lenses(RGPCL)and highly aspherical lenslets(HAL)for myopia control in children and adolescents with moderate to high myopia.

  METHODS:A retrospective study was conducted, enrolling patients aged 8-17 y with moderate to high myopia who presented to Sichuan Eye Hospital, Aier Eye Hospital Group between January 2022 and January 2024. Subjects were divided into the RGPCL group and the HAL group according to myopia correction modalities. Refractive diopters, axial length, corneal curvature, and visual quality were examined at 6 and 12 mo after lens wear, and relevant data were statistically analyzed.

  RESULTS:A total of 96 eyes from 96 cases were enrolled, with 48 cases(48 eyes, 8 males and 40 females)allocated to the RGPCL group with a median age of 12.00(11.50, 15.00)y, and 48 cases(48 eyes, 14 males and 34 females)to the HAL group with a median age of 13.00(12.00,14.00)y. At the 6-month follow-up, no significant changes in spherical diopters were observed in either group relative to baseline. Spherical diopters increased in both groups at the 12-month visit, with a significantly smaller increment in the RGPCL group(P<0.01). At the 6- and 12-month follow-up visits, the magnitude of changes in cylindrical refractive power was markedly larger in the RGPCL group relative to the HAL group(P<0.01). At the 6-and 12-month follow-up visits, axial length in both groups had increased relative to baseline, and no significant intergroup difference was detected in axial elongation(P>0.05). At 6 and 12 mo of lens wear, no significant difference in K1,K2 was found in the HAL group compared with baseline, while the K2 value decreased significantly in the RGPCL group(P<0.0167). The RGPCL group achieved substantially higher scores in four domains including visual clarity, image scaling, glare tolerance, visual field range and total at both follow-up time points(all P<0.001).

  CONCLUSION:Defocus RGPCL yields superior performance in slowing the progression of spherical and cylindrical, as well as providing better overall visual experience, when compared with HAL.

• Predictive value of exodrift for long-term postoperative eye position regression in children with intermittent exotropia

  Shi Zhesong, Song Run

  2026,26(9):1536-1543 ,DOI: 10.3980/j.issn.1672-5123.2026.9.06

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  Abstract:

  AIM:To investigate the predictive role of exodrift amount on long-term postoperative eye position regression in children with intermittent exotropia.

  METHODS:Prospective cohort study.Children with intermittent exotropia who underwent surgical treatment at the hospital between September 2023 and July 2025 were included. Based on the eye position regression status at 6 mo postoperatively, patients were divided into a regression group and a non-regression group. Clinical data of two groups were compared. The relationship between exodrift and visual function was analyzed. Multivariate linear regression was used to examine the association between exodrift and visual function. Logistic multivariable analysis identified factors influencing long-term postoperative eye position regression. A regression discontinuity design(RDD)was employed to evaluate the validity and robustness of the results. Interval likelihood ratios were analyzed to assess the relationship between exodrift and long-term postoperative eye position regression. Receiver operating characteristic(ROC)curves were used to evaluate the predictive value of exodrift for long-term postoperative eye position regression. Restricted cubic splines(RCS)were applied to analyze the dose-response relationship between exodrift and the risk of long-term postoperative eye position regression.

  RESULTS:This study initially included 133 children with intermittent exotropia. Among them, 5 cases were lost to follow-up. Eventually, 128 cases completed the follow-up(43 cases in the regression group and 85 cases in the non-regression group). The age of the children with intermittent exotropia ranged from 2 to 15 y(mean 9.89±2.61 y), with 82 boys and 46 girls. The age of the regression group was 9.82±2.64 y(26 boys and 17 girls). The age of the non-regression group was 9.96±2.58 y(56 boys and 29 girls). The two groups showed significant differences in Titmus near stereopsis, strabismus type, postoperative day 1 eye position, and postoperative day 1 exodrift(all P<0.05). There was no significant correlation between the amount of exodrift 1 d after the surgery and visual function(all P>0.05). Multiple linear regression analysis showed that there was no statistical significance between visual function and the amount of exodrift 1 d after surgery(all P>0.05). Titmus near stereopsis, convergence insufficiency type of strabismus, inward deviation(esophoria)at 1 d postoperatively, and an increased exodrift at 1 d postoperatively were identified as risk factors for postoperative eye position regression(all P<0.05). When exodrift after surgery was 9 PD at 1 d postoperatively, the risk of long-term eye position regression after surgery significantly decreased(P<0.001). When exodrift of the eye after surgery ≥14 PD at 1 d postoperatively, the probability of long-term eye position regression was relatively highest. When the cut-off value was 9 PD, the AUC of the predicted postoperative 1-day exodrift for predicting the long-term postoperative eye position regression was 0.809(95%CI: 0.749-0.869), indicating a relatively high predictive value. As the amount of exodrift increases 1 d after the surgery, the risk of long-term eye position regression also increases.

  CONCLUSION:The amount of exodrift 1 d after surgery is arisk factor for the long-term eye position regression in children with intermittent exotropia. The two are in a dose-response relationship. When the amount of exodrift 1 d after surgery is ≥14 PD, the risk of regression is the highest. The optimal cut-off value of 9 PD has a high predictive value for long-term eye position regression. Clinically, the amount of exodrift 1 d after surgery can be monitored to assess the risk of regression 6 mo after surgery, providing a reference basis for the clinical formulation of individualized follow-up plans.

Review Aritcle

• OCT-based quantitative measurement of Bruch's membrane opening indicators and its clinical application progress

  Yan Xin, Yao Yijun, Tian Meng, Yang Fan, Lu Zixing, Sun Fanqi, Tian Bei

  2026,26(9):1544-1550 ,DOI: 10.3980/j.issn.1672-5123.2026.9.07

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  Abstract:

  Bruch's membrane opening(BMO)is the true anatomical border of the optic nerve head and provides higher anatomical accuracy, structural stability and measurement repeatability than traditional assessments based on the clinically visible optic disc margin. Optical coherence tomography(OCT)serves as a key technical tool for quantitative assessment of BMO-associated structural parameters. With the development of spectral-domain OCT(SD-OCT)and swept-source OCT(SS-OCT), parameters such as BMO-minimum rim width(BMO-MRW), BMO-minimum rim area(BMO-MRA), BMO area, offset, tilt, and torsion have emerged as important imaging biomarkers for evaluating optic nerve head morphology and for assisting in the diagnosis, staging, and longitudinal monitoring of glaucoma, myopia, and pathological myopia. Traditionally, the acquisition of these parameters has relied heavily on manual segmentation, which is limited by low efficiency, strong subjectivity, and considerable inter-observer variability. In recent years, artificial intelligence has been increasingly applied to OCT image segmentation, quality control, cross-device calibration, and automated quantitative analysis, thereby improving efficiency, objectivity, and reproducibility, particularly in eyes with complex optic disc morphology. This review summarizes recent advances in the BMO-related terminology standardization, imaging and quantitative methodologies, quality control,artificial intelligence-assisted analysis, as well as clinical evidence of its application in glaucoma, myopia and pathological myopia. Particular emphasis is placed on their potential value in the differential diagnosis and follow-up evaluation of highly myopic eyes with glaucoma, aiming to provide a reference for the standardized clinical application and future translational use of BMO-related parameters.

• Research progress on key signaling pathways in ocular surface inflammation and their therapeutic potential

  Tang Yueyao, Gao Ruoshan, Liu Xue, Xie Ruiping

  2026,26(9):1551-1555 ,DOI: 10.3980/j.issn.1672-5123.2026.9.08

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  Abstract:

  Ocular surface inflammation constitutes a core pathological mechanism underlying prevalent ocular disorders, including dry eye disease, allergic conjunctivitis, and infectious keratitis. Its pathogenesis is intimately linked to the dysregulated activation of multiple intracellular signaling cascades. This review systematically delineates the pivotal functions of four core signaling pathways—nuclear factor-kappa B(NF-κB), mitogen-activated protein kinase(MAPK), Janus kinase/signal transducer and activator of transcription(JAK/STAT), and the NOD-like receptor protein 3(NLRP3)inflammasome—in the ocular surface inflammation. Specifically, NF-κB functions as a master regulator driving the expression of pro-inflammatory factors; MAPK acts as a central signaling hub that integrates diverse stress stimuli and potentiates inflammatory amplification; JAK/STAT mediates cytokine-driven signal transduction and modulates immune cell differentiation; and NLRP3 senses danger signals and thereby promotes the maturation of inflammatory factors such as interleukin-1β(IL-1β). Notably, these pathways do not function independently but constitute a highly interconnected regulatory network via phosphorylation, and the assembly of transcription factor complexes, which results in limited efficacy of single-targeted therapies due to the reactivation of bypass pathways. Therefore, future treatment for ocular surface inflammation is expected to prioritize multi-target synergistic strategies and personalized precision medicine, thereby enabling more sustained and effective therapeutic options for clinical practice.

• Role and research progress of TGF-β and its signaling pathway in scleral remodeling

  Ding Wanyue, Zeng Wen, Tang Liang, Fu Jingwen, Li Xin, Su Chunli

  2026,26(9):1556-1560 ,DOI: 10.3980/j.issn.1672-5123.2026.9.09

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  Abstract:

  The self-remodeling of scleral extracellular matrix(ECM)is a significant characteristic alterationin the development of myopia, and it also influences the progression of myopia. The mechanisms of scleral remodeling are intricate, with transforming growth factor-β(TGF-β)and its associated signaling pathways playing a pivotal role. This review systematically summarizes the major metabolic changes in scleral ECM, the molecular mechanisms of the TGF-β signaling pathway, and its regulatory effects on scleral remodeling during myopic development, aiming to provide new insights and potential strategies for the treatment and prevention of myopia.

• Technological innovations and clinical translation advances of metabolomics in diabetic cataract research

  Wang Jingrui, Liu Ying, Mu Yi, Han Jindong

  2026,26(9):1561-1565 ,DOI: 10.3980/j.issn.1672-5123.2026.9.10

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  Abstract:

  Diabetic cataract is a prevalent and severe complication of diabetes mellitus. Its pathogenesis is complex and driven by multiple metabolic disorders. Conventional research methods are insufficient to fully clarify its complex pathophysiological processes. As a high-throughput and unbiased systems biology approach, metabolomics allows comprehensive profiling of small-molecule metabolites in biological systems, serving as a robust tool for exploring the metabolic signatures underlying this disease. This review systematically summarizes recent progress in the application of metabolomics to diabetic cataract research, with a focus on technological innovations in sample pretreatment, data acquisition, and bioinformatics analysis. This article elaborates on how these advances contribute to the identification of disease-specific biomarkers, the clarification of intrinsic molecular mechanisms, and the discovery of potential therapeutic targets, ultimately advancing the translational application of metabolomics in the early clinical diagnosis, prognostic assessment, and development of innovative therapeutic strategies for diabetic cataract.

• Research progress of degenerative retinoschisis

  Bai Yaqi, Li Jing, Zhang Xiaodan, Wang Wenjuan, Wang Yongrui, Qin Yanan, Yang Jiajia, Zhou Guohong

  2026,26(9):1566-1571 ,DOI: 10.3980/j.issn.1672-5123.2026.9.11

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  Abstract:

  Degenerative retinoschisis(RS)is a common peripheral retinal degeneration that typically remains asymptomatic and follows a benign clinical course. However, its morphological resemblance to rhegmatogenous retinal detachment(RRD)presents a diagnostic challenge, as the two conditions demand fundamentally different management and carry distinct prognoses. Precise differentiation is therefore clinically imperative. Recent advances in multimodal imaging have substantially refined the diagnostic accuracy and differential assessment of degenerative RS, establishing spectral-domain optical coherence tomography(SD-OCT)as the definitive reference standard. When the disease progresses to progressive symptomatic schisis-related retinal detachment(PSSRD), prompt surgical intervention, including scleral buckling, pars plana vitrectomy, or a combined approach, is mandated to preserve visual function. Clinical decision-making must be individualized, with the surgical strategy carefully tailored to the specific characteristics of eachcase. This review provides a systematic synthesis of current evidence on the natural history, imaging hallmarks, and surgical management of degenerative RS and its complications, aiming to inform and optimize clinical practice.

• Research progress of systemic inflammatory markers in retinal vein occlusion

  Lin Qiyang, Liu Jingwen, Lu Yijie, Liu Dongcheng, Qin Bo

  2026,26(9):1572-1577 ,DOI: 10.3980/j.issn.1672-5123.2026.9.12

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  Abstract:

  Retinal vein occlusion(RVO), the second most common retinal vascular disease, is primarily caused by thrombosis or mechanical compression from adjacent arteries, leading to partial or complete venous obstruction. Emerging evidence suggests that inflammation plays a pivotal role in the pathogenesis of RVO. Various systemic inflammatory markers, such as NLR, SII, and PLR, have gained increasing attention due to their close association with the occurrence and clinical outcomes of RVO and secondary macular edema. Given their accessibility, low cost, and high reproducibility, these markers can serve as valuable adjuncts to ophthalmic imaging in assessing systemic inflammatory status and disease progression. This review systematically summarizes recent advances in systemic inflammatory markers for RVO, highlighting their associations with the occurrence, prognosis, and treatment response of RVO and macular edema. Furthermore, the limitations of current evidence were evaluated and outline future research directions were discussed, aiming to provide hematological adjunctive evidence for early risk identification and treatment monitoring in RVO.

• Timing selection for the treatment of vitreous hemorrhage after panretinal photocoagulation in proliferative diabetic retinopathy

  Ma Hongru, Hou Xinyi, Fu Chenglin, Dai Chunhua, Zhang Jing, Xin Meng, Liu Shu

  2026,26(9):1578-1584 ,DOI: 10.3980/j.issn.1672-5123.2026.9.13

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  Abstract:

  Panretinal photocoagulation(PRP)is the first-line treatment for severe non-proliferative diabetic retinopathy and proliferative diabetic retinopathy(PDR).Its therapeutic efficacy varies due to multiple patient-specific systemic and ocular factors. Despite standardized PRP, some patients fail to show adequate regression of neovascularization and subsequently develop vitreous hemorrhage(VH). In such cases, pars plana vitrectomy(PPV)effectively clears the hemorrhage, restores transparency of the ocular media, supplement PRP, and delays the progression of PDR, thus becoming a critical intervention. With recent advances in surgical techniques, concepts, and equipment, early PPV intervention for VH following PRP has emerged as a growing research focus. Nevertheless, consensus remains lacking regarding its indications, optimal timing, and surgical protocols. This article systematically reviews relevant domestic and international studies, summarizing the surgical timing, approaches, and prognoses of PPV for VH in PDR patients after PRP, aiming to provide evidence-based reference for clinical decision-making and reduce the risk of PDR-related blindness.

• Advances in the application of artificial intelligence in the diagnosis and treatment of diabetic retinopathy

  Li Feiyu, Geriletu

  2026,26(9):1585-1591 ,DOI: 10.3980/j.issn.1672-5123.2026.9.14

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  Abstract:

  Diabetic retinopathy(DR)represents the most prevalent microvascular complication of diabetes mellitus(DM)and has emerged as the primary cause of blindness among working-age individuals. Timely screening and intervention are essential for preventing and treating vision loss. Recently, artificial intelligence(AI)technology has been increasingly integrated into ophthalmology, exhibiting considerable promise in the screening, diagnosis, prognosis prediction, and personalized management of DR, thus becoming a focal point of research and practice. This article systematically reviews the advancements in AI concerning the comprehensive management of DR. In the domains of screening and diagnosis, deep learning-based systems have achieved efficient and automated lesion detection and grading, demonstrating performance that is comparable to, or even exceeds, that of ophthalmologists. These systems can be deployed in grassroots and remote areas through various modalities. In the realm of prognosis prediction, AI can assess the risk of disease progression by analyzing fundus images and clinical data, thereby establishing a foundation for personalized follow-up. Regarding treatment and management, AI can aid in the development of laser treatment plans, forecast drug efficacy, and facilitate the creation of intelligent management platforms that integrate data from multiple sources. This article seeks to summarize the practical application models, key methodologies, and clinical validation of AI technology throughout the entire continuum of “screening-diagnosis-prediction-individualized management” of DR. Additionally, it examines the current technical, ethical, and promotional challenges while anticipating future developmental directions, with the aim of providing valuable insights for further research and application of AI in the prevention and treatment of DR.

• Research progress on retinal displacement following rhegmatogenous retinal detachment repair

  Liu Jia, Shi Yanyun, Xie Guoli

  2026,26(9):1592-1597 ,DOI: 10.3980/j.issn.1672-5123.2026.9.15

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  Abstract:

  Historically,most vitreoretinal surgeons have considered the single operation anatomical reattachment rate of the retina following rhegmatogenous retinal detachment(RRD)repair as the primary outcome measure.Nevertheless,even with successful anatomical retinal reattachment,many patients still experience visual function defects such as metamorphopsia and aniseikonia.Retinal displacement is one of the primary contributing factors.Accumulating evidence suggests that postoperative visual function and vision related quality of life are of greater clinical importance to patients.PubMed and Web of Science database were searched for studies published before November 2025 on “retinal displacement”and“rhegmatogenous retinal detachment”.This paper systematically reviews the research advances in retinal displacement after RRD repair, as well as its detection modalities,pathogenesis,risk factors,and functional prognosis.

• Recent advances in the pathogenesis of evaporative dry eye disease

  Huang Yiyun, Wang Yan, Li Xiaolong, Naiyila Xiaokaiti, Zhao Yong

  2026,26(9):1598-1602 ,DOI: 10.3980/j.issn.1672-5123.2026.9.16

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  Abstract:

  The ocular surface must maintain homeostasis to withstand continuous environmental stimuli, while increased tear evaporation represents a critical initiating event in the progression of evaporative dry eye disease. The composition, distribution, and function of the tear film lipid layer determine its anti-evaporative capacity. Multiple factors, including meibomian gland dysfunction, abnormalities of the lipid layer, blinking disorders, mucin deficiency, and epithelial barrier impairment, collectively weaken the evaporative barrier, subsequently inducing hyperosmotic stress and ocular surface inflammation, activating neuro-immune pathways, and thereby establishing a self-perpetuating cycle and contributing to disease chronicity. The environmental characteristics of northwestern regions, including low humidity, limited rainfall,strong winds, frequent windblown dust, and high evaporation rates, may further exacerbate these processes. This review integrates modern ocular surface pathological mechanisms with the theory of “Northwest dryness syndrome” to summarize the pathogenesis of evaporative dry eye disease and the effects of dry environmental exposure, aiming to provide a reference for risk assessment and intervention strategies for dry eye in Northwest China.

Clinical research

• Value of OCT imaging features in predicting the prognosis of Conbercept therapy for diabetic macular edema

  Zhang Yao, Xu Lishuai

  2026,26(9):1603-1608 ,DOI: 10.3980/j.issn.1672-5123.2026.9.17

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  Abstract:

  AIM: To explore the value of optical coherence tomography(OCT)imaging features in predicting the prognosis of intravitreal injection of conbercept in the treatment of diabetic macular edema(DME).

  METHODS: A retrospective selection was made of patients with DME who underwent intravitreal injection of conbercept at the hospital from July 2021 to August 2024. All patients received intravitreal injection of conbercept once a month for a total of 3 mo. OCT and best corrected visual acuity(BCVA)examinations were conducted at 4 mo after the treatment. The change in BCVA at 4 mo post-treatment served as the primary efficacy evaluation metric, with patients achieving a 2-line or greater improvement classified into the favorable prognosis group, while those with less than a 2-line improvement were categorized into the unfavorable prognosis group. Clinical data and OCT-related imaging features of the two groups were collected, and the factors influencing the unfavorable prognosis of patients treated with conbercept for DME and the predictive value of OCT-related imaging features for treatment efficacy were analyzed.

  RESULTS:A total of 115 DME patients(115 eyes)were included in this study \〖for patients with bilateral DME, only the eye with greater central macular thickness(CMT)was included\〗. After 4 mo of treatment, 78 cases(78 eyes)were in the good prognosis group, including 45 males and 33 females, with an average age of 60.57±7.46 y. There were 37 cases(37 eyes)in the poor prognosis group, including 24 males and 13 females, with an average age of 59.36±8.72 y. The poor prognosis rate was 32.2%. The BCVA and CMT before treatment in the poor prognosis group were higher than those in the good prognosis group(all P<0.05). The proportions of ELM integrity destruction, EZ integrity destruction, and retinal inner layer structure disorder in the poor prognosis group were all higher than those in the good prognosis group(all P<0.05). The factors influencing the prognosis of DME patients treated with conbercept were pre-treatment CMT(OR=1.030, P<0.001), ELM integrity destruction(OR=22.475, P=0.002), EZ integrity destruction(OR=23.584, P=0.001), and retinal inner layer structure disorder(OR=7.901, P=0.016). The AUC values for predicting poor prognosis of DME patients treated with conbercept by each of the indicators of ELM integrity destruction, EZ integrity destruction, and retinal inner layer structure disorder alone and in combination were 0.699, 0.653, 0.637, and 0.843, respectively.

  CONCLUSION: Clinically, OCT examination should be emphasized in patients with DME. In the early stage, by identifying high-risk imaging features, the prognosis of DME patients can be evaluated, providing objective evidence for the formulation of individualized treatment plans.

• Factors affecting the efficacy of Conbercept for diabetic macular edema and construction of a nomogram prediction model

  Gao Yanhua, Li Xiao, Wang Xizhe, Chen Boya

  2026,26(9):1609-1615 ,DOI: 10.3980/j.issn.1672-5123.2026.9.18

  Abstract: (33) HTML (0) PDF (1.14 MKB)(41)

  Abstract:

  AIM: To explore the factors influencing the efficacy of diabetic macular edema(DME)with conbercept and to construct a nomogram prediction model.

  METHODS:Retrospective analysis. Patients with DME admitted from January 2021 to October 2025 were selected. All patients received intravitreal conbercept injection once monthly for three consecutive months. Subjects were divided into a good response group and a poor response group according to the reduction in central macular thickness(CMT)at 3 mo after treatment. The clinical data of the patients were collected to analyze factors associated with poor response to conbercept therapy in patients with DME, and to construct a nomogram prediction model for identifying poor responders to conbercept treatment among DME patients.

  RESULTS:A total of 400 DME patients(400 eyes)were included in this study. The response group consisted of 312 patients(312 eyes), with 200 males and 112 females, with an average age of 64.85±5.13 y. The non-response group consisted of 88 patients(88 eyes), with 54 males and 34 females, with an average age of 65.14±4.93 y. There were no differences between the two groups in terms of gender, age, alcohol consumption, smoking status, duration of diabetes, edema classification, disease classification, low-density lipoprotein, HRF, ELM and/or EZ continuity interruption, and SRF(all P>0.05). However, there were differences in DR disease duration, pre-treatment BCVA, high-density lipoprotein, glycated hemoglobin, DRIL, and VMIA(all P<0.05). Multivariate Logistic regression analysis showed that DR disease duration ≥1 y(OR=2.351, 95%CI: 1.360-4.065), poor pre-treatment BCVA(OR=3.432, 95%CI: 1.581-6.988), high glycated hemoglobin(OR=1.656, 95%CI: 1.346-2.038), presence of DRIL(OR=3.115, 95%CI: 1.532-6.333), and presence of VMIA(OR=2.526, 95%CI: 1.445-4.415)were all risk factors for poor response to conbercept treatment in DME patients, while elevated high-density lipoprotein(OR=0.025, 95%CI: 0.004-0.163)was a protective factor for poor response to conbercept treatment in DME patients(P<0.05). ROC analysis showed that the area under the curve(AUC)of the nomogram model for predicting poor response to conbercept treatment in DME patients was 0.817(95%CI: 0.776-0.854), with a sensitivity of 73.86% and a specificity of 78.21%. When the threshold probability was >3%, the nomogram model for predicting poor response to conbercept treatment in DME patients was more favorable for all patient treatment plans.

  CONCLUSION:The nomogram prediction model constructed in this study is helpful for the clinical early identification of patients with DME who have a high risk of poor response to conbercept treatment, and can provide a reference for the early prevention of poor response to conbercept treatment.

• Consistency analysis of macular microvascular parameters measured by three OCTA devices in patients with long-term hydroxychloroquine administration

  Jiang Hong, Yu Xinyue, Hao Yajing, Chai Lijing

  2026,26(9):1616-1622 ,DOI: 10.3980/j.issn.1672-5123.2026.9.19

  Abstract: (25) HTML (0) PDF (1.70 MKB)(37)

  Abstract:

  AIM:To compare the consistency of macular microvascular parameters measured by three devices: frequency-domain optical coherence tomography angiography(FD-OCTA)with split-spectrum amplitude-decorrelation angiography(SSADA), FD-OCTA with optical microangiography(OMAG), and swept-source OCTA(SS-OCTA), in patients with long-term hydroxychloroquine(HCQ)administration for rheumatoid arthritis(RA).

  METHODS:This prospective study enrolled patients treated with HCQ for 5 y due to RA who visited the Department of Ophthalmology of the hospital from January 2022 to November 2025. All subjects underwent a 6 mm×6 mm macular scan with three OCTA devices in random order, with a 5-minute interval between examinations by different devices. Images of the superficial capillary plexus(SCP)and deep capillary plexus(DCP)were acquired. The following microvascular parameters were compared: foveal superficial capillary plexus vessel density(F-SCP VD), parafoveal superficial capillary plexus vessel density(PF-SCP VD), foveal deep capillary plexus vessel density(F-DCP VD), parafoveal deep capillary plexus vessel density(PF-DCP VD), and the area of the foveal avascular zone(FAZ).

  RESULTS:A total of 34 female patients(68 eyes)treated with HCQ for 5 y due to RA were enrolled in this study, aged 38-58 y with a mean age of 49.3±5.05 y. Statistically significant differences were found in F-SCP VD, PF-SCP VD, F-DCP VD, PF-DCP VD, and FAZ area among measurements obtained by SS-OCTA, SSADA-based FD-OCTA, and OMAG-based FD-OCTA(all P<0.05). No statistically significant differences in all above parameters were observed between SSADA-based FD-OCTA and OMAG-based FD-OCTA(all P>0.05). FAZ areas measured by the three devices were highly positively correlated(|r|≥0.8, P<0.01). The F-SCP VD, PF-SCP VD, F-DCP VD, and PF-DCP VD values obtained by SSADA-based FD-OCTA and OMAG-based FD-OCTA were all highly positively correlated(|r|≥0.8, P<0.01). The PF-SCP VD and PF-DCP VD values measured by SS-OCTA versus SSADA-based FD-OCTA and OMAG-based FD-OCTA showed moderate positive correlations(0.5≤|r|<0.8, P<0.01). The F-SCP VD and F-DCP VD values measured by SS-OCTA versus SSADA-based FD-OCTA and OMAG-based FD-OCTA exhibited low positive correlations(0.3≤|r|<0.5, P<0.05). Bland-Altman plots demonstrated good agreement between SSADA-based FD-OCTA and OMAG-based FD-OCTA for the measurements of F-SCP VD, PF-SCP VD, F-DCP VD and PF-DCP VD. By contrast, poor agreement was observed when comparing SS-OCTA with SSADA-based FD-OCTA or OMAG-based FD-OCTA for measurements of F-SCP VD, PF-SCP VD, F-DCP VD and PF-DCP VD.Satisfactory agreement was found among the three OCTA devices for FAZ area measurements.

  CONCLUSION:SSADA-based FD-OCTA and OMAG-based FD-OCTA show favorable correlation and agreement in measuring macular vessel density of patients receiving HCQ, which allows cautious interchangeable use during clinical follow-up. The vessel density parameters measured by SS-OCTA were markedly different from those obtained by SSADA-based FD-OCTA and OMAG-based FD-OCTA; therefore, these devices cannot be directly interchanged.FAZ area measurements exhibit favorable inter-device agreement among the three systems, and interchangeability should be considered in the context of clinical practice.

• Modified Danggui Yinzi decoction combined with diclofenac sodium eye drops for allergic conjunctivitis

  Zhou Xiaodan, Yang Yuqian, Leng Butian, Wu Andi, Xu Qiangsong

  2026,26(9):1623-1631 ,DOI: 10.3980/j.issn.1672-5123.2026.9.20

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  Abstract:

  AIM:To investigate the effects of modified Danggui Yinzi decoction combined with diclofenac sodium eye drops on tear film stability and tear protein levels in patients with allergic conjunctivitis.

  METHODS:Prospective study. Patients with allergic conjunctivitis who attended Suzhou Hospital of Integrated Traditional Chinese and Western Medicine from March 2021 to August 2024 were enrolled as study subjects. They were divided into two groups based on their treatment regimen: a control group(treated with diclofenac sodium eye drops alone)and an observation group(treated with modified Danggui Yinzi decoction combined with diclofenac sodium eye drops). Propensity score matching was used to balance baseline characteristics between the two groups. Log-binomial regression was performed to estimate the risk of adverse reactions. Repeated-measures analysis of variance(ANOVA)was used to assess tear film stability indicators. A difference-in-differences(DID)model was employed to assess the net effect of the combined therapy on changes in tear protein levels.

  RESULTS:After propensity score matching, a total of 172 patients(344 eyes)were finally enrolled, with 86 patients(172 eyes)in each of the control and observation groups. In the control group, there were 51 males and 35 females, with a mean age of 35.91±10.10 y; in the observation group, there were 49 males and 37 females, with a mean age of 37.87±8.09 y. After treatment, symptom scores decreased in both groups compared with baseline(all P<0.05). At 2 and 4 wk after treatment, symptom scores in the observation group were significantly lower than those in the control group(all P<0.05). The overall response rate was significantly higher in the observation group(89.5%)than in the control group(77.9%)(P<0.05), while the incidence of total adverse reactions was significantly lower in the observation group(7.0%)than in the control group(36.0%)(RR=0.133, P<0.001). Compared with baseline, both groups showed increases in BUT and SⅠt, and a decrease in FL score at 2 and 4 wk after treatment(P<0.017). At 2 and 4 wk after treatment, the BUT and SⅠt levels in the observation group were higher than those in the control group, and the FL score was significantly lower(all P<0.05). The DID model showed that the observation group had greater increases than the control group in lactoferrin(0.411 g/L), total protein(2.792 g/L), secretory immunoglobulin A(14.610 mg/L), and lysozyme(0.419 g/L), respectively(all P<0.05), and these differences remained significant after adjusting for covariates.

  CONCLUSION:Modified Danggui Yinzi decoction combined with diclofenac sodium eye drops significantly improves tear film stability indicators and tear protein levels in patients with allergic conjunctivitis, and its therapeutic efficacy is superior to that of diclofenac sodium eye drops alone.

• Impact of various diabetic conditions on ocular surface status and tear MMP-9 levels in patients with meibomian gland dysfunction

  Tian Qin, Zhang Dan, Liu Xingde

  2026,26(9):1632-1637 ,DOI: 10.3980/j.issn.1672-5123.2026.9.21

  Abstract: (24) HTML (0) PDF (505.07 KKB)(27)

  Abstract:

  AIM: To investigate the changes in ocular surface-related indicators and tear matrix metalloproteinase-9(MMP-9)levels in diabetic patients complicated with meibomian gland dysfunction(MGD), analyze the effects of diabetes mellitus on ocular surface status and tear MMP-9 levels in patients with MGD, and provide evidence for clinical diagnosis and treatment.

  METHODS: Prospective observational study.Patients with type 2 diabetes mellitus complicated with MGD who visited the Department of Ophthalmology of the hospital from June 2024 to December 2024 were enrolled(diabetes mellitus+MGD group), and patients diagnosed solely with MGD without a history of diabetes mellitus during the same period were recruited as the non-diabetic MGD group. Patients in the diabetes mellitus+MGD group were further subdivided into aglycosylated hemoglobin(HbA1c)<7.5% subgroup and an HbA1c≥7.5% subgroup based on HbA1c levels, and into a diabetes duration<10 y subgroup and a diabetes duration ≥10 y subgroup according to the duration of diabetes mellitus. Multiple ocular surface parameters, including the Ocular Surface Disease Index(OSDI)score and eyelid margin alteration score, as well as tear MMP-9 concentration, were measured in all participants, followed by between-group comparative analyses.

  RESULTS:Total of 101 patients(202 eyes)with type 2 diabetes mellitus combined with MGD were enrolled, including 56 males and 45 females with a mean age of 60.2±8.5 y. The non-diabetic MGD group consisted of 151 patients(302 eyes), with 82 males and 69 females and a mean age of 57.5±7.8 y.The HbA1c <7.5% group comprised 55 patients(110 eyes)aged 59.6±8.2 y; 31 males and 24 females. The HbA1c ≥7.5% group included 46 patients(92 eyes)aged 60.9±8.7 y; 25 males and 21 females.The subgroup with diabetes duration <10 y had 50 patients(100 eyes)aged 58.7±8.1 y; 28 males and 22 females, and the subgroup with duration ≥10 y consisted of 51 patients(102 eyes)aged 61.6±8.4 y; 27 males and 24 females. Patients in diabetes mellitus+MGD group exhibited higher OSDI scores, meibomian gland orifice scores, meibum expressibility scores, meibum quality scores, corneal fluorescein staining scores, and tear MMP-9 levels compared with non-diabetic MGD patients(all P<0.01), while tear film breakup time(BUT)and Schirmer test values were lower(all P<0.01).Among diabetic patients with MGD, the HbA1c≥7.5% subgroup had significantly higher OSDI score, meibomian gland orifice score, meibum expressibility scores, meibum quality scores, corneal fluorescein staining scores, and tear MMP-9 concentration than the HbA1c<7.5% subgroup(all P<0.05), accompanied by significantly shorter BUT and lower Schirmer I test results(all P<0.05). Similarly, the diabetes duration≥10 y subgroup showed significantly higher OSDI score, meibomian gland orifice score, meibum expressibility scores, meibum quality scores, corneal fluorescein staining scores, and tear MMP-9 concentration compared with the diabetes duration<10 y subgroup(all P<0.05), whereas BUT and Schirmer I values were significantly lower(all P<0.05).

  CONCLUSION: Diabetes mellitus may be associated with aggravated ocular surface damage in patients with MGD, accompanied by elevated tear MMP-9 levels. Poor glycemic control and longer disease duration are related to more severe ocular surface injury and higher tear MMP-9 levels. Tear MMP-9 may serve as a potential indicator for evaluating ocular surface inflammation and damage in diabetic patients with MGD, providing certain evidence for clinical treatment decision-making.

• Multimodal machine learning model-based study on pterygium-related risk factors in southeast coastal areas

  Ye Xia, Zhou Zheyuan, Wang Shikun, Zhao Na, Liu Zhen

  2026,26(9):1638-1643 ,DOI: 10.3980/j.issn.1672-5123.2026.9.22

  Abstract: (21) HTML (0) PDF (1.37 MKB)(28)

  Abstract:

  AIM: To investigate the prevalence of pterygium in the southeast coastal area, analyze associated risk factors, and develop a multimodal machine learning predictive model.

  METHODS:A cross-sectional epidemiological study. A random sampling of the resident population of the Zhoushan Islands was performed. Data were collected through on-site ophthalmic examinations and epidemiological surveys. Univariate and multivariate analyses were performed to identify risk factors associated with pterygium. A multimodal artificial intelligence machine learning model was constructed to integrate and analyze both structured and unstructured data for predictive modeling.

  RESULTS:A total of 1 842 participants were enrolled in this study, including 926 males(50.27%)and 916 females(49.73%), with a mean age of 48.62±10.35 y. A total of 644 patients(34.96%), including 323 males(50.15%)and 321 females(49.84%)were diagnosed with pterygium, including 502 cases(77.95%)were unilateral, and 142 cases(22.05%)were bilateral. There were 1 198 cases without pterygium, including 603 males(50.33%)and 595 females(49.67%). Occupation, daily outdoor sunlight exposure duration, meibomian gland orifice obstruction, age, smoking, and alcohol consumption were identified as significant risk factors for pterygium. Occupation and daily outdoor sunlight exposure duration were the most potent risk factors(OR=6.125, P<0.001; OR=5.348, P<0.001, respectively), followed by age >40 y(OR=5.295, P<0.001)and meibomian gland orifice obstruction(OR=5.248, P<0.001). The multimodal machine learning model demonstrated good predictive performance, as evidenced by the receiver operating characteristic(ROC)curve, precision-recall(PR)curve, and confusion matrix, all indicating high predictive value, AUC=0.86, AP=0.77.

  CONCLUSION: Fishermen and farmers aged over 40 y with more than 4 h of daily sunlight exposure are at high risk for pterygium in the southeast coastal area. Meibomian gland dysfunction is correlated with corneal invasion of pterygium and may facilitate its progression; therefore, active health education and targeted intervention are recommended. The multimodal machine learning model provides accurate and reliable predictive capability for pterygium risk, which may facilitate risk stratification and early warning for pterygium in southeast coastal populations.

• Clinical efficacy of the Phorcides algorithm in topography-guided myopic surgery

  Zhao Haifeng

  2026,26(9):1644-1650 ,DOI: 10.3980/j.issn.1672-5123.2026.9.23

  Abstract: (40) HTML (0) PDF (1.58 MKB)(27)

  Abstract:

  AIM: To evaluate the efficacy and safety of Phorcides algorithm combined with Contoura Vision system in topography-guided myopic correction surgery, and compare its clinical outcomes with conventional wavefront-optimized(WFO)mode.

  METHODS: A single-center open-label trial was conducted. Patients who underwent myopic correction surgery from June to December 2024 were enrolled and divided into two groups according to surgical protocols. The Phorcides algorithm combined with corneal topography-guided treatment constituted the Phorcides group, while conventional WFO treatment served as the WFO group. Both groups received surgery using the WaveLight EX500 excimer laser platform. In the Phorcides group, individualized ablation profiles were generated by the Phorcides software based on Topolyzer Vario topographic data. The WFO group underwent treatment with a standardized wavefront-optimized protocol.The primary outcome indicators included uncorrected distance visual acuity(UDVA), corrected distance visual acuity(CDVA), manifest residual spherical equivalent(MRSE), higher-order aberrations(HOAs, including spherical aberration C12, vertical coma C7, horizontal coma C8, trefoil aberration C6/C9)and incidence of postoperative complications at 3 mo after surgery.

  RESULTS:This study enrolled 128 patients(256 eyes), including 64 patients(128 eyes)in the Phorcides group and 64 patients(128 eyes)in the conventional WFO group. The mean age was 28.1±5.3 y(34 males, 30 females)in the Phorcides group and 27.9±5.0 y(33 males, 31 females)in the WFO group.There were no significant inter-group differences in age, gender, preoperative MRSE and preoperative astigmatism and total higher-order aberrations(HOAs)between the two groups(all P>0.05). At 3 mo postoperatively, 1)visual acuity and refractive outcomes: the proportion of eyes achieving UDVA of 20/16 or better in the Phorcides group was 65.6%, which was obviously higher than 37.5% in the WFO group(χ²=22.18,P<0.001). MRSE in the Phorcides group was -0.07±0.14 D, significantly lower than -0.16±0.21 D in the WFO group(t=4.12, P<0.001), indicating closer alignment with the target refraction. The proportion of eyes with residual astigmatism ≤0.50 D reached 92.2% in the Phorcides group, which was 20.3% higher than 71.9% in the WFO group(χ²=16.35, P<0.001).Only one eye of one-line CDVA loss was observed in the WFO group, while no CDVA decline occurred in the Phorcides group; 2)higher-order aberrations: the total HOAs was 0.37±0.07 μm in the Phorcides group, markedly lower than 0.51±0.10 μm in the WFO group(t=12.84, P<0.001). Spherical aberration C12(0.21±0.05 μm), vertical coma C7(0.09±0.02 μm), and horizontal coma C8(0.08±0.02 μm)in the Phorcides group were all significantly lower than those in the WFO group(all P<0.001). No significant inter-group difference was found in postoperative trefoil aberration C6(P=0.056). Although there was a statistical difference in C9(P=0.022), its absolute difference was less than 0.06 μm with limited clinical significance. 3)complications: no severe adverse complications occurred in either group. Grade 1 diffuse lamellar keratitis(DLK)was found in 5 eyes(3.9%)in the Phorcides group and 7 eyes(5.5%)in the WFO group, with no significant difference in incidence between groups(χ²=0.42, P=0.517), and all of which were completely resolved after hormone therapy.

  CONCLUSION:By integrating three-dimensional corneal topography data, the Phorcides algorithm can effectively improve the accuracy of myopia correction, reduce postoperative residual refractive error and accumulation of HOAs with reliable safety. It provides a superior individualized surgical strategy for patients with complex refractive errors.

Artificial intelligence and ophthalmology

• Application performance and limitations of general and ophthalmology-specific large models in ophthalmic images

  Lai Shixin, Fan Xinyan, Luo Mingjie

  2026,26(9):1651-1657 ,DOI: 10.3980/j.issn.1672-5123.2026.9.24

  Abstract: (28) HTML (0) PDF (544.25 KKB)(33)

  Abstract:

  With the rapid advancement of large language models, both general-purpose and ophthalmology-specific variants have shown substantial potential for ophthalmic image analysis. However, their task-specific effectiveness and applicable boundaries in clinical practice remain to be fully clarified. This review outlines the technical evolution of large models in ophthalmology, including masked visual modeling, vision-language contrastive learning, and subsequent stages of knowledge integration and multimodal reasoning. The performance of general-purpose versus ophthalmology-specific models across common clinical scenarios, including disease screening and initial triage, disease grading and lesion segmentation, and medical report generation with multimodal reasoning were further compared. Results show that general-purpose models are well-suited for multi-disease screening and primary-care triage, whereas ophthalmology-specific models excel in fine-grained grading, subtle lesions detection, and rare disease diagnosis. Moreover, instruction-tuned domain-specific models produce medical reports with greater clinical consistency. These findings provide practical guidance for selecting appropriate model types and technical pathways tailored to specific ophthalmic tasks. Furthermore, the review identifies the current challenges facing these models, including reliability, generalizability, evaluation frameworks, and reproducibility, as well as the resulting limitations in clinical application.

Clinical report

• Macular thickness changes after phacoemulsification in cataract patients with asymptomatic epiretinal membrane

  Kong Jiahui, Huo Yongjun

  2026,26(9):1658-1660 ,DOI: 10.3980/j.issn.1672-5123.2026.9.25

  Abstract: (23) HTML (0) PDF (421.59 KKB)(37)

  Abstract:

  AIM: To observe the changes in macular thickness after phacoemulsification in cataract patients with asymptomatic epiretinal membrane.

  METHODS: This was a prospective study. Clinical data of cataract patients with asymptomatic epiretinal membrane treated in the hospital from August 2023 to August 2025 were collected. Patients were followed up for 3 mo postoperatively. Best corrected visual acuity(BCVA), central foveal thickness(CFT), and macular thickness in the central 3 mm area were compared before and after surgery.

  RESULTS:A total of 87 patients(90 eyes)with cataract and asymptomatic epiretinal membrane were enrolled. One patient(1 eye)was lost to follow-up at 1 mo postoperatively, with a loss rate of 1%. Among the 86 patients(89 eyes)who completed the follow-up, there were 38 males and 48 females, with a mean age of 76.51±5.23 y. The mean axial length was 23.32±0.27 mm. Eighty-five eyes(95.5%)had nuclear hardness of grade Ⅲ or above. Preoperative CFT was 344.56±54.13 μm, and preoperative macular thickness in the central 3 mm area was 351.25±32.32 μm. At 1 wk, 1 and 3 mo postoperatively, BCVA improved compared with preoperative values(all P<0.05), while CFT and macular thickness in the central 3 mm area increased significantly(all P<0.05). At 1 wk postoperatively, pseudocystoid macular edema(PCME)occurred in one eye. After treatment with prednisolone acetate eye drops 4 times daily and bromfenac sodium eye drops 2 times daily for 2 mo, edema fully resolved, visual acuity recovered to the average postoperative level, and no metamorphopsia was observed.

  CONCLUSION: Phacoemulsification is safe and effective for cataract patients with asymptomatic epiretinal membrane.

• Efficacy of 0.05% cyclosporine combined with olopatadine hydrochlorideeye drops for moderate-to-severe pediatric vernal keratoconjunctivitis

  Li Jingwei, Yu Lan, Dong Qiaoqiao, Qin Jiao

  2026,26(9):1661-1664 ,DOI: 10.3980/j.issn.1672-5123.2026.9.26

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  Abstract:

  AIM:To observe the therapeutic efficacy of 0.05% cyclosporine combined with olopatadine hydrochlorideeye drops in the treatment of moderate-to-severe pediatric vernal keratoconjunctivitis.

  METHODS:A prospective randomized controlled study was conducted. Patients with moderate-to-severe pediatric vernal keratoconjunctivitis admitted to the hospital from January to December 2023 were collected and divided into two groups according to the random number table method: the observation group was treated with olopatadine combined with 0.05% cyclosporine hydrochloride eye drops \〖1 drop per time of 0.05% cyclosporine eye drops(II), four times a day; 1 drop per time of olopatadine hydrochloric eye drops, twice a day\〗; the control group was treated with sodium hyaluronate combined with olopatadine hydrochloride eye drops(1 drop per time of sodium hyaluronate eye drops, four times a day; 1 drop per time of olopatadine hydrochloric eye drops, twice a day; ). The treatment lasted for 12 wk. The changes in symptom and sign scores of the two groups before treatment, and at 4, 8, and 12 wk after treatment were compared.

  RESULTS:Totally 42 children(84 eyes)with moderate-to-severe vernal keratoconjunctivitis were enrolled. All patients returned for follow-up visits on time, with no lossto follow-up. The observation group consisted of 21 patients(42 eyes), with 15 males and 6 females, and the average age was 9.00±3.02 y. The control group consisted of 21 patients(42 eyes), with 18 males and 3 females, and the average age was 9.38±3.28 y(all P>0.05). At 4, 8, and 12 wk after treatment, the ocular symptom and sign scores of both groups decreased compared to those before treatment(all P<0.05), and the decrease in the observation group was more significant than that in the control group(P<0.05). During the treatment period, one patient in the observation group experienced a transient mild ocular irritation at the beginning of medication, which was not treated specially and relieved spontaneously after 3 d. No severe adverse reactions such as elevated intraocular pressure or corneal infection occurred in either group during the treatment period.

  CONCLUSION:The combination of 0.05% cyclosporine and olopatadine hydrochlorideeye drops significantly alleviates the clinical symptoms and signs of moderate-to-severe vernal keratoconjunctivitis, showing favorable safety and efficacy in the treatment of moderate-to-severe pediatric vernal keratoconjunctivitis.

• Therapeutic efficacy of eyelid margin incision combined with floating bridge technique for ptosis

  Liu Tong, Zhao Na, Wu Hailiang, Du Jialing, Cai Chenxi, Zheng Yuqing, Yan Li

  2026,26(9):1665-1669 ,DOI: 10.3980/j.issn.1672-5123.2026.9.27

  Abstract: (32) HTML (0) PDF (909.84 KKB)(30)

  Abstract:

  AIM: To explore the application effect of eyelid margin incision combined with floating bridge technique in the treatment of ptosis patients, and to analyze its effects on the margin reflex distance 1(MRD1)and the aesthetic effect of the eyes.

  METHODS:Prospective study. This study enrolled patients with blepharoptosis treated at the Department of Ophthalmology of the hospital between January 2023 and July 2025, who were assigned to either an observation group or a control group. The patients in the control group received levator aponeurosis shortening surgery through conventional double-eyelid incision, while the patients in the observation group underwent levator aponeurosis shortening surgery using the eyelid margin incision combined with floating bridge technique. Subsequently, the surgical-related indicators,the correction effect of ptosis, the aesthetic effect, the ocular function indicators, the postoperative complication occurrence rate, and recurrence rate were compared and analyzed between two groups.

  RESULTS:A total of 100 patients(100 eyes)with blepharoptosis were enrolled in this study, with 50 patients(50 eyes)in the observation group and 50 patients(50 eyes)in the control group. The observation group had a mean age of 27.33±5.32 y, including 20 males and 30 females. The control group had a mean age of 27.64±4.66 y, including 24 males and 26 females. Compared with the control group, the operative time of the observation group was longer, the postoperative swelling resolution time and natural recovery time were shorter,and the correction rate was higher(P<0.05). Three months after the surgery, the VSS score and POSAS score of the observation group were lower than those of the control group, while the scores for eyelid curvature, symmetry of eyelid height, and the PFH, MRD1, palpebral fissure size, and upper eyelid levator muscle strength were all higher than those of the control group(all P<0.05). However, there was no significant difference in postoperative complication occurrence rate and recurrence rate between two groups(all P>0.05).

  CONCLUSION:The combined use of eyelid margin incision and floating bridge technique for treating ptosis results in slightly longer operation time, but it can shorten the postoperative recovery period, effectively ameliorate the MRD1 and ocular function of patients, and enhance the correction effect and aesthetic quality of the eyes. In addition, it has a low incidence of complications and guaranteed safety.

• Prevalence and risk factors of dry eye disease in male computer professionals under different meteorological and air quality conditions

  Hu Ke, Gui Yu, Kong Huanhuan, Chen Peng, Sun Lijuan

  2026,26(9):1670-1674 ,DOI: 10.3980/j.issn.1672-5123.2026.9.28

  Abstract: (30) HTML (0) PDF (594.33 KKB)(39)

  Abstract:

  AIM: To investigate the prevalence of dry eye symptoms among computer professionals in different climate zones and to identify the risk factors associated with dry eye disease.

  METHODS: A cross-sectional study was conducted by distributing questionnaires from December 2023 to January 2024 to computer professionals in six prefecture-level cities located in three distinct climate zones. Mixed-effects logistic regression analysis was employed to explore the relationship between environmental factors and the severity of dry eye disease. Environmental factors, including meteorological parameters and air pollutant concentrations, were obtained from the National Meteorological Information Center and the China Air Quality Online Monitoring and Analysis Platform, respectively. The annual mean values of environmental parameters served as independent variables, while the participants' Ocular Surface Disease Index(OSDI)scores were used as the dependent variable in the regression analysis.

  RESULTS:A total of 364 male participants aged 18-50 y were enrolled in this study. Among them, 80 participants presented with dry eye symptoms, corresponding to a detection rate of 22.0%.There was a significant difference in the detection rate of dry eye symptoms across different regions(P<0.05). Mixed-effects logistic regression analysis identified the following risk factors: daily eye use time(P<0.001, OR=1.669), relative humidity(P=0.047,OR=1.237), NO₂ concentration(P=0.042, OR=1.283), PM2.5 concentration(P=0.006,OR=1.485), and CO concentration(P=0.018, OR=1.388). Temperature was found to be a protective factor(P=0.003, OR=0.701).

  CONCLUSION: Meteorological conditions and air quality significantly influence the occurrence of dry eye symptoms in male computer professionals. Prevention and treatment strategies for dry eye diseases should be tailored to the environmental characteristics of different regions to protect the ocular surface health of this occupational group.

• Comparison of the clinical outcomes of two extended depth of focus diffractive intraocular lenses

  Zhang Chuyao, Cheng Zhigang, Cheng Yue, Wang Jing, Zhang Jinsong, Zhang Tianxiao

  Abstract:

  ?AIM: To compare the postoperative clinical outcomes of two extended depth of focus (EDF) diffractive intraocular lenses (IOLs), the AMEUH and the Tecnis Symfony IOL. ?METHODS: This prospective cohort, multicenter study enrolled patients with cataract who underwent cataract phacoemulsification with IOL implantation at three hospitals between October 2024 and June 2025. Patients were divided into the AMEUH group and the ZXR00 group according to the implanted IOL. The AMEUH group included patients implanted with an EDF diffractive IOL, and the ZXR00 group included patients implanted with the Tecnis Symfony IOL. At 6 months postoperatively, ocular biometric parameters; photopic uncorrected distance visual acuity (UDVA), uncorrected intermediate visual acuity (UIVA), uncorrected near visual acuity (UNVA), corrected distance visual acuity (CDVA), distance-corrected intermediate visual acuity (DCIVA), and distance-corrected near visual acuity (DCNVA); mesopic CDVA, DCIVA, and DCNVA; defocus curves; manifest refraction; contrast sensitivity; visual symptoms; spectacle independence; patient satisfaction; and intraocular pressure (IOP) were compared between the two groups. ?RESULTS: A total of 83 patients (83 eyes) were included in this study, including 31 males (31 eyes) and 52 females (52 eyes), with a mean age of 63.18 ± 10.30 years. The AMEUH group included 41 patients (41 eyes), aged 67.00 (60.00, 72.00) years, including 13 males and 28 females. The ZXR00 group included 42 patients (42 eyes), aged 62.00 (57.50, 69.00) years, including 18 males and 24 females. At 6 months postoperatively, there were no significant differences in ocular biometric parameters between the two groups (all P＞0.05). No significant differences were observed in photopic UDVA, UIVA, UNVA, CDVA, and DCIVA, or in mesopic CDVA and DCIVA between the two groups (all P＞0.05). However,photopic and mesopic DCNVA were significantly better in the AMEUH group than in the ZXR00 group (both P＜0.05). The effective depth of focus in the AMEUH group was increased by 0.5D compared with the ZXR00 group. Significant differences were observed in manifest refraction between the two groups (P＜0.05). Under specific lighting conditions and spatial frequencies, contrast sensitivity was significantly better in the AMEUH group than in the ZXR00 group (all P＜0.05). The incidences of glare, halos, and blurred vision were all significantly lower in the AMEUH group than in the ZXR00 group (allP＜0.05). There were no significant differences in spectacle independence for distance, intermediate, and near vision, or in patient satisfaction for distance and intermediate vision between the two groups (all P＞0.05). However, patient satisfaction for near vision was significantly higher in the AMEUH group than in the ZXR00 group(P＜0.05). ?CONCLUSION: The EDF diffractive IOL AMEUH further extended the depth of focus through a higher-order aspheric optical design based on a diffractive design, providing comparable efficacy to the Symfony IOL in improving distance and intermediate vision, while its higher addition power provided superior near visual performance, and reduced spectacle dependence. The AMEUH IOL was associated with a lower incidence of visual symptoms, as well as favorable safety and patient satisfaction.

• Feasibility of sequential trans-PTK and intraocular salvage surgery for pediatric

  pengzongyi, yehehua, zhaopeiquan

  Abstract:

  Purpose: To investigate the feasibility of sequential transepithelial phototherapeutic keratectomy (trans-PTK) followed by emergent intraocular surgery under a single general anesthesia session in young pediatric patients with band keratopathy who require urgent intraocular intervention. Methods: A retrospective case series was performed. Clinical data were collected from 13 pediatric patients (13 eyes) who received above-mentioned treatment between August 2024 and August 2025. All patients presented with complex intraocular diseases requiring urgent surgical intervention, complicated by visual axis-involving band keratopathy (BK)that obscured fundus visualization and precluded intraocular surgery. Under stable general anesthesia, trans-PTK was performed to remove corneal epithelium and calcific plaquesand then the planned intraocular procedures were carried out. BK was evaluated in terms of both extent and visualization, based on standardized grading scales. Intraoperative parameters, postoperative corneal clarity, improvement of intraocular visualization and any adjunctive ocular surface measures were documented and evaluated. The changes of intraocular visualization and best corrected visual acuity were statistically analyzed by Wilcoxon signed-rank test. Results: The mean age of patients was 6.15±3.10 years (including 9 males). All patients completed the combined procedure under the same general anesthesia. The indications for salvage surgery included retinal detachment (6 cases), silicone oil-related complications requiring removal (emulsification or displacement, 4 cases), and anterior chamber loss or angle closure (3 cases).Mean maximum corneal ablation depth was 97.08±15.60 μm, and mean laser treatment time was 57.85±14.80seconds. Postoperatively, corneal transparency improved in all eyes， including completed improvement in 9 cases and partial improvement in 4 cases. Intraocular visualization was significantly improved (P＜0.05). Best-corrected visual acuity (BCVA) did not differ significantly from preoperative levels (P＞0.05). During sequential intraocular surgery, corneal dehydration accelerated in eyes not treated with viscoelastic agents, with a mean corneal wetting interval of 11.66±4.10seconds. Viscoelastic agents were applied in 5 eyes to reduce irregular refraction and severe dehydration, maintaining corneal hydration and surgical field clarity. No adverse events occurred in any pediatric patient during the intraoperative or postoperative periods. Conclusion: Trans-PTK performed under the same session of general anesthesia allows for a rapid enhancement of intraocular visualization, facilitating the successful implementation of sequential intraocular procedures.

• The predictive value of serum ptx3, tlr4, and sdf-1 for postoperative dry eye disease in patients with type 2 diabetes mellitus complicated with cataract

  Wang Ying

  Abstract:

  Objective: To explore predictive value of serum pentraxin-3 (PTX3), Toll-like receptor 4 (TLR4), stromal cell-derived factor-1 (SDF-1) for postoperative dry eye disease (DED) in patients with type 2 diabetes mellitus (T2DM) complicated with cataract.. Methods From February 2024 to August 2025, 120 patients with T2DM complicated with cataract who underwent phacoemulsification cataract aspiration and intraocular lens implantation in our hospital were selected and separated into the DED group (39 cases) and the N-DED group (81 cases) according to whether there was concurrent DED after the operation. The levels of serum PTX3, TLR4 and SDF-1 were measured by ELISA. Multivariate Logistic regression analysis was performed to screen the factors influencing the occurrence of postoperative DED in patients with T2DM complicated with cataract. The ROC curve was used to evaluate the predictive value of serum PTX3, TLR4 and SDF-1 for postoperative DED in these patients.Relative risk analysis was conducted to evaluate the effects of different levels of PTX3, TLR4, and SDF-1 on postoperative DED in these patients. The DCA curve was used to evaluate the clinical applicability of the combined prediction model for postoperative DED in these patients. Results: Compared with the N-DED group, the DED group had higher levels of serum PTX3, TLR4 and SDF-1 (P < 0.05). There were clear differences in the course of T2DM, HbA1c and BUT between the N-DED group and the DED group (P < 0.05). Duration of T2DM, HbA1c level, and serum levels of PTX3, TLR4, and SDF-1 were identified as independent risk factors for postoperative DED in patients (P < 0.05). The AUC of combination of serum PTX3, TLR4 and SDF-1 levels in predicting DED was clearly higher than that of individual predictions (Z=2.394, 2.538, 2.529, P < 0.05). The risks of postoperative DED in these patients with high-level PTX3, TLR4, and SDF-1 were 4.316 times （95%CI：2.506~7.431）, 4.029 times （95%CI：2.282~7.114）, 5.403 times (95%CI: 2.591-11.264) that of those with low levels, respectively (P < 0.05). Within the high-risk threshold range of 0.04 to 0.85, the combined model of serum PTX3, TLR4, and SDF-1 in predicting the net benefit rate of postoperative DED in these patients was superior to the individual prediction. Conclusion: In patients with T2DM complicated with cataract who have postoperative DED, serum PTX3, TLR4, and SDF-1 are clearly increased, and they have certain predictive value for postoperative DED in patients.

• Differences on Intraocular Pressure Measurements and Relative Anterior Segment Biometric Parameters at Different Altitudes in Xizang Autonomous Region

  Chen Xiaorong, Han Tianyi, Liu Zexi, Song Yuanhang, Xiao Dawa, Fan Xiang

  Abstract:

  AIM: To compare the differences in intraocular pressure (IOP) and anterior segment biometric parameters among Tibetan populations permanent residing at different altitudes in Xizang Autonomous Region, and to explore the impact of high-altitude environments on ocular characteristics. METHODS: This was a retrospective cross-sectional study. Data were collected from Tibetan patients who visited the People''s Hospital of Xizang Autonomous Region from September 2019 to October 2021. Inclusion criteria were native Tibetans without glaucoma or other ocular or systemic diseases affecting IOP. Participants were divided into two groups based on their permanent residence altitude: a higher altitude group (2500–3750 m) and a very high-altitude group (>3750 m). The eye with better best-corrected visual acuity was selected for each participant, and recorded parameters included IOP, refractive error, and anterior segment biometric measurements [white-to-white corneal diameter (WTW), central corneal thickness (CCT), anterior chamber depth (ACD), lens thickness (LT), axial length (AL)]. Differences between the two groups were compared using students t-test, Mann-Whitney U test, and chi-square test. RESULTS: 43 eyes of 43 patients were included, comprising 23 males and 20 females, with a mean age of 57.88±13.90 years. There were 19 patients in the very high-altitude group and 24 in the higher altitude group. The mean IOP in the very high-altitude group was 11.79±1.72 mmHg, which was significantly lower than 13.44±2.43 mmHg in the higher altitude group (P=0.019). CCT in the very high-altitude group was 482.70±23.76 μm, significantly thinner than 503.00±31.09 μm in the higher altitude group (P=0.012). AL in the very high-altitude group was 22.96±0.96 mm, significantly shorter than 23.64±1.10 mm in the higher altitude group (P=0.020). No statistically significant differences were found between the two groups in WTW, ACD, LT, or refractive error (P > 0.05). CONCLUSION: Among the Tibetan population in Xizang Autonomous Region, as the altitude of residence increases, IOP significantly decreases, CCT becomes thinner and AL shortens. These morphological changes suggest possible adaptive remodelling of the eye in very high-altitude environments, and a thinner cornea may be an important factor contributing to the lower measured IOP values.

• several challenges of precise refractive cataract surgery during the perioperative period

  zhao zhenbo, ding yuxi, wang huanping, cheng yue, li luan, zhang shuo, ma liwei

  Abstract:

  Modern cataract surgery has evolved from traditional vision restoration to refractive cataract surgery (RCS), focusing on precise refractive correction for personalized vision. However, precise perioperative management faces bottlenecks. Preoperatively, biometry devices show poor consistency, and intraocular lens (IOL) selection lacks standardized systems. Intraoperatively, capsulorhexis quality is unstable, and surgical navigation systems are often ineffective. Postoperatively, IOL design limitations and posterior capsular opacification (PCO) challenge long-term visual quality. This paper reviews these challenges and summarizes solutions using technologies like error compensation models, AI-assisted decision-making, VR simulation, and intelligent surgical platforms, aiming to guide RCS clinical application and innovation.

• Expression and Research Progress of Mucins in Ocular Surface Diseases

  wangbinxin, yuyi, wangyue, xiangminhong

  Abstract:

  Mucins are a class of large, highly glycosylated proteins that play a critical role in maintaining ocular surface homeostasis, tear film stability and the ocular surface barrier. This article provides a systematic review of recent advances in clinical and basic research on mucins, summarizing their role in maintaining ocular surface health and their involvement in the onset and progression of ocular surface diseases. It also reviews current methods for detecting mucins and therapeutic strategies targeting mucins. Particular emphasis is placed on examining changes in the mucin expression profile in different subtypes of dry eye, ocular surface diseases and following ocular surface surgery, with the aim of providing guidance for the diagnosis, assessment and treatment of mucin-related ocular surface diseases.

• Research Advances on the Imbalance of Th17/Treg Cells in the Immunopathology of Thyroid-Associated Ophthalmopathy

  lanchenghong

  Abstract:

  TAO is an organ-specific autoimmune disorder closely associated with autoimmune thyroid diseases. It is characterized by typical pathological features such as activation of orbital fibroblasts, accumulation of glycosaminoglycans, and fibrosis of extraocular muscles, which severely affect patients'' visual function and quality of life. Dysregulation of the immune response is a core pathogenic mechanism in TAO, and the imbalance between Th17 and Tregs plays a critical role in disease progression. This article reviews recent advances in the role of Th17/Treg imbalance in TAO. It begins with an overview of the immunopathological mechanisms of TAO, highlighting the roles of the thyroid-stimulating hormone receptor, insulin-like growth factor 1 receptor, and various orbital autoantigens. It then elaborates on the biological characteristics and functional balance mechanisms of Th17 and Treg cells, including the regulatory roles of key transcription factors such as retinoic acid-related orphan receptor γt in Th17 cell differentiation and forkhead box protein 3 in Treg cell function. Furthermore, clinical evidence of Th17/Treg imbalance in TAO patients is summarized, along with detailed mechanisms through which Th17 cells drive intraorbital inflammation via secretion of pro-inflammatory cytokines such as interleukin-17A, and Treg cells fail to maintain immune suppression due to reduced numbers and functional impairments. Finally, therapeutic strategies targeting this imbalance are discussed, including cytokine antagonism, epigenetic regulation, and immune checkpoint intervention, while also addressing current research limitations and future directions. This review aims to provide insights into the immunopathological mechanisms of TAO and support the development of precise clinical treatments.

• Application and Clinical Value of Multimodal Artificial Intelligence Based on Fundus Photography and OCT in Ophthalmic Diseases

  chaiai, Yu Ping

  Abstract:

  In recent years, the scope of application of artificial intelligence (AI) in ophthalmology has continued to expand. AI-assisted analysis of colour fundus photography (CFP) and optical coherence tomography (OCT) can yield more quantitative data on retinal vasculature, thereby aiding in the assessment of systemic vascular health. Although single-modality AI systems (based solely on fundus analysis or OCT imaging) have achieved some success, they are unable to replicate the thought processes of clinicians who integrate multi-source information to make comprehensive judgements. Multi-modality AI, which fuses the structural information from colour fundus photography with the cross-sectional information from optical coherence tomography, can exploit the complementary features of different modalities to improve diagnostic accuracy and predictive capabilities. This systematic review summarises the progress in the application of multimodal AI based on fundus photography and OCT in blinding eye diseases, elucidates its technical foundations, and outlines its current applications and clinical value in blinding eye diseases such as diabetic retinopathy, age-related macular degeneration, glaucoma, and pathological myopia, and discusses the challenges currently facing multimodal AI and its future development directions, thereby providing a reference for ophthalmologists and promoting the advancement of ophthalmic diagnostic and therapeutic technologies.

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

  Rui-Bo Zhao, Jian-Jun Li

  Abstract: (17784) HTML (0) PDF (225.96 KKB) (2564)

  Abstract:

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

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• Effect of anti-vascular endothelial growth factor therapy on intraocular inflammatory cytokine levels in the treatment of proliferative diabetic retinopathy

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

  Abstract: (17129) HTML (0) PDF (537.47 KKB) (2207)

  Abstract:

  AIM: To explore the effects of anti-vascular endothelial growth factor(VEGF)agents(Conbercept)before pars plana vitrectomy(PPV)on inflammatory cytokine levels of patients with proliferative diabetic retinopathy(PDR).

  METHODS: A total of 49 patients(49 eyes)who diagnosed with PDR at the First Affiliated Hospital with Nanjing Medical University from June 2017 to January 2018 were recruited and randomly divided into two groups. A total of 25 cases(25 eyes)who did not receive intravitreal injection before PPV were included in no-intravitreal injection of Conbercept(IVC)group, and 24 cases(24 eyes)who received IVC 5～7d before PPV were included in IVC group. The vitreous samples were collected from all the patients at the start of PPV. Levels of VEGF-A, monocyte chemotactic protein-1(MCP-1)and inflammatory cytokines in the vitreous humor were measured using Luminex technology.

  RESULTS: Compared with the no-IVC group, the level of VEGF-A decreased significantly(P<0.001), the concentration of IL-6(P=0.004), IL-8(P=0.002), IL-18(P=0.04)and TNF-α(P=0.03)increased remarkably in the IVC group. The other inflammatory cytokines in the vitreous humor showed no significant difference between the IVC and no-IVC groups.

  CONCLUSION: IVC before PPV can effectively decrease the concentration of VEGF-A, but had limited influence on the level of inflammatory cytokines in the vitreous humor of patients with PDR.

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• Selection of intraocular lens calculation formula for cataract surgery in glaucoma patients

  He-Lin Zhu, Jian Zhang, Hong Yan

  Abstract: (15804) HTML (0) PDF (465.56 KKB) (2103)

  Abstract:

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

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• Current situation and prospect of minimally invasive glaucoma surgery in childhood glaucoma

  Xiao-Jie Zhou, Ren-Yi Wu

  Abstract: (13427) HTML (0) PDF (480.93 KKB) (2448)

  Abstract:

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

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• Clinical efficacy of femtosecond laser-assisted cataract surgery combined with PanOptix trifocal intraocular lens implantation

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

  Abstract: (13261) HTML (0) PDF (551.33 KKB) (2039)

  Abstract:

  AIM: To evaluate the clinical efficacy of femtosecond laser-assisted cataract surgery combined with PanOptix trifocal intraocular lens implantation.

  METHODS:The retrospective study enrolled 22 cases(26 eyes)of cataract patients who underwent femtosecond laser-assisted cataract surgery combined with PanOptix trifocal intraocular lens implantation from August 2020 to August 2021. Follow-up to 3mo after surgery, the changes of far, intermediate and near visual acuity, aberration, Strehl ratio(SR)and modulation transfer function cutoff(MTF-cutoff)frequency were compared. Defocus curve at 1mo postoperatively was made, and the visual quality and satisfaction were evaluated after 3mo of surgery.

  RESULTS: The visual acuity of all patients was better than 0.1(LogMAR)at the far, intermediate and near distance at 1d, 1wk, 1 and 3mo postoperatively, and it was significantly improved compared with those before surgery(all P<0.01). The defocus curve transitioned smoothly between +0.5 and -3.0D at 1mo after surgery, and visual acuity was better than 0.63. The total aberration and spherical aberration in the whole eye were significantly lower after surgery than before, and the SR and MTF-cutoff were significantly improved at 1d and 1wk after surgery(all P<0.05). With high satisfaction and good visual quality, patients could watch at far, intermediate and near distance without wearing glasses at 3mo after surgery.

  CONCLUSION: Femtosecond laser-assisted cataract surgery combined with PanOptix trifocal intraocular lens implantation gave patients a comfortable and satisfactory full-course vision.

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• Pars plana vitrectomy combined with inverted internal limiting membrane flap technique for treating macular hole retinal detachment in high myopia

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

  Abstract: (12485) HTML (0) PDF (435.98 KKB) (2189)

  Abstract:

  AIM: To investigate the clinical efficacy of pars plana vitrectomy(PPV)combined with inverted internal limiting membrane flap technique in the treatment of macular hole retinal detachment(MHRD)in high myopia.

  METHODS: A retrospective clinical study was conducted. A total of 63 patients(64 eyes)with high myopia and MHRD who treated at our hospital from October 2017 to October 2021 were selected as research subjects. They were divided into two groups according to different surgery, with 34 cases(35 eyes)who received PPV combined with inverted internal limiting membrane flap technique in group A, and 29 cases(29 eyes)received PPV combined with internal limiting membrane peeling in group B. The patients were followed up for 6mo. The two groups were compared in terms of the hole closure rate, the reduction rate of retinal detachment and best corrected visual acuity(BCVA)before operation and at 1wk, 1, 3 and 6mo after operation, and the postoperative complications were recorded.

  RESULTS: The hole closure rate within 6mo after operation was significantly higher in group A than in group B(P<0.05), but there was no statistically significant difference in the reduction rate of retinal detachment(P>0.05). The BCVA of the two groups was significantly improved over time after operation(P<0.05). There was no statistically significant difference in BCVA between the two groups before operation and at 1wk, 1, 3 and 6mo after operation(P>0.05). Complications were observed in the two groups, but there was no statistically significant difference in the incidence of complications between the two groups(P<0.05).

  CONCLUSION: PPV combined with inverted internal limiting membrane flap technique is safe and effective in the treatment of MHRD in high myopia, which can effectively improve the patients' BCVA and the hole closure rate without influence on intraocular pressure.

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• Risk factors associated with neovascular glaucoma after vitrectomy for proliferative diabetic retinopathy

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

  Abstract: (12332) HTML (0) PDF (1.96 MKB) (2569)

  Abstract:

  AIM: To investigate the risk factors associated with neovascular glaucoma(NVG)after pars plana vitrectomy(PPV)for proliferative diabetic retinopathy(PDR).

  METHODS: The PDR patients who received 23G PPV treatment at Shenyang He Eye Specialist Hospital from October 2015 to September 2020 and were followed up for at least 12mo with complete data were retrospectively collected. The patients were divided into two groups according to the occurrence of NVG during follow-up. The preoperative and intraoperative variables between two groups were compared. The cumulative hazard ratio for NVG was evaluated.

  RESULTS: A total of 151 PDR patients(169 eyes)with a mean follow-up of 18.07±12.55(1～79)mo were included, of which 30(17.8%)eyes developed NVG, the mean time of occurrence was 6.27±4.01(1～17)mo, and 50%(15 eyes)of NVG occurred within 5mo after vitrectomy. The cumulative hazard ratios of NVG at postoperative 3, 6 and 12mo were 4.8%, 12.6% and 18.1%, respectively. Multivariate logistic regression analysis showed that preoperative best corrected visual acuity(OR=3.077, 95%CI: 1.203～7.869, P=0.019), preoperative iris rubeosis(OR=7.897, 95%CI: 1.313～47.498, P=0.024), and contralateral NVG(OR=22.108, 95%CI: 1.562～312.861, P=0.022)were risk factors with the occurrence of NVG, while the number of intraoperative retinal laser photocoagulation(OR=0.772, 95%CI: 0.666～0.893, P=0.001)was the protective factor with the occurrence of NVG.

  CONCLUSIONS: The incidence of NVG in PDR eyes after PPV was 17.8%, of which 50% occurred within 5mo after surgery. PDR eyes with poor baseline visual acuity, iris rubeosis, and contralateral NVG are prone to postoperative NVG, and sufficient intraoperative retinal laser photocoagulation has a certain protective effect. PDR eyes after PPV should be closely followed up for 1a.

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• Surgery management and progress of familial exudative vitreoretinopathy associated retinal detachment

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

  Abstract: (12205) HTML (0) PDF (475.18 KKB) (2149)

  Abstract:

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

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• Expression of CTRP9 in serum of patients with diabetic retinopathy and diabetic macular edema

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

  Abstract: (12135) HTML (0) PDF (498.90 KKB) (2170)

  Abstract:

  AIM: To investigate the expression and correlation of C1q/tumor necrosis factor related protein 9(CTRP9)levels in the serum of patients with different stages of diabetic retinopathy(DR)and diabetic macular edema(DME).METHODS: A total of 135 patients with type 2 diabetes who were admitted to Gansu Provincial Hospital from April 2021 to April 2022 were selected as the experimental group. According to the results of non-mydriatic fundus photography, they were divided into non-DR(NDR)group(n=45), non-proliferative DR(NPDR)group(n=45), proliferative DR(PDR)group(n=45); according to the results of optical coherence tomography, DR patients were divided into DME group(n=51), non-DME group(n=39). In addition, other 45 healthy subjects who matched the age and sex of the experimental group were selected as normal control group. The clinical data and biochemical index test results of subjects in each group were recorded and compared, the correlation between serum CTRP9 level and other biochemical indexes was analyzed, and the risk factors affecting the occurrence of DR and DME were explored.RESULTS: There were significant differences in serum CTRP9 levels among subjects in normal control group, NDR group, NPDR group and PDR group(P&#x0026;#x003C;0.001), and normal control group &#x0026;#x003E; NDR group &#x0026;#x003E; NPDR group &#x0026;#x003E; PDR group. There was significant difference in serum CTRP9 level between DME group and non-DME group(P&#x0026;#x003C;0.001), and non-DME group &#x0026;#x003E; DME group. Spearman rank correlation analysis showed that the level of serum CTRP9 in DR patients was negatively correlated with the course of diabetes(rs=-0.251, P&#x0026;#x003C;0.05), the level of serum CTRP9 in DME patients was negatively correlated with fasting blood glucose(FBG)(rs=-0.370, P&#x0026;#x003C;0.05)and glycosylated hemoglobin(HbA1c)(rs=-0.421, P&#x0026;#x003C;0.05). Logistic multivariate regression analysis showed that the course of diabetes(OR=1.194, 95%CI: 1.068～1.335,P=0.002)and the level of serum CTRP9(OR=0.936, 95%CI: 0.907～0.966,P&#x0026;#x003C;0.001)were risk factors for DR. The level of serum CTRP9 was a risk factor affecting the occurrence of DME(OR=0.838, 95%CI: 0.778～0.903, P&#x0026;#x003C;0.001).CONCLUSION: The reduction of CTRP9 level is a risk factor for the occurrence of DR and DME, which may be of great significance to the risk assessment of both DR and DME.

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• Femtosecond laser-assisted cataract phacoemulsification combined with Toric intraocular lenses implantation in correction of high myopia cataract and corneal astigmatism

  Wei Fan, Guang-Bin Zhang

  Abstract: (10364) HTML (0) PDF (433.14 KKB) (2141)

  Abstract:

  AIM: To measure the indexes including postoperative distance, middle, near visual acuity and near stereopsis vision of patients with high myopia cataract and corneal astigmatism by femtosecond laser, which can quantify the diameter of capsulorhexis opening, and to evaluate the availability and necessity of Toric intraocular lenses(IOL)in high myopia.

  METHODS: Prospective case-control study. Patients with binocular high myopia cataract and corneal astigmatism who undergone femtosecond laser-assisted cataract surgery in our hospital were selected, and they were divided into two groups, with 20 cases(40 eyes)in group A(Toric IOL)and 20 cases(40 eyes)in group B(IQ IOL). Indexes, including preoperative corneal astigmatism and spherical equivalent and best-corrected distance visual acuity, uncorrected middle visual acuity, uncorrected near visual acuity, residual refractive astigmatism, near stereopsis acuity, total high-order aberration and total spherical aberration, were measured postoperatively at 7d, 1 and 3mo.

  RESULTS: The uncorrected middle and near visual acuity, Titmus near stereopsis acuity and residual astigmatism at 7d, 1 and 3mo after surgery were significantly improved in the Toric IOL group than the non-Toric group(all P<0.05). The dependence on glasses was reduced. The postoperative best-corrected distance visual acuity, total high-order aberration and total spherical aberration of the two groups showed no statistically significant differences(all P>0.05).

  CONCLUSIONS: The implantation of Toric IOL in patients with high myopia cataract and corneal astigmatism can effectively correct corneal astigmatism, improve postoperative uncorrected middle and near visual acuity and near stereopsis visual function, reduce postoperative dependence on glasses and enhance binocular stereopsis visual function.

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• Application value of new assistive technology in keratopathy-associated cataract surgery

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

  Abstract: (10300) HTML (0) PDF (493.57 KKB) (2343)

  Abstract:

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

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• Applicability comparison between Chinese dry eye questionnaire and ocular surface disease index questionnaire among college students

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

  Abstract: (9603) HTML (0) PDF (1.17 MKB) (2489)

  Abstract:

  AIM: To evaluate the applicability of Chinese dry eye questionnaire in college students using the ocular surface disease index(OSDI)questionnaire as a reference.

  METHODS: Cross-sectional study. A total of 711 college students from Nanyang Medical College were enrolled in the study and assessed for dry eye condition using OSDI questionnaire and Chinese dry eye questionnaire. The response rate of each question in the two questionnaires was counted. Cronbach α was calculated to evaluate the internal consistency of both questionnaires. Correlation between the total scores of the two questionnaires was analyzed to evaluate the criterion validity. Based on OSDI scores, the discriminant validity of Chinese dry eye questionnaire was evaluated; receiver operating characteristic(ROC)curves was plotted for Chinese dry eye questionnaire scores, area under the ROC curve(AUC)was calculated, and diagnostic thresholds and corresponding sensitivity and specificity were also analyzed.

  RESULT: The response rates of the 12 questions on the OSDI questionnaire were 33.2%-100.0%, while it was 100.0% for each question on the Chinese dry eye questionnaire. The Cronbach α values of OSDI questionnaire and Chinese dry eye questionnaire were 0.905 and 0.789, respectively. The Chinese dry eye questionnaire score was positively correlated with the OSDI score(r_s=0.712, P<0.001). According to OSDI questionnaire scores, dry eye severity was divided into normal group, mild dry eye group, moderate dry eye group and severe dry eye group. The scores of Chinese dry eye questionnaire in these groups were 4.00(2.00, 6.00), 9.00(7.00, 11.00), 12.00(9.00, 14.00)and 16.00(13.50, 22.00), respectively, which increased with the severity of dry eye, and the overall difference was statistically significant(P<0.001), as well as pairwise comparison between groups(P<0.05). The AUCs of Chinese dry eye questionnaire in distinguishing normal population from dry eye population, mild dry eye from moderate dry eye, moderate dry eye from severe dry eye were 0.862, 0.661 and 0.769, respectively, and the diagnostic thresholds were 6.5, 11.5 and 14.5, respectively.

  CONCLUSION:Chinese dry eye questionnaire has an equivalent reliability, validity, discriminant ability and better response rate for dry eye screening and epidemiological survey among college students in China compared with OSDI questionnaire.

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• Recent advances in treatment of retinitis pigmentosa

  Ming Ai, Ming Sun, Dai Li

  Abstract: (9493) HTML (0) PDF (412.02 KKB) (2635)

  Abstract:

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

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• Research progress on optical coherence tomography imaging indicators of macular edema secondary to retinal vein occlusion

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

  Abstract: (9480) HTML (0) PDF (470.25 KKB) (2236)

  Abstract:

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

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• Evaluation of macular microvasculature alterations in patients with proliferative diabetic retinopathy after vitrectomy by swept-source optical coherence tomography angiography

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

  Abstract: (9253) HTML (0) PDF (936.23 KKB) (2454)

  Abstract:

  AIM: To investigate the changes in retinal and choroidal blood flow after pars plana vitrectomy(PPV)for proliferative diabetic retinopathy(PDR).

  METHODS: A cross-sectional study was conducted on 35 patients(35 eyes)who were diagnosed as monocular PDR and received 23GPPV in ophthalmology department of the Second People's Hospital of Hefei between September 2020 and July 2022. All eyes underwent swept-source optical coherence tomography angiography(SS-OCTA)examination. Retinal and choroidal vascular parameters within 3mm×3mm of macular zone were measured by built-in analyzer, and its correlation with postoperative best corrected visual acuity(BCVA)was analyzed.

  RESULTS: The follow-up was 1～22(average 9.72±6.67)mo. At the last follow-up, flow area(FA)of intermediate capillary plexus(ICP)layer in paranasal foveal region was significantly reduced in PPV eyes(0.31±0.06mm²)compared with contralateral eyes(0.38±0.05mm²), and FA of deep capillary plexus(DCP)in temporal foveal region was significantly lower in PPV eyes(0.19±0.08mm²)than contralateral eyes(0.27±0.07mm²; all P<0.05). Choroidal vascularity index(CVI)were lower in PPV eyes than contralateral eyes in parafoveal subregions except temporal region(P<0.05). After PPV, BCVA had a certain correlation with the density and FA of middle and deep retinal vessels.

  CONCLUSIONS: Eyes with severe PDR may be prone to having a decrease in the DCP and parafoveal choroidal perfusion in the parafoveal regions after PPV than contralateral eyes.

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• Diquafosol sodium combined with intense pulsed light in the treatment of meibomian gland dysfunction dry eye after corneal refractive surgery

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

  Abstract: (9164) HTML (0) PDF (1.47 MKB) (2631)

  Abstract:

  AIM: To observe the therapeutic effect of the diquafosol sodium combined with intense pulsed light(IPL)on meibomian gland dysfunction(MGD)dry eye after refractive surgery.

  METHODS:A total of 64 patients(128 eyes)with MGD dry eye diagnosed within 6mo after laser corneal refractive surgery in our hospital from March 2021 to December 2021 were selected. They were randomly divided into control group and experimental group. A total of 33 patients(66 eyes)in the control group were treated with sodium hyaluronate combined with IPL, and 31 patients(62 eyes)in the experimental group were treated with diquafosol sodium combined with IPL. Ocular symptom scores were performed before each IPL treatment in both groups to examine non-invasive tear breakup time(NIBUT), tear meniscus height, lipid layer grade of tear film, meibomian gland deletion rate and uncorrected visual acuity.

  RESULTS:After IPL treatment, ocular symptom scores and meibomian gland deletion rate score of two groups were decreased continuously. NIBUT, tear meniscus height and lipid layer grade of tear film were increased continuously, and there was no significant change in uncorrected visual acuity. NIBUT of patients in the experimental group was better than that in the control group before the third IPL treatment(6.24±0.27s vs. 5.51±0.24s, P=0.046).

  CONCLUSIONS:Both diquafosol sodium and sodium hyaluronate combined with IPL showed good therapeutic effect on MGD dry eye, but there was no significant difference in the short-term efficacy between the two groups.

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• Research advances in contact lens associated bacterial keratitis

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

  Abstract: (9060) HTML (0) PDF (512.03 KKB) (2382)

  Abstract:

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

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• Suture guided gonioscopy-assisted transluminal trabeculotomy combined with phacoemulsification in the treatment of primary open angle glaucoma

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

  Abstract: (9033) HTML (0) PDF (467.79 KKB) (2305)

  Abstract:

  AIM: To investigate the clinical efficacy of suture-guided gonioscopy-assisted transluminal trabeculotomy(GATT)combined with phacoemulsification in the treatment of primary open angle glaucoma(POAG).

  METHODS: A total of 84 patients(84 eyes)with POAG and cataract who underwent surgery in our hospital from January 2021 to July 2022 were selected and randomly divided into two groups. There were 43 cases(43 eyes)in the combined group who underwent suture-guided GATT combined with phacoemulsification, and 41 cases(41 eyes)in the simple group who underwent suture-guided GATT. The two groups were followed up for 3mo to compare the surgical success rate, intraocular pressure, topical intraocular pressure-lowering drugs, visual acuity and postoperative complications.

  RESULTS: There was no significant difference in overall success rate between the combination and simple groups at 3 mo after surgery(88% vs. 85%, P>0.05). The intraocular pressure levels and topical intraocular pressure-lowering drugs at 1wk, 1 and 3mo after surgery in the two groups were significantly lower than those before surgery(all P<0.05), but there was no significant difference between the two groups(all P>0.05). The visual acuity at 1wk, 1 and 3mo after surgery of patients in the combined group was significantly better than that in the simple group(P<0.01). During the follow-up period, the incidence of anterior chamber hemorrhage and transient hypertension in the combined group was significantly lower than that in the simple group(P<0.05).

  CONCLUSION: Both suture-guided GATT combined with cataract phacoemulsification and suture-guided GATT are effective treatment for POAG, however, suture-guided GATT combined with phacoemulsification has a lower incidence of anterior chamber hemorrhage and transient ocular hypertension.

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• Relationship among fasting plasma glacose coefficient of variation and macular morphology and microcirculation in patients with nonproliferative diabetic retinopathy

  Shu-Ying Fu, Yan-Min Dong

  Abstract: (8949) HTML (0) PDF (1.78 MKB) (2230)

  Abstract:

  AIM: To investigate the relationship among the fasting plasma glucose coefficient of variation(FPG-CV)and macular morphology and microcirculation in patients with nonproliferative diabetic retinopathy(NPDR).

  METHODS: A retrospective analysis of 82 cases(82 eyes)with NPDR admitted to our hospital from February 2018 to June 2022 was the research object, and another 82 cases(82 eyes)of non-diabetic retinopathy(NDR)patients during the same period were selected as the control group, and the clinical data of the two groups of patients were analyzed. Multivariate Logistic regression was used to analyze the risk factors affecting the incidence of NPDR, and the back propagation(BP)neural network model was established and evaluated. Pearson correlation was used to analyze the correlation among FPG-CV and macular morphology and microcirculation in patients.

  RESULTS: The results of multivariate Logistic regression analysis showed that the disease duration ≥7.2a, glycated hemoglobin A1c(HbA1c)≥7.7%, triglyceride(TG)≥1.9 mmol/L, microalbuminuria(MALB)≥24.5 mg/L, FPG-CV ≥9.8%, superficial capillary plexus-vessel density(SCP-VD)<27.6%, deep capillary plexus-vessel density(DCP-VD)<47.7%, foveal avascular zone(FAZ)area ≥0.38 mm², central retinal thickness(CRT)≥197.7 μm and subfoveal choroidal thickness(SFCT)<227.7 μm were risk factors for NPDR(P<0.05). The number of hidden layer nodes is 5, and the receiver operating characteristic(ROC)curve, calibration curve and clinical decision curve show that the prediction model has good discrimination, accuracy and validity. The results of Pearson correlation analysis showed that FPG-CV was negatively correlated with SCP-VD, DCP-VD and SFCT(P<0.05); FPG-CV was positively correlated with FAZ area and CRT(P<0.05).

  CONCLUSION: The course of disease, HbA1c, TG, MALB, FPG-CV, SCP-VD, DCP-VD, FAZ area, CRT and SFCT are all related to the pathogenesis of NPDR. With the increase of FPG-CV, the indexes of macular morphology and microcirculation changed. FPG-CV was negatively correlated with SCP-VD, DCP-VD and SFCT and positively correlated with FAZ area and CRT.

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• Research progress on corneal nerves and substance P in viral keratitis

  Yi Mu, Hong Zhang

  Abstract: (8882) HTML (0) PDF (490.87 KKB) (2191)

  Abstract:

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

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