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International Eye Science—IES (Guoji Yanke Zazhi, ISSN:1672-5123) is a Chinese-English-mixed Ophthalmological publication indexed in Scopus, EMBASE, CA, IC, WPRIM of WHO, Chinese Core Journals, and China Core Periodical of Science and Technology. Its CST JCR IF in 2019 is 1.628, monthly.

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Advances in Research on the Regulatory Role of Amphiregulin in Ocular Diseases 解析：

Tao Yunhe, Li Yujuan, Yin Xuewei, Guo Bin

Abstract:

Amphiregulin (AREG) is a member of the epidermal growth factor family. As a key ligand of the epidermal growth factor receptor (EGFR), it can activate signaling pathways such as PI3K/Akt, ERK1/2, and STAT3, participating in biological processes such as cell proliferation, apoptosis inhibition, and inflammatory immune regulation. AREG is closely related to ocular diseases and plays an important role in corneal repair, improvement of retinal damage, and regulation of ocular axial length. This article summarizes the structure, distribution, and biological functions of AREG, focusing on its regulatory mechanisms in ophthalmic diseases: participating in dry eye disease associated with Sj?gren"s syndrome by driving epithelial thickening and chronic inflammation; promoting corneal repair through an immune-epithelial coordination mechanism; abnormally activating the EGFR/PI3K pathway leading to lens opacity; regulating ocular axial length elongation through the retinal-scleral signal axis; modulating microglial polarization affecting the progression of diabetic retinopathy; and enhancing ocular tumor drug resistance through epigenetic modification. This article systematically reviews the molecular regulatory mechanisms of AREG in ophthalmic diseases, aiming to explore its potential for clinical application in ophthalmic diseases.
Differential expression of oxidative stress-related genes in the medial rectus muscle of concomitant exotropia

li fang, Deng Siyuan, Luo Furong, Zeng Mingbing, He Hong

Abstract:

Abstract Objective To identify key oxidative stress-related genes and pathways in the medial rectus (MR) muscle of patients with concomitant exotropia (XT). Methods RNA sequencing was performed on MR muscle specimens obtained from 20 XT patients and 10 healthy controls. Comprehensive bioinformatics analyses were conducted, including the identification of oxidative stress-related differentially expressed genes (OSRDEGs), functional enrichment analysis (Gene Ontology and Kyoto Encyclopedia of Genes and Genomes), protein-protein interaction (PPI) network construction, and receiver operating characteristic (ROC) curve analysis. Key hub genes were validated using reverse transcription-quantitative polymerase chain reaction (RT-qPCR). Results A total of 319 OSRDEGs were identified. Functional enrichment analysis revealed significant associations with the reactive oxygen species metabolic process, response to oxidative stress, and the p53 signaling pathway. PPI network analysis identified five hub genes (IL6, TNF, CD4, PTPRC and ITGAM).?ROC curve analysis demonstrated high diagnostic accuracy of CD4, PTPRC, and ITGAM (AUC > 0.9) in distinguishing XT patients from healthy controls, while IL6 and TNF showed moderate diagnostic accuracy (0.7 < AUC < 0.9). RT-qPCR validation confirmed the significant differential expression of?TNF,?CD4, and?IL6. Conclusion This study highlights the role of oxidative stress in the pathogenesis of concomitant exotropia. The identified hub genes provide new directions for investigating the molecular mechanisms underlying concomitant exotropia.
Influencing factors and prediction model construction of poor response to anti VEGF therapy in patients with diabetic retinopathy

zhangxi

Abstract:

Objective: To explore the influencing factors of poor response to anti vascular endothelial growth factor (VEGF) treatment in patients with diabetic retinopathy (DR), and to build a prediction model based on the influencing factors, so as to provide reference for clinical individualized treatment.Method: A retrospective analysis was conducted on the clinical data of 1250 DR patients (1250 eyes) who received anti VEGF treatment in the hospital from July 2022 to August 2025. The patients were randomly divided into a training set (n=875) and a validation set (n=375) in a 7:3 ratio. Patients in the training set were divided into a poor response group (n=266) and a good response group (n=609) based on their treatment response 1 month after 3 sessions of anti VEGF therapy. The basic information of patients was collected. The influencing factors of poor response to anti-VEGF treatment in DR Patients were analyzed through univariate and multivariate Logistic regression. A nomogram prediction model was constructed based on the influencing factors. The correction curve and the receiver operating characteristic (ROC) curve were drawn to verify and evaluate the model. The decision curve was adopted to evaluate the actual clinical benefits of the nomogram model.Result: There was no statistical significant difference in the general information of patients between the training set and the validation set (P>0.05). Multivariate Logistic regression analysis showed that the classification of diabetic macular edema (DME) - serous retinal detachment, macular fovea retinal thickness (CMT) before treatment, best corrected visual acuity (BCVA) before treatment, destruction of ellipsoidal zone (EZ), glycosylated hemoglobin (HbA1c) before treatment, and neutrophil count before treatment were all risk factors for poor response to anti VEGF treatment in DR patients (OR>1, P<0.05). A nomogram risk model was drawn based on risk factors. The C-index of the training set for predicting poor response to anti-VEGF treatment was 0.880 (95%CI: 0.855-0.904), and that of the validation set was 0.867 (95%CI: 0.828-0.906). The ROC curves were drawn. The area under the curve (AUC) of the prediction model in the training set and validation set was 0.884 (95%CI: 0.859-0.908) and 0.880 (95%CI: 0.841-0.919), respectively, suggesting that the model had good discrimination. The decision curve showed that the net benefit rate of the training set and validation set thresholds within the range of 0.06 to 0.99 was greater than 0.Conclusion: DME classification serous retinal detachment, pre-treatment CMT, pre-treatment BCVA, EZ disruption, pre-treatment HbA1c, and pre-treatment neutrophil count levels are all risk factors for poor anti VEGF treatment response in DR patients. The column chart risk prediction model constructed based on this has high predictive power and can provide reference for the early development of targeted intervention strategies in clinical p
Study on the treatment of severe dry eye syndrome with corneal injury using alkaline fibroblast growth factor eye drops combined with fluorometholone eye drops

yinjuntao

Abstract:

Objective: To analyze the clinical efficacy of basic fibroblast growth factor (bFGF) eye drops combined with fluorometholone eye drops in the treatment of severe dry eye syndrome with corneal injury. Method: A retrospective analysis was conducted on 104 patients (104 eyes) with severe dry eye syndrome and corneal injury after cataract phacoemulsification surgery admitted to the hospital from January 2022 to December 2024. According to different treatment plans for dry eye syndrome, they were divided into two groups: a control group of 50 eyes were treated with conventional artificial tears and fluorometholone eye drops; 54 eyes in the observation group were treated with conventional artificial tears+bFGF eye drops combined with fluorometholone eye drops for a course of 8 weeks. The ocular surface disease index (OSDI), tear film rupture time (BUT), corneal fluorescein sodium staining (FL) score, and tear inflammatory factors [interleukin-1 β (IL-1 β) and interleukin-18 (IL-18)] were compared between the two groups before and 4 and 8 weeks after treatment. Statistics on the occurrence of adverse reactions in the eyes of two groups during the treatment period. Result: After 4 and 8 weeks of treatment, the OSDI, FL, and IL-1 β and IL-18 in tears of both groups were lower than before treatment, and the BUT was higher than before treatment (all P<0.001). The OSDI, FL, and IL-1 β and IL-18 in tears of the observation group were lower than those of the control group, and the BUT was higher than that of the control group (all P<0.001). During the follow-up period of treatment, there was no statistical significant difference in the incidence of eye adverse reactions between the two groups of patients (P>0.05).Conclusion: The combination of bFGF eye drops and fluorometholone eye drops can effectively improve dry eye symptoms in patients with severe dry eye syndrome and corneal injury, improve tear film stability and corneal injury repair, and inhibit ocular surface inflammation, with acceptable safety.
Clinical observation on two different surgical methods in the treatment of lens subluxation combined with cataract

zhu qiaoping, li wujun, li hong

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Aim：Observation on two different surgical methods in treating lens subluxation of varying degrees with cataracts. Methods: Prospective observational study. A total of 40 patients with lens subluxation complicated by cataracts who were treated in Yulin Hospital of Traditional Chinese Medicine from May 1, 2021 to April 30, 2024 were included in the study. The surgical method was determined according to the range of zonular abnormalities or injuries. If the zonular abnormality or injury range is ≤6 clock hours and the capsular bag is intact and stable with no aggravation of the zonular injury after completion of phacoemulsification, the triple procedure of phacoemulsification and lens aspiration combined with capsular tension ring (CTR) implantation plus intraocular lens (IOL) implantation is adopted (CTR group); if the zonular abnormality or injury range is ＞6–9 clock hours, or if the stability of the lens capsular bag is poor and the zonular injury range is aggravated during the operation, phacoemulsification and lens aspiration combined with scleral-sutured intracapsular IOL fixation is performed (Suture group). The uncorrected visual acuity, best-corrected visual acuity, spherical equivalent, intraocular pressure, corneal endothelial cell count, anterior chamber depth and complications of all patients were recorded at 1 month, 3 months, 6 months and 12 months after surgery, respectively. Results: A total of 40 cases (40 eyes) were included in study, including 21 cases (21 eyes) in CTR group (aged 60.62±1.65 years, 15 males and 6 females) and 19 cases (19 eyes) in Suture group (aged 64.26±1.69 years, 15 males and 4 females).Based on preoperative and intraoperative evaluations, there were 21 cases in the CTR group and 19 cases in the Suture group. The median range of zonular injury in the CTR group was 4.0 (2.5) clock hours, while that in the Suture group was 7.0 (1.5) clock hours (P＜0.001). There were no significant differences in other basic data between the two groups. The visual acuity of patients in both groups significantly improved one month after surgery. The CTR group showed an improvement of 0.72±0.45 logMAR compared with preoperative values (t=5.44, P＜0.001), and the Suture group showed an improvement of 1.11±1.01 logMAR compared with preoperative values (t=4.09, P=0.001). There was no significant difference in visual acuity between the two groups 12 months after surgery (t=0.24, P=0.81). There was no significant difference in the spherical equivalent between the two groups 12 months after surgery (P＞0.05). The corneal endothelial cell count in the Suture group was significantly lower than that in CTR group after surgery (t=3.75, P=0.001). In the CTR group, the postoperative IOL horizontal tilt was 3.06°±1.47°, and the IOL horizontal decentration was 0.25±0.10 mm, both of which were significantly smaller than those in the Suture group (P＜0.001). There was no significant difference in the total incidence of complications between the two groups (23.8% vs 36.8%,χ2=0.807, P=0.369). Conclusion:For cases with zonular abnormalities or injury involving ≤6 clock hours, where the capsular bag remains intact and stable after phacoemulsification, the triple procedure of phacoemulsification combined with CTR implantation and IOL implantation is adopted. In cases with zonular abnormalities or injury involving ＞6–9 clock hours, or when intraoperative capsular bag stability is poor and zonular injury worsens, phacoemulsification combined with transscleral sutured intrascleral IOL fixation is performed. Both approaches can achieve favorable postoperative outcomes. Comprehensive preoperative and intraoperative evaluations help determine the appropriate surgical method.
Dynamic changes in tear inflammatory mediators after SPT-TPRK and FS-LASIK and their correlation with ocular surface function

Yan Zeyu, Li Yan, Yang Hua, Niu Shiyang, Zhang Ouyang, Wang Baojun

Abstract:

Objective: To compare the differences in postoperative tear inflammatory mediator levels and ocular surface health recovery between transepithelial photorefractive keratectomy with smart pulse technology (SPT-TPRK) and femtosecond laser-assisted laser in situ keratomileusis (FS-LASIK). Methods: Patients undergoing corneal refractive surgery at the Department of Ophthalmology, The First Affiliated Hospital of Henan Medical University, from July 2024 to February 2025 were enrolled and divided into an SPT-TPRK group (30 patients, 60 eyes) and an FS-LASIK group (30 patients, 60 eyes) based on the surgical procedure. Tear samples were collected preoperatively and at 1 week, 1 month, 3 months, and 6 months postoperatively. Levels of tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β), interleukin-6 (IL-6), matrix metalloproteinase-9 (MMP-9), intercellular cell adhesion molecule-1 (ICAM-1), and nerve growth factor (NGF) were measured using enzyme-linked immunosorbent assay. Tear film break-up time (BUT) and ocular surface disease index (OSDI) questionnaire were also assessed. Results: At 1 week postoperatively, tear levels of TNF-α, IL-1β, IL-6, MMP-9, and ICAM-1 in the SPT-TPRK group were significantly higher than those in the FS-LASIK group (all P < 0.05). However, these levels decreased rapidly from 1 month postoperatively and were lower in the SPT-TPRK group than in the FS-LASIK group at 3 and 6 months postoperatively. NGF concentrations in the FS-LASIK group were significantly higher than those in the SPT-TPRK group at all postoperative time points (all P < 0.05) and declined more slowly. At 1 week postoperatively, BUT was significantly lower and OSDI scores significantly higher in the SPT-TPRK group compared to the FS-LASIK group (both P < 0.05). From 1 month postoperatively onwards, no statistically significant differences were observed in BUT or OSDI scores between the two groups (all P > 0.05). Correlation analysis revealed that all inflammatory mediator levels were significantly negatively correlated with BUT and significantly positively correlated with OSDI scores (all P < 0.05). Conclusion: Both SPT-TPRK and FS-LASIK induce elevated inflammatory mediator levels and decreased ocular surface function postoperatively. SPT-TPRK is associated with a more intense but rapidly resolving early inflammatory response, whereas FS-LASIK results in a more pronounced and persistently elevated NGF response. Postoperative tear film stability and subjective discomfort in patients undergoing SPT-TPRK and FS-LASIK are closely correlated with inflammatory mediator levels.
Research Progress on the Pathogenesis of macular edema secondary to Cataract Surgery in Diabetic Patients

tianyinde, jiechuanhong, bixuqi, yuebingjie, houxiaoyu

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Secondary macular edema following cataract surgery in diabetic patients is a critical complication that impairs postoperative visual acuity.It is not only closely associated with the pathological basis including microvascular lesions and inflammatory responses intrinsic to diabetic patients,but also influenced by factors such as ocular tissue trauma and postoperative inflammatory stress induced by cataract surgery.This review summarizes the relevant pathogenesis and analyzes that the superimposed mechanism of these two factors is mainly manifested by the amplification of inflammatory reactions,the imbalance of vasoactive factors,and impaired blood circulation,aiming to provide a theoretical basis for the prevention and management of this complication in such patients in clinical settings.
The role of structural alterations and functional imbalance of the retinal neurovascular unit in the pathogenesis of glaucoma.

Liu Yuhan, Li Qiang, Wang Hongyi, Song Qiongtao

Abstract:

The neurovascular unit (NVU) is a sophisticated functional network comprising neurons, glial cells, and microvessels. NVU’s homeostatic imbalance plays a pivotal role in the pathogenesis of glaucoma. The disease mechanism can be attributed to disruptions within the interactive network among retinal ganglion cells, glial cells, and microvessels. Current research has increasingly focused on multi-target synergistic interventions aimed at restoring global NVU homeostasis. This provides novel avenues for neuroprotective strategies in glaucoma. This review summarizes the structural and functional alterations in these cellular components and discusses the interplay of multiple pathogenic mechanisms, including oxidative stress and inflammation, excitotoxicity, neurovascular uncoupling, dysregulation of intercellular communication, and impaired clearance of metabolic waste.
Deep Learning in the Early Screening of Diabetic Retinopathy

Zhimiao Yin, Rong Li

Abstract:

Diabetic retinopathy (DR) is the most common microvascular complication of diabetes and a leading cause of vision loss among the working-age population. Conventional screening methods, which depend on manual interpretation of fundus images by ophthalmologists, face limitations including uneven distribution of medical resources and subjectivity in diagnosis. In recent years, deep learning (DL) technology, with its strengths in image recognition and feature learning, has emerged as a novel and efficient automated approach for early DR screening. This article provides a systematic review of DL applications in DR screening, covering technical principles, mainstream algorithms, dataset construction, model training strategies, and the potential for integrating multi-modal data. It further examines key challenges in current applications, such as data quality, model interpretability, system integration, and obstacles to clinical translation. Finally, future directions are discussed, including the development of lightweight models, multi-disease joint prediction, and the establishment of interdisciplinary collaborative frameworks, with the aim of supporting the clinical adoption of DL-based DR screening.

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

Rui-Bo Zhao, Jian-Jun Li

Abstract: (17511) HTML (0) PDF (225.96 KKB) (2291)

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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: (16952) HTML (0) PDF (537.47 KKB) (1916)

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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: (15637) HTML (0) PDF (465.56 KKB) (1780)

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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: (13207) HTML (0) PDF (480.93 KKB) (2121)

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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: (13096) HTML (0) PDF (551.33 KKB) (1762)

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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

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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

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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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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

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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&#x003C;0.001), and normal control group &#x003E; NDR group &#x003E; NPDR group &#x003E; PDR group. There was significant difference in serum CTRP9 level between DME group and non-DME group(P&#x003C;0.001), and non-DME group &#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&#x003C;0.05), the level of serum CTRP9 in DME patients was negatively correlated with fasting blood glucose(FBG)(rs=-0.370, P&#x003C;0.05)and glycosylated hemoglobin(HbA1c)(rs=-0.421, P&#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&#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&#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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Surgery management and progress of familial exudative vitreoretinopathy associated retinal detachment

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

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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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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

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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: (10043) HTML (0) PDF (493.57 KKB) (2053)

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: (9332) HTML (0) PDF (1.17 MKB) (2147)

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: (9200) HTML (0) PDF (412.02 KKB) (2329)

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: (9178) HTML (0) PDF (470.25 KKB) (1954)

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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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: (8962) HTML (0) PDF (1.47 MKB) (2300)

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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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: (8937) HTML (0) PDF (936.23 KKB) (2171)

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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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: (8886) HTML (0) PDF (467.79 KKB) (2031)

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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Research advances in contact lens associated bacterial keratitis

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

Abstract: (8845) HTML (0) PDF (512.03 KKB) (1987)

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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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: (8823) HTML (0) PDF (1.78 MKB) (1921)

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: (8717) HTML (0) PDF (490.87 KKB) (1884)

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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Volume 26,2026 Issue 5

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