Volume 26,2026 Issue 7

Articles in English

• Efficacy comparison of modified Yamane vs Z-suture techniques in aphakic eyes lacking adequate capsular support

  Kadriye Demir, İsa Yuvacı, Erkan Çelik

  2026,26(7):1105-1109 ,DOI: 10.3980/j.issn.1672-5123.2026.7.01

  Abstract: (17) HTML (0) PDF (365.75 KKB)(49)

  Abstract:

  AIM:To compare the visual outcomes, refractive predictability, and complication rates associated with scleral-fixated intraocular lens(IOL)implantation using the modified Yamane and Z-suture techniques in aphakic patients lacking adequate capsular support.

  METHODS:This retrospective study included aphakic patients who underwent scleral-fixated IOL implantation between 2017 and 2024. Patients were divided into two groups: Group 1 received the modified Yamane technique, while Group 2 underwent fixation using the Z-suture technique. Best-corrected visual acuity(BCVA, LogMAR), spherical equivalent(SE), cylindrical error(CE), corneal astigmatism(CA), mean absolute error(MAE), and postoperative complications were assessed.

  RESULTS:Totally 101 aphakic patients(mean age 72.6±10.7 y)were included. Group 1 included 22 males and 19 females, with a mean age of 72.1±11.0 y. Group 2 included 35 males and 25 females, with a mean age of 73.0±10.5 y. At 1 mo postoperatively, the BCVA in Group 1 was significantly better than that in Group 2, 0.49±0.21 vs 0.66±0.17 LogMAR, P=0.02. By month 6, BCVA was comparable between groups(0.38±0.19 vs 0.41±0.20 LogMAR, P>0.05). No statistically significant differences were observed in SE, CE, or CA at any time point(all P>0.05). MAE was slightly lower in Group 1 at both 1(0.72±0.80 vs 0.80±0.64 D)and 6 mo(0.63±0.41 vs 0.72±0.33 D), although these differences were not statistically significant(P>0.05). Overall complication rates were similar; however, haptic dislocation was significantly more common in the Yamane group(P=0.025).

  CONCLUSION:Both the modified Yamane and Z-suture techniques are safe and effective options for secondary IOL implantation in aphakic eyes lacking adequate capsular support. The Yamane technique demonstrates faster visual recovery and slightly improved refractive predictability in the short term, while long-term outcomes are comparable between the two methods.

• Changes of optic nerve head morphology in high myopia

  Tang Wenquan, Nie Fen, Luo Yulin

  2026,26(7):1110-1115 ,DOI: 10.3980/j.issn.1672-5123.2026.7.02

  Abstract: (15) HTML (0) PDF (822.17 KKB)(43)

  Abstract:

  AIM:To analyze the correlation of age, axial length(AL)and spherical equivalent(SE)with the morphology of optic nerve head(ONH)in high myopia(HM)patients.

  METHODS:In this retrospective study, the medical records of HM patients were reviewed, and were classified based on age, AL, and SE. Participants were stratified into three age subgroups: Age1(<20 y), Age2(20-29 y), and Age3(≥30 y). For SE, participants were classified into three subgroups: SE1(-9 D≤SE<-6 D), SE2(-12 D≤SE<-9 D), and SE3(SE<-12 D). AL was further divided into four groups: AL1(<26 mm), AL2(26≤AL<27 mm), AL3(27≤AL<28 mm), and AL4(AL≥28 mm). The effects of different ages, AL, and SE on optic disc morphological parameters and their correlations were investigated.

  RESULTS:Totally 188 right eyes from 188 HM patients(65 males and 123 females)with mean age of 25.00±6.44 y were analyzed. No significant difference was observed in morphological data of ONH among the age groups(all P>0.05). The ONH tilt index and ONH rotation angle had no correlation with the age, AL, and SE. However, the optic disc-fovea distance(DFD), angle α, largest diameter(LD), short diameter(SD), and ONH area were significantly correlated with AL and SE(DFD: r=0.195, 0.221; angle α: r=-0.242, -0.266; LD: r=0.319, 0.295; SD: r=0.274, 0.225; ONH area: 0.310, 0.265; all P<0.01)but not with age(P>0.05). In HM, as the AL grew larger than 28 mm, the angle α was smaller and the DFD was larger significantly.

  CONCLUSION:The DFD and angle α can be used as evaluation indicators for the changes of ONH morphology in HM patients. The main cause of morphology change may be related to AL and SE increase rather than age.

Experimental Article

• Proanthocyanidins activate Nrf2/GPX4 pathway to inhibit ferroptosis and exert protective effects on dry ARMD

  Feng Chuan, Tang Zhong

  2026,26(7):1116-1126 ,DOI: 10.3980/j.issn.1672-5123.2026.7.03

  Abstract: (21) HTML (0) PDF (7.17 MKB)(41)

  Abstract:

  AIM: To investigate whether proanthocyanidins(PAC)can ameliorate ferroptosis in retinal pigment epithelium(RPE)cells via the Nrf2/GPX4 pathway, and to evaluate its protective effect in dry age-related macular degeneration(ARMD).

  METHODS: The protective effects of PAC against ferroptosis were evaluated using an in vitro model of H₂O₂-stimulated human RPE cells(ARPE-19)and an in vivo dry ARMD animal model induced by sodium iodate(NaIO₃). CCK-8 assay was applied to assess cell viability. Calcein-AM/PI staining was applied to determine the level of cell death. Lipid peroxidation(LPO)levels were measured using a lipid peroxidation assay kit. CM-H2DCFDA was used to detect the level of reactive oxygen species(ROS)in cells. MitoSOX probe was employed to measure the mitochondrial ROS level. JC-1 staining was used to evaluate the changes in mitochondrial membrane potential. Western Blot was performed to detect the expression levels of proteins(Nrf2, GPX4, and HO-1)related to the Nrf2 pathway. Retinal flat mounts were used to evaluate the structure and function of RPE. Hematoxylin and eosin(H & E)staining was applied to assess the morphological changes in rat retinas. Rhodopsin and opsin staining was used to evaluate visual function in the retina. TUNEL staining was employed to detect apoptosis in retinal cells.

  RESULTS: H₂O₂ exacerbates ferroptosis in ARPE-19 cells, as evidenced by elevated levels of Fe²⁺, ROS, and LPO. PAC preconditioning ameliorates mitochondrial function, reduces intracellular Fe²⁺, ROS, and LPO levels, and suppresses ferroptosis in RPE cells via activation of the Nrf2/GPX4 signaling pathway. In a NaIO₃-induced dry ARMD model, both PAC and the ferroptosis inhibitor Fer-1 reverse the downregulation of retinal Nrf2/GPX4 expression and attenuate retinal cell death.

  CONCLUSION:PAC inhibits ferroptosis via the Nrf2/GPX4 pathway, offering a novel potential therapeutic strategy for retinal degeneration.

Experimental study

• Construction of a CRISPR/Cas9-mediated VEGFA gene knockout vector and its effects on ARPE-19 cells

  Zhang Wenhua, Xu Jingxuan, Cao Keying, Wang Chunmei, Song Zongming, Li Xiaoli

  2026,26(7):1127-1132 ,DOI: 10.3980/j.issn.1672-5123.2026.7.04

  Abstract: (26) HTML (0) PDF (1.73 MKB)(46)

  Abstract:

  AIM: To develop a novel gene-delivery therapeutic based on CRISPR/Cas9 genome editing technology capable of specifically targeting and knocking out the VEGFA gene, thereby achieving sustained suppression of VEGFA expression in retinal pigment epithelial(RPE)cells and providing a new strategy for gene therapy in retinal neovascular diseases.

  METHODS:Single guide RNAs targeting the human VEGFA gene for knockout were designed, and corresponding recombinant plasmids were constructed. A novel polymer(PTEE)was used to encapsulate the plasmids to prepare a PTEE-loaded anti-VEGFA plasmid(PLAP)gene delivery system. PTEE materials at concentrations of 0.1, 0.2, 0.4, 0.8, and 1.6 μg/μL were co-incubated with ARPE-19 cells, and the biocompatibility of PTEE was evaluated using the cell counting kit-8(CCK-8)assay. Recombinant plasmids expressing green fluorescent protein(GFP)were constructed. Lipofectamine 3000 and jetOPTIMUS^®DNA transfection reagents were used as control groups, and PTEE nanomaterials were used as the experimental group to encapsulate the plasmids. When the cell confluence reached 80%, the formulations were transfected into ARPE-19 and 293T cells. GFP expression was observed under light microscopy, and the transfection efficiencies of each group were compared. ARPE-19 cells were induced under hypoxia, and PLAP was transfected into the cells. The expression level of VEGFA was detected by enzyme-linked immunosorbent assay(ELISA)to evaluate the efficacy of this novel gene delivery system.

  RESULTS: After co-incubation of ARPE-19 cells with different concentrations of PTEE for 24 h and 48 h, no significant effect on cell viability was observed in any group. The transfection efficiency of PLAP in ARPE-19 cells was higher than that in the Lipo3000 and jetOPTIMUS groups, with statistically significant differences(P<0.01). Hypoxia for 6 h significantly induced the upregulation of VEGFA mRNA expression in ARPE-19 cells, and under hypoxic conditions, the PTEE group exhibited a significant inhibitory effect on VEGFA expression(P<0.01).

  CONCLUSION:PLAP exhibits favorable biocompatibility and prominent VEGFA inhibitory effects in vitro, making it a potential candidate drug for gene therapy of retinal neovascular diseases.

Clinical Article

• Associations of aqueous humor miR-21 and miR-29b levels with optic nerve damage severity and GMPE parameters in POAG patients

  Zhang Yaxin, Zheng Yanjin, Liu Lingkun, Liu Yuning, Mu Qirui

  2026,26(7):1133-1140 ,DOI: 10.3980/j.issn.1672-5123.2026.7.05

  Abstract: (9) HTML (0) PDF (1.88 MKB)(35)

  Abstract:

  AIM: To investigate the associations of aqueous humor miR-21 and miR-29b levels with the severity of optic nerve damage and GMPE in patients with primary open angle glaucoma(POAG).

  METHODS:POAG patients who presented to the hospital from May 2023 to May 2025 were prospectively enrolled as the disease group, and patients with cataract treated during the same period were included as the control group. Baseline characteristics and aqueous humor levels of miR-21 and miR-29b were compared between the two groups. POAG patients were categorized into mild and moderate-to-severe groups according to the mean deviation(MD)of visual field. Clinical characteristics and the expression levels of miR-21 and miR-29b in aqueous humor were compared between the two groups. Correlations and nonlinear associations between miR-21/miR-29b levels and RNFL thickness, visual field MD, and BMO-MRW were evaluated. Furthermore, factors influencing the progression of optic nerve damage were analyzed. Based on prognostic outcomes, patients were divided into good prognosis and poor prognosis groups, and the aqueous humor levels of miR-21 and miR-29b were compared. ROC curve analysis was performed to assess the predictive value of combined GMPE with miR-21 and miR-29b for prognosis in POAG patients.Internal validation and decision curve analysis(DCA)were also conducted.

  RESULTS:This study included 151 patients in the disease group(age 56.07±7.59 y, 84 males and 67 females)and 138 patients in the control group(age 56.84±8.25 y, 68 males and 70 females). There were 45 cases in the mild group(age 54.63±7.34 y, 27 males and 18 females)and 106 cases in the moderate-severe group(age 56.68±8.39 y, 57 males and 49 females). There were 118 cases in the good prognosis group(age 55.83±8.07 y, 67 males and 51 females)and 33 cases in the poor prognosis group(age 56.94±8.23 y, 17 males and 16 females). Compared with the control group, the disease group exhibited significantly higher miR-21 levels and lower miR-29b levels(all P<0.001). Compared with the mild group, intraocular pressure and miR-21 levels were significantly higher in the moderate-to-severe group, while RNFL thickness, visual field MD, BMO-MRW, and miR-29b levels were significantly lower(all P<0.01). The miR-21/miR-29b ratio was negatively correlated with RNFL thickness, visual field MD, and BMO-MRW(all P<0.05). Elevated intraocular pressure and miR-21 levels, reduced RNFL thickness, lower visual field MD, and decreased BMO-MRW and miR-29b levels were identified as risk factors for aggravated optic nerve damage in POAG patients(all P<0.05). Compared with the good prognosis group, the poor prognosis group showed significantly higher miR-21 levels and lower miR-29b, RNFL, and BMO-MRW levels(all P<0.001). The combined prediction model incorporating aqueous humor miR-21, miR-29b, RNFL, and BMO-MRW yielded significantly higher AUC and specificity for predicting POAG prognosis than individual parameters alone(both P<0.05). The ROC prediction model demonstrated good consistency, and the combined prediction model exhibited high clinical utility.

  CONCLUSION: Aqueous humor levels of miR-21 are significantly elevated while miR-29b levels are significantly decreased in POAG patients, and these alterations are closely correlated with the severity of optic nerve damage and GMPE parameters.

• Modified Zhujing formula combined with ranibizumab for wet age-related macular degeneration

  Gao Rui, Hu Pineng, Zhou Meijiao, Zhang Jian, Zhang Yu, Zhang Tiejun, Li Wujun

  2026,26(7):1141-1146 ,DOI: 10.3980/j.issn.1672-5123.2026.7.06

  Abstract: (13) HTML (0) PDF (536.43 KKB)(35)

  Abstract:

  AIM:To analyze the efficacy of modified Zhujing formula combined with intravitreal ranibizumab(IVR)injection in the treatment of wet age-related macular degeneration(wARMD).

  METHODS: A prospective study was conducted on wARMD patients at the Ophthalmology Department of Yulin Hospital of Traditional Chinese Medicine from September 2022 to October 2024. The study subjects were divided into the experimental group and the control group according to the random number table method. The control group received IVR treatment, while the experimental group was treated with modified Zhujing formula in addition to IVR injection. The clinical efficacy, TCM symptom scores, central retinal thickness(CRT), best corrected visual acuity(BCVA), macular hemorrhage area, choroidal neovascularization area(CNV), ocular hemodynamic parameters \〖resistance index(RI), maximum diastolic blood flow(EDV), maximum systolic blood flow(PSV)\〗, and 1-year recurrence rate were compared between the two groups.

  RESULTS: This study included 60 eyes from 60 wARMD patients. Among them, the control group consisted of 30 patients and 30 eyes, while the experimental group consisted of 30 patients and 30 eyes. The age of the control group was 67.52±3.12 y, with 17 males and 13 females. The age of the experimental group was 67.62±3.04 y, with 18 males and 12 females.The clinical efficacy of the experimental group(97%)was higher than that of the control group(73%)(P<0.05). After treatment, the scores of blurred vision, soreness and weakness of the waist and knees, restlessness and insomnia, dizziness and tinnitus in the experimental group were all lower than those in the control group(all P<0.05); the EDV and PSV in the experimental group were both higher than those in the control group(both P<0.05); the BCVA, CRT, macular hemorrhage area, CNV and RI of the experimental group were all lower than those of the control group(all P<0.05), and the 1-year recurrence rate in the experimental group(3%)was lower than that in the control group(27%)(P<0.05).

  CONCLUSION:The combined use of modified Zhujing formula and IVR can effectively alleviate symptoms such as blurred vision and retinal hemorrhage in wARMD patients, improve vision and ocular hemodynamic conditions, and reduce the recurrence rate. This suggests that there may be a synergistic enhancing effect.

• Intravitreal Conbercept for macular edema secondary to non-ischemic retinal vein occlusion

  Yang Min, Li Shanshan, Liu Shuang, Zhang Dawei

  2026,26(7):1147-1151 ,DOI: 10.3980/j.issn.1672-5123.2026.7.07

  Abstract: (13) HTML (0) PDF (446.34 KKB)(36)

  Abstract:

  AIM:To observe the clinical efficacy of intravitreal injection of conbercept in the treatment of macular edema secondary to non-ischemic retinal vein occlusion(RVO).

  METHODS: Single center retrospective study. ME patients secondary to non-ischemic RVO admitted to the hospital from January 2023 to March 2024 were selected, and were divided into central retinal vein occlusion(CRVO)group and branch retinal vein occlusion(BRVO)group according to the location of obstruction. All patients were treated with intravitreal injection of conbercept once a month for 3 mo. The best corrected visual acuity(BCVA), macular foveal thickness(CMT), superficial capillary density(SVD), deep capillary density(DVD), and foveal avascular zone(FAZ)area were recorded before and after treatment(with 3 injections per course)at 1, 3, and 6 mo.

  RESULTS:This study included a total of 120 ME secondary to non-ischemic RVO patients(128 eyes), who were divided into CRVO group(51 cases, 56 eyes, 31 males, 20 females, mean age 61.39±10.32 y)and BRVO group(69 cases, 72 eyes, 41 males, 28 females, mean age 61.48±10.41 y)based on the location of obstruction. There was no significant difference in general data between the two groups before treatment(both P>0.05). After 1, 3, and 6 mo of treatment, both groups showed improvement in BCVA, CMT, SVD, and DVD compared to before treatment(all P<0.05). BCVA in the BRVO group was better than that in the CRVO group at all time points after treatment(all P<0.05), while there was no difference in CMT, SVD, and DVD between the two groups(all P>0.05); There was no significant difference in FAZ area between the two groups before and after treatment(both P>0.05). Follow up for 6 mo showed no significant difference in the incidence of complications between the two groups of patients(both P>0.05), but there was a significant difference in the recurrence rate(P<0.05).

  CONCLUSION: The first intravitreal injection of conbercept is effective in treating macular edema caused by non-ischemic CRVO and BRVO, improving visual function, reducing macular edema, and repairing retinal structure and blood flow perfusion. Notably, the recovery of visual function and improvement of capillary density are more significant in BRVO patients.

• Efficacy of 0.05% cyclosporine A eye drops for preventing dry eye after FS-LASIK

  Liang Huanhuan, Wang He

  2026,26(7):1152-1162 ,DOI: 10.3980/j.issn.1672-5123.2026.7.08

  Abstract: (14) HTML (0) PDF (4.23 MKB)(42)

  Abstract:

  AIM: To explore the efficacy of 0.05% cyclosporine A(CsA)eye drops for preventing dry eye after femtosecond laser-assisted laser in situ keratomileusis(FS-LASIK).

  METHODS: In this prospective randomized controlled study, a total of 80 patients(80 eyes)who underwent FS-LASIK surgery at the Affiliated Hospital of Xuzhou Medical University from January 2025 to September 2025 were enrolled, and only the data from the right eye were included for analysis. Before surgery, these patients were randomly assigned in a 1:1 ratio using a computer-generated sequence to a control group or an experimental group. All patients received standard postoperative treatment starting from postoperative day 1, including 0.5% levofloxacin eye drops, 0.1% fluorometholone eye drops, and 0.1% sodium hyaluronate eye drops(four times daily for 3 mo). The experimental group additionally received 0.05% cyclosporine A eye drops in addition to the standard treatment. The following parameters were compared between the two groups preoperatively and at 1 and 3 mo postoperatively: ocular surface disease index(OSDI)score, numerical rating scale(NRS)for ocular symptoms, lipid layer thickness(LLT), meibomian gland dropout score, Schirmer's Ⅰ test(SⅠt), corneal fluorescein staining(CFS)score, non-invasive tear breakup time(NIBUT), and tear meniscus height(TMH). Confocal microscopy was employed to evaluate corneal nerve parameters, including corneal nerve fiber density(CNFD), corneal nerve branch density(CNBD), corneal nerve fiber length(CNFL), and corneal total branch density(CTBD), and to count Langerhans cell density(DCD). In addition, levels of interferon-gamma(IFN-γ), interleukin(IL)-1β, IL-6, IL-10, and matrix metalloproteinase-9(MMP-9)in the tear were measured using liquid chip technology.

  RESULTS: A total of 72 patients completed the final follow-up, including 37 patients(15 males, 22 females, mean age 24.05±4.00 y)in the experimental group, 35 patients(16 males, 19 females, mean age 23.77±3.71 y)in the control group. At 1 and 3 mo postoperatively, the experimental group showed significantly lower OSDI scores, NRS eye pain scores, and CFS scores(all P<0.01), and significantly higher NIBUT and TMH values, compared with the control group. Confocal microscopy revealed that DCD was significantly lower in the experimental group at 1 and 3 mo postoperatively, whereas CNFD, CNBD, CNFL, and CTBD were significantly higher at 3 mo postoperatively(all P<0.01). Analysis of tear inflammatory cytokines showed that the levels of IFN-γ, IL-1β, IL-6, and MMP-9 were significantly lower in the experimental group at 1 and 3 mo postoperatively compared with the control group(all P<0.01). Spearman correlation analysis revealed that OSDI and NRS scores were negatively correlated with NIBUT, corneal nerve parameters(CNFD, CNBD, CNFL, CTBD), and corneal sensitivity(all P<0.01), and positively correlated with CFS scores, tear inflammatory cytokines(IFN-γ, IL-10, IL-1β, IL-6, and MMP-9), and DCD(all P<0.01). Tear inflammatory cytokines were negatively correlated with corneal nerve parameters, NIBUT, and corneal sensitivity(all P<0.01), and positively correlated with CFS scores and DCD(all P<0.01). No significant correlations were observed among the remaining parameters(P>0.05).

  CONCLUSION: Prophylactic use of 0.05% cyclosporine A eye drops significantly improves dry eye symptoms and signs, suppresses ocular surface inflammation, and promotes the restoration of tear film stability in patients after FS-LASIK. Through its dual anti-inflammatory and neuroregenerative effects, cyclosporine A constitutes an effective adjuvant therapy for reestablishing ocular surface microenvironment homeostasis after refractive surgery.

Review Aritcle

• Structural characteristics of lamina cribrosa and research progress in high myopia with primary open angle glaucoma

  Li Ying, Qiu Kunliang

  2026,26(7):1163-1167 ,DOI: 10.3980/j.issn.1672-5123.2026.7.09

  Abstract: (13) HTML (0) PDF (486.00 KKB)(38)

  Abstract:

  High myopia combined with primary open angle glaucoma is an increasingly concerned and complex disease in ophthalmology, and its pathogenesis is closely associated with multiple alterations in structural parameters of the lamina cribrosa. As the main supportive structure of the optic nerve, the lamina cribrosa plays an important role in pathophysiology of glaucoma through parameters including curvature, depth, defects, and thickness. Meanwhile, fundus alterations induced by high myopia may obscure typical glaucomatous features. Current research on the relationship between lamina cribrosa parameters and high myopia combined with primary open angle glaucoma still have certain limitations, particularly in terms of mechanism exploration and clinical application. Through systematically reviewing the relevant literature, this article aims to summarize the latest research advances on lamina cribrosa parameters in high myopia combined with primary open angle glaucoma, with a focus on discussing the potential and current limitations of these parameters as biomarkers for early diagnosis and prognosis assessment.

• Research progress on gender differences of keratoconus

  Yin Chenchen, Yuan Yi, Ren Shengwei

  2026,26(7):1168-1173 ,DOI: 10.3980/j.issn.1672-5123.2026.7.10

  Abstract: (22) HTML (0) PDF (515.48 KKB)(38)

  Abstract:

  Keratoconus is an adolescent-onset blinding eye disease characterized by the protrusion and thinning of the central or paracentral cornea. The cause of keratoconus remains unclear, though its onset and progression arise from a multifactorial interplay involving a polygenic background, environmental exposures, and biomechanical decompensation. Recent studies have demonstrated significant gender differences in the pathogenesis and progression of keratoconus.At the epidemiological level, most studies suggest that the disease shows a male predominance; in terms of clinical features, male patients tend to experience an earlier onset and present with more severe clinical phenotypes, such as more serious corneal morphological deterioration; at the pathological mechanism level, sex hormone expression differences and genetic susceptibility differences play a key role in disease progression; this difference further affects the formulation of clinical prevention and treatment strategies, such as early warning screening for high-risk male groups and individualized corneal cross-linking intervention timing. This article reviews gender differences in keratoconus from the perspectives of epidemiology, clinical characteristics, prevention and treatment, and pathological mechanisms, providing relevant references and insights for future clinical practice.

• Advances in basic and clinical research on congenital ectopia lentis

  Liu Xiaomin, Zhou Jian

  2026,26(7):1174-1179 ,DOI: 10.3980/j.issn.1672-5123.2026.7.11

  Abstract: (8) HTML (0) PDF (908.84 KKB)(31)

  Abstract:

  Congenital ectopialentis(CEL)is a significant cause of blindness-related disease in children and adolescents, with a highly heterogeneous etiology. It can manifest either as a prominent ocular phenotype of connective tissue disorders such as Marfan syndrome or as an isolated condition. Emerging evidence indicates that zonular microfibrils and extracellular matrix homeostasis represent the core pathological basis. Variants in genes including FBN1, ADAMTSL4, LTBP2, ADAMTS10/17, ASPH, and SUOX lead to lens malposition and anterior segment remodeling by disrupting microfibril assembly, anchoring, and signaling regulation. Clinically, after excluding secondary causes, a stratified diagnosis based on phenotypic presentation should be pursued. Genetic testing can adopt a stepwise strategy of “panel-first, supplemented by whole-exome/whole-genome sequencing(WES/WGS)”, combined with family-based follow-up and reassessment. This review synthesizes current knowledge on the pathogenic basis, genetic spectrum and genotype-phenotype correlations, diagnostic workflows, and testing strategies, and presents a clinically oriented stratified diagnostic framework aimed at improving early recognition and systemic risk management.

• Advances in application of lens constant optimization for IOL power calculation

  Xia Ruoqiu, Xu Hao, Wang Xuanxuan, Hu Chenqiong

  2026,26(7):1180-1184 ,DOI: 10.3980/j.issn.1672-5123.2026.7.12

  Abstract: (6) HTML (0) PDF (459.09 KKB)(31)

  Abstract:

  With the advent of the refractive era of cataract surgery, postoperative residual refractive error has become a key factor affecting visual quality. The accuracy of intraocular lens(IOL)power calculation is affected by multiple factors, including ocular biological parameters, calculation formulas, and lens constants. Currently, the lens constants widely used in clinical practice are mostly based on Western populations, which have a mismatch with the ocular characteristics of the Chinese population, such as shorter axial length and steeper cornea. Therefore, the personalized optimization of the constant has become a research hotspot. This review primarily summarizes the research progress on lens constant optimization in improving the accuracy of IOL power calculation. Currently, there is no consensus on lens constant optimization methods. Single-constant formulas can be optimized through iterative methods, while multi-constant formulas require the combination of linear or nonlinear strategies. Simplified gradient descent and data-driven techniques offer new optimization pathways, but cross-validation is needed to evaluate their performance. Segmented optimization based on axial length, corneal curvature, and anterior chamber depth has shown significant effectiveness in patients with special anatomical structures, effectively reducing postoperative refractive errors in different patient groups, but limitations remain in some extreme cases. The interaction of multiple parameters significantly impacts the predictive accuracy of complex cases. While new-generation formulas integrating multiple parameters or incorporating AI algorithms have improved accuracy, constant optimization still holds value. Currently, the complex relationships between multiple parameters and intraoperative dynamic changes require further in-depth research. Future research, including targeted population optimization studies, the development of real-time monitoring technologies, and innovative IOL designs, may make achieving zero postoperative refractive error a possibility.

• Neuroimmune mechanisms and perioperative management strategies for post-cataract surgery dry eye

  Wang Xuejiao, Yu Fangliang

  2026,26(7):1185-1191 ,DOI: 10.3980/j.issn.1672-5123.2026.7.13

  Abstract: (12) HTML (0) PDF (577.11 KKB)(37)

  Abstract:

  Post-cataract surgery dry eye(PCSDE)is a common complication, with an incidence of 9.2%-72.6%, and approximately 20% of patients experience persistent long-term symptoms. In the era of refractive cataract surgery, dry eye has become a critical factor affecting surgical satisfaction due to rising patient expectations for visual quality. Emerging evidence highlights that the interplay between neurosensory abnormalities and immune-inflammatory responses drives PCSDE chronicity, with psychoneurological factors gaining increasing attention. This review systematically examines PCSDE pathogenesis and contributing factors from this novel perspective, including surgical variables(incision design, operative duration, techniques), patient-related factors(age, meibomian gland function, systemic diseases, psychological status), and perioperative management(drug toxicity, disinfectant use). Additionally, based on the latest clinical evidence, comprehensive prevention and treatment strategies including preoperative optimization of ocular surface conditions, intraoperative ocular surface protection techniques, and personalized postoperative regimens are summarized. A deeper understanding of the multifactorial mechanisms of PCSDE is crucial for enhancing the quality of cataract surgery and improving patient outcomes. This review establishes a novel framework for PCSDE management based on neuro-immune-psychological interactions, offering crucial theoretical updates and practical guidance to enhance visual quality and patient satisfaction in refractive cataract surgery.

• Application of OCTA in evaluating retinal vascular density in ocular diseases

  Li Xiaotong, Sun Ruixue

  2026,26(7):1192-1197 ,DOI: 10.3980/j.issn.1672-5123.2026.7.14

  Abstract: (16) HTML (0) PDF (533.98 KKB)(35)

  Abstract:

  Optical coherence tomography angiography(OCTA)is an innovative non-invasive imaging technology that enables non-invasive, layered, and three-dimensional quantitative visualization of the retinal and choroidal capillary networks by detecting blood flow signals in a contrast-free manner. With its non-invasiveness, high resolution, and quantifiability, OCTA demonstrates significant potential in disease screening, precise staging, treatment decision-making, and prognosis prediction. Its core advantage lies in the accurate quantification of key microcirculation parameters, such as vessel density(VD), non-perfusion area(NPA), foveal avascular zone(FAZ)morphology, and neovascular activity. In diabetic retinopathy(DR), retinal vascular occlusive diseases(RVO/RAO), age-related macular degeneration(ARMD), and glaucoma, OCTA can sensitively detect reduced vessel density in the deep capillary plexus before clinically visible lesions appear, providing a basis for early screening and risk stratification. Additionally, OCTA has shown important value in managing uveitis, pathological myopia, and other ocular conditions. This review systematically elaborates on the technical principles, key quantitative parameters, and core application value of OCTA in the management of various ophthalmic diseases and presents scientific prospects for the application of OCTA in standardized ophthalmic treatment. With further advancements in hardware scanning speed, wide-field imaging capabilities, artificial intelligence algorithms, and multi-modal integration, OCTA is expected to become an essential component of standard ophthalmic diagnosis and treatment. It may also provide a non-invasive window for microcirculation research in neurological and systemic diseases.

• Research progress on changes in retinal and choroidal structure and blood flow density after SMILE and FS-LASIK surgery

  Chai Ai, Yu Ping

  2026,26(7):1198-1202 ,DOI: 10.3980/j.issn.1672-5123.2026.7.15

  Abstract: (9) HTML (0) PDF (500.02 KKB)(38)

  Abstract:

  Femtosecond laser small-incision lenticule extraction(SMILE)and femtosecond laser-assisted in situ keratomileusis(FS-LASIK)are the mainstream corneal refractive surgeries at present. With the emergence of optical coherence tomography angiography(OCTA), an automatic and precise analytical technique, it has been widely applied in the evaluation of retinal and choroidal diseases, and has emerged as a novel tool for exploring the impacts of corneal refractive surgery on posterior ocular segment microcirculation. This article systematically reviews the characteristics of fundus microcirculation changes after SMILE and FS-LASIK surgeries, compares the differences in microcirculatory alterations between the two procedures, analyzes the limitations of existing studies, and discusses future research directions. It provides a theoretical basis for evaluating the safety of refractive surgery and selecting individualized surgical approaches.

• New perspectives on the neuro-immune mechanisms of itch in allergic conjunctivitis

  Ma Yuhua, Zhang Lu, Pan Junyang, Wu Chunli, Nie Dinghuan, Wang Yanting, Peng Ao, Ma Nan

  2026,26(7):1203-1209 ,DOI: 10.3980/j.issn.1672-5123.2026.7.16

  Abstract: (14) HTML (0) PDF (603.98 KKB)(30)

  Abstract:

  Allergic conjunctivitis is a common ocular inflammatory disease, with intense itching being the most typical and distressing symptom for patients. In recent years, with the in-depth study of the interaction between the nervous and immune systems, significant progress has been made in understanding the mechanism of itching in allergic conjunctivitis. This review elaborates on the neurobiological basis of itching in allergic conjunctivitis, with a focus on the complex dialogue between immune cells and sensory neurons, particularly the core role of the IL-33-ST2-CGRP signaling axis in mediating itching. Additionally, this article introduces new findings in genetic susceptibility research, including the identification of susceptibility genes for allergic conjunctivitis through transcriptome-wide association studies. The sensory nervous system not only transmits itch signals but also actively participates in the formation of antigen channels related to conjunctival goblet cells, thereby regulating the local uptake of allergens and the initiation of the immune response. Moreover, targeted novel therapeutic strategies offer hope for patients with refractory allergic conjunctivitis. Exploring the molecular and cellular mechanisms of itching in allergic conjunctivitis will provide a theoretical basis for the development of more effective treatment methods.

• Research progress on ocular accommodative function in the mechanism of axial elongation

  Diao Jiale, Wu Peng, Ren Jiantao, Sheng Shuai, Huang Xudong

  2026,26(7):1210-1215 ,DOI: 10.3980/j.issn.1672-5123.2026.7.17

  Abstract: (16) HTML (0) PDF (1006.34 KKB)(37)

  Abstract:

  Accommodative dysfunction, particularly accommodative lag, acts as a core hub connecting near work activity to myopic axial elongation. This review thoroughly explores the multidimensional biological mechanisms by which accommodative function drives axial growth. In addition to the classic pathway where hyperopic defocus signals induce retinal-choroidal-scleral biochemical remodeling, two other mechanisms are highlighted: a biomechanical pathway involving direct mechanical traction on the equatorial sclera caused by sustained ciliary muscle contraction, and a neural pathway where abnormal accommodative micro fluctuations degrade retinal image quality, thereby triggering abnormal ocular growth. Based on these comprehensive mechanisms, this paper systematically analyzes the principles of pharmacological(atropine), optical(orthokeratology, defocus lenses), and vision therapy interventions. Myopia progression results from the integrated regulation of optical defocus, mechanical stress, and neural dynamics. Future myopia control should advance toward precise, personalized combination strategies tailored to individual accommodative and genetic profiles.

• Latest advances and future prospects of stimuli-responsive ocular drug delivery strategies

  Ni Xisen, Li Xiumiao, Zhou Lujia, Cao Guofan

  2026,26(7):1216-1221 ,DOI: 10.3980/j.issn.1672-5123.2026.7.18

  Abstract: (8) HTML (0) PDF (1.05 MKB)(35)

  Abstract:

  The intricate anatomical architecture and complex dynamic physiological barriers of the eye severely restrict the intraocular bioavailability of ophthalmic drugs. The limited absorption efficiency of conventional eye drops(<5%)and the highly invasive nature of intravitreal injections remain persistent bottlenecks in ophthalmic therapeutics. Driven by the convergence of materials science and biomedical engineering, intelligent stimuli-responsive drug delivery systems offer revolutionary strategies to overcome these physiological barriers and achieve spatiotemporally controlled drug release. These systems leverage specific recognition and response capabilities targeted at pathological microenvironments or exogenous physical fields. This article systematically reviews recent advances in this domain, providing an in-depth analysis of the physicochemical mechanisms underlying various stimuli-responsive carriers from the perspectives of polymer phase transition thermodynamics and chemical bond cleavage kinetics. By synthesizing preclinical and clinical research data on major ocular diseases, including glaucoma, age-related macular degeneration, and intraocular infections, the significant advantages of these intelligent systems were demonstrated. Highlighted benefits include prolonged ocular surface retention, biomarker-triggered on-demand release, and minimized systemic toxicity. Finally, this review critically analyzes the challenges of translating these complex formulations to the clinic, specifically regarding sterile scale-up manufacturing and regulatory approval pathways, while providing perspectives on future development.

• Advances in PI3K/AKT/eNOS/NO pathway in repeated low-intensity red light treatment for myopia

  Li Hui, Zhu Qin, Hu Min

  2026,26(7):1222-1227 ,DOI: 10.3980/j.issn.1672-5123.2026.7.19

  Abstract: (11) HTML (0) PDF (708.00 KKB)(38)

  Abstract:

  Myopia has become a growing public health issue globally, characterized by an earlier age of onset and a rising annual incidence rate, particularly among adolescents. Repeated low-intensity red light therapy(RLRL)has gained widespread attention in recent years as an emerging non-invasive intervention, showing promise for controlling myopia. This article examines the role of the PI3K/AKT signaling pathway in RLRL,specifically advances in promoting choroidal thickening via the phosphorylation mechanism of endothelial nitric oxide synthase(eNOS). Choroidal thickening is recognized as a critical part of myopia control. Activation of the PI3K/AKT/eNOS-NO signaling pathway may attenuate axial elongation by enhancing choroidal blood flow and nutrient supply. Although certain basic and clinical studies have supported this mechanism, many unresolved issues still remain, such as the specific mechanisms of RLRL action, its safety, and its applicability in different populations. This article systematically reviews the relevant research progress, aiming to provide a valuable reference for future studies and explore the application prospects of RLRL in myopia prevention and control.

• Core signaling axes of TGF-β-mediated scleral remodeling and their significance in myopia progression

  Li Ruixue, Zhu Yujie

  2026,26(7):1228-1233 ,DOI: 10.3980/j.issn.1672-5123.2026.7.20

  Abstract: (10) HTML (0) PDF (929.23 KKB)(44)

  Abstract:

  Myopia is a globally prevalent refractive eye disease, with abnormal axial elongation as its core structural feature, and scleral remodeling is the key terminal event driving axial elongation. Transforming growth factor-β(TGF-β), as a core cytokine regulating tissue remodeling, modulates the phenotype of scleral fibroblasts, extracellular matrix(ECM)metabolism, and tissue mechanical properties through a multi-signaling axis network, thereby playing a crucial role in myopic scleral remodeling. This article systematically summarizes the core signaling mechanisms of TGF-β-mediated scleral remodeling. As a core driver, TGF-β synergistically promotes scleral remodeling at both transcriptional regulatory and cellular mechanical levels through its two downstream core signaling axes, namely Smad and Rho/ROCK. Bone morphogenetic protein(BMP), an important member of the TGF-β superfamily and a key negative regulator of the core signaling axes, maintains scleral homeostasis by antagonizing the TGF-β/Smad signaling. Additionally, the TGF-β core signaling axes may crosstalk with pathways such as Wnt/β-catenin and PI3K/Akt. This article clarifies the core significance of the TGF-β-mediated signaling axis network in the progression of myopia, provides a systematic framework for understanding the molecular mechanisms of myopic scleral remodeling, and identifies research gaps in areas such as crosstalk molecules among signaling axes, stage-specific functions, and clinical translation. It also offers novel insights for the precise prevention, control, and targeted treatment of myopia.

• Research progress on the role and molecular mechanisms of growth hormone in myopia development

  Chen Haobin, Fan Xiao'e

  2026,26(7):1234-1238 ,DOI: 10.3980/j.issn.1672-5123.2026.7.21

  Abstract: (10) HTML (0) PDF (492.21 KKB)(33)

  Abstract:

  In recent years, the incidence of myopia has been increasing annually, emerging as a significant public health issue, particularly among adolescents. Recombinant human growth hormone(rhGH), a primary treatment for short stature in children, has raised widespread concern due to its potential to promote myopia progression. Recent studies have revealed that growth hormone(GH)may contribute to the development of myopia by regulating scleral extracellular matrix metabolism and axial length through multiple mechanisms, including downstream signaling pathways\〖e.g., insulin-like growth factor-1(IGF-1)\〗, cellular signaling pathways(e.g., MMP/TIMP balance and the Wnt/β-catenin pathway), and epigenetic mechanisms(e.g., miR-29a and DNA methylation). Therefore, this article reviews recent research progress on the role of GH in the pathogenesis and progression of myopia, with the aim of providing insights into visual protection and myopia prevention strategies for children receiving GH therapy for short stature.

Clinical research

• Relationship between serum Sirt1-6 levels and oxidative stress indicators in age-related cataract patients and their diagnostic value

  Lu Lu, Wu Fangfang, Wu Wenwen, Yang Lidong, Liu Yawen

  2026,26(7):1239-1245 ,DOI: 10.3980/j.issn.1672-5123.2026.7.22

  Abstract: (8) HTML (0) PDF (2.41 MKB)(35)

  Abstract:

  AIM: To investigate the relationship between serum levels of sirtuins(Sirts)1-6 and oxidative stress markers, and to evaluate their diagnostic value for age-related cataract(ARC).

  METHODS:A prospective cohort of ARC patients admitted to the hospital between June 2019 and July 2021 was enrolled as the study subjects. Concurrently, age-matched healthy individuals undergoing routine physical examinations at the hospital during the same period were recruited as the control group. Baseline demographic and clinical characteristics were compared between the two groups. Serum levels of Sirt1-6 and oxidative stress markers including malondialdehyde(MDA), superoxide dismutase(SOD), glutathione peroxidase(GSH-Px), and total antioxidant capacity(TAC)were compared. Pearson correlation analysis was performed to assess the associations between serum Sirt1-6 levels and oxidative stress parameters. Multivariate Logistic regression analysis was conducted to analysis risk factors associated with ARC occurrence. Receiver operating characteristic(ROC)curve was used to evaluate the diagnostic value of serum Sirt1-6 levels and oxidative stress indicators for ARC.

  RESULTS: The study included 127 ARC patients, comprising 68 men and 59 women, with a mean age of 66.05±2.58 y; the concurrent control group consisted of 121 patients, comprising 63 men and 58 women, with a mean age of 65.54±2.86 y. Serum levels of Sirt1, 3 and 6, SOD, GSH-Px, and TAC were significantly lower in the ARC group compared to the control group(all P<0.001), whereas MDA levels were markedly elevated(P<0.001). Pearson correlation analysis revealed that serum levels of Sirt1, Sirt3, Sirt6 in the ARC group were positively correlated with SOD, GSH-Px, and TAC, and negatively correlated with MDA. Multivariate Logistic regression analysis demonstrated that serum Sirt1, Sirt6, MDA, SOD, and GSH-Px were significantly associated with the occurrence of ARC(all P<0.001). ROC curve analysis showed that the combination of Sirt1, Sirt6, MDA, SOD, and GSH-Px yielded an area under the curve(AUC)of 0.995 for diagnosing ARC, which was significantly higher than that of Sirt1 alone(Z=4.978,P<0.001), Sirt6 alone(Z=7.487,P<0.001), MDA alone(Z=6.449,P<0.001), SOD alone(Z=5.773,P<0.001), or GSH-Px alone(Z=5.056,P<0.001), indicating superior diagnostic accuracy of the multimarker panel(P<0.05).

  CONCLUSION: Serum levels of Sirt1, 3, and 6 are generally reduced in ARC patients and are closely associated with oxidative stress imbalance. Specifically, decreased serum levels of Sirt1 and Sirt6, along with oxidative stress markers(elevated MDA and reduced SOD and GSH-Px)are identified as risk factors for ARC. Moreover, the combined detection of these indicators presents high diagnostic value for ARC.

• Correlation of serum SESN2, SCUBE-1, and PTX3 levels with disease severity and prognosis in patients with diabetes macular edema

  Wei Yingnan, Zhai Xiaoyu, Li Junzhi

  2026,26(7):1246-1252 ,DOI: 10.3980/j.issn.1672-5123.2026.7.23

  Abstract: (12) HTML (0) PDF (685.73 KKB)(38)

  Abstract:

  AIM: To investigate the correlation between serum Sestrin 2(SESN2), signal peptide, CUB and EGF-like domain-containing protein 1(SCUBE-1), and longpentraxin 3(PTX3)levels, with disease severity and prognosis in patients with diabetes macular edema(DME).

  METHODS:Prospective study. The study included DME patients who were treated at the hospital between January 2023 and October 2024, as well as patients with type 2 diabetes mellitus(T2DM)and healthy individuals who underwent physical examinations during the same period. Serum levels of SESN2, SCUBE-1, and PTX3 were measured using the ELISA method. Factors influencing poor prognosis in DME patients were analyzed.

  RESULTS:This study included a total of 114 eye from 114 DME patients, For unilateral disease, the affected eye was enrolled; for bilateral disease, the more severely affected eye was selected for enrollment.(72 men and 42 women, with a mean age of 56.94±7.38 y), 114 T2DM patients(65 men, 49 women, mean age 56.18±7.22 y), and 114 healthy individuals(77 men, 37 women, mean age 56.33±7.26 y). There were no cases of loss to follow-up. FPG and HbA1c levels in the DME and T2DM groups were significantly higher than those in the healthy group(all P<0.05). Serum SESN2 levels decreased progressively from the healthy group to the T2DM group to the DME group, while SCUBE-1 and PTX3 levels increased progressively(all P<0.05). DME patients were classified by disease severity into a mild group of 23 cases(14 men, 9 women, mean age 55.81±7.52 y), a moderate group 54 cases(35 males, 19 females, mean age 56.97±7.35y), and a severe group 37 cases(23 males, 14 females, mean age 57.60±7.41 y). Serum SESN2 levels decreased progressively from the mild to the moderate and to the severe group, while SCUBE-1, PTX3, and CST levels increased progressively(all P<0.05). Serum SESN2 levels were negatively correlated with DME severity and CST, whereas SCUBE-1 and PTX3 levels were positively correlated with both DME severity and CST(all P<0.001). Among the 114 DME patients, 81 were in the favorable prognosis group and 33 were in the unfavorable prognosis group. In the poor prognosis group, serum SESN2 levels were lower than those in the favorable prognosis group, while SCUBE-1 and PTX3 levels were higher(all P<0.05). Low serum SESN2 levels, high SCUBE-1 levels, and high PTX3 levels were factors associated with poor prognosis in DME patients(all P<0.05). The AUC(0.916)for the combined prediction of poor prognosis in DME patients using serum SESN2, SCUBE-1, and PTX3 levels was higher than that for each marker individually(0.780, 0.782, and 0.783, respectively, all P<0.05).

  CONCLUSION:Serum SESN2 levels are reduced in DME patients, while SCUBE-1 and PTX3 levels are elevated. Changes in these three markers are associated with disease severity and prognosis, and the combined detection has high predictive value for poor patient outcomes.

• Expression of Ficolin-3 and SFRP5 in serum of patients with T2DM combined with DR and their diagnostic value

  Dou Runpeng, Liu Tingting, Ma Yuanyuan, Li Suhua

  2026,26(7):1253-1257 ,DOI: 10.3980/j.issn.1672-5123.2026.7.24

  Abstract: (8) HTML (0) PDF (645.43 KKB)(34)

  Abstract:

  AIM: To investigate the expression of Ficolin-3 and secreted frizzled-related protein 5(SFRP5)in the serum of patients with type 2 diabetes mellitus(T2DM)combined with diabetic retinopathy(DR)and their diagnostic value.

  METHODS: Prospectively selected patients with T2DM combined with DR admitted to the hospital from May 2023 to May 2025 were divided into non-proliferative and proliferative groups according to the severity of DR. Another patients with T2DM alone during the same period were selected as the T2DM group. ELISA was used to detect Ficolin-3 and SFRP5 levels; Correlation of serum Ficolin-3, SFRP5 levels, and inflammatory markers in T2DM patients with DR were analyzed using Pearson method; Logistic regression was used to analyze related influencing factors; ROC curve analysis was used to evaluate the diagnostic value of serum Ficolin-3 and SFRP5 for DR in T2DM patients.

  RESULTS: This study included a total of 108 patients with T2DM combined with DR(57 cases in the non-proliferative group, 51 cases in the proliferative group)and 108 cases in the T2DM group. The non-proliferative group had an average age of 59.01±6.28 y, with 34 males and 23 females. The proliferative group had an average age of 59.09±6.35 y, with 30 males and 21 females. The T2DM group had an average age of 58.96±6.18 y, with 62 males and 46 females.The serum levels of Ficolin-3, TNF-α, and IL-6 in the non-proliferative and proliferative groups were higher than those in the T2DM group(all P<0.05), while the level of SFRP5 was lower than that in the T2DM group(all P<0.05). The serum levels of Ficolin-3, TNF-α, and IL-6 in the proliferative group were higher than those in the non-proliferative group(all P<0.05), and the level of SFRP5 was lower than that in the non-proliferative group(P<0.05).Complying with Pearson correlation analysis showed that serum Ficolin-3 was negatively correlated with SFRP5(P<0.05), and both were related to TNF-α and IL-6(all P<0.001). Logistic analysis showed that the course of diabetes, SUA, HbA1c, Ficolin-3, TNF-α, and IL-6 were the risk factors for T2DM patients with DR(all P<0.05), and SFRP5 was a protective factor(P<0.05). Complying with the ROC curve, the AUC values of serum Ficolin-3 and SFRP5 alone and their combination for diagnosing T2DM patients with DR were 0.774, 0.793, and 0.864, respectively. The AUC of combined diagnosis was better than that of single diagnosis(Z=2.694, Z=2.708, both P<0.05).

  CONCLUSION: In patients with T2DM complicated by DR, serum levels of Ficolin-3 and SFRP5 are abnormally expressed. Both are influencing factors for T2DM with DR, and the combined detection can improve the diagnostic value in these patients.

• Correlation analysis of the severity of OSAHS with visual field defects and visual evoked potentials in patients with AION

  Duan Pengfei, Li Shuo, Wu Yuman, Ma Yufeng, Ji Sujuan

  2026,26(7):1258-1263 ,DOI: 10.3980/j.issn.1672-5123.2026.7.25

  Abstract: (10) HTML (0) PDF (1.09 MKB)(40)

  Abstract:

  AIM: To investigate the correlation between different severity grades of obstructive sleep apnea-hypopnea syndrome(OSAHS)and visual field defects as well asvisual evoked potential(VEP)parameters in patients with anterior ischemic optic neuropathy(AION).

  METHODS: A retrospective case-control study. Patients diagnosed with AION complicated by OSAHS at the Department of Ophthalmology, the Affiliated Xuzhou Municipal Hospital of Xuzhou Medical University, between June 2022 and October 2025 were selected as the study subjects. According to the AHI and mSaO₂, the patients were divided into three groups: a mild group(AHI 5-15 events/h, mSaO₂ 85%-90%), moderate group(AHI 16-30 events/h, mSaO₂ 80%-85%), and severe group(AHI >30 events/h, mSaO₂ <80%). General demographic data, retinal nerve fiber layer(RNFL)thickness, visual field defect indicators including mean defect(MD)and pattern standard deviation(PSD), as well as VEP parameters(P100 latency and amplitude)were compared among the three groups.

  RESULTS: This study included a total of 110 patients with AION complicated by OSAHS. Based on the severity of OSAHS, the patients were divided into a mild group of 37 patients(21 men and 16 women, mean age 62.15±9.37 y), a moderate group of 35 patients(20 men, 15 women; mean age 61.82±8.94 y), and a severe group of 38 patients(22 men, 16 women; mean age 63.02±9.61 y). There were no significant differences among the three groups in terms of age, sex, TG, TC, LDL-C, HDL-C levels, or AION severity(all P>0.05); however, there were significant differences in history of hypertension, history of diabetes, systolic blood pressure, diastolic blood pressure, and FPG levels(all P<0.05). The mean RNFL thickness in the severe group(63.27±5.58 μm)was significantly lower than that in the moderate group(74.14±6.28 μm)and the mild group(83.22±7.02 μm), and the moderate group was lower than the mild group(all P<0.05); The MD value(-11.57±1.82 dB)and PSD value(7.35±0.87 dB)in the severe group were both higher than those in the moderate group \〖(-7.62±1.31 dB),(4.89±0.62 dB)\〗 and the mild group \〖(-4.38±1.05 dB),(2.57±0.45 dB)\〗(all P<0.05); the P100 latency in the severe group(132.41±8.57 ms)was longer than that in the moderate group(118.75±7.32 ms)and the mild group(105.62±6.14 ms), and the amplitude(7.65±1.53 μV)was lower than that of the moderate group(11.24±1.89 μV)and the mild group(15.38±2.11 μV)(all P<0.05). Spearman's correlation analysis revealed that the severity of OSAHS was negatively correlated with the MD value(r_s=-0.901, P<0.05)and positively correlated with the PSD value and P100 latency(r_s=0.947, 0.807, P<0.05), and was negatively correlated with P100 amplitude(r_s=-0.878, P<0.05).

  CONCLUSION:The severity of OSAHS is closely associated with RNFL thickness, visual field defects, and VEP parameters in patients with AION; the more severe the OSAHS, the more pronounced the structural and functional damage to the optic nerve. Monitoring AHI and mSaO₂ can aid in assessing the condition of patients with AION and developing personalized intervention plans.

• Teprotumumab combined with glucocorticoid pulse therapy for thyroid-associated ophthalmopathy

  Liu Yuan, Yang Qian, Du Juan, Chang Hu, Gao Ge

  2026,26(7):1264-1269 ,DOI: 10.3980/j.issn.1672-5123.2026.7.26

  Abstract: (12) HTML (0) PDF (497.62 KKB)(40)

  Abstract:

  AIM: To explore the clinical therapeutic effect of teprotumumab combined with glucocorticoid pulse therapy for thyroid-associated ophthalmopathy(TAO), and its impacts on thyroid function, levels of inflammatory factors, and adverse reactions in patients.

  METHODS: Active TAO patients admitted to the Ophthalmology Department were enrolled and randomly divide into the steroid group and the combined group. Then the steroid group was treated with glucocorticoid pulse therapy, while the combined group was combined with intravenous infusion of teprotumumab on the basis of the steroid group. The clinical therapeutic effect, the CAS, OSDI, M-C-TAO-QOL scores, ocular sign indicators(fissure width, proptosis), levels of inflammatory factors(TNF-α, CRP, IL-17), thyroid function(TSH, FT3, FT4)before and after treatment, and occurrence of adverse reactions were compared between two groups.

  RESULTS:Totally 96 TAO patients(192 eyes)were included, with 48 cases(96 eyes)in each group. In the combined group, there were 17 males and 31 females, with an average age of 51.85±3.53 y; in the steroid group, there were 14 males and 34 females, with an average age of 51.26±3.84 y. The total effective rate of the combined group(94%)was higher than that of the steroid group(79%)(P<0.05). After treatment, the CAS score, OSDI score, fissure width, proptosis, levels of TNF-α, CRP, and IL-17 in the combined group were all lower than those in the steroid group, and the M-C-TAO-QOL score was higher than that in the steroid group(P<0.05). However, there was no difference in thyroid function indicators and adverse reactions between two groups after treatment(P>0.05).

  CONCLUSION: The combination of teprotumumab and glucocorticoid pulse therapy for TAO has a prominent therapeutic effect. Meantime, it can more effectively control ocular inflammation, improve ocular signs and quality of life of patients, and has no obvious adverse effect on thyroid function, with controllable safety.

Clinical report

• XGboost algorithm-based risk prediction model for postoperative dry eye in glaucoma patients

  Shi Qili, Jin Can

  2026,26(7):1270-1275 ,DOI: 10.3980/j.issn.1672-5123.2026.7.27

  Abstract: (8) HTML (0) PDF (827.72 KKB)(33)

  Abstract:

  AIM:To construct a risk prediction model for postoperative dry eye in glaucoma patients using the XGBoost algorithm.

  METHODS:A retrospective analysis was performed on glaucoma patients who received surgical treatment at the hospital from July 2022 to June 2025. All patients were divided into a dry eye group and a non-dry eye group according to the occurrence of postoperative dry eye disease. Clinical data of the patients were collected, and univariate and multivariate logistic regression analyses were employed to screen out the risk factors for postoperative dry eye. The patients were randomly allocated into a training set and a validation set at a ratio of 7:3. An XGboost risk prediction model was built with the risk factors as feature variables, and the SHapley Additive exPlanations(SHAP)bar plot and beeswarm plot were used for visual interpretation of the model. The predictive efficacy of the model was evaluated via receiver operating characteristic(ROC)curve analysis.

  RESULTS:The study included 300 glaucoma patients(300 eyes). The non-dry eye group comprised 204 patients(204 eyes, 104 males and 100 females), and the dry eye group comprised 96 patients(96 eyes, 55 males and 41 females). The incidence rate of postoperative dry eye was 32.0%. Univariate analysis revealed statistically significant differences between the two groups in terms of age, comorbid diabetes, meibum viscosity grade, tear film breakup time, meibomian gland dysfunction, and operative time(all P<0.05). Multivariate logistic regression analysis showed that all the above factors were risk factors for postoperative dry eye(all P<0.01). The XGBoost model showed that these risk factors were ranked in descending order of predictive importance as: tear film breakup time, comorbid diabetes, operative time, age, meibomian gland dysfunction, and meibum viscosity grade. ROC curve analysis demonstrated that the area under the curve(AUC)of the XGboost model was 0.84(95%CI: 0.78-0.90)for the training set and 0.83(95%CI: 0.74-0.92)for the validation set, with both values showing statistical significance(both P<0.05).

  CONCLUSION:The XGboost algorithm-based risk prediction model for postoperative dry eye in glaucoma patients exhibits favorable predictive performance. It can be clinically applied to identify patients at high risk of developing postoperative dry eye, thereby facilitating targeted interventions for preventive purposes.

• Clinicopathological analysis of conjunctival lymphangiectasia

  Ran Jie, Xia Duosheng, Wang Fuli, Su Xuandi, Zheng Lele, Wang Yujin

  2026,26(7):1276-1280 ,DOI: 10.3980/j.issn.1672-5123.2026.7.28

  Abstract: (13) HTML (0) PDF (2.09 MKB)(43)

  Abstract:

  AIM: To analyze the pathological features, immunophenotype, and imaging findings of conjunctival lymphangiectasia(CL), and to explore the etiological mechanisms and provide a theoretical basis for clinical diagnosis and treatment.

  METHODS:This single-center descriptive cross-sectional study enrolled postoperative specimens from patients with CL who underwent surgical treatment in the hospital between Feb. 2023 and Sept. 2025. Routine hematoxylin and eosin(HE)staining and immunohistochemical staining(D2-40, CD31, CD34, CK)were performed. Anterior segment optical coherence tomography(AS-OCT)was used to observe the lesion morphology. The pathological results were comprehensively analyzed combined with clinical data.

  RESULTS: A total of postoperative specimens from 32 eyes of 32 patients with CL were enrolled, including 23 females(72%)and 9 males(28%), with a mean age of 53.03±12.47 y. All patients presented with single or multiple transparent cystic elevations beneath the bulbar conjunctiva. The postoperative pathological manifestations were characterized by dilation of conjunctival lymphatic vessels lined with a single layer of flattened endothelial cells, accompanied by edema and inflammatory infiltration in the surrounding stroma. All cases were positive for D2-40, confirming a lymphatic origin; some cases also expressed CD31 and CD34. AS-OCT revealed the lesions as unilocular or multilocular cystic spaces with low reflectivity. After complete surgical resection, the mean follow-up period was 16.2 mo with no recurrence.

  CONCLUSION:CL is a benign ocular surface lesion characterized by lymphatic vessel dilation. The endothelium co-expresses lymphatic and some vascular markers, suggesting that CL may belong to the spectrum of vascular malformations. AS-OCT has adjunctive diagnostic value, and surgical resection has definitive therapeutic efficacy.

• Correlation between extraocular muscle thickness and clinical activity score in thyroid-associated ophthalmopathy

  Peng Laijuan, Xu Xu, Sun Zhongxu, Zhu Peng, Meng Ke, Zhang Tao

  2026,26(7):1281-1286 ,DOI: 10.3980/j.issn.1672-5123.2026.7.29

  Abstract: (10) HTML (0) PDF (794.87 KKB)(29)

  Abstract:

  AIM: To analysis the correlation between extraocular muscle thickness measured by quantitative CT analysis of orbital structures and clinical activity score(CAS)of thyroid-associated ophthalmopathy(TAO).

  METHODS:This was a retrospective analysis, selecting clinical data of TAO patients admitted to the hospital from October 2020 to February 2025. Healthy individuals were chosen from hospital's physical examination as the control group. All participants underwent CT examination, the superior rectus muscle, inferior rectus muscle, medial rectus muscle, lateral rectus muscle, orbital area, protrusion degree, and total cross-sectional area of extraocular muscles/total orbital area ratio(OM/TOA)from the two groups of participants were compared. CAS was used to evaluate TAO patients, and the correlation between CAS score and quantitative analysis indicators of CT orbital structure was analyzed. Quantitative analysis indicators for CT orbital structure in TAO patients at different stages of activity were compared, and the predictive value of these indicators for TAO patients at different activity stages was investigated.

  RESULTS:A total of 77 TAO patients were enrolled in this study, including 38 males and 39 females, with ages ranging from 28 to 70 y(mean age 49.5±6.9 y). There were 77 cases in the control group, including 40 males and 37 females, with ages ranging from 26 to 70 y(mean age 49.0±7.3 y). There was no significant difference in gender and age between the two groups(both P>0.05). The quantitative analysis of left eye, right eye, and binocular CT orbital structure in TAO group patients showed significantly higher indicators than the control group(all P<0.001), and the CAS score of TAO group was 3.94±1.51 points. The CAS score was positively correlated with various indicators of CT orbital structure quantitative analysis(all P<0.05). According to the CAS score results, 14 cases(28 eyes)of TAO patients with a CAS score<3 were classified as inactive phase, including 8 males and 6 females, with an average age of 43.79±9.58 y. A total of 63 cases(126 eyes)with a CAS score of ≥3 was classified as active phase, including 30 males and 33 females, with an average age of 50.78±5.47 y. There was no significant difference in gender among TAO patients with different active phases(P=0.519), but there was a significant difference in age(P<0.001). The quantitative indicators of CT orbital structure in inactive patients were significantly lower than those in active patients(P<0.05). Finally, the superior rectus muscle, age, and degree of protrusion were selected to be included in the Logistic regression model. The analysis results showed that there was a correlation between the superior rectus muscle index, degree of protrusion and TAO activity phase(P<0.05), while age, and TAO activity phase showed no significant correlation(P>0.05). The ROC curve analysis results showed that the area under the curve(AUC)was 0.863, the standard error was 0.063, P<0.001, and the 95% confidence interval(95% CI)of AUC was 0.740-0.985. The sensitivity of the model prediction was 73.0%, the specificity was 92.9%, and the Youden index was 0.659. The prediction accuracy was 97.9%, the recall rate was 73.0%, and the F1 value was 0.836. The predicted optimal critical value was 0.857. The predicted probability was 0.74.

  CONCLUSION:Quantitative CT analysis of orbital structures can be used to assess disease severity in TAO patients.

• Construction of a residual astigmatism prediction model after Toric IOL implantation based on preoperative parameters

  Wang Yafei, Hou Mingjia, Wang Xiaoyan, Feng Du

  2026,26(7):1287-1292 ,DOI: 10.3980/j.issn.1672-5123.2026.7.30

  Abstract: (9) HTML (0) PDF (1.12 MKB)(33)

  Abstract:

  AIM: To explore preoperative risk factors affecting residual astigmatism after Toric intraocular lens(IOL)implantation, and construct and verify a clinically applicable prediction model.

  METHODS: This retrospective study included patients who underwent Toric IOL implantation at Puyang Oilfield General Hospital and the Second People's Hospital of Puyang City from October 2023 to August 2025. Patients were categorized into two groups according to residual astigmatism at 3 mo postoperatively: >0.25 D group and ≤0.25 D group. Preoperative clinical data and ocular parameters of the two groups were collected and compared. Multivariate Logistic regression analysis was used to screen risk factors, and a nomogram prediction model was established accordingly. Receiver operating characteristic(ROC)curve, calibration curve, and Hosmer-Lemeshow test were adopted to evaluate discrimination, calibration, and clinical applicability of the model. Bootstrap method was applied for internal validation.

  RESULTS: Totally 103 patients(103 eyes)were included, with 72 patients(72 eyes)in the group with residual astigmatism ≤0.25 D, including 38 males and 34 females, with an average age of 67.35±6.12 y; There were 31 cases(31 eyes)in group with residual astigmatism >0.25 D, including 19 males and 12 females, with an average age of 69.87±6.45 y. The proportion of patients with a history of diabetes, as well as the values for axial length, horizontal corneal diameter, flat corneal curvature(K1), steep corneal curvature(K2), astigmatic axis and proportion of lens nuclear hardness grade III-IV were significantly higher in the residual astigmatism group >0.25 D than those in the residual astigmatism ≤0.25 D group(all P<0.05). Multivariate analysis identified increased horizontal corneal diameter, higher K1 value, higher K2 value, and higher lens nuclear hardness(grade III-IV)as independent risk factors for postoperative residual astigmatism >0.25 D(all P<0.05). The nomogram constructed from these factors demonstrated that the area under the ROC curve(AUC)was 0.794, with a sensitivity of 80.31% and a specificity of 75.20%. The concordance index(C-index)of internal validation was 0.865. Calibration curve and Hosmer-Lemeshow test(χ²=5.231, P=0.734)indicated good consistency between predicted and actual values of the model.

  CONCLUSION: The nomogram model established based on horizontal corneal diameter, K1, K2 and lens nucleus hardness exhibits favorable predictive performance. It can effectively predict the risk of residual astigmatism prior to Toric IOL surgery, providing reference for individualized clinical surgical planning.

• Peripheral microstructure designed spectacles for myopia control in children

  Yang Min, Huang Zaihong, Li Liwen, Yang Sihao, Mou Weiqi, Tang Xiuping

  2026,26(7):1293-1298 ,DOI: 10.3980/j.issn.1672-5123.2026.7.31

  Abstract: (13) HTML (0) PDF (619.92 KKB)(35)

  Abstract:

  AIM:To evaluate the clinical efficacy of three types of spectacle lenses with different peripheral microstructure designs in controlling myopia progression among children.

  METHODS: Retrospective case analysis was conducted. Children diagnosed with myopia aged 6 to 12 y who were received initial spectacle fitting and completed 1-year follow-up at the Optometry Clinic of Suining Central Hospital between January 2023 and August 2024 were enrolled. Only right eye data of all subjects were included for analysis. Based on the type of spectacle lenses independently selected by the children and their parents/guardians, they were divided into four groups: diffusion optics technology(DOT), cylindrical annular refractive element(CARE), highly aspherical lenslets(HAL), and single-vision lenses(SVL). Changes in axial length(AL)and spherical equivalent(SE)from baseline were observed after 1-year lens wear in four groups. Variations between three peripheral microstructure-designed spectacles and single-vision spectacles were compared. The effects of different lens designs on spherical power, astigmatism, corneal curvature, corneal astigmatism, anterior chamber depth, lens thickness, and vitreous cavity depth were analyzed.

  RESULTS:In this retrospective study, a total of 118 eyes from 118 myopic children were included. There were 28 eyes in 28 children in DOT group \〖16 males and 12 females, age 10(9, 12)y\〗. CARE group contained 26 eyes in 26 children, \〖12 males and 14 females, age 11(9, 12)y\〗. HAL group had 26 eyes in 26 children \〖16 males and 10 females, age 10(9, 11)y\〗. SVL group included 38 eyes in 38 children \〖20 males and 18 females, age 11(9, 12)y\〗. There were no significant differences in age, gender, baseline AL, or SE among the four groups(all P>0.05). After 1-year wearing, no increase and slight regression were observed in AL and SE in the DOT group, with no significant differences compared with baseline(all P>0.05). AL and SE increased to varying degrees in the CARE, HAL and SVL groups(all P<0.01). Significant inter-group differences were found in the changes of AL and SE(F=22.820, 30.949, both P<0.001). The mean changes in AL and SE for the DOT group(-0.034±0.180 mm, 0.040±0.243 D)were significantly smaller than those in the CARE group(0.225±0.174 mm, -0.375±0.308 D)and the HAL group(0.147±0.130 mm, -0.255±0.256 D). The changes of AL and SE in the three groups were significantly lower than those in the SVL group(0.355±0.240 mm, -0.891±0.592 D)(all P<0.05).

  CONCLUSION: In children, short-term wear of spectacles with peripheral microstructural design demonstrates better myopia control efficacy compared to single-vision spectacles. DOT lenses show superior short-term efficacy compared with CARE and HAL lenses.

• Evaluation on clinical curative effect of amniotic membrane transplantation combined with recombinant human epidermal growth factor in patients with corneal alkaline burns

  duqian, zhangle, yujianmi, zhangyang

  Abstract:

  Objective The aims of this study was to evaluate clinical curative effect of amniotic membrane transplantation combined with recombinant human epidermal growth factor (rhEGF) in patients with corneal alkaline burns. Methods A total of 110 patients (110 eyes) with corneal alkaline burns treated in the hospital were enrolled between November 2022 and November 2021. After emergency treatment, they were divided into combined treatment group (55 eyes) and routine treatment group (55 eyes) by random number table method. The routine treatment group was given basic treatment (including rhEGF), while combined treatment group was given amniotic membrane transplantation on basis of routine treatment group. The clinical curative effect, healing time of corneal epithelium, best corrected visual acuity, VAS scores, corneal neovascularization area, break-up time, score of corneal opacity and levels of inflammatory factors (IL-6, hs-CRP, TNF-α) were observed. Results The total response rate of combined treatment group was significantly higher than that of routine treatment group [94.55% (52/55) vs 81.82% (45/55), P<0.05]. After treatment, healing time of corneal epithelium in combined treatment group was significantly shorter than that in routine treatment group (P<0.05), and VAS score was significantly lower than that in routine treatment group (P<0.05). The corneal neovascularization area in combined treatment group was significantly smaller than that in routine treatment group (P<0.05), break-up time was significantly longer than that in routine treatment group (P<0.05), and score of corneal opacity was significantly lower than that in routine treatment group (P<0.05). After treatment, levels of inflammatory factors in combined treatment group were significantly lower than those in routine treatment group (P<0.05). Conclusion The clinical application advantages of amniotic membrane transplantation combined with rhEGF is significant in patients with corneal alkaline burns, which can improve curative effect, accelerate wound healing, relieve pain, reduce corneal neovascularization, prolong break-up time, alleviate corneal opacity and reduce levels of inflammatory factors, with good clinical application value.

• Research Progress on the Application of Virtual Reality Technology in Amblyopia Visual Training

  WANGkang, WANG qiao, LI pengfei, ZHANGyunfan, QINzifan, LI jing

  Abstract:

  Amblyopia treatment has shifted from improving monocular visual acuity to restoring binocular visual function as understanding of interocular suppression and visual cortical plasticity has deepened. Conventional approaches, including patching and routine visual training, are limited by long treatment courses, low engagement, and poor adherence. Virtual reality (VR) provides immersive interaction, precise dichoptic separation, and adjustable stimulus parameters, and has therefore been increasingly applied to amblyopia rehabilitation. Current evidence suggests that VR-based training can improve visual acuity, stereopsis, and some aspects of binocular visual function, while its gamified and feedback-driven design may also enhance motivation and adherence. This review summarizes the mechanisms and theoretical basis of VR training for amblyopia, its advantages over conventional methods, current systems and training modes, clinical efficacy, commonly used outcome measures, safety, and acceptability, aiming to support the standardized development and clinical translation of VR-based visual training.

• The Dual Regulatory Role of Müller Glial Cells in Glaucoma and Its Potential for Targeted Therapy

  Sun Weihua, Huang Xiaojuan

  Abstract:

  The core pathological process of optic neuropathy caused by glaucoma is the progressive loss of retinal ganglion cells (RGCs). As the primary glial cells in the retina, Müller glial cells play a crucial and complex dual regulatory role in the pathological microenvironment of glaucoma. On one hand, Müller cells can exert endogenous protective effects by secreting neurotrophic factors, enhancing RGC viability through co-culture, and regulating glutamate metabolism. On the other hand, under sustained stress such as elevated intraocular pressure, Müller cells are activated by mechanosensitive channels (e.g.,TRPV4), transforming into a reactive gliosis phenotype. This leads to the release of inflammatory cytokines that exacerbate RGC apoptosis, while their metabolic reprogramming and epigenetic alterations also contribute to the process of neuronal injury. This article systematically reviews the research progress on the dual roles of Müller cells in protecting and damaging the optic nerve in glaucoma, exploring new therapeutic strategies for neuroprotection by regulating their cellular states. It outlines the main controversies and unresolved issues in this field and, based on the latest research advances, analyzes the implications of targeting Müller cells for current clinical treatments and future development trends.

• Recent advances on the role of various derived exosomes on corneal diseases

  QueZongrun, Qianshang He

  Abstract:

  The cornea, a transparent tissue essential for refractive function and visual quality, is vulnerable to injury and disease that can impair vision or cause blindness. Conventional therapies—topical drugs and transplantation—are constrained by immune rejection, donor shortages, and limited long?term efficacy. Exosomes, nano?sized extracellular vesicles carrying proteins, lipids, mRNAs, miRNAs, and other bioactive molecules, combine low immunogenicity and excellent biocompatibility with targeted delivery and sustained modulation of inflammation and tissue repair. Consequently, they present a promising strategy to overcome the limitations of traditional corneal treatments. This review synthesizes recent advances in exosome sources, mechanisms, and therapeutic applications for corneal wound healing, immunomodulation, and disease management, with the aim of informing standardized preclinical and clinical translation.

• Research progress of Perfluorohexyloctane Eyedrop in Dry Eye Disease Associated with Meibomian Gland Dysfunction

  YuHongyue, SunBin, LiYan, LiXiaodan, XinMeng

  Abstract:

  Dry eye disease (DED) is a multifactorial ocular surface disorder characterized by the loss of tear film homeostasis. Dry eye associated with meibomian gland dysfunction (MGD) accounts for up to 86% of all DED cases, and traditional drugs fail to effectively target this core pathological mechanism. As a new type of anhydrous and preservative-free eye drops approved by the FDA, perfluorohexyloctane has a unique amphiphilic structure, which can form an artificial lipid monolayer at the air-liquid interface of the tear film. It exerts its therapeutic effects by inhibiting tear evaporation, stabilizing the tear film, unclogging meibomian gland orifices, and promoting corneal oxygen supply. This drug can not only serve as a first-line treatment option for evaporative dry eye but also be combined with other drugs for personalized treatment of complex cases. In this review, we summarized the mechanism of action, pharmacological properties, clinical efficacy, and safety of perfluorohexyloctane eye drops, and further elaborate on its application value in complex types of dry eye and patients with other concurrent ocular surface diseases, aiming to provide more evidence support for the precise treatment of DED.

• Application Value of Contrast-Enhanced Ultrasound Time Parameters in the Typing Diagnosis of Choroidal Space-Occupying Lesions

  Wanting Jiang, Na Yuan, Lingmin Li, Jianhong Wang

  Abstract:

  Objective: To evaluate the application value of contrast-enhanced ultrasound (CEUS) time parameters in the typing diagnosis of choroidal space-occupying lesions. Methods: A total of 120 patients with choroidal space-occupying lesions who underwent CEUS at Xi"an People"s Hospital (Xi"an Fourth Hospital) from June 2020 to January 2024 were selected. Based on the final clinical and pathological diagnoses, patients were divided into three groups: benign (choroidal hemangioma), malignant (choroidal melanoma), and hemorrhage (subchoroidal hemorrhage), with 40 cases in each group. The characteristics of CEUS, contrast parameters (such as time to fill, time to peak, and washout time), and the incidence of adverse reactions were analyzed to evaluate the diagnostic efficacy. Results: The benign group showed homogeneous high perfusion, presenting a "fast-in and slow-out" perfusion mode. The malignant group predominantly showed heterogeneous high perfusion, presenting a "fast-in and fast-out" perfusion mode. The hemorrhage group showed no significant perfusion, presenting a "no-in and no-out" perfusion mode. Significant differences were found in the CEUS characteristics and parameters among the three groups, while there was no significant difference in the incidence of adverse reactions. Conclusion: CEUS can significantly improve the diagnostic accuracy of choroidal space-occupying lesions, providing important reference value for clinical practice and demonstrating a high safety profile.

• Incidence and Risk Factors of Retinopathy of Prematurity in Sichuan Province

  liziyuan

  Abstract:

  Objective:To investigate the current incidence of retinopathy of prematurity (ROP) in Sichuan Province and analyze its associated risk factors, providing a scientific basis for establishing and improving the regional ROP screening and prevention system. Methods: A retrospective study was conducted on 861 premature infants who underwent fundus screening at the Departments of Ophthalmology and Neonatology of Sichuan Provincial Maternity and Child Health Care Hospital from January 1, 2017, to February 10, 2025. The incidence of ROP was calculated. Clinical characteristics were compared between the ROP and non-ROP groups. Multivariate logistic regression was used to analyze risk factors for ROP. Results:This study included a total of 861 preterm infants, with 445 males (51.7%) and 416 females (48.3%).Among the infants, 166 were diagnosed with ROP,resulting in an incidence rate of 19.3%.The mean gestational age of the ROP and non-ROP groups was 30.24 ± 2.20 weeks and 33.06 ± 1.90 weeks, respectively, while the mean birth weight was 1438.94 ± 389.66 g and 1977.32 ± 438.68 g, respectively. The differences between the two groups were statistically significant (both P＜0.01).Univariate analysis identified the following factors associated with ROP occurrence: younger gestational age, low birth weight, history of oxygen therapy, respiratory distress syndrome, intracranial hemorrhage, neonatal anemia, bronchopulmonary dysplasia, patent ductus arteriosus, and septicemia(all P＜0.05). Multivariate logistic regression analysis revealed that gestational age (OR=0.685,95%CI:0.592-0.792,P＜0.01), birth weight(OR=0.999,95%CI:0.998-0.999,P＜0.01), and respiratory distress syndrome (OR=2.312,95%CI:1.313-4.070,P＜0.01) were independent risk factors for ROP. Gestational age had the greatest impact, with younger age correlating with higher ROP risk. Conclusions:The incidence of ROP in Sichuan Province is relatively high compared to multicenter results from mainland China. Significant risk factors include younger gestational age, low birth weight, and respiratory distress syndrome. Screening, prevention, and treatment systems for ROP should be established and optimized based on regional epidemiological data and standardized screening criteria.

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

  Rui-Bo Zhao, Jian-Jun Li

  Abstract: (17560) HTML (0) PDF (225.96 KKB) (2381)

  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.

  • 1
• 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: (17014) HTML (0) PDF (537.47 KKB) (2015)

  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.

  • 1
• Selection of intraocular lens calculation formula for cataract surgery in glaucoma patients

  He-Lin Zhu, Jian Zhang, Hong Yan

  Abstract: (15671) HTML (0) PDF (465.56 KKB) (1870)

  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.

  • 1
• Current situation and prospect of minimally invasive glaucoma surgery in childhood glaucoma

  Xiao-Jie Zhou, Ren-Yi Wu

  Abstract: (13273) HTML (0) PDF (480.93 KKB) (2236)

  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.

  • 1
• 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: (13135) HTML (0) PDF (551.33 KKB) (1856)

  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.

  • 1
• 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: (12401) HTML (0) PDF (435.98 KKB) (1997)

  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.

  • 1
• Risk factors associated with neovascular glaucoma after vitrectomy for proliferative diabetic retinopathy

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

  Abstract: (12238) HTML (0) PDF (1.96 MKB) (2377)

  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.

  • 1
• Surgery management and progress of familial exudative vitreoretinopathy associated retinal detachment

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

  Abstract: (12075) HTML (0) PDF (475.18 KKB) (1943)

  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.

  • 1
• 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: (12017) HTML (0) PDF (498.90 KKB) (2000)

  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.

  • 1
• 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: (10254) HTML (0) PDF (433.14 KKB) (1961)

  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.

  • 1
• 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: (10089) HTML (0) PDF (493.57 KKB) (2154)

  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.

  • 1
• 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: (9417) HTML (0) PDF (1.17 MKB) (2256)

  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.

  • 1
• Recent advances in treatment of retinitis pigmentosa

  Ming Ai, Ming Sun, Dai Li

  Abstract: (9300) HTML (0) PDF (412.02 KKB) (2432)

  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.

  • 1
• 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: (9228) HTML (0) PDF (470.25 KKB) (2033)

  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.

  • 1
• 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: (9017) HTML (0) PDF (1.47 MKB) (2438)

  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.

  • 1
• 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: (8991) HTML (0) PDF (936.23 KKB) (2268)

  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.

  • 1
• 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: (8929) HTML (0) PDF (467.79 KKB) (2116)

  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.

  • 1
• Research advances in contact lens associated bacterial keratitis

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

  Abstract: (8902) HTML (0) PDF (512.03 KKB) (2072)

  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.

  • 1
• 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: (8858) HTML (0) PDF (1.78 MKB) (2026)

  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.

  • 1
• Research progress on corneal nerves and substance P in viral keratitis

  Yi Mu, Hong Zhang

  Abstract: (8755) HTML (0) PDF (490.87 KKB) (1984)

  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.

  • 1