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

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Congenital Ectopia Lentis: Advances in Basic and Clinical Research

liu xiao min, zhou jian

Abstract:

Congenital ectopia lentis (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. Furthermore, we propose a clinically oriented stratified diagnostic framework aimed at improving early recognition and systemic risk management.
Clinical study on the treatment of wet age-related macular degeneration with modified and ranibizumab of Zhujing prescription

GAORUI

Abstract:

Objective: To analyze the efficacy of wet age-related macular degeneration (wAMD) in combination with ranibizumab (IVR) injection and modified Zhujing formula. Methods: The research subjects were 60 patients with wAMD in the ophthalmology department of Yulin Hospital of Traditional Chinese Medicine from September 2022 to October 2024. The research subjects were divided into the experimental group and the control group according to the random number table method. The control group (n=30) was treated with IVR, while the experimental group (n=30) was treated with modified Zujingfang on the basis of 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: The clinical efficacy of the experimental group (96.67%) was higher than that of the control group (76.67%) (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 (P<0.05). After treatment, the EDV and PSV in the experimental group were both higher than those in the control group (P<0.05). After treatment, the BCVA, CRT, macular hemorrhage area, CNV and RI of the experimental group were all lower than those of the control group (P<0.05), and the 1-year recurrence rate in the experimental group (3.33%) was lower than that in the control group (26.67%) (P<0.05). Conclusion: The modified Zujingfang combined with ranibizumab can effectively alleviate symptoms such as blurred vision and fundus hemorrhage in patients with wAMD, improve visual acuity and ocular hemodynamics, and reduce the recurrence rate, with remarkable effects.
Efficacy of Multi-segment Spectacle Lenses for myopia control in children and adolescents

yang min, Huang zaihong, li liwen, yang sihao, mou weiqi, tang xiu ping

Abstract:

Objective To evaluate the clinical effect of three Multi-segmentspectaclelenses with different designs in controlling myopia progression in children and adolescents. Methods This study employed a retrospective case analysis. Children and adolescents diagnosed with myopia who were fitted with spectacle lenses at the Optometry Clinic of Suining Central Hospital between January 2023 and August 2024 and completed a one-year follow-up were enrolled. Participants were categorized into four groups based on the lens design: 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) after one year of wear were compared to baseline values. Furthermore, alterations in AL and SE among the three Multi-segment lens groups were compared against the SVL group. The effects of different design spectacles lenses on refractive, astigmatism, corneal curvature, corneal astigmatism, anterior chamber depth, lens thickness and vitreous cavity depth were also analyzed. Results In this retrospective study, a total of 118 eyes from 118 myopic children were included.The DOT group (28 eyes; age 10 [9, 12]; 16 males and 12 females), the CARE group (26 eyes; age 11 [9, 12]; 12 males and 14 females), the HAL group (26 eyes; age 10 [9, 11]; 16 males and 10 females), and the SVL group (38 eyes; age 11 [9, 12]; 20 males and 18 females).There were no significant differences in age, gender, baseline AL, or SE among the four groups (all P > 0.05). After 1 year of wear, there were no significant differences in AL and SE compared to baseline in the DOT group (all P > 0.05), with AL showing no increase but a slight regression, and SE showing no progression but a mild regression. In contrast, both AL and SE increased to varying degrees in the CARE, HAL, and SVL groups compared to baseline (all P < 0.01). Significant inter-group differences were found in the changes of AL and SE(F=22.820, P＜0.001; F=30.949, P＜0.001, respectively). The mean changes in AL and SE for the DOT group(-0.034±0.180mm, 0.040±0.243D) were significantly smaller than those in the CARE group(0.225±0.174mm, -0.375±0.308D) and the HAL group(0.147±0.130mm, -0.255±0.256D). All three Multi-segment groups exhibited significantly less progression than the SVL group(0.355±0.240mm,-0.891±0.592D)(P＜0.05). Conclusion For children and adolescents, Multi-segment spectacles lenses are more effective than single-vision spectacle lenses in preventing myopia progression . Among the tested designs, DOT spectacle lenses demonstrated superior efficacy in controlling myopia in children compared to CARE and HAL spectacle lenses.
A Risk Prediction Model for Postoperative Dry Eye Disease in Glaucoma Patients Based on the XGBoost Algorithm

Shi Qili

Abstract:

Objective： To construct a reliable risk prediction model for postoperative dry eye disease (DED) in glaucoma patients using the XGBoost algorithm. Methods：A retrospective analysis was performed on 300 glaucoma patients who received surgical treatment at our hospital from July 2022 to June 2025. All patients were divided into a DED group and a non-DED 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 independent risk factors for postoperative DED. The patients were randomly allocated into a training set (210 cases) and a validation set (90 cases) at a ratio of 7:3. An XGBoost risk prediction model was built with the identified independent 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： Among the 300 glaucoma patients (300 eyes), 96 developed postoperative DED, resulting in an incidence rate of 32.00%. The non-DED group comprised 204 patients (204 eyes) (104 males and 100 females), and the DED group comprised 96 patients (96 eyes) (55 males and 41 females). Univariate analysis revealed statistically significant differences between the DED and non-DED 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 confirmed that all the above factors were independent risk factors for postoperative DED (all P＜0.05). The XGBoost model showed that these independent 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 (all P＜0.05). Conclusion： The XGBoost risk prediction model established in this study exhibits favorable predictive performance for postoperative DED in glaucoma patients. This model can be clinically applied to accurately identify high-risk patients with postoperative DED, and provide a reliable theoretical basis for clinicians to implement targeted preventive and interventional measures, thus optimizing the perioperative eye surface management of glaucoma patients.
Relationship between serum Ficolin-3, SFRP5 levels and diabetic retinopathy in patients with type 2 diabetes mellitus

Dou Runpeng

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Objective: To explore the relationship between serum Ficolin-3 and secreted frizzled related protein 5 (SFRP5) levels and diabetic retinopathy (DR) in patients with type 2 diabetes mellitus (T2DM). Methods: From May 2023 to May 2025, 108 T2DM patients with concurrent DR admitted to our hospital were included as the DR group and separated into non proliferative group and proliferative group Complying with the severity of DR. Another 108 patients with T2DM alone during the same period were included as the T2DM group. ELISA was used to detect the levels of Ficolin-3 and SFRP5. Pearson method was performed to analyze the correlation between serum Ficolin-3, SFRP5 levels and inflammatory markers in the DR group. Logistic method was performed to explore the relevant influencing factors. Moreover, ROC curve was performed to explore the diagnostic value of serum Ficolin-3 and SFRP5 for concurrent DR in T2DM patients. Results: The DR group had higher serum Ficolin-3, TNF-α, and IL-6 (P<0.05), and lower SFRP5 than the T2DM group (P<0.05). The proliferative group had higher serum Ficolin-3, TNF-α, and IL-6 (P<0.05), and lower SFRP5 than the non proliferative group (P<0.05). Complying with Pearson correlation analysis, serum Ficolin-3 was negatively correlated with SFRP5 (P<0.05), and both were related to TNF-α and IL-6 (P<0.05). 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 (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 DR in T2DM patients 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: T2DM patients with concurrent DR have abnormal expression of serum Ficolin-3 and SFRP5 levels. Both are influencing factors of DR, and combined detection can improve the diagnostic value for DR in T2DM patients.
Research Progress on the Neuroimmune Mechanisms of Itch in Allergic Conjunctivitis: A New Perspective from Sensory Neurons to Immune Regulation

mayuhua, zhanglu, panjunyang, wuchunli, niedinghuan, wangyanting, pengao, manan

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 the PI3K/AKT/eNOS/NO Signaling Pathway Promoting Choroidal Thickening in Myopia through Repeated Low-Intensity Red Light Therapy (RLRL)

lihui, zhuqin, humin

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 axis in RLRL-induced effects，specifically its mediation of endothelial nitric oxide synthase (eNOS) phosphorylation to promote choroidal thickening. Choroidal thickening is recognized as a critical mechanism in controlling myopia. Activation of the PI3K/AKT/eNOS/NO signaling pathway may attenuate axial elongation by enhancing choroidal blood flow and nutrient supply. Although preliminary preclinical and clinical studies support this mechanism,numerous unanswered questions remain, such as the underlying 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 elucidate the potential applications of RLRL in myopia prevention and control.
Neuroimmune Mechanisms and Perioperative Management Strategies for Dry Eye After Cataract Surgery

wangxuejiao, Yufangliang

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Postcataract surgery dry eye (PCSDE) is a common complication with an incidence of 9.2%-72.6%, and approximately 20% of patients experience persistent 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, encompassing surgical variables (incision design, duration, technique), patient-related factors (age, meibomian gland function, systemic diseases, psychological status), and perioperative management (drug toxicity, disinfectant use). Additionally, we synthesize recent clinical evidence to propose comprehensive prevention and treatment strategies, including preoperative optimization of ocular surface conditions, intraoperative ocular surface protection techniques, and personalized postoperative regimens. 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 theoretical updates and practical guidance to enhance visual quality and patient satisfaction in refractive cataract surgery.
Stimuli-responsive ocular drug delivery strategies: latest advances and future prospects

nixisen, lixiumiao, zhoulujia, caoguofan

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 high invasive risks associated with intravitreal injections constitute persistent bottlenecks in ophthalmic therapeutics. However, driven by the convergence of materials science and biomedical engineering, intelligent drug delivery systems (SDDS) based on stimulus-responsive mechanisms offer revolutionary strategies for overcoming these physiological barriers and achieving spatiotemporally controlled drug release. These systems leverage specific recognition and response capabilities toward 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 stimulus-responsive carriers from the perspectives of polymer phase transition thermodynamics and chemical bond cleavage kinetics. Synthesizing preclinical and clinical research data on major ocular diseases—including glaucoma, age-related macular degeneration (AMD), and intraocular infections—we demonstrate the significant advantages of these intelligent systems. Key benefits highlighted include prolonged ocular surface retention, biomarker-triggered on-demand release, and reduced systemic toxicity. Finally, this review critically analyzes the challenges facing these complex formulations regarding sterile scale-up manufacturing, regulatory approval pathways, and clinical translation, while offering perspectives on future development.

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

Rui-Bo Zhao, Jian-Jun Li

Abstract: (17538) HTML (0) PDF (225.96 KKB) (2311)

Abstract:

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

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

Abstract: (16981) HTML (0) PDF (537.47 KKB) (1947)

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AIM: To explore the effects of anti-vascular endothelial growth factor(VEGF)agents(Conbercept)before pars plana vitrectomy(PPV)on inflammatory cytokine levels of patients with proliferative diabetic retinopathy(PDR).
METHODS: A total of 49 patients(49 eyes)who diagnosed with PDR at the First Affiliated Hospital with Nanjing Medical University from June 2017 to January 2018 were recruited and randomly divided into two groups. A total of 25 cases(25 eyes)who did not receive intravitreal injection before PPV were included in no-intravitreal injection of Conbercept(IVC)group, and 24 cases(24 eyes)who received IVC 5～7d before PPV were included in IVC group. The vitreous samples were collected from all the patients at the start of PPV. Levels of VEGF-A, monocyte chemotactic protein-1(MCP-1)and inflammatory cytokines in the vitreous humor were measured using Luminex technology.
RESULTS: Compared with the no-IVC group, the level of VEGF-A decreased significantly(P<0.001), the concentration of IL-6(P=0.004), IL-8(P=0.002), IL-18(P=0.04)and TNF-α(P=0.03)increased remarkably in the IVC group. The other inflammatory cytokines in the vitreous humor showed no significant difference between the IVC and no-IVC groups.
CONCLUSION: IVC before PPV can effectively decrease the concentration of VEGF-A, but had limited influence on the level of inflammatory cytokines in the vitreous humor of patients with PDR.
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Selection of intraocular lens calculation formula for cataract surgery in glaucoma patients

He-Lin Zhu, Jian Zhang, Hong Yan

Abstract: (15660) HTML (0) PDF (465.56 KKB) (1806)

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

Xiao-Jie Zhou, Ren-Yi Wu

Abstract: (13241) HTML (0) PDF (480.93 KKB) (2150)

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

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

Abstract: (13114) HTML (0) PDF (551.33 KKB) (1781)

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AIM: To evaluate the clinical efficacy of femtosecond laser-assisted cataract surgery combined with PanOptix trifocal intraocular lens implantation.
METHODS:The retrospective study enrolled 22 cases(26 eyes)of cataract patients who underwent femtosecond laser-assisted cataract surgery combined with PanOptix trifocal intraocular lens implantation from August 2020 to August 2021. Follow-up to 3mo after surgery, the changes of far, intermediate and near visual acuity, aberration, Strehl ratio(SR)and modulation transfer function cutoff(MTF-cutoff)frequency were compared. Defocus curve at 1mo postoperatively was made, and the visual quality and satisfaction were evaluated after 3mo of surgery.
RESULTS: The visual acuity of all patients was better than 0.1(LogMAR)at the far, intermediate and near distance at 1d, 1wk, 1 and 3mo postoperatively, and it was significantly improved compared with those before surgery(all P<0.01). The defocus curve transitioned smoothly between +0.5 and -3.0D at 1mo after surgery, and visual acuity was better than 0.63. The total aberration and spherical aberration in the whole eye were significantly lower after surgery than before, and the SR and MTF-cutoff were significantly improved at 1d and 1wk after surgery(all P<0.05). With high satisfaction and good visual quality, patients could watch at far, intermediate and near distance without wearing glasses at 3mo after surgery.
CONCLUSION: Femtosecond laser-assisted cataract surgery combined with PanOptix trifocal intraocular lens implantation gave patients a comfortable and satisfactory full-course vision.
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Pars plana vitrectomy combined with inverted internal limiting membrane flap technique for treating macular hole retinal detachment in high myopia

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

Abstract: (12391) HTML (0) PDF (435.98 KKB) (1890)

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AIM: To investigate the clinical efficacy of pars plana vitrectomy(PPV)combined with inverted internal limiting membrane flap technique in the treatment of macular hole retinal detachment(MHRD)in high myopia.
METHODS: A retrospective clinical study was conducted. A total of 63 patients(64 eyes)with high myopia and MHRD who treated at our hospital from October 2017 to October 2021 were selected as research subjects. They were divided into two groups according to different surgery, with 34 cases(35 eyes)who received PPV combined with inverted internal limiting membrane flap technique in group A, and 29 cases(29 eyes)received PPV combined with internal limiting membrane peeling in group B. The patients were followed up for 6mo. The two groups were compared in terms of the hole closure rate, the reduction rate of retinal detachment and best corrected visual acuity(BCVA)before operation and at 1wk, 1, 3 and 6mo after operation, and the postoperative complications were recorded.
RESULTS: The hole closure rate within 6mo after operation was significantly higher in group A than in group B(P<0.05), but there was no statistically significant difference in the reduction rate of retinal detachment(P>0.05). The BCVA of the two groups was significantly improved over time after operation(P<0.05). There was no statistically significant difference in BCVA between the two groups before operation and at 1wk, 1, 3 and 6mo after operation(P>0.05). Complications were observed in the two groups, but there was no statistically significant difference in the incidence of complications between the two groups(P<0.05).
CONCLUSION: PPV combined with inverted internal limiting membrane flap technique is safe and effective in the treatment of MHRD in high myopia, which can effectively improve the patients' BCVA and the hole closure rate without influence on intraocular pressure.
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Risk factors associated with neovascular glaucoma after vitrectomy for proliferative diabetic retinopathy

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

Abstract: (12223) HTML (0) PDF (1.96 MKB) (2289)

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AIM: To investigate the risk factors associated with neovascular glaucoma(NVG)after pars plana vitrectomy(PPV)for proliferative diabetic retinopathy(PDR).
METHODS: The PDR patients who received 23G PPV treatment at Shenyang He Eye Specialist Hospital from October 2015 to September 2020 and were followed up for at least 12mo with complete data were retrospectively collected. The patients were divided into two groups according to the occurrence of NVG during follow-up. The preoperative and intraoperative variables between two groups were compared. The cumulative hazard ratio for NVG was evaluated.
RESULTS: A total of 151 PDR patients(169 eyes)with a mean follow-up of 18.07±12.55(1～79)mo were included, of which 30(17.8%)eyes developed NVG, the mean time of occurrence was 6.27±4.01(1～17)mo, and 50%(15 eyes)of NVG occurred within 5mo after vitrectomy. The cumulative hazard ratios of NVG at postoperative 3, 6 and 12mo were 4.8%, 12.6% and 18.1%, respectively. Multivariate logistic regression analysis showed that preoperative best corrected visual acuity(OR=3.077, 95%CI: 1.203～7.869, P=0.019), preoperative iris rubeosis(OR=7.897, 95%CI: 1.313～47.498, P=0.024), and contralateral NVG(OR=22.108, 95%CI: 1.562～312.861, P=0.022)were risk factors with the occurrence of NVG, while the number of intraoperative retinal laser photocoagulation(OR=0.772, 95%CI: 0.666～0.893, P=0.001)was the protective factor with the occurrence of NVG.
CONCLUSIONS: The incidence of NVG in PDR eyes after PPV was 17.8%, of which 50% occurred within 5mo after surgery. PDR eyes with poor baseline visual acuity, iris rubeosis, and contralateral NVG are prone to postoperative NVG, and sufficient intraoperative retinal laser photocoagulation has a certain protective effect. PDR eyes after PPV should be closely followed up for 1a.
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Surgery management and progress of familial exudative vitreoretinopathy associated retinal detachment

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

Abstract: (12037) HTML (0) PDF (475.18 KKB) (1891)

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Familial exudative vitreoretinopathy(FEVR)is a hereditary disorder of retinal angiogenesis, of which the most typical clinical feature is the peripheral avascular area. The progression of the disease can lead to retinal detachment(RD), followed by secondary complications such as cataracts, glaucoma, corneal opacification, and even bulbi phthisis. As one of the main reasons for the RD in Asian children and juvenile, FEVR-associated retinal detachment(FEVR-RD)is mainly treated by surgery, including pars plana vitrectomy, scleral bucking, and combined with retinal photocoagulation or anti-vascular endothelial grouth factor(VEGF)sometimes. The surgery of FEVR-RD requires careful pre/intra-operative evaluation to determine the best surgical procedure and its outcome, including the nature of the affected eye, the stage, the fibrosis of fiber proliferation and the anterior complications, and the anatomy and prognosis of eyes in different stages vary greatly. Adult patients with rhegmatogenous RD have a higher rate of post-operative retina reattachment compared to young patients with tractional RD. In young or advanced patients, surgery is difficult and the prognosis is less optimistic, thus the surgery strategy is controversial. This article reviews the surgical outcomes and progress of FEVR-associated RD.
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Expression of CTRP9 in serum of patients with diabetic retinopathy and diabetic macular edema

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

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AIM: To investigate the expression and correlation of C1q/tumor necrosis factor related protein 9(CTRP9)levels in the serum of patients with different stages of diabetic retinopathy(DR)and diabetic macular edema(DME).METHODS: A total of 135 patients with type 2 diabetes who were admitted to Gansu Provincial Hospital from April 2021 to April 2022 were selected as the experimental group. According to the results of non-mydriatic fundus photography, they were divided into non-DR(NDR)group(n=45), non-proliferative DR(NPDR)group(n=45), proliferative DR(PDR)group(n=45); according to the results of optical coherence tomography, DR patients were divided into DME group(n=51), non-DME group(n=39). In addition, other 45 healthy subjects who matched the age and sex of the experimental group were selected as normal control group. The clinical data and biochemical index test results of subjects in each group were recorded and compared, the correlation between serum CTRP9 level and other biochemical indexes was analyzed, and the risk factors affecting the occurrence of DR and DME were explored.RESULTS: There were significant differences in serum CTRP9 levels among subjects in normal control group, NDR group, NPDR group and PDR group(P&#x003C;0.001), and normal control group &#x003E; NDR group &#x003E; NPDR group &#x003E; PDR group. There was significant difference in serum CTRP9 level between DME group and non-DME group(P&#x003C;0.001), and non-DME group &#x003E; DME group. Spearman rank correlation analysis showed that the level of serum CTRP9 in DR patients was negatively correlated with the course of diabetes(rs=-0.251, P&#x003C;0.05), the level of serum CTRP9 in DME patients was negatively correlated with fasting blood glucose(FBG)(rs=-0.370, P&#x003C;0.05)and glycosylated hemoglobin(HbA1c)(rs=-0.421, P&#x003C;0.05). Logistic multivariate regression analysis showed that the course of diabetes(OR=1.194, 95%CI: 1.068～1.335,P=0.002)and the level of serum CTRP9(OR=0.936, 95%CI: 0.907～0.966,P&#x003C;0.001)were risk factors for DR. The level of serum CTRP9 was a risk factor affecting the occurrence of DME(OR=0.838, 95%CI: 0.778～0.903, P&#x003C;0.001).CONCLUSION: The reduction of CTRP9 level is a risk factor for the occurrence of DR and DME, which may be of great significance to the risk assessment of both DR and DME.
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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: (10231) HTML (0) PDF (433.14 KKB) (1891)

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AIM: To measure the indexes including postoperative distance, middle, near visual acuity and near stereopsis vision of patients with high myopia cataract and corneal astigmatism by femtosecond laser, which can quantify the diameter of capsulorhexis opening, and to evaluate the availability and necessity of Toric intraocular lenses(IOL)in high myopia.
METHODS: Prospective case-control study. Patients with binocular high myopia cataract and corneal astigmatism who undergone femtosecond laser-assisted cataract surgery in our hospital were selected, and they were divided into two groups, with 20 cases(40 eyes)in group A(Toric IOL)and 20 cases(40 eyes)in group B(IQ IOL). Indexes, including preoperative corneal astigmatism and spherical equivalent and best-corrected distance visual acuity, uncorrected middle visual acuity, uncorrected near visual acuity, residual refractive astigmatism, near stereopsis acuity, total high-order aberration and total spherical aberration, were measured postoperatively at 7d, 1 and 3mo.
RESULTS: The uncorrected middle and near visual acuity, Titmus near stereopsis acuity and residual astigmatism at 7d, 1 and 3mo after surgery were significantly improved in the Toric IOL group than the non-Toric group(all P<0.05). The dependence on glasses was reduced. The postoperative best-corrected distance visual acuity, total high-order aberration and total spherical aberration of the two groups showed no statistically significant differences(all P>0.05).
CONCLUSIONS: The implantation of Toric IOL in patients with high myopia cataract and corneal astigmatism can effectively correct corneal astigmatism, improve postoperative uncorrected middle and near visual acuity and near stereopsis visual function, reduce postoperative dependence on glasses and enhance binocular stereopsis visual function.
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Application value of new assistive technology in keratopathy-associated cataract surgery

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

Abstract: (10065) HTML (0) PDF (493.57 KKB) (2076)

Abstract:

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

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

Abstract: (9375) HTML (0) PDF (1.17 MKB) (2175)

Abstract:

AIM: To evaluate the applicability of Chinese dry eye questionnaire in college students using the ocular surface disease index(OSDI)questionnaire as a reference.
METHODS: Cross-sectional study. A total of 711 college students from Nanyang Medical College were enrolled in the study and assessed for dry eye condition using OSDI questionnaire and Chinese dry eye questionnaire. The response rate of each question in the two questionnaires was counted. Cronbach α was calculated to evaluate the internal consistency of both questionnaires. Correlation between the total scores of the two questionnaires was analyzed to evaluate the criterion validity. Based on OSDI scores, the discriminant validity of Chinese dry eye questionnaire was evaluated; receiver operating characteristic(ROC)curves was plotted for Chinese dry eye questionnaire scores, area under the ROC curve(AUC)was calculated, and diagnostic thresholds and corresponding sensitivity and specificity were also analyzed.
RESULT: The response rates of the 12 questions on the OSDI questionnaire were 33.2%-100.0%, while it was 100.0% for each question on the Chinese dry eye questionnaire. The Cronbach α values of OSDI questionnaire and Chinese dry eye questionnaire were 0.905 and 0.789, respectively. The Chinese dry eye questionnaire score was positively correlated with the OSDI score(r_s=0.712, P<0.001). According to OSDI questionnaire scores, dry eye severity was divided into normal group, mild dry eye group, moderate dry eye group and severe dry eye group. The scores of Chinese dry eye questionnaire in these groups were 4.00(2.00, 6.00), 9.00(7.00, 11.00), 12.00(9.00, 14.00)and 16.00(13.50, 22.00), respectively, which increased with the severity of dry eye, and the overall difference was statistically significant(P<0.001), as well as pairwise comparison between groups(P<0.05). The AUCs of Chinese dry eye questionnaire in distinguishing normal population from dry eye population, mild dry eye from moderate dry eye, moderate dry eye from severe dry eye were 0.862, 0.661 and 0.769, respectively, and the diagnostic thresholds were 6.5, 11.5 and 14.5, respectively.
CONCLUSION:Chinese dry eye questionnaire has an equivalent reliability, validity, discriminant ability and better response rate for dry eye screening and epidemiological survey among college students in China compared with OSDI questionnaire.
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Recent advances in treatment of retinitis pigmentosa

Ming Ai, Ming Sun, Dai Li

Abstract: (9247) HTML (0) PDF (412.02 KKB) (2351)

Abstract:

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

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

Abstract: (9205) HTML (0) PDF (470.25 KKB) (1973)

Abstract:

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

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

Abstract: (8989) HTML (0) PDF (1.47 MKB) (2334)

Abstract:

AIM: To observe the therapeutic effect of the diquafosol sodium combined with intense pulsed light(IPL)on meibomian gland dysfunction(MGD)dry eye after refractive surgery.
METHODS:A total of 64 patients(128 eyes)with MGD dry eye diagnosed within 6mo after laser corneal refractive surgery in our hospital from March 2021 to December 2021 were selected. They were randomly divided into control group and experimental group. A total of 33 patients(66 eyes)in the control group were treated with sodium hyaluronate combined with IPL, and 31 patients(62 eyes)in the experimental group were treated with diquafosol sodium combined with IPL. Ocular symptom scores were performed before each IPL treatment in both groups to examine non-invasive tear breakup time(NIBUT), tear meniscus height, lipid layer grade of tear film, meibomian gland deletion rate and uncorrected visual acuity.
RESULTS:After IPL treatment, ocular symptom scores and meibomian gland deletion rate score of two groups were decreased continuously. NIBUT, tear meniscus height and lipid layer grade of tear film were increased continuously, and there was no significant change in uncorrected visual acuity. NIBUT of patients in the experimental group was better than that in the control group before the third IPL treatment(6.24±0.27s vs. 5.51±0.24s, P=0.046).
CONCLUSIONS:Both diquafosol sodium and sodium hyaluronate combined with IPL showed good therapeutic effect on MGD dry eye, but there was no significant difference in the short-term efficacy between the two groups.
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Evaluation of macular microvasculature alterations in patients with proliferative diabetic retinopathy after vitrectomy by swept-source optical coherence tomography angiography

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

Abstract: (8968) HTML (0) PDF (936.23 KKB) (2200)

Abstract:

AIM: To investigate the changes in retinal and choroidal blood flow after pars plana vitrectomy(PPV)for proliferative diabetic retinopathy(PDR).
METHODS: A cross-sectional study was conducted on 35 patients(35 eyes)who were diagnosed as monocular PDR and received 23GPPV in ophthalmology department of the Second People's Hospital of Hefei between September 2020 and July 2022. All eyes underwent swept-source optical coherence tomography angiography(SS-OCTA)examination. Retinal and choroidal vascular parameters within 3mm×3mm of macular zone were measured by built-in analyzer, and its correlation with postoperative best corrected visual acuity(BCVA)was analyzed.
RESULTS: The follow-up was 1～22(average 9.72±6.67)mo. At the last follow-up, flow area(FA)of intermediate capillary plexus(ICP)layer in paranasal foveal region was significantly reduced in PPV eyes(0.31±0.06mm²)compared with contralateral eyes(0.38±0.05mm²), and FA of deep capillary plexus(DCP)in temporal foveal region was significantly lower in PPV eyes(0.19±0.08mm²)than contralateral eyes(0.27±0.07mm²; all P<0.05). Choroidal vascularity index(CVI)were lower in PPV eyes than contralateral eyes in parafoveal subregions except temporal region(P<0.05). After PPV, BCVA had a certain correlation with the density and FA of middle and deep retinal vessels.
CONCLUSIONS: Eyes with severe PDR may be prone to having a decrease in the DCP and parafoveal choroidal perfusion in the parafoveal regions after PPV than contralateral eyes.
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Suture guided gonioscopy-assisted transluminal trabeculotomy combined with phacoemulsification in the treatment of primary open angle glaucoma

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

Abstract: (8912) HTML (0) PDF (467.79 KKB) (2059)

Abstract:

AIM: To investigate the clinical efficacy of suture-guided gonioscopy-assisted transluminal trabeculotomy(GATT)combined with phacoemulsification in the treatment of primary open angle glaucoma(POAG).
METHODS: A total of 84 patients(84 eyes)with POAG and cataract who underwent surgery in our hospital from January 2021 to July 2022 were selected and randomly divided into two groups. There were 43 cases(43 eyes)in the combined group who underwent suture-guided GATT combined with phacoemulsification, and 41 cases(41 eyes)in the simple group who underwent suture-guided GATT. The two groups were followed up for 3mo to compare the surgical success rate, intraocular pressure, topical intraocular pressure-lowering drugs, visual acuity and postoperative complications.
RESULTS: There was no significant difference in overall success rate between the combination and simple groups at 3 mo after surgery(88% vs. 85%, P>0.05). The intraocular pressure levels and topical intraocular pressure-lowering drugs at 1wk, 1 and 3mo after surgery in the two groups were significantly lower than those before surgery(all P<0.05), but there was no significant difference between the two groups(all P>0.05). The visual acuity at 1wk, 1 and 3mo after surgery of patients in the combined group was significantly better than that in the simple group(P<0.01). During the follow-up period, the incidence of anterior chamber hemorrhage and transient hypertension in the combined group was significantly lower than that in the simple group(P<0.05).
CONCLUSION: Both suture-guided GATT combined with cataract phacoemulsification and suture-guided GATT are effective treatment for POAG, however, suture-guided GATT combined with phacoemulsification has a lower incidence of anterior chamber hemorrhage and transient ocular hypertension.
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Research advances in contact lens associated bacterial keratitis

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

Abstract: (8861) HTML (0) PDF (512.03 KKB) (2012)

Abstract:

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

Shu-Ying Fu, Yan-Min Dong

Abstract: (8842) HTML (0) PDF (1.78 MKB) (1953)

Abstract:

AIM: To investigate the relationship among the fasting plasma glucose coefficient of variation(FPG-CV)and macular morphology and microcirculation in patients with nonproliferative diabetic retinopathy(NPDR).
METHODS: A retrospective analysis of 82 cases(82 eyes)with NPDR admitted to our hospital from February 2018 to June 2022 was the research object, and another 82 cases(82 eyes)of non-diabetic retinopathy(NDR)patients during the same period were selected as the control group, and the clinical data of the two groups of patients were analyzed. Multivariate Logistic regression was used to analyze the risk factors affecting the incidence of NPDR, and the back propagation(BP)neural network model was established and evaluated. Pearson correlation was used to analyze the correlation among FPG-CV and macular morphology and microcirculation in patients.
RESULTS: The results of multivariate Logistic regression analysis showed that the disease duration ≥7.2a, glycated hemoglobin A1c(HbA1c)≥7.7%, triglyceride(TG)≥1.9 mmol/L, microalbuminuria(MALB)≥24.5 mg/L, FPG-CV ≥9.8%, superficial capillary plexus-vessel density(SCP-VD)<27.6%, deep capillary plexus-vessel density(DCP-VD)<47.7%, foveal avascular zone(FAZ)area ≥0.38 mm², central retinal thickness(CRT)≥197.7 μm and subfoveal choroidal thickness(SFCT)<227.7 μm were risk factors for NPDR(P<0.05). The number of hidden layer nodes is 5, and the receiver operating characteristic(ROC)curve, calibration curve and clinical decision curve show that the prediction model has good discrimination, accuracy and validity. The results of Pearson correlation analysis showed that FPG-CV was negatively correlated with SCP-VD, DCP-VD and SFCT(P<0.05); FPG-CV was positively correlated with FAZ area and CRT(P<0.05).
CONCLUSION: The course of disease, HbA1c, TG, MALB, FPG-CV, SCP-VD, DCP-VD, FAZ area, CRT and SFCT are all related to the pathogenesis of NPDR. With the increase of FPG-CV, the indexes of macular morphology and microcirculation changed. FPG-CV was negatively correlated with SCP-VD, DCP-VD and SFCT and positively correlated with FAZ area and CRT.
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Research progress on corneal nerves and substance P in viral keratitis

Yi Mu, Hong Zhang

Abstract: (8734) HTML (0) PDF (490.87 KKB) (1907)

Abstract:

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