Volume ,2026 Issue 9

Basic Research

• Glucocorticoid-induced RPE injury in ARPE-19 cells: association with excessive autophagy and AMPK/mTOR signaling

  Wen-Xue Guan, Yue Guo, Si-Tong Chen, Zhi-Ming Liu, Yao-Yao Sun, Ming-Wei Zhao

  2026(9):1657-1666 ,DOI: 10.18240/ijo.2026.09.01

  Abstract: (27) HTML (0) PDF (3.59 MKB)(82)

  Abstract:

  AIM: To investigate whether excessive glucocorticoid (GC) exposure disrupts retinal pigment epithelial (RPE) homeostasis through glucocorticoid receptor (GR)-dependent autophagy hyperactivation. METHODS: Human retinal pigment epithelial cell line (ARPE-19 cells) were exposed to GC (0–100 μmol/L, 48h). RESULTS: GC induced GR upregulation and mitochondrial translocation in a dose- and time-dependent manner, correlating with pathological autophagy activation. Key findings included: 1) tight junction disruption, evidenced by ZO-1 fragmentation, 2) reduction in phagocytic uptake efficiency, 3) mitochondrial shrinkage and autolysosome accumulation (TEM), 4) altered AMPK/mTOR signaling (p-AMPK up, p-mTOR down) associated with autophagosome formation, 5) elevated LC3-II levels confirming excessive autophagic flux. Critically, all GC-induced effects, including GR upregulation, signaling changes, and increased autophagy, were abolished by GR antagonism with RU486. CONCLUSION: This study shows that GR-dependent GC exposure induces autophagic flux with ultrastructural evidence suggestive of mitochondria-targeted autophagy and alters AMPK/mTOR signaling, correlating with RPE barrier collapse and phagocytic failure, a possible link to steroid-associated central serous chorioretinopathy (CSC).

• Mitochondrial outer membrane protein FUNDC2 contributes to ferroptosis as a potential upstream regulator in retinitis pigmentosa

  Jie-Yu Chen, Ya-Fen Huang, Yu Hong

  2026(9):1667-1675 ,DOI: 10.18240/ijo.2026.09.02

  Abstract: (23) HTML (0) PDF (2.31 MKB)(56)

  Abstract:

  AIM: To investigate the key role of the mitochondrial outer membrane protein FUN14 domain-containing 2 (FUNDC2) in retinal pigment epithelium (RPE) ferroptosis during retinitis pigmentosa (RP) progression. METHODS: Unbiased label-free proteomics was employed to identify differentially expressed proteins in the RPE of a sodium iodate (SI)-induced rat model. In vitro experiments were conducted using human retinal pigment epithelial (ARPE)-19 cells. The effects of SI treatment and FUNDC2 knockdown on cell viability and the expression of ferroptosis-protective molecules, including glutathione peroxidase 4 (GPX4), solute carrier family 7 member 11 (SLC7A11), ferritin heavy chain 1 (FTH1), and solute carrier family 25 member 11 (SLC25A11) were evaluated. RESULTS: Proteomic analysis revealed that FUNDC2 was significantly upregulated in the RPE of SI-induced rats. In ARPE-19 cells, SI treatment significantly increased FUNDC2 expression while decreasing the levels of ferroptosis-protective molecules. Functional experiments demonstrated that knocking down FUNDC2 effectively rescued SI-induced loss of cell viability and restored GPX4 expression. CONCLUSION: These findings provide the first evidence that FUNDC2 acts as a potential upstream regulator of RPE ferroptosis in RP, at least partially by negatively regulating GPX4. Consequently, FUNDC2 is a potential therapeutic target for the future treatment of RP.

• Resveratrol mitigates hypoxia-induced mitochondrial oxidative damage and apoptosis via inhibition of TRPA1 channel in retinal pigment epithelial cells

  Mehmet Argun, Mustafa Nazıroğlu

  2026(9):1676-1686 ,DOI: 10.18240/ijo.2026.09.03

  Abstract: (21) HTML (0) PDF (6.61 MKB)(61)

  Abstract:

  AIM: To investigate the modulator action of resveratrol (RSV) through the suppression of transient receptor potential ankyrin 1 (TRPA1) on the hypoxia (HPO)-caused oxidative degeneration and apoptosis in human retinal pigment epithelial cells (ARPE19). METHODS: The control (CNT), RSV (50 µmol/L for 24h), HPO (200 µmol/L CoCl2 for 24h), and HPO+RSV groups were induced in the ARPE19. Apoptosis, caspases (caspases 3, 8, and 9), oxidants [lipid peroxidation, oxygen free radical (OFR), and dysfunction of mitochondrial membrane], antioxidants (glutathione and glutathione peroxidase), Ca2+, Zn2+ levels, live cell number and percentage were all measured in the cells of four groups. RESULTS: The HPO increased Ca2+ and Zn2+ fluorescence intensity in the cells. It also upregulated the apoptosis, caspases, and oxidant indicators while downregulating the antioxidants, and the count of live cells. TRPA1 agonist (cinnamonaldehyde) further upregulated these indicators (all P<0.05). When the HPO-induced increase in TRPA1 activation was treated with RSV and the TRPA1 antagonist (AP18), cell viability and antioxidants rose while the oxidant and apoptotic indicators decreased due to TRPA1 suppression (P<0.05). CONCLUSION: HPO exposure through TRPA1-mediated Ca2+ signaling, induces mitochondrial oxidative cell cytotoxicity and death, which may offer a treatment option for HPO-induced retinal disorders linked to increased OFR and Ca2+ influx.

• FLNA promotes the progression of diabetic retinopathy by increasing M1 macrophages

  Chun-Hua Li, Mao-Fei Feng, Xue Zhang, Lei Yu

  2026(9):1687-1699 ,DOI: 10.18240/ijo.2026.09.04

  Abstract: (20) HTML (0) PDF (7.43 MKB)(53)

  Abstract:

  AIM: To clarify the role of filamin A (FLNA) in promoting diabetic retinopathy (DR) progression and explore its underlying mechanism via modulating M1 macrophage inflammation and adenosine 5'-monophosphate activated protein kinase (AMPK) phosphorylation, as well as its potential as a diagnostic biomarker and therapeutic target. METHODS: Gene Expression Omnibus (GEO) dataset and Weighted Gene Co-Expression Network Analysis (WGCNA) were used to identify differentially expressed genes across DR, diabetes mellitus (DM), and control groups. Gene Set Enrichment Analysis (GSEA), Gene Ontology (GO), and Kyoto Encyclopedia of Genes and Genomes (KEGG) were employed to analyze the enrichment of intersecting genes. Machine learning models assessed the predictive performance of these genes, while single-cell sequencing and cell chat examined their expression in M1 macrophages and interactions with other cell types. Quantitative PCR (q-PCR) measured mRNA levels of interleukin- 6 (IL-6), interleukin-1β (IL-1β), and tumor necrosis factor-α (TNF-α), and Western blotting assessed protein levels of FLNA, AMPK, and phosphorylated-AMPK (p-AMPK). RESULTS: Key findings revealed FLNA, plectin (PLEC), and Tweety family member 3 (TTYH3) as critical genes in DR, with FLNA showing the highest area under the curve (AUC) value and importance, and the random forest model performing best. The AMPK signaling pathway was enriched for FLNA, which was most significantly expressed in M1 macrophages. M1 macrophages promote IL-6, IL-1β, and TNF-α expression. FLNA increases the effect of M1 macrophages on DR progression and AMPK phosphorylation. CONCLUSION: Our study identifies FLNA as a key regulator in DR progression, primarily by enhancing M1 macrophage-mediated inflammation and AMPK phosphorylation. These findings highlight FLNA's critical role in DR pathogenesis and its potential as a biomarker for early diagnosis and a therapeutic target for intervening in macrophage-driven inflammatory responses.

• Desferrioxamine attenuating high glucose-induced ferroptosis and inflammatory responses in Müller glial cells via Nrf2/TXNRD1 pathway

  Min Luo, Yi Zhang, Na Li, Wen-Fang Zhan

  2026(9):1700-1710 ,DOI: 10.18240/ijo.2026.09.05

  Abstract: (19) HTML (0) PDF (3.26 MKB)(55)

  Abstract:

  AIM: To investigate the protective effects of deferoxamine (DFO) on high glucose (HG)-induced ferroptosis and inflammatory responses in retinal Müller glial cells (MGCs) and offer potential therapeutic targets for early intervention in diabetic retinopathy (DR). METHODS: Primary MGCs were cultured from C57BL/6J mouse retinas and exposed to normal glucose (NG, 5 mmol/L) or HG (25 mmol/L) conditions for various durations. Ferroptosis-related markers, including intracellular Fe2+ levels, glutathione (GSH), reactive oxygen species (ROS), malondialdehyde (MDA), and key proteins glutathione peroxidase 4 (GPX4), solute carrier family 7 member 11 (SLC7A11), ferritin heavy chain 1 (FTH1), were examined using multiple assays such as immunoblotting, enzyme-linked immunosorbent assay (ELISA), immunofluorescence (IF), and fluorometric detection. The role of DFO was evaluated through cell viability assessment and analysis of inflammatory cytokines interleukin-1 beta (IL-1β) and tumor necrosis factor-alpha (TNF-α). RESULTS: HG exposure significantly increased intracellular Fe2+ content, decreased GSH levels, elevated ROS and MDA concentrations, and altered expression profiles of ferroptosis regulators GPX4 and SLC7A11. Immunoblot and IF analyses confirmed downregulation of GPX4 and SLC7A11 alongside accumulation of FTH1 under prolonged HG treatment. DFO administration markedly attenuated these ferroptotic changes while reducing inflammatory cytokine secretion, demonstrating its protective effect against HG-induced damage in MGCs by modulating the nuclear factor erythroid 2-related factor 2 (Nrf2)/thioredoxin reductase 1 (TXNRD1) pathway. CONCLUSION: Low-dose DFO effectively mitigates HG-induced ferroptosis and inflammatory responses in MGCs through the Nrf2/TXNRD1 signaling axis, providing a theoretical framework for developing novel therapeutic strategies in DR management.

Clinical Research

• Safety and effectiveness of Bian-stone and moxibustion in treatment of meibomian gland dysfunction

  Ran Hao, Xue-Mei Bai, Da-Lan Jing, Xiao-Dan Jiang, Xue-Min Li

  2026(9):1711-1719 ,DOI: 10.18240/ijo.2026.09.06

  Abstract: (20) HTML (0) PDF (1.33 MKB)(50)

  Abstract:

  AIM: To propose a novel Bian-stone and moxibustion (BSM) therapy for meibomian gland dysfunction (MGD) treatment, and to evaluate its clinical efficacy and safety based on objective ocular surface parameters. METHODS: A total of 140 patients with MGD were enrolled in this randomized controlled study and equally allocated (1:1 ratio) into the BSM group and the intense pulsed light (IPL) group. Patients in the BSM group received 30-minute BSM treatment every other day. Subjects in the IPL group completed four independent treatment sessions. The evaluated outcomes included the Ocular Surface Disease Index (OSDI), eyelid margin morphology, meibomian gland (MG) morphology and function, tear film breakup time (TBUT), ocular surface staining (OSS) score, Schirmer's test (ST), and tear meniscus height (TMH). All assessments were performed at baseline, as well as at 1- and 3-month follow-ups after treatment. RESULTS: The BSM group consisted of 24 males and 47 females with a mean age of 59.04±16.50y, while the IPL group included 27 males and 42 females with a mean age of 60.39±15.90y. No significant differences in age, sex distribution, and clinical history were observed between the two groups. At 1 and 3mo post-treatment, the BSM group exhibited significant improvements in OSDI scores, eyelid margin hyperemia and neovascularization, MG expression, secretion status and gland loss, conjunctival hyperemia, and TBUT. Notably, the BSM group achieved superior improvements in OSDI scores and eyelid neovascularization compared with the IPL group at the 3-month follow-up. Additionally, significant reductions in eyelid margin edema and irregularity were only observed in the BSM group at 3mo after intervention. CONCLUSION: BSM therapy can effectively relieve clinical symptoms and restore tear film homeostasis in patients with MGD, serving as a promising and viable therapeutic approach for MGD management.

• Intraocular pressure profiles between ipsilateral surgically and contralateral medically-controlled in primary open angle glaucoma patients

  Tze Suen Chow, Farrah Jaafar, Rona Asnida Nasaruddin, Chenshen Lam, Norshamsiah Md Din

  2026(9):1720-1730 ,DOI: 10.18240/ijo.2026.09.07

  Abstract: (26) HTML (0) PDF (2.13 MKB)(52)

  Abstract:

  AIM: To compare the fluctuating characteristics, mean value and peak value of intraocular pressure (IOP) between medically and surgically controlled eyes in patients with primary open angle glaucoma (POAG) based on a 12-hour daytime diurnal curve (12-DDC) and water drinking test (WDT). Additionally, this study evaluated the consistency of 12-DDC outcomes measured on two separate days. METHODS: This was a cross-sectional observational study. Eligible POAG patients with unilateral medically and contralateral surgically controlled IOP via functional augmented trabeculectomy bleb were enrolled. Diurnal IOP was detected every 3h from 8:00 a.m. to 8:00 p.m. over two consecutive days to establish the 12-DDC. The WDT was performed subsequent to the completion of diurnal IOP measurement. RESULTS: A total of 21 POAG patients were included, with a mean age of 65.5±7.3y, predominantly male (n=17, 81.0%), and of Malay ethnicity (n=13, 61.9%). The medically controlled eyes exhibited significantly greater diurnal IOP fluctuation (4.6±1.7 mm Hg) compared with surgically controlled eyes (3.0±1.5 mm Hg, P=0.005). Similarly, the peak IOP derived from WDT was significantly higher in medically controlled eyes (19.6±4.1 mm Hg) than in surgical counterparts (11.2±3.4 mm Hg, P<0.001). A strong and significant positive correlation was identified between peak IOP values of 12-DDC and WDT. For surgically controlled eyes, 12-DDC measurements obtained on two different days showed excellent consistency at all corresponding time points, with Kappa values ranging from 0.88 to 0.95. CONCLUSION: Under the condition of consistent physiological background affecting IOP circadian variation in the same individual, surgically controlled eyes demonstrate a superior IOP profile with lower fluctuation and peak IOP compared with medically controlled eyes in POAG patients.

• Safety and efficacy of micropulse transscleral laser therapy for glaucoma: a two-year follow-up

  Michele Lanza, Italo Fattore, Salvatore Ambrosio, Francesco Abbate, Rosa Boccia, Luigi Serra, Teresa Cangiano, Francesca Simonelli

  2026(9):1731-1738 ,DOI: 10.18240/ijo.2026.09.08

  Abstract: (25) HTML (0) PDF (488.75 KKB)(70)

  Abstract:

  AIM: To evaluate the efficacy and safety of micropulse transscleral laser therapy (MP-TLT) in lowering intraocular pressure (IOP) in eyes with primary glaucoma at different stages. METHODS: In this retrospective longitudinal cohort study, data were collected from the charts of patients who undergo MP-TLT. Information regarding medication burden (including oral carbonic anhydrase inhibitor use), IOP, and visual acuity, were gathered prior to the procedure and at day 1, week 1 and at 1, 3, 6, 12, 18, and 24mo follow-up. Glaucoma severity staging was performed according to the Hodapp-Parrish-Anderson classification system based on visual field parameters assessed with standardized automated perimetry. Early glaucoma was defined as mean deviation (MD) better than -6 dB, moderate glaucoma as MD between -6 and -12 dB, and advanced glaucoma as MD worse than -12 dB. RESULTS: Totally 84 eyes of 53 patients (22 females), with a mean age of 67.14±11.39y affected by progressive primary open angle glaucoma (POAG) and primary angle-closure glaucoma (PACG) were included. Before treatment, mean best corrected visual acuity was 0.26±0.36 logMAR, mean IOP was 22.32±6.64 mm Hg and patients took a mean of 2.96±0.75 topical IOP lowering molecules; moreover, 18 patients also required acetazolamide tablets. At 1mo follow-up, a significant (P<0.001) reduction of mean IOP was detected both in POAG (-7.16±2.92 mm Hg) and PACG (-6.89±3.12 mm Hg) eyes, remaining stable during the further follow-up. A significant (P<0.01) reduction in the number of drugs taken was observed at 3-month follow-up both in POAG (-0.59±0.32) and PACG (-1.06±0.73) eyes. These effects persisted over time during the further follow-up. Furthermore, marked decreases in IOP and IOP-lowering drugs were seen in patients with early, moderate, and advanced glaucoma, and these results closely matched the findings from the entire study cohort. CONCLUSION: The results obtained suggest that MP-TLT may be an effective and safe option for managing patients with POAG and PACG at every stage of the disease.

• Visual and accommodative outcomes after femtosecond LASIK with and without monovision in patients over 40 years

  Yuan-Yuan Qi, Qi Li, Gui-Li Wang, Hui-Yu Wang, Wan-Ting Li, Shao-Zhen Zhao

  2026(9):1739-1748 ,DOI: 10.18240/ijo.2026.09.09

  Abstract: (24) HTML (0) PDF (2.04 MKB)(56)

  Abstract:

  AIM: To evaluate changes in visual acuity and accommodation function following femtosecond laser-assisted in situ keratomileusis (FS-LASIK) combined with monovision in patients aged over 40y. METHODS: This prospective, non-randomized cohort study included patients who were divided into an FS-LASIK binocular group (full correction) and an FS-LASIK monovision group. The binocular group consisted of Group 1 (15 patients) with simple myopia and Group 2 (12 patients) with myopia and presbyopia. The monovision group (Group 3) included 13 patients with myopia and presbyopia. Parameters assessed included the uncorrected distance visual acuity (UCVA), the uncorrected near visual acuity (UNVA), contrast sensitivity (CS), binocular cross-cylinder (BCC), accommodative amplitude (AMP), positive relative accommodation (PRA), negative relative accommodation (NRA), and accommodative facility (AF). Patient satisfaction was evaluated at 3mo postoperatively. RESULTS: A total of 40 patients (80 eyes) were enrolled (mean age 43.63±3.666y; 12 males). At 3mo after FS-LASIK, UCVA improved significantly in all patients (P<0.001), while UNVA remained comparable to preoperative levels (P>0.05). BCC in Group 3 decreased by 0.30±0.43 compared to preoperative levels, showing a statistically significant difference (P=0.037). The AMP in Group 3 showed an increasing trend with greater improvement in the nondominant eye than in the dominant eye (P>0.05). Patient satisfaction was high in all groups. CONCLUSION: FS-LASIK combined with monovision is an effective treatment for patients aged over 40y with myopia and presbyopia, which not only improves visual acuity but also achieves high patient satisfaction and improves postoperative BCC.

• Enhanced predictability and axis precision of SMILE Pro, a retrospective analysis of myopic astigmatism correction

  İlter İritaş, Ziya Burke

  2026(9):1749-1756 ,DOI: 10.18240/ijo.2026.09.10

  Abstract: (17) HTML (0) PDF (3.10 MKB)(49)

  Abstract:

  AIM: To evaluate three-month visual and refractive outcomes after small incision lenticule extraction (SMILE) Pro with the VISUMAX 800 femtosecond laser for myopic astigmatism correction and to compare results with previously reported VISUMAX 800 and VisuMax 500 outcomes. METHODS: Retrospective, observational clinical study. Records of 64 patients (128 eyes) who underwent SMILE Pro using the VISUMAX 800 laser (Carl Zeiss Meditec AG, Jena, Germany) between June and November 2024 were reviewed. Preoperative and 3-month postoperative data were analyzed in eyes with corrected distance visual acuity (CDVA) of 1.0 or better, including spherical equivalent (SE), refractive astigmatism, and vector analysis. Patients were classified into low (≤1.50 D) and high (>1.50 D) astigmatism subgroups. RESULTS: The mean age of 64 patients (128 eyes) was 26.10±4.25y (19–36y). Attempted and achieved SE were strongly correlated (r=0.97, P<0.001). At 3mo, 36.7% and 87.5% of eyes were within ±0.50 and ±1.00 D of target refraction, respectively. Mean residual astigmatism was -0.56±0.27 D, lower in the low-astigmatism group (-0.39±0.23 D) than in the high group (-0.72±0.21 D; P<0.001). The mean absolute astigmatic angle of error was 4.47°±4.68°, with 97.6% ≤15°. No intraoperative or postoperative complications occurred. CONCLUSION: SMILE Pro using the VISUMAX 800 femtosecond laser provides safe and predictable correction of myopic astigmatism with good axis alignment. However, the observed undercorrection in higher cylinders suggests that further optimization of astigmatic nomograms may improve refractive accuracy.

• Relationship between retinal nerve fibre thickness, suprasellar extension and post-operative visual outcome in pituitary macroadenoma

  Teck Chee Cheng, Mae-Lynn Catherine Bastion, Norshamsiah Md Din, Jegan Thanabalan, Kah Lay Oh, Seng Fai Tang, Diana Lim, Amalina Saiful Anwar, Safinaz Mohd Khialdin

  2026(9):1757-1765 ,DOI: 10.18240/ijo.2026.09.11

  Abstract: (17) HTML (0) PDF (715.71 KKB)(46)

  Abstract:

  AIM: To evaluate the relationship between retinal nerve fibre layer (RNFL) thickness, suprasellar extension (SSE), tumour volume (TV) and visual outcome after pituitary adenoma surgery. METHODS: A prospective observational study was conducted in a tertiary teaching hospital which included patients with pituitary macroadenoma who required surgical resection between December 2015 to February 2020. Agreeable subjects underwent complete ocular examination, Humphrey visual field (HVF) and RNFL measurement using spectral domain optical coherence tomography preoperatively and 3-month postoperatively. Post-operative visual outcome was evaluated using both best-corrected visual acuity (BCVA, logMAR) and HVF mean deviation (MD). TV was estimated by multiplying the transverse, anteroposterior, and craniocaudal maximum diameter; and SSE by measuring tumour extension beyond the supraclinoid internal carotid artery from magnetic resonance imaging. RESULTS: Thirty-eight patients (18 males) were recruited. The mean age was 47.6±14.8y. The median and interquartile range (IQR) was 10.78 (6.45–16.94) cm3 and 14.05 (4.99–22.90) mm for TV and SSE, respectively. While postoperative RNFL significantly reduced in all sectors, significant improvement was seen in median BCVA in logMAR (from 0.301 to 0.176, P<0.001) and MD of HVF (from -10.04 to -3.91, P<0.001). Pre-operative global RNFL was significantly correlated with post-operative logMAR (r=-0.303, P=0.015) and MD (r=0.510, P<0.001). Only SSE showed significant negative correlations with all RNFL sectors. Each 10 µm thicker pre-operative global RNFL was associated with 0.13 lower (better) postoperative logMAR (β=-0.013, P<0.001) and 0.83 dB higher (better) MD (β=0.083, P=0.008). Patients with normal RNFL had better post-operative MD [median (IQR)=-2.35 (-1.45, -5.94)] than with thinned RNFL [median (IQR)=-6.63 (-2.80, -8.77), P=0.009]. CONCLUSION: SSE shows stronger association with RNFL thinning than TV, and thicker pre-operative RNFL predicted better post-operative visual outcomes.

• How retinal artery occlusion reveals moyamoya disease—a case series and descriptive study

  Zi-Yue Li, Ying Li, Ya-Qi Wang, Ting Chen, Xuan Xiao

  2026(9):1766-1776 ,DOI: 10.18240/ijo.2026.09.12

  Abstract: (22) HTML (0) PDF (3.08 MKB)(41)

  Abstract:

  AIM: To systematically characterize the clinical features, correlations, and therapeutic implications of participants with moyamoya disease (MMD)-related retinal artery occlusion (RAO) through a case series and pooled descriptive analysis. METHODS: A total of 9 participants with MMD-RAO (2020–2025) and 9 cases retrieved from published literature (1981–2025) were retrospectively reviewed to descriptively explore the association between MMD and RAO. Mean difference (MD) was adopted as the effect size for continuous variables, while odds ratio (OR) was used for categorical variables. Heterogeneity was evaluated using the Q statistic and I2 index. Publication bias was assessed via funnel plots, and sensitivity analysis was performed using the leave-one-out method. RESULTS: Eighteen participants were enrolled in the final analysis, with a male predominance (male:female=1.25:1). Limited improvement in best-corrected visual acuity (BCVA) was observed after treatment (logMAR range: 0.22–3.0). Central retinal artery occlusion (CRAO) was the predominant subtype (83.3%), followed by branch retinal artery occlusion (BRAO, 11.1%) and cilioretinal artery occlusion (CLRAO, 5.6%). Participants in our institutional cohort were significantly older than those reported in literature (52.89±9.53 vs 25.56±12.58y, P<0.001). Our cohort presented slightly worse initial BCVA (2.04±0.9 vs 1.90±0.68; MD=0.14, 95%CI: -0.60–0.88, P=0.711, I2=78.3%) and inferior visual recovery (1.99±0.9 vs 1.22±1.14; MD=0.77, 95%CI: -0.19–1.73, P=0.132, I2=82.5%), whereas complete visual recovery (logMAR=0.1) was documented in one BRAO case from published reports. The efficacy of intra-arterial thrombolysis (IAT) reached 60% (3/5) in our cohort, and the overall rate of visual improvement was 41.2%. Mild publication bias was detected; however, sensitivity analysis verified the robustness of primary results. CONCLUSION: Participants with MMD-related RAO exhibit unique clinical characteristics differing from those with isolated RAO or uncomplicated MMD. This study identifies an “older MMD phenotype” complicated by RAO, and highlights the necessity of comprehensive vascular screening in elderly participants presenting with RAO to facilitate timely combined ophthalmological and neurological intervention.

• Abnormalities in retinal vascularity and blood perfusion associated with early syphilis revealed by optical coherence tomography angiography

  Xiao-Liu Wang, Yan-Qiong Zhu, Hui-Yin Zheng, Xin-Yi Luo, Jie-Hui Li, Hou-Jian Zhang, Zu-Guo Liu, Qiu-Ping Liu

  2026(9):1777-1784 ,DOI: 10.18240/ijo.2026.09.13

  Abstract: (24) HTML (0) PDF (2.06 MKB)(39)

  Abstract:

  AIM: To explore the feasibility of optical coherence tomography angiography (OCTA) in the early detection of syphilis and syphilitic chorioretinopathy. METHODS: Patients with newly diagnosed syphilis were enrolled from September 2022 to November 2023. All the participants underwent serological examinations including rapid plasma reagin (RPR) test and treponema pallidum particle agglutination (TPPA) test, as well as macular OCTA scanning. Quantitative indicators including macular vessel flow density (VFD), vessel length density (VLD), and foveal avascular zone (FAZ) were measured and analyzed. RESULTS: A total of 44 participants were recruited in this study, including 24 patients in the syphilis group (14 males, mean age: 30.83±9.59y) and 20 healthy individuals in the control group (6 males, mean age: 29.6±11.86y). Compared with the control group, the syphilis group presented significantly higher macular VLD and VFD (P<0.05), as well as an increased FAZ perimeter. Subgroup analysis was performed based on RPR titers, with patients divided into the low-titer subgroup (1:2–1:4) and high-titer subgroup (1:8–1:128). Both subgroups showed elevated VLD and VFD (excluding inner VFD) relative to controls (all P<0.05). Moreover, significant elevation of VFD was only observed in the high-titer subgroup. Receiver operating characteristic analysis identified outer VLD as the optimal indicator for distinguishing syphilis patients from controls, with an area under the curve of 0.802 (95%CI: 0.667–0.937). CONCLUSION: Syphilis patients with either low or high RPR titers show increased macular VLD and VFD in the absence of obvious visual impairment, indicating the potential of OCTA microvascular parameters for early auxiliary diagnosis of syphilitic ocular lesions.

• Utility of 3D-display surgical videos for better educational effects in pediatric persistent fetal vasculature for trainees

  Jing-Hua Liu, Ming-Zhen Yuan, Song-Feng Li, Guang-Da Deng, Jing Ma, Liang Li, Tian-Yu Wang, Hai Lu

  2026(9):1785-1791 ,DOI: 10.18240/ijo.2026.09.14

  Abstract: (21) HTML (0) PDF (855.25 KKB)(55)

  Abstract:

  AIM: To compare the educational benefits of three-dimensional (3D) surgical videos compared with two-dimensional (2D) surgical videos as a training tool for trainees in pediatric persistent fetal vasculature (PFV). METHODS: Trainees were stratified into three tiers by retinal surgery exposure and independent operating experience: Level 1 (≤5y, no independent cases), Level 2 (5–10y, ≤5 independent years), Level 3 (>10y, >5 independent years). Trainees viewed 3D and 2D surgical videos of pediatric PFV in a randomized order and immediately completed a questionnaire to provide educational assessments. RESULTS: Twelve trainees viewed 9 paired 3D and 2D surgical videos from 9 pediatric PFV patients (9 3D videos and 9 2D videos), resulting in 216 completed questionnaires. For pediatric PFV cases, trainees demonstrated a higher accuracy rate when watching 3D surgical videos compared to 2D surgical videos in discerning the depth of the anterior chamber (85.2% vs 70.4%, χ²=6.857, P=0.009), the location of lens opacity (86.1% vs 69.4%, χ²=8.679, P=0.003), and vitreous strips (89.8% vs 78.7%, χ²=5.027, P=0.025). Trainees believed that, compared to 2D surgical videos, 3D surgical videos significantly improved their ability to discriminate shallow anterior chambers (5.70±1.58 vs 3.92±1.14, P<0.001), the location of lens opacity (6.80±1.60 vs 4.36±1.35, P<0.001), vitreous strips (9.06±2.02 vs 7.16±2.42, P<0.001), complicated tractional retinal detachment (9.31±2.13 vs 7.99±2.63, P<0.001), and macular involvement (8.47±2.62 vs 6.91±2.84, P<0.001) in pediatric PFV cases. Trainees found 3D surgical videos to be significantly more satisfactory than 2D surgical videos in terms of image magnification (8.90±1.61 vs 7.17±1.65, P<0.001), clarity (9.21±2.11 vs 7.42±2.27, P<0.001), and depth of field (8.31±2.38 vs 6.78±2.79, P<0.001). Trainees regarded 3D surgical videos as significantly more suitable for ophthalmic surgical teaching (9.23±0.83 vs 5.75±0.93, P<0.001) and implementation (8.83±2.69 vs 6.15±2.83, P<0.001) compared to 2D surgical videos. CONCLUSION: 3D-display surgical videos offer superior educational benefits for trainees earning pediatric PFV vitrectomy surgery compared to 2D videos.

Investigation

• Monthly variations and climatic factors on acute primary angle-closure admissions: a 5-year retrospective hospital-based study in Shenzhen, China

  Ai-Xia Jin, Jiao Si, Yu-Fei Tao, Ming-Min Yang, Xiao-Hua Pan, Yan-Ting Feng, Di Gong, Ning Fan

  2026(9):1792-1799 ,DOI: 10.18240/ijo.2026.09.15

  Abstract: (15) HTML (0) PDF (847.55 KKB)(41)

  Abstract:

  AIM: To investigate the monthly distribution of acute primary angle-closure (APAC) admissions in a specialized hospital in Shenzhen and its association with climatic factors. METHODS: A 5-year retrospective study of APAC inpatients from 2017 to 2021 at Shenzhen Eye Hospital were conducted. The medical records were retrieved and climate information was obtained from the government website. The monthly APAC admissions and evaluated the correlation with climatic factors were compared, including precipitation, air pressure, temperature, sunshine duration, humidity, and evaporation. RESULTS: The overall mean age of 997 APAC inpatients was 64.63±9.89y, with females predominating (72.12%) and exhibiting significantly shorter axial lengths than males (22.26±0.89 vs 22.87±0.87 mm, P<0.001). APAC admissions peaked in May, especially for males ≤65y. Significant positive correlations were identified between admissions and humidity (r=0.498, P<0.01) as well as precipitation (r=0.306, P<0.05), while evaporation correlated negatively (r=-0.333, P<0.05). Males exhibited elevated APAC risk under high humidity [odds ratio (OR)=2.76, P=0.038], while increased air pressure (OR=0.12; 95%CI: 0.07–0.19), higher temperature (OR=0.22; 95%CI: 0.15–0.31), and greater evaporation (OR=0.92; 95%CI: 0.90–0.94) each exerted protective effects against such humidity-associated risk (all P<0.001). CONCLUSION: Elevated relative humidity in May is the primary climatic driver, significantly increasing the risk of APAC attack in males ≤65y. However, these correlations are not significant in female, suggesting the possibility of an associated confounding factor.

Meta-Analysis

• Diagnostic value of urinary albumin creatinine ratio in predicting vision-threatening diabetic retinopathy in patients with diabetes: a systematic review and Meta-analysis

  Ying Gao, Jia-Yuan Zhuang, Yu-Yan Ren, Hua-Zhi Zhang, Yi-Ming Hu, Cheng-Hao Li, Mei Hu, Heng Zhou, Xiang-Xia Luo

  2026(9):1800-1808 ,DOI: 10.18240/ijo.2026.09.16

  Abstract: (22) HTML (0) PDF (1.75 MKB)(49)

  Abstract:

  AIM: To evaluate the predictive value of urinary albumin creatinine ratio (UACR), albumin excretion rate (AER), and estimated glomerular filtration rate (eGFR) for vision-threatening diabetic retinopathy (VTDR) in individuals with diabetes. METHODS: A comprehensive literature search across PubMed, Embase, Web of Science, Scopus, and the Cochrane Library from their inception to February 2024 were performed. The diagnostic accuracy of microalbuminuria (MA; including UACR and AER) and eGFR in predicting VTDR using sensitivity, specificity, positive likelihood ratio and negative likelihood ratio, diagnostic odds ratio (DOR), and the area under the summary receiver operating characteristic (ROC) curve were assessed. Analyses incorporated both bivariate generalized linear mixed models and random-effects models to ensure a robust and unbiased interpretation of the data. RESULTS: The review included 14 studies with a total of 87 223 patients. The pooled sensitivity and specificity of MA and eGFR for predicting VTDR were 0.77 [95% confidence interval (CI), 0.57–0.89] and 0.51 (95%CI, 0.31–0.72), respectively. The DOR was 3.47 (95%CI, 1.94–6.18), with the area under the summary ROC curve at 0.70 (95%CI, 0.66–0.74). Notably, UACR as a predictor showed a sensitivity of 0.88 (95%CI, 0.43–0.99) and specificity of 0.55 (95%CI, 0.22–0.84), with an area under the curve of 0.78 (95%CI, 0.74–0.82). Despite significant heterogeneity among the studies (P<0.01), no publication bias was detected. CONCLUSION: UACR is a highly sensitive but moderately specific indicator for early detection and management strategies in this high-risk population.

Review Article

• Why aren’t we using AI in eye clinics? A systematic review of barriers and solutions in AI-based fundus image diagnostics for ocular diseases

  Tehmina Shehryar, Zoha Zahid Fazal, Anum Abdul Salam, Santhoshi Varada, Fakhar Jabran, Muhammad Usman Akram

  2026(9):1809-1825 ,DOI: 10.18240/ijo.2026.09.17

  Abstract: (18) HTML (0) PDF (1.69 MKB)(67)

  Abstract:

  Artificial intelligence (AI) has shown remarkable accuracy in the diagnosis of common ocular diseases such as diabetic retinopathy (DR), glaucoma, retinopathy of prematurity (ROP), and age-related macular degeneration (AMD), often matching or even outperforming expert clinicians. Despite these advancements, AI adoption in clinical settings remains limited due to key barriers. This systematic review evaluates 34 studies (2018–2025) highlighting AI's diagnostic performance (often >90% accuracy) while pointing out significant gaps in real-world deployment. We identify these persistent challenges through comprehensive analysis of current literature and propose actionable pathways to bridge the “last-mile gap” between research and clinical practice. This review pointed out three significant gaps in real-world deployment. These include 1) disjointed integration into clinical workflows, 2) lack of transparency in AI decision-making, and 3) poor generalizability across diverse populations. Our findings provide a framework for advancing AI implementation in ocular diagnostics to achieve equitable, scalable, and trustworthy solutions for global vision care.

• Research progress on glaucoma complicated with anxiety and depression

  Yan Liu, Qing-Qing Mu, Li-Qiao Ge, Yuan-Yuan Zhang, Xu Liu, Rui-Xue Zhang, Jun Jia, Guo-Xin Shi, Jia-Xing Duan, Yuan He

  2026(9):1826-1836 ,DOI: 10.18240/ijo.2026.09.18

  Abstract: (27) HTML (0) PDF (834.52 KKB)(54)

  Abstract:

  Glaucoma is a leading cause of irreversible blindness globally, with its incidence continuing to rise. Anxiety and depression are highly prevalent psychological comorbidities among patients with glaucoma. This narrative review summarizes the latest domestic and international research regarding anxiety and depression in glaucoma populations, focusing on their epidemiology, risk factors, bidirectional interactions with glaucoma, and relevant intervention strategies. This review aims to provide theoretical evidence for optimizing clinical psychosomatic comprehensive management regimens, so as to improve therapeutic outcomes and quality of life in glaucoma patients.

• Enzymatic glycosylation as a potential molecular link between Alzheimer’s disease and glaucoma

  Rui-Zi Liu, Qing-Ping Liu, Ming-Zhi Zhang

  2026(9):1837-1846 ,DOI: 10.18240/ijo.2026.09.19

  Abstract: (23) HTML (0) PDF (706.18 KKB)(92)

  Abstract:

  Alzheimer's disease (AD) and glaucoma are prevalent age-related neurodegenerative disorders affecting the brain and the eye, respectively. Despite their distinct clinical manifestations, both conditions share convergent pathological features, including neuronal loss, neuroinflammation, and metabolic stress, suggesting common upstream regulatory mechanisms. Protein glycosylation, a fundamental post-translational modification, has emerged as a key modulator of neuronal survival, protein aggregation, and inflammatory signaling in neurodegenerative diseases. In this review, we summarize recent advances in enzymatic glycosylation that are mechanistically relevant to both AD and glaucoma, with particular emphasis on N-linked glycosylation (N-glycosylation) and O-linked β-N-acetylglucosaminylation (O-GlcNAcylation). We focus on key enzymes, including O-GlcNAc transferase (OGT), O-GlcNAcase (OGA), and N-acetylglucosaminyltransferase III (GnT-III), and describe their roles in regulating neuronal viability, microglial activation, trabecular meshwork function, and retinal ganglion cell (RGC) survival. Integrating evidence from cerebral and ocular systems, we propose two glycosylation-dependent regulatory axes: the OGT/OGA–O-GlcNAc axis as an upstream metabolic and stress sensor, and the GnT-III–bisecting GlcNAc–intercellular adhesion molecule-1 (ICAM-1) axis as a downstream modulator of neuroinflammatory cell–cell interactions. We discuss the potential of glycosylation signatures as biomarkers in cerebrospinal fluid, plasma, and aqueous humor, and the feasibility of enzyme-targeted modulation as a therapeutic strategy. Collectively, this enzyme-centered framework provides a conceptual and regulatory perspective on potential links between AD and glaucoma, highlighting opportunities for translational research while acknowledging current evidence gaps that warrant further investigation.

• Childhood myopia in the modern environment: modifiable risk factors and evidence-based prevention

  Farheen Tariq, Shi-Long Huang, Bing-Xin Ren, Ju Zhang, Xiao Lin, Xin-Hai Wang, Hua Gao

  2026(9):1847-1857 ,DOI: 10.18240/ijo.2026.09.20

  Abstract: (20) HTML (0) PDF (781.62 KKB)(59)

  Abstract:

  This review aimed to summarize modifiable environmental and lifestyle risk factors for childhood myopia and evaluate evidence-based preventive strategies for family, school, and public health practice. Following the PRISMA-ScR framework, relevant studies on children aged 5–18y published up to January 2026 were retrieved from mainstream databases, and eligible literature was synthesized according to study design and evidence level. Reduced outdoor activity, excessive near-work and screen exposure, urban residence, insufficient sleep, and gene-environment interaction are major risk factors for childhood myopia. Daily outdoor activity of 1–2h or longer confers protective effects via promoting retinal dopamine release and inhibiting axial elongation, whereas prolonged close work and excessive screen time notably elevate myopia risk. Optimizing outdoor time, regulating ocular use habits, ensuring sufficient sleep, and implementing school-based interventions are core evidence-based preventive measures, and wearable devices and objective biomarkers can facilitate behavioral management and intervention evaluation. In conclusion, childhood myopia is influenced by multiple adjustable factors; increased outdoor exposure is the most effective preventive measure, and combined behavioral and policy interventions are essential to curb the global prevalence of childhood myopia and prevent subsequent severe visual complications.

• Targeting ferroptosis in ocular diseases: mechanisms, clinical implications, and therapeutic horizons

  Nai-Yuan Zhang, Hui-Qian Kong, Yu-Qiao Liao, Yi-Ji Pan, Wei Sun, Lei Xi, Hong-Hua Yu, Yun-Hong Shi

  2026(9):1858-1877 ,DOI: 10.18240/ijo.2026.09.21

  Abstract: (19) HTML (0) PDF (1.36 MKB)(39)

  Abstract:

  Ferroptosis, an iron-dependent form of regulated cell death driven by lipid peroxidation, has been increasingly implicated in selected ocular diseases, although its causal relevance varies across disease entities. The retina and retinal pigment epithelium are biologically susceptible to ferroptosis-related injury because of their high oxygen demand, abundant polyunsaturated lipids, mitochondrial activity, light exposure, and tightly regulated iron handling. This review summarizes core mechanisms of ocular ferroptosis, including iron uptake and export, glutathione–glutathione peroxidase 4 (GPX4)-dependent antioxidant defense, lipid peroxidation, mitochondrial dysfunction, neuroinflammation, and blood–retina barrier disruption. We discuss evidence from major degenerative, vascular, ischemic, hereditary, infectious, and immune-mediated retinal diseases, with particular attention to glaucoma, age-related macular degeneration, diabetic retinopathy, ocular toxoplasmosis, uveitis, retinal vasculitis, and inflammatory chorioretinopathy. We also evaluate ferroptosis-targeted therapeutic strategies, proposed operational criteria for defining ferroptosis in retinal disease, and candidate structural, functional, biochemical, and imaging endpoints for future translational studies. Current evidence supports ferroptosis as a context-dependent contributor to retinal injury rather than a uniform pathogenic mechanism. Future studies should integrate cell-type-resolved biomarkers, lipidomic and imaging readouts, functional rescue experiments, and clinically meaningful visual outcomes to clarify when ferroptosis modulation may support vision preservation.

Brief Report

• “Pocket” technique: a multiple-layer amniotic membrane transplant approach for managing graft-versus-host disease-associated corneal perforations

  Fang-Ting Li, Qin Zhang, Xiao-Xin Li

  2026(9):1878-1882 ,DOI: 10.18240/ijo.2026.09.22

  Abstract: (21) HTML (0) PDF (991.29 KKB)(41)

  Abstract:

  AIM: To describe a modified technique using multiple-layer amniotic membrane (AM) to manage corneal perforations in graft-versus-host disease (GVHD). METHODS: This case series included three eyes from 3 patients with GVHD and corneal perforation who underwent AM transplantation between 2019 and 2020. AM was collected from human placenta shortly after the cesarean section. During surgery, the AM was folded and sutured into the wound to create an “AM pocket” into which small AM debris was placed. The pocket was then closed using a 10-0 nylon suture and covered with an AM seal. After re-epithelization and AM scarring, sutures were removed. RESULTS: All 3 patients achieved successful wound closure with a single surgery, and corneal thickness remained >300 μm at the 6-month follow-up. Visual acuity improved in patients with peripheral perforation. CONCLUSION: The “Pocket” AM transplantation technique is an effective option and recommend for treating acute corneal perforations in patients with GVHD. Our modified AM transplantation method provided definitive wound closure and successfully repaired wounds of various sizes without recurrent corneal melting or perforations.

Letter to the Editor

• Extensive ocular metastases involving choroid, optic disc, and ciliary body more than 20y after mastectomy: a case report

  Li-Ping Wang, Guo-Ping Wang, Xue-Jing Lu

  2026(9):1883-1885 ,DOI: 10.18240/ijo.2026.09.23

  Abstract: (112) HTML (0) PDF (1.43 MKB)(52)

  Abstract:

• Orbital compartment syndrome following the use of sinonasal oxidized cellulose and gelatin sponge hemostat: report of two cases and literature review

  Hossein Ghahvehchian, Mohsen Bahmani Kashkouli, Nasser Karimi, Mansooreh Jamshidian Tehrani, Gholamhoseyn Aghai, Amir Manavishad

  2026(9):1886-1890 ,DOI: 10.18240/ijo.2026.09.24

  Abstract: (112) HTML (0) PDF (1.23 MKB)(41)

  Abstract:

Comment and Response

• Comment on “Comparison of visual acuity and optical quality between higher-order aspheric monofocal and standard intraocular lenses”

  Ankita Bandyopathyay, Suraj Kumar Chaurasiya

  2026(9):1891-1892 ,DOI: 10.18240/ijo.2026.09.25

  Abstract: (114) HTML (0) PDF (281.26 KKB)(46)

  Abstract:

• Algorithm of automatic identification of diabetic retinopathy foci based on ultra-widefield scanning laser ophthalmoscopy

  Jie Wang, Su-Zhen Wang, Xiao-Lin Qin, Meng Chen, Heng-Ming Zhang, Xin Liu, Meng-Jun Xiang, Jian-Bin Hu, Hai-Yu Huang, Chang-Jun Lan

  Abstract:

  ● AIM: To propose an algorithm for automatic detection of diabetic retinopathy (DR) lesions based on ultra-widefield scanning laser ophthalmoscopy (SLO). ● METHODS: The algorithm utilized the FasterRCNN (Faster Regions with CNN features)+ResNet50 (Residua Network 50)+FPN (Feature Pyramid Networks) method for detecting hemorrhagic spots, cotton wool spots, exudates, and microaneurysms in DR ultra-widefield SLO. Subimage segmentation combined with a deeper residual network FasterRCNN+ResNet50 was employed for feature extraction to enhance intelligent learning rate. Feature fusion was carried out by the feature pyramid network FPN, which significantly improved lesion detection rates in SLO fundus images. ● RESULTS: By analyzing 1076 ultra-widefield SLO images provided by our hospital, with a resolution of 2600×2048 dpi, the accuracy rates for hemorrhagic spots, cotton wool spots, exudates, and microaneurysms were found to be 87.23%, 83.57%, 86.75%, and 54.94%, respectively. ● CONCLUSION: The proposed algorithm demonstrates intelligent detection of DR lesions in ultra-widefield SLO, providing significant advantages over traditional fundus color imaging intelligent diagnosis algorithms.

• The relationship of blood cell-associated inflammatory indices and diabetic retinopathy: a Meta-analysis and systematic review

  Wen-Juan Luo, Wen-Fang Zhang

  Abstract: (64817) HTML (1305) PDF (1.51 MKB) (1953)

  Abstract:

  AIM: To explore the correlation between several blood cell-associated inflammatory indices including mean platelet volume (MPV), platelet distribution width (PDW), neutrophil to lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR), and the presence and severity of diabetic retinopathy (DR). METHODS: We searched for eligible studies from PubMed, EMBASE, Web of Science and CNKI up to December 13, 2017. Standardized mean difference (SMD) calculated with confidence interval (CI) of 95% was used to estimate the values of those indices. RESULTS: A total of 31 studies were included in the present Meta-analysis. As compared with type 2 diabetes mellitus (T2DM) patients without DR, the values of MPV, PDW, NLR, and PLR were higher in patients with DR (SMD=0.67; 95%CI: 0.36 to 0.98; SMD=0.51; 95%CI: 0.27 to 0.75; SMD=0.77; 95%CI: 0.49 to 1.05 and SMD=1.18; 95%CI: 0.07 to 2.28). Additionally, it was also observed that MPV was closely correlated with the severity of DR. CONCLUSION: MPV, PDW, NLR, and PLR could be recommended as diagnostic biomarkers for DR, and MPV could be applied to assess the severity of DR.

  • 1
• Surgical outcome of 21 patients with congenital upper eyelid coloboma

  Arshad Ali Lodhi, Sameen Afzal Junejo, Mahtab Alam Khanzada, Imran Akram Sahaf, Zahid Kamal Siddique

  Abstract: (60485) HTML (0) PDF (420.04 KKB) (2389)

  Abstract:

  AIM: To evaluate the surgical outcome of congenital upper eyelid coloboma repair. · METHODS: All patients underwent complete ophthalmic and general examination before going to surgery, and then examination under anesthesia was performed to assess the site and size of eyelid defect, conjunctival involvement. The status of cornea and ocular motility with forced duction test was also being noted. The surgical procedure was performed according to the size of defect. · RESULTS: Out of 21 cases of congenital upper eyelid coloboma, 18 occurred in isolation with upper eyelid medial defect, 13 were bilateral and 5 were unilateral. Others were associated with Goldenhar syndrome and CHARGE syndrome with bilateral upper lid medial defects. All patients were presented for surgical corrections during age of 2.5-4.0 years except one that presented at 25 years of age. Cosmetically surgical results were acceptable, except one that was already presented with opaque corneal. · CONCLUSION: In this study, overall surgical results were satisfactory except one that was presented late with compromised cornea.

  • 1
• Safety of intravitreal quinupristin/dalfopristin in an animal model

  Veronica E. Giordano, Sergio E. Hern, ez-Da Mota, Tania N. Adabache-Guel, Arm, o Castillejos-Chevez, Sonia Corredor-Casas, Samantha M. Salinas-Longoria, Rafael Romero-Vera, Juan M. Jimenez-Sierra, Jose L. Guerrero-Naranjo, Virgilio Morales-Canton

  Abstract: (51173) HTML (1241) PDF (594.71 KKB) (1797)

  Abstract:

  AIM: To determine whether different intravitreal doses of quinupristin/dalfopristin lead to electroretinographic or histological changes in the rabbit retina over one month period after injection. METHODS: Eighteen New Zealand white rabbits were divided into three treatment groups (groups 1 to 3) and different intravitreal doses of quinupristin/dalfopristin were tested in each group. The right eye was injected with the drug and the left eye received intravitreal injection of 5% dextrose water and served as control eye. The doses delivered to each group were 0.1 mg/0.1 mL, 1 mg/0.1 mL and 10 mg/0.1 mL. Simultaneous, bilateral, dark-adapted electroretinography and clinical images of both eyes were obtained in all groups before injection (baseline) and after 7, 14, 21 and 28d, followed by enucleation for histological examination. RESULTS: Subjects in the group 1 showed no signs of toxicity in the electroretinogram when compared with groups 2 and 3 (Kruskall-Wallis test, P=0.000). By day 7, no electrical response to light stimuli was recorded in the treated eyes in groups 2 and 3, consistent with severe damage due to retinal toxicity. Light microscopy revealed no significant histopathological changes in the group 1, while rabbits in groups 2 and 3 had signs of granulomatous inflammation in most cases. CONCLUSION: Intravitreal 0.1 mg/0.1 mL doses of quinupristin/dalfopristin do not lead to electroretinographic or histological signs of retinal toxicity compared with 1 mg/0.1 mL and 10 mg/0.1 mL in this rabbit model.

  • 1
• Ocular manifestation and their associated factors among HIV/AIDS patients receiving highly active antiretroviral therapy in Southern Ethiopia

  Anteneh Amsalu, Kindie Desta, Demiss Nigussie, Demoze Delelegne

  Abstract: (50706) HTML (1264) PDF (338.44 KKB) (1807)

  Abstract:

  AIM: To assess the pattern of ocular manifestation and associated factors among human immunodeficiency virus (HIV) /acquired immunodeficiency syndrome (AIDS) patients on highly active antiretroviral therapy (HAART) at Hawassa University Referral Hospital, Southern Ethiopia. METHODS: A cross sectional study was conducted from January 2014 to April 2015. After obtaining informed written consent, 240 adult HIV/AIDS patients on HAART were randomly selected regardless of their ophthalmic symptoms, WHO status or CD4 count. Data were collected using structured questionnaires and ophthalmologic clinical examination. Data were entered and analyzed using SPSS version 20.0 software. RESULTS: The mean duration of HAART was 62.5mo. The prevalence of HIV related ocular manifestation was 14.2%. Seborrheic blepharitis (5%) was the most common ocular manifestation, followed by squamoid conjunctival growth (3.8%). The rate of ocular manifestation was significantly higher among study participants who had CD4+ count <200 cells/μL (AOR=3.83; 95%CI: 1.315-11.153), low duration of HAART (AOR=3.0; 95%CI: 1.305-6.891) and who had primary school education [odds ratio (OR) =2.8; 95%CI: 1.105-7.099]. Prevalence of visual impairment and blindness was 10.9% and 5.8%, respectively. CONCLUSION: HAART may be the reason for the decline in the prevalence of ocular manifestation in HIV/AIDS patients in the study area. Ophthalmologic screening of HIV/AIDS patients, especially those with CD4 counts of <200/μL cells and in the first five years of HAART follow-up is recommended to reduce visual impairment and/or blindness.

  • 1
• Research progress about the effect and prevention of blue light on eyes

  Zhi-Chun Zhao, Ying Zhou, Gang Tan, Juan Li

  Abstract: (14877) HTML (1409) PDF (290.71 KKB) (4206)

  Abstract:

  In recent years, people have become increasingly attentive to light pollution influences on their eyes. In the visible spectrum, short-wave blue light with wavelength between 415 nm and 455 nm is closely related to eye light damage. This high energy blue light passes through the cornea and lens to the retina causing diseases such as dry eye, cataract, age-related macular degeneration, even stimulating the brain, inhibiting melatonin secretion, and enhancing adrenocortical hormone production, which will destroy the hormonal balance and directly affect sleep quality. Therefore, the effect of Blu-rays on ocular is becoming an important concern for the future. We describe blue light’s effects on eye tissues, summarize the research on eye injury and its physical prevention and medical treatment.

  • 1
• Proteomic analysis of anti-angiogenic effects by conbercept in the mice with oxygen induced retinopathy

  Ji Jin, Lei Chen, Gao-Qin Liu, Pei-Rong Lu

  Abstract: (10704) HTML (0) PDF (2.76 MKB) (1835)

  Abstract:

  AIM: To analyze the retinal proteomes with and without conbercept treatments in mice with oxygen-induced retinopathy (OIR) and identify proteins involved in the molecular mechanisms mediated by conbercept. METHODS: OIR was induced in fifty-six C57BL/6J mouse pups and randomly divided into four groups. Group 1: Normal17 (n=7), mice without OIR and treated with normal air. Group 2: OIR12/EXP1 (n=14), mice received 75% oxygen from postnatal day (P) 7 to 12. Group 3: OIR17/Control (n=14), mice received 75% oxygen from P7 to P12 and then normal air to P17. Group 4: Lang17/EXP2 (n=21), mice received 75% oxygen from P7 to P12 with intravitreal injection of 1 μL conbercept at the concentration of 10 mg/mL at P12, and then normal air from P12 to P17. Liquid Chromatography-Mass Spectrometry (LC-MS)/MS data were reviewed to find proteins that were up-regulated after the conbercept treatment. Gene ontology (GO) analysis was performed of conbercept-mediated changes in proteins involved in single-organism processes, biological regulation, cellular processes, immune responses, metabolic processes, locomotion and multiple-organism processes. RESULTS: Conbercept induced a reversal of hypoxia-inducible factor 1 signaling pathway as revealed by the Kyoto Encyclopedia of Genes and Genomes (KEGG) analysis and also induced down-regulation of proteins involved in blood coagulation and fibrin clot formation as demonstrated by the Database for Annotation, Visualization and Integrated Discovery (DAVID) and the stimulation of interferon genes studies. These appear to be risk factors of retinal fibrosis. Additional conbercept-specific fibrosis risk factors were also identified and may serve as therapeutic targets for fibrosis. CONCLUSION: Our studies reveal that many novel proteins are differentially regulated by conbercept. The new insights may warrant a valuable resource for conbercept treatment.

  • 1
• Achromatopsia caused by novel missense mutations in the CNGA3 gene

  Xi-Teng Chen, Hui Huang, Yan-Hua Chen, Li-Jie Dong, Xiao-Rong Li, Xiao-Min Zhang

  Abstract: (9748) HTML (0) PDF (771.47 KKB) (1838)

  Abstract:

  AIM:To identify the genetic defects in a Chinese family with achromatopsia.METHODS:A 2.5-year-old boy, who displayed nystagmus, photophobia, and hyperopia since early infancy, was clinically evaluated. To further confirm and localize the causative mutations in this family, targeted region capture and next-generation sequencing of candidate genes, such as CNGA3, CNGB3, GNAT2, PDE6C, and PDE6H were performed using a custom-made capture array.RESULTS:Slit-lamp examination showed no specific findings in the anterior segments. The optic discs and maculae were normal on fundoscopy. The unaffected family members reported no ocular complaints. Clinical signs and symptoms were consistent with a clinical impression of autosomal recessive achromatopsia. The results of sequence analysis revealed two novel missense mutations in CNGA3, c.633T>A (p.D211E) and c.1006G>T (p.V336F), with an autosomal recessive mode of inheritance.CONCLUSION: Genetic analysis of a Chinese family confirmed the clinical diagnosis of achromatopsia. Two novel mutations were identified in CNGA3, which extended the mutation spectrum of this disorder.

  • 1
• Tests for malingering in ophthalmology

  Ali Ihsan Incesu

  Abstract: (9360) HTML (0) PDF (281.98 KKB) (2405)

  Abstract:

  Simulation can be defined as malingering, or sometimes functional visual loss (FVL). It manifests as either simulating an ophthalmic disease (positive simulation), or denial of ophthalmic disease (negative simulation). Conscious behavior and compensation or indemnity claims are prominent features of simulation. Since some authors suggest that this is a manifestation of underlying psychopathology, even conversion is included in this context. In today’s world, every ophthalmologist can face with simulation of ophthalmic disease or disorder. In case of simulation suspect, the physician’s responsibility is to prove the simulation considering the disease/disorder first, and simulation as an exclusion. In simulation examinations, the physician should be firm and smart to select appropriate test(s) to convince not only the subject, but also the judge in case of indemnity or compensation trials. Almost all ophthalmic sensory and motor functions including visual acuity, visual field, color vision and night vision can be the subject of simulation. Examiner must be skillful in selecting the most appropriate test. Apart from those in the literature, we included all kinds of simulation in ophthalmology. In addition, simulation examination techniques, such as, use of optical coherence tomography, frequency doubling perimetry (FDP), and modified polarization tests were also included. In this review, we made a thorough literature search, and added our experiences to give the readers up-to-date information on malingering or simulation in ophthalmology.

  • 1
• Therapeutic effects of mesenchymal stem cells administered at later phase of recurrent experimental autoimmune uveitis

  Ping-Ting Zhao, Ling-Jun Zhang, Hui Shao, Ling-Ling Bai, Bo Yu, Chang Su, Li-Jie Dong, Xun Liu, Xiao-Rong Li, Xiao-Min Zhang

  Abstract: (8981) HTML (0) PDF (2.01 MKB) (1901)

  Abstract:

  AIM: To test the therapeutic effects of delayed treatment of mesenchymal stem cells (MSCs) in recurrent experimental autoimmune uveitis (rEAU). METHODS: The efficacy of different regimens of MSC administration in rEAU were tested by evaluation of clinical and pathological intraocular inflammation, as well as retinal structural and functional integrity using optical coherence tomography (OCT) and electroretinogram (ERG). The retinal sections were also immunostained with antibodies to glial fibrillary acidic protein (GFAP) and rhodopsin (RHO). RESULTS: Delayed treatment of MSCs effectively alleviated the severity of intraocular inflammation with relative intact of outer retinal structure and function. Moreover, double therapies with longer interval led to an even better clinical evaluation, as well as a trend of decrease in relapse and amelioration of retinal function. MSC therapies also effectively reduced GFAP expression and increased RHO expression in the retina. CONCLUSION: MSC administration can effectively treat developed diseases of rEAU, and multiple therapies can provide additional therapeutic benefits.

  • 1
• Rapamycin ameliorates experimental autoimmune uveoretinitis by inhibiting Th1/Th2/Th17 cells and upregulating CD4+CD25+ Foxp3 regulatory T cells

  Li-Fei Yuan, Guang-Da Li, Xin-Jun Ren, Hong Nian, Xiao-Rong Li, Xiao-Min Zhang

  Abstract: (8289) HTML (0) PDF (871.51 KKB) (1796)

  Abstract:

  AIM:To determine the effects of rapamycin on experimental autoimmune uveoretinitis (EAU) and investigate of role of rapamycin on T cell subsets in the disease. METHODS:EAU was induced in rats using peptides 1169 to 1191 of the interphotoreceptor binding protein (IRBP). Rapamycin (0.2 mg/kg/d) was administrated by intraperitoneal injection for a consecutive 7d after immunization. Th1/Th2/Th17 cytokines, TGF-β1, and IL-6 produced by lymphocyteswere measured by ELISA, while Th17 cells and CD4+CD25+ regulatory T cells (Tregs) from rat spleen were detected by flow cytometry. RESULTS: Intraperitoneal treatment immediately after immunization dramatically ameliorated the clinical course of EAU. Clinical responses were associated with reduced retinal inflammatory cell infiltration and tissue destruction. Rapamycin induced suppression of Th1/Th2/Th17 cytokines, including IFN-γ, IL-2, IL-17, IL-4, and IL-10 release from T lymphocytes of EAU rats, in vitro. Rapamycin also significantly increased TGF-β1 production but had no effect on IL-6 productionof T lymphocytes from EAU rats in vitro. Furthermore, rapamycin decreased the ratio of Th17 cells/CD4+T cells and upregulated Tregs in EAU, as detected by flow cytometry. CONCLUSION: Rapamycin effectively interferes with T cell mediated autoimmune uveitis by inhibiting antigen-specific T cell functions and enhancing Tregs in EAU. Rapamycin is a promising new alternative as an adjunct corticosteroid-sparing agent for treating uveitis.

  • 1
• Superglue injuries of the eye

  Sagili Ch, rasekhara Reddy

  Abstract: (8223) HTML (0) PDF (669.75 KKB) (2392)

  Abstract:

  AIM: To report various ocular lesions caused by accidental instillation of superglue.METHODS: Three cases of ocular injuries are described in children aged 6 years, 3 years and 8 months, following accidental instillation of superglue in the eye.RESULTS: In the first case there was sticking of eyelashes in the medial 1/3 of eyelids in both eyes. In the second case sticking of eye lashes was present in the lateral 1/3 of eyelids in the left eye. In the third case, superglue was present on the right cheek, above the right ear and sticking of eyelids in medial 1/3 in right eye. The eyelids were separated by pulling the lid margins with fingers in the first case and later on superglue was removed by trimming the eyelashes; and by direct trimming the eyelashes in second and third cases. There was no injury to other structures of anterior segment in the first two cases. However, removal of the superglue on the cornea resulted in corneal abrasion in the third case which healed with medical treatment and patching of the right eye.CONCLUSION: Accidental instillation of superglue is possible because of the appearance of the tube like eye ointment tube. Immediate medical aid will prevent ocular morbidity.

  • 1
• A near-vision chart for children aged 3-5 years old:new designs and clinical applications

  Yang-Qing Huang, He Huang, Rong-Zhi Huang

  Abstract: (7222) HTML (0) PDF (963.79 KKB) (2042)

  Abstract:

  AIM:To introduce a new near-vision chart for children aged 3-5 years old and its clinical applications.METHODS:The new near-vision chart which combined the Bailey-Lovie layout with a newly devised set of symmetry symbols was designed based on Weber-Fechner law. It consists of 15 rows of symmetry symbols, corresponding to a visual acuity range from 1.3 to 0.1 logMAR. The optotypes were red against a white background and were specially shaped four basic geometric symbols:circle, square, triangle，and cross, which matched the preschool children''s cognitive level. A regular geometric progression of the optotype sizes and distribution was employed to arrange in 15 lines. The progression rate of the optotype size between two lines was 1.2589 and two smaller groups of optotypes ranging from 0.7 to -0.1 logMAR were included for repetitive testing. A near visual acuity was recorded in logMAR or decimal, and the testing distance was 25 cm.RESULTS:This new near-vision chart with pediatric acuity test optotypes which consists of 4 different symbols (triangle, square, cross, and circle) met the national and international eye chart design guidelines. When performing the near visual acuity assessment in preschoolers (3-5 years old). It overcame an inability to recognize the letters of the alphabet and difficulties in designating the direction of black abstract symbols such as the tumbling ''E'' or Landolt ''C'', which the subjects were prone to lose interest in. Near vision may be recorded in different notations:decimal acuity and logMAR. These two notations can be easily converted each other in the new near-vision chart. The measurements of this new chart not only showed a significant correlation and a good consistency with the Chinese national standard logarithmic near-vision chart (r=0.932, P<0.01), but also indicated good test-retest reliability (89% of retest scores were within 0.1 logMAR units of the initial test score) and a high response rate.CONCLUSION:The results of this study support the validity and reliability of near visual acuity measurements using the new near-vision chart in children aged 3-5y over a wide range of visual acuities, and the new eye chart was especially suitable for the detection of amblyopia risk factors and low vision examination in children (3-5y of age). It can be applied in routine clinical practice.

  • 1
• Malingering or simulation in ophthalmology-visual acuity

  Ali Ihsan Incesu, Güng?r Sobac?

  Abstract: (6812) HTML (0) PDF (320.40 KKB) (2150)

  Abstract:

  Simulation can be defined as malingering, or sometimes functional visual loss (FVL). It manifests as either simulating an ophthalmic disease (positive simulation), or denial of ophthalmic disease (negative simulation). Conscious behavior and compensation or indemnity claims are prominent features of simulation. Since some authors suggest that this is a manifestation of underlying psychopathology, even conversion is included in this context. In today's world, every ophthalmologist can face with simulation of ophthalmic disease or disorder. In case of simulation suspect, the physician's responsibility is to prove the simulation considering the disease/disorder first, and simulation as an exclusion. In simulation examinations, the physician should be firm and smart to select appropriate test(s) to convince not only the subject, but also the judge in case of indemnity or compensation trials. Almost all ophthalmic sensory and motor functions including visual acuity, visual field, color vision and night vision can be the subject of simulation. Examiner must be skillful in selecting the most appropriate test. Apart from those in the literature, we included all kinds of simulation in ophthalmology. In addition, simulation examination techniques, such as, use of OCT (optical coherence tomography), frequency doubling perimetry (FDP), and modified polarization tests were also included. In this review, we made a thorough literature search, and added our experiences to give the readers up-to-date information on malingering or simulation in ophthalmology.

  • 1
• Prevalence of vitreous floaters in a community sample of smartphone users

  Blake F. Webb, Jadon R. Webb, Mary C. Schroeder, Carol S. North

  Abstract: (6778) HTML (0) PDF (202.26 KKB) (2231)

  Abstract:

  AIM: To estimate the prevalence and risk factors for vitreous floaters in the general population.METHODS: An electronic survey was administered through a smartphone app asking various demographic and health questions, including whether users experience floaters in their field of vision. Multivariate logistic regression analysis was used to determine risk factors.RESULTS:A total of 603 individuals completed the survey, with 76% reporting that they see floaters, and 33% reporting that floaters caused noticeable impairment in vision. Myopes were 3.5 times more likely (P=0.0004), and hyperopes 4.4 times more likely (P=0.0069) to report moderate to severe floaters compared to those with normal vision. Floater prevalence was not significantly affected by respondent age, race, gender, and eye color.CONCLUSION:Vitreous floaters were found to be a very common phenomenon in this non-clinical general population sample, and more likely to be impairing in myopes and hyperopes.

  • 1
• Photobiomodulation for the treatment of retinal diseases: a review

  Ivayla I. Geneva

  Abstract: (6592) HTML (0) PDF (331.95 KKB) (2438)

  Abstract:

  Photobiomodulation (PBM), also known as low level laser therapy, has recently risen to the attention of the ophthalmology community as a promising new approach to treat a variety of retinal conditions including age-related macular degeneration, retinopathy of prematurity, diabetic retinopathy, Leber’s hereditary optic neuropathy, amblyopia, methanol-induced retinal damage, and possibly others. This review evaluates the existing research pertaining to PBM applications in the retina, with a focus on the mechanisms of action and clinical outcomes. All available literature until April 2015 was reviewed using PubMed and the following keywords: “photobiomodulation AND retina”, “low level light therapy AND retina”, “low level laser therapy AND retina”, and “FR/NIR therapy AND retina”. In addition, the relevant references listed within the papers identified through PubMed were incorporated. The literature supports the conclusion that the low-cost and non-invasive nature of PBM, coupled with the first promising clinical reports and the numerous preclinical-studies in animal models, make PBM well-poised to become an important player in the treatment of a wide range of retinal disorders. Nevertheless, large-scale clinical trials will be necessary to establish the PBM therapeutic ranges for the various retinal diseases, as well as to gain a deeper understanding of its mechanisms of action.

  • 1
• Comparison of fibrin glue and suture technique in pterygium surgery performed with limbal autograft

  Bora Yüksel, Sultan Kaya ünsal, Sevgi Onat

  Abstract: (6553) HTML (0) PDF (165.03 KKB) (2108)

  Abstract:

  AIM: To compare the efficiency and safety of fibrin glue to suture technique in pterygium surgery performed with limbal autograft. METHODS: A prospective randomised clinical trial was carried out in 58 eyes of 58 patients operated for primary nasal pterygium. Autologous conjunctival graft taken from the superotemporal limbus was used to cover the sclera after pterygium excision. In 29 eyes, the transplant was attached to the sclera with a fibrin tissue adhesive (Beriplast P) and in 29 eyes with 8-0 Virgin silk sutures. The Mann-Whitney U test was used for statistical analysis. Postoperative patient discomfort (pain, stinging, watering) and biomicroscopic findings (hyperemia, edema) were graded. Patients were followed up at least for six months. RESULTS: Subconjunctival hemorrhage occured under the graft in one patient in group 1. In seven cases of group 2, sutures were removed at the 15th day because of granulomatous tissue reaction. Patient symptoms were significantly less and biomicroscopic findings were better in group 1. Pterygium recurrence was seen in one case of group 1, and 2 cases of group 2. Average surgery cost was higher (P<0.05) and surgery time was shorter (P<0.05) in fibrin group. CONCLUSION: Using fibrin glue for graft fixation in pterygium surgery causes significantly less postoperative pain and shortens surgery time significantly.

  • 1
• Cod liver oil: a potential protective supplement for human glaucoma

  Wen-Bin Huang, Qian Fan, Xiu-Lan Zhang

  Abstract: (6479) HTML (0) PDF (246.01 KKB) (2023)

  Abstract:

  Glaucoma is one of the leading causes of visual impairment and blindness. Improved knowledge of the pathogenesis of this disease has allowed the exploration of new therapeutic methods. In general, elevated intraocular pressure (IOP), oxidative stress, and vascular insufficiency are accepted as the major risk factors for the progression of glaucoma. Many natural compounds have been found beneficial for glaucoma. Nutritional therapies are now emerging as potentially effective in glaucomatous therapy. One nutritional supplement with potential therapeutic value is cod liver oil, a dietary supplement that contains vitamin A and omega-3 polyunsaturated fatty acids (PUFAs). Vitamin A is important for preserving normal vision and it is a well-known antioxidant that prevents the oxidative damage that contributes to the etiology and progression of glaucoma. Vitamin A is also a crucial factor for maintaining the integrity of conjunctival and corneal ocular surfaces, and preventing the impairment of ocular epithelium caused by topical antiglaucomatous drugs. Omega-3 fatty acids are beneficial for glaucoma patients as they decrease IOP, increase ocular blood flow, and improve optic neuroprotective function. In this article, we propose that cod liver oil, as a combination of vitamin A and omega-3 fatty acids, should be beneficial for the treatment of glaucoma. However, further studies are needed to explore the relationship between cod liver oil and glaucoma.

  • 1
• Epidemiology and molecular genetics of congenital cataracts

  Jun Yi, Jun Yun, Zhi-Kui Li, Chang-Tai Xu, Bo-Rong Pan

  Abstract: (6244) HTML (0) PDF (570.98 KKB) (2398)

  Abstract:

  · Congenital cataract is a crystallin severe blinding disease and genetic factors in disease development are important. Crystallin growth is under a combination of genes and their products in time and space to complete the coordination role of the guidance. Congenital cataract-related genes, included crystallin protein gene (CRYAA, CRYAB, CRYBA1/A3, CRYBA4, CRYBB1, CRYBB2, CRYBB3, CRYGC, CRYGD, CRYGS), gap junction channel protein gene (GJA1, GJA3, GJA8), membrane protein gene (GJA3, GJA8, MIP, LIM2), cytoskeletal protein gene (BF-SP2), transcription factor genes (HSF4, MAF, PITX3, PAX6), ferritin light chain gene (FTL), fibroblast growth factor (FGF) and so on. Currently, there are about 39 genetic loci isolated to which primary cataracts have been mapped, although the number is constantly increasing and depends to some extent on definition. We summarized the recent advances on epidemiology and genetic locations of congenital cataract in this review.

  • 1
• Aniridia rings implantation for treatment of congenital aniridia combined with cataract surgery: a case report

  Juan-Juan Li, Yun-Peng Li, Zhu-Lin Hu

  Abstract: (6006) HTML (0) PDF (87.46 KKB) (2115)

  Abstract:

  We describe the successful treatment in a patient with bilateral congenital aniridia and cataract by insertion of capsular tension rings and IOL.

  • 1
• Prevention of exposure keratopathy in intensive care unit

  Hua Shan, Du Min

  Abstract: (5986) HTML (0) PDF (107.88 KKB) (2037)

  Abstract:

  AIM: To compare the efficacy for preventing exposure keratopathy of three forms of eye care (artificial tear, moist chamber and polyethylene covers) for intensive care patients. METHODS: Eighty-four patients in Intensive Care Unit (ICU) were randomized to three treatment groups, including artificial tears group, moist chambers group and polyethylene film group. Patients of artificial tear group received two drops of carboxymethylcellulose drops to each eye every 2 hours. The moist chambers and the polyethylene were changed every 12 hours or as needed if they became unclean or torn. The corneal fluorescein stains were performed daily. RESULTS: No of 28 patients (0%) in the polyethylene group and one of the 27 patients (3.70%) in the moist chamber group had exposure keratopathy, compared to 8 of the 29 patients (27.59%) in the artificial tear group. There were statistical significance between the artificial tear group and the moist chamber group (P=0.02), and the artificial tear group and the polyethylene group (P =0.003). The time on eye care every day of the artificial tear group, the moist chamber group and the polyethylene group was 26.69±2.39 minutes, 35.33±2.63 minutes and 7.48±0.87 minutes, respectively. The eye care of the polyethylene group were statistically more time-save than that of the artificial tear group (P<0.001) and the moist chamber group (P<0.001). CONCLUSION: Polyethylene covers are more effective and more time-saving in reducing the incidence of corneal damage in intensive care patients

  • 1