International Journal of Ophthalmology-IJO is a global ophthalmological scientific publication and a peer-reviewed open access periodical (ISSN 2222-3959 print, ISSN 2227-4898 online). This journal is sponsored by Chinese Medical Association Xi’an Branch and published by the IJO Press. It has been indexed in SCIE, PubMed, PMC, CA, IC, Scopus, EMBASE and DOAJ, and was selected for China's Science and Technology Journal International Influence Enhancement Plan (D-class projects). IJO’s JCR IF in 2024 is 1.8 (Q3), Five-year Impact Factor is 1.8, CiteScore in 2024 is 2.8. IJO was established in 2008, with editorial office in Xi’an, China. It is a monthly publication and accept contributions from all over the world, both basic and clinical research.
- Current Issue
- Advance Publication
- Latest Accepted
- Article Ranking
- Archive
-
Tsung-Hsien Tsai, Chin-Ling Tsai, Jui-Hung Hsu, Ching-Hsi Hsiao, Hung-Chi Chen
2026(6):1019-1027 ,DOI: 10.18240/ijo.2026.06.01
Abstract:
AIM: To evaluate the ability of six advanced large language models (LLMs)—in providing accurate, comprehensive, and readable patient education on corneal refractive surgeries [laser in-situ keratomileusis (LASIK), keratorefractive lenticule extraction (KLEx), and photorefractive keratectomy (PRK)] in both English and Chinese. METHODS: This is a cross-sectional, comparative study. Twenty-six questions, compiled from authoritative ophthalmologic sources and covering four domains (procedure basics and eligibility; safety, risks and long-term stability; recovery and postoperative experience; and practical concerns), were administered in both English and Chinese via fresh chat sessions with each LLM, respectively. Five performance metrics were evaluated: accuracy, comprehensiveness, word count, readability, and reproducibility, using appropriate statistical tests. RESULTS: OpenAI o1 and DeepSeek-R1 consistently achieved the highest accuracy and most comprehensive responses, significantly outperforming ChatGPT-4o, Gemini Advanced, Claude Sonnet, and Tongyi Qwen (Friedman P<0.001). Although overall accuracy and comprehensiveness were similar across languages, Chinese responses were significantly longer. Readability varied among the models, with Claude Sonnet generally producing the most readable English texts. Reproducibility analysis revealed moderate consistency, reflecting inherent variability in outputs to identical prompts. CONCLUSION: Reasoning-augmented LLMs, particularly OpenAI o1 and DeepSeek-R1, demonstrate superior performance in delivering bilingual patient education for corneal refractive surgery, with high accuracy and comprehensiveness. However, variations in response length, readability, and reproducibility indicate that further refinement is necessary before these tools can be reliably integrated into clinical practice.
-
Hui-Hui Zhang, Yu-Sheng Zhu, Jing-Yu Guo, Xiao-Dong Chen
2026(6):1028-1037 ,DOI: 10.18240/ijo.2026.06.02
Abstract:
AIM: To explore the effect of SP600125, a c-Jun N-terminal kinases (JNK) inhibitor, on epithelial-mesenchymal transition (EMT) in retinal pigment epithelial (RPE) cell caused by transforming growth factor-beta 2 (TGF-β2). METHODS: Human RPE cell line (ARPE-19) cells were treated with TGF-β2 and JNK inhibitor SP600125 in vitro. Cellular viability, migration and proliferation in ARPE-19 cells were examined by cell counting kit-8 (CCK-8) assay, wound scratch, and bromodeoxyuridine (BrdU) staining assay, respectively. Transforming growth factor-beta receptor 2 (TGF-βR2), Smad2/3, JNK, c-Jun, alpha-smooth muscle actin (α-SMA), N-cadherin, and vimentin proteins were analyzed by immunoblotting. Moreover, TGF-βR2 was detected by immunofluorescence assay. RESULTS: TGF-β2 significantly enhanced viability, migration, and proliferation in ARPE 19 cells, induced phosphorylation of TGF-βR2, Smad2/3, JNK, and c Jun, and upregulated α SMA, N cadherin, and vimentin expression. SP600125 inhibited these cellular processes and reduced the expression/phosphorylation of the above proteins; notably, it blocked TGF-β2 induced effects, including cell viability, migration, proliferation, phosphorylation of TGF-βR2, Smad2/3, JNK, and c Jun, as well as upregulation of α SMA, N cadherin, and vimentin. CONCLUSION: JNK inhibitor SP600125 suppresses TGF-β2-induced the increases in cell viability, migration, proliferation, and EMT in RPE cells via the TGFβR2/Smad2/3 and JNK/c-Jun signaling pathways.
-
Jing-Yu Liu, Jun-Ya Zhu, Yi-Fang Xiao, Yi-Rui Ge, Feng Yan, Qin Jiang
2026(6):1038-1047 ,DOI: 10.18240/ijo.2026.06.03
Abstract:
AIM: To investigate whether catalpol protects against diabetic retinal vascular endothelial injury by targeting the methyltransferase-like 3 (METTL3)-m6A-thioredoxin-interacting protein (TXNIP) axis and inhibiting nucleotide-binding oligomerization domain (NOD)-like receptor family pyrin domain containing 3 (NLRP3) inflammasome activation. METHODS: A streptozotocin-induced diabetic mouse model (n=20 per group) was used to assess retinal function via electroretinogram (ERG) and vascular integrity via Evans Blue leakage. Human retinal vascular endothelial cells (HRVECs) were exposed to high glucose (HG, 30 mmol/L) with or without catalpol or the METTL3 inhibitor STM2457. NLRP3 inflammasome components (Western blot), oxidative stress (DCFH-DA probe), global m6A levels (Dot blot), and TXNIP expression were measured. The binding of catalpol to METTL3, NLRP3, TXNIP, and interleukin-1β (IL-1β) was analyzed via molecular docking and dynamics simulations. RESULTS: Catalpol treatment improved ERG amplitudes [a-wave, b-wave, oscillatory potentials (OPs)] and reduced vascular leakage in diabetic mice (P<0.05), while downregulating retinal vascular endothelial growth factor (VEGF), NLRP3, IL-1β, and IL-18 protein levels. In HG-stimulated HRVECs, catalpol inhibited the NLRP3-apoptosis-associated speck-like protein containing a CARD (ASC)-caspase-1 inflammasome, reduced reactive oxygen species, and suppressed METTL3 expression and global m6A methylation (P<0.05). It also attenuated HG-induced TXNIP upregulation. METTL3 inhibition by STM2457 mimicked all protective effects of catalpol. Molecular simulations confirmed stable binding of catalpol to METTL3, NLRP3, TXNIP, and IL-1β. CONCLUSION: Catalpol alleviates diabetic retinal vascular endothelial injury by inhibiting the NLRP3 inflammasome. This effect is mediated, at least in part, through downregulating METTL3-dependent m6A RNA methylation of TXNIP.
-
Yuan Peng, Ling-Yan Liang, Han-Lei Wei, Qin Huang, Ling-Mei Yuan, Yu-Yan Xie, Qiu-Yu Tang, An-Qi Wang, Jia-Ming Li, Qin-Shang Guo, Bing-Lin Huang
2026(6):1048-1056 ,DOI: 10.18240/ijo.2026.06.04
Abstract:
AIM: To evaluate the effect of Fructus lycii (FL) aqueous extract on dry age-related macular degeneration (AMD) in mice via the nuclear factor erythroid 2-related factor 2/antioxidant response element (Nrf2/ARE) signaling pathway and investigate the protective effect of FL-containing serum on hydrogen peroxide (H2O2)-treated human retinal pigment epithelial cells (ARPE-19) in vitro. METHODS: In vivo dry AMD mouse model was established by intraperitoneal injection of NaIO3 solution and treated with aqueous extract of FL. The pathological changes of mouse retinal tissues were observed by electron microscopy; the activity of superoxide dismutase (SOD) and catalase (CAT) in mouse serum was detected by colorimetric method. In vitro dry AMD model was established by H2O2 induction of ARPE-19 cells and treated with FL-containing serum. Methylthiazolyldiphenyl-tetrazolium bromide assay and scratch assay were performed to detect cell activity and proliferation ability. Expression of Nrf2, heme oxygenase-1 (HO-1), and glutamate-cysteine ligase catalytic subunit (GCLC) in retinal tissues and ARPE-19 cells were detected by Western blot and quantitative real-time polymerase chain reaction (Q-PCR). RESULTS: The in vivo study revealed severe deposits under the retinal pigment epithelium and thickened Bruch’s membrane in dry AMD mice. However, aqueous extract of FL reduced the formation of deposits and decreased the thickness of Bruch’s membrane. SOD and CAT activities were significantly reduced in the serum of dry AMD mice, and aqueous extract of FL upregulated SOD and CAT activities. In addition, gene and protein expression of Nrf2, HO-1, and GCLC were significantly downregulated in dry AMD mice, but significantly upregulated by FL aqueous extract treatment. In vitro studies showed that H2O2 inhibited the activity and proliferative capacity of ARPE-19 cells and downregulated the protein and gene expression of Nrf2, HO-1 and GCLC. However, in H2O2-treated ARPE-19 cells, FL-containing serum not only increased cell activity and proliferative capacity, but also upregulated protein and gene expression of Nrf2, HO-1, and GCLC. CONCLUSION: FL reduces oxidative stress in an animal model of dry AMD through the Nrf2/ARE signaling pathway and has a protective effect on dry AMD in vitro and in vivo, providing new insights into the therapeutic use of FL for dry AMD.
-
Jian Jiao, Yi-Jun Xu, Xue-Dong Li, Wen Hua, Yan-Rong Jiang
2026(6):1057-1064 ,DOI: 10.18240/ijo.2026.06.05
Abstract:
AIM: To evaluate the effect of laser photocoagulation on transfection efficiency of lentivirus (LV) vectors injected intravitreally. METHODS: The rat retina was photocoagulated prior to intravitreal injection of LV vectors encoding red fluorescent protein. Rats given intravitreal injection or photocoagulation alone served as controls. The transduction efficiency was analyzed by fundus angiography, histopathology, and immunofluorescence staining. Potential adverse effect of laser photocoagulation was evaluated in choroid flat mounts by observing the morphology of retinal pigment epithelium (RPE) that formed the outer blood-retina barrier. RESULTS: Laser photocoagulation enhanced the retinal area transduced by LV vectors in fundus images and increased the maximum transduction thickness in histopathological sections. Choroid flat mounts showed the RPE transduced by LV vectors maintained normal morphology. CONCLUSION: Laser photocoagulation improves the transduction efficiency of LV vectors injected intravitreally, identifying this as a promising gene therapy strategy for inherited retinal dystrophies caused by gene mutations in RPE and photoreceptor cells.
-
Athar Shadmani, Aretha Y. Zhu, Ajay E. Kuriyan, Prashanth G. Iyer, Hiroyuki Takahashi, Abdelrahman M. Elhusseiny, Yoseph Sayegh, Sander G. Dubovy, Harry W Flynn, William E. Smiddy
2026(6):1065-1071 ,DOI: 10.18240/ijo.2026.06.06
Abstract:
AIM: To investigate correlation of clinical, optical coherence tomography (OCT), and immunohistochemistry (IHC) in idiopathic and secondary epiretinal membrane (ERM). METHODS: Retrospective review of patients undergoing pars plana vitrectomy with membrane peeling (PPV-MP). Excised membranes were evaluated by IHC staining for glial fibrillary acidic protein (GFAP), α-smooth muscle actin (α-SMA), cytokeratin, pigment, and fibrosis grading. Pre-operative and post-operative OCTs, and clinical follow-up information at least 3mo were collected. RESULTS: This study analyzed 104 eyes of 104 patients, of whom 83 (79.8%) had idiopathic ERM (iERM) and 21 (20.2%) had secondary ERM (sERM). Mean age at the time of surgery was 67.3±10.5y. OCT demonstrated greater foveal distortion (P=0.012), intraretinal (IR) spaces (P=0.009), and ellipsoid zone (EZ) discontinuity (P=0.022) in sERMs. Poorer pre-operative BCVA for all cases correlated with foveal distortion (P=0.011), loss of parallelism (P=0.014), IR spaces (P=0.027), and EZ disruption (P=0.012). Poorer post-operative BCVA for all cases was associated with foveal distortion (P=0.027). GFAP was expressed in nearly all ERMs (99%). Pigment was expressed more in sERM (61.9%) compared with iERM (21.7%; P=0.005) and associated with poorer post-operative BCVA (P=0.035) and ERM dehiscence (P=0.008). Fibrosis severity correlated with poorer pre-operative BCVA (P=0.027). GFAP intensity correlated with longer symptom duration (P=0.002). CONCLUSION: The high prevalence of many cell types not distinguished for iERM versus sERM suggests a common pathway of formation with local influences rather than an etiologic cell type or substrate location.
-
Fan Fan, Xi-Yue Zhou, Jia-Ning Yang, Xin Liu, Yi Luo
2026(6):1072-1078 ,DOI: 10.18240/ijo.2026.06.07
Abstract:
AIM: To compare the visual performances of extended depth of focus (EDOF) lenses, diffractive bifocal intraocular lenses (IOLs) and their combination. METHODS: This was a prospective, consecutive observational comparative study performed from Dec 2020 to Dec 2021. Cataract patients who meet the indications for multifocal IOLs implantation were divided into three groups, including binocular diffractive bifocal IOL (Human Optics Diff-aAY) implantation group, binocular EDOF IOL (Tecnis Symfony ZXR00) group and mix-and-match group (Symfony in one eye and Diff-aAY in the other). Follow-ups were scheduled at 1d, 3d, 2wk, and 6mo. Visual acuities (VA) at different distances were examined at every follow-up. At 6mo, optic path difference (OPD) scans, and questionnaire answers were evaluated. RESULTS: Thirty patients (60 eyes) were included in the binocular Diff-aAY group [age 63 (59-68), 11 males], 29 patients (58 eyes) in the binocular Symfony group [age 62 (56.75-68), 15 males] and 27 patients in mix-and-match group [age 65 (51-71), 11 males]. There was no significant difference in binocular uncorrected distance VA, uncorrected intermediate VA, or uncorrected near VA among the three groups (P=0.082, 0.151, and 0.703, respectively) at the last follow-up. The mix-and-match group had a superior Strehl ratio (SR; P=0.025) and modulation transfer function (MTF; P<0.05) and an inferior root mean square (RMS; P<0.05) in OPD scan. The three groups reported comparable level of postoperative satisfaction (P=0.141) and spectacle independence (P=0.278). Mild subjective dysphotopsia was more common (22.22%) in mix-and-match group (P=0.030). CONCLUSION: Bilateral Symfony, bilateral Diff-aAY, and the combination of these two IOLs are all remarkable regarding all range vision, objective visual quality, and spectacle independence.
-
Yan Gao, Dan-Ting Lin, Tao Zhou, Lin-Hui He, Ke-Xin Zhao, Xiao-Wei Yu, Lin Deng, Zhi-Gang Fan, Yan Shi
2026(6):1079-1087 ,DOI: 10.18240/ijo.2026.06.08
Abstract:
AIM: To explore the genetic variants of trabeculodysgenesis under ultrasound biomicroscopy (UBM) and its association with surgical outcomes in patients with primary congenital glaucoma (PCG). METHODS: In this prospective case series, consecutive patients with PCG underwent microcatheter-assisted trabeculotomy (MAT) and followed for at least 24-month after surgery. All participants underwent UBM and whole-exome sequencing prior to MAT and were classified into two groups with severe trabeculodysgenesis or mild trabeculodysgenesis under UBM. Surgical success was defined as a postoperative IOP of ≤21 mm Hg with at least a 20% reduction from preoperative IOP without additional medical or surgical therapy. RESULTS: Severe trabeculodysgenesis was observed in 23 (40%) eyes of 14 patients (median age: 57mo, range: 3–169mo; 11 males) with 8 carrying causative CYP1B1 variants, while mild trabeculodysgenesis occurred in 34 eyes (60%) of 18 patients (median age: 23.5mo, range: 3–110mo; 12 males) without any causative variants. The success rate of MAT was 0 in patients with causative CYP1B1 gene variants and 75.0% in those without (P<0.001). Cox regression survival analysis showed that carrying CYP1B1 gene variants [ORCYP1B1=0.356 (95%CI: 0.132, 0.962), P=0.042] and having severe trabeculodysgenesis [ORType=0.116 (95%CI: 0.034, 0.403), P=0.001] were associated with a higher risk of surgical failure. CONCLUSION: PCG patients with severe trabeculodysgenesis under UBM are prone to harbor causative CYP1B1 gene variants, which could serve as a valuable predictor of potential Schlemm’s canal dysgenesis and MAT prognosis. Genetic screening in patients with severe trabeculodysgenesis under UBM is beneficial for genetic counseling and may help reduce the incidence of complex cases.
-
Pei-Yao Jin, Min Tang, Min-Wen Zhou, Ying Fan, Yu-Ye Ling, Jian-Feng Zhu, Hai-Dong Zou, Jiang-Nan He, Wen-Wen Xue
2026(6):1088-1095 ,DOI: 10.18240/ijo.2026.06.09
Abstract:
AIM: To investigate the relationship between choroidal thickness (CT) and primary open angle glaucoma (POAG) in highly myopic eyes across different categories of myopic atrophic maculopathy (MAM). METHODS: This observational analytical case–control study enrolled highly myopic patients. All participants underwent comprehensive ophthalmic examinations. CT was measured in peripapillary and macular regions using optical coherence tomography (OCT). Each eye was classified for POAG status and MAM category. Stepwise logistic regression was performed to identify factors independently associated with POAG. RESULTS: Among 248 highly myopic subjects, 37 (18 males, mean age 68.25±7.16y) had POAG (25 bilateral, 12 unilateral) and 211 (97 males, mean age 67.09±7.63y) were non-glaucomatous. Age and sex did not differ significantly between groups (both P>0.05). Seventy-eight patients had unilateral high myopia and 170 bilateral, yielding 418 highly myopic eyes, of which 58 (13.88%) had POAG. POAG prevalence across MAM categories (no lesion to complete macular atrophy) was 7.14%, 16.28%, 14.07%, 17.86%, and 17.14%, respectively (P=0.44). In the diffuse chorioretinal atrophy subgroup, POAG eyes showed significantly thicker CT in central, inner nasal, outer superior, inner superior, and inner inferior macular regions, and thinner central corneal thickness (all P<0.05). Stepwise logistic regression showed that only parafoveal inferior CT was independently associated with POAG in this subgroup (OR=1.017; 95%CI: 1.005–1.028; P<0.01). No significant CT–POAG association was found in other MAM categories. CONCLUSION: Increased macular CT is independently associated with POAG in highly myopic eyes with diffuse chorioretinal atrophy. This implies distinct pathogenic mechanisms underlying POAG development across different MAM categories in high myopia.
-
Maria J. Rodrigo, Diego Fernandez-Velasco, Pablo Pérez-Gómez, Isabel Fuertes, Luis E. Pablo, Manuel Subías, Josep O. Casanovas-Marsal, Elena Garcia-Martin
2026(6):1096-1106 ,DOI: 10.18240/ijo.2026.06.10
Abstract:
AIM: To investigate optic nerve vascularization in patients with anterior ischemic optic neuropathy (AION) during the first 3mo after onset, using comprehensive ophthalmic assessments combined with optical coherence tomography (OCT) and optical coherence tomography angiography (OCT-A). METHODS: A prospective longitudinal observational study was performed with a 3-month follow-up. Clinical data recorded included age, sex, laterality of ocular involvement, AION subtype, previous history of ischemic events, cardiovascular risk factors such as high blood pressure, dyslipidemia, diabetes mellitus, smoking status, obstructive sleep apnea, and systemic treatments received. Functional, structural, and vascular examinations, including best corrected visual acuity (BCVA), visual field, OCT, and OCT-A, were performed at baseline, 1, and 3mo. RESULTS: Twenty-two subjects included 12 patients with AION and 10 healthy controls were enrolled. Mean age was 63.75±8.32y in the AION group and 61.80±5.04y in the control group (P=0.365). Gender and laterality distributions were comparable. AION patients showed significantly decreased optic nerve head perfusion at baseline (P=0.024) and 1mo (P=0.033). OCT revealed early thickening and subsequent atrophy of the peripapillary retinal nerve fiber layer and macular layers. OCT-A vascular parameters correlated significantly with 1-month BCVA (r=0.800, P≤0.05) and 3-month structural outcomes (r=0.807-0.835, P≤0.05). CONCLUSION: Vascular parameters derived from OCT-A can act as predictive markers for medium-term visual and structural outcomes in patients with ischemic optic neuropathy.
-
Osman Kizilay, Ahmad Kunbaz, Ozge Pinar Akarsu Acar, Murat Gunay, Gokhan Celik
2026(6):1107-1116 ,DOI: 10.18240/ijo.2026.06.11
Abstract:
AIM: To evaluate the long-term refractive and visual outcomes in infants with retinopathy of prematurity (ROP) treated with intravitreal bevacizumab (IVB), laser photocoagulation (LPC), or combined IVB+LPC therapy, and to assess disease severity on refractive development over five years. METHODS: This retrospective cohort study analyzed data from infants diagnosed with ROP between 2013 and 2018. Patients were categorized into four groups: IVB (n=44), LPC (n=41), IVB+LPC (n=17), and regressed ROP (RROP, n=50). A subgroup analysis was performed for Type 1 ROP and aggressive ROP (AROP). Primary outcomes included spherical equivalent (SE), astigmatism, and visual acuity (logMAR), measured at 6-month intervals up to 60mo. RESULTS: The study included 152 patients (76 females). The mean birth weight was 1256.1±555.6 g, and the mean week of birth was 29.1±2.9wk. RROP infants had the highest SE, closest to emmetropia. The IVB+LPC group showed the most significant myopic shift compared to other groups (P<0.05). In Type 1 ROP, SE was lower in the IVB+LPC group initially, but by 60mo, the difference was not significant. Astigmatism was higher in the LPC group at later time points (36–60mo). However, no differences in visual acuity were observed at the final follow-up among treatment groups. CONCLUSION: Refractive outcomes vary more in Type 1 ROP than AROP. IVB+LPC results in greater myopia; LPC is associated with increased astigmatism. Individualized refractive follow-up is essential, particularly for Type 1 ROP.
-
Xiao-Han Yang, Xiao Feng, Bi-Ying Qi, Xi-Jin Wu, Qin-Lang Jia, Wu Liu
2026(6):1117-1123 ,DOI: 10.18240/ijo.2026.06.12
Abstract:
AIM: To observe the clinical features and the surgical outcomes of the high myopic (HM) patients with epiretinal membranes (ERM). METHODS: This was a retrospective study enrolled HM patients diagnosed with ERM who underwent vitrectomy between May 2012 and November 2021. Three groups were divided according to axial length (AXL): 26–<28 mm (n=43), 28–<30 mm (n=22), and ≥30 mm (n=11). Baseline characteristics and postoperative visual and anatomical outcomes were analyzed. RESULTS: Totally 76 consecutive eyes of 73 HM patients (27 males), with a mean age of 60.5±9.2y (range: 38–84y) were enrolled. The initial best-corrected visual acuity (BCVA) of the three groups was not significantly different (P=0.498). Longer AXL was associated with a higher incidence of both inner and outer macular retinoschisis (MRS), ellipsoid zone (EZ) disruption, and foveal retinal detachment (all P<0.05). Only the eyes in the 26–<28 mm group showed a significant improvement in postoperative BCVA. BCVA was improved in 77.6% of the eyes. Among the eyes with BCVA not improved, 58.8% belonged to the group 26–<28 mm. The postoperative macular hole was seen in 1 (1.32%) eye. Multivariate linear regression analysis indicated that initial BCVA (P<0.001) and epiretinal proliferation (P=0.010) influenced the final BCVA. CONCLUSION: AXL is not significantly associated with visual recovery. Early operative intervention might have better visual and anatomical outcomes in HM-ERM patients.
-
Tsetsegjargal Baasanjav, Davaalkham Dambadarjaa, Baasankhuu Jamyanjav, Uranchimeg Davaatseren
2026(6):1124-1131 ,DOI: 10.18240/ijo.2026.06.13
Abstract:
AIM: To compare the clinical outcomes of the current V4c model of the myopic implantable Collamer lens (ICL) with those of laser in situ keratomileusis (LASIK) for the correction of myopia ranging from −2.0 to −18.0 diopters (D). METHODS: This prospective, non-randomized study enrolled participants who underwent either LASIK or implantation of the ICL V4c at Bolor Melmii Eye Hospital. In the LASIK group, participants received Intralase LASIK (I-LASIK) using the Intralase FS-200 femtosecond laser and the MEL-80 excimer laser. Each group comprised the same number of participants and eyes (38 participants, 73 eyes). RESULTS: A total of 146 eyes from 76 participants were analyzed. Among the LASIK group, 76.3% were female, with a mean age at surgery of 29.76±5.95y (range, 20–43y). In the ICL group, 92.1% were female, with a mean age of 31.59±8.32y (range, 20–49y). Preoperative best-corrected visual acuity (BCVA) did not differ significantly between the LASIK and ICL groups (P=0.68). Postoperatively, the ICL group consistently demonstrated better BCVA (20/20 or better) at all follow-up points, with statistically significant differences observed at 1d (56.2% vs 30.1%, P=0.003) and 3mo (54.8% vs 32.9%, P=0.012). The mean BCVA improvement also favored the ICL group for up to 6mo postoperatively. A higher proportion of eyes in the ICL group achieved uncorrected distance visual acuity (UDVA) of 20/20 or better at 1mo (50.7% vs 41.1%, P=0.319) and 6mo (57.5% vs 43.8%, P=0.136), although these differences were not statistically significant. Predictability was comparable between the groups, except at 6mo, where fewer ICL-treated eyes were within ±0.5 D of the intended correction (49.3% vs 64.4%, P=0.094). Nevertheless, both groups achieved identical outcomes within ±1.0 D (90.4%, P=1.000). Between 1 and 6mo, 78.1% of eyes in the ICL group showed a change in spherical equivalent refraction of no more than 0.5 D, compared to 65.8% in the LASIK group. Refraction stability, defined as a change of less than 1.0 D, remained good in both groups throughout all follow-up periods. CONCLUSION: Both LASIK and ICL implantation leads to significant improvements in visual outcomes, with early postoperative gains observed in both groups. However, the ICL group demonstrates greater long-term improvement in BCVA compared to the LASIK group, particularly among participants with higher degrees of myopia. Visual outcomes in both groups stabilized by 6mo postoperatively.
-
Qiu-Jian Zhu, Lie Ma, Hong Qian, Wei-Jian Zhu, You Yuan, E Song
2026(6):1132-1139 ,DOI: 10.18240/ijo.2026.06.14
Abstract:
AIM: To quantitatively evaluate the influence of four posterior chamber morphological features—wide iris-ciliary angle (ICA), concave iris (CI), anteriorly positioned ciliary body (APCB), and ciliary body cyst (CBC)—on vault after implantable Collamer lens (ICL) implantation. METHODS: In this retrospective paired study, 925 eyes from 506 patients were analyzed. Participants were matched 1:1 based on ICL size, horizontal/vertical sulcus-to-sulcus (STS) diameters, and lens thickness. Posterior chamber morphology was assessed using ultrasound biomicroscopy (UBM). Actual vault measurements were compared against vault values predicted using the Zhu formula. Statistical analyses included paired t-tests and Bland-Altman agreement assessment. RESULTS: Eyes with wide ICA (n=82) and CI (n=26) exhibited significantly lower actual vault (mean difference: −137.93 and −145.00 μm, respectively; P<0.001) compared to controls. Conversely, the APCB group (n=77) showed higher vault (mean increase: 222.60 μm; P<0.001), while CBC (n=36) had no significant impact (P=0.054). Bland-Altman analysis revealed systematic prediction errors: wide ICA and CI groups had underestimated vault (mean bias: −165.4 and −175.0 μm), whereas APCB showed overestimation (mean bias: +212.4 μm). Notably, 31.71% of wide ICA and 36.36% of APCB cases exceeded prediction errors of ±300 μm. CONCLUSION: Posterior chamber morphology, particularly wide ICA, CI, and APCB, significantly affects postoperative vault. These features introduce systematic deviations in vault prediction, highlighting the need for integrating morphological parameters into ICL sizing algorithms to optimize surgical outcomes and reduce complications.
-
Zhi-Hui Li, Jing Lin, Jie Li, Cheng-Yu Ji, Yan Guan, Run-Yu Zhu, Lan Hu
2026(6):1140-1148 ,DOI: 10.18240/ijo.2026.06.15
Abstract:
AIM: To analyze the correlation between ocular biometric parameters and cycloplegic refractive shift (ΔSE) and to provide evidence for clinical decision-making regarding cycloplegic refraction in pediatric myopia management. METHODS: This retrospective study enrolled myopic patients aged 5-17y between July 2022 and November 2023. Data collected included age, gender, pre-cycloplegic spherical equivalent (SE1), axial length (AL), average corneal curvature (K), lens thickness (LT), anterior chamber depth (ACD), central corneal thickness (CCT), positive relative accommodation (PRA), negative relative accommodation (NRA), and post-cycloplegic spherical equivalent (SE2). Only right eyes were analyzed. Participants were divided into three groups by ΔSE: Group A (ΔSE≤0.25 D), Group B (0.25<ΔSE<0.75 D), and Group C (ΔSE≥0.75 D). Based on SE2, subjects were classified into pre-myopia (−0.50
-
Ke-Jun Li, Yin Zhang, Yi-Ze Han, Zhi-Hua Zhao, Fang Fan, Yi-Ming Chen, Jian-Min Wang
2026(6):1149-1157 ,DOI: 10.18240/ijo.2026.06.16
Abstract:
AIM: To investigate morphological changes in the cornea and meibomian glands using in vivo confocal microscopy (IVCM) in patients with type 2 diabetes (T2DM) and to analyze the correlation of these changes with disease duration (DD). METHODS: Patients with T2DM who visited the ophthalmology and endocrinology departments of our hospital from May 2023 to December 2023 were selected. According to DD, they were divided into the short-DD (≤10y) and long-DD (>10y) groups. The control group consisted of age-matched non-diabetes patients. All underwent Ocular Surface Disease Index (OSDI), tear break-up time (TBUT), Schirmer I test (SIT), and IVCM imaging. Corneal nerve parameters, including corneal nerve fiber density (CNFD), corneal nerve branch density (CNBD), corneal nerve fiber length (CNFL), and meibomian gland metrics, including density of meibomian gland acinar units (MGAUD), the longest diameter of the meibomian gland acini (MGALD), the shortest diameter of meibomian gland acini (MGASD), the area of meibomian gland acinar units (MGAUA), were analyzed using ImageJ and ACCMetrics. RESULTS: A total of 130 patients with T2DM were included in this study, among which 68 were male (52.3%, age 30-76y) and 62 were female (47.7%, age 30-76y), the average age of the group was 55.54±11.65y. Significant differences (P<0.001) were observed in OSDI, TBUT, SIT, CNFD, CNBD, CNFL, MGALD, MGASD, MGAUD, and MGAUA between diabetes groups and controls. DD positively correlated with OSDI, MGALD, and MGASD (P<0.05), and negatively correlated with TBUT, SIT, CNFD, and CNFL (P<0.05). No correlation was found between DD and CNBD, MGAUD, or MGAUA (P>0.05). CONCLUSION: T2DM patients exhibit greater corneal nerve and meibomian gland damage than age 30-76y non-type 2 diabetes patients. Prolonged DD exacerbates these morphological changes.
-
Neşe Arslan, Şule Barman Kakil, Ayşenur Çoban
2026(6):1158-1164 ,DOI: 10.18240/ijo.2026.06.17
Abstract:
AIM: To evaluate the comparative effects of a combined trehalose-sodium hyaluronate (TD) formulation versus sodium hyaluronate (SH) monotherapy on postoperative ocular surface recovery following eyelid surgery, with additional analysis across surgical subgroups. METHODS: This retrospective comparative study included patients who underwent eyelid surgery for ectropion, entropion, or eyelid reconstruction between August 2021 and July 2024. Patients were divided into two treatment groups based on the postoperative tear substitutes used: Group SH treated with 0.15% SH eye drops, and Group TD treated with a combination of 3% trehalose and 0.15% SH. Postoperatively, patients received either 0.15% SH alone or a combination of 3% trehalose and 0.15% SH four times daily for 3mo. Ocular surface parameters—including tear break-up time (TBUT), Ocular Surface Disease Index (OSDI), Oxford staining score, meibomian gland loss (MGL), and central corneal epithelial thickness (CCET)—were assessed at baseline and 3mo. Subgroup analyses were performed by surgical indication. RESULTS: A total of 114 patients were included in the study (mean age: 70.3±12.1y; 25 females). Group SH comprised 57 patients (15 females, mean age: 69.2±11.4y), while the Group TD also included 57 patients (10 females, mean age: 71.5±12.8y). Both groups showed significant improvement across all parameters; however, the TD group demonstrated superior outcomes in TBUT (mean difference: +0.77s, 95%CI: 0.12–1.42, P=0.036), Oxford score (mean difference: –0.39, 95%CI: –0.75 to –0.03, P=0.036), and MGL (mean difference: –2.02%, 95%CI: –3.78% to –0.26%, P=0.025). Subgroup analysis revealed that the TD formulation resulted in significantly better outcomes in patients undergoing reconstruction (P<0.05 for all parameters) and in most measures within ectropion and entropion subgroups. No significant differences were found in OSDI between groups, despite objective improvements favoring the TD group. CONCLUSION: This study is the first to comparatively assess trehalose-based tear supplementation across distinct oculoplastic surgery subgroups. The combination of TD significantly enhanced postoperative ocular surface parameters—especially in complex reconstructive settings—compared to SH alone. These findings highlight the potential of tailored, antioxidative tear film strategies in optimizing recovery after eyelid surgery.
-
Rui Qi, Qi Zhou, Mei-Jiao Ma, Yuan-Yuan Lian, Wei-Ning Rong, Xun-Lun Sheng
2026(6):1165-1176 ,DOI: 10.18240/ijo.2026.06.18
Abstract:
AIM: To identify pathogenic variants in families with congenital stationary night blindness (CSNB) accompanied by early-onset high myopia (eoHM) using whole-exome sequencing (WES), and to evaluate the clinical value of electrophysiological and genetic testing for the differential diagnosis of CSNB, which is frequently misdiagnosed as amblyopia. METHODS: The study cohort comprised families clinically diagnosed with eoHM. Probands and available family members underwent comprehensive ophthalmic examinations. Pathogenic variants were identified via WES, in silico analysis, co-segregation analysis, Sanger sequencing and classified according to the American College of Medical Genetics and Genomics (ACMG) guidelines. Genotype-phenotype correlations were analyzed within the context of CSNB, supplemented by a review of relevant literature utilizing databases including HGMD, PubMed, CNKI, and Wanfang. RESULTS: Among 42 families with eoHM, five were identified with CSNB. The probands aged 2–5y, with spherical equivalents (SE) ranging from −6.00 to −11.00 D and best-corrected visual acuity (BCVA) between 0.15 and 0.6. No organic ocular abnormalities were observed. Initially diagnosed as high myopia and refractive amblyopia, they received optical correction and amblyopia therapy. Electroretinogram (ERG) revealed diminished rod responses and a negative waveform under dark-adapted 3.0 ERG conditions. Seven pathogenic variants were identified in CACNA1F, NYX, and TRPM1, including two novel variants. All five probands were ultimately diagnosed with CSNB-associated eoHM. In Family 1, the proband carrying a CACNA1F variant (c.1873C>T; p.Arg625Ter) exhibited slow myopic progression without fundus changes over 9y of follow-up. A literature review highlighted significant genetic and clinical heterogeneity in CSNB-related eoHM. CONCLUSION: This study reveals marked genetic and clinical heterogeneity in CSNB-related eoHM. TRPM1 and NYX variants (complete CSNB) cause earlier and more severe myopia than CACNA1F variants (incomplete CSNB). Characteristic ERG patterns differentiate subtypes. Reduced BCVA in eoHM may indicate inherited retinal disorders, not just refractive errors. Children with eoHM and reduced BCVA need systematic electrophysiological and genetic evaluations to prevent misdiagnosis and enable personalized care.
-
Qing-Qing Mu, Ping Ge, Xu Liu, Jun Jia, Na Cui, Xiang-Xiang Yang, Rui-Xue Zhang, Yan Liu, Yuan-Yuan Zhang, Yuan He
2026(6):1177-1185 ,DOI: 10.18240/ijo.2026.06.19
Abstract:
Primary open angle glaucoma (POAG) is a chronic, blinding ocular disorder characterized by progressive degeneration of retinal ganglion cells (RGCs). Its incidence and prevalence of blindness continue to increase with global population aging. Non-pathologic high myopia (HM) has been established as an independent risk factor for POAG, and the two conditions share similar structural changes in the lamina cribrosa (LC) during the early phase of optic nerve injury. This review summarizes the common and distinct pathological alterations of LC in POAG and HM, with the aim of clarifying its central role in the initiation and progression of optic nerve damage. Elucidating these similarities and differences may facilitate early detection and targeted intervention strategies for at-risk individuals from a structural perspective.
-
Alene Liu Wan Yi, Wan Haslina Wan Abdul Halim, Norshamsiah Md Din
2026(6):1186-1193 ,DOI: 10.18240/ijo.2026.06.20
Abstract:
This scoping review aims to focus on the association between topical anti-glaucoma medication and limbal stem cell deficiency through a comprehensive analysis from the available relevant case reports, research articles and experimental studies. By understanding the potential risks associated with long-term anti-glaucoma medication use and their impact on corneoscleral limbus, precautions can be taken to balance between the risk of glaucoma progression and limbal stem cell deficiency. All relevant publications from 2000 to 2023 were included and evidence of strong emerging potential link between topical glaucoma eyedrops and the disruption of limbal stem cell homeostasis were found. Prolong use of topical glaucoma medication with preservatives were found to have a negative effect on limbal stem cells. The frequent use of topical preservative-free prostaglandin analogues and beta-blockers, commonly prescribed for glaucoma, is associated with morphological alterations in the corneoscleral limbus. These changes appear to be mediated through an inflammatory process, leading to disruption of the corneoscleral limbal niche which eventually results in limbal stem cell deficiency. With the advancement of glaucoma surgical treatment, it is possible for glaucoma treatment to shift towards earlier surgical modality to reduce topical anti-glaucoma burden leading to limbal stem cell deficiency.
-
Chen Yuan, Xiao-Chuan Hu, Rui-Xia Tan, Chao Liu
2026(6):1194-1200 ,DOI: 10.18240/ijo.2026.06.21
Abstract:
Breast cancer is the leading malignancy among women worldwide, with endocrine therapy (e.g., selective estrogen receptor modulators, aromatase inhibitors) serving as a cornerstone of treatment; although these therapies are effective against hormone-sensitive breast cancer, they alter patients’ systemic hormone profiles, which may disrupt the balance of the ocular surface microbiota that maintains ocular homeostasis. This review systematically examines the mechanisms of mainstream breast cancer endocrine therapies, the dynamics of the ocular surface microbiota, the association between hormonal imbalance and ocular surface homeostasis, as well as the relationship between ocular surface flora alterations, and therapy-related ocular complications, integrating evidence from oncology, endocrinology, and ophthalmology to propose research frameworks and prevention strategies for therapy-related ocular complications.
-
Yi Gong, Shuo Sun, Rong Luan, Bo-Shi Liu, Rong-Guo Yu, Xiao-Rong Li
2026(6):1201-1205 ,DOI: 10.18240/ijo.2026.06.22
Abstract:
-
Van C. Lansingh, Nicoletta Fynn-Thompson, Akshay Gopinathan Nair, Minal ShahBaldota, Stephen Chai
2026(6):1216-1218 ,DOI: 10.18240/ijo.2026.06.26
Abstract:
Volume ,2026 Issue 6
Intelligent Ophthalmology
Basic Research
Clinical Research
Investigation
Review Article
Letter to the Editor
Comment and Response
-
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.
-
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
-
Arshad Ali Lodhi, Sameen Afzal Junejo, Mahtab Alam Khanzada, Imran Akram Sahaf, Zahid Kamal Siddique
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
-
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:
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
-
Anteneh Amsalu, Kindie Desta, Demiss Nigussie, Demoze Delelegne
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
-
Zhi-Chun Zhao, Ying Zhou, Gang Tan, Juan Li
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
-
Ji Jin, Lei Chen, Gao-Qin Liu, Pei-Rong Lu
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
-
Xi-Teng Chen, Hui Huang, Yan-Hua Chen, Li-Jie Dong, Xiao-Rong Li, Xiao-Min Zhang
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
-
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
-
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:
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
-
Li-Fei Yuan, Guang-Da Li, Xin-Jun Ren, Hong Nian, Xiao-Rong Li, Xiao-Min Zhang
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
-
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
-
Yang-Qing Huang, He Huang, Rong-Zhi Huang
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
-
Ali Ihsan Incesu, Güng?r Sobac?
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
-
Blake F. Webb, Jadon R. Webb, Mary C. Schroeder, Carol S. North
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
-
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
-
Bora Yüksel, Sultan Kaya ünsal, Sevgi Onat
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
-
Wen-Bin Huang, Qian Fan, Xiu-Lan Zhang
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
-
Jun Yi, Jun Yun, Zhi-Kui Li, Chang-Tai Xu, Bo-Rong Pan
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
-
Juan-Juan Li, Yun-Peng Li, Zhu-Lin Hu
Abstract:
We describe the successful treatment in a patient with bilateral congenital aniridia and cataract by insertion of capsular tension rings and IOL.
- 1
-
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
