Abstract:AIM: To explore and compare the effect of corneal epithelial thickening on predictability of 7 common intraocular lens(IOL)calculation formulas: the Barrett Universal II, Haigis, Holladay 2, Kane, EVO, Hill-RBF and SRK/T.

METHODS: Patients undergoing phacoemulsification and IOL implantation surgery from July 2023 to September 2023 were included. Before the surgery, biometry data was obtained by IOLMaster 700 and epithelial thickness was determined using optical coherence tomography. A monofocal IOL(Hoya iSert 250)was inserted into the capsular bag. The postoperative refraction was measured 3 mo after the surgery. The median epithelial thickness of 57.0 μm was set as a grouping criterion: ≥57.0 μm(thick group)and Symbol|@@57.0 μm(thin group). The percentage of eyes within prediction errors of ±0.25 D, ±0.50 D, ±0.75 D and ±1.00 D, mean absolute error(MAE), and median absolute error(MedAE)were reviewed.

RESULTS: Fifty-nine eyes of 59 patients(34 females, 25 males, mean age 68.85±8.71 y)were included in the study. The thin group included 30 eyes and the thick group included 29 eyes. Among all 59 eyes, Barrett Universal II showed the highest percentage of prediction error within ±0.50 D(83%), followed by Hill RBF(81%). Kane(71%)and EVO(73%)exhibited the lowest percentages. When calculating the percentage of eyes with absolute error within ±0.25 D using seven IOL calculation formulas, most formulas showed significant declined accuracy in the thick group compared with the thin group(U=6.00, PSymbol|@@0.05). Hill RBF showed better accuracy in eyes with thickened epithelium, with higher percentage of prediction error within ±0.25 D(52%)and ±0.50 D(83%).

CONCLUSION: The accuracy of IOL calculation is associated with corneal epithelium thickening. Hill-RBF has better validity in eyes with thickened corneal epithelium.

Abstract:AIM:To investigate the prevalence and associated factors of comorbid myopia and scoliosis among primary and junior school students in Binhu District, Wuxi, China.

METHODS:A stratified cluster random sampling method was used to select students from 10 primary and junior schools in Binhu District for visual acuity testing, scoliosis examination, and a questionnaire survey on related factors. The relationship between scoliosis and myopia was detected using univariate analysis. A binary multivariable logistic regression model was applied to analyze the risk factors associated with comorbid myopia and scoliosis.

RESULTS: A total of 17 951 students were selected, including 8948(49.85%)boys and 9003(50.15%)girls; 9784(54.50%)primary school students and 8167(45.50%)junior school students. The detection rates of myopia, scoliosis, and comorbidity were 68.30%, 2.95%, and 2.76%, respectively. The comorbidity rate was higher in girls(3.78%)than in boys(1.74%). Junior school students(3.67% in Grade 7-9)had a higher total comorbidity detection rate than primary school students(2.00% in Grade 4-6; all P<0.001). Logistic regression analysis showed that being in Grade 7-9 \〖odds ratio(OR)=4.43, 95% confidence interval(CI): 2.36-7.85\〗, spending 2-3 h(OR=1.46, 95%CI: 1.02-2.16)or ≥3 h(OR=1.5, 95%CI: 1.21-2.55)on homework or reading after school, engaging in >60 min of moderate-to-vigorous physical activity >6 days per week(OR=1.39, 95%CI: 1.08-1.7), and not adjusting desk and chair height to match the student's height(OR=1.73, 95%CI: 1.2-2.25)were positively associated with comorbidity(all P<0.05).

CONCLUSION: The prevalence of comorbid myopia and scoliosis among primary and junior school students in Binhu District of Wuxi is concerning. Reducing the time of

homework or reading and writing after school and engaging in ≥60 min of moderate-to-vigorous physical activity at least three days per week may help lower the risk of comorbid myopia and scoliosis in this population.

Abstract:AIM: To assess myopia prevalence and associated behavioral factors among primary schoolchildren in southern Morocco.

METHODS: A cross-sectional school-based study of 598 students ages 7-13 y(49.00% girls, 51.00% boys; mean age 10.07±1.81 y). Refractive status was assessed using cycloplegic autorefraction, and myopia was defined as a spherical equivalent(SE)≤-0.50 diopters. Behavioral variables, including after-school screen time, near-work viewing distance, outdoor activity, and family history of myopia, were collected through structured questionnaires. Associations between SE and behavioral variables were evaluated using Pearson's correlation coefficient. Categorical associations were assessed using the Chi-square test.

RESULTS: The prevalence of myopia was 12.21%. SE was significantly correlated with screen time(r=-0.333, P<0.01), near-work viewing distance(r=0.369, P<0.01), and outdoor activity(r=0.129, P<0.01). Family history of myopia was significantly associated with myopia(χ2=15.32, P<0.001). Prevalence of myopia increased with higher school grade, but there was no significant difference between boys and girls.

CONCLUSION:Modifiable behavioral factors are significantly associated with myopia among schoolchildren. Healthier visual habits(such as increasing outdoor time, establishing appropriate viewing distance, and minimizing prolonged near work)can help prevent the onset of and delay the progression of myopia. The results support the use of public health approaches designed to promote visual hygiene in school settings.

Abstract:AIM: To investigate the effect of luteolin on tissue fibrosis in the filtering area following glaucoma trabeculectomy, and its relationship with the Wnt3a/β-catenin signaling pathway.

METHODS: Rabbits were selected to establish a fibrosis model after glaucoma trabeculectomy, and randomly divided into the sham operation group, model group, luteolin-L group and luteolin-H group. Dynamic monitoring of postoperative intraocular pressure was performed in all groups. Slit-lamp biomicroscopy was used to observe postoperative conjunctival morphological changes, conjunctival healing degree, corneal integrity, and anterior chamber inflammatory responses in the filtering bleb area. HE staining was performed to evaluate conjunctival epithelial integrity, subepithelial fibrous proliferation, and inflammatory cell infiltration in the filtering tissues. Masson's trichrome staining was applied to assess collagen deposition and the degree of tissue fibrosis. The expression of α-SMA was observed by immunohistochemical staining. The mRNA and protein expression levels of Wnt3a, Wnt7a, Wnt2b, β-catenin, LC3-I, LC3-II and p62-SQSTM1 in conjunctival tissues of the operative area were quantitatively detected by RT-

qPCR and Western blot, respectively.

RESULTS:Postoperative dynamic monitoring showed that the luteolin-H group achieved significantly better intraocular pressure control than the luteolin-L group compared with the model group(all P<0.05). Slit lamp observations confirmed that luteolin effectively ameliorated postoperative conjunctival injury, alleviated anterior chamber inflammatory response, and maintained the structural stability of the filtering area. HE and Masson staining revealed that luteolin intervention reduced conjunctival epithelial damage and inflammatory cell infiltration, markedly inhibited fibroblast proliferation, neovascularization and excessive collagen deposition, and significantly delayed the progression of filtering bleb scarring, with stronger effects in the luteolin-H group than luteolin-L group compared with the model group. Immunohistochemical staining demonstrated that luteolin intervention decreased the positive expression rate of α-SMA. Molecular assays indicated that the luteolin-H group had lower expression levels of Wnt3a, β-catenin and LC3-II/LC3-I, and the highest p62-SQSTM1 level in the operative site relative to the model group and luteolin-L group(all PSymbol|@@0.05). No significant intergroup differences were observed in Wnt2b and Wnt7a expression. These findings suggested that luteolin could specifically regulated the Wnt3a pathway and dose-dependently suppressed the activation of the Wnt3a/β-catenin pathway after glaucoma trabeculectomy, downregulated LC3-II/LC3-I expression, upregulated p62-SQSTM1 levels, and inhibited excessive autophagy activation.

CONCLUSION: Luteolin can significantly inhibit filtering bleb fibrosis after trabeculectomy, which may reduce the degree of fibrosis via the Wnt3a/β-catenin pathway.

Abstract:AIM: To analyze the effect of preoperative macular ganglion cell complex(GCC)thickness on visual quality after cataract combined with glaucoma surgery.

METHODS:This retrospective study collected clinical data of patients with cataract and glaucoma who underwent phacoemulsification, intraocular lens implantation, and goniosynechialysis surgery in the hospital from January 2023 to December 2024. Preoperative macular GCC thickness was assessed and patients were divided into three groups according to preoperative macular GCC thickness using the tertile method: low thickness group(<43.8 μm), medium thickness group(43.8-60.4 μm), and high thickness group(>60.4 μm). Postoperative visual quality was evaluated by visual acuity(LogMAR), contrast sensitivity, visual field and subjective visual quality(QoV)at 1, 3 and 6 mo post-operation. Linear regression analysis was used to verify the effect of preoperative macular GCC thickness on visual acuity at 6 mo after surgery.

RESULTS: Totally 115 patients(115 eyes)with cataract combined with glaucoma were enrolled, including 31 patients(31 eyes)in the low thickness group(17 males, 14 females, 65.23±8.11 y), 47 patients(47 eyes)in the medium thickness group(20 males, 27 females, 64.87±7.89 y)and 37 patients(37 eyes)in the high thickness group(23 males, 14 females, 63.92±7.44 y). There were significant differences in visual acuity, contrast sensitivity, mean deviation of visual field, and QoV scores among the three groups at different time points pre- and post-operation(all P<0.05). At 1, 3 and 6 mo postoperatively, the visual acuity(LogMAR)and QoV scores in the low thickness group were higher than those in the medium thickness and high thickness groups, and the medium thickness group showed higher values than the high thickness group(all P<0.05). The low thickness group had lower low-frequency, medium-frequency and high-frequency contrast sensitivity values as well as lower mean deviation of visual field compared with the medium and high thickness groups, and the medium thickness group had lower values than the high thickness group(all P<0.05). Visual acuity and QoV scores at 1, 3 and 6 mo post-operation were significantly decreased, while low-, medium- and high-frequency contrast sensitivity values and mean deviation of visual field were significantly elevated in the three groups compared with pre-operation.(all P<0.05). In all three groups, visual acuity(LogMAR)and QoV scores were higher at 1 mo postoperatively than those at 3 and 6 mo, and the values at 3 mo were higher than those at 6 mo(all P<0.05). Low-, medium- and high-frequency contrast sensitivity and mean deviation of visual field in three groups were lower at 1 mo postoperatively than those at 3 and 6 mo, with lower values at 3 mo than at 6 mo(all P<0.05). Through linear regression analysis, the model fit was good(F=32.435, PSymbol|@@0.001), and the thickness of GCC in the macular area pre-opertation had a negative impact on visual acuity(LogMAR)at 6 mo post-operation(β=-0.003, PSymbol|@@0.001). The regression equation was: Y=0.421-0.003×X _{preoperative macular GCC thickness}. The model determination coefficient R²=0.223. It indicated that the preoperative macular GCC thickness could explain 22.3% of the variance in visual acuity at 6 mo postoperatively. For every 1 μm decrease in preoperative GCC thickness, the average visual acuity(LogMAR)increased by 0.003 at 6 mo postoperatively.

CONCLUSION: Preoperative macular GCC thickness is a protective factor for visual quality after cataract combined with glaucoma surgery. The thicker the preoperative GCC thickness, the better the visual acuity, contrast sensitivity, and visual field recovery at 1, 3, and 6 mo post-operation. Moreover, for every 1 μm decrease in preoperative GCC thickness, the average visual acuity(LogMAR)at 6 mo after surgery increases by 0.003, which can be used as one of the preoperative predictive indicators for postoperative visual quality.

Abstract:AIM: To investigate the differences in ocular parameters among patients with varying degrees of myopia, analyze the correlation between tessellated fundus(FT)severity and ocular biometric parameters as well as fundus lesions, and evaluate the clinical value of peripheral retinal lesions, FT, and ultra-wide-field imaging(UWFI)in the risk assessment of myopic fundus lesions.

METHODS: Patients with ametropia who were admitted to the Department of Ophthalmology, Liuzhou Red Cross Hospital from June 2022 to June 2025 were retrospectively collected.The participants were divided into four groups according to different spherical equivalent(SE): emmetropia and mild myopia group(-3.0 DRESULTS:A total of 197 patients(197 eyes)were enrolled, including 88 males and 109 females, with a median age of 36.00(27.00, 47.00)y. Totally 25 eyes(13 males and 12 females)were in emmetropia and mild myopia group with a median age of 36.00(23.00, 47.00)y; 38 eyes(18 males and 20 females)were in moderate myopia group with a median age of 30.00(23.00, 37.00)y; 94 eyes were in high myopia group(40 males and 54 females)with a median age of 36.00(23.00, 47.00)y; 40 eyes werein ultra-high myopia group(17 males and 23 females), with a median age of 42.50(27.25, 52.75)years. AL increased and SE decreased progressively with myopia severity, with significant differences among all groups(all PSymbol|@@0.001). The severity of FT also increased progressively with myopia severity(H=68.057, PSymbol|@@0.001). FT was positively correlated with AL(rs=0.669, PSymbol|@@0.001)and negatively correlated with SE(rs=-0.628, PSymbol|@@0.001). Multivariate analysis showed that AL, age, gender, lattice degeneration(LD)and myopic macular degeneration(MM)in the AL-containing model were the influencing factors of FT(all P<0.05). In the SE-containing model, SE, age, gender, peripheral retinal pigmentary changes, LD and MM were the influencing factors of FT(all P<0.05).

CONCLUSION: FT severity is positively correlated with the degree of myopia and can serve as a simple indicator reflecting AL elongation and myopia progression. Together with peripheral retinal lesions, it has important clinical value in the risk assessment of myopic fundus lesions.

Abstract:AIM:To establish a transtheoretical model(TTM)-based health management protocol for pediatric dry eye disease, and explore its practical application value in the clinical management of pediatric dry eye disease.

METHODS: This was a prospective study. Children diagnosed with dry eye disease in the ophthalmology outpatient department from January to June 2025 were enrolled and randomly assigned to a control group and a management group. The control group received routine symptomatic treatment for dry eye, whereas the management group received TTM-based health management interventions in addition to conventional treatment, with a total intervention duration of 6 mo. Subjective symptoms were assessed using the ocular surface disease index(OSDI)and Dry Eyerelated Quality of Life Score(DEQS)at baseline, 1-month, 3-month and 6-month follow-up visits. Slitlamp biomicroscopy, tear film break-up time(BUT), Schirmer's I test(SIt), corneal fluorescein staining(FL), and doublepass optical quality measurement were conducted. Modulation transfer function cutoff frequency(MTF cutoff), Strehl ratio(SR), and objective scattering index(OSI)were recorded. All outcome indicators were compared between the two groups.

RESULTS: A total of 235 children completed the follow-up, including 118 in the management group(64 males, 54 females; mean age 11.31±1.92 y)and 117 in the control group(60 males, 57 females; mean age 11.08±1.85 y). There was no significant difference in the indexes between the two groups before treatment(all P>0.05). At 1, 3, and 6 mo after intervention, BUT, SIt, MTF cutoff, and SR values were significantly increased in both groups compared with baseline, whereas OSDI, DEQS, FL, and OSI were significantly decreased(all P<0.05). At 1 mo posttreatment, there was no significant difference in the indexes between the two groups(all P>0.05). At 3 and 6 mo, the management group exhibited significantly higher BUT, SIt, MTF cutoff, and SR, as well as significantly lower OSDI, DEQS, FL, and OSI than the control group(all P<0.05).

CONCLUSION: The TTM-centered health management model can effectively improve the ocular surface status and visual function of pediatric dry eyedisease and relieve dry eye symptoms, which exerts a remarkable effect on consolidating the long-term therapeutic efficacy of pediatric dry eye.

Abstract:AIM: To characterize the current status, research hotspots, and evolutionary differences in clinical studies on amblyopia published in Chinese and English from 2015 to 2025, and to provide a reference for the clinical diagnosis and treatment as well as relevant research of amblyopia.

METHODS: Clinical studies on amblyopia in both Chinese and English were retrieved from the CNKI, VIP, Wanfang and Web of Science(WoS)databases. Bibliometric and visualization analyses of publication output, institutions, authors, and keywords were conducted using Cite Space 6.4.R1 and VOS viewer 1.6.19.

RESULTS: Totally 1 302 publications were included, comprising 920 Chinese and 382 English publications. The publications of Chinese literature declined after 2019, while that of English literature showed an upward trend. Relevant studies involved 18 countries, and the institutional cooperation connections of English literature were relatively closer. The core author cooperation networks of both Chinese and English literature presented multi-cluster distribution. A total of 360 and 283 keyword nodes were obtained from Chinese and English literature, respectively. The high-frequency keywords of both literatures covered four aspects, including amblyopia types, research populations, evaluation indicators, and treatment methods. Both Chinese and English studies focus on anisometropic and strabismic amblyopia. Chinese studies predominantly investigated children of different age groups, whereas adult amblyopia received earlier attention in the English literature. Visual acuity, contrast sensitivity, and stereopsis were the major outcome measures of common interest, while optical correction and occlusion therapy remained the mainstay treatments. Totally 19 and 13 keyword clusters were identified in the Chinese and English literatures, respectively. Burst analysis indicated that digital treatment such as binocular dichoptic training appeared relatively early in English literature. In recent years, quality of life and risk factor screening for amblyopia received increasing attention. In Chinese literature, growing focus was placed on digital visual training and traditional Chinese medicine intervention. In addition, neuroimaging evaluation based on resting-state functional magnetic resonance imaging was conducted much earlier in English studies.

CONCLUSION:From 2015 to 2025, Chinese and English clinical research on amblyopia has shown diversified development, with substantial similarities in the major types of amblyopia investigated, visual function assessment, and basic treatment modalities, but differences in the timing and emphasis of some research hotspots. Clinical research on amblyopia is gradually expanding from improvement in visual acuity toward restoration of binocular visual function, multidimensional outcome assessment, and investigation of visual neural mechanisms, while treatment strategies are becoming increasingly digitalized and individualized. Future research should further optimize standardized treatment, strengthen investigations into adult amblyopia, binocular digital vision training, visual neural mechanisms, and multidimensional outcome assessment, and evaluate the clinical value of integrated traditional Chinese and Western medicine interventions through high-quality clinical studies.

Abstract:The PRSS56 gene encodes a trypsin-like serine protease, which is a key molecule in the regulation of ocular axial length. Loss-of-function mutationin PRSS56 result in a shortened axial length, whereas gain-of-functionmutation promote axial elongation, exemplifying the bidirectional regulatory paradigm often termed “one gene, opposite phenotypes”. At the loss-of-function mutation, the hotspot mutation represented by c.1066 dupC leads to nanophthalmos and posterior microphthalmia by truncation of the protein. The gain-of-function mutation up-regulates the expression of PRSS56, driving excessive axial elongation, resulting in high myopia. This review systematically summarizes the genetic mutation spectrum, molecular regulatory networks, downstream signaling pathways, and translational therapeutic prospects of PRSS56 from both loss-of-function and gain-of-functionmutations.

Abstract:Corneal transparency depends on an avascular microenvironment, regularly organized stromal collagen, and regulated inflammatory repair response.CD34+ cells should not be regarded as a single functional population; rather, they comprise cornea-resident mesenchymal stem cell-like cells, peripheral blood-derived endothelial progenitor cells(EPCs), and fibrocytes with distinct origins, phenotypes, and pathological effects. Resident CD34+ cells are mainly associated with limbal stem cell niche maintenance and stromal homeostasis, whereas recruited EPCs and fibrocytes may contribute to corneal neovascularization and scarring under hypoxic, inflammatory, or TGF-β-driven conditions. This review summarizes the biological characteristics, corneal distribution, and key signaling pathways of CD34+ cells, including VEGF/VEGFR-2, SDF-1/CXCR4, NF-κB, and TGF-β/Smad signaling. And further discuss their roles in infectious keratitis, limbal stem cell deficiency, keratoconus, and post-traumatic corneal fibrosis. By integrating controversial findings with clinical evidence and translational limitations, this review suggests that future CD34-related therapies should shift from non-selective CD34 modulation toward spatiotemporally precise strategies that preserve resident reparative subpopulations while inhibiting recruited proangiogenic and profibrotic cells.

Abstract:Microcystic macular edema(MME)is a characteristic retinal imaging finding characterized by cystic changes within the inner nuclear layer(INL). It was first described in patients with optic neuritis associated with multiple sclerosis(MS). Subsequent studies have shown that MME is also present in a broad spectrum of neuro-ophthalmic disorders, including neuromyelitis optica spectrum disorder(NMOSD), non-arteritic anterior ischemic optic neuropathy(NAION), and hereditary optic neuropathies. Moreover, its presence is closely associated with disease severity and visual dysfunction. Current evidence suggests the occurrence of MME in neuro-ophthalmic diseases may be related to retrograde transsynaptic degeneration and vitreomacular traction.A deeper understanding of the clinical characteristics and pathophysiological mechanisms of MME may provide a new perspective and scientific basis for the clinical diagnosis, disease monitoring and prognosis evaluation of various neuro-ophthalmic diseases.

Abstract:Uveal melanoma(UM)is a rare but highly aggressive intraocular malignancy. Although it accounts for less than 5% of all melanoma cases, UM is the most common primary intraocular malignancy in adults. In recent years, advances in molecular targeted therapies and immunomodulatory strategies have provided new opportunities for the clinical management of UM. This review summarizes the pathogenesis, molecular biomarkers, and major therapeutic advances in UM, with particular emphasis on analyzing the research achievements and clinical application prospects of signaling pathway-targeted inhibitors, immune checkpoint inhibitors, and combination treatment strategies. The potential value of individualized treatment and the limitations of current therapeutic approaches are also discussed. Current evidence suggest that multidisciplinary intervention and precision molecular diagnosis and treatment may significantly improve the prognosis of patients with UM, providing references for future clinical research and the optimization of therapeutic strategies.

Abstract:The 577 nm subthreshold micropulse laser(577 nm SML)is a non-invasive retinal laser treatment technique that selectively acts on the retinal pigment epithelium(RPE), induces heat shock protein expression, regulates inflammatory response, promotes blood retinal barrier repair, downregulates vascular endothelial growth factor(VEGF)levels, improves Müller cell function, promotes retinal metabolism and functional recovery, and avoids thermal damage caused by traditional threshold lasers. In recent years, 577 nm SML has been widely used in the treatment of various fundus diseases, including central serous chorioretinopathy(CSC), diabetes macular edema(DME), macular edema secondary to retinal vein occlusion(RVO-ME), age-related macular degeneration(ARMD), type 2 macular telangiectasia(MacTel2), persistent subretinal fluid after retinal detachment repair, and Irvine-Gass syndrome. Characterized by favorable safety and repeatability, 577 nm SML possesses high clinical application value and serves as a vital adjuvant and complementary strategy for anti-VEGF therapy. This review aims to summarize the therapeutic mechanisms and clinical applications of 577 nm SML in common fundus diseases, and provide a theoretical basis for its further clinical application.

Abstract:Diabetes-associated dry eye disease(DDED)is a common ocular surface complication in patients with diabetes mellitus. It is characterized by lacrimal gland dysfunction, corneal neuropathy, meibomian gland dysfunction, and ocular surface barrier impairment,with the accumulation of reactive oxygen species(ROS)and the disruption of ocular surface homeostasis driven by positive ROS-inflammatory feedback as its key pathogenesis. Chronic hyperglycemia induces excessive production of ROS via activation of the polyol pathway, accumulation of advanced glycation end products(AGEs), protein kinase C(PKC)activation, and mitochondrial dysfunction. Through the interplay among the ROS-inflammation positive feedback loop, autophagy dysfunction, and endoplasmic reticulum(ER)stress, excess ROS triggers corneal nerve degeneration, reduced tear secretion, abnormal meibum, and systemic disruption of multiple ocular surface barriers, thereby forming a “hyperglycemia-oxidative stress-ocular surface injury” vicious cycle. In addition to artificial tears, anti-inflammatory agents, and physical therapies, treatment should include multi-target strategies such as stringent glycemic control, antioxidant therapy, neuroprotective therapy, secretagogue therapy, and integrative traditional Chinese and Western medicine. This review proposes an oxidative stress-centered pathophysiological framework for DDED and outlines the intervention targets of traditional Chinese and Western medicine, aims to provide a reference for mechanistic research and precision interventions.

Abstract:As an extension of the central nervous system, the retina is the only tissue in the body that allows direct in vivo observation of both neural and vascular structures, offering a unique non-invasive window for the assessment of cerebral neurovascular diseases. Recent studies have shown that multimodal imaging techniques—such as fundus photography, optical coherence tomography(OCT), and OCT angiography(OCTA)—enable quantitative analysis of retinal indicators including vascular caliber, fractal dimension, retinal nerve fiber layer thickness, and microvascular density. These metrics can, to some extent, reflect the severity and progression risk of cerebrovascular and neurodegenerative diseases such as stroke, Alzheimer's disease, and Parkinson's disease. Consequently, retinal imaging holds promise as a powerful tool for early screening, risk stratification, and treatment monitoring. This article systematically reviews the application of retinal imaging technologies in the diagnosis and management of cerebral neurovascular disorders, with a particular focus on the important role of artificial intelligence(AI)-driven image analysis in enhancing screening efficiency, improving risk assessment accuracy, and promoting multidisciplinary collaborative care, thereby providing insights for clinical translation.

Abstract:Abnormal blinking can manifest in various ways, including a significant increase or decrease in blink frequency, incomplete blinking, and uncoordinated blinking movements. Currently, a unified diagnostic criterion is still lacking. Abnormal blinking is closely linked to factors such as ocular surface diseases, neurodevelopmental disorders, and visual function abnormalities. In recent years, an increasing number of pediatric patients have visited ophthalmic clinics with abnormal blinking as their primary complaint. With the rising incidence of pediatric meibomian gland dysfunction(MGD)and dry eye disease, their proportion among cases of abnormal blinking has also grown continuously.This article reviews the research progress on meibomian gland changes in children with abnormal blinking. It aims to provide guidance for the early prevention and clinical care of pediatric MGD, reduce the incidence of MGD, and shorten the treatment cycle, thereby providing a solid basis for clinical diagnosis, treatment, and precise prevention.

Abstract:In recent years, the global prevalence of myopia has continued to rise. In China, myopia shows a trend toward widespread prevalence, earlier onset, and greater severity, and high myopia poses a serious threat to adolescent ocular health. Orthokeratology is currently one of the most effective clinical interventions for slowing myopia progression, yet its exact mechanisms of action have not been fully elucidated. Focusing on the various hypotheses proposed in the literature, this review summarizes the role of peripheral retinal defocus, choroidal thickness and blood flow, higher-order aberrations, accommodation, and biomechanics in myopia control with orthokeratology lenses. Specifically, the induction of peripheral myopic defocus through the reverse-geometry design of orthokeratology lenses constitutes the core mechanism by which axial elongation is slowed. After lens wear, choroidal thickening and increased blood perfusion improve the nutritional supply to the outer retina and inhibit scleral remodeling. Increases in higher-order aberrations, such as spherical aberration and coma, expand the depth of focus and reduce accommodative lag. Improvements in accommodative function and alterations in corneal biomechanics also act synergistically. These mechanisms are interrelated and act in a cascading manner to jointly inhibit axial elongation. This review aims to provide a theoretical basis for a deeper understanding of the mechanisms of orthokeratology lenses and to offer clinical references for individualized lens fitting, optimized lens design, and future research on myopia prevention and control.

Abstract:Myopia has evolved into a global public health concern, highlighting the critical importance of myopia prevention and control. This paper elaborates on the pathogenetic mechanisms of myopia and relevant therapeutic interventions, with a focused discussion on the action mechanisms and research advances of low-dose atropine combined with other interventional measures for myopia control. By comparing the advantages and limitations of such combined regimens, this review aims to provide scientific and safe strategies for myopia prevention and management.

Abstract:PANoptosis is a newly recognized form of inflammatory programmed cell death(PCD)that involves key molecular features of pyroptosis, apoptosis, and necroptosis, rather than a simple combination of these pathways. It is characterized primarily by loss of plasma membrane integrity and the subsequent release of inflammatory cytokines and damage-associated molecular patterns, thereby contributing to immune regulation and tissue injury. Previous studies have mainly focused on the roles of PANoptosis in cancer, infectious diseases, and inflammatory disorders, while research on its application in ocular diseases is still relatively limited. This review summarizes the current evidence regarding PANoptosis in ocular diseases, including glaucoma, diabetic retinopathy, age-related macular degeneration, and keratitis, and may provide a reference for further investigation into its potential roles and underlying mechanisms.

Abstract:Conventional ocular drug delivery approaches have notable clinical limitations: eye drops achieve only 1%-5% bioavailability, while intravitreal injections carry a 0.01%-0.1% risk of endophthalmitis. As a minimally invasive delivery technology that overcomes the bottlenecks of traditional administration, ocular microneedles can significantly improve drug bioavailability and extend sustained release, showing promising advantages in preclinical studies. Focused on clinical needs, this review systematically summarizes the classification, preclinical evidence, and clinical translation potential of ocular microneedles, outlines their scope of application and efficacy characteristics, analyzes potential risks and translational bottlenecks, and proposes targeted implementation strategies. Currently, this technology still faces challenges such as insufficient puncture precision and insufficient long-term ocular safety data in humans. There is an urgent need to establish an ophthalmology-specific safety evaluation system, improve approval procedures and quality control standards, and prioritize the clinical translation of ocular-surface microneedles ,so as to provide accessible, minimally invasive treatment options for chronic and refractory ophthalmic diseases.

Abstract:AIM:To explore the feasibility of predicting orthokeratology lens ordering parameters(flat K, spherical power, lens diameter, and lens toricity)using the extreme gradient boosting(XGBoost)algorithm based on corneal topographic parameters and basic clinical examination indicators, and to provide references for intelligent clinical fitting.

METHODS:Clinical data were retrospectively collected from myopic patients who underwent initial orthokeratology lens fitting and achieved successful fitting at Puyang Second People's Hospital between January 2019 and March 2024. Data from right and left eyes were treated as independent samples, and the dataset was partitioned at the patient level into training and test sets in a 7∶3 ratio. Input features included uncorrected visual acuity(UCVA), axial length(AL), horizontal visible iris diameter(HVID), flat K, steep K, horizontal eccentricity, and vertical eccentricity. The lens toricity prediction model additionally incorporated keratometric astigmatism(ΔK)and surface asymmetry index(SAI). The output labels were the final ordering parameters(flat K, spherical power, lens diameter, and lens toricity). Separate XGBoost regression models were constructed for each output parameter, with hyperparameters optimized independently through grid search combined with 5-fold cross-validation. Model performance was evaluated on the test set using the coefficient of determination(R2), mean absolute error(MAE), and root mean square error(RMSE). Feature importance analysis was also performed.

RESULTS:Totally 400 patients(800 eyes)were included in the final analysis. The 400 patients comprised 208 male(52.0%)and 192 female(48.0%)patients, with a mean age of 10.1±2.3 y. After partitioning at the patient level, the training set comprised 280 patients(560 eyes; 146 males and 134 females; mean age 10.1±2.3 y), and the test set comprised 120 patients(240 eyes; 62 males and 58 females; mean age 10.0±2.2 y). No statistically significant differences in sex composition or age were found between the two sets(P>0.05). Toric lenses were used by 140 of the 280 patients(50.0%)in the training set and by 50 of the 120 patients(41.7%)in the test set(χ2=2.017, P=0.156). The flat K prediction model achieved an MAE of 0.34 D and an R2 of 0.84. The spherical power model attained an MAE of 0.43 D and an R2 of 0.70. The lens diameter model yielded an MAE of 0.12 mm and an R2 of 0.42. The lens toricity model(Tweedie regression, power=1.5)achieved an MAE of 0.44 D and an R2 of 0.38. The MAE for each parameter fell within the clinically acceptable tolerance limits(flat K≤0.50 D, spherical power ≤0.75 D, lens diameter ≤0.25 mm, lens toricity ≤0.75 D). Scatter plots and Bland-Altman analysis demonstrated strong agreement between predicted values and actual observations. Feature importance analysis revealed that flat K(0.70)and steep K(0.11)were the most influential predictors in the flat K prediction model.

CONCLUSION: The XGBoost model based on routine clinical parameters provides predictions of flat K, spherical power, and lens diameter with MAEs within clinically acceptable ranges, and offers useful reference for cylindrical power prediction. This approach may serve as a useful adjunct to clinical lens fitting. Nevertheless, future prospective studies are warranted to validate its clinical utility in improving actual fitting success rates.

Abstract:AIM: To quantitatively evaluate the vectorial effect of different incision locations on surgically induced astigmatism(SIA)following implantable collamer lens(ICL)implantation and to clarify the relative contributions of the anterior and posterior corneal surfaces to total corneal SIA.

METHODS: A prospective study was conducted on who underwent ICL/toric ICL implantation between July 1, 2023 and January 1, 2024. Patients were divided into superior incision group and temporal incision group according to the expected postoperative residual astigmatism. Pentacam measurements were performed preoperatively and at 3 mo postoperatively to obtain total corneal refractive power and anterior and posterior corneal curvature radii. Anterior and posterior corneal surface powers and total corneal astigmatism were calculated. Thibos vector analysis was applied to decompose corneal astigmatism into orthogonal components J0 and J45, and the changes in J0(ΔJ0)were calculated for each surface. Multiple linear regression analysis was performed to explore the associations of anterior surface ΔJ0, posterior surface ΔJ0, and incision location with total corneal ΔJ0.

RESULTS: This study included 162 patients(162 eyes), with 75 patients 75 eyes in the superior incision group and 87 patients 87 eyes in the temporal incision group. Totally 154 patients(154 eyes)completed follow-up: 72 patients(72 eyes)in the superior incision group(17 males and 55 females, aged 25.96±6.17 y)and 82 patients(82 eyes)in the temporal incision group(20 males and 62 females, aged 27.79±6.47 y). In the superior incision group, the total cornea and anterior surface J0 shifted toward positive values(against-the-rule), with ΔJ0 of 0.146±0.108 D and 0.199±0.117 D, respectively, while the posterior surface J0 shifted toward negative values(with-the-rule), with ΔJ0 of -0.050±0.022 D. The temporal incision group showed the opposite trend. Multiple regression analysis showed an excellent model fit(adjusted R2=0.943), with anterior surface ΔJ0 as the main influencing factor(B=0.968, β=1.137, P<0.001)and posterior surface ΔJ0 also contributing independently and significantly(B=1.018, β=0.297, P<0.001). Incision location and its interaction terms with anterior and posterior surface ΔJ0 were not statistically significant(all P>0.05).

CONCLUSION: Based on 3 mo postoperative followup, superior incisions induce a predominant withtherule SIA vector, while temporal incisions induce a predominant againsttherule SIA vector. Anterior surface ΔJ0 is the primary contributor to total corneal ΔJ0, and posterior surface ΔJ0 also demonstrates a statistically significant association.

Abstract:AIM: To investigate the value of optical coherence tomography angiography(OCTA)parameters and serum caspase-1 for assessing the severity of diabetic retinopathy(DR).

METHODS:Patients diagnosed with DR in our hospital from June 2024 to December 2025 were retrospectively enrolled and were divided into early non-proliferative DR(NPDR)and advanced proliferative DR(PDR)groups according to fundus fluorescein angiography(FFA)findings. Patients with diabetes mellitus but without DR were selected as the control group. OCTA parameters included macular vascular density, the perimeter and area of the foveal avascular zone(FAZ), mean retinal thickness, hyperreflective foci(HRF), and internal limiting membrane abnormalities. Blood biochemical indicators contained fasting blood glucose, glycated hemoglobin(HbA1c), systemic immune-inflammation index(SII), triglyceride/high-density lipoprotein(TG/HDL)ratio, urinary albumin/creatinine ratio(UACR), and caspase-1.

RESULTS: Totally 128 DR patients(151 eyes)were enrolled in this study, including 75 patients(90 eyes)in the NPDR group(40 males and 35 females, mean age: 74.3±5.6 y)and 53 patients(61 eyes)in the PDR group(27 males and 26 females, mean age: 75.9±5.8 y). Meanwhile, 60 diabetic patients(120 eyes)without DR were recruited as the control group(33 males and 27 females, mean age: 72.6±5.4 y).The macular vascular density gradually decreased in the control, NPDR and PDR groups, while perimeter and area of FAZ, and mean retinal thickness gradually increased, and the incidence of HRF and internal limiting membrane abnormalities gradually increased(all PSymbol|@@0.001). The levels of SII, UACR and caspase-1 gradually increased(all PSymbol|@@0.001). The duration of diabetes mellitus was longer in the NPDR and PDR groups than in the control group(all PSymbol|@@0.001).Multivariate logistic regression analysis demonstrated that diabetic duration, HRF, and caspase-1 were risk factors for the occurrence of DR, while macular vascular density served as a protective factor(all P<0.001). Moreover, caspase-1 was identified as a risk factor for the progression of DR to PDR, and macular vascular density was a protective factor against DR progression(all P<0.001). Receiver operating characteristic(ROC)curve analysis showed that the area under the curve(AUC)of caspase-1 combined with macular vascular density for predicting DR occurrence and PDR was 0.864 and 0.890, respectively, both higher than those of single indicators(all PSymbol|@@0.05).

CONCLUSION: The combination of macular vascular density from OCTA parameters and serum caspase-1 has important clinical value in assessing severity of DR.

Abstract:AIM:To investigate the compositional and structural differences in the ocular surface microbiota of patients with primary pterygium during the progressive and stationary stages, and to identify key microbial biomarkers associated with pterygium progression.

METHODS: A cross-sectional study design was adopted. Patients with progressive pterygium(PPG group), stationary pterygium(SPG group), and age- and sex-matched healthy volunteers(HCG group)were enrolled. Conjunctival swabs were collected from the affected eye(or the healthy eye in controls)of each participant. 16S rRNA gene amplicon sequencing of the V3V4 region was performed. The analytical workflow encompassed rarefaction curve analysis, Alpha/Beta diversity analyses, ASV analysis. LEfSe analysis and the Kruskal-Wallis H test were used to screen differential microbiota.

RESULTS: Final enrollment included 28 patients(28 eyes)in each group: PPG(11 males, 17 females; mean age 60.54±8.44 y), SPG(10 males, 18 females; mean age 61.82±10.21 y), and HCG(12 males, 16 females; mean age 64.07±7.27 y). No significant differences were found among the three groups in baseline characteristics(all P>0.05). The number of valid sequences and the rarefaction curves confirmed sufficient sequencing depth. Alpha/Beta diversity analyses showed no statistically significant differences among the three groups(all P>0.05), indicating that the overall structure of the ocular surface microbiota was relatively stable. LEfSe analysis(LDA score>3.0)revealed that the Propionibacteriales, the Propionibacteriaceae, the Cutibacterium and the Comamonadaceae were significantly enriched in the PPG group. Following Kruskal-Wallis H tests with Bonferroni correction for multiple comparisons, the relative abundances of Propionibacteriales, Propionibacteriaceae, and Cutibacterium were significantly higher in PPG group than in the HCG group(all PSymbol|@@0.05), but did not differ significantly between the PPG and SPG groups(all P>0.05). The abundance of Comamonadaceae was significantly higher in SPG group than in HCG group(PSymbol|@@0.05), whereas PPG group not differ from either group(all P>0.05).

CONCLUSION: Cutibacterium, the representative genus of the propionibacterial group, tends to be enriched in eyes with progressive pterygium, indicating a potential association between this genus and pterygium progression.

Abstract:AIM: To construct an assessment model for the risk of myopia in preschool children and evaluate its clinical value.

METHODS: A retrospective analysis was conducted on the data of preschool children who established refractive profiles in our hospital from January 2020 to December 2024. The eye with lower refractive error was selected. The right eye was chosen in cases where the refractive error of both eyes was identical. The data were divided into a training set(n=385)and a validation set(n=165)in a 7∶3 ratio. The data of the children were collected in detail, and the children's spherical equivalent(SE)was used as the dependent variable. The multiple linear regression model was used to screen the indicators that affected the biological indicators related to myopia in preschool children.Subsequently, the children in the training set were divided into a myopia group and a normal vision group based on whether myopia occurred(SE≤-0.50 D can be diagnosed as myopia according to refractive power assessment). Subsequently, the influencing factors selected by the multiple linear regression model were included as predictive variables, and a risk assessment equation was constructed using Logistic regression. The discrimination, calibration and clinical application value of the assessment model were verified through the receiver operating characteristic(ROC)curve, Hosmer-Lemeshow test and decision curve.

RESULTS: This study included 550 preschool children(550 eyes). The training set comprised 385 children(385 eyes; 190 boys and 195 girls), and the validation set comprised 165 children(165 eyes; 82 boys and 83 girls). Among the children in the training set, the myopia group included 34 children(34 eyes; 16 boys and 18 girls), and the non-myopic group included 351 children(351 eyes; 174 boys and 177 girls). Multiple linear regression analysis showed that the ratio of axial length(AL)to corneal curvature radius(CR), subfoveal choroidal thickness(SFCT), anterior chamber depth(ACD), age, parental myopia history, and outdoor activity time were risk factors for myopia in preschool children(all P<0.05). Based on the above risk factors, a Logistic regression risk assessment model was constructed, and the evaluation model Logit(P)was obtained as 0.894×AL/CR-1.312×SFCT+1.182×ACD+2.063×age+0.763×parental myopia history-5.868. The effectiveness of the myopia risk assessment model for preschool children based on the training set was evaluated. The results showed that the area under the ROC curve(AUC)was 0.939(95%CI: 0.912-0.965), the H-L test was χ2=1.487, P=0.993, and the decision curve indicated that within the threshold range of 0.03-0.81 and 0.89-0.97, the net return rate was greater than 0. This suggested that the model had good discrimination, calibration, and clinical application value in evaluating the myopia risk and actual risk of preschool children. Internal validation was conducted in an independent validation set, and the results showed that the AUC of the ROC curve was 0.967(95%CI: 0.919-1.000), the H-L test was χ2=3.818, P=0.873, and the decision curve indicated that within the threshold range of 0.01-0.99, the net return rate was greater than 0, further suggesting that the model assessment had good consistency with the actual risk.

CONCLUSION: Age, parental history of myopia, AL/CR, SFCT, and ACD are risk factors for myopia in preschool children. The Logistic regression risk assessment model constructed based on these factors has high evaluation value and can effectively evaluate the probability of myopia occurrence in individuals, providing reference for individualized prevention of myopia risk in preschool children.

Abstract:AIM: To address the problem of cognitive overload and deviation from core teaching objectives caused by information redundancy in traditional case-based teaching in ophthalmology, Occam's Razor principle was innovatively applied to construct a set of streamlined case-based teaching resources, and their effectiveness was subsequently validated.

METHODS:This was a prospective randomized controlled trial. Intern students from the 2019 and 2020 cohorts of the five-year clinical medicine program who completed their ophthalmology clerkship at the Department of Ophthalmology, Tangdu Hospital, Air Force Medical University between June 2023 and May 2025 were enrolled. By using a random number table, they were randomly assigned to an experimental group and a control group. Cases refined by Occam's Razor principle(removing irrelevant information and focusing on core principles, clinical reasoning, and the diagnostic and therapeutic workflow)were adopted for the experimental group, whereas the original complete cases were used for the control group. Teaching effectiveness was assessed through knowledge tests, classroom performance evaluation, teaching case assessment, and student satisfaction.

RESULTS:Totally 120 students were included in this study and all of them completed the research. There were 60 students in the experimental group(43 males and 17 females, mean age 21.72±0.76 y)and 60 students in control group(41 males and 19 females, mean age 21.68±0.57 y)(all P>0.05). The score rates on the ocular trauma section and on the case analysis questions were significantly higher in the experimental group than in the control group(83.21%±7.96% vs 74.25%±11.01%; 84.31%±8.08% vs 67.62%±11.63%; both P<0.001). Teacher evaluations indicated that the experimental group achieved better scores than the control group in aspects such as identification of key case points and logical clinical reasoning(all P<0.001). A significantly lower cognitive load score was observed in the experimental group, whereas higher scores were obtained for clarity of case structure, thought-provoking quality, and teaching value(all P<0.001). The teaching satisfaction rate reached 95% in the experimental group, which was higher than the 83% observed in the control group(P<0.05).

CONCLUSION: Refined cases guided by Occam's Razor principle can significantly reduce cognitive load, enhance medical students' efficiency in mastering core diagnostic and therapeutic principles, improve the precision of clinical reasoning, and strengthen execution of clinical procedures, thereby providing an innovative pathway for clinical teaching reform.

Abstract:AIM: To investigate the epidemiological characteristics and changing trends of myopia among children and adolescents in Bijie from 2021 to 2025, and to provide scientific evidence for formulating regional myopia prevention and control strategies.

METHODS:This was a longitudinal cross-sectional study. Stratified cluster sampling method was used to select students from 48 primary schools, 25 middle schools, and 8 high schools from urban and rural districts and counties of Bijie. From 2021 to 2025, annual examinations were performed, including uncorrected visual acuity, corrected visual acuity, corneal curvature, refractive error, axial length, and fundus examination. Questionnaires were also administered to collect information on visual health-related influencing factors. Myopia was defined as spherical equivalent refraction(SE)≤-0.50 D under non-cycloplegic autorefraction. The multivariate logistic regression model was used to analyze the myopia status and its influencing factors among children and adolescents.

RESULTS: From 2021 to 2025, the age- and sex-standardized myopia prevalence rates among children and adolescents in Bijie were 42.37%, 44.57%, 47.32%, 49.98%, and 52.91%, respectively, showing a significant upward trend year by year(P<0.001). The overall standardized myopia prevalence rate was 47.61%. The myopia rate increased with higher educational stage, and the differences were statistically significant(P<0.001). The myopia rates in girls were higher than those in boys over the 5 y, with statistically significant differences(P<0.001). Multivariable logistic regression analysis identified gender(female vs male: OR=1.17, 95%CI: 1.15-1.19), school stage(junior high school vs primary school: OR=2.14, 95%CI: 2.09-2.19; senior high school vs primary school: OR=3.60, 95%CI: 3.53-3.68), daily outdoor activity time <2 h(OR=3.25, 95%CI: 2.98-3.54), both parents with myopia(OR=2.87, 95%CI: 2.63-3.13), daily near work time ≥4 h(OR=2.56, 95%CI: 2.35-2.79), electronic screen use ≥2 h/d(OR=2.18, 95%CI: 2.01-2.37), incorrect reading and writing posture(OR=3.94, 95%CI: 3.87-4.02), residence in a karst landform region(OR=1.32, 95%CI: 1.18-1.48), and absence of professional equipment in school vision screening(OR=1.27, 95%CI: 1.15-1.41)as risk factors for myopia(all P<0.001).

CONCLUSION: From 2021 to 2025, the myopia rate among children and adolescents in Bijie shows an increasing trend, indicating a severe situation for myopia prevention and control, with tendencies toward younger age of onset and higher myopia. It is necessary to establish a prevention and control system led by the government, with multi-departmental collaboration and school-family linkage, and to carry out targeted health education and intervention measures.

Abstract:AIM: To evaluate the effects of the myopia prevention and control guidance station(MPCGS)on axial elongation in school-age children.

METHODS:This was a prospective cohort study.Students enrolled in Grades 1 to 3 of primary schools in Qingyang District, Chengdu, in the first half of 2022 who completed continuous follow-up from 2022 to 2025 were included in this study. Among them, three schools that implemented the MPCGS in 2023 were assigned to the intervention group, and another three schools in the same district without MPCGS served as the control group. The intervention group received the school-hospital-family integrated model for myopia prevention and control,while the control group only received routine vision screening without such intervention measures.Students were categorized into three groups based on their grade in 2022: Group A(Grade 1), Group B(Grade 2), and Group C(Grade 3). Comparisons were stratified by grade, with independent samples t-tests used for intergroup analyses of annual axial elongation(ΔAL)between the intervention and control groups, and repeated-measures ANOVA(Bonferroni-corrected post-hoc test)used for intervention group comparisons across different time points.

RESULTS:Totally 3 404 students were enrolled in this study, including 1 709 in the intervention group(897 males and 812 females, aged 7.64±0.88 y)and 1 695 in the control group(902 males and 793 females, aged 7.75±0.97 y). In the intervention group, there were 537 students in subgroup A(293 males and 244 females, aged 7.08±0.28 y), 721 in subgroup B(369 males and 352 females, aged 8.03±0.29 y), and 451 in subgroup C(235 males and 216 females, aged 9.07±0.30 y). In the control group, there were 559 students in subgroup A(295 males and 264 females, aged 7.05±0.28 y), 497 in subgroup B(269 males and 228 females, aged 8.04±0.30 y), and 639 in subgroup C(338 males and 301 females, aged 9.08±0.30 y). No significant differences were observed between the intervention and control groups within each grade(A, B, and C)at baseline age, sex, SE, AL, ΔSE(2022-2023), and ΔAL(2022-2023)(all P>0.05). During the first intervention year(2023-2024), intergroup comparisons revealed no significant differences in ΔAL between the intervention and control groups within Groups A, B, and C(all P>0.05). During the second intervention year(2024-2025), the intervention group showed significantly lower ΔAL than the control group within Groups A and B(PSymbol|@@0.001 and P=0.017, respectively), while no significant difference in ΔAL was detected in Group C(P=0.419). In the intervention group, there were significant differences in ΔAL at different time points among Groups A, B and C(all P<0.001). Compared with the first year before intervention, the ΔAL of each subgroup significantly decreased in the second year of intervention(all P<0.0167).

CONCLUSION:The implementation of the school-hospital-family integrated MPCGS model was associated with slowed axial elongation. This association exhibited a time-dependent cumulative effect and was more pronounced in lower-grade children(grades 1-2).

Abstract:AIM: To compare the clinical efficacy of Conbercept 3+pro re nata(PRN)and 5+PRN regimens in the treatment of macular edema secondary to ischemic branch retinal vein occlusion(BRVO).

METHODS: A retrospective cohort study design was adopted. Patients with macular edema secondary to ischemic BRVO admitted to our hospital from June 2021 to March 2024 were included and divided into the 3+PRN group and the 5+PRN group. Both groups received intravitreal injections of Conbercept(0.5 mg per dose). The 3+PRN group received three consecutive monthly loading injections followed by PRN treatment, while the 5+PRN group received five consecutive monthly loading injections followed by PRN treatment. The best-corrected visual acuity(BCVA), central foveal retinal thickness(CRT), mean macular sensitivity(MS), number of injections, and adverse reactions were observed before treatment and at 1, 3, 6, and 12 mo after treatment in both groups.

RESULTS:Totally 97 patients(97 eyes)were included. There were 49 cases(49 eyes)in 3+PRN group(26 males and 23 females, aged 58.61±8.67 y)and 48 cases(48 eyes)in 5+PRN group(23 males and 25 females, aged 59.18±8.54 y)(all P>0.05). There was no significant difference in BCVA and MS between the two groups before and after treatment(all P>0.05). CRT in 5+PRN group was smaller than that in 3+PRN group at 6 and 12 mo after treatment(all P<0.05). BCVA, CRT, and MS were improved after treatment compared with before treatment in both groups(all P<0.05). There was no significant difference in the total number of injections during the whole follow-up between the 5+PRN group(6.24±0.94 injections)and the 3+PRN group(6.41±0.88 injections)(P>0.05). There was no significant difference in the incidence of adverse reactions between the two groups during follow-up(10% vs 13%, P=0.721).

CONCLUSION: Both the Conbercept 3+PRN and 5+PRN regimens are safe and effective for treating macular edema secondary to ischemic BRVO. The 5+PRN regimen is characterized by “more injections in the early loading phase and fewer injections in the later PRN phase”, while the 3+PRN regimen features “fewer injections in the early loading phase and more injections in the later PRN phase”. The two regimens show comparable efficacy in long-term visual function improvement, while the 5+PRN regimen has greater advantages in macular edema resolution.

Abstract:AIM:To explore the effectiveness of predictive models based on quantitative characteristics of multimodal fundus images in assessing the risk of progression of non-proliferative diabetic retinopathy(NPDR).

METHODS:A single-center retrospective cohort study was conducted. Patients diagnosed with moderate to severe NPDR between January 2021 and December 2023 in Wuhan Ninth Hospital were included. Baseline color fundus photography(CFP), optical coherence tomography(OCT), and fundus autofluorescence(FAF)images were collected. Microaneurysm count, hard exudate area, central retinal thickness, retinal nerve fiber layer thickness, and total area of hyperautofluorescent spots were extracted and quantified. All patients were followed up regularly. The primary endpoint was the progression to treatment-requiring proliferative diabetic retinopathy(PDR)or clinically significant diabetic macular edema(DME)during the follow-up period. According to the occurrence of endpoint events during follow-up, the patients were divided into the progression group and the non-progression group. Combined with clinical significance and inter-group comparison results, candidate quantitative imaging parameters were included in the multivariate logistic regression analysis to construct a prediction model. The model was visualized using a Nomogram. The discriminative ability and calibration degree of the model were evaluated via receiver operating characteristic(ROC)curves and calibration curves.

RESULTS:A total of 300 patients(300 eyes)completed follow-up, with 93 in the progression group, including 47 males and 46 females, with an average age of 59.02±8.21 y. There were 207 cases in the non-progression group, including 105 males and 102 females, with an average age of 58.01±8.10 y. Multivariate logistic regression showed that the total area of FAF hyperautofluorescent spots(OR=1.580, 95%CI: 1.061-1.718, P=0.002),OCT retinal nerve fiber layer thickness(OR=1.520, 95%CI: 1.307-6.212, P=0.013), and CFP microaneurysm count(OR=1.459, 95%CI: 1.089-2.095, P=0.015)were risk factors for DR progression. The AUC of the Nomogram for predicting progression risk during the follow-up period was 0.889(95%CI: 0.826-0.952), and the calibration curve showed good consistency between predicted probability and actual risk.

CONCLUSION: The prediction model integrating quantitative imaging features of CFP, OCT and FAF can effectively identify NPDR patients with high progression risk and exhibits good predictive efficacy, which can serve as a quantitative tool for individualized clinical risk management.

Abstract:AIM:To evaluate the clinical efficacy and safety of the silk thread traction intubation as a rescue technique for intraoperative silicone stent perforation during RS bicanalicular lacrimal intubation, and to clarify the value of technical innovation and promotion in primary care.

METHODS: A retrospective analysis was conducted on patients with silicone stent perforation and failed conventional RS intubation treated at the Department of Ophthalmology, the Second People's Hospital of Changzhou from July 2022 to June 2025. All patients underwent reconstruction of the physiological lacrimal-nasal passage using Zhang's memory guidewire lacrimal probing and guiding needle. Repositioning and implantation of the damaged silicone stent were completed via 3-0 silk thread traction. Standard follow-up was performed for at least 6 mo postoperatively. Intraoperative and postoperative conditions of the patients were observed.

RESULTS: A total of 21 patients(21 eyes)were enrolled in this study, including 6 males and 15 females, with a mean age of 59.6±10.8 y. The intraoperative salvage intubation success rate was 100% for all 21 eyes. Among them, 3 eyes required immediate removal of the silicone stent after implantation(1 eye developed a nasal corneal ulcer requiring priority treatment of ocular infection; 2 eyes had intolerable epiphora and discomfort and requested stent removal voluntarily). The remaining 18 eyes had no re-displacement or stent prolapse during indwelling, and the stents were successfully extracted after 3 mo of indwelling as scheduled. The complete lacrimal patency rates at 1, 3 and 6 mo after successful silicone stent implantation were 95%(20 eyes), 90%(19 eyes)and 81%(17 eyes), respectively. At 6 mo postoperatively, 17 eyes(81%)presented complete lacrimal passage patency, 3 eyes(14%)showed incomplete lacrimal patency, and 1 eye(5%)had complete obstruction. Postoperative complications included mild lacrimal puncta tearing in 2 eyes, lacrimal puncta granulation hyperplasia in 1 eye, and lacrimal puncta eversion in 1 eye. Among the 3 eyes with immediate silicone stent removal, only 1 eye developed recurrent lacrimal passage obstruction at 3 wk postoperatively, which was effectively treated by re-intubation. The remaining 2 eyes were cured without aggravation of corneal ulcer, lacrimal stenosis, or persistent lacrimal obstruction.

CONCLUSION: The silk thread traction intubation represents a safe, efficient and minimally invasive salvage approach for stent perforation during RS lacrimal intubation. With the advantages of precise localization, high operative efficiency and minimal tissue damage, it greatly increases the success rate of silicone stent repositioning and reintubation accompanied by manageable complications.