Abstract:ABSTRACT   Objective To analyze the demographic and clinical characteristics, as well as surgical patterns, of patients undergoing strabismus surgery at the People’s Hospital of Xinjiang Uygur Autonomous Region, and to provide reference for strabismus management in Northwest China. Methods Data on gender, ethnicity, age, type of strabismus, angle of deviation, and surgical procedures were retrospectively collected from 476 patients who underwent strabismus surgery between March 2023 and September 2024. Descriptive statistics and group comparisons (chi-square test, t-test, ANOVA with Bonferroni correction for multiple comparisons) were performed. Results Among 476 patients, the male-to-female ratio was nearly 1:1.03. Han Chinese accounted for 48.5%, while ethnic minorities constituted 51.5% (Uyghur being the largest, 35.9%). Exotropia was predominant (75.0%), with intermittent exotropia being the most common subtype (47.7% of all cases). Esotropia accounted for 23.5%, among which acute acquired comitant esotropia comprised 14.7% of esotropia cases. Vertical strabismus was present in 38.8% of patients. Surgery primarily involved horizontal rectus muscles, with lateral rectus surgery being the most performed (48.1%); the majority underwent two-muscle surgery (61.7%). Preoperative horizontal deviation was significantly smaller in unilateral surgery group (30.8±12.9 PD) than in bilateral surgery group (40.6±23.1 PD, P<0.001). Among A-V pattern strabismus, the oblique muscle weakening group had a larger AV angle than the horizontal muscle transposition group (P=0.036). Conclusion In Northwest China, intermittent exotropia is the most common type requiring surgery, frequently accompanied by vertical deviation. The relatively high proportion of acute acquired comitant esotropia suggests that lifestyle factors such as near work may influence the disease spectrum. Surgical strategy is mainly based on horizontal rectus muscles, with individualized design for cases with vertical components according to quantitative indicators.

Abstract:Abstract? Objective：To investigate the prevalence, epidemiological distribution, primary etiological factors, and associated risk factors of blindness and low vision among residents aged 40 years and older in Xilingol League.? Methods：A multistage clustersampling design was adopted. A total of 1?429 participants were enrolled, and 1?295 completed the whole survey with a response rate of 90.62?%. Standardized ophthalmic examinations and MongolianChinese bilingual questionnaire surveys were performed for all subjects. Grading of blindness and lowvision was conducted according to the World Health Organization 2009 criteria aligned with the ICD11 system, based on the bestcorrected visual acuity (BCVA) of the betterseeing eye. The chisquare test was used for intergroup comparisons, and multivariate Logistic regression was applied to explore factors associated with visual impairment. Results：The prevalence of blindness, low vision, and overall visual impairment in the study population was 0.3%, 3.3%, and 3.7%, respectively. The overall prevalence of visual impairment was 3.9% in pastoral areas and 3.2% in urban areas, with no statistically significant difference between the two groups (P = 0.696). The prevalence of visual impairment increased significantly with age, and the low vision prevalence reached 18.0% among individuals aged 80 years and above (trend χ² = 44.35, P < 0.001). The overall prevalence of visual impairment in the Mongolian population (2.9%) was lower than that in the Han population (5.0%). Cataract was the leading cause of visual impairment, accounting for 78.3% of all affected cases. The unoperated rate of cataract was 80.0% in pastoral areas and 78.7% in urban areas. Multivariate Logistic regression analysis demonstrated that age ≥ 80 years was an independent risk factor for visual impairment (OR = 5.86, 95%CI: 2.71–12.67, P < 0.001). Regular dairy product consumption was significantly correlated with a lower risk of visual impairment (OR = 0.45, 95%CI: 0.24–0.84, P = 0.012). Diabetes mellitus, hypertension, and primary school education or below were not identified as independent risk factors for visual impairment (all P > 0.05). Conclusions：The overall prevalence of blindness and low vision among residents aged 40 years and above in Xilingol League was 3.7%. Advanced age was identified as an independent risk factor for visual impairment. Dairy product intake was protectively correlated with visual impairment, although a causal relationship could not be determined. Cataract remained the leading cause of visual impairment. The accessibility of cataract surgery in pastoral areas still needs urgent improvement. Key Words：Blindness; Low Vision; Prevalence; Risk Factors; Epidemiological Investigation

Abstract:AIM: To explore the predictive efficacy of NVU, Nrf2 and HO-1 on retinal injury in AMD susceptible population, and to provide laboratory reference indicators for screening and stratified management of individuals at high risk of injury in this population. MethodsThis study is a prospective study. The study included a period of time from April 2023 to March 2025. A total of 185 AMD-susceptible people were screened and included. All subjects were treated with traditional Chinese medicine and followed up for 12 months. The deadline for follow-up was unified in March 2026. According to whether retinal injury occurred during the follow-up period, the patients were divided into injury group and non-injury group. The probability of overall retinal injury was 35 %. Collect the baseline data of the subjects ; the retinal injury indexes were evaluated by OCT and fluorescence angiography. Peripheral blood was collected, and NVU function index and Nrf2 and HO-1 expression were detected by ELISA, and the differences between the two groups were compared. The data were analyzed by SPSS 26.0. The measurement data were analyzed by mean ± standard deviation ( t test ), the count data rate ( χ2 test ), Spearman analysis correlation, multivariate Logistic regression screening independent influencing factors, ROC curve evaluation predictive value, P < 0.05 for the difference was statistically significant..Results After 12 months of follow-up, 65 of 185 AMD susceptible people had retinal injury, with an incidence of 35.00 %. The macular foveal retinal thickness, retinal nerve fiber layer thickness and choroidal thickness in the injury group were significantly lower than those in the non-injury group, and the retinal injury score was significantly higher than that in the non-injury group ( all P < 0.001 ). The levels of vascular endothelial growth factor ( VEGF ) and endothelin-1 ( ET-1 ) in the injury group were significantly higher than those in the non-injury group, and the levels of tight junction protein 1 ( ZO-1 ) and occludin were significantly lower than those in the non-injury group ( all P < 0.001 ). The expression levels of Nrf2 and HO-1 protein in the injury group were significantly lower than those in the non-injury group ( all P < 0.001 ). Spearman correlation analysis showed that the expression of Nrf2 and HO-1 protein was positively correlated with retinal structure index and NVU tight junction protein ( r = 0.692-0.776, all P < 0.01 ), and negatively correlated with VEGF, ET-1 and retinal injury score ( r = -0.802--0.741, all P < 0.01 ). Multivariate Logistic regression analysis showed that advanced age, low Nrf2 expression, low HO-1 expression, high VEGF and low ZO-1 were independent risk factors for retinal injury in AMD susceptible population ( all P < 0.05 ). ROC curve analysis showed that the area under the curve ( AUC ) of combined detection of Nrf2, HO-1, VEGF and ZO-1 in predicting retinal injury was 0.921, the sensitivity was 98.38 %, and the specificity was 83.33 %. The predictive value was significantly higher than that of single index ( all P < 0.001 ).Conclusions NVU combined with Nrf2 and HO-1 related indicators can be used to predict the early risk of retinal injury in AMD susceptible population and guide the refined follow-up management of high-risk subjects.

Abstract:【Abstract】 Objective To characterize the changes in macular retinal microvascular circulation in patients taking hydroxychloroquine (HCQ) using optical coherence tomography angiography (OCTA), and to explore the value of OCTA in the early screening of HCQ-related retinal toxicity. Methods A retrospective case-control study was conducted. Forty-one patients with rheumatic immune diseases (case group) treated at The First People’s Hospital of Lianyungang from January 2025 to March 2026 were enrolled. All patients regularly took HCQ, with no obvious organic abnormalities found on fundus examination. Nineteen healthy subjects matched for age, gender and other demographic characteristics were selected as the control group.A total of 60 subjects were included, and data from the right eye were used for statistical analysis.The subjects were divided into three groups according to the duration of HCQ intake: healthy control group (Group A), HCQ intake < 5 years (Group B), and HCQ intake ≥ 5 years (Group C).All subjects underwent best-corrected visual acuity (BCVA), spectral-domain optical coherence tomography (SD-OCT), visual field examination and fundus examination.OCTA was used to measure vessel density of the superficial capillary plexus (SCP) and deep capillary plexus (DCP) in the 6 mm×6 mm macular region (fovea, parafovea and perifovea), as well as the area, perimeter, and vessel density of the foveal avascular zone (FAZ) and outer retinal Flow Area.One-way analysis of variance (ANOVA) was used for comparison of quantitative data among multiple groups, and t-test was used for pairwise comparison. Spearman’s rank correlation was used to analyze the correlation between regional retinal vessel density and duration of HCQ intake in the case group (Groups B and C). Results Macular retinal DCP vessel density in Group C was significantly lower than that in Group A (P<0.05). There was no significant difference in SCP vessel density among the three groups (P>0.05).Regional DCP vessel density (whole image, superior hemi-field, inferior hemi-field, fovea, parafovea, perifovea) was negatively correlated with the duration of HCQ intake in patients taking HCQ (r=-0.176, -0.219, -0.184, -0.317, -0.436, -0.259, all P<0.05). Conclusions OCTA reveals reduced vascular density in macular deep capillary plexus (DCP) among patients with rheumatic disorders receiving long-term hydroxychloroquine (HCQ). This parameter correlates negatively with treatment duration, suggesting OCTA may serve as an adjunctive tool for early screening of HCQ-related retinal toxicity.

Abstract:Abstract Purpose: To investigate the effects of blue light exposure derived from light-emitting diodes (LEDs) on the human ocular surface. Methods: Thirty healthy volunteers were enrolled in this study. The ocular surface disease index (OSDI), tear secretion volume, non-invasive keratograph break-up time (NIBUT), and corneal sodium fluorescein staining were measured before and after close-range exposure to blue light emitted by LEDs. Concentrations of the oxidative stress markers hexanoyl lysine (HEL) and 4-hydroxy-2-nonenal (4-HNE) in the tear film were quantified by ELISA. All measurements were conducted at baseline and after 1 and 4 hours of exposure. Results: All parameters showed no significant differences at baseline. Compared with the baseline group, the OSDI scores significantly increased in both the group exposed to blue light via smartphone for 1 hour and the group exposed for 4 hours (P <0.01). The 4-hour group exhibited higher OSDI, fatigue, burning, and dryness scores than the other groups. The 4-hour group showed a significant reduction in NIBUT (P < 0.01). HEL concentrations were significantly increased in the 1-hour and 4-hour groups compared with the baseline group (P < 0.05). No statistically significant differences were observed in tear secretion, corneal fluorescence staining, or 4-HNE levels throughout the study. Conclusions: While minimizing excessive tear evaporation caused by prolonged inter-blink intervals during gazing and the accommodative-convergence load associated with near work, Close-range exposure to blue light emitted by LEDs from smartphones not only exacerbates subjective symptom indices such as OSDI but also destabilizes the tear film and elevates oxidative stress levels in tears. This may increase ocular surface oxidative stress, thereby contributing to potential risks of corneal oxidative damage, ocular surface inflammation, and dry eye. Keywords: Dry eye disease; Blue light

Abstract:Primary glaucoma is a group of blinding eye diseases with high genetic heterogeneity, mainly comprising primary congenital glaucoma (PCG), primary open-angle glaucoma (POAG), and primary angle-closure glaucoma (PACG). PCG is mainly caused by recessive mutations in genes such as CYP1B1 and LTBP2, and is classified as a Mendelian disorder; however, it exhibits incomplete penetrance and regulation by modifier genes. In contrast, POAG and PACG are polygenic complex diseases. In POAG, rare high-penetrance variants in MYOC, OPTN, and TBK1 account for a small fraction of families, whereas most patients show an accumulation of small-effect variants involving endophenotypes such as intraocular pressure (IOP), cup-to-disc ratio (CDR), central corneal thickness (CCT). PACG is closely associated with genes related to anterior segment anatomical structures, including ABCC5, COL11A1, and PCMTD1-ST18. Both diseases are influenced by gene-environment interactions. Genome-wide association studies (GWAS), next-generation sequencing, and multi-omics technologies have identified numerous susceptibility loci and enhanced the clinical value of EPs and polygenic risk scores (PRS), laying the foundation for molecular diagnosis, risk stratification, and targeted therapy. In the future, integrating multi-omics and clinical imaging data, optimizing genetic risk prediction, and improving relevant ethical standards will promote the realization of precision medicine for primary glaucoma.

Abstract:Dry eye disease is a widespread, multifactorial ocular condition; its core pathophysiological mechanism involves a self-perpetuating cycle of chronic inflammation driven by the reciprocal activation of innate and adaptive immune responses. Persistent inflammation disrupts tear film homeostasis and elevates tear osmolarity, ultimately leading to a decline in visual function and impaired quality of life. Focusing on the immunopathogenesis of dry eye disease, this article systematically compares the therapeutic targets, clinical evidence, and safety profiles of three representative topical immunomodulators: cyclosporine A, lifitegrast, and tacrolimus. By blocking T-cell activation and proliferation at various stages, these agents interrupt the self-amplifying inflammatory loop and have become central to the long-term management of moderate-to-severe dry eye disease. After analyzing the limitations of existing research, the article highlights the need for future head-to-head clinical trials and the identification of predictive biomarkers to bridge current evidence gaps and guide the rational clinical selection of medications.

Abstract:Impairment of the retinal neurovascular unit (NVU) is a critical driver of blood-retinal barrier (BRB) dysfunction, which constitutes a major pathological basis for the onset and progression of diabetic retinopathy (DR). In the absence of timely therapeutic intervention, BRB disruption can contribute to diabetic macular edema (DME) and proliferative diabetic retinopathy (PDR), ultimately leading to severe and irreversible visual impairment. The core pathomechanisms underlying BRB dysfunction during DR pathogenesis encompass the structural disorganization of intercellular junctional complexes, aberrant upregulation of vascular endothelial growth factor (VEGF), pathological accumulation of advanced glycation end products (AGEs), and sustained oxidative stress. Although the regulatory networks governing vascular permeability have been relatively well elucidated, the precise molecular circuitry that modulates BRB junctional proteins within the distinctive pathological microenvironment of DR remains incompletely understood. This review provides a systematic overview of the molecular architecture of the BRB, with a particular focus on the mechanisms by which aberrant remodeling of key junctional proteins—including tight junctions (TJs) and adherens junctions (AJs)—promotes microvascular leakage and macular edema throughout DR progression. A comprehensive understanding of these mechanistic cascades will inform the rational design of targeted interventions aimed at preserving BRB integrity and restoring the structural and functional homeostasis of the inner BRB, thereby mitigating retinal microvascular hyperpermeability and slowing DME progression.

Abstract:Dry eye disease (DED) is a multifactorial ocular surface disorder characterized by disruption of tear film homeostasis. Persistent hyperosmolarity, oxidative stress, and inflammation can overwhelm adaptive responses in ocular surface epithelial cells, leading to mitochondrial bioenergetic dysfunction, endoplasmic reticulum proteostasis disturbance, and impaired autophagy-lysosome flux. Mitochondrial injury promotes reactive oxygen species accumulation and mitochondrial DNA (mtDNA) release; endoplasmic reticulum stress disrupts protein folding and secretion; and autophagy-lysosome dysfunction compromises the clearance of damaged organelles. These processes are interconnected and can amplify ocular surface injury through cyclic GMP-AMP synthase-stimulator of interferon genes (cGAS-STING) signaling, inflammasome activation, lipid peroxidation, pyroptosis, and ferroptosis, This review summarizes stress-related alterations in mitochondria, the endoplasmic reticulum, and the autophagy-lysosome system in dry eye disease, discusses their functional crosstalk and downstream injury pathways, and evaluates emerging therapeutic strategies aimed at restoring organelle homeostasis.