Abstract:Objective: To construct a predictive model for the risk of myopia in preschool children and evaluate its clinical value.Method: A retrospective analysis was conducted on the data of 550 preschool children (550 eyes, including those with poor vision and those with the same vision in the right eye) who visited hospitals from January 2020 to December 2024. 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 (n=34) and a normal vision group (n=351) based on whether myopia occurred (SE ≤ -0.50D 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 prediction equation was constructed using Logistic regression. The discrimination, calibration and clinical application value of the prediction model were verified through the receiver operating characteristic (ROC) curve, Hosmer-Lemeshow test and decision curve.Result: The clinical data between the training set and the validation set were comparable (P>0.05). Multiple linear regression analysis showed that the ratio of axial length (AL) to corneal curvature radius (CR), axial length (AL), choroidal thickness (SFCT), anterior chamber depth (ACD), age, and parental myopia history were risk factors for myopia in preschool children (all P<0.05). Based on the above risk factors, a Logistic regression risk prediction model was constructed to obtain a warning model logit (P)=0.881 × AL/CR-0.318 × SFCT+0.408 × ACD+2.064 × age+1.442 × parental myopia history -29.310. The evaluation of the effectiveness of the myopia risk prediction model for preschool children based on the training set showed that the area under the ROC curve (AUC) was 0.941 (95% CI: 0.916-0.966), and the H-L test was χ2=4.194, P=0.839. The decision curve indicated that within the threshold range of 0.01-0.72 and 0.77-0.98, the net return rate was greater than 0, suggesting that the model had good discrimination, calibration, and clinical application value in predicting the risk of myopia in preschool children compared to the actual risk. 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 prediction 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 prediction model constructed based on these factors has high predictive 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 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 98 patients (162 eyes) who underwent ICL/toric ICL implantation between July 2023 and January 2024. Patients were divided into superior incision group (78 eyes) and temporal incision group (84 eyes) according to the expected postoperative residual astigmatism. Pentacam measurements were performed preoperatively and at 3 months 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 eyes in the superior incision group and 87 eyes in the temporal incision group. A total of 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 years) and 82 patients (82 eyes) in the temporal incision group (20 males and 62 females, aged 27.79 ± 6.47 years). 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 3month postoperative follow-up, superior incisions induce a predominant withtherule SIA vector, while temporal incisions induce a predominant against-the-rule SIA vector. Anterior surface ΔJ0 is the primary contributor to total corneal ΔJ0, and posterior surface ΔJ0 also demonstrates a statistically significant association. Incision location exerts no direct independent effect on the magnitude of total corneal ΔJ0; its effect is indirectly realized by inducing specific directional SIA vector changes on the anterior and posterior corneal surfaces.

Abstract:Objective: To analyze the effect of preoperative retinal ganglion cell complex thickness (GCC) on visual quality after cataract combined with glaucoma surgery. Method: A retrospective study was conducted. Clinical data of 115 patients (115 eyes) with cataract and glaucoma who underwent phacoemulsification, intraocular lens implantation, and angle separation surgery in the hospital were collected from January 2023 to December 2024. Preoperative evaluation of retinal GCC was performed, and the three-point method was used to divide the GCC thickness in the macular area into low thickness group (<70.00 μ m, 31 cases), medium thickness group (70.00-74.00 μ m, 47 cases), and high thickness group (>74.00 μ m, 37 cases). Postoperative visual quality was evaluated by visual acuity, contrast sensitivity, field of view, and subjective visual quality (QoV) at 1 month, 3 months, and 6 months after surgery. Univariate covariance analysis was used to analyze the inter group data of GCC thickness in different macular regions before surgery. Linear regression analysis was used to verify the effect of preoperative macular GCC thickness on postoperative visual acuity at 6 months. Result: Comparative analysis of baseline data among the three patient groups showed no statistically significant differences (P>0.05). However, there were statistically significant differences in visual acuity LogMAR values, contrast sensitivity values, mean visual field deviation values, QoV scores, group effects, time effects, and interaction effects among the groups (P<0.05). There was no statistical significant difference in the LogMAR values, contrast sensitivity values, mean visual field deviation values, and QoV scores among the three groups before surgery (P>0.05). At postoperative months 1, 3, and 6, the low-thickness group exhibited higher visual acuity LogMAR values and QoV scores compared to the medium-and high-thickness groups, with the medium-thickness group showing superior performance to the high-thickness group (P<0.05). The low-frequency, mid frequency, and high-frequency contrast sensitivity values, as well as the average deviation of the field of view, were lower in the low thickness group than in the medium and high thickness groups, and the medium thickness group was lower than the high thickness group, with statistical significant diffwerences (P<0.05). At 1 month, 3 months, and 6 months after surgery, the LogMAR and QoV scores of the three groups of patients decreased compared to preoperative visual acuity, while the contrast sensitivity and visual field average deviation values of low frequency, medium frequency, and high frequency increased, with statistical significant diffwerences (P<0.05). The LogMAR and QoV scores of the three groups of patients were higher at 1 month after surgery than at 3 and 6 months after surgery, with statistical significant diffwerences (P<0.05). The low frequency, mid frequency, and high frequency contrast sensitivity values, as well as the average deviation of the visual field, were all lower in the three groups of patients one month after surgery than at 3 and 6 months after surgery, with statistical significant diffwerences (P<0.05). Through linear regression analysis, the model fit was good (F=53.846, P<0.001), and the thickness of GCC in the macular area before surgery had a negative impact on the LogMAR value of visual acuity at 6 months after surgery (β=-0.006, P<0.001). The regression equation was: Y=0.716-0.006 × X preoperative macular GCC thickness. The model determination coefficient R2=0.323 suggested that preoperative GCC thickness can explain 32.3% of the degree of visual acuity variation at 6 months after surgery. For every 1 μm reduction in the thickness of the GCC before the surgery, the average LogMAR visual acuity value increased by 0.006 at 6 months after the surgery. Conclusion: Preoperative retinal GCC thickness is a protective factor for visual quality after cataract combined with glaucoma surgery. The thicker the preoperative GCC, the better the visual acuity, contrast sensitivity, and visual field recovery at 1, 3, and 6 months after surgery. Moreover, for every 1 μ m decrease in preoperative GCC thickness, the average LogMAR visual acuity value at 6 months after surgery increases by 0.006, which can be used as one of the preoperative predictive indicators for postoperative visual quality.

Abstract:Abstract Objective： To investigate the value of optical coherence tomography angiography (OCTA) parameters and serum caspase-1 for assessing the severity of diabetic retinopathy (DR). Methods： 128 patients(151 eyes) with DR into our hospital from June 2024 to December 2025 were selected in the retrospective study and divided into early non-proliferative DR (NPDR) group (n=75,90 eyes,40 males and 35 females,age of 74.3±5.6 years) and late proliferative DR (PDR) group (n=53,61 eyes,27 males and 26 females,age of 75.9±5.8 years) based on the results of fundus fluorescein angiography (FFA). Additionally, 60 patients(0 eyes,33 males and 27 females,age of 72.6±5.4 years) of diabetes without DR were selected as control group. OCTA parameters, including macular blood flow density, foveal avascular zone (FAZ) circumference and area, mean retinal thickness, hyperreflective dots (HRF) and internal limiting membrane abnormalities among the groups were compared. Blood biochemistry parameters, including fasting blood glucose, glycated hemoglobin (HbA1c), systemic immune-inflammation index (SII), triglyceride/high-density lipoprotein (TG/HDL), urinary albumin-to-creatinine ratio (UACR) and caspase-1 were also compared. Results： Among control group, NPDR group and PDR group, macular blood flow density gradually decreased, while FAZ circumference and area, mean retinal thickness gradually increased, HRF and internal limiting membrane abnormalities gradually increased, SII, UACR and caspase-1 levels gradually increased,too (P<0.05). The duration of diabetes in NPDR group and PDR group were longer than control group (P<0.05). Multivariate logistic regression showed that duration of diabetes, HRF and caspase-1 level were the risk factors to occurrence of DR, while macular blood flow density was protective factor (P<0.05),caspase-1 level was risk factor to progression of DR to PDR, macular blood flow density was protective factor (P<0.05). Receiver operating characteristic (ROC) curve showed that area under curve (AUC) of caspase-1 combined with macular blood flow density for predicting occurrence of DR and PDR were 0.864 and 0.890, respectively, both higher than single indicators (P<0.05). Conclusion： The combination of macular blood flow density from OCTA parameter and serum caspase-1 has important clinical value in assessing severity of DR.

Abstract:Objective: To evaluate the effect of the myopia prevention and control guidance stations (MPCGS) on axial length elongation in school-aged children. Methods: This was a prospective cohort study. Three schools in Qingyang District, Chengdu, that implemented the MPCGS in 2023 were selected as the intervention group, while three schools in the same district without such stations served as the control group. A total of 3,404 students enrolled in grades 1–3 in 2022 and completed continuous follow-up from 2022 to 2025 were included, with 1,709 in the intervention group and 1,695 in the control group. Students were categorized into three groups based on their enrollment grade in 2022: Group A (Grade 1), Group B (Grade 2), and Group C (Grade 3). The intervention group received the school-hospital-family integrated model for myopia prevention and control. 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 with Bonferroni-corrected post hoc tests used for within-group comparisons across time points. Results: No significant differences were observed between the intervention and control groups within each grade (A, B, and C) at baseline for age, sex, SE, AL, ΔSE (2022-2023), or 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 (P < 0.001 and P = 0.017, respectively), while no significant between-group difference in ΔAL was detected in Group C (P = 0.419). Within-group comparisons revealed significant differences in ΔAL across time points within each of Groups A, B, and C (all P < 0.001). Compared with the pre-intervention year, ΔAL significantly decreased in all groups during the second intervention year (all P < 0.05). Conclusion: The school-hospital-family integrated MPCGS model was associated with a deceleration in axial elongation, with this association exhibiting a time-dependent cumulative effect and being more pronounced in lower-grade children (grades 1-2).

Abstract:Objective: To characterize the current status, research hotspots, and differences in the evolution of Chinese- and English-language clinical research on amblyopia from 2015 to 2025, and to provide a reference for the clinical diagnosis and treatment of amblyopia and future research. Methods: Chinese- and English-language studies on the clinical management of amblyopia were retrieved from CNKI, VIP, Wanfang Data, and Web of Science (WoS) databases. Bibliometric and visualization analyses of publication output, institutions, authors, and keywords were conducted using CiteSpace 6.4.R1 and VOSviewer 1.6.19. Results:A total of 1,302 publications were included, comprising 920 Chinese-language and 382 English-language publications. The annual number of Chinese-language publications declined after 2020, whereas that of English-language publications showed an overall increasing trend. Relevant studies involved 18 countries, with relatively closer interinstitutional collaboration observed in the English-language literature; the collaboration networks of core authors in both Chinese- and English-language literature exhibited multiple clusters. A total of 360 and 283 keyword nodes were identified in the Chinese- and English-language literature, respectively. High-frequency keywords in both groups mainly involved four aspects: amblyopia types, study populations, outcome measures, and treatment modalities. Both Chinese- and English-language studies focused on anisometropic and strabismic amblyopia. Chinese-language studies predominantly investigated children of different age groups, whereas adult amblyopia received earlier attention in the English-language 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. 19 and 13 keyword clusters were identified in the Chinese- and English-language literature, respectively. Burst analysis showed that digital treatment such as binocular dichoptic training, emerged relatively earlier in the English-language literature, and quality of life, and amblyopia risk factors screening have received considerable attention in recent years. In Chineselanguage literature, attention to digital visual training and traditional Chinese medicine interventions has gradually increased. English-language studies initiated neuroimaging assessments using restingstate functional magnetic resonance imaging at an earlier stage. Conclusions: From 2015 to 2025, Chinese- and English-language 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 alone 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, digital binocular 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: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 that the development of MME may be attributed to transsynaptic cell loss and vitreomacular traction. A deeper understanding of the clinical characteristics and underlying pathophysiological mechanisms of MME may provide valuable insights into its role as a potential biomarker and offer important evidence for the diagnosis, disease monitoring, and prognostic assessment of various neuro-ophthalmic disorders.

Abstract:PANoptosis is a newly recognized form of inflammatory programmed cell death (PCD) that integrates key molecular features of pyroptosis, apoptosis, and necroptosis, rather than representing a simple combination of these pathways. It is characterized primarily by loss of plasma membrane integrity and the subsequent release of pro-inflammatory cytokines and damage-associated molecular patterns, thereby contributing to immune regulation and tissue injury. Previous studies have focused mainly on the roles of PANoptosis in cancer, infectious diseases, and inflammatory disorders, whereas its involvement in ocular diseases remains incompletely understood. 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 basis for further investigation into its potential roles and underlying mechanisms.

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:Abstract Objective: 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 ultra-widefield imaging (UWFI) in the risk assessment of myopic fundus lesions. Methods: A cross-sectional study was conducted. A total of 197 eyes were enrolled and divided into four groups: emmetropia and mild myopia group (n=25), moderate myopia group (n=38), high myopia group (n=94), and ultra-high myopia group (n=40). Axial length (AL), anterior chamber depth (ACD), central corneal thickness (CCT), and spherical equivalent (SE) were measured. FT severity (0=none, 1=mild, 2=moderate, 3=severe) and fundus lesions were evaluated. Statistical analyses were performed using the chi-square test, Kruskal-Wallis H test, Mann-Whitney U test, Spearman correlation analysis, and ordinal logistic regression. Results: A total of 197 patients (197 eyes) were enrolled, including 88 males (44.7%) and 109 females (55.3%), with a median age of 36.00 (27.00, 47.00) years (range: 18–60 years). The patients were divided into four groups based on refractive status: emmetropia and mild myopia group (25 eyes), with a median age of 36.00 (23.00, 47.00) years, 13 males (52.0%) and 12 females (48.0%); moderate myopia group (38 eyes), with a median age of 30.00 (23.00, 37.00) years, 18 males (47.4%) and 20 females (52.6%); high myopia group (94 eyes), with a median age of 36.00 (23.00, 47.00) years, 40 males (42.6%) and 54 females (57.4%); and ultra?high myopia group (40 eyes), with a median age of 42.50 (27.25, 52.75) years, 17 males (42.5%) and 23 females (57.5%). Sex distribution was balanced among the four groups (χ² = 0.902, P = 0.825), while age distribution differed significantly (H = 9.911, P = 0.019). Axial length (AL) increased and spherical equivalent (SE) decreased progressively with myopia severity, with significant differences among all groups (both P < 0.001). The severity of foveal thickness (FT) also increased progressively with myopia severity (Kruskal?Wallis H = 68.057, P < 0.001). Spearman correlation analysis showed that FT was positively correlated with AL (rs = 0.669, P < 0.001) and negatively correlated with SE (rs = -0.628, P < 0.001). Multivariate ordinal logistic regression revealed that in the AL?containing model, AL, age, sex, lattice degeneration (LD), and myopic maculopathy (MM) were independent influencing factors for FT (all P < 0.05); in the SE?containing model, SE, age, sex, peripheral retinal pigmentary changes, LD, and MM were independent influencing factors for FT (all P < 0.05). Conclusion: FT severity is positively correlated with the degree of myopia and can serve as a simple indicator reflecting axial elongation and myopia progression. Together with peripheral retinal lesions, it has important clinical value in the risk assessment of myopic fundus lesions. UWFI should be incorporated into routine screening protocols for high-risk myopic patients.