Welcome To International Journal of Ophthalmology Press

International Eye Science (IES), the Chinese edition of the International Eye Journal, is an international bilingual ophthalmic academic journal supervised by the Health Commission of Shaanxi Province and sponsored by the Xi’an Branch of the Chinese Medical Association. Its China Standard Serial Number: ISSN 1672-5123, CN 61-1419/R.

IES is currently a Chinese Core Journal of Science and Technology, a Chinese Medical and Health Core Journal, a Chinese Applied Core Journal, a Q1 journal in the Chinese Academic Journal Classification, and a High-Quality Scientific and Technological Journal of Shaanxi Province. It is indexed by multiple authoritative domestic and international databases including WJCI, Scopus, Embase, JST, UPD, CA, IC and WPRIM.

Rooted in China and oriented to the world, the journal welcomes manuscripts on basic and clinical research in ophthalmology, related disciplines and interdisciplinary fields. It is committed to developing a high-quality Chinese ophthalmic academic journal with international characteristics.

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Clinical characteristics and surgical pattern analysis of strabismus patients in Xinjiang

Qin yanli

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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:Objective To analyze the prevalence, distribution characteristics, etiologies and risk factors of blindness and low vision among people aged 40 years and above in Xilinguole League.

houyifan, zhangguisen, liulei, muqier, xujiawei, taode, liuyunxia, alima

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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
Predictive analysis of NVU, Nrf2 combined with HO-1 on the risk of retinal injury in patients with age-related macular degeneration

chu jiangjing, wang yahui, yang guangyifang, hu haijuan, si shizhong, zhang yu, zhao hui

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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.
Application of OCTA in Evaluating the Effects of Hydroxychloroquine on Macular Retinal Microcirculation

yuting, jianghaitao

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【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.
Effect of Short-Term Exposure to Light-Emitting Diode-Derived Blue Light on the Ocular Surface

Jinhaiyan

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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
Research Progress on Genetic Heterogeneity of Primary Glaucoma

WANG Yanghe, YUE Hongyun, QI Yunkai, HUANG Xiaojuan

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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.
Research Progress on Topical Immunomodulatory Therapy for Dry Eye Disease

CongCong, WangPei, WangSheng

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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.
Regulatory Mechanisms of Blood–Retinal Barrier Breakdown in Diabetic Retinopathy

puxuanhao, Zhao Hongchao, Shi Meiyu, Wang Die, Yang Hong

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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.
Research Progress on Organelle Stress Crosstalk in Ocular Surface Homeostatic Dysregulation in Dry Eye Disease

wangwenqi, jingxi, linannan, zhanghongxing

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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.

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Clinical analysis of 112 cases of giant papillary conjunctivitis in contact lenses wearers

Rui-Bo Zhao, Jian-Jun Li

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AIM:To investigate giant papillary conjunctivitis patients who can not be divorced from contact lenses change to frequent replacement type contact lenses and rigid gas permeable contact lenses and observe the condition of giant papillary conjunctivitis with or without changes.And to investigate the efficacy of desensitizing agents at the same time.METHODS:Totally 112 cases(208 eyes) who were diagnosed with giant papillary conjunctivitis in our center were randomly divided into four groups:Group 1(Ⅰ group) of 68 eyes were treated with frequent replacement type contact lenses combined with mingmuqing eye drops;Group 2(Ⅱ group)of 56 eyes were treated with frequent replacement type contact lenses combined with desensitizer eye drops;Group 3(Ⅲ group) of 52 eyes were treated with rigid gas permeable contact lenses combined with mingmuqing eye drops;Group 4(Ⅳ group)of 32 eyes were treated with rigid gas permeable contact lenses combined with desensitizer eye drops.RESULTS:Condition of giant papillary conjunctivitis patients in all the 4 groups were significantly improved,data of 4 groups were no statistically significant difference(P>0.05).CONCLUSION:The giant papillary conjunctivitis caused by contact lenses wearing can get effective control and cure of the disease without affecting wearing of contact lenses if the replacement of rigid gas permeable contact lenses or frequent replacement type contact lenses can be introduced timely.
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Effect of anti-vascular endothelial growth factor therapy on intraocular inflammatory cytokine levels in the treatment of proliferative diabetic retinopathy

Jin-Xiu Luo, Zi-Zhong Hu, Qing-Huai Liu, Yuan Fang

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AIM: To explore the effects of anti-vascular endothelial growth factor(VEGF)agents(Conbercept)before pars plana vitrectomy(PPV)on inflammatory cytokine levels of patients with proliferative diabetic retinopathy(PDR).
METHODS: A total of 49 patients(49 eyes)who diagnosed with PDR at the First Affiliated Hospital with Nanjing Medical University from June 2017 to January 2018 were recruited and randomly divided into two groups. A total of 25 cases(25 eyes)who did not receive intravitreal injection before PPV were included in no-intravitreal injection of Conbercept(IVC)group, and 24 cases(24 eyes)who received IVC 5～7d before PPV were included in IVC group. The vitreous samples were collected from all the patients at the start of PPV. Levels of VEGF-A, monocyte chemotactic protein-1(MCP-1)and inflammatory cytokines in the vitreous humor were measured using Luminex technology.
RESULTS: Compared with the no-IVC group, the level of VEGF-A decreased significantly(P<0.001), the concentration of IL-6(P=0.004), IL-8(P=0.002), IL-18(P=0.04)and TNF-α(P=0.03)increased remarkably in the IVC group. The other inflammatory cytokines in the vitreous humor showed no significant difference between the IVC and no-IVC groups.
CONCLUSION: IVC before PPV can effectively decrease the concentration of VEGF-A, but had limited influence on the level of inflammatory cytokines in the vitreous humor of patients with PDR.
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Selection of intraocular lens calculation formula for cataract surgery in glaucoma patients

He-Lin Zhu, Jian Zhang, Hong Yan

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Glaucoma and cataracts are the leading causes of blindness, and surgery is an important treatment option. Patients with glaucoma have clinical characteristics such as high intraocular pressure, shallow anterior chamber and short axial length, and the ocular structure is often altered after anti-glaucoma surgery like trabeculectomy. These changes also lead to differences in the accuracy of intraocular lens(IOL)refractive calculation between cataract surgery after anti-glaucoma surgery or combined glaucoma and cataract surgery and alone cataract surgery. Meanwhile glaucoma patients' individual clinical characteristics and structural changes caused by anti-glaucoma surgery have shown differences in the impact on the predictive accuracy of IOL diopters and the type of refractive drift. This article reviews the latest research advances in the causes of refractive error(RE), the characteristics of refractive drift, and the selection of the most appropriate IOL formula for glaucoma patients undergoing cataract surgery or cataract surgery after anti-glaucoma surgery or combined glaucoma and cataract surgery.
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Current situation and prospect of minimally invasive glaucoma surgery in childhood glaucoma

Xiao-Jie Zhou, Ren-Yi Wu

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Childhood glaucoma is a kind of refractory glaucoma. Minimally invasive glaucoma surgery(MIGS)provides a safe and effective treatment option for childhood glaucoma. Most of the published studies tend to be with circumferential ab interno trabeculotomy, showing that its safety and effectiveness in the treatment of childhood glaucoma are comparable to non-MIGS circumferential ab externo trabeculotomy. Studies on KDB, trabectome and Xen-gel stent are relatively limited, but they may have advantages in some specific cases. While considering the advantages of each MIGs operation, it is also necessary to weigh the long-term effect of each operation method. In addition, more prospective and comparative researches, larger sample size and longer follow-up time are needed to verify the safety and effectiveness of MIGs in the treatment of childhood glaucoma.
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Clinical efficacy of femtosecond laser-assisted cataract surgery combined with PanOptix trifocal intraocular lens implantation

Lei Guo, Xian-Jun Liang, Xi-Qiao Zhang, Yan-Xue Xu, Ying-Jie Lin

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AIM: To evaluate the clinical efficacy of femtosecond laser-assisted cataract surgery combined with PanOptix trifocal intraocular lens implantation.
METHODS:The retrospective study enrolled 22 cases(26 eyes)of cataract patients who underwent femtosecond laser-assisted cataract surgery combined with PanOptix trifocal intraocular lens implantation from August 2020 to August 2021. Follow-up to 3mo after surgery, the changes of far, intermediate and near visual acuity, aberration, Strehl ratio(SR)and modulation transfer function cutoff(MTF-cutoff)frequency were compared. Defocus curve at 1mo postoperatively was made, and the visual quality and satisfaction were evaluated after 3mo of surgery.
RESULTS: The visual acuity of all patients was better than 0.1(LogMAR)at the far, intermediate and near distance at 1d, 1wk, 1 and 3mo postoperatively, and it was significantly improved compared with those before surgery(all P<0.01). The defocus curve transitioned smoothly between +0.5 and -3.0D at 1mo after surgery, and visual acuity was better than 0.63. The total aberration and spherical aberration in the whole eye were significantly lower after surgery than before, and the SR and MTF-cutoff were significantly improved at 1d and 1wk after surgery(all P<0.05). With high satisfaction and good visual quality, patients could watch at far, intermediate and near distance without wearing glasses at 3mo after surgery.
CONCLUSION: Femtosecond laser-assisted cataract surgery combined with PanOptix trifocal intraocular lens implantation gave patients a comfortable and satisfactory full-course vision.
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Pars plana vitrectomy combined with inverted internal limiting membrane flap technique for treating macular hole retinal detachment in high myopia

Wen-Kui Zhu, Wen-Shuai Li, Pei-Shan Xu

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AIM: To investigate the clinical efficacy of pars plana vitrectomy(PPV)combined with inverted internal limiting membrane flap technique in the treatment of macular hole retinal detachment(MHRD)in high myopia.
METHODS: A retrospective clinical study was conducted. A total of 63 patients(64 eyes)with high myopia and MHRD who treated at our hospital from October 2017 to October 2021 were selected as research subjects. They were divided into two groups according to different surgery, with 34 cases(35 eyes)who received PPV combined with inverted internal limiting membrane flap technique in group A, and 29 cases(29 eyes)received PPV combined with internal limiting membrane peeling in group B. The patients were followed up for 6mo. The two groups were compared in terms of the hole closure rate, the reduction rate of retinal detachment and best corrected visual acuity(BCVA)before operation and at 1wk, 1, 3 and 6mo after operation, and the postoperative complications were recorded.
RESULTS: The hole closure rate within 6mo after operation was significantly higher in group A than in group B(P<0.05), but there was no statistically significant difference in the reduction rate of retinal detachment(P>0.05). The BCVA of the two groups was significantly improved over time after operation(P<0.05). There was no statistically significant difference in BCVA between the two groups before operation and at 1wk, 1, 3 and 6mo after operation(P>0.05). Complications were observed in the two groups, but there was no statistically significant difference in the incidence of complications between the two groups(P<0.05).
CONCLUSION: PPV combined with inverted internal limiting membrane flap technique is safe and effective in the treatment of MHRD in high myopia, which can effectively improve the patients' BCVA and the hole closure rate without influence on intraocular pressure.
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Risk factors associated with neovascular glaucoma after vitrectomy for proliferative diabetic retinopathy

Xue Zu, Guang-Zheng Dai, Tie-Zhu Lin

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AIM: To investigate the risk factors associated with neovascular glaucoma(NVG)after pars plana vitrectomy(PPV)for proliferative diabetic retinopathy(PDR).
METHODS: The PDR patients who received 23G PPV treatment at Shenyang He Eye Specialist Hospital from October 2015 to September 2020 and were followed up for at least 12mo with complete data were retrospectively collected. The patients were divided into two groups according to the occurrence of NVG during follow-up. The preoperative and intraoperative variables between two groups were compared. The cumulative hazard ratio for NVG was evaluated.
RESULTS: A total of 151 PDR patients(169 eyes)with a mean follow-up of 18.07±12.55(1～79)mo were included, of which 30(17.8%)eyes developed NVG, the mean time of occurrence was 6.27±4.01(1～17)mo, and 50%(15 eyes)of NVG occurred within 5mo after vitrectomy. The cumulative hazard ratios of NVG at postoperative 3, 6 and 12mo were 4.8%, 12.6% and 18.1%, respectively. Multivariate logistic regression analysis showed that preoperative best corrected visual acuity(OR=3.077, 95%CI: 1.203～7.869, P=0.019), preoperative iris rubeosis(OR=7.897, 95%CI: 1.313～47.498, P=0.024), and contralateral NVG(OR=22.108, 95%CI: 1.562～312.861, P=0.022)were risk factors with the occurrence of NVG, while the number of intraoperative retinal laser photocoagulation(OR=0.772, 95%CI: 0.666～0.893, P=0.001)was the protective factor with the occurrence of NVG.
CONCLUSIONS: The incidence of NVG in PDR eyes after PPV was 17.8%, of which 50% occurred within 5mo after surgery. PDR eyes with poor baseline visual acuity, iris rubeosis, and contralateral NVG are prone to postoperative NVG, and sufficient intraoperative retinal laser photocoagulation has a certain protective effect. PDR eyes after PPV should be closely followed up for 1a.
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Surgery management and progress of familial exudative vitreoretinopathy associated retinal detachment

Zi-Wei Zhao, Jie Peng, Pei-Quan Zhao

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Familial exudative vitreoretinopathy(FEVR)is a hereditary disorder of retinal angiogenesis, of which the most typical clinical feature is the peripheral avascular area. The progression of the disease can lead to retinal detachment(RD), followed by secondary complications such as cataracts, glaucoma, corneal opacification, and even bulbi phthisis. As one of the main reasons for the RD in Asian children and juvenile, FEVR-associated retinal detachment(FEVR-RD)is mainly treated by surgery, including pars plana vitrectomy, scleral bucking, and combined with retinal photocoagulation or anti-vascular endothelial grouth factor(VEGF)sometimes. The surgery of FEVR-RD requires careful pre/intra-operative evaluation to determine the best surgical procedure and its outcome, including the nature of the affected eye, the stage, the fibrosis of fiber proliferation and the anterior complications, and the anatomy and prognosis of eyes in different stages vary greatly. Adult patients with rhegmatogenous RD have a higher rate of post-operative retina reattachment compared to young patients with tractional RD. In young or advanced patients, surgery is difficult and the prognosis is less optimistic, thus the surgery strategy is controversial. This article reviews the surgical outcomes and progress of FEVR-associated RD.
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Expression of CTRP9 in serum of patients with diabetic retinopathy and diabetic macular edema

Hai-Xia Jing, Shu Zhang, Hui-Ling Bai, Qin Liu, Xiao-Yan Zhu

Abstract: (12253) HTML (0) PDF (498.90 KKB) (2305)

Abstract:

AIM: To investigate the expression and correlation of C1q/tumor necrosis factor related protein 9(CTRP9)levels in the serum of patients with different stages of diabetic retinopathy(DR)and diabetic macular edema(DME).METHODS: A total of 135 patients with type 2 diabetes who were admitted to Gansu Provincial Hospital from April 2021 to April 2022 were selected as the experimental group. According to the results of non-mydriatic fundus photography, they were divided into non-DR(NDR)group(n=45), non-proliferative DR(NPDR)group(n=45), proliferative DR(PDR)group(n=45); according to the results of optical coherence tomography, DR patients were divided into DME group(n=51), non-DME group(n=39). In addition, other 45 healthy subjects who matched the age and sex of the experimental group were selected as normal control group. The clinical data and biochemical index test results of subjects in each group were recorded and compared, the correlation between serum CTRP9 level and other biochemical indexes was analyzed, and the risk factors affecting the occurrence of DR and DME were explored.RESULTS: There were significant differences in serum CTRP9 levels among subjects in normal control group, NDR group, NPDR group and PDR group(P&#x003C;0.001), and normal control group &#x003E; NDR group &#x003E; NPDR group &#x003E; PDR group. There was significant difference in serum CTRP9 level between DME group and non-DME group(P&#x003C;0.001), and non-DME group &#x003E; DME group. Spearman rank correlation analysis showed that the level of serum CTRP9 in DR patients was negatively correlated with the course of diabetes(rs=-0.251, P&#x003C;0.05), the level of serum CTRP9 in DME patients was negatively correlated with fasting blood glucose(FBG)(rs=-0.370, P&#x003C;0.05)and glycosylated hemoglobin(HbA1c)(rs=-0.421, P&#x003C;0.05). Logistic multivariate regression analysis showed that the course of diabetes(OR=1.194, 95%CI: 1.068～1.335,P=0.002)and the level of serum CTRP9(OR=0.936, 95%CI: 0.907～0.966,P&#x003C;0.001)were risk factors for DR. The level of serum CTRP9 was a risk factor affecting the occurrence of DME(OR=0.838, 95%CI: 0.778～0.903, P&#x003C;0.001).CONCLUSION: The reduction of CTRP9 level is a risk factor for the occurrence of DR and DME, which may be of great significance to the risk assessment of both DR and DME.
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Femtosecond laser-assisted cataract phacoemulsification combined with Toric intraocular lenses implantation in correction of high myopia cataract and corneal astigmatism

Wei Fan, Guang-Bin Zhang

Abstract: (10482) HTML (0) PDF (433.14 KKB) (2290)

Abstract:

AIM: To measure the indexes including postoperative distance, middle, near visual acuity and near stereopsis vision of patients with high myopia cataract and corneal astigmatism by femtosecond laser, which can quantify the diameter of capsulorhexis opening, and to evaluate the availability and necessity of Toric intraocular lenses(IOL)in high myopia.
METHODS: Prospective case-control study. Patients with binocular high myopia cataract and corneal astigmatism who undergone femtosecond laser-assisted cataract surgery in our hospital were selected, and they were divided into two groups, with 20 cases(40 eyes)in group A(Toric IOL)and 20 cases(40 eyes)in group B(IQ IOL). Indexes, including preoperative corneal astigmatism and spherical equivalent and best-corrected distance visual acuity, uncorrected middle visual acuity, uncorrected near visual acuity, residual refractive astigmatism, near stereopsis acuity, total high-order aberration and total spherical aberration, were measured postoperatively at 7d, 1 and 3mo.
RESULTS: The uncorrected middle and near visual acuity, Titmus near stereopsis acuity and residual astigmatism at 7d, 1 and 3mo after surgery were significantly improved in the Toric IOL group than the non-Toric group(all P<0.05). The dependence on glasses was reduced. The postoperative best-corrected distance visual acuity, total high-order aberration and total spherical aberration of the two groups showed no statistically significant differences(all P>0.05).
CONCLUSIONS: The implantation of Toric IOL in patients with high myopia cataract and corneal astigmatism can effectively correct corneal astigmatism, improve postoperative uncorrected middle and near visual acuity and near stereopsis visual function, reduce postoperative dependence on glasses and enhance binocular stereopsis visual function.
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Application value of new assistive technology in keratopathy-associated cataract surgery

Zhen-Bo Zhao, Li-Wei Ma, Kai-Li Tang, Yu-Xi Ding, Dong Han, Jing Wang

Abstract: (10457) HTML (0) PDF (493.57 KKB) (2459)

Abstract:

Keratopathy-associated cataract, that is, on the basis of corneal disease, and later the development of lens opacity, seriously damage visual quality. In order to avoid corneal transplantation for some patients, partial visual quality can be restored. A comprehensive and accurate evaluation of the effect of corneal opacity on visual function is of great improtance for determining cataract surgery alone. Due to the opacity of the cornea, the operation is very difficult and challenging. Therefore, it is of clinical value to develop and use new assistive technologies, including capsule staining, endoillumination, pupil dialation technology, femtosecond laser assisted technology, etc., avoiding problems such as limited visibility and decreased light flow caused by corneal opacity and facilitating cataract surgery. This article reviews progress of assistive technologies for keratopathy-associated cataract, hoping to guide clinical application.
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Applicability comparison between Chinese dry eye questionnaire and ocular surface disease index questionnaire among college students

Ruo-Jun Geng, Jing-Jing Wei, Kai-Li Yang, Shao-Pei Wang, Sheng-Wei Ren

Abstract: (10000) HTML (0) PDF (1.17 MKB) (2657)

Abstract:

AIM: To evaluate the applicability of Chinese dry eye questionnaire in college students using the ocular surface disease index(OSDI)questionnaire as a reference.
METHODS: Cross-sectional study. A total of 711 college students from Nanyang Medical College were enrolled in the study and assessed for dry eye condition using OSDI questionnaire and Chinese dry eye questionnaire. The response rate of each question in the two questionnaires was counted. Cronbach α was calculated to evaluate the internal consistency of both questionnaires. Correlation between the total scores of the two questionnaires was analyzed to evaluate the criterion validity. Based on OSDI scores, the discriminant validity of Chinese dry eye questionnaire was evaluated; receiver operating characteristic(ROC)curves was plotted for Chinese dry eye questionnaire scores, area under the ROC curve(AUC)was calculated, and diagnostic thresholds and corresponding sensitivity and specificity were also analyzed.
RESULT: The response rates of the 12 questions on the OSDI questionnaire were 33.2%-100.0%, while it was 100.0% for each question on the Chinese dry eye questionnaire. The Cronbach α values of OSDI questionnaire and Chinese dry eye questionnaire were 0.905 and 0.789, respectively. The Chinese dry eye questionnaire score was positively correlated with the OSDI score(r_s=0.712, P<0.001). According to OSDI questionnaire scores, dry eye severity was divided into normal group, mild dry eye group, moderate dry eye group and severe dry eye group. The scores of Chinese dry eye questionnaire in these groups were 4.00(2.00, 6.00), 9.00(7.00, 11.00), 12.00(9.00, 14.00)and 16.00(13.50, 22.00), respectively, which increased with the severity of dry eye, and the overall difference was statistically significant(P<0.001), as well as pairwise comparison between groups(P<0.05). The AUCs of Chinese dry eye questionnaire in distinguishing normal population from dry eye population, mild dry eye from moderate dry eye, moderate dry eye from severe dry eye were 0.862, 0.661 and 0.769, respectively, and the diagnostic thresholds were 6.5, 11.5 and 14.5, respectively.
CONCLUSION:Chinese dry eye questionnaire has an equivalent reliability, validity, discriminant ability and better response rate for dry eye screening and epidemiological survey among college students in China compared with OSDI questionnaire.
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Recent advances in treatment of retinitis pigmentosa

Ming Ai, Ming Sun, Dai Li

Abstract: (9685) HTML (0) PDF (412.02 KKB) (2745)

Abstract:

Retinitis pigmentosa(RP) is a group of inherited retinal disorders characterized by the progressive photoreceptor and pigment epithelial cells dysfunction.It is the common cause of blindness in the whole worldwide.Until now it is not clear about its exact pathogenesis and etiology,so effective treatments are still little.This paper looks back on lots of the recent domestic and abroad related documents,eapecially abroad,and then reviews research advances in treatment of RP.
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Research progress on optical coherence tomography imaging indicators of macular edema secondary to retinal vein occlusion

Mei Sun, Xiao-Feng Hao, Li-Ke Xie, Qi Jin

Abstract: (9681) HTML (0) PDF (470.25 KKB) (2373)

Abstract:

Retinal vein occlusion(RVO)is the second most common cause of visual loss classified under retinal vascular disorders after diabetic retinopathy, and its complication, macular edema(ME), is the leading cause of vision loss. Currently, the first-line treatment for RVO-ME is the intravitreal injection of anti-vascular endothelial growth factor drugs, which can improve retinal morphology and patients' vision. Optical coherence tomography(OCT)can clearly image retinal structures, and some specific imaging features found by OCT have become biomarkers for evaluating the prognosis of RVO patients. The recent findings of biomarkers are reviewed, such as central retinal thickness, choroidal thickness, disorganization of retinal inner layers, hyperreflective foci, integrity of external limiting membrane and ellipsoid zone, central macular volume, prominent middle limiting membrane, paracentral acute middle maculopathy, highly reflective line, to provide references for selecting the best treatment for RVO.
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Evaluation of macular microvasculature alterations in patients with proliferative diabetic retinopathy after vitrectomy by swept-source optical coherence tomography angiography

Feng-Tao Ji, Hui Wang, Ke Wei, Yong-Rong Li, Wei Dai, Zhi-Min Wang, Rong-Feng Liao

Abstract: (9448) HTML (0) PDF (936.23 KKB) (2590)

Abstract:

AIM: To investigate the changes in retinal and choroidal blood flow after pars plana vitrectomy(PPV)for proliferative diabetic retinopathy(PDR).
METHODS: A cross-sectional study was conducted on 35 patients(35 eyes)who were diagnosed as monocular PDR and received 23GPPV in ophthalmology department of the Second People's Hospital of Hefei between September 2020 and July 2022. All eyes underwent swept-source optical coherence tomography angiography(SS-OCTA)examination. Retinal and choroidal vascular parameters within 3mm×3mm of macular zone were measured by built-in analyzer, and its correlation with postoperative best corrected visual acuity(BCVA)was analyzed.
RESULTS: The follow-up was 1～22(average 9.72±6.67)mo. At the last follow-up, flow area(FA)of intermediate capillary plexus(ICP)layer in paranasal foveal region was significantly reduced in PPV eyes(0.31±0.06mm²)compared with contralateral eyes(0.38±0.05mm²), and FA of deep capillary plexus(DCP)in temporal foveal region was significantly lower in PPV eyes(0.19±0.08mm²)than contralateral eyes(0.27±0.07mm²; all P<0.05). Choroidal vascularity index(CVI)were lower in PPV eyes than contralateral eyes in parafoveal subregions except temporal region(P<0.05). After PPV, BCVA had a certain correlation with the density and FA of middle and deep retinal vessels.
CONCLUSIONS: Eyes with severe PDR may be prone to having a decrease in the DCP and parafoveal choroidal perfusion in the parafoveal regions after PPV than contralateral eyes.
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Diquafosol sodium combined with intense pulsed light in the treatment of meibomian gland dysfunction dry eye after corneal refractive surgery

Mei-Mei Zhang, Shen Wang, Jing Zhang, Chen Li, Shan-Shan Ge, Jia Yu, Yue-Hua Zhou

Abstract: (9287) HTML (0) PDF (1.47 MKB) (2782)

Abstract:

AIM: To observe the therapeutic effect of the diquafosol sodium combined with intense pulsed light(IPL)on meibomian gland dysfunction(MGD)dry eye after refractive surgery.
METHODS:A total of 64 patients(128 eyes)with MGD dry eye diagnosed within 6mo after laser corneal refractive surgery in our hospital from March 2021 to December 2021 were selected. They were randomly divided into control group and experimental group. A total of 33 patients(66 eyes)in the control group were treated with sodium hyaluronate combined with IPL, and 31 patients(62 eyes)in the experimental group were treated with diquafosol sodium combined with IPL. Ocular symptom scores were performed before each IPL treatment in both groups to examine non-invasive tear breakup time(NIBUT), tear meniscus height, lipid layer grade of tear film, meibomian gland deletion rate and uncorrected visual acuity.
RESULTS:After IPL treatment, ocular symptom scores and meibomian gland deletion rate score of two groups were decreased continuously. NIBUT, tear meniscus height and lipid layer grade of tear film were increased continuously, and there was no significant change in uncorrected visual acuity. NIBUT of patients in the experimental group was better than that in the control group before the third IPL treatment(6.24±0.27s vs. 5.51±0.24s, P=0.046).
CONCLUSIONS:Both diquafosol sodium and sodium hyaluronate combined with IPL showed good therapeutic effect on MGD dry eye, but there was no significant difference in the short-term efficacy between the two groups.
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Research advances in contact lens associated bacterial keratitis

Yu-Lin Yan, Yan-Ning Yang, Shan-Shan Wan

Abstract: (9255) HTML (0) PDF (512.03 KKB) (2528)

Abstract:

Contact lens(CL)is currently one of the most common methods of vision correction, with more than 140 million users worldwide and the demand is rising yearly as constantly development of materials and features. Wearing CL can lead to a variety of complications such as dry eye, corneal abrasions, giant papillary conjunctivitis, and infectious keratitis is one of the most severe complications. According to research, bacteria account for 80%～95% of the pathogens that cause CL-associated infective keratitis, it may have been related to the bacterial composition, virulence mechanism, biofilm formation and the combined effect of the lens itself and the process of use, which is prone to introducing pathogens, reducing antimicrobial capacity of the cornea and tears and causing ocular surface hypoxia and ocular surface inflammation. Overnight and prolonged lens wear, irregular lens purchase, use and care procedures can also be risk factors for bacterial infections. This article reviews the studies on the pathogenesis, risk factors, diagnosis, treatment and prevention of CL-related bacterial keratitis.
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Suture guided gonioscopy-assisted transluminal trabeculotomy combined with phacoemulsification in the treatment of primary open angle glaucoma

Shan Zhong, Hui Yang, Shi He, Wen-Jing He

Abstract: (9125) HTML (0) PDF (467.79 KKB) (2425)

Abstract:

AIM: To investigate the clinical efficacy of suture-guided gonioscopy-assisted transluminal trabeculotomy(GATT)combined with phacoemulsification in the treatment of primary open angle glaucoma(POAG).
METHODS: A total of 84 patients(84 eyes)with POAG and cataract who underwent surgery in our hospital from January 2021 to July 2022 were selected and randomly divided into two groups. There were 43 cases(43 eyes)in the combined group who underwent suture-guided GATT combined with phacoemulsification, and 41 cases(41 eyes)in the simple group who underwent suture-guided GATT. The two groups were followed up for 3mo to compare the surgical success rate, intraocular pressure, topical intraocular pressure-lowering drugs, visual acuity and postoperative complications.
RESULTS: There was no significant difference in overall success rate between the combination and simple groups at 3 mo after surgery(88% vs. 85%, P>0.05). The intraocular pressure levels and topical intraocular pressure-lowering drugs at 1wk, 1 and 3mo after surgery in the two groups were significantly lower than those before surgery(all P<0.05), but there was no significant difference between the two groups(all P>0.05). The visual acuity at 1wk, 1 and 3mo after surgery of patients in the combined group was significantly better than that in the simple group(P<0.01). During the follow-up period, the incidence of anterior chamber hemorrhage and transient hypertension in the combined group was significantly lower than that in the simple group(P<0.05).
CONCLUSION: Both suture-guided GATT combined with cataract phacoemulsification and suture-guided GATT are effective treatment for POAG, however, suture-guided GATT combined with phacoemulsification has a lower incidence of anterior chamber hemorrhage and transient ocular hypertension.
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Relationship among fasting plasma glacose coefficient of variation and macular morphology and microcirculation in patients with nonproliferative diabetic retinopathy

Shu-Ying Fu, Yan-Min Dong

Abstract: (9070) HTML (0) PDF (1.78 MKB) (2383)

Abstract:

AIM: To investigate the relationship among the fasting plasma glucose coefficient of variation(FPG-CV)and macular morphology and microcirculation in patients with nonproliferative diabetic retinopathy(NPDR).
METHODS: A retrospective analysis of 82 cases(82 eyes)with NPDR admitted to our hospital from February 2018 to June 2022 was the research object, and another 82 cases(82 eyes)of non-diabetic retinopathy(NDR)patients during the same period were selected as the control group, and the clinical data of the two groups of patients were analyzed. Multivariate Logistic regression was used to analyze the risk factors affecting the incidence of NPDR, and the back propagation(BP)neural network model was established and evaluated. Pearson correlation was used to analyze the correlation among FPG-CV and macular morphology and microcirculation in patients.
RESULTS: The results of multivariate Logistic regression analysis showed that the disease duration ≥7.2a, glycated hemoglobin A1c(HbA1c)≥7.7%, triglyceride(TG)≥1.9 mmol/L, microalbuminuria(MALB)≥24.5 mg/L, FPG-CV ≥9.8%, superficial capillary plexus-vessel density(SCP-VD)<27.6%, deep capillary plexus-vessel density(DCP-VD)<47.7%, foveal avascular zone(FAZ)area ≥0.38 mm², central retinal thickness(CRT)≥197.7 μm and subfoveal choroidal thickness(SFCT)<227.7 μm were risk factors for NPDR(P<0.05). The number of hidden layer nodes is 5, and the receiver operating characteristic(ROC)curve, calibration curve and clinical decision curve show that the prediction model has good discrimination, accuracy and validity. The results of Pearson correlation analysis showed that FPG-CV was negatively correlated with SCP-VD, DCP-VD and SFCT(P<0.05); FPG-CV was positively correlated with FAZ area and CRT(P<0.05).
CONCLUSION: The course of disease, HbA1c, TG, MALB, FPG-CV, SCP-VD, DCP-VD, FAZ area, CRT and SFCT are all related to the pathogenesis of NPDR. With the increase of FPG-CV, the indexes of macular morphology and microcirculation changed. FPG-CV was negatively correlated with SCP-VD, DCP-VD and SFCT and positively correlated with FAZ area and CRT.
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Research progress on corneal nerves and substance P in viral keratitis

Yi Mu, Hong Zhang

Abstract: (8993) HTML (0) PDF (490.87 KKB) (2307)

Abstract:

Diseases like viral keratitis can harm corneal nerves, which are necessary for maintaining the health and functionality of the cornea. Recent research has shown that corneal nerve pathology affects the infected eye as well as the contralateral one, and that aberrant changes in sympathetic nerves can be seen, with the exception of sensory nerves that correspond to corneal sensation. However, apart from in vivo confocal microscopy and corneal sensation, there have been no additional prognostic indicators that allow clinicians to assess the severity of corneal nerve damage. While multiple functions of corneal nerves are mediated by neuropeptides, substance P, the first topical neuropeptide used in ocular clinical practice, was proved to regulate the process of viral infections, and it is involved in bilateral corneal pathologies through pro-inflammatory and neurotrophic functions in viral keratitis, so it may be used as a diagnostic biomarker or a therapeutic target. Therefore, this review summarized the changes and roles of corneal nerves as well as substance P in viral keratitis, which may serve as a reference for further study into associated mechanisms and clinical applications.
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Volume 26,2026 Issue 11

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