Blindness affected 45 million people globally in 2021,and moderate to severe vision loss a further 295 million.[1]The most common causes,cataract and uncorrected refractive error,are generally the easiest to treat,and...Blindness affected 45 million people globally in 2021,and moderate to severe vision loss a further 295 million.[1]The most common causes,cataract and uncorrected refractive error,are generally the easiest to treat,and are among the most cost-effective procedures in all of medicine and international development.[1-2]Thus,vision impairment is both extremely common and,in principle,readily manageable.展开更多
Good vision is fundamental to human experience,profoundly influencing educational attainment,economic productivity and overall quality of life.Currently,it is estimated that at least 2.2 billion people globally suffer...Good vision is fundamental to human experience,profoundly influencing educational attainment,economic productivity and overall quality of life.Currently,it is estimated that at least 2.2 billion people globally suffer from vision impairment(VI),with over 1 billion of these cases being preventable or treatable yet remaining unaddressed.Despite significant advancements in global eye care services over the past few decades,which have yielded considerable benefits,the challenges continue to mount.展开更多
BACKGROUND Globally,it’s estimated that at least 1 billion people have a near and/or distance vision impairment that could have been prevented or is yet to be addressed.The burden of unaddressed vision impairment and...BACKGROUND Globally,it’s estimated that at least 1 billion people have a near and/or distance vision impairment that could have been prevented or is yet to be addressed.The burden of unaddressed vision impairment and blindness is estimated to be four times higher in low and intermediate-resource settings than in high-income settings.[1]展开更多
Objective:Evidence pertaining to the associations between hyperuricemia and diabetic microvascular complications is limited and inconclusive.In this study,we aimed to prospectively investigate the independent associat...Objective:Evidence pertaining to the associations between hyperuricemia and diabetic microvascular complications is limited and inconclusive.In this study,we aimed to prospectively investigate the independent associations of hyperuricemia and retinopathy,nephropathy and neuropathy in individuals with type 2 diabetes mellitus(T2DM).Methods:This cohort study enrolled 25,094 participants from UK Biobank with T2DM and without microvascular complications at baseline.Hyperuricemia was defined as serum uric acid(SUA)higher than 420μmol/L.The incidence of diabetic microvascular complications was identified from hospital inpatient records that were coded according to the International Classification of Diseases(ICD)-10 coding system.Multivariable adjusted Cox proportional hazards regression models were used to calculate adjusted hazard ratios(aHR).Results:Among all participants,3,844(15.3%)were classified as having hyperuricemia at baseline.During a median follow-up of 14.0 years,555(14.4%)individuals with hyperuricemia developed diabetic microvascular complications,compared with 12.6%of individuals without hyperuricemia(P=0.002).In the multivariable-adjusted model accounted for socioeconomic status,lifestyle factors,physical and biochemical measurements,and medication use,when compared with individuals of T2DM who had a normal SUA level,those with hyperuricemia had an 82.9%higher risk of developing diabetic nephropathy(95%CI:1.41-2.38,P<0.001),and a 30.2%higher risk of diabetic neuropathy(95%CI:1.06-1.60,P=0.011).However,the association between hyperuricemia and diabetic retinopathy was not statistically significant(aHR:1.070,95%CI:0.94-1.22,P=0.320).Conclusions:Hyperuricemia was independently associated with diabetic nephropathy and neuropathy but not retinopathy in individuals with T2DM.These findings underscore the importance of monitoring SUA level in prevention of certain microvascular complications.展开更多
Objective:This study aimed to investigate the prevalence,causes,and influencing factors of vision impairment in the elderly population aged 60 years and above in Mangxin Town,Kashgar region,Xinjiang,China.Located in a...Objective:This study aimed to investigate the prevalence,causes,and influencing factors of vision impairment in the elderly population aged 60 years and above in Mangxin Town,Kashgar region,Xinjiang,China.Located in a region characterized by intense ultraviolet radiation and arid climatic conditions,Mangxin Town presents unique environmental challenges that may exacerbate ocular health issues.Despite the global emphasis on addressing vision impairment among aging populations,there remains a paucity of updated and region-specific data in Xinjiang,necessitating this comprehensive assessment to inform targeted interventions.Methods:A cross-sectional study was conducted from May to June 2024,involving 1,311 elderly participants(76.76%participation rate)out of a total eligible population of 1,708 individuals aged≥60 years.Participants underwent detailed ocular examinations,including assessments of uncorrected visual acuity(UVA)and best-corrected visual acuity(BCVA)using standard logarithmic charts,slit-lamp biomicroscopy,optical coherence tomography(OCT,Topcon DRI OCT Triton),fundus photography,and intraocular pressure measurement(Canon TX-20 Tonometer).A multidisciplinary team of 10 ophthalmologists and 2 local village doctors,trained rigorously in standardized protocols,ensured consistent data collection.Demographic,lifestyle,and medical history data were collected via questionnaires.Statistical analyses,performed using STATA 16,included multivariate logistic regression to identify risk factors,with significance defined as P<0.05.Results:The overall prevalence of vision impairment was 13.21%(95%CI:11.37%-15.04%),with low vision at 11.76%(95%CI:10.01%-13.50%)and blindness at 1.45%(95%CI:0.80%-2.10%).Cataract emerged as the leading cause,responsible for 68.20%of cases,followed by glaucoma(5.80%),optic atrophy(5.20%),and age-related macular degeneration(2.90%).Vision impairment prevalence escalated significantly with age:7.74%in the 60–69 age group,17.79%in 70–79,and 33.72%in those≥80.Males exhibited higher prevalence than females(15.84%vs.10.45%,P=0.004).Multivariate analysis revealed age≥80 years(OR=6.43,95%CI:3.79%-10.90%),male sex(OR=0.53,95%CI:0.34%-0.83%),and daily exercise(OR=0.44,95%CI:0.20%-0.95%)as significant factors.History of eye disease showed a non-significant trend toward increased risk(OR=1.49,P=0.107).Education level,income,and smoking status showed no significant associations.Conclusions:This study underscores cataract as the predominant cause of vision impairment in Mangxin Town’s elderly population,with age and sex as critical determinants.The findings align with global patterns but highlight region-specific challenges,such as environmental factors contributing to cataract prevalence.Public health strategies should prioritize improving access to cataract surgery,enhancing grassroots ophthalmic infrastructure,and integrating portable screening technologies for early detection of fundus diseases.Additionally,promoting health education on UV protection and lifestyle modifications,such as regular exercise,may mitigate risks.Future research should expand to broader regions in Xinjiang,employ advanced diagnostic tools for complex conditions like glaucoma,and explore longitudinal trends to refine intervention strategies.These efforts are vital to reducing preventable blindness and improving quality of life for aging populations in underserved areas.展开更多
Background:Blindness and vision impairment(BVI)continue to pose significant global public health challenges,disproportionately impacting vulnerable populations and further widening socioeconomic disparities.This study...Background:Blindness and vision impairment(BVI)continue to pose significant global public health challenges,disproportionately impacting vulnerable populations and further widening socioeconomic disparities.This study conducts a comprehensive evaluation of the global burden of BVI and the socioeconomic inequalities in its distribution from 1990 to 2021,aiming to provide insights for targeted intervention strategies.Methods:Using data from Global Burden of Disease 2021,this study performed a multiscale analysis of BVI burden,examining patterns at the global,regional and national levels.We quantified the disease burden using disability-adjusted life years DALY and prevalence rates.Temporal trends were analyzed by calculating estimated annual percentage changes(EAPC).Stratified assessments were carried out by sex and age group across 21 regions and 204 countries.The study also included comparative analyses of six major eye conditions and evaluated their associations with socio-demographic index(SDI).Results:Globally,the age-standardized prevalence of BVI increased from 12,453.52 per million(95%UI:10,287.58-15,226.09)in 1990 to 15,784.33 per million(12,761.44-19,502.32)in 2021,with an EAPC of 1.09%(95%UI:0.97-1.20).During this period,global DALYs attributable to BVI increased by 37.7%.Disease trends exhibited significant divergence,with near vision loss showing the steepest increase(EAPC:1.47%),while the prevalence of glaucoma declined(EAPC:-0.73%).Geographic disparities were pronounced,with substantial improvements observed in Equatorial Guinea(EAPC:-1.75)and worsening burdens in Benin(+0.54).Disease distribution demonstrated strong regional clustering,with near vision loss being predominant in Sub-Saharan Africa(64.47%)and East Asia(50.97%),while cataract was the most common condition in Oceania(33.86%).Females consistently bore a higher burden,particularly in South Asia(646.3 vs 563.2 DALYs).Moreover,we identified a strong inverse correlation between SDI and BVI burden(Ρ=-0.772 for DALYs).Conclusions:This study highlights the severe global burden of BVI and the significant cross-country inequality,particularly in low-and middle-income countries.It emphasizes the urgent need for targeted interventions and the integration of eye care into universal health policies to promote global health equity in the post-pandemic era.展开更多
The cornea is a transparent tissue that serves as the main refractive element of the eye ball.Limbal epithelial stem cells(LESCs),residing in the basal epithelial layer of the Palisades of Vogt located in the corneal ...The cornea is a transparent tissue that serves as the main refractive element of the eye ball.Limbal epithelial stem cells(LESCs),residing in the basal epithelial layer of the Palisades of Vogt located in the corneal limbus between cornea and scleral,are believed to be crucial for the continuous turnover of the corneal epithelium.The proliferation,migration,and differentiation of the LESCs are modulated by unique physical and chemical futures contained within the microenvironment known as the limbal niche.This niche,composed of nerve terminals,cells,extracellular matrix,vasculature,and signaling molecules,is the home for processes such as proliferation,migration and differentiation.Corneal nerve terminals possess special anatomical structures in the limbal region and basal epithelial cells,and they demonstrate pivotal biological effects in the regulation of the LESC function and corneal epithelium homeostasis.Biological molecules such as neuropeptides,neurotransmitters,and neurotrophic factors play a crucial role in modulating the LESCs phenotype responsible for corneal epithelium homeostasis.This paper will review recent studies on how these nerve derived molecules function in this process and provide clear orientations for future research.展开更多
Objective:Accurate intraocular pressure(IOP)measurement is a cornerstone of glaucoma diagnosis and management.While Goldmann applanation tonometry(GAT)remains the accepted gold standard,technological advancements have...Objective:Accurate intraocular pressure(IOP)measurement is a cornerstone of glaucoma diagnosis and management.While Goldmann applanation tonometry(GAT)remains the accepted gold standard,technological advancements have introduced alternative methods such as noncontact tonometry(NCT)and the dynamic Scheimpflug-based Corvis ST(CST).This study aims to conduct a rigorous comparative analysis of IOP measurements obtained by NCT,GAT,and CST across a wide spectrum of intraocular pressures.The primary objectives were to evaluate the performance of these devices in both healthy and glaucomatous eyes,assess their intra-and interobserver variability,and determine their level of agreement with the established reference.Methods:In this prospective,comparative study,a total of 212 eyes from 212 subjects were enrolled,comprising 137 eyes of patients with glaucoma and 75 eyes of healthy individuals.All participants underwent IOP measurement using the three devices in a randomized order to minimize bias.Based on the initial GAT readings,eyes were systematically classified into one of four predefined IOP levels:Level A(low,<10 mmHg),Level B(normal range,10-21 mmHg),Level C(moderately elevated,>21 to 40 mmHg),and Level D(severely elevated,>40 mmHg).A mixed-model analysis of variance(ANOVA)was employed to statistically analyze the differences in IOP measurements among the three tonometers at each distinct pressure level.The agreement between each pair of devices(CST vs.GAT,CST vs.NCT,and NCT vs.GAT)was meticulously assessed using Bland-Altman plots,which provide metrics for bias(mean difference)and the 95%limits of agreement(LoA).Results:CST and GAT exhibited better intra-and interobserver variability compared to NCT.Significant differences in IOP measurements were observed among CST,NCT,and GAT at levels A and D(P<0.001,P=0.030).Bland-Altman analysis revealed biases between CST and GAT,CST and NCT,and NCT and GAT at different levels(level A:-0.61,0.94,and-1.55 mmHg;level B:0.16,-0.7,and 0.8;level C:0.5,0.5,and-0.1;level D:0.83,-3.4,and 4.2).Notably,NCT tended to overestimate IOP more at higher levels(level D)and underestimate at lower levels(level A)compared to CST.CST demonstrated better agreement with GAT than NCT did.Conclusions:This study confirms that the Corvis ST(CST)shows superior agreement with the Goldmann applanation tonometer than noncontact tonometry,particularly at low and high IOP ranges.It also exhibits greater measurement consistency.While NCT remains a useful screening tool,its significant over-and underestimation at pressure extremes is a critical limitation.The findings strongly suggest that CST may serve as a more suitable and reliable alternative to NCT for measuring IOP across a broad clinical range.However,the results underscore that these three methods are not directly interchangeable.Clinicians must therefore exercise careful interpretation of IOP values,taking into account the specific tonometer used and the patient's probable pressure level for accurate diagnosis and management of glaucoma.展开更多
Myopia,a common cause of visual impairment,together with the global decline in physical fitness and increasing prevalence of childhood obesity,has become a prominent global health problem.The beneficial effect of incr...Myopia,a common cause of visual impairment,together with the global decline in physical fitness and increasing prevalence of childhood obesity,has become a prominent global health problem.The beneficial effect of increasing the time of outdoor activities on the incidence of myopia and physical well-being in children has been widely recognized.However,in countries with highly competitive education systems,such as China,parents and school administrators may be reluctant to increase their children's time for extracurricular outdoor activities for fear of affecting their academic performance.Therefore,it is crucial to accurately assess the role of after-school outdoor activities in preventing and controlling myopia,as well as in promoting the physical and mental development of adolescents.Schools and families should be encouraged to collaboratively support children’s engagement in outdoor activities to foster their healthy growth.Given the dual benefits of outdoor activities-improving visual health and promoting overall physical and mental well-being-it is essential to encourage schools and families to work together to support children's engagement in such activities.By doing so,it is hoped that a balanced environment can be created,one that values both academic achievement and healthy development.Policymakers,educators,and parents must recognize the long-term advantages of integrating outdoor activities into children's daily lives,as this approach can help alleviate the burden of myopia,enhance physical fitness,and support emotional and cognitive development.Ultimately,fostering a culture that views outdoor activities as an essential component of education and health will be key to ensuring the well-rounded development of future generations.展开更多
Objective:To develop a survival prediction model for primary conjunctival malignant tumors.Methods:Detailed information on cases diagnosed with primary conjunctival malignant tumors from 2000 to 2019 was collected fro...Objective:To develop a survival prediction model for primary conjunctival malignant tumors.Methods:Detailed information on cases diagnosed with primary conjunctival malignant tumors from 2000 to 2019 was collected from SEER database.Subsequently,cases meeting the inclusion criteria were randomly assigned to either the development group(1,216 cases)or validation group(608 cases).Relevant risk factors affecting overall survival(OS)were identified using Cox proportional hazards regression analysis.A nomogram was constructed to predict the 1-year,3-year,and 5-year survival rates.The concordance index(C index)was calculated to assess the predictive power of the model.Receiver operating characteristic curves(ROC curves)and calibration curves were plotted.The area under the curve(AUC)was measured.Decision curve analysis(DCA)was also applied.Results:The overall survival rate was 77.8%.Statistically significant differences in the survival time distribution were observed among groups based on age(P<0.001),histology(P<0.001),and stage(P=0.01).According to the multivariate analysis,patients with lymphoma,younger age,and localized lesions exhibited better survival outcomes.The C-index of the constructed model was 0.79.In the training group,the AUC values for predicting 1-year,3-year,and 5-year mortality were 0.824,0.796,and 0.815,respectively.In the validation group,age corresponding AU values were 0.750,0.820,and 0.838.The DCA results demonstrated a significant advantage of the model,while the calibration plots indicated that the predicted OS was in good agreement with the actual OS in both groups.Conclusions:This study presents a satisfying survival prediction model for malignant conjunctival tumors.展开更多
Objective:Diabetic retinopathy(DR)is a top leading cause of blindness worldwide,requiring early detection for timely intervention.Artificial intelligence(AI)has emerged as a promising tool to improve DR screening effi...Objective:Diabetic retinopathy(DR)is a top leading cause of blindness worldwide,requiring early detection for timely intervention.Artificial intelligence(AI)has emerged as a promising tool to improve DR screening efficiency,accessibility,and cost-effectiveness.This study conducted a systematic review of literature and meta-analysis on the economic outcomes of AI-based DR screening.Methods:A systematic review of studies published before September 2024 was conducted throughout PubMed,Scopus,Embase,the Cochrane Library,the National Health Service Economic Evaluation Database,and the Cost-Effectiveness Analysis Registry.Eligible studies were included if they were(1)conducted among type 1 diabetes mellitus or type 2 diabetes mellitus adult diabetic population;(2)studies compared AI-based DR screening strategy to non-AI screening;and(3)performed a cost-effectiveness analysis.Meta-analysis was applied to pool incremental net benefit(INB)across studies stratified by country income and study perspective using a random-effects model.Statistical heterogeneity among studies was assessed using the I2 statistic,Cochrane Q statistics,and meta regression.Results:Nine studies were included in the analysis.From a healthcare system/payer perspective,AI-based DR screening was significantly cost-effective compared to non-AI-based screening,with a pooled INB of 615.77(95%confidence interval[CI]:558.27-673.27).Subgroup analysis showed robust cost-effectiveness of AI-based DR screening in high-income countries(INB=613.62,95%CI:556.06-671.18)and upper-/lower-middle income countries(INB=1,739.97,95%CI:423.13-3,056.82)with low heterogeneity.From a societal perspective,AI-based DR screening was generally cost-effective(INB=5,102.33,95%CI:-815.47-11,020.13),though the result lacked statistical significance and showed high heterogeneity.Conclusions:AI-based DR screening is generally cost-effective from a healthcare system perspective,particularly in high-income countries.Heterogeneity in cost-effectiveness across different perspectives highlights the importance of context-specific evaluations,to accurately evaluate the potential of AI-based DR screening in reducing global healthcare disparities.展开更多
Virtual Reality(VR)technology is widely recognized as a prominent technological paradigm.Its potential and promise in the domain of ophthalmology are substantial,and the evolution of VR technology has significantly in...Virtual Reality(VR)technology is widely recognized as a prominent technological paradigm.Its potential and promise in the domain of ophthalmology are substantial,and the evolution of VR technology has significantly influenced the contemporary landscape of ophthalmology.Numerous empirical studies have validated the practical utility of VR technology in domains such as ophthalmic disease treatment and surgery training.This paper offers a comprehensive overview of VR technology's utilization in ophthalmic disease treatment,student education,and surgery training,expands the application of VR technology in ophthalmic evaluation and disease diagnosis,discusses the challenges and limitations of VR technology in ophthalmology,and expounds on emerging trends and future developments of VR technology in ophthalmology.This endeavor aims to provide readers with an in-depth comprehension of the current status and future prospects of VR technology application in ophthalmology,with the ultimate objective of fostering more effective advancements and applications of VR technology in the realm of ophthalmology.展开更多
Achieving universal eye health remains a global challenge,particularly in low-and middle-income countries where visual impairment and blindness are prevalent.While advances in tertiary eye care have improved outcomes,...Achieving universal eye health remains a global challenge,particularly in low-and middle-income countries where visual impairment and blindness are prevalent.While advances in tertiary eye care have improved outcomes,access to primary eye care(PEC)continues to be inadequate in rural and underserved regions.This gap necessitates innovative,scalable models that provide accessible,affordable,and comprehensive eye care.The Vision Centre(VC)model,pioneered by the Aravind Eye Care System(AECS),exemplifies a sustainable approach to delivering PEC.Designed as permanent facilities in rural communities,VCs are equipped with state-of-the-art diagnostic tools and staffed by trained allied ophthalmic personnel.The integration of teleophthalmology,electronic medical records,and artificial intelligence enhances the model’s capacity to address complex conditions like diabetic retinopathy and glaucoma.VCs have demonstrated significant impact in improving accessibility,reducing financial burdens,and increasing utilization of eye care services.In the fiscal year 2023-2024,AECS VCs recorded nearly one million outpatient visits,achieving a 25%population coverage rate and generating substantial cost savings of ₹647 million(US$7.8 million)for patients.The model's success is underpinned by community engagement,a focus on operational excellence,and a robust referral system to tertiary hospitals.This review explores the evolution,implementation,and impact of the AECS VC model,emphasizing its alignment with the Sustainable Development Goals and Universal Health Coverage.By addressing accessibility and affordability,the VC model serves as a scalable template for primary eye care delivery in resource-limited settings globally.展开更多
Objective:The day surgery mode has significantly reduced preoperative waiting time for patients.However,this mode also led to brief and sometimes abrupt interactions between patients with vision loss and nursing staff...Objective:The day surgery mode has significantly reduced preoperative waiting time for patients.However,this mode also led to brief and sometimes abrupt interactions between patients with vision loss and nursing staff during the preoperative visits.Additionally,patients may experience negative emotions.The aim of this study was to describe the preoperative experiences and identify related stressful factors among patients waiting vitreo-retinal day surgery.Methods:This study was guided by an interpretive approach.Semi-structured,face-to-face,in-depth interviews were conducted with patients from August 2021 to October 2024.Inductive content analysis and research software were used to analyze the data.Results:Twenty-seven patients agreed to participate the interviews.Their ages ranged from 19 to 70 years old.The waiting time before hospitalization varied from 7 to 90 days.Three main categories emerged from patients’complaints:day surgery procedures,concerns about eye conditions and supports.Conclusions:The findings underscore the importance of preoperative care services.It is suggested that providing accurate preoperative information and effective support can significantly enhance the quality of preoperative care service.展开更多
Objective:To evaluate the performance of orthokeratology(ortho-k)lens reordering using software-designed system,so as to determine the feasibility of ortho-k lens reordering without discontinuing lens wear.Methods:Thi...Objective:To evaluate the performance of orthokeratology(ortho-k)lens reordering using software-designed system,so as to determine the feasibility of ortho-k lens reordering without discontinuing lens wear.Methods:This study is a retrospective analysis of data of ortho-k lens wearers who had a history of short-term discontinuation of lens wear.A total of 94 individuals aged over 8 years with spherical equivalent refraction ranging from-0.50 to-6.50 diopters were included.The corneal topography data at baseline(before ortho-k)and after lens wear discontinuation(cessation of ortho-k treatment)were imported separately into the lens-design software,along with corresponding refraction data.Subsequently,corneal and lens parameters were generated and compared.Intraclass correlation coefficients(ICC)were calculated,and Bland and Altman analyses were conducted.Results:All 94 children were involved in the retrospective analysis.Compared with baseline data,there was a high level of consistency between Rwo(without discontinuation)and Rwith(with discontinuation),with an ICC of 0.96(P<0.001).Furthermore,the comparison of lens parameters generated by the Easyfit software between baseline and after short-term discontinuation showed a high degree of consistency,with all of the ICC values exceeding 0.90.Similar results were obtained using the WAVE software,as both ICC values and Bland-Altman plots demonstrated a high level of consistency in lens parameters between two conditions(nearly all data points fell within the 95%LoAs).Conclusions:It is feasible to directly reorder new ortho-k lenses using software fitting approaches.However,further investigations are necessary to validate their practicability in a clinical setting.展开更多
An 81-year-old man with a history of central retinal artery occlusion(CRAO),under follow-up for neovascular glaucoma,presented with an unusual vitreous detachment in which a prior vitreous hemorrhage had formed a dist...An 81-year-old man with a history of central retinal artery occlusion(CRAO),under follow-up for neovascular glaucoma,presented with an unusual vitreous detachment in which a prior vitreous hemorrhage had formed a distinctive heart-shaped Weiss ring(Figure 1)(1).Although such floaters can often be bothersome,especially during reading or in bright lighting,the patient reported no symptoms due to his severely reduced visual acuity,which was limited to hand motion following the CRAO.This case serves as a lighthearted reminder that,even in ophthalmology and in patients with a poor visual prognosis,love can appear in the most unexpected places.展开更多
Schools are an important avenue to tackle the rising prevalence of uncorrected refractive error among children.School-based vision programs are an innovative approach of vision care delivery in the urban school settin...Schools are an important avenue to tackle the rising prevalence of uncorrected refractive error among children.School-based vision programs are an innovative approach of vision care delivery in the urban school setting in the United States.These programs are effective in improving vision outcomes and advancing health equity,especially among the disadvantaged school districts.While most school-based vision programs provide vision screening,eye examinations,and eyeglasses prescription to students directly in schools,different mechanisms and models have been reported.In this paper,we describe two large-scale school-based vision programs,Vision for Baltimore and Helen Keller International’s United States Vision Program,representing national and regional efforts to partner with local communities in improving access to pediatric vision care.These programs also serve as data collection platforms and provide evidence to inform public health policy and guide best practice.Collectively,these two programs showed that one in three students failed vision screening.The prevalence of uncorrected refractive error was high and the demand for eyeglasses was great among those who failed vision screening.While most of the students’uncorrected refractive errors could be addressed in the school setting,one in seven needed additional eye care.We found that schools with more socioeconomically disadvantaged students had greater needs of school-based vision program services.We hope this knowledge helps to maximize the impact of school-based vision programs and promote a system that ensures better health outcomes for all children.展开更多
Objective:Fengqing County,situated in Yunnan Province,is a high-altitude region known for its ethnic diversity and a notably high prevalence of pterygium.As a key area for Sun Yat-sen University's poverty alleviat...Objective:Fengqing County,situated in Yunnan Province,is a high-altitude region known for its ethnic diversity and a notably high prevalence of pterygium.As a key area for Sun Yat-sen University's poverty alleviation initiatives,this study aims to investigate the unique characteristics of pterygium in specific region.Methods:We analyzed data from hospitalized patients admitted to the Ophthalmology department of the People's Hospital of Fengqing in 2023.The data were extracted from medical records through the hospital information system.The chi-square test was used for statistical comparison,and multivariate logistic regression analysis was conducted to explore the factors influencing the onset of pterygium.A significance level of P<0.005 was set.Results:In 2023,out of 1137 ophthalmic inpatients,207(18.2%)underwent pterygium surgery.There was a significant female predominance,with a female-to-male ratio of 6.67:1(P<0.001).However,no significant ethnic variation was observed(P=0.57).The majority of patients were in the 46-55 age group(36.71%),and the recurrence rate was low at 1.71%.Female gender,increasing age,diabetes mellitus,age-related cataract,and meibomian gland dysfunction were identified as independent risk factors for pterygium in this region.Conclusion:Fengqing is likely to have intricate connections between the occurrence and treatment of pterygium and its local geography,culture,and socio-economic conditions.Medical assistance programs should take these factors into account and prioritize them in poverty alleviation initiatives.展开更多
Objective:Strabismus is associated with a higher prevalence of idiopathic thoracic scoliosis(ITS)in children.This study aims to investigate whether superior oblique palsy(SOP)poses a higher risk for developing ITS amo...Objective:Strabismus is associated with a higher prevalence of idiopathic thoracic scoliosis(ITS)in children.This study aims to investigate whether superior oblique palsy(SOP)poses a higher risk for developing ITS among children and adolescents.Methods:A cross-sectional study.The study group comprised 347 consecutive candidates for SOP surgery aged 4 to 18 years;Patients within the same age range with ocular trauma were enrolled as the control group.Preoperative chest plain radiographs were used to measure the Cobb angle.Demographic information and clinical data,including diopter,best corrected visual acuity,deviation degree,and binocular function,were analyzed.Results:A significantly higher prevalence of ITS was found in study group compared with control group(12.68%vs 4.18%,P<0.001).Additionally,the mean Cobb angle was lagger in SOP group than that in control group(5.02°±3.87°vs 3.84°±3.09°,P<0.001).Males in SOP group showed a higher prevalence of ITS(12.9%vs 2.87%,P=0.007),but there was no significant difference in females between two groups(12.3%vs 7.69%,P=0.295).Good near stereopsis acuity was significantly associated with high prevalence of thoracic scoliosis(P<0.001).Multivariate logistic regression analysis revealed that a large distant magnitude of deviation(>20 PD)and near stereoacuity were significantly associated with ITS.Conclusions:Patients with SOP have a significantly higher risk of developing idiopathic thoracic scoliosis,especially those with good near stereoscopic and large distant magnitude of deviation.展开更多
Background:With the rapid development of artificial intelligence(AI),large language models(LLMs)have emerged as a potent tool for invigorating ophthalmology across clinical,educational,and research fields.Their accura...Background:With the rapid development of artificial intelligence(AI),large language models(LLMs)have emerged as a potent tool for invigorating ophthalmology across clinical,educational,and research fields.Their accuracy and reliability have undergone tested.This bibliometric analysis aims to provide an overview of research on LLMs in ophthalmology from both thematic and geographical perspectives.Methods:All existing and highly cited LLM-related ophthalmology research papers published in English up to 24th April 2025 were sourced from Scopus,PubMed,and Web of Science.The characteristics of these publications,including publication output,authors,journals,countries,institutions,citations,and research domains,were analyzed using Biblioshiny and VOSviewer software.Results:A total of 277 articles from 1,459 authors and 89 journals were included in this study.Although relevant publications began to appear in 2019,there was a significant increase starting from 2023.He M and Shi D are the most prolific authors,while Investigative Ophthalmology&Visual Science stands out as the most prominent journal.Most of the top-publishing countries are high-income economies,with the USA taking the lead,and the University of California is the leading institution.VOSviewer identified 5 clusters in the keyword co-occurrence analysis,indicating that current research focuses on the clinical applications of LLMs,particularly in diagnosis and patient education.Conclusions:While LLMs have demonstrated effectiveness in retaining knowledge,their accuracy in image-based diagnosis remains limited.Therefore,future research should investigate fine-tuning strategies and domain-specific adaptations to close this gap.Although research on the applications of LLMs in ophthalmology is still in its early stages,it holds significant potential for advancing the field.展开更多
文摘Blindness affected 45 million people globally in 2021,and moderate to severe vision loss a further 295 million.[1]The most common causes,cataract and uncorrected refractive error,are generally the easiest to treat,and are among the most cost-effective procedures in all of medicine and international development.[1-2]Thus,vision impairment is both extremely common and,in principle,readily manageable.
文摘Good vision is fundamental to human experience,profoundly influencing educational attainment,economic productivity and overall quality of life.Currently,it is estimated that at least 2.2 billion people globally suffer from vision impairment(VI),with over 1 billion of these cases being preventable or treatable yet remaining unaddressed.Despite significant advancements in global eye care services over the past few decades,which have yielded considerable benefits,the challenges continue to mount.
文摘BACKGROUND Globally,it’s estimated that at least 1 billion people have a near and/or distance vision impairment that could have been prevented or is yet to be addressed.The burden of unaddressed vision impairment and blindness is estimated to be four times higher in low and intermediate-resource settings than in high-income settings.[1]
基金supported by the Guangzhou Basic Research Program,City&University(Institute)Joint Funding Project(2023A03J0174).
文摘Objective:Evidence pertaining to the associations between hyperuricemia and diabetic microvascular complications is limited and inconclusive.In this study,we aimed to prospectively investigate the independent associations of hyperuricemia and retinopathy,nephropathy and neuropathy in individuals with type 2 diabetes mellitus(T2DM).Methods:This cohort study enrolled 25,094 participants from UK Biobank with T2DM and without microvascular complications at baseline.Hyperuricemia was defined as serum uric acid(SUA)higher than 420μmol/L.The incidence of diabetic microvascular complications was identified from hospital inpatient records that were coded according to the International Classification of Diseases(ICD)-10 coding system.Multivariable adjusted Cox proportional hazards regression models were used to calculate adjusted hazard ratios(aHR).Results:Among all participants,3,844(15.3%)were classified as having hyperuricemia at baseline.During a median follow-up of 14.0 years,555(14.4%)individuals with hyperuricemia developed diabetic microvascular complications,compared with 12.6%of individuals without hyperuricemia(P=0.002).In the multivariable-adjusted model accounted for socioeconomic status,lifestyle factors,physical and biochemical measurements,and medication use,when compared with individuals of T2DM who had a normal SUA level,those with hyperuricemia had an 82.9%higher risk of developing diabetic nephropathy(95%CI:1.41-2.38,P<0.001),and a 30.2%higher risk of diabetic neuropathy(95%CI:1.06-1.60,P=0.011).However,the association between hyperuricemia and diabetic retinopathy was not statistically significant(aHR:1.070,95%CI:0.94-1.22,P=0.320).Conclusions:Hyperuricemia was independently associated with diabetic nephropathy and neuropathy but not retinopathy in individuals with T2DM.These findings underscore the importance of monitoring SUA level in prevention of certain microvascular complications.
基金supported by Science and Technology Planning Project of Guangzhou City(2024A04J4474).
文摘Objective:This study aimed to investigate the prevalence,causes,and influencing factors of vision impairment in the elderly population aged 60 years and above in Mangxin Town,Kashgar region,Xinjiang,China.Located in a region characterized by intense ultraviolet radiation and arid climatic conditions,Mangxin Town presents unique environmental challenges that may exacerbate ocular health issues.Despite the global emphasis on addressing vision impairment among aging populations,there remains a paucity of updated and region-specific data in Xinjiang,necessitating this comprehensive assessment to inform targeted interventions.Methods:A cross-sectional study was conducted from May to June 2024,involving 1,311 elderly participants(76.76%participation rate)out of a total eligible population of 1,708 individuals aged≥60 years.Participants underwent detailed ocular examinations,including assessments of uncorrected visual acuity(UVA)and best-corrected visual acuity(BCVA)using standard logarithmic charts,slit-lamp biomicroscopy,optical coherence tomography(OCT,Topcon DRI OCT Triton),fundus photography,and intraocular pressure measurement(Canon TX-20 Tonometer).A multidisciplinary team of 10 ophthalmologists and 2 local village doctors,trained rigorously in standardized protocols,ensured consistent data collection.Demographic,lifestyle,and medical history data were collected via questionnaires.Statistical analyses,performed using STATA 16,included multivariate logistic regression to identify risk factors,with significance defined as P<0.05.Results:The overall prevalence of vision impairment was 13.21%(95%CI:11.37%-15.04%),with low vision at 11.76%(95%CI:10.01%-13.50%)and blindness at 1.45%(95%CI:0.80%-2.10%).Cataract emerged as the leading cause,responsible for 68.20%of cases,followed by glaucoma(5.80%),optic atrophy(5.20%),and age-related macular degeneration(2.90%).Vision impairment prevalence escalated significantly with age:7.74%in the 60–69 age group,17.79%in 70–79,and 33.72%in those≥80.Males exhibited higher prevalence than females(15.84%vs.10.45%,P=0.004).Multivariate analysis revealed age≥80 years(OR=6.43,95%CI:3.79%-10.90%),male sex(OR=0.53,95%CI:0.34%-0.83%),and daily exercise(OR=0.44,95%CI:0.20%-0.95%)as significant factors.History of eye disease showed a non-significant trend toward increased risk(OR=1.49,P=0.107).Education level,income,and smoking status showed no significant associations.Conclusions:This study underscores cataract as the predominant cause of vision impairment in Mangxin Town’s elderly population,with age and sex as critical determinants.The findings align with global patterns but highlight region-specific challenges,such as environmental factors contributing to cataract prevalence.Public health strategies should prioritize improving access to cataract surgery,enhancing grassroots ophthalmic infrastructure,and integrating portable screening technologies for early detection of fundus diseases.Additionally,promoting health education on UV protection and lifestyle modifications,such as regular exercise,may mitigate risks.Future research should expand to broader regions in Xinjiang,employ advanced diagnostic tools for complex conditions like glaucoma,and explore longitudinal trends to refine intervention strategies.These efforts are vital to reducing preventable blindness and improving quality of life for aging populations in underserved areas.
基金supported by grants from the National Natural Science Foundation of China(82000901,82171084).
文摘Background:Blindness and vision impairment(BVI)continue to pose significant global public health challenges,disproportionately impacting vulnerable populations and further widening socioeconomic disparities.This study conducts a comprehensive evaluation of the global burden of BVI and the socioeconomic inequalities in its distribution from 1990 to 2021,aiming to provide insights for targeted intervention strategies.Methods:Using data from Global Burden of Disease 2021,this study performed a multiscale analysis of BVI burden,examining patterns at the global,regional and national levels.We quantified the disease burden using disability-adjusted life years DALY and prevalence rates.Temporal trends were analyzed by calculating estimated annual percentage changes(EAPC).Stratified assessments were carried out by sex and age group across 21 regions and 204 countries.The study also included comparative analyses of six major eye conditions and evaluated their associations with socio-demographic index(SDI).Results:Globally,the age-standardized prevalence of BVI increased from 12,453.52 per million(95%UI:10,287.58-15,226.09)in 1990 to 15,784.33 per million(12,761.44-19,502.32)in 2021,with an EAPC of 1.09%(95%UI:0.97-1.20).During this period,global DALYs attributable to BVI increased by 37.7%.Disease trends exhibited significant divergence,with near vision loss showing the steepest increase(EAPC:1.47%),while the prevalence of glaucoma declined(EAPC:-0.73%).Geographic disparities were pronounced,with substantial improvements observed in Equatorial Guinea(EAPC:-1.75)and worsening burdens in Benin(+0.54).Disease distribution demonstrated strong regional clustering,with near vision loss being predominant in Sub-Saharan Africa(64.47%)and East Asia(50.97%),while cataract was the most common condition in Oceania(33.86%).Females consistently bore a higher burden,particularly in South Asia(646.3 vs 563.2 DALYs).Moreover,we identified a strong inverse correlation between SDI and BVI burden(Ρ=-0.772 for DALYs).Conclusions:This study highlights the severe global burden of BVI and the significant cross-country inequality,particularly in low-and middle-income countries.It emphasizes the urgent need for targeted interventions and the integration of eye care into universal health policies to promote global health equity in the post-pandemic era.
文摘The cornea is a transparent tissue that serves as the main refractive element of the eye ball.Limbal epithelial stem cells(LESCs),residing in the basal epithelial layer of the Palisades of Vogt located in the corneal limbus between cornea and scleral,are believed to be crucial for the continuous turnover of the corneal epithelium.The proliferation,migration,and differentiation of the LESCs are modulated by unique physical and chemical futures contained within the microenvironment known as the limbal niche.This niche,composed of nerve terminals,cells,extracellular matrix,vasculature,and signaling molecules,is the home for processes such as proliferation,migration and differentiation.Corneal nerve terminals possess special anatomical structures in the limbal region and basal epithelial cells,and they demonstrate pivotal biological effects in the regulation of the LESC function and corneal epithelium homeostasis.Biological molecules such as neuropeptides,neurotransmitters,and neurotrophic factors play a crucial role in modulating the LESCs phenotype responsible for corneal epithelium homeostasis.This paper will review recent studies on how these nerve derived molecules function in this process and provide clear orientations for future research.
文摘Objective:Accurate intraocular pressure(IOP)measurement is a cornerstone of glaucoma diagnosis and management.While Goldmann applanation tonometry(GAT)remains the accepted gold standard,technological advancements have introduced alternative methods such as noncontact tonometry(NCT)and the dynamic Scheimpflug-based Corvis ST(CST).This study aims to conduct a rigorous comparative analysis of IOP measurements obtained by NCT,GAT,and CST across a wide spectrum of intraocular pressures.The primary objectives were to evaluate the performance of these devices in both healthy and glaucomatous eyes,assess their intra-and interobserver variability,and determine their level of agreement with the established reference.Methods:In this prospective,comparative study,a total of 212 eyes from 212 subjects were enrolled,comprising 137 eyes of patients with glaucoma and 75 eyes of healthy individuals.All participants underwent IOP measurement using the three devices in a randomized order to minimize bias.Based on the initial GAT readings,eyes were systematically classified into one of four predefined IOP levels:Level A(low,<10 mmHg),Level B(normal range,10-21 mmHg),Level C(moderately elevated,>21 to 40 mmHg),and Level D(severely elevated,>40 mmHg).A mixed-model analysis of variance(ANOVA)was employed to statistically analyze the differences in IOP measurements among the three tonometers at each distinct pressure level.The agreement between each pair of devices(CST vs.GAT,CST vs.NCT,and NCT vs.GAT)was meticulously assessed using Bland-Altman plots,which provide metrics for bias(mean difference)and the 95%limits of agreement(LoA).Results:CST and GAT exhibited better intra-and interobserver variability compared to NCT.Significant differences in IOP measurements were observed among CST,NCT,and GAT at levels A and D(P<0.001,P=0.030).Bland-Altman analysis revealed biases between CST and GAT,CST and NCT,and NCT and GAT at different levels(level A:-0.61,0.94,and-1.55 mmHg;level B:0.16,-0.7,and 0.8;level C:0.5,0.5,and-0.1;level D:0.83,-3.4,and 4.2).Notably,NCT tended to overestimate IOP more at higher levels(level D)and underestimate at lower levels(level A)compared to CST.CST demonstrated better agreement with GAT than NCT did.Conclusions:This study confirms that the Corvis ST(CST)shows superior agreement with the Goldmann applanation tonometer than noncontact tonometry,particularly at low and high IOP ranges.It also exhibits greater measurement consistency.While NCT remains a useful screening tool,its significant over-and underestimation at pressure extremes is a critical limitation.The findings strongly suggest that CST may serve as a more suitable and reliable alternative to NCT for measuring IOP across a broad clinical range.However,the results underscore that these three methods are not directly interchangeable.Clinicians must therefore exercise careful interpretation of IOP values,taking into account the specific tonometer used and the patient's probable pressure level for accurate diagnosis and management of glaucoma.
文摘Myopia,a common cause of visual impairment,together with the global decline in physical fitness and increasing prevalence of childhood obesity,has become a prominent global health problem.The beneficial effect of increasing the time of outdoor activities on the incidence of myopia and physical well-being in children has been widely recognized.However,in countries with highly competitive education systems,such as China,parents and school administrators may be reluctant to increase their children's time for extracurricular outdoor activities for fear of affecting their academic performance.Therefore,it is crucial to accurately assess the role of after-school outdoor activities in preventing and controlling myopia,as well as in promoting the physical and mental development of adolescents.Schools and families should be encouraged to collaboratively support children’s engagement in outdoor activities to foster their healthy growth.Given the dual benefits of outdoor activities-improving visual health and promoting overall physical and mental well-being-it is essential to encourage schools and families to work together to support children's engagement in such activities.By doing so,it is hoped that a balanced environment can be created,one that values both academic achievement and healthy development.Policymakers,educators,and parents must recognize the long-term advantages of integrating outdoor activities into children's daily lives,as this approach can help alleviate the burden of myopia,enhance physical fitness,and support emotional and cognitive development.Ultimately,fostering a culture that views outdoor activities as an essential component of education and health will be key to ensuring the well-rounded development of future generations.
文摘Objective:To develop a survival prediction model for primary conjunctival malignant tumors.Methods:Detailed information on cases diagnosed with primary conjunctival malignant tumors from 2000 to 2019 was collected from SEER database.Subsequently,cases meeting the inclusion criteria were randomly assigned to either the development group(1,216 cases)or validation group(608 cases).Relevant risk factors affecting overall survival(OS)were identified using Cox proportional hazards regression analysis.A nomogram was constructed to predict the 1-year,3-year,and 5-year survival rates.The concordance index(C index)was calculated to assess the predictive power of the model.Receiver operating characteristic curves(ROC curves)and calibration curves were plotted.The area under the curve(AUC)was measured.Decision curve analysis(DCA)was also applied.Results:The overall survival rate was 77.8%.Statistically significant differences in the survival time distribution were observed among groups based on age(P<0.001),histology(P<0.001),and stage(P=0.01).According to the multivariate analysis,patients with lymphoma,younger age,and localized lesions exhibited better survival outcomes.The C-index of the constructed model was 0.79.In the training group,the AUC values for predicting 1-year,3-year,and 5-year mortality were 0.824,0.796,and 0.815,respectively.In the validation group,age corresponding AU values were 0.750,0.820,and 0.838.The DCA results demonstrated a significant advantage of the model,while the calibration plots indicated that the predicted OS was in good agreement with the actual OS in both groups.Conclusions:This study presents a satisfying survival prediction model for malignant conjunctival tumors.
基金supported by the Global STEM Professorship Scheme(P0046113)Henry G.Leong Endowed Professorship in Elderly Vision Health.
文摘Objective:Diabetic retinopathy(DR)is a top leading cause of blindness worldwide,requiring early detection for timely intervention.Artificial intelligence(AI)has emerged as a promising tool to improve DR screening efficiency,accessibility,and cost-effectiveness.This study conducted a systematic review of literature and meta-analysis on the economic outcomes of AI-based DR screening.Methods:A systematic review of studies published before September 2024 was conducted throughout PubMed,Scopus,Embase,the Cochrane Library,the National Health Service Economic Evaluation Database,and the Cost-Effectiveness Analysis Registry.Eligible studies were included if they were(1)conducted among type 1 diabetes mellitus or type 2 diabetes mellitus adult diabetic population;(2)studies compared AI-based DR screening strategy to non-AI screening;and(3)performed a cost-effectiveness analysis.Meta-analysis was applied to pool incremental net benefit(INB)across studies stratified by country income and study perspective using a random-effects model.Statistical heterogeneity among studies was assessed using the I2 statistic,Cochrane Q statistics,and meta regression.Results:Nine studies were included in the analysis.From a healthcare system/payer perspective,AI-based DR screening was significantly cost-effective compared to non-AI-based screening,with a pooled INB of 615.77(95%confidence interval[CI]:558.27-673.27).Subgroup analysis showed robust cost-effectiveness of AI-based DR screening in high-income countries(INB=613.62,95%CI:556.06-671.18)and upper-/lower-middle income countries(INB=1,739.97,95%CI:423.13-3,056.82)with low heterogeneity.From a societal perspective,AI-based DR screening was generally cost-effective(INB=5,102.33,95%CI:-815.47-11,020.13),though the result lacked statistical significance and showed high heterogeneity.Conclusions:AI-based DR screening is generally cost-effective from a healthcare system perspective,particularly in high-income countries.Heterogeneity in cost-effectiveness across different perspectives highlights the importance of context-specific evaluations,to accurately evaluate the potential of AI-based DR screening in reducing global healthcare disparities.
基金supported by the Fujian Provincial Undergraduate Teaching Reform Project(J21008)Teaching Research Program for Undergraduate Education at Fujian Medical University(J24030).
文摘Virtual Reality(VR)technology is widely recognized as a prominent technological paradigm.Its potential and promise in the domain of ophthalmology are substantial,and the evolution of VR technology has significantly influenced the contemporary landscape of ophthalmology.Numerous empirical studies have validated the practical utility of VR technology in domains such as ophthalmic disease treatment and surgery training.This paper offers a comprehensive overview of VR technology's utilization in ophthalmic disease treatment,student education,and surgery training,expands the application of VR technology in ophthalmic evaluation and disease diagnosis,discusses the challenges and limitations of VR technology in ophthalmology,and expounds on emerging trends and future developments of VR technology in ophthalmology.This endeavor aims to provide readers with an in-depth comprehension of the current status and future prospects of VR technology application in ophthalmology,with the ultimate objective of fostering more effective advancements and applications of VR technology in the realm of ophthalmology.
文摘Achieving universal eye health remains a global challenge,particularly in low-and middle-income countries where visual impairment and blindness are prevalent.While advances in tertiary eye care have improved outcomes,access to primary eye care(PEC)continues to be inadequate in rural and underserved regions.This gap necessitates innovative,scalable models that provide accessible,affordable,and comprehensive eye care.The Vision Centre(VC)model,pioneered by the Aravind Eye Care System(AECS),exemplifies a sustainable approach to delivering PEC.Designed as permanent facilities in rural communities,VCs are equipped with state-of-the-art diagnostic tools and staffed by trained allied ophthalmic personnel.The integration of teleophthalmology,electronic medical records,and artificial intelligence enhances the model’s capacity to address complex conditions like diabetic retinopathy and glaucoma.VCs have demonstrated significant impact in improving accessibility,reducing financial burdens,and increasing utilization of eye care services.In the fiscal year 2023-2024,AECS VCs recorded nearly one million outpatient visits,achieving a 25%population coverage rate and generating substantial cost savings of ₹647 million(US$7.8 million)for patients.The model's success is underpinned by community engagement,a focus on operational excellence,and a robust referral system to tertiary hospitals.This review explores the evolution,implementation,and impact of the AECS VC model,emphasizing its alignment with the Sustainable Development Goals and Universal Health Coverage.By addressing accessibility and affordability,the VC model serves as a scalable template for primary eye care delivery in resource-limited settings globally.
基金supported by the Nursing Innovation and Development Research Project of the Lingnan Nightingale Nursing Research Institute and Nursing Association,Guangdong Province(GDHLYJYB202403,GDHLYJYM202417)Research Project on Party Building Theory and Practice at Zhongshan Ophthalmic Center in 2024,Research Project on Standardized Management of Day Medical Services by the Institute of Hospital Management,National Health Commission(DSQ20251016)Medical Science and Technology Foundation of Guangdong Province(A2021088).
文摘Objective:The day surgery mode has significantly reduced preoperative waiting time for patients.However,this mode also led to brief and sometimes abrupt interactions between patients with vision loss and nursing staff during the preoperative visits.Additionally,patients may experience negative emotions.The aim of this study was to describe the preoperative experiences and identify related stressful factors among patients waiting vitreo-retinal day surgery.Methods:This study was guided by an interpretive approach.Semi-structured,face-to-face,in-depth interviews were conducted with patients from August 2021 to October 2024.Inductive content analysis and research software were used to analyze the data.Results:Twenty-seven patients agreed to participate the interviews.Their ages ranged from 19 to 70 years old.The waiting time before hospitalization varied from 7 to 90 days.Three main categories emerged from patients’complaints:day surgery procedures,concerns about eye conditions and supports.Conclusions:The findings underscore the importance of preoperative care services.It is suggested that providing accurate preoperative information and effective support can significantly enhance the quality of preoperative care service.
基金supported by the National Natural Science Foundation of China(82371089).
文摘Objective:To evaluate the performance of orthokeratology(ortho-k)lens reordering using software-designed system,so as to determine the feasibility of ortho-k lens reordering without discontinuing lens wear.Methods:This study is a retrospective analysis of data of ortho-k lens wearers who had a history of short-term discontinuation of lens wear.A total of 94 individuals aged over 8 years with spherical equivalent refraction ranging from-0.50 to-6.50 diopters were included.The corneal topography data at baseline(before ortho-k)and after lens wear discontinuation(cessation of ortho-k treatment)were imported separately into the lens-design software,along with corresponding refraction data.Subsequently,corneal and lens parameters were generated and compared.Intraclass correlation coefficients(ICC)were calculated,and Bland and Altman analyses were conducted.Results:All 94 children were involved in the retrospective analysis.Compared with baseline data,there was a high level of consistency between Rwo(without discontinuation)and Rwith(with discontinuation),with an ICC of 0.96(P<0.001).Furthermore,the comparison of lens parameters generated by the Easyfit software between baseline and after short-term discontinuation showed a high degree of consistency,with all of the ICC values exceeding 0.90.Similar results were obtained using the WAVE software,as both ICC values and Bland-Altman plots demonstrated a high level of consistency in lens parameters between two conditions(nearly all data points fell within the 95%LoAs).Conclusions:It is feasible to directly reorder new ortho-k lenses using software fitting approaches.However,further investigations are necessary to validate their practicability in a clinical setting.
文摘An 81-year-old man with a history of central retinal artery occlusion(CRAO),under follow-up for neovascular glaucoma,presented with an unusual vitreous detachment in which a prior vitreous hemorrhage had formed a distinctive heart-shaped Weiss ring(Figure 1)(1).Although such floaters can often be bothersome,especially during reading or in bright lighting,the patient reported no symptoms due to his severely reduced visual acuity,which was limited to hand motion following the CRAO.This case serves as a lighthearted reminder that,even in ophthalmology and in patients with a poor visual prognosis,love can appear in the most unexpected places.
文摘Schools are an important avenue to tackle the rising prevalence of uncorrected refractive error among children.School-based vision programs are an innovative approach of vision care delivery in the urban school setting in the United States.These programs are effective in improving vision outcomes and advancing health equity,especially among the disadvantaged school districts.While most school-based vision programs provide vision screening,eye examinations,and eyeglasses prescription to students directly in schools,different mechanisms and models have been reported.In this paper,we describe two large-scale school-based vision programs,Vision for Baltimore and Helen Keller International’s United States Vision Program,representing national and regional efforts to partner with local communities in improving access to pediatric vision care.These programs also serve as data collection platforms and provide evidence to inform public health policy and guide best practice.Collectively,these two programs showed that one in three students failed vision screening.The prevalence of uncorrected refractive error was high and the demand for eyeglasses was great among those who failed vision screening.While most of the students’uncorrected refractive errors could be addressed in the school setting,one in seven needed additional eye care.We found that schools with more socioeconomically disadvantaged students had greater needs of school-based vision program services.We hope this knowledge helps to maximize the impact of school-based vision programs and promote a system that ensures better health outcomes for all children.
基金supported by Guangdong Basic Research Center of Excellence for Major Blinding Eye Diseases Prevention and Treatment(2024-YXGG-016).
文摘Objective:Fengqing County,situated in Yunnan Province,is a high-altitude region known for its ethnic diversity and a notably high prevalence of pterygium.As a key area for Sun Yat-sen University's poverty alleviation initiatives,this study aims to investigate the unique characteristics of pterygium in specific region.Methods:We analyzed data from hospitalized patients admitted to the Ophthalmology department of the People's Hospital of Fengqing in 2023.The data were extracted from medical records through the hospital information system.The chi-square test was used for statistical comparison,and multivariate logistic regression analysis was conducted to explore the factors influencing the onset of pterygium.A significance level of P<0.005 was set.Results:In 2023,out of 1137 ophthalmic inpatients,207(18.2%)underwent pterygium surgery.There was a significant female predominance,with a female-to-male ratio of 6.67:1(P<0.001).However,no significant ethnic variation was observed(P=0.57).The majority of patients were in the 46-55 age group(36.71%),and the recurrence rate was low at 1.71%.Female gender,increasing age,diabetes mellitus,age-related cataract,and meibomian gland dysfunction were identified as independent risk factors for pterygium in this region.Conclusion:Fengqing is likely to have intricate connections between the occurrence and treatment of pterygium and its local geography,culture,and socio-economic conditions.Medical assistance programs should take these factors into account and prioritize them in poverty alleviation initiatives.
基金the National Natural Science Foundation of China grant NSFC(82070995).
文摘Objective:Strabismus is associated with a higher prevalence of idiopathic thoracic scoliosis(ITS)in children.This study aims to investigate whether superior oblique palsy(SOP)poses a higher risk for developing ITS among children and adolescents.Methods:A cross-sectional study.The study group comprised 347 consecutive candidates for SOP surgery aged 4 to 18 years;Patients within the same age range with ocular trauma were enrolled as the control group.Preoperative chest plain radiographs were used to measure the Cobb angle.Demographic information and clinical data,including diopter,best corrected visual acuity,deviation degree,and binocular function,were analyzed.Results:A significantly higher prevalence of ITS was found in study group compared with control group(12.68%vs 4.18%,P<0.001).Additionally,the mean Cobb angle was lagger in SOP group than that in control group(5.02°±3.87°vs 3.84°±3.09°,P<0.001).Males in SOP group showed a higher prevalence of ITS(12.9%vs 2.87%,P=0.007),but there was no significant difference in females between two groups(12.3%vs 7.69%,P=0.295).Good near stereopsis acuity was significantly associated with high prevalence of thoracic scoliosis(P<0.001).Multivariate logistic regression analysis revealed that a large distant magnitude of deviation(>20 PD)and near stereoacuity were significantly associated with ITS.Conclusions:Patients with SOP have a significantly higher risk of developing idiopathic thoracic scoliosis,especially those with good near stereoscopic and large distant magnitude of deviation.
基金supported by Health and Medical Research Fund,Hong Kong(11220386,12230246).
文摘Background:With the rapid development of artificial intelligence(AI),large language models(LLMs)have emerged as a potent tool for invigorating ophthalmology across clinical,educational,and research fields.Their accuracy and reliability have undergone tested.This bibliometric analysis aims to provide an overview of research on LLMs in ophthalmology from both thematic and geographical perspectives.Methods:All existing and highly cited LLM-related ophthalmology research papers published in English up to 24th April 2025 were sourced from Scopus,PubMed,and Web of Science.The characteristics of these publications,including publication output,authors,journals,countries,institutions,citations,and research domains,were analyzed using Biblioshiny and VOSviewer software.Results:A total of 277 articles from 1,459 authors and 89 journals were included in this study.Although relevant publications began to appear in 2019,there was a significant increase starting from 2023.He M and Shi D are the most prolific authors,while Investigative Ophthalmology&Visual Science stands out as the most prominent journal.Most of the top-publishing countries are high-income economies,with the USA taking the lead,and the University of California is the leading institution.VOSviewer identified 5 clusters in the keyword co-occurrence analysis,indicating that current research focuses on the clinical applications of LLMs,particularly in diagnosis and patient education.Conclusions:While LLMs have demonstrated effectiveness in retaining knowledge,their accuracy in image-based diagnosis remains limited.Therefore,future research should investigate fine-tuning strategies and domain-specific adaptations to close this gap.Although research on the applications of LLMs in ophthalmology is still in its early stages,it holds significant potential for advancing the field.
