BACKGROUND Dry eye disease(DED)is a multifactorial ocular surface disorder with rising prevalence.It is closely related to systemic health and psychological factors,such as sleep and mood disorders,which significantly...BACKGROUND Dry eye disease(DED)is a multifactorial ocular surface disorder with rising prevalence.It is closely related to systemic health and psychological factors,such as sleep and mood disorders,which significantly impact the quality of life of patients.AIM To explore the correlations between ocular surface function,sleep quality,and anxiety/depression in patients with DED.METHODS This was a cross-sectional investigative study that included 358 patients with DED between January 2022 and January 2025.Ocular surface was assessed using the ocular surface disease index(OSDI),tear film break-up time,fluorescein staining score,and Schirmer I test.The Pittsburgh Sleep Quality Index(PSQI),Self-Rating Anxiety Scale(SAS),and Self-Rating Depression Scale(SDS)were used to evaluate sleep quality and anxiety/depression levels.Correlation and linear regression analyses were used to explore the relationships.RESULTS The mean PSQI score of the patients was 9.94±2.18;the mean SAS score was 47.30±4.90,and the mean SDS score was 50.08±5.52.These suggested a prevalence of sleep and psychological abnormalities.There was a significant correlation between the indicators of ocular surface function(OSDI,tear film break-up time,fluorescein staining,and Schirmer I test)and PSQI,SAS,and SDS scores(P<0.05).Moreover,multiple regression revealed that age≥50 years(β=1.55,P=0.029),PSQI scores(β=0.58,P<0.001),SAS scores(β=0.17,P=0.017),and SDS scores(β=0.15,P=0.019)were independent predictors of the OSDI scores.CONCLUSION Ocular surface function in patients with DED is closely related to sleep quality and anxiety/depression,emphasizing the need for holistic clinical management.展开更多
AIM:To evaluate 3%diquafosol ophthalmic solution on ocular surface parameters and the alterations of lipid and muco-aqueous layer in tear film of patients with visual display terminal(VDT)-associated dry eye disease(D...AIM:To evaluate 3%diquafosol ophthalmic solution on ocular surface parameters and the alterations of lipid and muco-aqueous layer in tear film of patients with visual display terminal(VDT)-associated dry eye disease(DED).METHODS:This study included patients with VDTassociated DED.It was a prospective single-arm interventional clinical trial.Patients were provided with 3%diquafosol ophthalmic solution for 3mo and were followed up in 1,2 and 3mo after treatment.Tear breakup time(TBUT),ocular surface staining score,and ocular surface disease index(OSDI)score were ocular surface characteristics.Lipid layer thickness(LLT),tear meniscus height(TMH),and mucin mRNA expression levels(MUC1,MUC4,MUC5AC,MUC16,and MUC20)were used to measure changes in the tear film.The LipiView interferometer was used to measure the partial blink rate(PBR).RESULTS:Sixty-eight eyes of 68 participants(54 females;mean age 25.12±4.10y;mean spherical equivalent-4.35±2.69 D)were enrolled.Compared with the pre-treatment,OSDI scores and TBUT improved significantly at all follow-up time points(all P<0.01),and TMH increased significantly at 1 and 3mo(P<0.01,P<0.001,respectively).Conjunctival lissamine green staining improved only at 2mo(P<0.05),while corneal fluorescein staining showed no significant changes.Overall LLT remained unchanged,but the PBR<1 subgroup exhibited significant LLT elevation at 3mo(P<0.05),unlike the PBR=1 subgroup.Conjunctival mRNA expression of MUC1,MUC5AC,MUC16,and MUC20 was significantly upregulated at 1 and 3mo(all P<0.01),and MUC4 expression increased significantly only at 1mo(P<0.001).CONCLUSION:In patients with VDT-associated DED,3%diquafosol ophthalmic solution dramatically reduced symptoms and enhanced tear film stability by promoting ocular surface muco-aqueous secretion.Patients with better blinking habits(PBR<1)demonstrate greater LLT improvement than those with poorer habits.展开更多
AIM:To investigate the impact of depression-like behavior on ocular surface homeostasis in a mouse model,with a focus on dry eye-like alterations.METHODS:Male C57BL/6J mice(10-12 weeks old)were randomly assigned to co...AIM:To investigate the impact of depression-like behavior on ocular surface homeostasis in a mouse model,with a focus on dry eye-like alterations.METHODS:Male C57BL/6J mice(10-12 weeks old)were randomly assigned to control or restraint stress(RS)groups.The RS group underwent three intermittent 24-hour restraint sessions to induce depressive-like behavior.Behavioral testing,tear secretion measurement,and corneal Oregon Green Dextran(OGD)staining were performed.Postmortem analyses included histological evaluation of lacrimal glands,goblet cell quantification using periodic acid-Schiff staining,and assessment of key inflammatory and apoptotic markers:interleukin(IL)-17,matrix metalloproteinases(MMP)-3,MMP-9,IL-13,interferon(IFN)-γ,and cleaved caspase-3 and-8.RESULTS:Repeated RS induced depression-like behavior and significant ocular surface changes.RStreated mice showed increased corneal OGD uptake and upregulation of gene/protein expression of IL-17,MMP-3,and MMP-9(P<0.05).Goblet cell density and IL-13 protein expression were reduced,while IFN-γprotein expression was elevated(P<0.05).Cleaved caspase-3 and-8 levels were significantly increased in both cornea and conjunctiva.Tear volume and lacrimal gland size were unchanged;however,mild inflammatory infiltration was observed in lacrimal glands.CONCLUSION:Repeated RS leads to ocular surface inflammation and dry eye-like pathology,including corneal barrier disruption,goblet cell loss,and epithelial apoptosis.These findings suggest that depression contributes to the pathogenesis of dry eye disease via immune-mediated mechanisms.展开更多
AIM:To evaluate ocular surface characteristics and dry eye symptoms in primary biliary cholangitis(PBC)patients with seasonal allergic conjunctivitis(SAC).METHODS:This retrospective case-control study included 73 PBC ...AIM:To evaluate ocular surface characteristics and dry eye symptoms in primary biliary cholangitis(PBC)patients with seasonal allergic conjunctivitis(SAC).METHODS:This retrospective case-control study included 73 PBC patients:38 with SAC(PBC+SAC group,38 eyes)and 35 controls(35 eyes).All the participants underwent comprehensive ocular surface assessment and ocular surface disease index(OSDI)scoring.The severity of ocular allergy in PBC+SAC group was indicated by total ocular symptom score(TOSS),and correlation analysis was carried out between TOSS and ocular parameters.RESULTS:Age(59.60±10.69y vs 58.72±11.13y,P=0.629)and gender distribution(34 vs 32 females,P=0.713)did not differ significantly between groups.Compared to controls,the PBC+SAC group had higher dry eye prevalence(65.79%vs 28.57%,P=0.002),higher OSDI score[median:34.3(interquartile range,IQR:26.05,43.6)vs 21.2(IQR:15.15,31.2),P<0.001],shorter non-invasive tear film breakup time[NIBUT,median:4.16s(IQR:2.52,6.48)vs 6.88s(IQR:4.81,9.28),P<0.001],more severe upper meibomian gland loss(P<0.001),higher corneal fluorescein staining score[median:1(IQR:0,1)vs 0(IQR:0,0.25),P<0.001],and higher rates of meibomian gland duct thinning(60.53%vs 31.43%,P=0.004)and distortion(73.68%vs 25.71%,P=0.001).TOSS was positively correlated with OSDI score(r=0.484,P<0.001)in PBC+SAC group but not with other ocular parameters(all P>0.05).CONCLUSION:PBC patients with SAC have higher dry eye prevalence and more severe dry eye symptoms,mainly evaporative dry eye with obvious upper meibomian gland morphological abnormalities.Allergic symptom severity is positively correlated with dry eye discomfort,suggesting allergic inflammation may exacerbate ocular surface burden in PBC patients.展开更多
AIM:To evaluate the efficacy and safety of 3%diquafosol sodium eye drops in children wearing orthokeratology lenses and with dry eye disease(DED)or at risk of DED.METHODS:Randomized controlled trials.Children with DED...AIM:To evaluate the efficacy and safety of 3%diquafosol sodium eye drops in children wearing orthokeratology lenses and with dry eye disease(DED)or at risk of DED.METHODS:Randomized controlled trials.Children with DED or at risk of DED were randomly assigned in a 1∶1 ratio to receive either 3%diquafosol sodium eye drops 6 times daily or a blank control at Chongqing Aier Children’s Eye Hospital from November 2023 to November 2024.The primary endpoint was the change in the Dry Eye Questionnaire-5(DEQ-5)score from baseline at 12 wk.Secondary assessments included non-invasive breakup time(NIBUT),tear meniscus height,Schirmer’s test,corneal fluorescein staining score,and axial length.RESULTS:A total of 80 participants(80 eyes)were enrolled(40 in each group),the average age of the participants was 11.11±1.88 years,with 43 females(54%)and 37 males(46%),and all completed the trial.After 12 wk,the DEQ-5 scores for the diquafosol sodium group and the blank control group were 1.88±2.02 and 2.88±2.79,respectively(P=0.079).The diquafosol sodium group demonstrated a significant improvement in DEQ-5 dryness symptom scores(-0.33±0.66 vs.0.05±0.81,P=0.023)and NIBUT(6.18±3.73 vs.-1.09±4.40 s,P<0.001)at 12 wk.Additionally,the diquafosol sodium group showed no axial length elongation,in contrast to the blank control group,which exhibited elongation(0.00±0.08 vs.0.05±0.10 mm,P=0.013).No other significant differences were found in the secondary endpoints.No adverse events occurred during the trial.CONCLUSION:Although no statistically significant improvements were noted in the overall DEQ-5 scores,the 3%diquafosol sodium eye drops significantly improved dryness symptoms and NIBUT when compared to the blank control group.展开更多
AIM:To evaluate nanosilver eye patches versus Atrauman nanosilver dressings for ocular surface trauma.METHODS:This randomized non-inferiority trial(November 2024-April 2025)enrolled 60 patients assessed pre-treatment ...AIM:To evaluate nanosilver eye patches versus Atrauman nanosilver dressings for ocular surface trauma.METHODS:This randomized non-inferiority trial(November 2024-April 2025)enrolled 60 patients assessed pre-treatment and on days 1,7,and 14 post-treatment.The patients were then randomized into treatment(nanosilver eye patches)and control groups(Atrauman nanosilver dressings).Outcomes included wound healing,comfort(Ocular Comfort Index,OCI),and safety.Statistical analyses used t-tests,non-inferiority tests,and Chi-square tests.RESULTS:Patient baseline characteristics were comparable between groups,with a mean age of 60.633±10.934 in the treatment group versus 64.933±9.606 in controls,and similar gender distribution(20/10 vs 17/13 male/female).Both groups showed comparable baseline OCI scores(treatment group:6.100±2.187 vs control group:6.267±2.303,P=0.775).Following treatment,scores increased significantly at day 1(treatment group:9.367±2.251;control group:9.067±2.212,both P<0.001 vs baseline).Marked improvement was observed by day 7(treatment group:4.067±1.929;control group:3.900±1.918,P<0.001 vs baseline),with complete resolution at day 14(0.467±0.860 vs 0.467±1.008,P<0.001).The non-inferiority criterion was met.The treatment group showed greater improvement in Grade A wound healing rates(76.67%to 93.33%)compared to controls(80.00%to 86.67%)between 1 and 7d post-treatment.By 14d posttreatment,all patients achieved Grade A healing in both groups,with no Grade C cases observed throughout the study period.No adverse events were reported.CONCLUSION:Nanosilver eye patches are non-inferior to Atrauman dressings,offering effective,safe emergency care for ocular trauma.展开更多
Globally,diabetes and glaucoma account for a high number of people suffering from severe vision loss and blindness.To treat these vision disorders effectively,proper diagnosis must occur in a timely manner,and with co...Globally,diabetes and glaucoma account for a high number of people suffering from severe vision loss and blindness.To treat these vision disorders effectively,proper diagnosis must occur in a timely manner,and with conventional methods such as fundus photography,optical coherence tomography(OCT),and slit-lamp imaging,much depends on an expert’s interpretation of the images,making the systems very labor-intensive to operate.Moreover,clinical settings face difficulties with inter-observer variability and limited scalability with these diagnostic devices.To solve these problems,we have developed the Efficient Channel-Spatial Attention Network(ECSA-Net),a new deep learning-based methodology that integrates lightweight channel-and spatial-attention modules into a convolutional neural network.Ultimately,ECSA-Net improves the efficiency of computational resource use while enhancing discriminative feature extraction from retinal images.The ECSA-Net methodology was validated by conducting a series of classification accuracy tests using two publicly available eye disease datasets and was benchmark against a number of different pretrained convolutional neural network(CNN)architectures.The results showed that the ECSA-Net achieved classification accuracies of 60.00%and 69.92%,respectively,while using only a compact architecture with 0.56 million parameters.This represents a reduction in parameter size by a factor of 14×to 247×compared to other pretrained models.Additionally,the attention modules added to the architecture significantly increased sensitivity to disease-relevant regions of the retina while maintaining low computational cost,making ECSA-Net a viable option for real-time clinical use.ECSA-Net is both efficient and accurate in automating the classification of eye diseases,combining high performance with the ethical considerations of medical artificial intelligence(AI)deployment.The ECSA-Net frameworkmitigates algorithmic bias in training datasets and protects individuals’privacy and transparency in decision-making,thereby facilitating human-AI collaboration.The two areas of technical performance and ethical integration are needed for the responsible and scalable use of ECSA-Net in a variety of ophthalmic care settings.展开更多
Numerous sectors,such as education,the IT sector,and corporate organizations,transitioned to virtual meetings after the COVID-19 crisis.Organizations now seek to assess participants’fatigue levels in online meetings ...Numerous sectors,such as education,the IT sector,and corporate organizations,transitioned to virtual meetings after the COVID-19 crisis.Organizations now seek to assess participants’fatigue levels in online meetings to remain competitive.Instructors cannot effectively monitor every individual in a virtual environment,which raises significant concerns about participant fatigue.Our proposed system monitors fatigue,identifying attentive and drowsy individuals throughout the online session.We leverage Dlib’s pre-trained facial landmark detector and focus on the eye landmarks only,offering a more detailed analysis for predicting eye opening and closing of the eyes,rather than focusing on the entire face.We introduce an Eye Polygon Area(EPA)formula,which computes eye activity from Dlib eye landmarks by measuring the polygonal area of the eye opening.Unlike the Eye Aspect Ratio(EAR),which relies on a single distance ratio,EPA adapts to different eye shapes(round,narrow,or wide),providing a more reliable measure for fatigue detection.The VMFD system issues a warning if a participant remains in a fatigued condition for 36 consecutive frames.The proposed technology is tested under multiple scenarios,including low-to high-lighting conditions(50-1400 lux)and both with and without glasses.This study builds an OpenCV application in Python,evaluated using the iBUG 300-W dataset,achieving 97.5%accuracy in detecting active participants.We compare VMFD with conventional methods relying on the EAR and show that the EPA technique performs significantly better.展开更多
Age-related macular degeneration is a serious neurodegenerative disease of the retina that significantly impacts vision.Unfortunately,the specific pathogenesis remains unclear,and effective early treatment options are...Age-related macular degeneration is a serious neurodegenerative disease of the retina that significantly impacts vision.Unfortunately,the specific pathogenesis remains unclear,and effective early treatment options are consequently lacking.The microbiome is defined as a large ecosystem of microorganisms living within and coexisting with a host.The intestinal microbiome undergoes dynamic changes owing to age,diet,genetics,and other factors.Such dysregulation of the intestinal flora can disrupt the microecological balance,resulting in immunological and metabolic dysfunction in the host,and affecting the development of many diseases.In recent decades,significant evidence has indicated that the intestinal flora also influences systems outside of the digestive tract,including the brain.Indeed,several studies have demonstrated the critical role of the gut-brain axis in the development of brain neurodegenerative diseases,including Alzheimer’s disease and Parkinson’s disease.Similarly,the role of the“gut-eye axis”has been confirmed to play a role in the pathogenesis of many ocular disorders.Moreover,age-related macular degeneration and many brain neurodegenerative diseases have been shown to share several risk factors and to exhibit comparable etiologies.As such,the intestinal flora may play an important role in age-related macular degeneration.Given the above context,the present review aims to clarify the gut-brain and gut-eye connections,assess the effect of intestinal flora and metabolites on age-related macular degeneration,and identify potential diagnostic markers and therapeutic strategies.Currently,direct research on the role of intestinal flora in age-related macular degeneration is still relatively limited,while studies focusing solely on intestinal flora are insufficient to fully elucidate its functional role in age-related macular degeneration.Organ-on-a-chip technology has shown promise in clarifying the gut-eye interactions,while integrating analysis of the intestinal flora with research on metabolites through metabolomics and other techniques is crucial for understanding their potential mechanisms.展开更多
OBJECTIVE:To explore the clinical observation of white eye distribution characteristics of hyperlipidemic patients based on artificial intelligence digital eye diagnosis technology.METHODS:One hundred and fifty subjec...OBJECTIVE:To explore the clinical observation of white eye distribution characteristics of hyperlipidemic patients based on artificial intelligence digital eye diagnosis technology.METHODS:One hundred and fifty subjects were examined in the outpatient and inpatient departments of Guang'anmen Hospital of the China Academy of Traditional Chinese Medicine from 01 February 2022 to 01 February 2023,including 80 cases in the hyperlipidemic patient(HLP)group and 70 cases in the normal lipid level patient(NC)group.The two groups were collected and extracted by the artificial intelligence visual diagnostic instrument and analyzed by the MyEyeD-10 white eye shadowless imaging health intelligence analysis system.Finally,SPSS 26.0(Version X;IBM Corp.,Armonk,NY,USA)was used for statistical processing.RESULTS:Significant differences were noted in the scores of"spot"and"foggy"features between the two groups.Between groups,the"spot"feature score of the white eye morphology in the HLP group(11.07±3.22)was higher than that in the NC group(7.50±4.11)(P<0.01).Moreover,the"foggy"feature score of the eye morphology in the HLP group(8.37±2.25)was higher than that in the NC group(P<0.01),higher than that of the NC group(5.72±1.21)(P<0.05).There were significant differences in the"A"(stomach),"B","O"(spleen),and"M"(liver)eye-contact region scores between the two groups,and the"B","O"(spleen)and"M"(liver)eye-contact region scores were significantly different.The scores of the white eye channel region in the HLP group were significantly higher than those in the control group,with the"A","B",and"O"regions(P<0.01),"M"region(P<0.01),"A","B","O",and"M"region(P<0.01)."M"zone(P<0.05).The scores of"dull red"and"yellow"features were significantly different,and the scores of"dull red"and"yellow"colors of the white eye choroid in the HLP group were significantly higher than those in the HLP group.The scores of"dull red"and"yellow"were significantly higher in the HLP group than in the NC group(P<0.01).CONCLUSION:The morphological features of the white eye ocular image,the white eye chakra's color,and the bulbar conjunctiva's vascular zoning are closely related to hyperlipidemia.Importantly,these provide a reference for the objectivity and precision of the identification of Chinese medicine by looking at the eyes.展开更多
AIM:To compare the efficacy of 3%diquafosol sodium(DQS)eye drops at different frequencies in dry eye(DE)after femtosecond laser-assisted in situ keratomileusis(FS-LASIK).METHODS:In this prospective study,DE patients a...AIM:To compare the efficacy of 3%diquafosol sodium(DQS)eye drops at different frequencies in dry eye(DE)after femtosecond laser-assisted in situ keratomileusis(FS-LASIK).METHODS:In this prospective study,DE patients after FS-LASIK were randomly divided into two groups.All patients were administered routine anti-inflammatory and anti-infective drugs after FS-LASIK.Additionally,both groups were treated with DQS,at frequencies of 4(DQS4 group)and 6(DQS6 group)times daily.Corneal fluorescein staining(CFS)score,non-invasive tear breakup time(NIBUT),tear meniscus height(TMH),lipid layer thickness(LLT),and incomplete blink rate(IBR)were assessed in patients preoperatively and at 1wk,1,and 3mo postoperatively.The Ocular Surface Disease Index(OSDI)questionnaire was also administered.RESULTS:Totally 119 patients(238 eyes)were randomly divided into the DQS4 group(60 individuals with 120 eyes)and DQS6 group(59 individuals with 118 eyes).From 1wk to 1mo after FS-LASIK,the CFS score in the DQS6 group decreased with statistical significance(P=0.014),while the DQS4 group showed an upward trend.Comparing with preoperative values,the NIBUT of both groups was significantly prolonged at various time points after FS-LASIK(P<0.05).Within 1mo post FS-LASIK,both groups had significantly higher OSDI scores compared with preoperative values(P<0.05).At postoperative 3mo,the DQS4 group recovered to a level similar to that before surgery(P>0.05),while the DQS6 group remained a little higher than preoperative values(P>0.05).The TMH levels in the DQS4 group increased significantly at 1wk postoperatively(P<0.05),while there was no statistically significant change in the TMH levels in the DQS6 group(P>0.05).There was no significant difference in IBR and LLT between the two groups within 1mo postoperatively.At postoperative 3mo,the LLT in the DQS4 group was significantly higher than that in the DQS6 group(P<0.05).CONCLUSION:Within 1mo post-FS-LASIK,applying DQS six times daily is superior to four daily applications in improving CFS score,and in increasing NIBUT meanwhile.After 1mo,applying DQS four times daily also effectively alleviate DE symptoms and improve DE signs.Therefore,we recommend DE patients using DQS eye drops 6 times daily within 1mo after FS-LASIK,and maintaining it 4 times daily until 3mo postoperatively.展开更多
Objective:To investigate the anti-inflammatory,antioxidant,and goblet cell-stimulating effects of a suspension of Ophiopogon japonicus(L.f.)Ker Gawl.(O.japonicus,Mai Dong)extract combined with hyaluronic acid(HA)in th...Objective:To investigate the anti-inflammatory,antioxidant,and goblet cell-stimulating effects of a suspension of Ophiopogon japonicus(L.f.)Ker Gawl.(O.japonicus,Mai Dong)extract combined with hyaluronic acid(HA)in the mouse model with dry eye disease(DED).Methods:A DED mouse model was induced using benzalkonium chloride(BAK),followed by treatment with O.japonicus extract-containing eye drops at varying concentrations.Experimental groups included a normal control,a DED model control,a positive control,and an O.japonicus extract-treated group.Corneal fluorescein staining and tear break-up time(TBUT)were used to assess tear film stability and ocular surface integrity.Enzyme-linked immunosorbent assay(ELISA)measured inflammatory factor levels in corneal and conjunctival tissues,whereas Western blot(WB)analyzed key antioxidant and inflammatory markers,including nuclear factor erythroid 2-related factor(2Nrf2)and heme oxygenase 1(HO-1).Periodic acid-schiff(PAS)staining and immunofluorescence were used to evaluate goblet cell density and mucin secretion.Results:O.japonicus extract significantly improved corneal damage,reduced fluorescein staining scores,prolonged TBUT,and increased tear secretion.It downregulated inflammatory markers,including interleukin-8(IL-8),interleukin-1β(IL-1β),and interferon-g(IFN-γ)while upregulating Nrf2,HO-1,and the interleukin-13(IL-13)/IFN-γ ratio,alleviating oxidative stress and inflammation.PAS staining showed increased conjunctival goblet cell density and restored mucin secretion,enhancing tear film stability.Conclusion:O.japonicus extract demonstrated significant anti-inflammatory,antioxidant,and goblet cell-stimulating effects in a DED model,with good biocompatibility and promising therapeutic potential.Future research should optimize extraction processes and validate their efficacy and safety in clinical settings.展开更多
Dry eye disease(DED)is a multifactorial disorder that disturbs ocular surface equilibrium,considerably diminishing quality of life.Present therapies only offer symptomatic alleviation.Stem cell treatment,especially me...Dry eye disease(DED)is a multifactorial disorder that disturbs ocular surface equilibrium,considerably diminishing quality of life.Present therapies only offer symptomatic alleviation.Stem cell treatment,especially mesenchymal stem cells(MSCs),has surfaced as a viable approach for tissue regeneration and immunological regulation in DED.Preclinical and early clinical investigations indicate that MSCs can improve lacrimal gland functionality,diminish inflammation,and facilitate corneal regeneration.Nonetheless,obstacles persist in enhancing MSC viability,determining the optimal MSC source,and guaranteeing sustained therapeutic effectiveness.Additional extensive randomized clinical trials are required to confirm the efficacy of MSC-based therapies for severe DED.展开更多
Background:Dry eye disease(DED)predominantly results from elevated tear film os-molarity,which can not only cause ocular inconvenience but may lead to visual impair-ments,severely compromising patient well-being and e...Background:Dry eye disease(DED)predominantly results from elevated tear film os-molarity,which can not only cause ocular inconvenience but may lead to visual impair-ments,severely compromising patient well-being and exerting substantial economic burdens as well.Astaxanthin(AST),a member of the xanthophylls and recognized for its robust abilities to combat inflammation and oxidation,is a common dietary sup-plement.Nonetheless,the precise molecular pathways through which AST influences DED are still poorly understood.Methods:Therapeutic targets for AST were identified using data from the GeneCards,PharmMapper,and Swiss Target Prediction databases,and STITCH datasets.Similarly,targets for dry eye disease(DED)were delineated leveraging resources such as the Therapeutic Target Database(TTD),DisGeNET,GeneCards,and OMIM databases,and DrugBank datasets.Interactions among shared targets were charted and dis-played using CytoScape 3.9.0.Gene Ontology and Kyoto Encyclopedia of Genes and Genomes pathway analyses were conducted to elucidate the functions of pivotal tar-gets within the protein-protein interaction network.Molecular interactions between AST and key targets were confirmed through molecular docking using AutoDock and PyMOL.Molecular dynamics simulations were performed using GROMACS 2022.3.Viability of human corneal epithelial cells(hCEC)was assessed across varying concen-trations of AST.A mouse model of experimental DED was developed using 0.1%ben-zalkonium chloride(BAC),and the animals were administered 100 mg/kg/day of AST orally for 7 days.The efficacy of the treatments was assessed through a series of di-agnostic tests to evaluate the condition of the ocular surface after the interventions.The levels of inflammation and oxidative stress were quantitatively assessed using methods such as reverse transcription-polymerase chain reaction(RT-PCR),Western blot,and immunofluorescence staining.Results:Network pharmacology suggests that AST may alleviate DED by influenc-ing oxidation-reduction signaling pathways and reducing oxidative stress provoked by BAC.In vivo experiments demonstrated an improved overall condition in AST-administered mice in contrast to the control group.Immunofluorescence staining analyses indicated a decrease in Keap1 protein in the corneal tissues of AST-treated mice and a significant increase in Nrf2 and HO-1 protein.In vitro studies demon-strated that AST significantly enhanced cell viability and suppressed reactive oxy-gen species expression under hyperosmotic(HS)conditions,thereby protecting the human corneal epithelium.Conclusion:AST is capable of shielding mice from BAC-induced DED,decelerating the progression of DED,and mitigating oxidative stress damage under HS conditions in hCEC cells.The protective impact of AST on DED may operate through stimulating the Keap1-Nrf2/HO-1 signaling pathway.Our research findings indicate that AST may be a promising treatment for DED,offering new insights into DED treatment.展开更多
As we all know,eyes are the windows of our souls.They make us see the colorful world and understand others’feelings.However,by①the wide use of digital devices like smartphones and computers,many of us are facing eye...As we all know,eyes are the windows of our souls.They make us see the colorful world and understand others’feelings.However,by①the wide use of digital devices like smartphones and computers,many of us are facing eye problems.So,it's important to protect our eyes。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
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 Dry eye,also known as keratoconjunctival dryness,refers to a group of conditions that lead to eye discomfort and visual dysfunction.Being one of the most common complications of diabetes,it can lead to visi...BACKGROUND Dry eye,also known as keratoconjunctival dryness,refers to a group of conditions that lead to eye discomfort and visual dysfunction.Being one of the most common complications of diabetes,it can lead to vision loss and,in severe cases,blindness in patients with diabetes.AIM To investigate ocular dryness manifestations,assess corneal neuropathy,and identify associated influencing factors in patients with type 2 diabetes(T2D)complicated with comorbid dry eye syndrome(DES).METHODS Data from 81 patients with T2D admitted to Xianyang First People’s Hospital between January 2022 and June 2023(18 months)were retrospectively reviewed.Patients were divided into the DES and non-DES groups.Additionally,50 individuals who concurrently underwent medical examinations served as the control group.Standardized assessments were conducted,including evaluations using the standard patient evaluation of eye dryness(SPEED)tool,noninvasive tear film breakup time(NIBUT)analysis,and Schirmer I test(SIt)determination of wetting length.Under a corneal confocal microscope,subbasal corneal neuropathy evaluations were conducted to determine the density,length,number,and tortuosity of the main nerves.Associations among SPEED scores,NIBUT,SIt results,and subbasal corneal neuropathy parameters in the DES group were examined.The DES and non-DES groups were further analyzed for differences in baseline characteristics,and potential risk factors for DES in patients with T2D were identified by multivariate logistic regression modeling.RESULTS The T2D+DES group showed an increase in the SPEED score,along with a decrease in the NIBUT and SIt wetting length,compared with the non-DES and control groups(P<0.05);however,no marked inter-group differences were noted for fluorescein staining test scores between T2D+DES group and DES group.Compared with the non-DES groups,the DES group exhibited reductions in density,length,and number of the main nerves,as well as an increase in nerve tortuosity(all P<0.05),and all these changes were more pronounced in the non-DES group than in the DES group(all P<0.05).In the DES group,the SPEED score demonstrated a significant negative correlation with nerve density and the length and number of the main nerves but a positive correlation with nerve tortuosity.Conversely,both the NIBUT and SIt wetting length showed a positive association with the density and number of the main nerves;however,the SIt wetting length demonstrated an inverse correlation with nerve tortuosity.Multivariate modeling identified several independent risk factors for DES in T2D,such as age,diabetes duration,lacrimal gland dysfunction,and insufficient insulin secretion,as well as fasting blood glucose and glycated hemoglobin.CONCLUSION Patients with T2D are more susceptible to DES.The T2D+DES group exhibited significant reductions in the density,length,and count,along with increased tortuosity,of the main nerve.These corneal nerve changes are also intimately linked to the severity of DES.展开更多
文摘BACKGROUND Dry eye disease(DED)is a multifactorial ocular surface disorder with rising prevalence.It is closely related to systemic health and psychological factors,such as sleep and mood disorders,which significantly impact the quality of life of patients.AIM To explore the correlations between ocular surface function,sleep quality,and anxiety/depression in patients with DED.METHODS This was a cross-sectional investigative study that included 358 patients with DED between January 2022 and January 2025.Ocular surface was assessed using the ocular surface disease index(OSDI),tear film break-up time,fluorescein staining score,and Schirmer I test.The Pittsburgh Sleep Quality Index(PSQI),Self-Rating Anxiety Scale(SAS),and Self-Rating Depression Scale(SDS)were used to evaluate sleep quality and anxiety/depression levels.Correlation and linear regression analyses were used to explore the relationships.RESULTS The mean PSQI score of the patients was 9.94±2.18;the mean SAS score was 47.30±4.90,and the mean SDS score was 50.08±5.52.These suggested a prevalence of sleep and psychological abnormalities.There was a significant correlation between the indicators of ocular surface function(OSDI,tear film break-up time,fluorescein staining,and Schirmer I test)and PSQI,SAS,and SDS scores(P<0.05).Moreover,multiple regression revealed that age≥50 years(β=1.55,P=0.029),PSQI scores(β=0.58,P<0.001),SAS scores(β=0.17,P=0.017),and SDS scores(β=0.15,P=0.019)were independent predictors of the OSDI scores.CONCLUSION Ocular surface function in patients with DED is closely related to sleep quality and anxiety/depression,emphasizing the need for holistic clinical management.
文摘AIM:To evaluate 3%diquafosol ophthalmic solution on ocular surface parameters and the alterations of lipid and muco-aqueous layer in tear film of patients with visual display terminal(VDT)-associated dry eye disease(DED).METHODS:This study included patients with VDTassociated DED.It was a prospective single-arm interventional clinical trial.Patients were provided with 3%diquafosol ophthalmic solution for 3mo and were followed up in 1,2 and 3mo after treatment.Tear breakup time(TBUT),ocular surface staining score,and ocular surface disease index(OSDI)score were ocular surface characteristics.Lipid layer thickness(LLT),tear meniscus height(TMH),and mucin mRNA expression levels(MUC1,MUC4,MUC5AC,MUC16,and MUC20)were used to measure changes in the tear film.The LipiView interferometer was used to measure the partial blink rate(PBR).RESULTS:Sixty-eight eyes of 68 participants(54 females;mean age 25.12±4.10y;mean spherical equivalent-4.35±2.69 D)were enrolled.Compared with the pre-treatment,OSDI scores and TBUT improved significantly at all follow-up time points(all P<0.01),and TMH increased significantly at 1 and 3mo(P<0.01,P<0.001,respectively).Conjunctival lissamine green staining improved only at 2mo(P<0.05),while corneal fluorescein staining showed no significant changes.Overall LLT remained unchanged,but the PBR<1 subgroup exhibited significant LLT elevation at 3mo(P<0.05),unlike the PBR=1 subgroup.Conjunctival mRNA expression of MUC1,MUC5AC,MUC16,and MUC20 was significantly upregulated at 1 and 3mo(all P<0.01),and MUC4 expression increased significantly only at 1mo(P<0.001).CONCLUSION:In patients with VDT-associated DED,3%diquafosol ophthalmic solution dramatically reduced symptoms and enhanced tear film stability by promoting ocular surface muco-aqueous secretion.Patients with better blinking habits(PBR<1)demonstrate greater LLT improvement than those with poorer habits.
基金Supported by the Key Program of the National Natural Science Foundation of China(No.82530034)the National Natural Science Foundation of China(No.82271054)the Nature Science Foundation of Xiamen,China(No.3502Z20227121).
文摘AIM:To investigate the impact of depression-like behavior on ocular surface homeostasis in a mouse model,with a focus on dry eye-like alterations.METHODS:Male C57BL/6J mice(10-12 weeks old)were randomly assigned to control or restraint stress(RS)groups.The RS group underwent three intermittent 24-hour restraint sessions to induce depressive-like behavior.Behavioral testing,tear secretion measurement,and corneal Oregon Green Dextran(OGD)staining were performed.Postmortem analyses included histological evaluation of lacrimal glands,goblet cell quantification using periodic acid-Schiff staining,and assessment of key inflammatory and apoptotic markers:interleukin(IL)-17,matrix metalloproteinases(MMP)-3,MMP-9,IL-13,interferon(IFN)-γ,and cleaved caspase-3 and-8.RESULTS:Repeated RS induced depression-like behavior and significant ocular surface changes.RStreated mice showed increased corneal OGD uptake and upregulation of gene/protein expression of IL-17,MMP-3,and MMP-9(P<0.05).Goblet cell density and IL-13 protein expression were reduced,while IFN-γprotein expression was elevated(P<0.05).Cleaved caspase-3 and-8 levels were significantly increased in both cornea and conjunctiva.Tear volume and lacrimal gland size were unchanged;however,mild inflammatory infiltration was observed in lacrimal glands.CONCLUSION:Repeated RS leads to ocular surface inflammation and dry eye-like pathology,including corneal barrier disruption,goblet cell loss,and epithelial apoptosis.These findings suggest that depression contributes to the pathogenesis of dry eye disease via immune-mediated mechanisms.
基金Supported by Beijing YouAn Hospital Construction of Talent Pool Program(No.YARCKB2024001).
文摘AIM:To evaluate ocular surface characteristics and dry eye symptoms in primary biliary cholangitis(PBC)patients with seasonal allergic conjunctivitis(SAC).METHODS:This retrospective case-control study included 73 PBC patients:38 with SAC(PBC+SAC group,38 eyes)and 35 controls(35 eyes).All the participants underwent comprehensive ocular surface assessment and ocular surface disease index(OSDI)scoring.The severity of ocular allergy in PBC+SAC group was indicated by total ocular symptom score(TOSS),and correlation analysis was carried out between TOSS and ocular parameters.RESULTS:Age(59.60±10.69y vs 58.72±11.13y,P=0.629)and gender distribution(34 vs 32 females,P=0.713)did not differ significantly between groups.Compared to controls,the PBC+SAC group had higher dry eye prevalence(65.79%vs 28.57%,P=0.002),higher OSDI score[median:34.3(interquartile range,IQR:26.05,43.6)vs 21.2(IQR:15.15,31.2),P<0.001],shorter non-invasive tear film breakup time[NIBUT,median:4.16s(IQR:2.52,6.48)vs 6.88s(IQR:4.81,9.28),P<0.001],more severe upper meibomian gland loss(P<0.001),higher corneal fluorescein staining score[median:1(IQR:0,1)vs 0(IQR:0,0.25),P<0.001],and higher rates of meibomian gland duct thinning(60.53%vs 31.43%,P=0.004)and distortion(73.68%vs 25.71%,P=0.001).TOSS was positively correlated with OSDI score(r=0.484,P<0.001)in PBC+SAC group but not with other ocular parameters(all P>0.05).CONCLUSION:PBC patients with SAC have higher dry eye prevalence and more severe dry eye symptoms,mainly evaporative dry eye with obvious upper meibomian gland morphological abnormalities.Allergic symptom severity is positively correlated with dry eye discomfort,suggesting allergic inflammation may exacerbate ocular surface burden in PBC patients.
文摘AIM:To evaluate the efficacy and safety of 3%diquafosol sodium eye drops in children wearing orthokeratology lenses and with dry eye disease(DED)or at risk of DED.METHODS:Randomized controlled trials.Children with DED or at risk of DED were randomly assigned in a 1∶1 ratio to receive either 3%diquafosol sodium eye drops 6 times daily or a blank control at Chongqing Aier Children’s Eye Hospital from November 2023 to November 2024.The primary endpoint was the change in the Dry Eye Questionnaire-5(DEQ-5)score from baseline at 12 wk.Secondary assessments included non-invasive breakup time(NIBUT),tear meniscus height,Schirmer’s test,corneal fluorescein staining score,and axial length.RESULTS:A total of 80 participants(80 eyes)were enrolled(40 in each group),the average age of the participants was 11.11±1.88 years,with 43 females(54%)and 37 males(46%),and all completed the trial.After 12 wk,the DEQ-5 scores for the diquafosol sodium group and the blank control group were 1.88±2.02 and 2.88±2.79,respectively(P=0.079).The diquafosol sodium group demonstrated a significant improvement in DEQ-5 dryness symptom scores(-0.33±0.66 vs.0.05±0.81,P=0.023)and NIBUT(6.18±3.73 vs.-1.09±4.40 s,P<0.001)at 12 wk.Additionally,the diquafosol sodium group showed no axial length elongation,in contrast to the blank control group,which exhibited elongation(0.00±0.08 vs.0.05±0.10 mm,P=0.013).No other significant differences were found in the secondary endpoints.No adverse events occurred during the trial.CONCLUSION:Although no statistically significant improvements were noted in the overall DEQ-5 scores,the 3%diquafosol sodium eye drops significantly improved dryness symptoms and NIBUT when compared to the blank control group.
基金Supported by High and New Technology Project of Hainan Key Research and Development Plan(No.ZDYF2024GXJS032)Health Care Special Project of PLA Logistics Research Fund(No.23BJZ37)Scientific Research Project of Health Industry in Hainan Province(No.22A200351).
文摘AIM:To evaluate nanosilver eye patches versus Atrauman nanosilver dressings for ocular surface trauma.METHODS:This randomized non-inferiority trial(November 2024-April 2025)enrolled 60 patients assessed pre-treatment and on days 1,7,and 14 post-treatment.The patients were then randomized into treatment(nanosilver eye patches)and control groups(Atrauman nanosilver dressings).Outcomes included wound healing,comfort(Ocular Comfort Index,OCI),and safety.Statistical analyses used t-tests,non-inferiority tests,and Chi-square tests.RESULTS:Patient baseline characteristics were comparable between groups,with a mean age of 60.633±10.934 in the treatment group versus 64.933±9.606 in controls,and similar gender distribution(20/10 vs 17/13 male/female).Both groups showed comparable baseline OCI scores(treatment group:6.100±2.187 vs control group:6.267±2.303,P=0.775).Following treatment,scores increased significantly at day 1(treatment group:9.367±2.251;control group:9.067±2.212,both P<0.001 vs baseline).Marked improvement was observed by day 7(treatment group:4.067±1.929;control group:3.900±1.918,P<0.001 vs baseline),with complete resolution at day 14(0.467±0.860 vs 0.467±1.008,P<0.001).The non-inferiority criterion was met.The treatment group showed greater improvement in Grade A wound healing rates(76.67%to 93.33%)compared to controls(80.00%to 86.67%)between 1 and 7d post-treatment.By 14d posttreatment,all patients achieved Grade A healing in both groups,with no Grade C cases observed throughout the study period.No adverse events were reported.CONCLUSION:Nanosilver eye patches are non-inferior to Atrauman dressings,offering effective,safe emergency care for ocular trauma.
基金Princess Nourah bint Abdulrahman University Researchers Supporting Project number(PNURSP2026R77)Princess Nourah bint Abdulrahman University,Riyadh,Saudi Arabia,the Deanship of Scientific Research at Northern Border University,Arar,Saudi Arabia,through the project number NBU-FFR-2026-2248-01.
文摘Globally,diabetes and glaucoma account for a high number of people suffering from severe vision loss and blindness.To treat these vision disorders effectively,proper diagnosis must occur in a timely manner,and with conventional methods such as fundus photography,optical coherence tomography(OCT),and slit-lamp imaging,much depends on an expert’s interpretation of the images,making the systems very labor-intensive to operate.Moreover,clinical settings face difficulties with inter-observer variability and limited scalability with these diagnostic devices.To solve these problems,we have developed the Efficient Channel-Spatial Attention Network(ECSA-Net),a new deep learning-based methodology that integrates lightweight channel-and spatial-attention modules into a convolutional neural network.Ultimately,ECSA-Net improves the efficiency of computational resource use while enhancing discriminative feature extraction from retinal images.The ECSA-Net methodology was validated by conducting a series of classification accuracy tests using two publicly available eye disease datasets and was benchmark against a number of different pretrained convolutional neural network(CNN)architectures.The results showed that the ECSA-Net achieved classification accuracies of 60.00%and 69.92%,respectively,while using only a compact architecture with 0.56 million parameters.This represents a reduction in parameter size by a factor of 14×to 247×compared to other pretrained models.Additionally,the attention modules added to the architecture significantly increased sensitivity to disease-relevant regions of the retina while maintaining low computational cost,making ECSA-Net a viable option for real-time clinical use.ECSA-Net is both efficient and accurate in automating the classification of eye diseases,combining high performance with the ethical considerations of medical artificial intelligence(AI)deployment.The ECSA-Net frameworkmitigates algorithmic bias in training datasets and protects individuals’privacy and transparency in decision-making,thereby facilitating human-AI collaboration.The two areas of technical performance and ethical integration are needed for the responsible and scalable use of ECSA-Net in a variety of ophthalmic care settings.
文摘Numerous sectors,such as education,the IT sector,and corporate organizations,transitioned to virtual meetings after the COVID-19 crisis.Organizations now seek to assess participants’fatigue levels in online meetings to remain competitive.Instructors cannot effectively monitor every individual in a virtual environment,which raises significant concerns about participant fatigue.Our proposed system monitors fatigue,identifying attentive and drowsy individuals throughout the online session.We leverage Dlib’s pre-trained facial landmark detector and focus on the eye landmarks only,offering a more detailed analysis for predicting eye opening and closing of the eyes,rather than focusing on the entire face.We introduce an Eye Polygon Area(EPA)formula,which computes eye activity from Dlib eye landmarks by measuring the polygonal area of the eye opening.Unlike the Eye Aspect Ratio(EAR),which relies on a single distance ratio,EPA adapts to different eye shapes(round,narrow,or wide),providing a more reliable measure for fatigue detection.The VMFD system issues a warning if a participant remains in a fatigued condition for 36 consecutive frames.The proposed technology is tested under multiple scenarios,including low-to high-lighting conditions(50-1400 lux)and both with and without glasses.This study builds an OpenCV application in Python,evaluated using the iBUG 300-W dataset,achieving 97.5%accuracy in detecting active participants.We compare VMFD with conventional methods relying on the EAR and show that the EPA technique performs significantly better.
基金supported by the National Natural Science Foundation of China,No.82171080Nanjing Medical Science and Technology Development Project,No.YKK23264Postgraduate Research&Practice Innovation Program of Jiangsu Province,Nos.JX10414151,JX10414152(all to KL)。
文摘Age-related macular degeneration is a serious neurodegenerative disease of the retina that significantly impacts vision.Unfortunately,the specific pathogenesis remains unclear,and effective early treatment options are consequently lacking.The microbiome is defined as a large ecosystem of microorganisms living within and coexisting with a host.The intestinal microbiome undergoes dynamic changes owing to age,diet,genetics,and other factors.Such dysregulation of the intestinal flora can disrupt the microecological balance,resulting in immunological and metabolic dysfunction in the host,and affecting the development of many diseases.In recent decades,significant evidence has indicated that the intestinal flora also influences systems outside of the digestive tract,including the brain.Indeed,several studies have demonstrated the critical role of the gut-brain axis in the development of brain neurodegenerative diseases,including Alzheimer’s disease and Parkinson’s disease.Similarly,the role of the“gut-eye axis”has been confirmed to play a role in the pathogenesis of many ocular disorders.Moreover,age-related macular degeneration and many brain neurodegenerative diseases have been shown to share several risk factors and to exhibit comparable etiologies.As such,the intestinal flora may play an important role in age-related macular degeneration.Given the above context,the present review aims to clarify the gut-brain and gut-eye connections,assess the effect of intestinal flora and metabolites on age-related macular degeneration,and identify potential diagnostic markers and therapeutic strategies.Currently,direct research on the role of intestinal flora in age-related macular degeneration is still relatively limited,while studies focusing solely on intestinal flora are insufficient to fully elucidate its functional role in age-related macular degeneration.Organ-on-a-chip technology has shown promise in clarifying the gut-eye interactions,while integrating analysis of the intestinal flora with research on metabolites through metabolomics and other techniques is crucial for understanding their potential mechanisms.
基金Supported by National Natural Science Foundation of China:Study on the Mechanism of Improving Cardiac Remodelling in Post-infarction Ischaemic Cardiomyopathy through lncRNA-Maternally Expressed Gene3/miR-223/Stromal Interaction Molecule 1 Calcium Signalling Axis by Activate Blood and Reassure Formula (No. 81973682)National Social Science Fund:Study on the Verification and Construction of the Theory System of Sanjiao Phase Fire and Yang Support Under the View of Civilisation Traceability (No. 21VJXG037)+1 种基金First Published:a Randomised Controlled Study of Fuyang Qiangxin Tang in the Treatment of Moderate to Severe Heart Failure (2024-1-4151)Project for Enhancing Clinical Research and Achievement Transformation Capabilities of High-Level Traditional Chinese Medicine Hospitals:Evaluation of the Efficacy and Preclinical Study of Fuyang Qiangxin Granules, a Traditional Chinese Medicine for Heart Failure (HLCMHPP2023045)
文摘OBJECTIVE:To explore the clinical observation of white eye distribution characteristics of hyperlipidemic patients based on artificial intelligence digital eye diagnosis technology.METHODS:One hundred and fifty subjects were examined in the outpatient and inpatient departments of Guang'anmen Hospital of the China Academy of Traditional Chinese Medicine from 01 February 2022 to 01 February 2023,including 80 cases in the hyperlipidemic patient(HLP)group and 70 cases in the normal lipid level patient(NC)group.The two groups were collected and extracted by the artificial intelligence visual diagnostic instrument and analyzed by the MyEyeD-10 white eye shadowless imaging health intelligence analysis system.Finally,SPSS 26.0(Version X;IBM Corp.,Armonk,NY,USA)was used for statistical processing.RESULTS:Significant differences were noted in the scores of"spot"and"foggy"features between the two groups.Between groups,the"spot"feature score of the white eye morphology in the HLP group(11.07±3.22)was higher than that in the NC group(7.50±4.11)(P<0.01).Moreover,the"foggy"feature score of the eye morphology in the HLP group(8.37±2.25)was higher than that in the NC group(P<0.01),higher than that of the NC group(5.72±1.21)(P<0.05).There were significant differences in the"A"(stomach),"B","O"(spleen),and"M"(liver)eye-contact region scores between the two groups,and the"B","O"(spleen)and"M"(liver)eye-contact region scores were significantly different.The scores of the white eye channel region in the HLP group were significantly higher than those in the control group,with the"A","B",and"O"regions(P<0.01),"M"region(P<0.01),"A","B","O",and"M"region(P<0.01)."M"zone(P<0.05).The scores of"dull red"and"yellow"features were significantly different,and the scores of"dull red"and"yellow"colors of the white eye choroid in the HLP group were significantly higher than those in the HLP group.The scores of"dull red"and"yellow"were significantly higher in the HLP group than in the NC group(P<0.01).CONCLUSION:The morphological features of the white eye ocular image,the white eye chakra's color,and the bulbar conjunctiva's vascular zoning are closely related to hyperlipidemia.Importantly,these provide a reference for the objectivity and precision of the identification of Chinese medicine by looking at the eyes.
基金Supported by National Natural Science Foundation of China(No.82271062)Tianjin Key Medical Discipline(Specialty)Construction Project(No.TJYXZDXK-037A)Tianjin Science and Technology Bureau(No.21JCZDJC01010).
文摘AIM:To compare the efficacy of 3%diquafosol sodium(DQS)eye drops at different frequencies in dry eye(DE)after femtosecond laser-assisted in situ keratomileusis(FS-LASIK).METHODS:In this prospective study,DE patients after FS-LASIK were randomly divided into two groups.All patients were administered routine anti-inflammatory and anti-infective drugs after FS-LASIK.Additionally,both groups were treated with DQS,at frequencies of 4(DQS4 group)and 6(DQS6 group)times daily.Corneal fluorescein staining(CFS)score,non-invasive tear breakup time(NIBUT),tear meniscus height(TMH),lipid layer thickness(LLT),and incomplete blink rate(IBR)were assessed in patients preoperatively and at 1wk,1,and 3mo postoperatively.The Ocular Surface Disease Index(OSDI)questionnaire was also administered.RESULTS:Totally 119 patients(238 eyes)were randomly divided into the DQS4 group(60 individuals with 120 eyes)and DQS6 group(59 individuals with 118 eyes).From 1wk to 1mo after FS-LASIK,the CFS score in the DQS6 group decreased with statistical significance(P=0.014),while the DQS4 group showed an upward trend.Comparing with preoperative values,the NIBUT of both groups was significantly prolonged at various time points after FS-LASIK(P<0.05).Within 1mo post FS-LASIK,both groups had significantly higher OSDI scores compared with preoperative values(P<0.05).At postoperative 3mo,the DQS4 group recovered to a level similar to that before surgery(P>0.05),while the DQS6 group remained a little higher than preoperative values(P>0.05).The TMH levels in the DQS4 group increased significantly at 1wk postoperatively(P<0.05),while there was no statistically significant change in the TMH levels in the DQS6 group(P>0.05).There was no significant difference in IBR and LLT between the two groups within 1mo postoperatively.At postoperative 3mo,the LLT in the DQS4 group was significantly higher than that in the DQS6 group(P<0.05).CONCLUSION:Within 1mo post-FS-LASIK,applying DQS six times daily is superior to four daily applications in improving CFS score,and in increasing NIBUT meanwhile.After 1mo,applying DQS four times daily also effectively alleviate DE symptoms and improve DE signs.Therefore,we recommend DE patients using DQS eye drops 6 times daily within 1mo after FS-LASIK,and maintaining it 4 times daily until 3mo postoperatively.
基金the National Natural Science Foundation of China(82070928 and 82171026).
文摘Objective:To investigate the anti-inflammatory,antioxidant,and goblet cell-stimulating effects of a suspension of Ophiopogon japonicus(L.f.)Ker Gawl.(O.japonicus,Mai Dong)extract combined with hyaluronic acid(HA)in the mouse model with dry eye disease(DED).Methods:A DED mouse model was induced using benzalkonium chloride(BAK),followed by treatment with O.japonicus extract-containing eye drops at varying concentrations.Experimental groups included a normal control,a DED model control,a positive control,and an O.japonicus extract-treated group.Corneal fluorescein staining and tear break-up time(TBUT)were used to assess tear film stability and ocular surface integrity.Enzyme-linked immunosorbent assay(ELISA)measured inflammatory factor levels in corneal and conjunctival tissues,whereas Western blot(WB)analyzed key antioxidant and inflammatory markers,including nuclear factor erythroid 2-related factor(2Nrf2)and heme oxygenase 1(HO-1).Periodic acid-schiff(PAS)staining and immunofluorescence were used to evaluate goblet cell density and mucin secretion.Results:O.japonicus extract significantly improved corneal damage,reduced fluorescein staining scores,prolonged TBUT,and increased tear secretion.It downregulated inflammatory markers,including interleukin-8(IL-8),interleukin-1β(IL-1β),and interferon-g(IFN-γ)while upregulating Nrf2,HO-1,and the interleukin-13(IL-13)/IFN-γ ratio,alleviating oxidative stress and inflammation.PAS staining showed increased conjunctival goblet cell density and restored mucin secretion,enhancing tear film stability.Conclusion:O.japonicus extract demonstrated significant anti-inflammatory,antioxidant,and goblet cell-stimulating effects in a DED model,with good biocompatibility and promising therapeutic potential.Future research should optimize extraction processes and validate their efficacy and safety in clinical settings.
文摘Dry eye disease(DED)is a multifactorial disorder that disturbs ocular surface equilibrium,considerably diminishing quality of life.Present therapies only offer symptomatic alleviation.Stem cell treatment,especially mesenchymal stem cells(MSCs),has surfaced as a viable approach for tissue regeneration and immunological regulation in DED.Preclinical and early clinical investigations indicate that MSCs can improve lacrimal gland functionality,diminish inflammation,and facilitate corneal regeneration.Nonetheless,obstacles persist in enhancing MSC viability,determining the optimal MSC source,and guaranteeing sustained therapeutic effectiveness.Additional extensive randomized clinical trials are required to confirm the efficacy of MSC-based therapies for severe DED.
基金supported by grants from the Beijing Municipal Public Welfare Development and Reform Pilot Project for Medical Research Institutes(PWD&RPP-MRI,JYY2023-6)the R&D Program of Beijing Municipal Education Commission(KZ20231002543).
文摘Background:Dry eye disease(DED)predominantly results from elevated tear film os-molarity,which can not only cause ocular inconvenience but may lead to visual impair-ments,severely compromising patient well-being and exerting substantial economic burdens as well.Astaxanthin(AST),a member of the xanthophylls and recognized for its robust abilities to combat inflammation and oxidation,is a common dietary sup-plement.Nonetheless,the precise molecular pathways through which AST influences DED are still poorly understood.Methods:Therapeutic targets for AST were identified using data from the GeneCards,PharmMapper,and Swiss Target Prediction databases,and STITCH datasets.Similarly,targets for dry eye disease(DED)were delineated leveraging resources such as the Therapeutic Target Database(TTD),DisGeNET,GeneCards,and OMIM databases,and DrugBank datasets.Interactions among shared targets were charted and dis-played using CytoScape 3.9.0.Gene Ontology and Kyoto Encyclopedia of Genes and Genomes pathway analyses were conducted to elucidate the functions of pivotal tar-gets within the protein-protein interaction network.Molecular interactions between AST and key targets were confirmed through molecular docking using AutoDock and PyMOL.Molecular dynamics simulations were performed using GROMACS 2022.3.Viability of human corneal epithelial cells(hCEC)was assessed across varying concen-trations of AST.A mouse model of experimental DED was developed using 0.1%ben-zalkonium chloride(BAC),and the animals were administered 100 mg/kg/day of AST orally for 7 days.The efficacy of the treatments was assessed through a series of di-agnostic tests to evaluate the condition of the ocular surface after the interventions.The levels of inflammation and oxidative stress were quantitatively assessed using methods such as reverse transcription-polymerase chain reaction(RT-PCR),Western blot,and immunofluorescence staining.Results:Network pharmacology suggests that AST may alleviate DED by influenc-ing oxidation-reduction signaling pathways and reducing oxidative stress provoked by BAC.In vivo experiments demonstrated an improved overall condition in AST-administered mice in contrast to the control group.Immunofluorescence staining analyses indicated a decrease in Keap1 protein in the corneal tissues of AST-treated mice and a significant increase in Nrf2 and HO-1 protein.In vitro studies demon-strated that AST significantly enhanced cell viability and suppressed reactive oxy-gen species expression under hyperosmotic(HS)conditions,thereby protecting the human corneal epithelium.Conclusion:AST is capable of shielding mice from BAC-induced DED,decelerating the progression of DED,and mitigating oxidative stress damage under HS conditions in hCEC cells.The protective impact of AST on DED may operate through stimulating the Keap1-Nrf2/HO-1 signaling pathway.Our research findings indicate that AST may be a promising treatment for DED,offering new insights into DED treatment.
文摘As we all know,eyes are the windows of our souls.They make us see the colorful world and understand others’feelings.However,by①the wide use of digital devices like smartphones and computers,many of us are facing eye problems.So,it's important to protect our eyes。
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.
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 Dry eye,also known as keratoconjunctival dryness,refers to a group of conditions that lead to eye discomfort and visual dysfunction.Being one of the most common complications of diabetes,it can lead to vision loss and,in severe cases,blindness in patients with diabetes.AIM To investigate ocular dryness manifestations,assess corneal neuropathy,and identify associated influencing factors in patients with type 2 diabetes(T2D)complicated with comorbid dry eye syndrome(DES).METHODS Data from 81 patients with T2D admitted to Xianyang First People’s Hospital between January 2022 and June 2023(18 months)were retrospectively reviewed.Patients were divided into the DES and non-DES groups.Additionally,50 individuals who concurrently underwent medical examinations served as the control group.Standardized assessments were conducted,including evaluations using the standard patient evaluation of eye dryness(SPEED)tool,noninvasive tear film breakup time(NIBUT)analysis,and Schirmer I test(SIt)determination of wetting length.Under a corneal confocal microscope,subbasal corneal neuropathy evaluations were conducted to determine the density,length,number,and tortuosity of the main nerves.Associations among SPEED scores,NIBUT,SIt results,and subbasal corneal neuropathy parameters in the DES group were examined.The DES and non-DES groups were further analyzed for differences in baseline characteristics,and potential risk factors for DES in patients with T2D were identified by multivariate logistic regression modeling.RESULTS The T2D+DES group showed an increase in the SPEED score,along with a decrease in the NIBUT and SIt wetting length,compared with the non-DES and control groups(P<0.05);however,no marked inter-group differences were noted for fluorescein staining test scores between T2D+DES group and DES group.Compared with the non-DES groups,the DES group exhibited reductions in density,length,and number of the main nerves,as well as an increase in nerve tortuosity(all P<0.05),and all these changes were more pronounced in the non-DES group than in the DES group(all P<0.05).In the DES group,the SPEED score demonstrated a significant negative correlation with nerve density and the length and number of the main nerves but a positive correlation with nerve tortuosity.Conversely,both the NIBUT and SIt wetting length showed a positive association with the density and number of the main nerves;however,the SIt wetting length demonstrated an inverse correlation with nerve tortuosity.Multivariate modeling identified several independent risk factors for DES in T2D,such as age,diabetes duration,lacrimal gland dysfunction,and insufficient insulin secretion,as well as fasting blood glucose and glycated hemoglobin.CONCLUSION Patients with T2D are more susceptible to DES.The T2D+DES group exhibited significant reductions in the density,length,and count,along with increased tortuosity,of the main nerve.These corneal nerve changes are also intimately linked to the severity of DES.
