The retrospective study by Edwar et al reinforces the role of therapeutic penetrating keratoplasty(PK)as a vital intervention in severe,treatment-resistant infectious keratitis.In advanced cases—often complicated by ...The retrospective study by Edwar et al reinforces the role of therapeutic penetrating keratoplasty(PK)as a vital intervention in severe,treatment-resistant infectious keratitis.In advanced cases—often complicated by trauma,delayed presentation,and corneal perforation—PK restores globe integrity and provides limited visual recovery.However,its application is constrained by graft-related complications and donor shortages,particularly in low-resource settings.These limitations highlight the need for earlier,globe-sparing strategies to prevent progression and reduce surgical demand.Photoactivated chromophore for infectious keratitis-corneal collagen cross-linking(PACK-CXL)has emerged as a promising adjunct or alternative.With both antimicrobial and tissue-stabilizing effects,PACK-CXL may control infection and preserve corneal structure in earlier stages.A layered treatment framework that incorporates PACK-CXL as an initial intervention and reserves PK for refractory cases may help improve clinical outcomes.Further studies are needed to define their best use in practice.展开更多
Diabetic corneal neuropathy and diabetic retinopathy are ocular complications occurring in the context of diabetes mellitus.Diabetic corneal neuropathy refers to the progressive damage of corneal nerves.Diabetic retin...Diabetic corneal neuropathy and diabetic retinopathy are ocular complications occurring in the context of diabetes mellitus.Diabetic corneal neuropathy refers to the progressive damage of corneal nerves.Diabetic retinopathy has traditionally been considered as damage to the retinal microvasculature.However,growing evidence suggests that diabetic retinopathy is a complex neurovascular disorder resulting from dysfunction of the neurovascular unit,which includes both the retinal vascular structures and neural tissues.Diabetic retinopathy is one of the leading causes of blindness and is frequently screened for as part of diabetic ocular screening.However,diabetic corneal neuropathy is commonly overlooked and underdiagnosed,leading to severe ocular surface impairment.Several studies have found that these two conditions tend to occur together,and they share similarities in their pathogenesis pathways,being triggered by a status of chronic hyperglycemia.This review aims to discuss the interconnection between diabetic corneal neuropathy and diabetic retinopathy,whether diabetic corneal neuropathy precedes diabetic retinopathy,as well as the relation between the stage of diabetic retinopathy and the severity of corneal neuropathy.We also endeavor to explore the relevance of a corneal screening in diabetic eyes and the possibility of using corneal nerve measurements to monitor the progression of diabetic retinopathy.展开更多
AIM:To evaluate changes in corneal light scattering and anterior segment parameters in newly diagnosed rheumatoid arthritis(RA)patients who achieved remission with systemic treatment,compared to healthy controls.METHO...AIM:To evaluate changes in corneal light scattering and anterior segment parameters in newly diagnosed rheumatoid arthritis(RA)patients who achieved remission with systemic treatment,compared to healthy controls.METHODS:A cross-sectional study was conducted at a tertiary care hospital,in ophthalmology,and rheumatology departments.A total of 42 RA patients(13 men and 29 women)and 56 healthy individuals(23 men 33 women)underwent comprehensive ophthalmologic evaluations,including Scheimpflug corneal densitometry and Pentacam HR measurements.Those who initiated systemic treatment for RA were monitored at first,third,and sixth-month follow-ups.Participants who achieved remission at each follow-up assessment were included.RESULTS:Significant differences in corneal densitometry were observed,with higher values in RA patients,particularly in the middle and posterior layers.Anterior segment parameters such as anterior chamber volume and angle were significantly reduced in RA patients compared to other groups(P<0.001).Following systemic treatment and achievement of remission,these parameters showed regression toward normal values.CONCLUSION:The study underscores the potential utility of corneal densitometry and anterior segment analysis as sensitive indicators of subclinical ocular involvement in RA,offering insights into disease progression and treatment efficacy.These findings highlight the importance of early detection and regular monitoring in preventing vision-threatening complications in RA patients.展开更多
AIM:To assess the corneal biometric parameters and endothelial cell characteristics in microcornea patients,and exploring their correlations.METHODS:This cross-sectional study included 28 patients of microcornea with ...AIM:To assess the corneal biometric parameters and endothelial cell characteristics in microcornea patients,and exploring their correlations.METHODS:This cross-sectional study included 28 patients of microcornea with uveal coloboma(MCUC),13 patients of microcornea without coloboma(MCNC),and 30 age-matched healthy individuals(the control group).Corneal biometric parameters such as axial length(AL),anterior chamber depth(ACD),and white-to-white corneal diameter(WTW)were measured using the IOL Master.The corneal endothelial cell density(ECD),percentage of hexagonal cells(6A),average cell area(AVE),maximum cell area(MAX),minimum cell area(MIN),cell area standard deviation(SD),and coefficient of variation(CV)were collected by specular microscopy.RESULTS:This study included MCUC and MCNC patients with age-and sex-matched controls.All patients exhibited significantly reduced WTW(MCUC:8.51±0.71 mm;MCNC:9.08±0.42 mm)and worse logMAR BCVA(MCUC 0.62±0.43;MCNC 0.46±0.28)compared to controls(both P<0.001).The ECD was 3106.32±336.80 cells/mm²in the MCUC group and 2906.92±323.53 cells/mm²in the MCNC group,both significantly higher than the control group(2647.43±203.06 cells/mm²,P<0.05).In contrast,the CV,AVE,SD,and ACD in the MCUC and MCNC groups were significantly lower compared to controls(P<0.01).In patients with microcornea,the WTW was negatively correlated with the ECD and 6A,but positively with the CV,MAX,AVE,and SD.The ACD was negatively linked to the ECD,but positively to the AVE.CONCLUSION:The corneal ECD and 6A are increased,while the CV is decreased in patients with microcornea,particularly in those accompanied by uveal coloboma.The ECD and morphology demonstrate close correlations with the WTW and ACD.展开更多
Objective:To investigate the influence of axial length(AL),corneal curvature(CR),and the ratio of axial length to corneal radius of curvature(AL/CR)on myopia in children,and to evaluate the accuracy and specificity of...Objective:To investigate the influence of axial length(AL),corneal curvature(CR),and the ratio of axial length to corneal radius of curvature(AL/CR)on myopia in children,and to evaluate the accuracy and specificity of AL/CR in diagnosing myopia in children.Methods:A cross-sectional study was conducted.A total of 200 children(400 eyes)aged 6-12 years were recruited from the ophthalmology outpatient clinic of Fuling District People’s Hospital from December 2022 to December 2023.AL,CR,and AL/CR were measured,and comprehensive optometry was performed under cycloplegia,with the results recorded in spherical equivalent(SE)form.Results:A total of 200 subjects(400 eyes)were included in this study,of which 330 eyes(82.50%)were myopic.No significant differences in CR were observed among different refractive groups,while significant differences were noted in SE,AL,and AL/CR.The AL and AL/CR ratios were higher in myopic eyes compared to emmetropic and hyperopic eyes.Using cycloplegia as the gold standard,SE in the myopia group was correlated with AL,AL/CR,and CR,with stronger correlations observed with AL and AL/CR.An AL/CR value>3 demonstrated a sensitivity of 0.918,specificity of 0.786,misdiagnosis rate of 0.214,missed diagnosis rate of 0.082,and accuracy of 89.5%in diagnosing myopia.Conclusion:AL and AL/CR values are highly correlated with SE,with the strongest correlation observed in the myopia group.The AL/CR value exhibits high diagnostic value in determining myopia in children.展开更多
AIM:To investigate the relationship between preoperative corneal biomechanical properties and corneal tomographic properties in cataract patients.METHODS:The study consisted of 59 eyes of 30 participants who were diag...AIM:To investigate the relationship between preoperative corneal biomechanical properties and corneal tomographic properties in cataract patients.METHODS:The study consisted of 59 eyes of 30 participants who were diagnosed as cataract in Peking University Third Hospital between September 2019 and November 2019.Stepwise multivariable linear regression analysis was calculated to determine the relationship between corneal biomechanical parameters and tomographic parameters.The patients were classified into three groups of with the rule(WTR)astigmatism,against the rule astigmatism and oblique astigmatism.And the differences in corneal parameters among different groups were compared.RESULTS:There were significant differences in the first applanation time(A1T),the first applanation length(A1L),corneal velocity during the first applanation(Vin),the second applanation time(A2T),highest concavity(HC)radius,displacement amount(DA),DA ratio,stiffness parameter A1(SPA1)and integrated radius(IR)between oblique astigmatism patients and the other two groups.Total corneal steep meridian(K2)was negatively associated with A1L,A1T and corneal velocity during the second applanation(Vout).Patients with higher anterior corneal curvature had lower HC radius and central corneal thickness(CCT;P=0.001 and 0.006,respectively),while the Ambrosio relational thickness to the horizontal profile(ARTh)was higher than those with lower anterior corneal curvature(P=0.009).CONCLUSION:The study reveals that the elasticity of corneal collagen fibers is greater,but the viscoelasticity of cornea is smaller in patients with oblique astigmatism.There is no significant difference in ARTh between patients with different types of astigmatism,that is,the corneal biomechanical specificity of oblique astigmatism group is probably not caused by corneal thickness.Moreover,we find patients with higher anterior corneal curvature has lower HC radius and CCT but higher ARTh than those with lower anterior corneal curvature.展开更多
Introduction Fuchs endothelial corneal dystrophy(FECD)is an inherited,degenerative disease of the corneal endothelial cells(CECs).It is characterized by a progressive deterioration of endothelial cells,altered extrace...Introduction Fuchs endothelial corneal dystrophy(FECD)is an inherited,degenerative disease of the corneal endothelial cells(CECs).It is characterized by a progressive deterioration of endothelial cells,altered extracellular matrix(ECM)production,and development of guttae(1,2).The presence of guttae has been shown to significantly impair corneal endothelial function,leading to corneal oedema and visual impairment.展开更多
AIM:To assess the visual outcomes and corneal biomechanical properties of myopia patients between laser in situ keratomileusis(LASIK)and LASIK combined with accelerated corneal crosslinking(LASIK Xtra).METHODS:This pr...AIM:To assess the visual outcomes and corneal biomechanical properties of myopia patients between laser in situ keratomileusis(LASIK)and LASIK combined with accelerated corneal crosslinking(LASIK Xtra).METHODS:This prospective study analyzed 52 consecutive myopia patients treated with LASIK Xtra and 45 consecutive myopia patients treated with LASIK.Only the right eyes in the two groups were analyzed.The uncorrected distance visual acuity(UDVA),keratometry values,postoperative central corneal thickness(CCT),corneal demarcation line depth,the corneal compensated intraocular pressure(IOPcc),Goldmann-correlated IOP(IOPg),corneal resistance factor(CRF)and corneal hysteresis(CH)from Ocular Response Analyzer(ORA)were analyzed.Further,the correlation between the demarcation line depth and ORA-related biomechanical parameters were analyzed.RESULTS:No significant differences in UDVA,postoperative CCT,or mean K values were found between the 2 groups at 1 to 12mo postoperative follow-up(all P>0.05).The changes of CRF was significantly lower in the LASIK Xtra group compared to the LASIK group(all P<0.05)at all the postoperative visits.The changes of CH were significantly higher in the LASIK Xtra group(all P<0.05).No significant differences were discovered regarding the changes of IOPcc and IOPg posperatively(all P>0.05).Out of 52 cases in the LASIK Xtra group,the demarcation line was present in 40 eyes(77%).The average depth of the demarcation was 220.73±42.70μm(136 to 288μm).No significant correlation was observed between the depth of the demarcation line and any of the ORA-related biomechanical parameters such as IOPcc,IOPg,CRF and CH at 12mo(all P>0.05).CONCLUSION:Both procedures demonstrate comparable outcomes in terms of visual acuity,refraction and ablation predictability.This study confirms that corneal biomechanical properties of the included patients weakened after both procedures,but the cornea after LASIK Xtra are stiffer than conventional LASIK.展开更多
●AIM:To explore the clinical efficacy and safety of stromal lenticule addition keratoplasty(SLAK)with corneal crosslinking(CXL)on patients with corneal ectasia secondary to femtosecond laser-assisted in situ keratomi...●AIM:To explore the clinical efficacy and safety of stromal lenticule addition keratoplasty(SLAK)with corneal crosslinking(CXL)on patients with corneal ectasia secondary to femtosecond laser-assisted in situ keratomileusis(FS-LASIK).●METHODS:A series of 5 patients undertaking SLAK with CXL for the treatment of corneal ectasia secondary to FS-LASIK were followed for 4-9mo.The lenticules were collected from patients undertaking small incision lenticule extraction(SMILE)for the correction of myopia.Adding a stromal lenticule was aimed at improving the corneal thickness for the safe application of crosslinking and compensating for the thin cornea to improve its mechanical strength.●RESULTS:All surgeries were conducted successfully with no significant complications.Their best corrected visual acuity(BCVA)ranged from 0.05 to 0.8-2 before surgery.The pre-operational total corneal thickness ranged from 345-404μm and maximum keratometry(Kmax)ranged from 50.8 to 86.3.After the combination surgery,both the corneal keratometry(range 55.9 to 92.8)and total corneal thickness(range 413-482μm)significantly increased.Four out of 5 patients had improvement of corneal biomechanical parameters(reflected by stiffness parameter A1 in Corvis ST).However,3 patients showed decreased BCVA after surgery due to the development of irregular astigmatism and transient haze.Despite the onset of corneal edema right after SLAK,the corneal topography and thickness generally stabilized after 3mo.●CONCLUSION:SLAK with CXL is a potentially beneficial and safe therapy for advanced corneal ectasia.Future work needs to address the poor predictability of corneal refractometry and compare the outcomes of different surgical modes.展开更多
Background:Besides seizures,a myriad of overlapping neuropsychiatric and cognitive comorbidities occur in patients with epilepsy,which further debilitates their quality of life.This study provides an in-depth characte...Background:Besides seizures,a myriad of overlapping neuropsychiatric and cognitive comorbidities occur in patients with epilepsy,which further debilitates their quality of life.This study provides an in-depth characterization of the impact of brivaracetam and rufinamide individually and in combination at 10 and 20 mg/kg doses,respec-tively,on corneal kindling-induced generalized seizures and behavioral alterations.Furthermore,observed convulsive frequency and behavioral changes were corre-lated to post-kindling-induced changes in the activity of markers of oxidative stress.Methods:Adult C57BL/6 mice were kindled via twice-daily transcorneal 50-Hz elec-trical stimulations(3 mA)for 3 s for 12 days until animals reached a fully kindled state.After the kindling procedure,animals were tested using a set of behavioral tests,and neurochemical alterations were assessed.Results:Corneal-kindled animals exhibited intense generalized convulsions,altered behavioral phenotypes typified by positive symptoms(hyperlocomotion),negative symptoms(anxiety and anhedonia),and deficits in semantic and working memory.BRV 10+RFM 20 dual regime increased convulsive threshold and propensity toward the start of stage 4–5 seizures and improved phenotypical deficits,that is,anxiety,depression,and memory impairments.Moreover,this combination therapy mitigated kindling-induced redox impairments as evidenced by reduced malondialdehyde and acetylcholinesterase levels and increased glutathione antioxidant activity in the brain of animals subjected to repetitive brain insult.Conclusion:Based on our outcomes,this dual therapy provides supporting evidence in alleviating epilepsy-induced neurobehavioral comorbidities and changes in redox homeostasis.展开更多
BACKGROUND The surgical management of corneal lesions resulting from eyelid pathologies requires a comprehensive approach to ensure optimal patient outcomes.Eyelid lesions,ranging from benign to malignant,can lead to ...BACKGROUND The surgical management of corneal lesions resulting from eyelid pathologies requires a comprehensive approach to ensure optimal patient outcomes.Eyelid lesions,ranging from benign to malignant,can lead to corneal damage through mechanisms such as mechanical abrasion,secondary infection,or inflammatory responses.AIM To assess the surgical methodologies utilized in the treatment of corneal lesions resulting from eyelid disorders and evaluate their effects on patient outcomes,recurrence rates,and postoperative complications.The incorporation of advanced imaging techniques,including optical coherence tomography and ultrasound biomicroscopy,in conjunction with histopathological analysis,is addressed to improve surgical accuracy and patient outcomes.METHODS The authors searched online databases(PubMed and Cochrane)for publications on the surgical management of lid lesions.Records received from the two databases were checked for duplicates and relevance.Only records with full texts and in English language were included.RESULTS A total of 28 records were obtained following the screening for relevancy and duplication.The review underscores essential surgical approaches employed in the treatment of corneal lesions resulting from common eyelid diseases,focusing on operative efficacy,complication rates,and long-term results.CONCLUSION This systematic review emphasizes the significance of choosing suitable surgical techniques tailored to individual patient characteristics and stresses the need for interdisciplinary collaboration in ophthalmic care.The results indicate that sophisticated imaging techniques and careful preoperative preparation markedly improve surgical accuracy and long-term results.展开更多
Background:Corneal scarring following bacterial keratitis,particularly from Pseudomonas infections,poses significant challenges in ophthalmic care.Current treatments often fall short in effectively reducing corneal ha...Background:Corneal scarring following bacterial keratitis,particularly from Pseudomonas infections,poses significant challenges in ophthalmic care.Current treatments often fall short in effectively reducing corneal haze and restoring vision.To our knowledge,this is the first report documenting the use of topical losartan,an angiotensin II receptor antagonist known to inhibit the transforming growth factor-β(TGF-β)pathway,for treating corneal haze resulting from bacterial keratitis.Case Description:A 30-year-old male presented with a persistent corneal scar in his right eye,178 days post-Pseudomonas keratitis.Despite a prolonged course of topical corticosteroids,his best-corrected visual acuity(BCVA)stabilized at 20/40 with a hybrid contact lens over a 2-month period.Given the lack of improvement,we initiated treatment with topical losartan at a concentration of 0.8 mg/mL,administered six times daily.After 4 months of therapy,the patient’s BCVA improved to 20/25.Slit-lamp examination and corneal tomography revealed a significant reduction in corneal haze,indicating a positive response to the treatment.Conclusions:This case suggests that topical losartan may be a promising therapeutic option for reducing corneal opacity following bacterial keratitis by inhibiting the TGF-βpathway.However,further clinical studies are necessary to confirm its efficacy and safety in broader patient populations.展开更多
BACKGROUND Corneal ulcers are a major cause of visual impairment in developing countries.In Indonesia,severe infective ulcers often require keratoplasty(KP)to preserve ocular integrity and improve outcomes.AIM To dete...BACKGROUND Corneal ulcers are a major cause of visual impairment in developing countries.In Indonesia,severe infective ulcers often require keratoplasty(KP)to preserve ocular integrity and improve outcomes.AIM To determine demographic,clinical and microbiological characteristics,complications,and KP outcomes in patients with moderate to severe infective corneal ulcers.METHODS A retrospective review was conducted on patients with moderate to severe infective corneal ulcers who underwent KP between January 1,2018 and December 31,2020,with a minimum follow-up period of 3 weeks at the Ocular Infection and Immunology clinic of a tertiary referral hospital in Jakarta.Data were extracted from medical records.RESULTS A total of 99 eyes from 99 patients with a mean age of 41.7±16.2 years were included.Eight-nine eyes of corneal cases were located at the central cornea with>6 mm lesion size(forty-one eyes).The culture positivity rate was 33%,primarily composed of Staphylococcus epidermidis.Eyeball integrity was maintained in all patients.Mean uncorrected visual acuity(VA)before KP was 2.50 and improved to 2.04 after 3 months of follow-up.Twenty patients with a cornea that was kept transparent achieved a VA of 0.40.Complications after KP appeared in 60 eyes,while secondary glaucoma was the most common complication(28 eyes),followed by graft failure(24 eyes)and graft rejection(14 eyes).CONCLUSION Corneal ulcers are a common problem in Indonesia following eye trauma.Therapeutic and tectonic KP can preserve the integrity of the eyeball in moderate to severe cases,although complications are common.展开更多
Background:Scientific evidence to guide clinicians on the use of different antiseizure drugs in combination therapy is either very limited or lacking.In this study,the impact of lacosamide and perampanel alone and in ...Background:Scientific evidence to guide clinicians on the use of different antiseizure drugs in combination therapy is either very limited or lacking.In this study,the impact of lacosamide and perampanel alone and in combination was tested in corneal kindling model in mice,which is a cost-effective mechanism for screening of antiseizure drugs.Methods:The impact of lacosamide(5 mg/kg)and perampanel(0.125 mg/kg)alone and their combination was tested in corneal kindling process(3-mA current for 3 s applied twice daily for consecutive 12 days)in male BALB/c mice.Post-kindling,mice were subjected to a battery of behavioral tests assessing anxiety,memory,and depression-like behaviors.Brain tissues were then harvested for analysis of oxidative stress biomarkers.Results:Our results showed that the combination therapy of lacosamide and perampanel was more effective in reducing seizure progression than monotherapy of these drugs.Animals treated with combination therapy showed significant behavioral improvements,as reduced anxiety and depression were noticed,and their cognitive abilities were notably better compared to animals of all other groups.Moreover,biochemical assays of isolated brains from combination-treated group revealed lesser amount of oxidative stress.In addition,outcomes of dual regime were comparable to the phenytoin in seizure control but showed superior benefits in mitigation of kindling-prompted behavioral dysfunction and oxidative stress.Conclusions:This study suggests that the lacosamide and perampanel combination therapy worked noticeably better in halting the corneal kindling process in mice and improved the epilepsy-associated psychiatric disorders that might be due to antioxidant effects of both drugs.展开更多
AIM:To compare analysis of the impact of high altitude on corneal endothelial cells,and the prognosis in patients with cataract surgeries.METHODS:Totally 265 plateau patients with cataract surgeries performed between ...AIM:To compare analysis of the impact of high altitude on corneal endothelial cells,and the prognosis in patients with cataract surgeries.METHODS:Totally 265 plateau patients with cataract surgeries performed between January 2019 and July 2022(average altitude=3000 m),and 524 plain patients with cataract surgeries performed between January 2020 and July 2022 were included.The propensity score matching(PSM)method was applied to match the basic information of patients in both regions on a 1:1 basis.Corneal endothelial cell density(ECD),coefficient of variation(CV),hexagonal cell ratio(HEX),duration of surgery,and pre-and postoperative visual acuity(VA)were compared retrospectively,and correlation tests were done.RESULTS:Totally 223 pairs have been matched successfully.The HEX in the plateau group was higher than that in the plain group(61.95%±6.191%vs 44.91%±6.829%,P<0.001).For ECD and CV,no significant differences were observed between both groups(P>0.1).The pre-and postoperative VA of patients with cataract surgeries in the plateau group were lower(1.40±0.610 vs 0.71±0.514,P<0.001&0.68±0.479 vs 0.18±0.259,P<0.001),and the duration of surgery was longer than those in the plain group(27.06±14.900 min vs 16.03±8.033 min,P<0.001).No significant associations were found between the post-operative VA and the corneal endothelial parameters(P>0.05),while the post-operative VA was significantly related to the pre-operative VA and the duration of surgery(P<0.05).CONCLUSION:The relative hypoxic environment of the plateau does not promote the apoptosis of corneal endothelial cells,but may lead to the compensatory increase of their functions.In plateau patients,no significant associations are found between the poor VA and the corneal endothelial functions early after cataract surgeries.展开更多
AIM:To assess tomographic changes and subclinical edema detection in Fuchs’endothelial corneal dystrophy(FECD)through Scheimpflug tomography in a group of phakic patients contemplating cataract surgery.METHODS:A retr...AIM:To assess tomographic changes and subclinical edema detection in Fuchs’endothelial corneal dystrophy(FECD)through Scheimpflug tomography in a group of phakic patients contemplating cataract surgery.METHODS:A retrospective study was conducted on 30 phakic eyes from patients diagnosed with FECD but without clinical edema,and 59 phakic eyes from a control group without corneal alterations.Comprehensive ophthalmic examinations were conducted,including slitlamp biomicroscopy,corneal specular microscopy(CSM),and Scheimpflug tomography.RESULTS:The study encompassed 30 phakic eyes with FECD(mean age 59.8±13.1y)and 59 control eyes(mean age 61.3±7.7y).The best-corrected visual acuity was higher in the control group compared to the FECD group[0(0,0.08)vs 0.05(0,0.15)logMAR;P=0.042].CSM revealed significant differences between the FECD and control groups in several parameters:number of analyzed cells(26±13 vs 135±42,P<0.001),cell density(2049±376 vs 2479±225 cells/mm2,P<0.001),mean cell area[463(434,544)vs 397(383,431)μm2;P<0.001],coefficient of variation(54.8%±18.7%vs 41.0%±7.2%,P<0.001),and hexagonal cells[0(0,47%)vs 47%(40%,53%),P<0.001].Although often used as a clinical parameter for detecting edema,central corneal thickness measured by CSM showed no significant difference between the FECD and control groups(530±57 vs 546±30μm,P=0.179).Significant differences were noted in various Pentacam measurements between the groups.Specifically,parameters like loss of parallel isopachs(13 vs 0 eyes,P<0.001),displacement of the thinnest point(11 vs 0 eyes,P<0.001),posterior focal depression(25 vs 7 eyes,P<0.001),and increased light scatter[21.4(17.6;23.9)vs 18.0(16.8,21.8),P=0.01]were significantly more prevalent in FECD eyes,reflecting the presence of subclinical edema and loss of corneal transparency.CONCLUSION:Scheimpflug tomography allows for an objective assessment of FECD,offering the capability to detect subclinical edema at an early stage,monitor disease progression,and serve as a predictor of corneal decompensation following cataract surgery.展开更多
AIM:To evaluate the potential of artificial intelligence(AI)for automating corneal topography interpretation in orthokeratology patients,aiming to enhance diagnostic precision,efficiency,and clinical decision-making i...AIM:To evaluate the potential of artificial intelligence(AI)for automating corneal topography interpretation in orthokeratology patients,aiming to enhance diagnostic precision,efficiency,and clinical decision-making in myopia management.METHODS:The 1469 corneal topography images from 582 eyes of 326 myopic children treated with orthokeratology lenses over 47mo were collected.Each sample was categorized by decentration,treatment zone size,shape variation,and eye laterality.A multi-task AI model was developed to predict these parameters,with performance measured using area under curve(AUC),accuracy,and F1 scores.We compared AI-only,humanonly,and combined Human+AI approaches on a subset of 100 images.External validation with images from additional hospitals tested model generalizability.RESULTS:The model achieved high accuracy in eyeside prediction(AUC 0.95)and AUC values of 0.52-0.74 for decentration,treatment zone,and shape variation tasks.The combined Human+AI method outperformed AI-only and human-only approaches,achieving the highest accuracy(up to 87%)and fastest processing time(80ms).External validation confirmed robust performance in simple tasks,though accuracy was lower for complex classifications due to imaging variations.CONCLUSION:AI provides efficient routine corneal topography assessments,while complex cases benefit most from a Human+AI approach,particularly in scenarios requiring nuanced clinical interpretation.The model currently functions as an assistive tool.展开更多
Dear Editor,Recurrent corneal erosion(RCE)is a common clinical condition characterized by repeated episodes of eye redness,pain,foreign-body sensation,photophobia,and tearing[1].The causes of RCE include trauma,chemic...Dear Editor,Recurrent corneal erosion(RCE)is a common clinical condition characterized by repeated episodes of eye redness,pain,foreign-body sensation,photophobia,and tearing[1].The causes of RCE include trauma,chemical and thermal injuries,previous herpetic keratitis,epithelial basement membrane dystrophy,and systemic conditions like epidermolysis bullosa[2-3].展开更多
Corneal topography serves as an essential reference for diagnostic treatment in ophthalmology.Accurate corneal topography is crucial for clinical practice.In this study,the refractive power calculation was performed b...Corneal topography serves as an essential reference for diagnostic treatment in ophthalmology.Accurate corneal topography is crucial for clinical practice.In this study,the refractive power calculation was performed based on the initial corneal information collected using the Placido disc.A corneal point cloud model was established in polar coordinates,and an interpolation algorithm was proposed to fill missing points of the local bicubic B-spline by searching control points in the selfdefined interpolation matrix.The grid interpolation of the point cloud information and the smooth imaging of the final topographic map were achieved by Delaunay triangulation and Gaussian kernel function smoothing.Experiment results show that the proposed interpolation algorithm has higher accuracy than previous algorithms.The mean absolute error between the measured diopter of the original detection and the reconstructed is less than 0.300 D,indicating that this algorithm is feasible.展开更多
AIM:To investigate the clinical signs of blepharokeratoconjunctivitis(BKC)and evaluate the efficacy of penetrating keratoplasty(PKP)for the disease.METHODS:Sixteen patients(16 eyes)with BKC complicated by corneal perf...AIM:To investigate the clinical signs of blepharokeratoconjunctivitis(BKC)and evaluate the efficacy of penetrating keratoplasty(PKP)for the disease.METHODS:Sixteen patients(16 eyes)with BKC complicated by corneal perforation hospitalised at Shandong Eye Hospital were retrospectively analyzed.All patients received PKP.Participants were assessed for symptoms,clinical manifestations,the activity and damage grading of BKC.A paired t-test was used to compare the uncorrected visual acuity(UCVA)before and after surgery for the perforated eye.RESULTS:The mean age of the patients was 16.3y.Blurred vision is the most common discomfort,followed by redness,and then photophobia.The duration of ocular discomfort lasted for 3.2y,on average.Three(18.8%)participants were associated with rosacea,while 11(68.8%)patients had recurrent chalazion or hordeolum.Demodex in eyelash follicles was positive in 11(68.8%)cases.All corneal perforations were≤3.0 mm in diameter.The perforation was located mainly in the inferior cornea(68.8%).The mean area of corneal vascularisation was 3.0 quadrants.All patients manifested bilateral BKC,with the perforated eyes ranked as severely damaged and presenting with severe inflammation.Most contralateral eyes manifested mild damage with no active inflammation.Majority(68.8%)of the perforated eyes were treated with PKP using a minimal graft.The UCVA increased significantly at the final follow-up(mean,21mo;P<0.001),with the manifestation of BKC alleviated greatly.None of the patients developed immune rejection or other serious complications.CONCLUSION:BKC combined with corneal perforation occurs mainly among young people with a long history of ocular discomfort.PKP,especially using a minimal graft,is an effective and safe option for treating the disease.展开更多
文摘The retrospective study by Edwar et al reinforces the role of therapeutic penetrating keratoplasty(PK)as a vital intervention in severe,treatment-resistant infectious keratitis.In advanced cases—often complicated by trauma,delayed presentation,and corneal perforation—PK restores globe integrity and provides limited visual recovery.However,its application is constrained by graft-related complications and donor shortages,particularly in low-resource settings.These limitations highlight the need for earlier,globe-sparing strategies to prevent progression and reduce surgical demand.Photoactivated chromophore for infectious keratitis-corneal collagen cross-linking(PACK-CXL)has emerged as a promising adjunct or alternative.With both antimicrobial and tissue-stabilizing effects,PACK-CXL may control infection and preserve corneal structure in earlier stages.A layered treatment framework that incorporates PACK-CXL as an initial intervention and reserves PK for refractory cases may help improve clinical outcomes.Further studies are needed to define their best use in practice.
文摘Diabetic corneal neuropathy and diabetic retinopathy are ocular complications occurring in the context of diabetes mellitus.Diabetic corneal neuropathy refers to the progressive damage of corneal nerves.Diabetic retinopathy has traditionally been considered as damage to the retinal microvasculature.However,growing evidence suggests that diabetic retinopathy is a complex neurovascular disorder resulting from dysfunction of the neurovascular unit,which includes both the retinal vascular structures and neural tissues.Diabetic retinopathy is one of the leading causes of blindness and is frequently screened for as part of diabetic ocular screening.However,diabetic corneal neuropathy is commonly overlooked and underdiagnosed,leading to severe ocular surface impairment.Several studies have found that these two conditions tend to occur together,and they share similarities in their pathogenesis pathways,being triggered by a status of chronic hyperglycemia.This review aims to discuss the interconnection between diabetic corneal neuropathy and diabetic retinopathy,whether diabetic corneal neuropathy precedes diabetic retinopathy,as well as the relation between the stage of diabetic retinopathy and the severity of corneal neuropathy.We also endeavor to explore the relevance of a corneal screening in diabetic eyes and the possibility of using corneal nerve measurements to monitor the progression of diabetic retinopathy.
文摘AIM:To evaluate changes in corneal light scattering and anterior segment parameters in newly diagnosed rheumatoid arthritis(RA)patients who achieved remission with systemic treatment,compared to healthy controls.METHODS:A cross-sectional study was conducted at a tertiary care hospital,in ophthalmology,and rheumatology departments.A total of 42 RA patients(13 men and 29 women)and 56 healthy individuals(23 men 33 women)underwent comprehensive ophthalmologic evaluations,including Scheimpflug corneal densitometry and Pentacam HR measurements.Those who initiated systemic treatment for RA were monitored at first,third,and sixth-month follow-ups.Participants who achieved remission at each follow-up assessment were included.RESULTS:Significant differences in corneal densitometry were observed,with higher values in RA patients,particularly in the middle and posterior layers.Anterior segment parameters such as anterior chamber volume and angle were significantly reduced in RA patients compared to other groups(P<0.001).Following systemic treatment and achievement of remission,these parameters showed regression toward normal values.CONCLUSION:The study underscores the potential utility of corneal densitometry and anterior segment analysis as sensitive indicators of subclinical ocular involvement in RA,offering insights into disease progression and treatment efficacy.These findings highlight the importance of early detection and regular monitoring in preventing vision-threatening complications in RA patients.
基金Supported by the National Natural Science Foundation of China(No.82271052No.82201154)+2 种基金Shandong Provincial Key Research and Development Program(No.2024CXGC010617)Taishan Scholar Program(No.tstp20240858)Educational and Teaching Reform Research Project of Shandong First Medical University(No.XM2024001).
文摘AIM:To assess the corneal biometric parameters and endothelial cell characteristics in microcornea patients,and exploring their correlations.METHODS:This cross-sectional study included 28 patients of microcornea with uveal coloboma(MCUC),13 patients of microcornea without coloboma(MCNC),and 30 age-matched healthy individuals(the control group).Corneal biometric parameters such as axial length(AL),anterior chamber depth(ACD),and white-to-white corneal diameter(WTW)were measured using the IOL Master.The corneal endothelial cell density(ECD),percentage of hexagonal cells(6A),average cell area(AVE),maximum cell area(MAX),minimum cell area(MIN),cell area standard deviation(SD),and coefficient of variation(CV)were collected by specular microscopy.RESULTS:This study included MCUC and MCNC patients with age-and sex-matched controls.All patients exhibited significantly reduced WTW(MCUC:8.51±0.71 mm;MCNC:9.08±0.42 mm)and worse logMAR BCVA(MCUC 0.62±0.43;MCNC 0.46±0.28)compared to controls(both P<0.001).The ECD was 3106.32±336.80 cells/mm²in the MCUC group and 2906.92±323.53 cells/mm²in the MCNC group,both significantly higher than the control group(2647.43±203.06 cells/mm²,P<0.05).In contrast,the CV,AVE,SD,and ACD in the MCUC and MCNC groups were significantly lower compared to controls(P<0.01).In patients with microcornea,the WTW was negatively correlated with the ECD and 6A,but positively with the CV,MAX,AVE,and SD.The ACD was negatively linked to the ECD,but positively to the AVE.CONCLUSION:The corneal ECD and 6A are increased,while the CV is decreased in patients with microcornea,particularly in those accompanied by uveal coloboma.The ECD and morphology demonstrate close correlations with the WTW and ACD.
基金Chongqing Fuling District Science and Health Joint Medical Research Project(2022KWLH069)。
文摘Objective:To investigate the influence of axial length(AL),corneal curvature(CR),and the ratio of axial length to corneal radius of curvature(AL/CR)on myopia in children,and to evaluate the accuracy and specificity of AL/CR in diagnosing myopia in children.Methods:A cross-sectional study was conducted.A total of 200 children(400 eyes)aged 6-12 years were recruited from the ophthalmology outpatient clinic of Fuling District People’s Hospital from December 2022 to December 2023.AL,CR,and AL/CR were measured,and comprehensive optometry was performed under cycloplegia,with the results recorded in spherical equivalent(SE)form.Results:A total of 200 subjects(400 eyes)were included in this study,of which 330 eyes(82.50%)were myopic.No significant differences in CR were observed among different refractive groups,while significant differences were noted in SE,AL,and AL/CR.The AL and AL/CR ratios were higher in myopic eyes compared to emmetropic and hyperopic eyes.Using cycloplegia as the gold standard,SE in the myopia group was correlated with AL,AL/CR,and CR,with stronger correlations observed with AL and AL/CR.An AL/CR value>3 demonstrated a sensitivity of 0.918,specificity of 0.786,misdiagnosis rate of 0.214,missed diagnosis rate of 0.082,and accuracy of 89.5%in diagnosing myopia.Conclusion:AL and AL/CR values are highly correlated with SE,with the strongest correlation observed in the myopia group.The AL/CR value exhibits high diagnostic value in determining myopia in children.
基金Supported by China Primary Health Care Foundation(No.MTP2022C025)Beijing Natural Science Foundation of China(No.7242168).
文摘AIM:To investigate the relationship between preoperative corneal biomechanical properties and corneal tomographic properties in cataract patients.METHODS:The study consisted of 59 eyes of 30 participants who were diagnosed as cataract in Peking University Third Hospital between September 2019 and November 2019.Stepwise multivariable linear regression analysis was calculated to determine the relationship between corneal biomechanical parameters and tomographic parameters.The patients were classified into three groups of with the rule(WTR)astigmatism,against the rule astigmatism and oblique astigmatism.And the differences in corneal parameters among different groups were compared.RESULTS:There were significant differences in the first applanation time(A1T),the first applanation length(A1L),corneal velocity during the first applanation(Vin),the second applanation time(A2T),highest concavity(HC)radius,displacement amount(DA),DA ratio,stiffness parameter A1(SPA1)and integrated radius(IR)between oblique astigmatism patients and the other two groups.Total corneal steep meridian(K2)was negatively associated with A1L,A1T and corneal velocity during the second applanation(Vout).Patients with higher anterior corneal curvature had lower HC radius and central corneal thickness(CCT;P=0.001 and 0.006,respectively),while the Ambrosio relational thickness to the horizontal profile(ARTh)was higher than those with lower anterior corneal curvature(P=0.009).CONCLUSION:The study reveals that the elasticity of corneal collagen fibers is greater,but the viscoelasticity of cornea is smaller in patients with oblique astigmatism.There is no significant difference in ARTh between patients with different types of astigmatism,that is,the corneal biomechanical specificity of oblique astigmatism group is probably not caused by corneal thickness.Moreover,we find patients with higher anterior corneal curvature has lower HC radius and CCT but higher ARTh than those with lower anterior corneal curvature.
文摘Introduction Fuchs endothelial corneal dystrophy(FECD)is an inherited,degenerative disease of the corneal endothelial cells(CECs).It is characterized by a progressive deterioration of endothelial cells,altered extracellular matrix(ECM)production,and development of guttae(1,2).The presence of guttae has been shown to significantly impair corneal endothelial function,leading to corneal oedema and visual impairment.
基金Supported by Wu Jieping Medical Foundation(No.320.6750.2021-04-15).
文摘AIM:To assess the visual outcomes and corneal biomechanical properties of myopia patients between laser in situ keratomileusis(LASIK)and LASIK combined with accelerated corneal crosslinking(LASIK Xtra).METHODS:This prospective study analyzed 52 consecutive myopia patients treated with LASIK Xtra and 45 consecutive myopia patients treated with LASIK.Only the right eyes in the two groups were analyzed.The uncorrected distance visual acuity(UDVA),keratometry values,postoperative central corneal thickness(CCT),corneal demarcation line depth,the corneal compensated intraocular pressure(IOPcc),Goldmann-correlated IOP(IOPg),corneal resistance factor(CRF)and corneal hysteresis(CH)from Ocular Response Analyzer(ORA)were analyzed.Further,the correlation between the demarcation line depth and ORA-related biomechanical parameters were analyzed.RESULTS:No significant differences in UDVA,postoperative CCT,or mean K values were found between the 2 groups at 1 to 12mo postoperative follow-up(all P>0.05).The changes of CRF was significantly lower in the LASIK Xtra group compared to the LASIK group(all P<0.05)at all the postoperative visits.The changes of CH were significantly higher in the LASIK Xtra group(all P<0.05).No significant differences were discovered regarding the changes of IOPcc and IOPg posperatively(all P>0.05).Out of 52 cases in the LASIK Xtra group,the demarcation line was present in 40 eyes(77%).The average depth of the demarcation was 220.73±42.70μm(136 to 288μm).No significant correlation was observed between the depth of the demarcation line and any of the ORA-related biomechanical parameters such as IOPcc,IOPg,CRF and CH at 12mo(all P>0.05).CONCLUSION:Both procedures demonstrate comparable outcomes in terms of visual acuity,refraction and ablation predictability.This study confirms that corneal biomechanical properties of the included patients weakened after both procedures,but the cornea after LASIK Xtra are stiffer than conventional LASIK.
基金Supported by the Science&Technology Department of Sichuan Province(China)Funding Project(No.2021YFS0221,No.2023YFS0179)1.3.5 Project for Disciplines of Excellence,West China Hospital,Sichuan University(No.2022HXFH032,No.ZYJC21058)the Postdoctoral Research Funding of West China Hospital,Sichuan University,China(No.2020HXBH044).
文摘●AIM:To explore the clinical efficacy and safety of stromal lenticule addition keratoplasty(SLAK)with corneal crosslinking(CXL)on patients with corneal ectasia secondary to femtosecond laser-assisted in situ keratomileusis(FS-LASIK).●METHODS:A series of 5 patients undertaking SLAK with CXL for the treatment of corneal ectasia secondary to FS-LASIK were followed for 4-9mo.The lenticules were collected from patients undertaking small incision lenticule extraction(SMILE)for the correction of myopia.Adding a stromal lenticule was aimed at improving the corneal thickness for the safe application of crosslinking and compensating for the thin cornea to improve its mechanical strength.●RESULTS:All surgeries were conducted successfully with no significant complications.Their best corrected visual acuity(BCVA)ranged from 0.05 to 0.8-2 before surgery.The pre-operational total corneal thickness ranged from 345-404μm and maximum keratometry(Kmax)ranged from 50.8 to 86.3.After the combination surgery,both the corneal keratometry(range 55.9 to 92.8)and total corneal thickness(range 413-482μm)significantly increased.Four out of 5 patients had improvement of corneal biomechanical parameters(reflected by stiffness parameter A1 in Corvis ST).However,3 patients showed decreased BCVA after surgery due to the development of irregular astigmatism and transient haze.Despite the onset of corneal edema right after SLAK,the corneal topography and thickness generally stabilized after 3mo.●CONCLUSION:SLAK with CXL is a potentially beneficial and safe therapy for advanced corneal ectasia.Future work needs to address the poor predictability of corneal refractometry and compare the outcomes of different surgical modes.
基金The authors extend their appreciation to the Distinguished Scientist Fellowship program at King Saud University,Riyadh,Saudi Arabia,for funding this work through Research Supporting Project Number RSP2024R131.
文摘Background:Besides seizures,a myriad of overlapping neuropsychiatric and cognitive comorbidities occur in patients with epilepsy,which further debilitates their quality of life.This study provides an in-depth characterization of the impact of brivaracetam and rufinamide individually and in combination at 10 and 20 mg/kg doses,respec-tively,on corneal kindling-induced generalized seizures and behavioral alterations.Furthermore,observed convulsive frequency and behavioral changes were corre-lated to post-kindling-induced changes in the activity of markers of oxidative stress.Methods:Adult C57BL/6 mice were kindled via twice-daily transcorneal 50-Hz elec-trical stimulations(3 mA)for 3 s for 12 days until animals reached a fully kindled state.After the kindling procedure,animals were tested using a set of behavioral tests,and neurochemical alterations were assessed.Results:Corneal-kindled animals exhibited intense generalized convulsions,altered behavioral phenotypes typified by positive symptoms(hyperlocomotion),negative symptoms(anxiety and anhedonia),and deficits in semantic and working memory.BRV 10+RFM 20 dual regime increased convulsive threshold and propensity toward the start of stage 4–5 seizures and improved phenotypical deficits,that is,anxiety,depression,and memory impairments.Moreover,this combination therapy mitigated kindling-induced redox impairments as evidenced by reduced malondialdehyde and acetylcholinesterase levels and increased glutathione antioxidant activity in the brain of animals subjected to repetitive brain insult.Conclusion:Based on our outcomes,this dual therapy provides supporting evidence in alleviating epilepsy-induced neurobehavioral comorbidities and changes in redox homeostasis.
文摘BACKGROUND The surgical management of corneal lesions resulting from eyelid pathologies requires a comprehensive approach to ensure optimal patient outcomes.Eyelid lesions,ranging from benign to malignant,can lead to corneal damage through mechanisms such as mechanical abrasion,secondary infection,or inflammatory responses.AIM To assess the surgical methodologies utilized in the treatment of corneal lesions resulting from eyelid disorders and evaluate their effects on patient outcomes,recurrence rates,and postoperative complications.The incorporation of advanced imaging techniques,including optical coherence tomography and ultrasound biomicroscopy,in conjunction with histopathological analysis,is addressed to improve surgical accuracy and patient outcomes.METHODS The authors searched online databases(PubMed and Cochrane)for publications on the surgical management of lid lesions.Records received from the two databases were checked for duplicates and relevance.Only records with full texts and in English language were included.RESULTS A total of 28 records were obtained following the screening for relevancy and duplication.The review underscores essential surgical approaches employed in the treatment of corneal lesions resulting from common eyelid diseases,focusing on operative efficacy,complication rates,and long-term results.CONCLUSION This systematic review emphasizes the significance of choosing suitable surgical techniques tailored to individual patient characteristics and stresses the need for interdisciplinary collaboration in ophthalmic care.The results indicate that sophisticated imaging techniques and careful preoperative preparation markedly improve surgical accuracy and long-term results.
文摘Background:Corneal scarring following bacterial keratitis,particularly from Pseudomonas infections,poses significant challenges in ophthalmic care.Current treatments often fall short in effectively reducing corneal haze and restoring vision.To our knowledge,this is the first report documenting the use of topical losartan,an angiotensin II receptor antagonist known to inhibit the transforming growth factor-β(TGF-β)pathway,for treating corneal haze resulting from bacterial keratitis.Case Description:A 30-year-old male presented with a persistent corneal scar in his right eye,178 days post-Pseudomonas keratitis.Despite a prolonged course of topical corticosteroids,his best-corrected visual acuity(BCVA)stabilized at 20/40 with a hybrid contact lens over a 2-month period.Given the lack of improvement,we initiated treatment with topical losartan at a concentration of 0.8 mg/mL,administered six times daily.After 4 months of therapy,the patient’s BCVA improved to 20/25.Slit-lamp examination and corneal tomography revealed a significant reduction in corneal haze,indicating a positive response to the treatment.Conclusions:This case suggests that topical losartan may be a promising therapeutic option for reducing corneal opacity following bacterial keratitis by inhibiting the TGF-βpathway.However,further clinical studies are necessary to confirm its efficacy and safety in broader patient populations.
文摘BACKGROUND Corneal ulcers are a major cause of visual impairment in developing countries.In Indonesia,severe infective ulcers often require keratoplasty(KP)to preserve ocular integrity and improve outcomes.AIM To determine demographic,clinical and microbiological characteristics,complications,and KP outcomes in patients with moderate to severe infective corneal ulcers.METHODS A retrospective review was conducted on patients with moderate to severe infective corneal ulcers who underwent KP between January 1,2018 and December 31,2020,with a minimum follow-up period of 3 weeks at the Ocular Infection and Immunology clinic of a tertiary referral hospital in Jakarta.Data were extracted from medical records.RESULTS A total of 99 eyes from 99 patients with a mean age of 41.7±16.2 years were included.Eight-nine eyes of corneal cases were located at the central cornea with>6 mm lesion size(forty-one eyes).The culture positivity rate was 33%,primarily composed of Staphylococcus epidermidis.Eyeball integrity was maintained in all patients.Mean uncorrected visual acuity(VA)before KP was 2.50 and improved to 2.04 after 3 months of follow-up.Twenty patients with a cornea that was kept transparent achieved a VA of 0.40.Complications after KP appeared in 60 eyes,while secondary glaucoma was the most common complication(28 eyes),followed by graft failure(24 eyes)and graft rejection(14 eyes).CONCLUSION Corneal ulcers are a common problem in Indonesia following eye trauma.Therapeutic and tectonic KP can preserve the integrity of the eyeball in moderate to severe cases,although complications are common.
基金The authors extended their appreciation to Distinguished Scientist Fellowship program at King Saud University,Riyadh,Saudi Arabia,for funding this work through research supporting project number(RSP2024R131).
文摘Background:Scientific evidence to guide clinicians on the use of different antiseizure drugs in combination therapy is either very limited or lacking.In this study,the impact of lacosamide and perampanel alone and in combination was tested in corneal kindling model in mice,which is a cost-effective mechanism for screening of antiseizure drugs.Methods:The impact of lacosamide(5 mg/kg)and perampanel(0.125 mg/kg)alone and their combination was tested in corneal kindling process(3-mA current for 3 s applied twice daily for consecutive 12 days)in male BALB/c mice.Post-kindling,mice were subjected to a battery of behavioral tests assessing anxiety,memory,and depression-like behaviors.Brain tissues were then harvested for analysis of oxidative stress biomarkers.Results:Our results showed that the combination therapy of lacosamide and perampanel was more effective in reducing seizure progression than monotherapy of these drugs.Animals treated with combination therapy showed significant behavioral improvements,as reduced anxiety and depression were noticed,and their cognitive abilities were notably better compared to animals of all other groups.Moreover,biochemical assays of isolated brains from combination-treated group revealed lesser amount of oxidative stress.In addition,outcomes of dual regime were comparable to the phenytoin in seizure control but showed superior benefits in mitigation of kindling-prompted behavioral dysfunction and oxidative stress.Conclusions:This study suggests that the lacosamide and perampanel combination therapy worked noticeably better in halting the corneal kindling process in mice and improved the epilepsy-associated psychiatric disorders that might be due to antioxidant effects of both drugs.
文摘AIM:To compare analysis of the impact of high altitude on corneal endothelial cells,and the prognosis in patients with cataract surgeries.METHODS:Totally 265 plateau patients with cataract surgeries performed between January 2019 and July 2022(average altitude=3000 m),and 524 plain patients with cataract surgeries performed between January 2020 and July 2022 were included.The propensity score matching(PSM)method was applied to match the basic information of patients in both regions on a 1:1 basis.Corneal endothelial cell density(ECD),coefficient of variation(CV),hexagonal cell ratio(HEX),duration of surgery,and pre-and postoperative visual acuity(VA)were compared retrospectively,and correlation tests were done.RESULTS:Totally 223 pairs have been matched successfully.The HEX in the plateau group was higher than that in the plain group(61.95%±6.191%vs 44.91%±6.829%,P<0.001).For ECD and CV,no significant differences were observed between both groups(P>0.1).The pre-and postoperative VA of patients with cataract surgeries in the plateau group were lower(1.40±0.610 vs 0.71±0.514,P<0.001&0.68±0.479 vs 0.18±0.259,P<0.001),and the duration of surgery was longer than those in the plain group(27.06±14.900 min vs 16.03±8.033 min,P<0.001).No significant associations were found between the post-operative VA and the corneal endothelial parameters(P>0.05),while the post-operative VA was significantly related to the pre-operative VA and the duration of surgery(P<0.05).CONCLUSION:The relative hypoxic environment of the plateau does not promote the apoptosis of corneal endothelial cells,but may lead to the compensatory increase of their functions.In plateau patients,no significant associations are found between the poor VA and the corneal endothelial functions early after cataract surgeries.
文摘AIM:To assess tomographic changes and subclinical edema detection in Fuchs’endothelial corneal dystrophy(FECD)through Scheimpflug tomography in a group of phakic patients contemplating cataract surgery.METHODS:A retrospective study was conducted on 30 phakic eyes from patients diagnosed with FECD but without clinical edema,and 59 phakic eyes from a control group without corneal alterations.Comprehensive ophthalmic examinations were conducted,including slitlamp biomicroscopy,corneal specular microscopy(CSM),and Scheimpflug tomography.RESULTS:The study encompassed 30 phakic eyes with FECD(mean age 59.8±13.1y)and 59 control eyes(mean age 61.3±7.7y).The best-corrected visual acuity was higher in the control group compared to the FECD group[0(0,0.08)vs 0.05(0,0.15)logMAR;P=0.042].CSM revealed significant differences between the FECD and control groups in several parameters:number of analyzed cells(26±13 vs 135±42,P<0.001),cell density(2049±376 vs 2479±225 cells/mm2,P<0.001),mean cell area[463(434,544)vs 397(383,431)μm2;P<0.001],coefficient of variation(54.8%±18.7%vs 41.0%±7.2%,P<0.001),and hexagonal cells[0(0,47%)vs 47%(40%,53%),P<0.001].Although often used as a clinical parameter for detecting edema,central corneal thickness measured by CSM showed no significant difference between the FECD and control groups(530±57 vs 546±30μm,P=0.179).Significant differences were noted in various Pentacam measurements between the groups.Specifically,parameters like loss of parallel isopachs(13 vs 0 eyes,P<0.001),displacement of the thinnest point(11 vs 0 eyes,P<0.001),posterior focal depression(25 vs 7 eyes,P<0.001),and increased light scatter[21.4(17.6;23.9)vs 18.0(16.8,21.8),P=0.01]were significantly more prevalent in FECD eyes,reflecting the presence of subclinical edema and loss of corneal transparency.CONCLUSION:Scheimpflug tomography allows for an objective assessment of FECD,offering the capability to detect subclinical edema at an early stage,monitor disease progression,and serve as a predictor of corneal decompensation following cataract surgery.
基金Supported by the National Natural Science Foundation of China(No.82201195).
文摘AIM:To evaluate the potential of artificial intelligence(AI)for automating corneal topography interpretation in orthokeratology patients,aiming to enhance diagnostic precision,efficiency,and clinical decision-making in myopia management.METHODS:The 1469 corneal topography images from 582 eyes of 326 myopic children treated with orthokeratology lenses over 47mo were collected.Each sample was categorized by decentration,treatment zone size,shape variation,and eye laterality.A multi-task AI model was developed to predict these parameters,with performance measured using area under curve(AUC),accuracy,and F1 scores.We compared AI-only,humanonly,and combined Human+AI approaches on a subset of 100 images.External validation with images from additional hospitals tested model generalizability.RESULTS:The model achieved high accuracy in eyeside prediction(AUC 0.95)and AUC values of 0.52-0.74 for decentration,treatment zone,and shape variation tasks.The combined Human+AI method outperformed AI-only and human-only approaches,achieving the highest accuracy(up to 87%)and fastest processing time(80ms).External validation confirmed robust performance in simple tasks,though accuracy was lower for complex classifications due to imaging variations.CONCLUSION:AI provides efficient routine corneal topography assessments,while complex cases benefit most from a Human+AI approach,particularly in scenarios requiring nuanced clinical interpretation.The model currently functions as an assistive tool.
基金Supported by the National High-Level Hospital Clinical Research Funding(No.2022-PUMCH-A-198).
文摘Dear Editor,Recurrent corneal erosion(RCE)is a common clinical condition characterized by repeated episodes of eye redness,pain,foreign-body sensation,photophobia,and tearing[1].The causes of RCE include trauma,chemical and thermal injuries,previous herpetic keratitis,epithelial basement membrane dystrophy,and systemic conditions like epidermolysis bullosa[2-3].
基金Shanghai Science and Technology Program,China (No.20DZ2251400)。
文摘Corneal topography serves as an essential reference for diagnostic treatment in ophthalmology.Accurate corneal topography is crucial for clinical practice.In this study,the refractive power calculation was performed based on the initial corneal information collected using the Placido disc.A corneal point cloud model was established in polar coordinates,and an interpolation algorithm was proposed to fill missing points of the local bicubic B-spline by searching control points in the selfdefined interpolation matrix.The grid interpolation of the point cloud information and the smooth imaging of the final topographic map were achieved by Delaunay triangulation and Gaussian kernel function smoothing.Experiment results show that the proposed interpolation algorithm has higher accuracy than previous algorithms.The mean absolute error between the measured diopter of the original detection and the reconstructed is less than 0.300 D,indicating that this algorithm is feasible.
基金Supported by Key Technology Research and Development Program of Shandong Province(No.2022CXGC010505)Natural Science Foundation of Shandong Province(No.ZR2019BH065)+1 种基金Taishan Scholars Program(No.20221110)the Innovation Project of Shandong Academy of Medical Sciences.
文摘AIM:To investigate the clinical signs of blepharokeratoconjunctivitis(BKC)and evaluate the efficacy of penetrating keratoplasty(PKP)for the disease.METHODS:Sixteen patients(16 eyes)with BKC complicated by corneal perforation hospitalised at Shandong Eye Hospital were retrospectively analyzed.All patients received PKP.Participants were assessed for symptoms,clinical manifestations,the activity and damage grading of BKC.A paired t-test was used to compare the uncorrected visual acuity(UCVA)before and after surgery for the perforated eye.RESULTS:The mean age of the patients was 16.3y.Blurred vision is the most common discomfort,followed by redness,and then photophobia.The duration of ocular discomfort lasted for 3.2y,on average.Three(18.8%)participants were associated with rosacea,while 11(68.8%)patients had recurrent chalazion or hordeolum.Demodex in eyelash follicles was positive in 11(68.8%)cases.All corneal perforations were≤3.0 mm in diameter.The perforation was located mainly in the inferior cornea(68.8%).The mean area of corneal vascularisation was 3.0 quadrants.All patients manifested bilateral BKC,with the perforated eyes ranked as severely damaged and presenting with severe inflammation.Most contralateral eyes manifested mild damage with no active inflammation.Majority(68.8%)of the perforated eyes were treated with PKP using a minimal graft.The UCVA increased significantly at the final follow-up(mean,21mo;P<0.001),with the manifestation of BKC alleviated greatly.None of the patients developed immune rejection or other serious complications.CONCLUSION:BKC combined with corneal perforation occurs mainly among young people with a long history of ocular discomfort.PKP,especially using a minimal graft,is an effective and safe option for treating the disease.
