Objective： To evaluate the effect of anti-vascular endothelial growth factor （VEGF） on juxtafoveal choroidal neovascularization （CNV） secondary to multifocal choroiditis （MFC） and wet age-related macular degene...Objective： To evaluate the effect of anti-vascular endothelial growth factor （VEGF） on juxtafoveal choroidal neovascularization （CNV） secondary to multifocal choroiditis （MFC） and wet age-related macular degeneration （AMD）. Methods： In this retrospective, comparative study, 20 unique eyes with CNV were divided into two groups： 10 patients affected by MFC and 10 patients diagnosed with wet AMD. They all received local intravitreal （Ivr） injections of ranibizumab, with 6 months of follow-up. Retreatment injections were performed based on findings suggestive of active neovascularization. Results： Significant improvements were observed in the juxtafoveal CNV lesions, and average central macular thickness decreased in both groups following the anti-VEGF therapy （P〈0.05）. The average number of injections used in MFC patients was 1.6, while three injections on average were used in wet AMD patients （Z=-2.844, P=0.009）. Best-corrected visual acuity was significantly improved in MFC patients after anti-VEGF therapy （P〈0.05）, and there was no significant difference in wet AMD patients between before anti-VEGF therapy and 6 months later （P〉0.05）. Conclusions： IVT ranibizumab resulted in good clinical outcomes for juxtafoveal CNV secondary to MFC and wet AMD, but the average number of injections used in MFC was fewer than that used in wet AMD over a 6-month observation period. Compared with the wet AMD group, visual acuity was obviously improved in the MFC group at 6 months.展开更多
Objective To investigate optical coherence tomography（OCT） characteristics of tuberculous serpiginous-like choroiditis（Tb-SLC） and serpiginous choroiditis（SC） and to perform OCT to differentiate between these co...Objective To investigate optical coherence tomography（OCT） characteristics of tuberculous serpiginous-like choroiditis（Tb-SLC） and serpiginous choroiditis（SC） and to perform OCT to differentiate between these conditions.Methods This retrospective,case-control study examined consecutively enrolled patients with active Tb-SLC or SC.Patients underwent comprehensive ocular examinations and imaging（OCT,color fundus photography,autofluorescence imaging,fluorescein angiography,and indocyanine green angiography）.Findings were examined and compared between eyes with SC and Tb-SLC.Results Nine patients with active Tb-SLC（14 eyes） and 8 with active SC（12 eyes） were included.The following OCT findings were observed significantly more often in the Tb-SLC group than in the SC group： vitreal hyper-reflective spots [5 Tb-SLC eyes（36%）,no SC eyes：P = 0.02],intraretinal edema [11 Tb-SLC eyes（79%）,3 SC eyes（25%）：P = 0.01],sub-retinal pigment epithelium（RPE） drusenoid deposits [11 Tb-SLC eyes（79%）,2 SC eyes（17%）：P 〈 0.01],and choroidal granulomas [8 Tb-SLC eyes（57%）,2 SC eyes（17%）：P = 0.03].A hyporeflective,wedge-shaped band was observed more often in the SC group [5 Tb-SLC eyes（36%）,9 SC eyes（75%）：P = 0.045] than in the Tb-SLC group.The incidence of other OCT signs did not differ between the groups and included outer nuclear layer hyper-reflection,outer retinal tabulation,and choriocapillaris point-like hyper-reflection.Conclusion Vitreal hyper-reflective spots,intraretinal fluid,sub-RPE drusenoid deposits,and choroidal granulomas on OCT images may indicate Tb-SLC.Additionally,a hyporeflective,wedge-shaped band may indicate SC.Therefore,OCT is likely helpful in differentiating between Tb-SLC and SC.展开更多
Purpose: To evaluate the short-term efficacy of intravitreal anti-VEGF (Lucentis) and sub-tenon injection of triamcinolone acetonide for choroidal neovascularization (CNV) associated with multifocal choroiditis (MC). ...Purpose: To evaluate the short-term efficacy of intravitreal anti-VEGF (Lucentis) and sub-tenon injection of triamcinolone acetonide for choroidal neovascularization (CNV) associated with multifocal choroiditis (MC). Methods: Eight eyes of 8 patients treated with intravitreal anti-VEGF and posterior sub-tenon injection of Triamcinolone Acetonide (TA) for subfoveal or juxtafoveal CNV associated with MC were retrospectively reviewed. Best corrected visual acuity (BCVA), results of fundus fluorescein angiography (FFA)/indocyanine green angiography (ICGA), optical coherence tomography (OCT) at baseline and 3, 6 months after treatment were compared. Results: All of the 8 patients showed significant improvement in BCVA at 3 and 6 months after treatment (P < 0.05). FFA/ICGA showed decrease or cessation of inflammation in 8 patients (100%). 7 patients (87.5%) had no significant active leakage while 1 patient (12.5%) had persistent leakage from the neovascular lesion at 3-month follow up. 6 months after treatment, no recurrence of inflammation occurred and no active leakage in all 8 patients. OCT showed reduced CNV area and alleviated edema. There are no severe treatment-related side effects expect slight eye pain during infusion in one patient. Intraocular pressure was all normal in follow up. Conclusion: Although the follow-up time and the number of patients in this study were limited, the use of intravitreal anti-VEGF combined with sub-tenon injection of TA was associated with improvement of visual acuity in patients with CNV secondary to MC. Further studies including a greater number of patients with longer follow up time are needed.展开更多
AIM:To report and analyze cases of sterile intraocular inflammation(IOI)following intravitreal faricimab injections in patients treated for neovascular age-related macular degeneration(nAMD)and diabetic macular edema(...AIM:To report and analyze cases of sterile intraocular inflammation(IOI)following intravitreal faricimab injections in patients treated for neovascular age-related macular degeneration(nAMD)and diabetic macular edema(DME).METHODS:This double-center case series included nine eyes of six patients who developed uveitis after faricimab therapy.Comprehensive clinical evaluation was performed,including slit-lamp examination,intraocular pressure(IOP)measurement,fluorescein and indocyanine green angiography(ICGA),and laboratory tests.Inflammatory responses were treated with topical or systemic corticosteroids,and patients were monitored for visual acuity and inflammatory activity.RESULTS:The incidence of IOI was 0.8%per patient(Innsbruck)and 0.23%(Czechia),with inflammation typically occurring between the third and sixth injection(mean interval:10d post-injection).Inflammator y presentations ranged from anterior uveitis to posterior segment involvement.One notable case demonstrated novel choroidal hypofluorescent lesions on angiography,suggesting deeper ocular involvement.The mean patient age was 76y;five of six affected patients were female.All cases responded to local and systemic corticosteroids,with full recovery of initial visual acuity.CONCLUSION:Sterile IOI after faricimab appears to be a rare but relevant adverse event.Although the incidence falls within expected ranges for anti-vascular endothelial growth factor(anti-VEGF)agents,the observed choroidal involvement represents a potentially new safety signal.Prompt diagnosis and corticosteroid therapy are effective in all cases.Our findings support the need for vigilant post-marketing surveillance and further studies to better understand the underlying mechanisms and risk factors of faricimab-associated inflammation.展开更多
AIM:To investigate the association between anti-DFS70 antibody positivity and ocular parameters,specifically,the choroidal vascularity index(CVI)and other optical coherence tomography(OCT)metrics,in a healthy populati...AIM:To investigate the association between anti-DFS70 antibody positivity and ocular parameters,specifically,the choroidal vascularity index(CVI)and other optical coherence tomography(OCT)metrics,in a healthy population.METHODS:This age-and sex-matched case-control study enrolled 84 healthy individuals with positive anti-DFS70 antibody findings and 84 healthy negative controls.All participants underwent detailed ophthalmological examinations,including biometry and OCT imaging.Anti-DFS70 positivity was determined by indirect immunofluorescence and scored semi-quantitatively(1+to 3+).CVI was calculated from OCT images using a standardized protocol with Image J software.Statistical analyses,including Student’s t-test,Mann-Whitney U test,Spearman correlation,and logistic regression,were used to compare groups and identify predictive factors.RESULTS:The individuals who tested positive and negative for anti-DFS70 included in the study were matched for age(median age=47y)and sex(F:M=7:1).CVI was significantly lower in the anti-DFS70-positive group compared to the negative group.A higher anti-DFS70 antibody titer was significantly associated with decreased subfoveal and nasal choroidal thickness(P=0.016 and P=0.014,respectively).In univariate regression analysis,CVI was the only significant predictor of anti-DFS70 positivity[odds ratio(OR)=0.02,P=0.025].Multivariate analysis revealed a positive correlation between macular thinning outside the subfoveal area and anti-DFS70 status(P<0.05).CONCLUSION:Our study demonstrates a novel association between anti-DFS70 antibody positivity and reduced choroidal vascularity in healthy individuals.These findings suggest that anti-DFS70 antibodies may be associated with subtle choroidal vascular changes detectable by OCT,even in asymptomatic individuals.Further longitudinal research is warranted to clarify the underlying mechanisms and long-term clinical significance of these ocular changes.展开更多
AIM:To explore the repeatability,reproducibility,and agreement in the measurement of the choroidal vascularity index(CVI)for different swept-source optical coherence tomography(OCT)devices and between OCT and OCT angi...AIM:To explore the repeatability,reproducibility,and agreement in the measurement of the choroidal vascularity index(CVI)for different swept-source optical coherence tomography(OCT)devices and between OCT and OCT angiography(OCTA)images.METHODS:Two swept-source OCT imaging systems,VG200I and Topcon DRI OCT Triton,were used to capture OCT and OCTA images in triplicate.The first and third images were taken by one operator,and the second image was taken by another operator.The built-in software was used to calculate the CVI from the OCTA images(CVI-OCTA),and a custom-designed algorithm was used to calculate the CVI from the OCT images(CVI-OCT).Repeatability and reproducibility were assessed with the intraclass correlation coefficient(ICC),and agreement between devices and between OCT and OCTA were evaluated with Bland-Altman analysis.RESULTS:Sixty-eight eyes from 35 adults(17 females)were included in the analysis.The average age of the participants was 23.6±2.3y,with an average spherical equivalent refraction of-3.08±2.47 D and an average AL of 25.21±1.20 mm.Both OCT devices demonstrated high repeatability and reproducibility in measuring the CVI-OCTA(all ICCs>0.894 across five choroidal regions)and CVI-OCT(all ICCs>0.838).Furthermore,the between-device agreement in measuring the CVI-OCT was good[mean difference(MD)ranging from-2.32%to-3.07%],but that in measuring the CVI-OCTA was poor(MD,1.48%to-7.43%).Additionally,the between-imaging agreement(CVI-OCTA versus CVI-OCT)was poor for both devices(Triton,MD,6.05%to 12.68%;VG200I,MD,6.67%to 12.09%).CONCLUSION:Both OCT devices and the two analytical methods demonstrate good stability.The inter-device consistency of CVI-OCT is good,while the inter-device consistency of CVI-OCTA and the consistency between the two analytical methods in the same device are both poor.展开更多
Subretinal fibrosis is the end-stage sequelae of neovascular age-related macular degeneration.It causes local damage to photoreceptors,retinal pigment epithelium,and choroidal vessels,which leads to permanent central ...Subretinal fibrosis is the end-stage sequelae of neovascular age-related macular degeneration.It causes local damage to photoreceptors,retinal pigment epithelium,and choroidal vessels,which leads to permanent central vision loss of patients with neovascular age-related macular degeneration.The pathogenesis of subretinal fibrosis is complex,and the underlying mechanisms are largely unknown.Therefore,there are no effective treatment options.A thorough understanding of the pathogenesis of subretinal fibrosis and its related mechanisms is important to elucidate its complications and explore potential treatments.The current article reviews several aspects of subretinal fibrosis,including the current understanding on the relationship between neovascular age-related macular degeneration and subretinal fibrosis;multimodal imaging techniques for subretinal fibrosis;animal models for studying subretinal fibrosis;cellular and non-cellular constituents of subretinal fibrosis;pathophysiological mechanisms involved in subretinal fibrosis,such as aging,infiltration of macrophages,different sources of mesenchymal transition to myofibroblast,and activation of complement system and immune cells;and several key molecules and signaling pathways participating in the pathogenesis of subretinal fibrosis,such as vascular endothelial growth factor,connective tissue growth factor,fibroblast growth factor 2,platelet-derived growth factor and platelet-derived growth factor receptor-β,transforming growth factor-βsignaling pathway,Wnt signaling pathway,and the axis of heat shock protein 70-Toll-like receptors 2/4-interleukin-10.This review will improve the understanding of the pathogenesis of subretinal fibrosis,allow the discovery of molecular targets,and explore potential treatments for the management of subretinal fibrosis.展开更多
Dear Editor,We introduce a novel surgical instrument designed to overcome the challenges in draining fluid from the suprachoroidal space in patients with choroidal detachment.In the evolving landscape of ophthalmic su...Dear Editor,We introduce a novel surgical instrument designed to overcome the challenges in draining fluid from the suprachoroidal space in patients with choroidal detachment.In the evolving landscape of ophthalmic surgeries,procedures that were once considered complex,such as those for choroidal detachment,are becoming increasingly common.Drainage of subchoroidal fluid was derived from 1985[1]with indirect visualization during scleral buckle surgery[2-4].展开更多
AIM:To investigate short-term changes in choroidal thickness in response to peripheral myopic defocus induced by two designs of multifocal corneal gas permeable contact lenses(MFGPCL)in young adults.METHODS:Seventeen ...AIM:To investigate short-term changes in choroidal thickness in response to peripheral myopic defocus induced by two designs of multifocal corneal gas permeable contact lenses(MFGPCL)in young adults.METHODS:Seventeen participants,with a mean age of 24.5±4y,underwent choroidal thickness and vascularity index measurements using enhanced depth imaging optical coherence tomography(EDI OCT)at baseline,one day,and one week following MFGPCL wear.Two center-distance MFGPCL designs with similar center zone diameters of 3.0 mm but different peripheral add powers(low add:+1.5 D and high add:+3.0 D)were tested.Each participant was randomly assigned to wear one of the two MFGPCL designs.Measurements of total,luminal,and stromal choroid thickness were obtained in five eccentric regions(6 mm towards the periphery)in all quadrants.RESULTS:Significant thickening in total choroidal thickness were observed after one week of wearing both high add(+10±6µm)and low add(+7±5µm)MFGPCLs,with no statistically significant difference between the two groups(P=0.42).Choroidal thickening was consistent across eccentric regions and quadrants,with no significant differences based on eccentricity or quadrant(all P>0.05).Both lens designs induced choroidal thickening,with no significant difference between them in total choroidal thickness(P=0.18 for quadrants,P=0.51 for eccentric regions).CONCLUSION:Peripheral myopic defocus induced by MFGPCLs lead to significant choroidal thickening,including total,luminal,and stromal components.This study highlights the need for future research to explore the dose-response relationship between peripheral myopic defocus and choroidal thickening,utilizing choroidal response as a potential biomarker.展开更多
AIM:To investigate the choroidal vascular index(CVI)and the choroidal structural changes beyond the subfoveal area(analyzed across a 20 mm×24 mm scanning area)in eyes with chronic central serous chorioretinopathy...AIM:To investigate the choroidal vascular index(CVI)and the choroidal structural changes beyond the subfoveal area(analyzed across a 20 mm×24 mm scanning area)in eyes with chronic central serous chorioretinopathy(cCSC)eyes with macular neovascularization(MNV)using ultra-widefield swept-source optical coherence tomography angiography(UWF SS-OCTA).METHODS:This retrospective comparative study included 46 cCSC with MNV eyes(With MNV group),52 cCSC without MNV eyes(Without MNV group),and 40 age-matched healthy controls.UWF SS-OCTA imaging with a 20 mm×24 mm protocol was used to quantify CVI across 9 subfields(superotemporal,superior,superonasal,temporal,central,nasal,inferotemporal,inferior,and inferonasal).The CVI was compared among the groups.RESULTS:With MNV group demonstrated significantly older mean age than Without MNV group(56.2±6.1 vs 47.5±8.6y,P<0.001).The CVI was significantly lower in the With MNV group than in the Without MNV group,except in the superotemporal,superior,and temporal regions(all P<0.05).Notably,despite MNV-associated CVI reductions,the With MNV group maintained a higher CVI than the control group in all 5 subfields(superior,temporal,central,inferior,and inferonasal;all P<0.05).In the central region,CONCLUSION:CVI decreases,and choroidal structural changes extend beyond the subfoveal area in cCSC with MNV eyes,providing with an imaging evidence for the important role of choroidal ischemia in the pathogenesis of MNV in cCSC.展开更多
AIM:To quantify and compare longitudinal thickness changes of the ganglion cell complex(GCC)and the choroid in patients with different patterns of age-related macular degeneration(AMD)progression.METHODS:Retrospective...AIM:To quantify and compare longitudinal thickness changes of the ganglion cell complex(GCC)and the choroid in patients with different patterns of age-related macular degeneration(AMD)progression.METHODS:Retrospective cohort analysis of anonymized data from participants aged 50y or more and diagnosed with early/intermediate AMD in at least one eye(with no evidence of advanced AMD).A total of 64 participants were included from the Instituto de Retina de Lisboa(IRL)study(IPL/2022/MetAllAMD_ESTeSL)and divided into 4 groups according to the Rotterdam classification for AMD.Spectral domain optical coherence tomography(SD-OCT)was used to assess and quantify GCC and choroid thickness at two time points(first visit vs last visit)with a minimum interval of 3y.RESULTS:In the GCC inner ring,a thinner thickness(P=0.001)was observed in the atrophic AMD group(51.3±21.4μm)compared to the early AMD(84.3±11.5μm),intermediate AMD(77.6±16.1μm)and neovascular AMD(88.9±16.3μm)groups.Choroidal thickness quantification showed a generalized reduction in the central circle(P=0.002)and inner ring(P=0.001).Slight reductions in retinal thickness were more accentuated in the inner ring in the atrophic AMD(-13%;P<0.01).CONCLUSION:The variation of the analyzed structures could be an indicator of risk of progression with neurodegenerative(GCC)or vascular(choroid)pattern in the intermediate and atrophic AMD.The quantification of both structures can provide important information about the risk of disease progression in the early and intermediate stages but also for the evolution pattern into late stages(atrophic or neovascular).展开更多
Automated classification of retinal fundus images is essential for identifying eye diseases,though there is earlier research on applying deep learning models designed especially for detecting tessellation in retinal f...Automated classification of retinal fundus images is essential for identifying eye diseases,though there is earlier research on applying deep learning models designed especially for detecting tessellation in retinal fundus images.This study classifies 4 classes of retinal fundus images with 3 diseased fundus images and 1 normal fundus image,by creating a refined VGG16 model to categorize fundus pictures into tessellated,normal,myopia,and choroidal neovascularization groups.The approach utilizes a VGG16 architecture that has been altered with unique fully connected layers and regularization using dropouts,along with data augmentation techniques(rotation,flip,and rescale)on a dataset of 302 photos.Training involves class weighting and critical callbacks(early halting,learning rate reduction,checkpointing)to maximize performance.Gains in accuracy(93.42%training,77.5%validation)and improved class-specific F1 scores are attained.Grad-CAM’s Explainable AI(XAI)highlights areas of the images that are important for each categorization,making it interpretable for better understanding of medical experts.These results highlight the model’s potential as a helpful diagnostic tool in ophthalmology,providing a clear and practical method for the early identification and categorization of retinal disorders,especially in cases such as tessellated fundus images.展开更多
AIM:To repor t the 24mo outcomes of vascular endothelial growth factor(VEGF)inhibitors for myopic choroidal neovascularization(mCNV)in routine clinical practice and simultaneously evaluated the real-world safety.METHO...AIM:To repor t the 24mo outcomes of vascular endothelial growth factor(VEGF)inhibitors for myopic choroidal neovascularization(mCNV)in routine clinical practice and simultaneously evaluated the real-world safety.METHODS:The patients who received intravitreal injections of VEGF inhibitors of either ranibizumab(0.5 mg)or conbercept(0.5 mg)for mCNV were analyzed from 1 January 2017 to 1 January 2022.The primary outcome variables were mean change in best-corrected visual acuity(BCVA)and central macular thickness(CMT)changes.The secondary outcome variables included IOP changes,the period of mCNV re-treatment,and ocular adverse events.RESULTS:Totally 83 patients aged 56.40±15.36y with axial length 29.67±2.09 mm were included.In visual acuity,the mean logMAR BCVA at baseline was 0.81±0.43.After the initial improvement at 1,3,and 6mo(P<0.05),from month 12 onwards,no statistical difference compared to baseline was found.The mean CMT from 1mo onwards had a statistically significant decrease compared with baseline CMT(P<0.05).The regression model showed better baseline BCVA and thicker baseline CMT,significantly associated with the final outcomes.In univariate analysis,choosing 3+pro re nata(PRN)as the initial injection treatment regimen was associated with better BCVA at 24mo[hazard ratio(HR)=-0.65,95%CI:-1.23,-0.07,P=0.048].However,the difference was not significant in multivariate analysis(HR=-0.59,95%CI:-1.21,0.03,P=0.089).Regarding mCNV recurrence,the mean period(P=0.725)and the proportion of mCNV reactivation(P=1.00)were similar between ranibizumab and conbercept.Kaplan-Meier plot also analyzed that the median time of re-injection was not significantly different among gender,drug,and initial injection treatment regimen.No systemic adverse events related to the therapy were observed.CONCLUSION:BCVA gains achieved by the end of our study maintain generally sustained at the 24-mo follow-up.The findings also indicate that ranibizumab and conbercept demonstrate comparable efficacy and safety profiles.Additionally,intravitreal anti-VEGF therapy using 1+PRN regimen,offers certain advantages in both efficacy and cost-effectiveness.展开更多
Purpose:To summarize and analyze the clinical features and management of postoperative choroidal detachment in glaucoma.Methods:Ten cases of choroidal detachment that occurred after glaucoma surgery were collected fro...Purpose:To summarize and analyze the clinical features and management of postoperative choroidal detachment in glaucoma.Methods:Ten cases of choroidal detachment that occurred after glaucoma surgery were collected from March 2023 to February 2024 in the hospital.Their clinical characteristics and treatment effects were observed and their causes were analyzed.Results:After the operations,the eyes with choroidal detachment after glaucoma surgery had 2 cases of true microphthalmos,6 cases of advanced glaucoma,and 2 cases of glaucoma secondary to vitreoretinal surgery.The postoperative manifestations were persistent shallow anterior chamber,the formation of anterior chamber,and then suddenly became shallow or disappeared.Meanwhile,the intraocular pressure was lower than 6 mmHg.Ultrasound and funduscopic examination showed that the choroid and retina were partially elevated,and the choroidal detachment recovered after treatment.Conclusion:Choroidal detachment is one of the common postoperative complications in glaucoma,especially in some special types of refractory glaucoma.Adequate perioperative management before surgery,cautious and delicate operation during surgery,and close observation and treatment after surgery can obviously decrease the occurrence and damage.展开更多
The global prevalence of myopia is becoming increasingly severe,with epidemiological models predicting that by 2050,approximately 50%of the world’s population will be affected by myopia,and about 10%will suffer from ...The global prevalence of myopia is becoming increasingly severe,with epidemiological models predicting that by 2050,approximately 50%of the world’s population will be affected by myopia,and about 10%will suffer from high myopia.The incidence of high myopia is projected to increase fivefold,making it the leading cause of irreversible vision impairment.Myopia often leads to various complications and has been associated with other ocular diseases,including early-onset cataracts,age-related macular degeneration,and primary open angle glaucoma.As a result,the control and management of myopia have become ongoing and long-term research priorities.The pathogenesis of myopia involves complex multisystem interactions.Current mainstream theories focus primarily on choroidal hypoxia-induced scleral remodeling,with neurotransmitters such as acetylcholine and dopamine playing regulatory roles.However,recent studies have increasingly suggested that changes in nutritional intake,including proteins,fats,and cholesterol,may also be related to myopia development.The role of lipid metabolism in the onset and progression of myopia has gradually attracted growing attention.Therefore,this review aims to systematically elucidate the molecular mechanisms of lipid metabolism regulatory networks in axial myopia,integrating multidimensional factors to provide a theoretical foundation for precision intervention strategies.展开更多
Artesunate is a derivative of artemisinin,and due to its high solubility,and it has a broader application in clinical settings.Extensive research has confirmed that artemisinin-based drugs show significant activities ...Artesunate is a derivative of artemisinin,and due to its high solubility,and it has a broader application in clinical settings.Extensive research has confirmed that artemisinin-based drugs show significant activities in antiinflammatory,anti-tumor,anti-viral,and anti-angiogenesis aspects,suggesting that artesunate might have potential in treating retinal diseases.Currently,the etiology of most retinal diseases is not fully understood,and there is a lack of effective treatment methods.This paper summarized the research progress of artesunate in the treatment of retinal diseases,including retinoblastoma,choroidal melanoma,diabetic retinopathy,central retinal vein occlusion,proliferative retinopathy,and ocular neovascularization.In addition,the potential applications and future research directions of artesunate in the treatment of retinal diseases were also discussed.展开更多
BACKGROUND Small blood vessels in the eyes are more susceptible to injury,which can lead to complications.However,since diabetic retinopathy is often a serious clinical condition,most of this study focuses on the vasc...BACKGROUND Small blood vessels in the eyes are more susceptible to injury,which can lead to complications.However,since diabetic retinopathy is often a serious clinical condition,most of this study focuses on the vascular system of the choroid.As part of this study,we looked at how gymnemic acid(from Gymnema sylvestre)and glabridin(from Glycyrrhiza glabra,or licorice)might help diabetic rats’choroid structural change and blood vessels.AIM To explore the effects of glabridin and gymnemic acid on the structural changes of the choroidal layer and choriocapillaris as well as the expression of vascular endothelial growth factor(VEGF)and cluster of differentiation(CD)31 in diabetic rat’s eye.METHODS The male Wistar rats were separated into five groups:The control group(control),the diabetic group(DM),the diabetic rats treated with glabridin 40 mg/kg body weight(DM+GB),the diabetic rats treated with gymnemic acid 400 mg/kg body weight(DM+GM),and the diabetic rats treated with glyburide 4 mg/kg body weight(DM+GR).RESULTS There was an increase in the thickness of both the choroid layer and the wall of the arteries in the DM.A decrease in vascularity and choroidal impairment was found in DM rats.After eight weeks of experimentation,the choroidal thickness increased,and the walls of choroid arteries.The choroidal thickness in the DM+GB was 15.69±1.54μm,DM+GM was 14.84±1.31,and DM+GR groups was 16.45±1.15 when compared with DM group(27.22±2.05),the walls thickness of choroid arteries in the DM+GB was 10.23±1.11,DM+GM was 10.41±1.44,and DM+GR was 9.80±1.78 when compared with DM group(16.35±5.01),The expression of VEGF and CD31 was lower compared to the DM group.CONCLUSION In diabetic choroidopathy,hyperglycemia and inflammation cause damage to the neurovascular unit and bloodretinal barrier.Anti-VEGF treatments can slow or reverse the progression of the disease.According to current research findings,glabridin and gymnemic acid can reduce damage to the choroid,which is a factor that can sometimes result in vision loss.展开更多
AIM:To explore choroidal thickness(CT)and choroidal vascularity index(CVI)changes around the macula and optic nerve head(ONH)using swept-source optical coherence tomography(SS-OCT)after small-incision lenticule extrac...AIM:To explore choroidal thickness(CT)and choroidal vascularity index(CVI)changes around the macula and optic nerve head(ONH)using swept-source optical coherence tomography(SS-OCT)after small-incision lenticule extraction(SMILE)and evaluate their associations with accommodation and aberrations.METHODS:Participants were divided into more myopic group(43 eyes)and less myopic group(33 eyes)according to refractive error.SS-OCT,negative relative accommodation(NRA),and positive relative accommodation(PRA)were analyzed before and 1d,1wk,and 1mo postoperatively.Root mean square higher-order aberrations(RMS HOAs),spherical aberrations(SAs),and coma were compared preoperative,1wk,and 1mo postoperatively.RESULTS:After surgery,RMS(0.29±0.26)and Coma(0.16±0.19)all increased.In the more myopic group,central and T macular CT(247.58±63.81 a n d 276.45±62.52μm)increased.NRA(0.41±0.51)and PRA(0.10±1.30)decreased,and SAs(0.21±0.21)increased.In the less myopic group,all regional and mean macular CT increased.NRA was correlated with mean and inferior CTs and mean ONH CVI.SE was correlated with macular CT,CVI,and ONH CT.Mean macular and ONH CTs were associated with RMS HOA,SA,and coma.Macular T2 CT was a significant predictor of SA.Macular T2 and N1 CT were correlated with coma.CONCLUSION:More variations in accommodation and aberrations and fewer choroid thickens on macular and ONH are found in more myopic eyes after SMILE.Choroidal values are associated with accommodation and aberrations during SMILE.Choroid parameters on SS-OCT varies in eyes with different refractive errors after SMILE and has an association with accommodation and visual quality.展开更多
Bilateral diffuse uveal melanocytic proliferation(BDUMP)is a rare paraneoplastic ocular syndrome,often associated with significant vision loss and poor prognosis.BDUMP is typically linked to systemic malignancies,incl...Bilateral diffuse uveal melanocytic proliferation(BDUMP)is a rare paraneoplastic ocular syndrome,often associated with significant vision loss and poor prognosis.BDUMP is typically linked to systemic malignancies,including ovarian,lung,pancreatic,and colorectal cancers.Here,we reported a case of BDUMP in a 59-year-old male patient who had been misdiagnosed with a nonfunctional adrenal adenoma.This man,with a history of diabetes mellitus and high blood pressure,complained of progressive visual loss in both eyes.He was diagnosed with BDUMP after undergoing comprehensive ophthalmic assessments at our eye center.After being referred to the urology department,he was initially diagnosed with a right nonfunctional adrenal adenoma because his renin-aldosterone levels and serum potassium levels were normal.However,three months later,the adrenal mass rapidly increased in size,and liver metastasis was confirmed.Despite normal tumor marker levels,a histopathological diagnosis ultimately confirmed adrenocortical carcinoma.This case underscores the importance of considering underlying malignancies in patients with BDUMP and highlights the necessity for early systemic evaluation,including imaging studies and multidisciplinary consultations.Timely diagnosis of underlying cancers may improve patient outcomes.It is worth noting that normal hormone levels and a tumor small-sized cannot be used as conclusive evidence that the tumor is a nonfunctional adrenal adenoma;patients with BDUMP should be closely followed up to identify the primary malignancy.展开更多
AIM:To describe the optical coherence tomography(OCT)findings of the retinal nerve fiber layer thickness(RNFLT)and choroidal thickness(CT)in beta-thalassemia major.METHODS:A systematic search was conducted on PubMed,C...AIM:To describe the optical coherence tomography(OCT)findings of the retinal nerve fiber layer thickness(RNFLT)and choroidal thickness(CT)in beta-thalassemia major.METHODS:A systematic search was conducted on PubMed,Cochrane,and Embase using a combination of specific key words.The records found were screened in two phases(title/abstract,and full-text screening).All the original observational cross-sectional studies conducted on beta-thalassemia major cases and controls reporting the RNFLT and CT were included.The Meta-analysis was run for comparing the OCT measurements between betathalassemia cases and controls including pooled effect size,confidence intervals(CI),quality assessment,and publication bias.The measurements included were RNFLT(average,and in various quadrants),and CT.RESULTS:A total of 10 studies were included in this Meta-analysis including a total of 684 individuals,362 cases and 322 controls.The RNFLT and CT showed a significant reduction in the values of beta-thalassemia cases as compared to controls.The heterogeneity among the included studies was found to be 92.65%for the average RNFLT and 30.13%for the CT making it obvious to use random effects model for analyzing the RNFLT values while fixed effects model for the CT.The Egger’s test showed significant publication bias among all the parameters except for nasal RNFLT(P=0.507),and CT(P=0.281).The estimated average effect size for the average RNFLT was 1.04(95%CI:0.35 to 1.72,Z=2.961,P=0.003)and for CT was 0.74(95%CI:0.51 to 0.96,Z=6.523,P<0.001).CONCLUSION:This Meta-analysis concludes that the RNFLT and CT are significantly thinner in beta-thalassemia cases in comparison to healthy individuals.Therefore,the RNFLT and CT must be evaluated in routine clinical practice in order to avoid irreversible vision loss particularly in betathalassemia individuals.展开更多
基金Project supported by the National Natural Science Foundation of China(No.81500760)
文摘Objective： To evaluate the effect of anti-vascular endothelial growth factor （VEGF） on juxtafoveal choroidal neovascularization （CNV） secondary to multifocal choroiditis （MFC） and wet age-related macular degeneration （AMD）. Methods： In this retrospective, comparative study, 20 unique eyes with CNV were divided into two groups： 10 patients affected by MFC and 10 patients diagnosed with wet AMD. They all received local intravitreal （Ivr） injections of ranibizumab, with 6 months of follow-up. Retreatment injections were performed based on findings suggestive of active neovascularization. Results： Significant improvements were observed in the juxtafoveal CNV lesions, and average central macular thickness decreased in both groups following the anti-VEGF therapy （P〈0.05）. The average number of injections used in MFC patients was 1.6, while three injections on average were used in wet AMD patients （Z=-2.844, P=0.009）. Best-corrected visual acuity was significantly improved in MFC patients after anti-VEGF therapy （P〈0.05）, and there was no significant difference in wet AMD patients between before anti-VEGF therapy and 6 months later （P〉0.05）. Conclusions： IVT ranibizumab resulted in good clinical outcomes for juxtafoveal CNV secondary to MFC and wet AMD, but the average number of injections used in MFC was fewer than that used in wet AMD over a 6-month observation period. Compared with the wet AMD group, visual acuity was obviously improved in the MFC group at 6 months.
基金supported by the National Natural Science Foundation of China[No.81400422 and 81271034]2015 Outstanding Young Scholar of Beijing[2015000021223ZK22]+1 种基金Key Discipline Leading Plan in Beijing Institute of Ophthalmology[201503]Capital’s Funds for Health Improvement and Research[2018-2-1081]
文摘Objective To investigate optical coherence tomography（OCT） characteristics of tuberculous serpiginous-like choroiditis（Tb-SLC） and serpiginous choroiditis（SC） and to perform OCT to differentiate between these conditions.Methods This retrospective,case-control study examined consecutively enrolled patients with active Tb-SLC or SC.Patients underwent comprehensive ocular examinations and imaging（OCT,color fundus photography,autofluorescence imaging,fluorescein angiography,and indocyanine green angiography）.Findings were examined and compared between eyes with SC and Tb-SLC.Results Nine patients with active Tb-SLC（14 eyes） and 8 with active SC（12 eyes） were included.The following OCT findings were observed significantly more often in the Tb-SLC group than in the SC group： vitreal hyper-reflective spots [5 Tb-SLC eyes（36%）,no SC eyes：P = 0.02],intraretinal edema [11 Tb-SLC eyes（79%）,3 SC eyes（25%）：P = 0.01],sub-retinal pigment epithelium（RPE） drusenoid deposits [11 Tb-SLC eyes（79%）,2 SC eyes（17%）：P 〈 0.01],and choroidal granulomas [8 Tb-SLC eyes（57%）,2 SC eyes（17%）：P = 0.03].A hyporeflective,wedge-shaped band was observed more often in the SC group [5 Tb-SLC eyes（36%）,9 SC eyes（75%）：P = 0.045] than in the Tb-SLC group.The incidence of other OCT signs did not differ between the groups and included outer nuclear layer hyper-reflection,outer retinal tabulation,and choriocapillaris point-like hyper-reflection.Conclusion Vitreal hyper-reflective spots,intraretinal fluid,sub-RPE drusenoid deposits,and choroidal granulomas on OCT images may indicate Tb-SLC.Additionally,a hyporeflective,wedge-shaped band may indicate SC.Therefore,OCT is likely helpful in differentiating between Tb-SLC and SC.
文摘Purpose: To evaluate the short-term efficacy of intravitreal anti-VEGF (Lucentis) and sub-tenon injection of triamcinolone acetonide for choroidal neovascularization (CNV) associated with multifocal choroiditis (MC). Methods: Eight eyes of 8 patients treated with intravitreal anti-VEGF and posterior sub-tenon injection of Triamcinolone Acetonide (TA) for subfoveal or juxtafoveal CNV associated with MC were retrospectively reviewed. Best corrected visual acuity (BCVA), results of fundus fluorescein angiography (FFA)/indocyanine green angiography (ICGA), optical coherence tomography (OCT) at baseline and 3, 6 months after treatment were compared. Results: All of the 8 patients showed significant improvement in BCVA at 3 and 6 months after treatment (P < 0.05). FFA/ICGA showed decrease or cessation of inflammation in 8 patients (100%). 7 patients (87.5%) had no significant active leakage while 1 patient (12.5%) had persistent leakage from the neovascular lesion at 3-month follow up. 6 months after treatment, no recurrence of inflammation occurred and no active leakage in all 8 patients. OCT showed reduced CNV area and alleviated edema. There are no severe treatment-related side effects expect slight eye pain during infusion in one patient. Intraocular pressure was all normal in follow up. Conclusion: Although the follow-up time and the number of patients in this study were limited, the use of intravitreal anti-VEGF combined with sub-tenon injection of TA was associated with improvement of visual acuity in patients with CNV secondary to MC. Further studies including a greater number of patients with longer follow up time are needed.
文摘AIM:To report and analyze cases of sterile intraocular inflammation(IOI)following intravitreal faricimab injections in patients treated for neovascular age-related macular degeneration(nAMD)and diabetic macular edema(DME).METHODS:This double-center case series included nine eyes of six patients who developed uveitis after faricimab therapy.Comprehensive clinical evaluation was performed,including slit-lamp examination,intraocular pressure(IOP)measurement,fluorescein and indocyanine green angiography(ICGA),and laboratory tests.Inflammatory responses were treated with topical or systemic corticosteroids,and patients were monitored for visual acuity and inflammatory activity.RESULTS:The incidence of IOI was 0.8%per patient(Innsbruck)and 0.23%(Czechia),with inflammation typically occurring between the third and sixth injection(mean interval:10d post-injection).Inflammator y presentations ranged from anterior uveitis to posterior segment involvement.One notable case demonstrated novel choroidal hypofluorescent lesions on angiography,suggesting deeper ocular involvement.The mean patient age was 76y;five of six affected patients were female.All cases responded to local and systemic corticosteroids,with full recovery of initial visual acuity.CONCLUSION:Sterile IOI after faricimab appears to be a rare but relevant adverse event.Although the incidence falls within expected ranges for anti-vascular endothelial growth factor(anti-VEGF)agents,the observed choroidal involvement represents a potentially new safety signal.Prompt diagnosis and corticosteroid therapy are effective in all cases.Our findings support the need for vigilant post-marketing surveillance and further studies to better understand the underlying mechanisms and risk factors of faricimab-associated inflammation.
文摘AIM:To investigate the association between anti-DFS70 antibody positivity and ocular parameters,specifically,the choroidal vascularity index(CVI)and other optical coherence tomography(OCT)metrics,in a healthy population.METHODS:This age-and sex-matched case-control study enrolled 84 healthy individuals with positive anti-DFS70 antibody findings and 84 healthy negative controls.All participants underwent detailed ophthalmological examinations,including biometry and OCT imaging.Anti-DFS70 positivity was determined by indirect immunofluorescence and scored semi-quantitatively(1+to 3+).CVI was calculated from OCT images using a standardized protocol with Image J software.Statistical analyses,including Student’s t-test,Mann-Whitney U test,Spearman correlation,and logistic regression,were used to compare groups and identify predictive factors.RESULTS:The individuals who tested positive and negative for anti-DFS70 included in the study were matched for age(median age=47y)and sex(F:M=7:1).CVI was significantly lower in the anti-DFS70-positive group compared to the negative group.A higher anti-DFS70 antibody titer was significantly associated with decreased subfoveal and nasal choroidal thickness(P=0.016 and P=0.014,respectively).In univariate regression analysis,CVI was the only significant predictor of anti-DFS70 positivity[odds ratio(OR)=0.02,P=0.025].Multivariate analysis revealed a positive correlation between macular thinning outside the subfoveal area and anti-DFS70 status(P<0.05).CONCLUSION:Our study demonstrates a novel association between anti-DFS70 antibody positivity and reduced choroidal vascularity in healthy individuals.These findings suggest that anti-DFS70 antibodies may be associated with subtle choroidal vascular changes detectable by OCT,even in asymptomatic individuals.Further longitudinal research is warranted to clarify the underlying mechanisms and long-term clinical significance of these ocular changes.
基金Supported by the National Key Research and Development Program of China(No.2022YFC3502503)the Medical and Health Science and Technology Project of the Zhejiang Provincial Health Commission of China(No.2022PY072).
文摘AIM:To explore the repeatability,reproducibility,and agreement in the measurement of the choroidal vascularity index(CVI)for different swept-source optical coherence tomography(OCT)devices and between OCT and OCT angiography(OCTA)images.METHODS:Two swept-source OCT imaging systems,VG200I and Topcon DRI OCT Triton,were used to capture OCT and OCTA images in triplicate.The first and third images were taken by one operator,and the second image was taken by another operator.The built-in software was used to calculate the CVI from the OCTA images(CVI-OCTA),and a custom-designed algorithm was used to calculate the CVI from the OCT images(CVI-OCT).Repeatability and reproducibility were assessed with the intraclass correlation coefficient(ICC),and agreement between devices and between OCT and OCTA were evaluated with Bland-Altman analysis.RESULTS:Sixty-eight eyes from 35 adults(17 females)were included in the analysis.The average age of the participants was 23.6±2.3y,with an average spherical equivalent refraction of-3.08±2.47 D and an average AL of 25.21±1.20 mm.Both OCT devices demonstrated high repeatability and reproducibility in measuring the CVI-OCTA(all ICCs>0.894 across five choroidal regions)and CVI-OCT(all ICCs>0.838).Furthermore,the between-device agreement in measuring the CVI-OCT was good[mean difference(MD)ranging from-2.32%to-3.07%],but that in measuring the CVI-OCTA was poor(MD,1.48%to-7.43%).Additionally,the between-imaging agreement(CVI-OCTA versus CVI-OCT)was poor for both devices(Triton,MD,6.05%to 12.68%;VG200I,MD,6.67%to 12.09%).CONCLUSION:Both OCT devices and the two analytical methods demonstrate good stability.The inter-device consistency of CVI-OCT is good,while the inter-device consistency of CVI-OCTA and the consistency between the two analytical methods in the same device are both poor.
基金supported by grants from National Key R&D Program of China,No.2023YFC2506100(to JZ)the National Natural Science Foundation of China,No.82171062(to JZ).
文摘Subretinal fibrosis is the end-stage sequelae of neovascular age-related macular degeneration.It causes local damage to photoreceptors,retinal pigment epithelium,and choroidal vessels,which leads to permanent central vision loss of patients with neovascular age-related macular degeneration.The pathogenesis of subretinal fibrosis is complex,and the underlying mechanisms are largely unknown.Therefore,there are no effective treatment options.A thorough understanding of the pathogenesis of subretinal fibrosis and its related mechanisms is important to elucidate its complications and explore potential treatments.The current article reviews several aspects of subretinal fibrosis,including the current understanding on the relationship between neovascular age-related macular degeneration and subretinal fibrosis;multimodal imaging techniques for subretinal fibrosis;animal models for studying subretinal fibrosis;cellular and non-cellular constituents of subretinal fibrosis;pathophysiological mechanisms involved in subretinal fibrosis,such as aging,infiltration of macrophages,different sources of mesenchymal transition to myofibroblast,and activation of complement system and immune cells;and several key molecules and signaling pathways participating in the pathogenesis of subretinal fibrosis,such as vascular endothelial growth factor,connective tissue growth factor,fibroblast growth factor 2,platelet-derived growth factor and platelet-derived growth factor receptor-β,transforming growth factor-βsignaling pathway,Wnt signaling pathway,and the axis of heat shock protein 70-Toll-like receptors 2/4-interleukin-10.This review will improve the understanding of the pathogenesis of subretinal fibrosis,allow the discovery of molecular targets,and explore potential treatments for the management of subretinal fibrosis.
基金Supported by Science and Technology Foundation of Tianjin Eye Hospital(No.YKPY2207)Tianjin Key Medical Discipline(Specialty)Construction Project(No.TJYXZDXK-016A).
文摘Dear Editor,We introduce a novel surgical instrument designed to overcome the challenges in draining fluid from the suprachoroidal space in patients with choroidal detachment.In the evolving landscape of ophthalmic surgeries,procedures that were once considered complex,such as those for choroidal detachment,are becoming increasingly common.Drainage of subchoroidal fluid was derived from 1985[1]with indirect visualization during scleral buckle surgery[2-4].
基金Supported by Ongoing Research Funding Program(No.ORF-2025-1160),King Saud University,Riyadh Saudi Arabia.
文摘AIM:To investigate short-term changes in choroidal thickness in response to peripheral myopic defocus induced by two designs of multifocal corneal gas permeable contact lenses(MFGPCL)in young adults.METHODS:Seventeen participants,with a mean age of 24.5±4y,underwent choroidal thickness and vascularity index measurements using enhanced depth imaging optical coherence tomography(EDI OCT)at baseline,one day,and one week following MFGPCL wear.Two center-distance MFGPCL designs with similar center zone diameters of 3.0 mm but different peripheral add powers(low add:+1.5 D and high add:+3.0 D)were tested.Each participant was randomly assigned to wear one of the two MFGPCL designs.Measurements of total,luminal,and stromal choroid thickness were obtained in five eccentric regions(6 mm towards the periphery)in all quadrants.RESULTS:Significant thickening in total choroidal thickness were observed after one week of wearing both high add(+10±6µm)and low add(+7±5µm)MFGPCLs,with no statistically significant difference between the two groups(P=0.42).Choroidal thickening was consistent across eccentric regions and quadrants,with no significant differences based on eccentricity or quadrant(all P>0.05).Both lens designs induced choroidal thickening,with no significant difference between them in total choroidal thickness(P=0.18 for quadrants,P=0.51 for eccentric regions).CONCLUSION:Peripheral myopic defocus induced by MFGPCLs lead to significant choroidal thickening,including total,luminal,and stromal components.This study highlights the need for future research to explore the dose-response relationship between peripheral myopic defocus and choroidal thickening,utilizing choroidal response as a potential biomarker.
基金Supported by General Program of National Natural Science Foundation of China(No.82471110)National Key Research and Development Program of China(No.2022YFC2502805)Postdoctoral Foundation of General Hospital of Central Theater Command(No.20210517KY04).
文摘AIM:To investigate the choroidal vascular index(CVI)and the choroidal structural changes beyond the subfoveal area(analyzed across a 20 mm×24 mm scanning area)in eyes with chronic central serous chorioretinopathy(cCSC)eyes with macular neovascularization(MNV)using ultra-widefield swept-source optical coherence tomography angiography(UWF SS-OCTA).METHODS:This retrospective comparative study included 46 cCSC with MNV eyes(With MNV group),52 cCSC without MNV eyes(Without MNV group),and 40 age-matched healthy controls.UWF SS-OCTA imaging with a 20 mm×24 mm protocol was used to quantify CVI across 9 subfields(superotemporal,superior,superonasal,temporal,central,nasal,inferotemporal,inferior,and inferonasal).The CVI was compared among the groups.RESULTS:With MNV group demonstrated significantly older mean age than Without MNV group(56.2±6.1 vs 47.5±8.6y,P<0.001).The CVI was significantly lower in the With MNV group than in the Without MNV group,except in the superotemporal,superior,and temporal regions(all P<0.05).Notably,despite MNV-associated CVI reductions,the With MNV group maintained a higher CVI than the control group in all 5 subfields(superior,temporal,central,inferior,and inferonasal;all P<0.05).In the central region,CONCLUSION:CVI decreases,and choroidal structural changes extend beyond the subfoveal area in cCSC with MNV eyes,providing with an imaging evidence for the important role of choroidal ischemia in the pathogenesis of MNV in cCSC.
基金Supported by FCT/MCTES UIDB/05608/2020(https://doi.org/10.54499/UIDB/05608/2020)UIDP/05608/2020(https://doi.org/10.54499/UIDP/05608/2020)+1 种基金IDI&CA grant IPL/2022/MetAllAMD_ESTeSL by H&TRC-Health&Technology Research Center,ESTeSL-Escola Superior de Tecnologia da Saúde,Instituto Politécnico de Lisboaby Retina Institute of Lisbon(IRL).
文摘AIM:To quantify and compare longitudinal thickness changes of the ganglion cell complex(GCC)and the choroid in patients with different patterns of age-related macular degeneration(AMD)progression.METHODS:Retrospective cohort analysis of anonymized data from participants aged 50y or more and diagnosed with early/intermediate AMD in at least one eye(with no evidence of advanced AMD).A total of 64 participants were included from the Instituto de Retina de Lisboa(IRL)study(IPL/2022/MetAllAMD_ESTeSL)and divided into 4 groups according to the Rotterdam classification for AMD.Spectral domain optical coherence tomography(SD-OCT)was used to assess and quantify GCC and choroid thickness at two time points(first visit vs last visit)with a minimum interval of 3y.RESULTS:In the GCC inner ring,a thinner thickness(P=0.001)was observed in the atrophic AMD group(51.3±21.4μm)compared to the early AMD(84.3±11.5μm),intermediate AMD(77.6±16.1μm)and neovascular AMD(88.9±16.3μm)groups.Choroidal thickness quantification showed a generalized reduction in the central circle(P=0.002)and inner ring(P=0.001).Slight reductions in retinal thickness were more accentuated in the inner ring in the atrophic AMD(-13%;P<0.01).CONCLUSION:The variation of the analyzed structures could be an indicator of risk of progression with neurodegenerative(GCC)or vascular(choroid)pattern in the intermediate and atrophic AMD.The quantification of both structures can provide important information about the risk of disease progression in the early and intermediate stages but also for the evolution pattern into late stages(atrophic or neovascular).
基金support from the"Intelligent Recognition Industry Service Center"as part of the Featured Areas Research Center Program under the Higher Education Sprout Project by the Ministry of Education(MOE)in Taiwan,and the National Science and Technology Council,Taiwan,under grants[113-2622-E-224-002]and[113-2221-E-224-041]support was provided by Isuzu Optics Corporation.
文摘Automated classification of retinal fundus images is essential for identifying eye diseases,though there is earlier research on applying deep learning models designed especially for detecting tessellation in retinal fundus images.This study classifies 4 classes of retinal fundus images with 3 diseased fundus images and 1 normal fundus image,by creating a refined VGG16 model to categorize fundus pictures into tessellated,normal,myopia,and choroidal neovascularization groups.The approach utilizes a VGG16 architecture that has been altered with unique fully connected layers and regularization using dropouts,along with data augmentation techniques(rotation,flip,and rescale)on a dataset of 302 photos.Training involves class weighting and critical callbacks(early halting,learning rate reduction,checkpointing)to maximize performance.Gains in accuracy(93.42%training,77.5%validation)and improved class-specific F1 scores are attained.Grad-CAM’s Explainable AI(XAI)highlights areas of the images that are important for each categorization,making it interpretable for better understanding of medical experts.These results highlight the model’s potential as a helpful diagnostic tool in ophthalmology,providing a clear and practical method for the early identification and categorization of retinal disorders,especially in cases such as tessellated fundus images.
基金Supported by Tianjin Key Medical Discipline(Specialty)Construction Project(No.TJYXZDXK-037A).
文摘AIM:To repor t the 24mo outcomes of vascular endothelial growth factor(VEGF)inhibitors for myopic choroidal neovascularization(mCNV)in routine clinical practice and simultaneously evaluated the real-world safety.METHODS:The patients who received intravitreal injections of VEGF inhibitors of either ranibizumab(0.5 mg)or conbercept(0.5 mg)for mCNV were analyzed from 1 January 2017 to 1 January 2022.The primary outcome variables were mean change in best-corrected visual acuity(BCVA)and central macular thickness(CMT)changes.The secondary outcome variables included IOP changes,the period of mCNV re-treatment,and ocular adverse events.RESULTS:Totally 83 patients aged 56.40±15.36y with axial length 29.67±2.09 mm were included.In visual acuity,the mean logMAR BCVA at baseline was 0.81±0.43.After the initial improvement at 1,3,and 6mo(P<0.05),from month 12 onwards,no statistical difference compared to baseline was found.The mean CMT from 1mo onwards had a statistically significant decrease compared with baseline CMT(P<0.05).The regression model showed better baseline BCVA and thicker baseline CMT,significantly associated with the final outcomes.In univariate analysis,choosing 3+pro re nata(PRN)as the initial injection treatment regimen was associated with better BCVA at 24mo[hazard ratio(HR)=-0.65,95%CI:-1.23,-0.07,P=0.048].However,the difference was not significant in multivariate analysis(HR=-0.59,95%CI:-1.21,0.03,P=0.089).Regarding mCNV recurrence,the mean period(P=0.725)and the proportion of mCNV reactivation(P=1.00)were similar between ranibizumab and conbercept.Kaplan-Meier plot also analyzed that the median time of re-injection was not significantly different among gender,drug,and initial injection treatment regimen.No systemic adverse events related to the therapy were observed.CONCLUSION:BCVA gains achieved by the end of our study maintain generally sustained at the 24-mo follow-up.The findings also indicate that ranibizumab and conbercept demonstrate comparable efficacy and safety profiles.Additionally,intravitreal anti-VEGF therapy using 1+PRN regimen,offers certain advantages in both efficacy and cost-effectiveness.
基金Key Research and Development Program of Hubei Province(Project No.:2021BCA125)。
文摘Purpose:To summarize and analyze the clinical features and management of postoperative choroidal detachment in glaucoma.Methods:Ten cases of choroidal detachment that occurred after glaucoma surgery were collected from March 2023 to February 2024 in the hospital.Their clinical characteristics and treatment effects were observed and their causes were analyzed.Results:After the operations,the eyes with choroidal detachment after glaucoma surgery had 2 cases of true microphthalmos,6 cases of advanced glaucoma,and 2 cases of glaucoma secondary to vitreoretinal surgery.The postoperative manifestations were persistent shallow anterior chamber,the formation of anterior chamber,and then suddenly became shallow or disappeared.Meanwhile,the intraocular pressure was lower than 6 mmHg.Ultrasound and funduscopic examination showed that the choroid and retina were partially elevated,and the choroidal detachment recovered after treatment.Conclusion:Choroidal detachment is one of the common postoperative complications in glaucoma,especially in some special types of refractory glaucoma.Adequate perioperative management before surgery,cautious and delicate operation during surgery,and close observation and treatment after surgery can obviously decrease the occurrence and damage.
基金Supported by the National Natural Science Foundation of China(No.82000922,No.81870647).
文摘The global prevalence of myopia is becoming increasingly severe,with epidemiological models predicting that by 2050,approximately 50%of the world’s population will be affected by myopia,and about 10%will suffer from high myopia.The incidence of high myopia is projected to increase fivefold,making it the leading cause of irreversible vision impairment.Myopia often leads to various complications and has been associated with other ocular diseases,including early-onset cataracts,age-related macular degeneration,and primary open angle glaucoma.As a result,the control and management of myopia have become ongoing and long-term research priorities.The pathogenesis of myopia involves complex multisystem interactions.Current mainstream theories focus primarily on choroidal hypoxia-induced scleral remodeling,with neurotransmitters such as acetylcholine and dopamine playing regulatory roles.However,recent studies have increasingly suggested that changes in nutritional intake,including proteins,fats,and cholesterol,may also be related to myopia development.The role of lipid metabolism in the onset and progression of myopia has gradually attracted growing attention.Therefore,this review aims to systematically elucidate the molecular mechanisms of lipid metabolism regulatory networks in axial myopia,integrating multidimensional factors to provide a theoretical foundation for precision intervention strategies.
基金Supported by the Ministry of National Natural Science Foundation of China(No.82260210)General Project of Jiangxi Provincial Traditional Chinese Medicine Science and Technology Plan(No.2023B1368)Jiangxi Provincial Health Science and Technology Program(No.202510055).
文摘Artesunate is a derivative of artemisinin,and due to its high solubility,and it has a broader application in clinical settings.Extensive research has confirmed that artemisinin-based drugs show significant activities in antiinflammatory,anti-tumor,anti-viral,and anti-angiogenesis aspects,suggesting that artesunate might have potential in treating retinal diseases.Currently,the etiology of most retinal diseases is not fully understood,and there is a lack of effective treatment methods.This paper summarized the research progress of artesunate in the treatment of retinal diseases,including retinoblastoma,choroidal melanoma,diabetic retinopathy,central retinal vein occlusion,proliferative retinopathy,and ocular neovascularization.In addition,the potential applications and future research directions of artesunate in the treatment of retinal diseases were also discussed.
基金Supported by the Prince of Songkla University Research Fund,No.SCI6302040S。
文摘BACKGROUND Small blood vessels in the eyes are more susceptible to injury,which can lead to complications.However,since diabetic retinopathy is often a serious clinical condition,most of this study focuses on the vascular system of the choroid.As part of this study,we looked at how gymnemic acid(from Gymnema sylvestre)and glabridin(from Glycyrrhiza glabra,or licorice)might help diabetic rats’choroid structural change and blood vessels.AIM To explore the effects of glabridin and gymnemic acid on the structural changes of the choroidal layer and choriocapillaris as well as the expression of vascular endothelial growth factor(VEGF)and cluster of differentiation(CD)31 in diabetic rat’s eye.METHODS The male Wistar rats were separated into five groups:The control group(control),the diabetic group(DM),the diabetic rats treated with glabridin 40 mg/kg body weight(DM+GB),the diabetic rats treated with gymnemic acid 400 mg/kg body weight(DM+GM),and the diabetic rats treated with glyburide 4 mg/kg body weight(DM+GR).RESULTS There was an increase in the thickness of both the choroid layer and the wall of the arteries in the DM.A decrease in vascularity and choroidal impairment was found in DM rats.After eight weeks of experimentation,the choroidal thickness increased,and the walls of choroid arteries.The choroidal thickness in the DM+GB was 15.69±1.54μm,DM+GM was 14.84±1.31,and DM+GR groups was 16.45±1.15 when compared with DM group(27.22±2.05),the walls thickness of choroid arteries in the DM+GB was 10.23±1.11,DM+GM was 10.41±1.44,and DM+GR was 9.80±1.78 when compared with DM group(16.35±5.01),The expression of VEGF and CD31 was lower compared to the DM group.CONCLUSION In diabetic choroidopathy,hyperglycemia and inflammation cause damage to the neurovascular unit and bloodretinal barrier.Anti-VEGF treatments can slow or reverse the progression of the disease.According to current research findings,glabridin and gymnemic acid can reduce damage to the choroid,which is a factor that can sometimes result in vision loss.
基金Supported by the National Natural Science Foundation of China(No.81900910)Natural Science Foundation of Zhejiang Province(No.LQ19H120003)Basic Scientific Research Project of Wenzhou(No.Y20210194,No.Y20190638).
文摘AIM:To explore choroidal thickness(CT)and choroidal vascularity index(CVI)changes around the macula and optic nerve head(ONH)using swept-source optical coherence tomography(SS-OCT)after small-incision lenticule extraction(SMILE)and evaluate their associations with accommodation and aberrations.METHODS:Participants were divided into more myopic group(43 eyes)and less myopic group(33 eyes)according to refractive error.SS-OCT,negative relative accommodation(NRA),and positive relative accommodation(PRA)were analyzed before and 1d,1wk,and 1mo postoperatively.Root mean square higher-order aberrations(RMS HOAs),spherical aberrations(SAs),and coma were compared preoperative,1wk,and 1mo postoperatively.RESULTS:After surgery,RMS(0.29±0.26)and Coma(0.16±0.19)all increased.In the more myopic group,central and T macular CT(247.58±63.81 a n d 276.45±62.52μm)increased.NRA(0.41±0.51)and PRA(0.10±1.30)decreased,and SAs(0.21±0.21)increased.In the less myopic group,all regional and mean macular CT increased.NRA was correlated with mean and inferior CTs and mean ONH CVI.SE was correlated with macular CT,CVI,and ONH CT.Mean macular and ONH CTs were associated with RMS HOA,SA,and coma.Macular T2 CT was a significant predictor of SA.Macular T2 and N1 CT were correlated with coma.CONCLUSION:More variations in accommodation and aberrations and fewer choroid thickens on macular and ONH are found in more myopic eyes after SMILE.Choroidal values are associated with accommodation and aberrations during SMILE.Choroid parameters on SS-OCT varies in eyes with different refractive errors after SMILE and has an association with accommodation and visual quality.
基金supported by the National Natural Science Foundation of China(81770971).
文摘Bilateral diffuse uveal melanocytic proliferation(BDUMP)is a rare paraneoplastic ocular syndrome,often associated with significant vision loss and poor prognosis.BDUMP is typically linked to systemic malignancies,including ovarian,lung,pancreatic,and colorectal cancers.Here,we reported a case of BDUMP in a 59-year-old male patient who had been misdiagnosed with a nonfunctional adrenal adenoma.This man,with a history of diabetes mellitus and high blood pressure,complained of progressive visual loss in both eyes.He was diagnosed with BDUMP after undergoing comprehensive ophthalmic assessments at our eye center.After being referred to the urology department,he was initially diagnosed with a right nonfunctional adrenal adenoma because his renin-aldosterone levels and serum potassium levels were normal.However,three months later,the adrenal mass rapidly increased in size,and liver metastasis was confirmed.Despite normal tumor marker levels,a histopathological diagnosis ultimately confirmed adrenocortical carcinoma.This case underscores the importance of considering underlying malignancies in patients with BDUMP and highlights the necessity for early systemic evaluation,including imaging studies and multidisciplinary consultations.Timely diagnosis of underlying cancers may improve patient outcomes.It is worth noting that normal hormone levels and a tumor small-sized cannot be used as conclusive evidence that the tumor is a nonfunctional adrenal adenoma;patients with BDUMP should be closely followed up to identify the primary malignancy.
文摘AIM:To describe the optical coherence tomography(OCT)findings of the retinal nerve fiber layer thickness(RNFLT)and choroidal thickness(CT)in beta-thalassemia major.METHODS:A systematic search was conducted on PubMed,Cochrane,and Embase using a combination of specific key words.The records found were screened in two phases(title/abstract,and full-text screening).All the original observational cross-sectional studies conducted on beta-thalassemia major cases and controls reporting the RNFLT and CT were included.The Meta-analysis was run for comparing the OCT measurements between betathalassemia cases and controls including pooled effect size,confidence intervals(CI),quality assessment,and publication bias.The measurements included were RNFLT(average,and in various quadrants),and CT.RESULTS:A total of 10 studies were included in this Meta-analysis including a total of 684 individuals,362 cases and 322 controls.The RNFLT and CT showed a significant reduction in the values of beta-thalassemia cases as compared to controls.The heterogeneity among the included studies was found to be 92.65%for the average RNFLT and 30.13%for the CT making it obvious to use random effects model for analyzing the RNFLT values while fixed effects model for the CT.The Egger’s test showed significant publication bias among all the parameters except for nasal RNFLT(P=0.507),and CT(P=0.281).The estimated average effect size for the average RNFLT was 1.04(95%CI:0.35 to 1.72,Z=2.961,P=0.003)and for CT was 0.74(95%CI:0.51 to 0.96,Z=6.523,P<0.001).CONCLUSION:This Meta-analysis concludes that the RNFLT and CT are significantly thinner in beta-thalassemia cases in comparison to healthy individuals.Therefore,the RNFLT and CT must be evaluated in routine clinical practice in order to avoid irreversible vision loss particularly in betathalassemia individuals.
