AIM:To examine the ocular toxicity linked to sildenafilusage and the possible protective benefits of adenosinetriphosphate(ATP)against this toxicity in rats.METHODS:Twenty-four male albino Wistar-type ratswere divided...AIM:To examine the ocular toxicity linked to sildenafilusage and the possible protective benefits of adenosinetriphosphate(ATP)against this toxicity in rats.METHODS:Twenty-four male albino Wistar-type ratswere divided into four equal groups(n=6/group)as follows:healthy group(HG),ATP-only group(ATPG),sildenafil-onlygroup(SILG),and ATP+sildenafil group(ATP+SLD).ATPG andATP+SLD groups were injected intraperitoneally with ATP(4 mg/kg),while SILG and HG groups were injected withsaline(0.9%NaCl)by the same route as a solvent.One hourafter the administration of ATP and solvent,sildenafil(10 m g/k g)was administered orally to the SILG andATP+SLD groups.This procedure was repeated once a dayfor 4wk.The animals were then sacrificed,eyeballs wereremoved and oxidant and antioxidant parameters weremeasured biochemically.Additionally,the ocular tissueswere evaluated histopathologically.RESULTS:Sildenafil increased oxidant(malondialdehyde)levels and decreased antioxidant levels(total glutathione,superoxide dismutase,catalase)in rat ocular tissues andcaused severe oxidative stress.In addition,sildenafil hasbeen shown histopathologically to cause oxidative damagein retinal layers.ATP treatment suppressed oxidative stressand attenuated histopathological damage in the retinal layers.CONCLUSION:ATP protects retinal tissue againstsildenafil-induced ocular oxidative damage in rats andmay contribute to the development of novel approaches toprevent or treat this damage.展开更多
Liver transplantation is a life-saving procedure for patients with end-stage liver diseases and acute liver failure.With advances in surgical techniques and immunosuppressive regimens,patient survival rates have signi...Liver transplantation is a life-saving procedure for patients with end-stage liver diseases and acute liver failure.With advances in surgical techniques and immunosuppressive regimens,patient survival rates have significantly improved.While the systemic complications of post-transplantation are well recognized,ophthalmic manifestations remain underreported.Ophthalmic complications can significantly impair visual function and increase morbidity in these patients.Prolonged immunosuppression makes the patients susceptible to the opportunistic pathogens such as Cytomegalovirus,Candida,Aspergillus,etc.Other common findings include dry eye disease,cataracts and retinal vascular complications which further contribute to the long-term morbidity in these patients.Early ophthalmic evaluation and prompt management are essential to prevent irreversible vision loss and improve post-transplant outcomes.High index of suspicion and multidisciplinary approach is essential to facilitate early diagnosis and treatment.This review highlights the range of ophthalmic complications observed in liver transplant recipients and underscores the need for future research focused on understanding the underlying pathophysiological mechanisms and refining the prophylactic protocols to improve outcomes in this unique patient population.展开更多
BACKGROUND Dry eye disease(DED)is a multifactorial ocular surface disorder with rising prevalence.It is closely related to systemic health and psychological factors,such as sleep and mood disorders,which significantly...BACKGROUND Dry eye disease(DED)is a multifactorial ocular surface disorder with rising prevalence.It is closely related to systemic health and psychological factors,such as sleep and mood disorders,which significantly impact the quality of life of patients.AIM To explore the correlations between ocular surface function,sleep quality,and anxiety/depression in patients with DED.METHODS This was a cross-sectional investigative study that included 358 patients with DED between January 2022 and January 2025.Ocular surface was assessed using the ocular surface disease index(OSDI),tear film break-up time,fluorescein staining score,and Schirmer I test.The Pittsburgh Sleep Quality Index(PSQI),Self-Rating Anxiety Scale(SAS),and Self-Rating Depression Scale(SDS)were used to evaluate sleep quality and anxiety/depression levels.Correlation and linear regression analyses were used to explore the relationships.RESULTS The mean PSQI score of the patients was 9.94±2.18;the mean SAS score was 47.30±4.90,and the mean SDS score was 50.08±5.52.These suggested a prevalence of sleep and psychological abnormalities.There was a significant correlation between the indicators of ocular surface function(OSDI,tear film break-up time,fluorescein staining,and Schirmer I test)and PSQI,SAS,and SDS scores(P<0.05).Moreover,multiple regression revealed that age≥50 years(β=1.55,P=0.029),PSQI scores(β=0.58,P<0.001),SAS scores(β=0.17,P=0.017),and SDS scores(β=0.15,P=0.019)were independent predictors of the OSDI scores.CONCLUSION Ocular surface function in patients with DED is closely related to sleep quality and anxiety/depression,emphasizing the need for holistic clinical management.展开更多
Synaptic plasticity is essential for maintaining neuronal function in the central nervous system and serves as a critical indicator of the effects of neurodegenerative disease.Glaucoma directly impairs retinal ganglio...Synaptic plasticity is essential for maintaining neuronal function in the central nervous system and serves as a critical indicator of the effects of neurodegenerative disease.Glaucoma directly impairs retinal ganglion cells and their axons,leading to axonal transport dysfuntion,subsequently causing secondary damage to anterior or posterior ends of the visual system.Accordingly,recent evidence indicates that glaucoma is a degenerative disease of the central nervous system that causes damage throughout the visual pathway.However,the effects of glaucoma on synaptic plasticity in the primary visual cortex remain unclear.In this study,we established a mouse model of unilateral chronic ocular hypertension by injecting magnetic microbeads into the anterior chamber of one eye.We found that,after 4 weeks of chronic ocular hypertension,the neuronal somas were smaller in the superior colliculus and lateral geniculate body regions of the brain contralateral to the affected eye.This was accompanied by glial cell activation and increased expression of inflammatory factors.After 8 weeks of ocular hypertension,we observed a reduction in the number of excitatory and inhibitory synapses,dendritic spines,and activation of glial cells in the primary visual cortex contralateral to the affected eye.These findings suggest that glaucoma not only directly damages the retina but also induces alterations in synapses and dendritic spines in the primary visual cortex,providing new insights into the pathogenesis of glaucoma.展开更多
AIM:To ascertain the pattern of ocular morbidity in a population of primary school children in rural Kenya as it is a prerequisite for planning effective preventive and therapeutic strategies.METHODS:A cross-sectional...AIM:To ascertain the pattern of ocular morbidity in a population of primary school children in rural Kenya as it is a prerequisite for planning effective preventive and therapeutic strategies.METHODS:A cross-sectional survey of ocular symptoms and clinical eye examinations were performed in a sample of 35 rural primary schools in the semi-arid region of Kajiado West sub-county in S.W.Kenya,amongst a seminomadic tribe(Maasai).Students in Grades 1-8 were included.Visual acuity was measured using the Snellen“tumbling E”chart at 6 m.Children with symptoms of refractive error underwent non-cycloplegic refraction.RESULTS:A total of 2036 children(1084 males)between the ages of 4-20y were examined.Conjunctival actinic changes were present in 22%(442/2036).Nine cases were seen with a potential squamous carcinoma.No overt classical ocular signs of vitamin A deficiency were noted,although 181(8.9%)children complained of nyctalopia.Three hundred thirty-six(16.5%)children had a visual acuity worse than 6/12 in either eye,were unable to read N10 near text at 40 cm or had symptoms suggestive of refractive error.Refractive data led to an estimate of hyperopia of+1.00 D or more in 3.9%and of myopia of-0.50 D or more in either eye in 3.0%of the study population.CONCLUSION:Solar exposure-and dust-related conjunctival pathology is common.As this may develop into potentially sight-or even life-threatening conditions,it warrants further study,and preventive strategies may be needed.Complaints of nyctalopia were common and could suggest vitamin A deficiency.The prevalence of refractive errors is low in this rural African population.展开更多
BACKGROUND Occult intraocular foreign bodies(IOFBs)can present with atypical symptoms and clinical signs,making diagnosis challenging.We describe a case of an undetected IOFB that was missed on both computed tomograph...BACKGROUND Occult intraocular foreign bodies(IOFBs)can present with atypical symptoms and clinical signs,making diagnosis challenging.We describe a case of an undetected IOFB that was missed on both computed tomography and B-ultrasound,ulti-mately leading to ocular siderosis and secondary glaucoma.CASE SUMMARY A 55-year-old male patient presented to our clinic reporting a one-month history of right ocular discomfort and progressive visual deterioration.The patient had previously received a glaucoma diagnosis at a local healthcare facility.His ocular history included blunt trauma to the affected eye five years prior to presentation.Slit-lamp examination revealed corneal and iris lesions in the right eye.Pupillary dilation facilitated the identification of traumatic lens opacities.Diagnostic imaging modalities,including B-scan ultrasonography and computed tomo-graphy,showed no evidence of retained intraocular foreign material.The patient subsequently underwent uncomplicated pars plana vitrectomy,during which the occult foreign body was successfully extracted.The procedure was completed without intraoperative or immediate postoperative complications.CONCLUSION Awareness of IOFBs in individuals who work in high-risk occupations and prompt referral to a retinal surgeon are very important.展开更多
Dear Editor,We report two rare cases of ocular perforating injuries caused by acupuncture needles.Both cases were approved by the Ethics Committee of Xi’an People’s Hospital(Xi’an No.4 Hospital)(KJLL-Z-K-2023060).W...Dear Editor,We report two rare cases of ocular perforating injuries caused by acupuncture needles.Both cases were approved by the Ethics Committee of Xi’an People’s Hospital(Xi’an No.4 Hospital)(KJLL-Z-K-2023060).Written informed consents were obtained from the patients.Acupuncture is an integral part of traditional Chinese medicine,and is widely used for the treatment of systemic diseases and ophthalmologic diseases^([1-8]),such as paralysis caused by stroke^([4]),diabetes^([7]),dry eye disease^([8]),pigmentary degeneration of retina,macular degeneration,glaucoma,and optic atrophy^([6]).Improper acupuncture technique can lead to accidents.展开更多
AIM:To describe ocular biometric parameters among Han and Uyghur myopic adults in Xinjiang,China.METHODS:A cross-sectional study was conducted.The different ocular biometric parameters collected using Pentacam were an...AIM:To describe ocular biometric parameters among Han and Uyghur myopic adults in Xinjiang,China.METHODS:A cross-sectional study was conducted.The different ocular biometric parameters collected using Pentacam were analyzed,including corneal curvature,corneal astigmatism(CA),horizontal corneal diameter(white-to-white,WTW),corneal volume(CV),pupil diameter(PD),anterior chamber angle(ACA),anterior chamber depth(ACD),anterior chamber volume(ACV)and axial length(AL).RESULTS:In total,2932 participants were included in the final analysis,comprising 2310 Han and 622 Uyghur adults.Adults in the high myopia(HM)group had steeper K2,larger CA,smaller WTW and longer AL in both the Uyghur and Han adults(all P<0.05).The moderate myopia(MM)and HM group had deeper ACV,ACD and wider ACA than the low myopia(all P<0.05)in Han adults,however there were no differences in anterior chamber indices with Uyghur adults.In the Uyghur adults,we noticed that CV,WTW,and ACD were smaller,ACA was narrower,PD was larger,and AL was shorter(all P<0.05).We also noticed sex differences:males had flatter corneas,deeper ACD and ACV,and larger WTW than females(all P<0.05).In the correlation analysis,WTW was positively correlated with ACD and ACV but negatively correlated with K1,K2 and CV(all P<0.05).Narrower ACA was associated with larger PD(rU=-0.25,rH=-0.16,all P<0.01).CONCLUSION:The Han population have different biometric parameters in eyes with HM compared to the Uyghur population,and the Uyghur population may anatomically more susceptible to primary angle closure glaucoma than the Han population.展开更多
BACKGROUND High-resolution optical coherence tomography(HR-OCT)has become an essential instrument in the screening and diagnosis of ocular surface neoplasms.Research demonstrates that HR-OCT possesses a diagnostic sen...BACKGROUND High-resolution optical coherence tomography(HR-OCT)has become an essential instrument in the screening and diagnosis of ocular surface neoplasms.Research demonstrates that HR-OCT possesses a diagnostic sensitivity ranging from 85%to 90%for ocular surface squamous neoplasia(OSSN).The connections between HR-OCT features and histological findings have consistently shown robustness,hence increasing the reliability of clinical diagnosis.AIM To examine the existing HR-OCT indicators employed in the identification of common non-benign ocular surface tumors,namely,basal cell carcinoma,OSSN,and melanocytic conjunctival lesions,and to assess their diagnostic efficacy,benefits,and prospective developments.METHODS A thorough literature review was performed to assess the published research on HR-OCT in the diagnosis of ocular surface cancers.Significant attention was given to research that compares HR-OCT characteristics with histopath-ologic validation,as well as on publications addressing the integration of emerging technologies and artificial intelligence in ocular oncology imaging.RESULTS HR-OCT exhibits elevated diagnostic sensitivity(85%-90%)for identifying OSSN and presents distinct imaging patterns that align closely with histology results.This approach has substantial clinical advantages due to its non-invasive characteristics,improved axial resolution,and real-time imaging capabilities.HR-OCT has demonstrated potential in assessing various lesions,including basal cell carcinoma and melanocytic conjunctival malignancies.CONCLUSION HR-OCT assumes an increasingly vital role in the early identification and clinical management of ocular surface malignancies.With advancements in imaging technology and the integration of artificial intelligence,HR-OCT is anticipated to enhance individualized diagnosis and treatment planning in ocular oncology,hence improving patient outcomes.展开更多
Objective The clinical features,disease course and visual outcomes of toxoplasmosis are less commonly reported in China than in other countries.To reduce misdiagnosis and improve visual function,the clinical character...Objective The clinical features,disease course and visual outcomes of toxoplasmosis are less commonly reported in China than in other countries.To reduce misdiagnosis and improve visual function,the clinical characteristics,management and visual outcomes of 13 cases of ocular toxoplasmosis(OT)were described.Methods This retrospective study included 14 eyes of 13 patients who were diagnosed with OT in Hubei,China.The clinical characteristics,course of treatment and outcomes are presented.There were 7 males and 6 females.Results The main form of OT was retinochoroiditis with vitritis or anterior uveitis.Next-generation sequencing was applied to 3 eyes,and positive results were found in those eyes.Thirteen patients were positive for Toxoplasma gondii IgG antibodies,and 3 of them were also positive for IgM T.gondii antibodies.One patient with acquired immune deficiency syndrome was diagnosed with coinfection with OT and cytomegalovirus,as evidenced by an aqueous humor etiological test.Three patients were misdiagnosed with noninfectious uveitis.Recurrence occurred in 3 eyes during the follow-up periods.One patient who received vitreous implantation of Ozurdex therapy at another hospital before referral relapsed.One patient who received sulfadiazine,azithromycin and glucocorticoid therapy relapsed.One patient who received sulfadiazine therapy experienced relapse.Patients who received clindamycin and sulfadiazine or who received clindamycin only did not experience recurrence during the follow-up period.The best corrected visual acuity was improved in 6 eyes after inflammation resolved.Conclusions Primary active retinochoroiditis is the main form of OT in Hubei,China.Timely correct diagnosis on the basis of ocular characteristics and aetiological test results and effective treatment should be adopted to prevent poor visual outcomes and recurrence.展开更多
Ocular hypertension(OHT),defined as increased intraocular pressure(IOP,>21 mmHg)in eyes without optic disc changes or visual field changes,is a condition that puts an eye at higher risk of developing glaucomatous o...Ocular hypertension(OHT),defined as increased intraocular pressure(IOP,>21 mmHg)in eyes without optic disc changes or visual field changes,is a condition that puts an eye at higher risk of developing glaucomatous optic neuropathy and may be related to the translaminar pressure gradient,individual differences in IOP-related glaucoma susceptibility,effects of arterial blood pressure on the optic nerve head,and vasospastic factors.IOP remains the most common modifiable risk factor to protect eyes against the development of glaucoma.The association between OHT and diabetes mellitus(DM)is poorly understood,although ocular effects of both conditions are related to vascular compromise of retinal and optic nerve circulation.Increased IOP in diabetic patients is attributable to increased aqueous osmotic gradient and accumulation of extracellular matrix constituents in the trabecular meshwork.Autonomic dysfunction and genetic factors may also play a role.Apart from eyes without diabetic retinopathy(DR)changes,OHT can also be observed in eyes with DR,where it can develop with or without antecedent vitreoretinal intervention.For example,photocoagulation of the retina in earlier stages of proliferative DR protects against the development of OHT,whereas intraocular silicone oil injection promotes it.While IOP has been directly implicated as an independent risk factor for DR,the retinopathy in DM is also related to comorbidities,like hypertension and heart disease,that are also correlated with OHT.All these factors are discussed in a comprehensive review exploring the association of OHT and DM in detail.展开更多
AIM:To assess visual outcomes and satisfaction of a non-diffractive extended depth of focus(EDOF)intraocular lens(IOL)in individuals with ocular hypertension(OHT)and well-controlled mild glaucoma undergoing cataract s...AIM:To assess visual outcomes and satisfaction of a non-diffractive extended depth of focus(EDOF)intraocular lens(IOL)in individuals with ocular hypertension(OHT)and well-controlled mild glaucoma undergoing cataract surgery.METHODS:An investigator-initiated,single-center,prospective,interventional,noncomparative study conducted in Montreal,Canada.The study enrolled 31 patients(55 eyes)with OHT or mild glaucoma who received a non-diffractive EDOF IOL(Acrysof IQ Vivity).Participants underwent sequential cataract surgery with the Vivity IOL.Follow-up evaluations occurred at 1d,1,and 3mo postoperatively,assessing uncorrected distance,intermediate,and near visual acuity.Questionnaires(QUVID:Questionnaire for visual disturbances and IOLSAT:Intraocular lens satisfaction)were administered pre and post-operatively to measure visual disturbances and spectacle independence in various lighting.Safety parameters included intraocular pressure(IOP),glaucoma medications,spherical equivalence,mean deviation and pattern standard deviation or square root of lost variance on Octopus visual field.RESULTS:At 1 and 3mo postoperatively,significant improvements were observed in uncorrected distance and intermediate visual acuity.Spectacle independence was enhanced for distance and intermediate vision,especially in bright light settings.Spectacle-free intermediate vision was improved even in dim lighting.Visual disturbances,particularly glare symptoms,were reduced,and there was a notable decrease in IOP and glaucoma medication burden at 3mo.There was more hazy vision postoperatively with no impact on visual acuity and visual satisfaction.CONCLUSION:The non-diffractive EDOF lens improves distance and intermediate spectacle-free visual function in patients with OHT and well-controlled glaucoma.The findings highlight significant improvements in visual acuity,reduced glare,enhanced spectacle independence,and improved visual performance in different lighting conditions.展开更多
BACKGROUND Lacrimal sac rhinosporidiosis,with nil or minor nasal extensions,rarely presents as an acquired cutaneous fistula in the periocular area.The correct diagnosis in such cases can be challenging,leading to rep...BACKGROUND Lacrimal sac rhinosporidiosis,with nil or minor nasal extensions,rarely presents as an acquired cutaneous fistula in the periocular area.The correct diagnosis in such cases can be challenging,leading to repeated failure of conservative or surgical interventions.CASE SUMMARY A 39-year-old female presented with a 6-year history of swelling in the periocular area,specifically in the left lacrimal sac area.Symptoms were limited to epiphora and constant mucoid discharge from the fistula,clinically mimicking chronic lacrimal sac fistula.She had a history of treatment with multiple antibiotic courses and dacryocystectomy in the past,with no or transient symptomatic relief.On surgical exploration of the site,a large pedunculated polypoidal vascular mass,suspicious of rhinosporidiosis,was noted.En bloc resection of the mass with cauterization of the base and fistulectomy was performed.Histopathology confirmed the diagnosis of lacrimal sac rhinosporidiosis.The patient was further evaluated and treated for the nasal extension of rhinosporidiosis.The patient has been frequently followed up for the last 3 years with a good clinical outcome and no recurrence.CONCLUSION Lacrimal sac rhinosporidiosis,in isolated or limited nasal extension cases,can rarely mimic a chronic discharging fistula.Patients with this disease often face distress due to misdiagnosis and repeated failure of conservative or surgical interventions.A high index of suspicion is needed for early diagnosis.Proper surgical intervention at the right time can lead to an excellent prognosis in such patients.展开更多
AIM:To investigate the effect of pharmacological pupil alterations on intraocular lens(IOL)power calculations.METHODS:A systematic review and Meta-analysis of studies published before December 2023 in the PubMed,Embas...AIM:To investigate the effect of pharmacological pupil alterations on intraocular lens(IOL)power calculations.METHODS:A systematic review and Meta-analysis of studies published before December 2023 in the PubMed,Embase,and Cochrane library databases on the accuracy of pharmacological pupil changes on IOL power calculation was performed.The primary outcome was the results of IOL power calculations before and after the use of medications.Subgroup analyses were performed based on participants’basic characteristics,such as age,axial length(AL),and whether miosis or mydriasis were used as classification criteria for further analyses.Each eligible study was evaluated for potential risk of bias by the AHRQ assessment scale.The study was registered on PROSPERO(CRD 42024497535).RESULTS:A total of 3062 eyes from 21 studies were eligible.There was no significant difference in the IOL power calculation before and after pharmacological pupil changes using any of the Hoffer Q(WMD=0.055,95%CI=-0.046–0.156;P=0.29),SRK/T(WMD=0.003,95%CI=-0.073–0.080;P=0.93),Haigis(WMD=-0.030,95%CI=-0.176–0.116;P=0.69),Holladay 2(WMD=-0.042,95%CI=-0.366–0.282;P=0.80),and Barrett Universal Ⅱ(WMD=0.033,95%CI=-0.061–0.127;P=0.49)formulas.On the measurement of parameters related to IOL power calculation,for either miosis or mydriasis AL(P=0.98 and 0.29,respectively),lens thickness(P=0.96 and 0.13,respectively),and mean keratometry(P=0.90 and 0.86,respectively)did not present significant differences,while anterior chamber depth(P=0.07 and<0.01,respectively)and white-to-white distance(P=0.01 and 0.04,respectively)changed significantly between the two measurements prior and posterior.At the same time,despite there being some participants with the difference between the before and after calculations greater than 0.5 diopter,there was no significant difference in the incidence rate between these formulas.CONCLUSION:There is no significant effect of pharmacological pupil changes on the IOL power calculation.It will considerably reduce the visit time burden for patients who require cataract surgery.展开更多
Traumatic brain injury (TBI) is defined as damage to the brain resulting from an external sudden physical force or shock to the head.It is considered a silent public health epidemic causing significant death and disab...Traumatic brain injury (TBI) is defined as damage to the brain resulting from an external sudden physical force or shock to the head.It is considered a silent public health epidemic causing significant death and disability globally.There were 64,000 TBI related deaths reported in the USA in 2020,with about US$76 billion in direct and indirect medical costs annually.展开更多
AIM:To assess the possibility of using different large language models(LLMs)in ocular surface diseases by selecting five different LLMS to test their accuracy in answering specialized questions related to ocular surfa...AIM:To assess the possibility of using different large language models(LLMs)in ocular surface diseases by selecting five different LLMS to test their accuracy in answering specialized questions related to ocular surface diseases:ChatGPT-4,ChatGPT-3.5,Claude 2,PaLM2,and SenseNova.METHODS:A group of experienced ophthalmology professors were asked to develop a 100-question singlechoice question on ocular surface diseases designed to assess the performance of LLMs and human participants in answering ophthalmology specialty exam questions.The exam includes questions on the following topics:keratitis disease(20 questions),keratoconus,keratomalaciac,corneal dystrophy,corneal degeneration,erosive corneal ulcers,and corneal lesions associated with systemic diseases(20 questions),conjunctivitis disease(20 questions),trachoma,pterygoid and conjunctival tumor diseases(20 questions),and dry eye disease(20 questions).Then the total score of each LLMs and compared their mean score,mean correlation,variance,and confidence were calculated.RESULTS:GPT-4 exhibited the highest performance in terms of LLMs.Comparing the average scores of the LLMs group with the four human groups,chief physician,attending physician,regular trainee,and graduate student,it was found that except for ChatGPT-4,the total score of the rest of the LLMs is lower than that of the graduate student group,which had the lowest score in the human group.Both ChatGPT-4 and PaLM2 were more likely to give exact and correct answers,giving very little chance of an incorrect answer.ChatGPT-4 showed higher credibility when answering questions,with a success rate of 59%,but gave the wrong answer to the question 28% of the time.CONCLUSION:GPT-4 model exhibits excellent performance in both answer relevance and confidence.PaLM2 shows a positive correlation(up to 0.8)in terms of answer accuracy during the exam.In terms of answer confidence,PaLM2 is second only to GPT4 and surpasses Claude 2,SenseNova,and GPT-3.5.Despite the fact that ocular surface disease is a highly specialized discipline,GPT-4 still exhibits superior performance,suggesting that its potential and ability to be applied in this field is enormous,perhaps with the potential to be a valuable resource for medical students and clinicians in the future.展开更多
Posaconazole(PCZ)is a broad-spectrum anti-fungal drug approved by FDA and currently used off-label for the treatment of fungal keratitis(FK).Although ocular route serves as the most bioavailable route for treating FK,...Posaconazole(PCZ)is a broad-spectrum anti-fungal drug approved by FDA and currently used off-label for the treatment of fungal keratitis(FK).Although ocular route serves as the most bioavailable route for treating FK,delivery of PCZ to the eye remains a challenge due to poor permeation though the cornea and rapid elimination from the eye.Here we outline a comprehensive formulation development process,beginning with in silico studies,progressing through in vitro evaluations,and ultimately achieving therapeutic benefits in vivo.We report modified niosome-like surfactant vesicles,hereafter termed as NioTherms,formulated using a novel and simple heat-mix method,encapsulating PCZ for ocular administration in the form of an in situ gel.Excipient screening performed using in silico simulations highly correlate with in vitro studies(R^(2)=0.77),guiding optimization by Quality by Design(QbD)approach for encapsulating PCZ in NioTherms resulting in particles with an average size of 180.7±2.3 nm,zeta potential of +27.5±2.2 mV and entrapment efficiency of 87.6%±1.7%.A 2-fold increase in both mucin binding and cellular uptake indicates a functional role of positive surface charge in enhancingmucoadhesive properties of PCZ-NioTherms.In an in vivo murine ocular keratitis model,we demonstrate a 2-fold enhancement in trans-corneal permeability of PCZ-NioTherms and a 3-fold reduction in fungal burden compared to the control standard of care,the PCZ solution.Owing to a facile formulation process,we anticipate that PCZ-NioTherms would serve as a clinically translatable and patient compliant therapeutic intervention for treating FK.展开更多
BACKGROUND The gut microbiome is integral to human health,with emerging research underscoring its potential impact on ocular health through the gut-eye axis.Various ocular disorders,such as dry eye syndrome,retinal va...BACKGROUND The gut microbiome is integral to human health,with emerging research underscoring its potential impact on ocular health through the gut-eye axis.Various ocular disorders,such as dry eye syndrome,retinal vascular diseases,macular degeneration,and glaucoma,may be influenced by gut dysbiosis,which could significantly contribute to their development and progression.AIM To evaluate the influence of the gut microbiome on the pathogenesis and progression of various ocular diseases.METHODS An extensive search of the scientific literature was undertaken by adhering to Preferred Reporting Items for Systematic Reviews&Meta-Analyses standards,using PubMed(MEDLINE),Scopus,EMBASE,and the Cochrane Library as sources to locate studies addressing the relationship between the gut microbiome and human health.To capture all relevant publications,search terms were systematically applied across these major databases,without limiting the search by language or publication date.Inclusion criteria covered randomized controlled trials,non-randomized controlled trial,prospective studies,cross-sectional studies,and case-control studies.Out of the 3077 articles,36 full texts were included in the review.RESULTS Ocular health appears to be shaped by the gut microbial community through mechanisms such as immune regulation,preservation of the blood–retinal barrier,and the generation of protective metabolites.Disturbances in this microbial balance can provoke measurable alterations in host immunity,providing a plausible immunopathogenic pathway that connects intestinal dysbiosis with eye disease.Both laboratory models and early human data suggest that targeted interventions,including prebiotics,probiotics,synbiotics,and faecal microbiota transfer,hold therapeutic potential.CONCLUSION The gut–eye relationship reflects a multifaceted interaction in which the intestinal microbiome contributes to ocular health through complex biological pathways.Integrating microbiome assessments into diagnostic methods can revolutionize disease management through early detection and targeted interventions.Further,randomised controlled clinical trials are necessary for ocular diseases to prove causal relationships.展开更多
Photobiomodulation has been known to have potential medicinal effects for ages.It involves the use of specific wavelengths to target specific regions in the cell.Different health conditions have been reported to be tr...Photobiomodulation has been known to have potential medicinal effects for ages.It involves the use of specific wavelengths to target specific regions in the cell.Different health conditions have been reported to be treated with exposure to light such as cardiovascular conditions,inflammatory diseases,infectious diseases,and most importantly ocular diseases.This review specifically targets the treatment of retinal diseases including age-related macular degeneration,diabetic macular edema,myopia and acute retinal light injury with photobiomodulation.Red light is used in this therapy since this wavelength has lower frequency and hence minimal chance of causing any damage.Red light has the potential to penetrate cellular structures such as mitochondria and facilitate cellular processes.For ocular diseases,the target wavelength ranges between 630 to 800 nm.In most of the cases the primary target for red light is the cytochrome C oxidase enzyme in mitochondria,which alters the gene expression and promotes cellular energy production.Clinical evidence shows improvement of visual activity and reduction in thickness of retina post treatment.Future prospects of photobiomodulation involve target-specific treatment,combinational therapy to treat complex retinal diseases including gene therapy,and longitudinal studies to predict long-term efficacy and the chance of any recurrence in the patients.Hence the future of photobiomodulation holds significant potential in medicine especially in ocular diseases characterized by progress in research,technology,and clinical trials.展开更多
Biomechanical study of the visual system by ocular response analyzer investigates the inter-structural biological relationships,mechanics,and function of the visual system.This review aimed to investigate the changes ...Biomechanical study of the visual system by ocular response analyzer investigates the inter-structural biological relationships,mechanics,and function of the visual system.This review aimed to investigate the changes in corneal biomechanical parameters with age and sex.The articles published in PubMed between 2000 and 2021 were investigated and critiqued,and valid scientific evidence was collected,reviewed and concluded according to the inclusion and exclusion criteria.Most studies showed that corneal biomechanical changes occur infrequently in children up to the age of 20y,and with increasing age and wider age range,there was a significant decrease in corneal biomechanical indices,especially corneal hysteresis.In children and adults,most studies have shown that these biomechanical indicators,especially corneal resistance factor,were higher in females.Although hormonal changes may contribute to this finding,the role of axial length and other biometric indicators should not be ignored.The axial length,the intraocular pressure,and the corneal thickness are other factors associated with biomechanical parameters that should be taken into account in clinical diagnosis and management especially for patients undergoing refractive surgery as well as keratoconus patients.展开更多
文摘AIM:To examine the ocular toxicity linked to sildenafilusage and the possible protective benefits of adenosinetriphosphate(ATP)against this toxicity in rats.METHODS:Twenty-four male albino Wistar-type ratswere divided into four equal groups(n=6/group)as follows:healthy group(HG),ATP-only group(ATPG),sildenafil-onlygroup(SILG),and ATP+sildenafil group(ATP+SLD).ATPG andATP+SLD groups were injected intraperitoneally with ATP(4 mg/kg),while SILG and HG groups were injected withsaline(0.9%NaCl)by the same route as a solvent.One hourafter the administration of ATP and solvent,sildenafil(10 m g/k g)was administered orally to the SILG andATP+SLD groups.This procedure was repeated once a dayfor 4wk.The animals were then sacrificed,eyeballs wereremoved and oxidant and antioxidant parameters weremeasured biochemically.Additionally,the ocular tissueswere evaluated histopathologically.RESULTS:Sildenafil increased oxidant(malondialdehyde)levels and decreased antioxidant levels(total glutathione,superoxide dismutase,catalase)in rat ocular tissues andcaused severe oxidative stress.In addition,sildenafil hasbeen shown histopathologically to cause oxidative damagein retinal layers.ATP treatment suppressed oxidative stressand attenuated histopathological damage in the retinal layers.CONCLUSION:ATP protects retinal tissue againstsildenafil-induced ocular oxidative damage in rats andmay contribute to the development of novel approaches toprevent or treat this damage.
文摘Liver transplantation is a life-saving procedure for patients with end-stage liver diseases and acute liver failure.With advances in surgical techniques and immunosuppressive regimens,patient survival rates have significantly improved.While the systemic complications of post-transplantation are well recognized,ophthalmic manifestations remain underreported.Ophthalmic complications can significantly impair visual function and increase morbidity in these patients.Prolonged immunosuppression makes the patients susceptible to the opportunistic pathogens such as Cytomegalovirus,Candida,Aspergillus,etc.Other common findings include dry eye disease,cataracts and retinal vascular complications which further contribute to the long-term morbidity in these patients.Early ophthalmic evaluation and prompt management are essential to prevent irreversible vision loss and improve post-transplant outcomes.High index of suspicion and multidisciplinary approach is essential to facilitate early diagnosis and treatment.This review highlights the range of ophthalmic complications observed in liver transplant recipients and underscores the need for future research focused on understanding the underlying pathophysiological mechanisms and refining the prophylactic protocols to improve outcomes in this unique patient population.
文摘BACKGROUND Dry eye disease(DED)is a multifactorial ocular surface disorder with rising prevalence.It is closely related to systemic health and psychological factors,such as sleep and mood disorders,which significantly impact the quality of life of patients.AIM To explore the correlations between ocular surface function,sleep quality,and anxiety/depression in patients with DED.METHODS This was a cross-sectional investigative study that included 358 patients with DED between January 2022 and January 2025.Ocular surface was assessed using the ocular surface disease index(OSDI),tear film break-up time,fluorescein staining score,and Schirmer I test.The Pittsburgh Sleep Quality Index(PSQI),Self-Rating Anxiety Scale(SAS),and Self-Rating Depression Scale(SDS)were used to evaluate sleep quality and anxiety/depression levels.Correlation and linear regression analyses were used to explore the relationships.RESULTS The mean PSQI score of the patients was 9.94±2.18;the mean SAS score was 47.30±4.90,and the mean SDS score was 50.08±5.52.These suggested a prevalence of sleep and psychological abnormalities.There was a significant correlation between the indicators of ocular surface function(OSDI,tear film break-up time,fluorescein staining,and Schirmer I test)and PSQI,SAS,and SDS scores(P<0.05).Moreover,multiple regression revealed that age≥50 years(β=1.55,P=0.029),PSQI scores(β=0.58,P<0.001),SAS scores(β=0.17,P=0.017),and SDS scores(β=0.15,P=0.019)were independent predictors of the OSDI scores.CONCLUSION Ocular surface function in patients with DED is closely related to sleep quality and anxiety/depression,emphasizing the need for holistic clinical management.
基金supported by the National Natural Science Foundation of China,No.82271115(to MY).
文摘Synaptic plasticity is essential for maintaining neuronal function in the central nervous system and serves as a critical indicator of the effects of neurodegenerative disease.Glaucoma directly impairs retinal ganglion cells and their axons,leading to axonal transport dysfuntion,subsequently causing secondary damage to anterior or posterior ends of the visual system.Accordingly,recent evidence indicates that glaucoma is a degenerative disease of the central nervous system that causes damage throughout the visual pathway.However,the effects of glaucoma on synaptic plasticity in the primary visual cortex remain unclear.In this study,we established a mouse model of unilateral chronic ocular hypertension by injecting magnetic microbeads into the anterior chamber of one eye.We found that,after 4 weeks of chronic ocular hypertension,the neuronal somas were smaller in the superior colliculus and lateral geniculate body regions of the brain contralateral to the affected eye.This was accompanied by glial cell activation and increased expression of inflammatory factors.After 8 weeks of ocular hypertension,we observed a reduction in the number of excitatory and inhibitory synapses,dendritic spines,and activation of glial cells in the primary visual cortex contralateral to the affected eye.These findings suggest that glaucoma not only directly damages the retina but also induces alterations in synapses and dendritic spines in the primary visual cortex,providing new insights into the pathogenesis of glaucoma.
基金Supported by Vision International Eye Missions-USA,“One Drop for All”,Italy,and Private Donors in the Netherlands.
文摘AIM:To ascertain the pattern of ocular morbidity in a population of primary school children in rural Kenya as it is a prerequisite for planning effective preventive and therapeutic strategies.METHODS:A cross-sectional survey of ocular symptoms and clinical eye examinations were performed in a sample of 35 rural primary schools in the semi-arid region of Kajiado West sub-county in S.W.Kenya,amongst a seminomadic tribe(Maasai).Students in Grades 1-8 were included.Visual acuity was measured using the Snellen“tumbling E”chart at 6 m.Children with symptoms of refractive error underwent non-cycloplegic refraction.RESULTS:A total of 2036 children(1084 males)between the ages of 4-20y were examined.Conjunctival actinic changes were present in 22%(442/2036).Nine cases were seen with a potential squamous carcinoma.No overt classical ocular signs of vitamin A deficiency were noted,although 181(8.9%)children complained of nyctalopia.Three hundred thirty-six(16.5%)children had a visual acuity worse than 6/12 in either eye,were unable to read N10 near text at 40 cm or had symptoms suggestive of refractive error.Refractive data led to an estimate of hyperopia of+1.00 D or more in 3.9%and of myopia of-0.50 D or more in either eye in 3.0%of the study population.CONCLUSION:Solar exposure-and dust-related conjunctival pathology is common.As this may develop into potentially sight-or even life-threatening conditions,it warrants further study,and preventive strategies may be needed.Complaints of nyctalopia were common and could suggest vitamin A deficiency.The prevalence of refractive errors is low in this rural African population.
基金Supported by The Tianjin Health Research Project,No.ZC20069the Foundation of the Committee of Integrated Traditional Chinese and Western Medicine,No.2021011the Science and Technology Foundation of Tianjin Eye Hospital,No.YKYB1901.
文摘BACKGROUND Occult intraocular foreign bodies(IOFBs)can present with atypical symptoms and clinical signs,making diagnosis challenging.We describe a case of an undetected IOFB that was missed on both computed tomography and B-ultrasound,ulti-mately leading to ocular siderosis and secondary glaucoma.CASE SUMMARY A 55-year-old male patient presented to our clinic reporting a one-month history of right ocular discomfort and progressive visual deterioration.The patient had previously received a glaucoma diagnosis at a local healthcare facility.His ocular history included blunt trauma to the affected eye five years prior to presentation.Slit-lamp examination revealed corneal and iris lesions in the right eye.Pupillary dilation facilitated the identification of traumatic lens opacities.Diagnostic imaging modalities,including B-scan ultrasonography and computed tomo-graphy,showed no evidence of retained intraocular foreign material.The patient subsequently underwent uncomplicated pars plana vitrectomy,during which the occult foreign body was successfully extracted.The procedure was completed without intraoperative or immediate postoperative complications.CONCLUSION Awareness of IOFBs in individuals who work in high-risk occupations and prompt referral to a retinal surgeon are very important.
基金Supported by Shaanxi Provincial Science and Technology Development Plan Project(No.2024SFYBXM-327).
文摘Dear Editor,We report two rare cases of ocular perforating injuries caused by acupuncture needles.Both cases were approved by the Ethics Committee of Xi’an People’s Hospital(Xi’an No.4 Hospital)(KJLL-Z-K-2023060).Written informed consents were obtained from the patients.Acupuncture is an integral part of traditional Chinese medicine,and is widely used for the treatment of systemic diseases and ophthalmologic diseases^([1-8]),such as paralysis caused by stroke^([4]),diabetes^([7]),dry eye disease^([8]),pigmentary degeneration of retina,macular degeneration,glaucoma,and optic atrophy^([6]).Improper acupuncture technique can lead to accidents.
基金Supported by the National Natural Science Foundation of China(No.81960181).
文摘AIM:To describe ocular biometric parameters among Han and Uyghur myopic adults in Xinjiang,China.METHODS:A cross-sectional study was conducted.The different ocular biometric parameters collected using Pentacam were analyzed,including corneal curvature,corneal astigmatism(CA),horizontal corneal diameter(white-to-white,WTW),corneal volume(CV),pupil diameter(PD),anterior chamber angle(ACA),anterior chamber depth(ACD),anterior chamber volume(ACV)and axial length(AL).RESULTS:In total,2932 participants were included in the final analysis,comprising 2310 Han and 622 Uyghur adults.Adults in the high myopia(HM)group had steeper K2,larger CA,smaller WTW and longer AL in both the Uyghur and Han adults(all P<0.05).The moderate myopia(MM)and HM group had deeper ACV,ACD and wider ACA than the low myopia(all P<0.05)in Han adults,however there were no differences in anterior chamber indices with Uyghur adults.In the Uyghur adults,we noticed that CV,WTW,and ACD were smaller,ACA was narrower,PD was larger,and AL was shorter(all P<0.05).We also noticed sex differences:males had flatter corneas,deeper ACD and ACV,and larger WTW than females(all P<0.05).In the correlation analysis,WTW was positively correlated with ACD and ACV but negatively correlated with K1,K2 and CV(all P<0.05).Narrower ACA was associated with larger PD(rU=-0.25,rH=-0.16,all P<0.01).CONCLUSION:The Han population have different biometric parameters in eyes with HM compared to the Uyghur population,and the Uyghur population may anatomically more susceptible to primary angle closure glaucoma than the Han population.
文摘BACKGROUND High-resolution optical coherence tomography(HR-OCT)has become an essential instrument in the screening and diagnosis of ocular surface neoplasms.Research demonstrates that HR-OCT possesses a diagnostic sensitivity ranging from 85%to 90%for ocular surface squamous neoplasia(OSSN).The connections between HR-OCT features and histological findings have consistently shown robustness,hence increasing the reliability of clinical diagnosis.AIM To examine the existing HR-OCT indicators employed in the identification of common non-benign ocular surface tumors,namely,basal cell carcinoma,OSSN,and melanocytic conjunctival lesions,and to assess their diagnostic efficacy,benefits,and prospective developments.METHODS A thorough literature review was performed to assess the published research on HR-OCT in the diagnosis of ocular surface cancers.Significant attention was given to research that compares HR-OCT characteristics with histopath-ologic validation,as well as on publications addressing the integration of emerging technologies and artificial intelligence in ocular oncology imaging.RESULTS HR-OCT exhibits elevated diagnostic sensitivity(85%-90%)for identifying OSSN and presents distinct imaging patterns that align closely with histology results.This approach has substantial clinical advantages due to its non-invasive characteristics,improved axial resolution,and real-time imaging capabilities.HR-OCT has demonstrated potential in assessing various lesions,including basal cell carcinoma and melanocytic conjunctival malignancies.CONCLUSION HR-OCT assumes an increasingly vital role in the early identification and clinical management of ocular surface malignancies.With advancements in imaging technology and the integration of artificial intelligence,HR-OCT is anticipated to enhance individualized diagnosis and treatment planning in ocular oncology,hence improving patient outcomes.
基金Hubei Natural Science Foundation of China(No.2022CFB296).
文摘Objective The clinical features,disease course and visual outcomes of toxoplasmosis are less commonly reported in China than in other countries.To reduce misdiagnosis and improve visual function,the clinical characteristics,management and visual outcomes of 13 cases of ocular toxoplasmosis(OT)were described.Methods This retrospective study included 14 eyes of 13 patients who were diagnosed with OT in Hubei,China.The clinical characteristics,course of treatment and outcomes are presented.There were 7 males and 6 females.Results The main form of OT was retinochoroiditis with vitritis or anterior uveitis.Next-generation sequencing was applied to 3 eyes,and positive results were found in those eyes.Thirteen patients were positive for Toxoplasma gondii IgG antibodies,and 3 of them were also positive for IgM T.gondii antibodies.One patient with acquired immune deficiency syndrome was diagnosed with coinfection with OT and cytomegalovirus,as evidenced by an aqueous humor etiological test.Three patients were misdiagnosed with noninfectious uveitis.Recurrence occurred in 3 eyes during the follow-up periods.One patient who received vitreous implantation of Ozurdex therapy at another hospital before referral relapsed.One patient who received sulfadiazine,azithromycin and glucocorticoid therapy relapsed.One patient who received sulfadiazine therapy experienced relapse.Patients who received clindamycin and sulfadiazine or who received clindamycin only did not experience recurrence during the follow-up period.The best corrected visual acuity was improved in 6 eyes after inflammation resolved.Conclusions Primary active retinochoroiditis is the main form of OT in Hubei,China.Timely correct diagnosis on the basis of ocular characteristics and aetiological test results and effective treatment should be adopted to prevent poor visual outcomes and recurrence.
文摘Ocular hypertension(OHT),defined as increased intraocular pressure(IOP,>21 mmHg)in eyes without optic disc changes or visual field changes,is a condition that puts an eye at higher risk of developing glaucomatous optic neuropathy and may be related to the translaminar pressure gradient,individual differences in IOP-related glaucoma susceptibility,effects of arterial blood pressure on the optic nerve head,and vasospastic factors.IOP remains the most common modifiable risk factor to protect eyes against the development of glaucoma.The association between OHT and diabetes mellitus(DM)is poorly understood,although ocular effects of both conditions are related to vascular compromise of retinal and optic nerve circulation.Increased IOP in diabetic patients is attributable to increased aqueous osmotic gradient and accumulation of extracellular matrix constituents in the trabecular meshwork.Autonomic dysfunction and genetic factors may also play a role.Apart from eyes without diabetic retinopathy(DR)changes,OHT can also be observed in eyes with DR,where it can develop with or without antecedent vitreoretinal intervention.For example,photocoagulation of the retina in earlier stages of proliferative DR protects against the development of OHT,whereas intraocular silicone oil injection promotes it.While IOP has been directly implicated as an independent risk factor for DR,the retinopathy in DM is also related to comorbidities,like hypertension and heart disease,that are also correlated with OHT.All these factors are discussed in a comprehensive review exploring the association of OHT and DM in detail.
文摘AIM:To assess visual outcomes and satisfaction of a non-diffractive extended depth of focus(EDOF)intraocular lens(IOL)in individuals with ocular hypertension(OHT)and well-controlled mild glaucoma undergoing cataract surgery.METHODS:An investigator-initiated,single-center,prospective,interventional,noncomparative study conducted in Montreal,Canada.The study enrolled 31 patients(55 eyes)with OHT or mild glaucoma who received a non-diffractive EDOF IOL(Acrysof IQ Vivity).Participants underwent sequential cataract surgery with the Vivity IOL.Follow-up evaluations occurred at 1d,1,and 3mo postoperatively,assessing uncorrected distance,intermediate,and near visual acuity.Questionnaires(QUVID:Questionnaire for visual disturbances and IOLSAT:Intraocular lens satisfaction)were administered pre and post-operatively to measure visual disturbances and spectacle independence in various lighting.Safety parameters included intraocular pressure(IOP),glaucoma medications,spherical equivalence,mean deviation and pattern standard deviation or square root of lost variance on Octopus visual field.RESULTS:At 1 and 3mo postoperatively,significant improvements were observed in uncorrected distance and intermediate visual acuity.Spectacle independence was enhanced for distance and intermediate vision,especially in bright light settings.Spectacle-free intermediate vision was improved even in dim lighting.Visual disturbances,particularly glare symptoms,were reduced,and there was a notable decrease in IOP and glaucoma medication burden at 3mo.There was more hazy vision postoperatively with no impact on visual acuity and visual satisfaction.CONCLUSION:The non-diffractive EDOF lens improves distance and intermediate spectacle-free visual function in patients with OHT and well-controlled glaucoma.The findings highlight significant improvements in visual acuity,reduced glare,enhanced spectacle independence,and improved visual performance in different lighting conditions.
文摘BACKGROUND Lacrimal sac rhinosporidiosis,with nil or minor nasal extensions,rarely presents as an acquired cutaneous fistula in the periocular area.The correct diagnosis in such cases can be challenging,leading to repeated failure of conservative or surgical interventions.CASE SUMMARY A 39-year-old female presented with a 6-year history of swelling in the periocular area,specifically in the left lacrimal sac area.Symptoms were limited to epiphora and constant mucoid discharge from the fistula,clinically mimicking chronic lacrimal sac fistula.She had a history of treatment with multiple antibiotic courses and dacryocystectomy in the past,with no or transient symptomatic relief.On surgical exploration of the site,a large pedunculated polypoidal vascular mass,suspicious of rhinosporidiosis,was noted.En bloc resection of the mass with cauterization of the base and fistulectomy was performed.Histopathology confirmed the diagnosis of lacrimal sac rhinosporidiosis.The patient was further evaluated and treated for the nasal extension of rhinosporidiosis.The patient has been frequently followed up for the last 3 years with a good clinical outcome and no recurrence.CONCLUSION Lacrimal sac rhinosporidiosis,in isolated or limited nasal extension cases,can rarely mimic a chronic discharging fistula.Patients with this disease often face distress due to misdiagnosis and repeated failure of conservative or surgical interventions.A high index of suspicion is needed for early diagnosis.Proper surgical intervention at the right time can lead to an excellent prognosis in such patients.
基金Supported by Beijing Natural Science Foundation from Beijing Municipal Government(No.7202030).
文摘AIM:To investigate the effect of pharmacological pupil alterations on intraocular lens(IOL)power calculations.METHODS:A systematic review and Meta-analysis of studies published before December 2023 in the PubMed,Embase,and Cochrane library databases on the accuracy of pharmacological pupil changes on IOL power calculation was performed.The primary outcome was the results of IOL power calculations before and after the use of medications.Subgroup analyses were performed based on participants’basic characteristics,such as age,axial length(AL),and whether miosis or mydriasis were used as classification criteria for further analyses.Each eligible study was evaluated for potential risk of bias by the AHRQ assessment scale.The study was registered on PROSPERO(CRD 42024497535).RESULTS:A total of 3062 eyes from 21 studies were eligible.There was no significant difference in the IOL power calculation before and after pharmacological pupil changes using any of the Hoffer Q(WMD=0.055,95%CI=-0.046–0.156;P=0.29),SRK/T(WMD=0.003,95%CI=-0.073–0.080;P=0.93),Haigis(WMD=-0.030,95%CI=-0.176–0.116;P=0.69),Holladay 2(WMD=-0.042,95%CI=-0.366–0.282;P=0.80),and Barrett Universal Ⅱ(WMD=0.033,95%CI=-0.061–0.127;P=0.49)formulas.On the measurement of parameters related to IOL power calculation,for either miosis or mydriasis AL(P=0.98 and 0.29,respectively),lens thickness(P=0.96 and 0.13,respectively),and mean keratometry(P=0.90 and 0.86,respectively)did not present significant differences,while anterior chamber depth(P=0.07 and<0.01,respectively)and white-to-white distance(P=0.01 and 0.04,respectively)changed significantly between the two measurements prior and posterior.At the same time,despite there being some participants with the difference between the before and after calculations greater than 0.5 diopter,there was no significant difference in the incidence rate between these formulas.CONCLUSION:There is no significant effect of pharmacological pupil changes on the IOL power calculation.It will considerably reduce the visit time burden for patients who require cataract surgery.
文摘Traumatic brain injury (TBI) is defined as damage to the brain resulting from an external sudden physical force or shock to the head.It is considered a silent public health epidemic causing significant death and disability globally.There were 64,000 TBI related deaths reported in the USA in 2020,with about US$76 billion in direct and indirect medical costs annually.
基金Supported by National Natural Science Foundation of China(No.82160195,No.82460203)Degree and Postgraduate Education Teaching Reform Project of Jiangxi Province(No.JXYJG-2020-026).
文摘AIM:To assess the possibility of using different large language models(LLMs)in ocular surface diseases by selecting five different LLMS to test their accuracy in answering specialized questions related to ocular surface diseases:ChatGPT-4,ChatGPT-3.5,Claude 2,PaLM2,and SenseNova.METHODS:A group of experienced ophthalmology professors were asked to develop a 100-question singlechoice question on ocular surface diseases designed to assess the performance of LLMs and human participants in answering ophthalmology specialty exam questions.The exam includes questions on the following topics:keratitis disease(20 questions),keratoconus,keratomalaciac,corneal dystrophy,corneal degeneration,erosive corneal ulcers,and corneal lesions associated with systemic diseases(20 questions),conjunctivitis disease(20 questions),trachoma,pterygoid and conjunctival tumor diseases(20 questions),and dry eye disease(20 questions).Then the total score of each LLMs and compared their mean score,mean correlation,variance,and confidence were calculated.RESULTS:GPT-4 exhibited the highest performance in terms of LLMs.Comparing the average scores of the LLMs group with the four human groups,chief physician,attending physician,regular trainee,and graduate student,it was found that except for ChatGPT-4,the total score of the rest of the LLMs is lower than that of the graduate student group,which had the lowest score in the human group.Both ChatGPT-4 and PaLM2 were more likely to give exact and correct answers,giving very little chance of an incorrect answer.ChatGPT-4 showed higher credibility when answering questions,with a success rate of 59%,but gave the wrong answer to the question 28% of the time.CONCLUSION:GPT-4 model exhibits excellent performance in both answer relevance and confidence.PaLM2 shows a positive correlation(up to 0.8)in terms of answer accuracy during the exam.In terms of answer confidence,PaLM2 is second only to GPT4 and surpasses Claude 2,SenseNova,and GPT-3.5.Despite the fact that ocular surface disease is a highly specialized discipline,GPT-4 still exhibits superior performance,suggesting that its potential and ability to be applied in this field is enormous,perhaps with the potential to be a valuable resource for medical students and clinicians in the future.
文摘Posaconazole(PCZ)is a broad-spectrum anti-fungal drug approved by FDA and currently used off-label for the treatment of fungal keratitis(FK).Although ocular route serves as the most bioavailable route for treating FK,delivery of PCZ to the eye remains a challenge due to poor permeation though the cornea and rapid elimination from the eye.Here we outline a comprehensive formulation development process,beginning with in silico studies,progressing through in vitro evaluations,and ultimately achieving therapeutic benefits in vivo.We report modified niosome-like surfactant vesicles,hereafter termed as NioTherms,formulated using a novel and simple heat-mix method,encapsulating PCZ for ocular administration in the form of an in situ gel.Excipient screening performed using in silico simulations highly correlate with in vitro studies(R^(2)=0.77),guiding optimization by Quality by Design(QbD)approach for encapsulating PCZ in NioTherms resulting in particles with an average size of 180.7±2.3 nm,zeta potential of +27.5±2.2 mV and entrapment efficiency of 87.6%±1.7%.A 2-fold increase in both mucin binding and cellular uptake indicates a functional role of positive surface charge in enhancingmucoadhesive properties of PCZ-NioTherms.In an in vivo murine ocular keratitis model,we demonstrate a 2-fold enhancement in trans-corneal permeability of PCZ-NioTherms and a 3-fold reduction in fungal burden compared to the control standard of care,the PCZ solution.Owing to a facile formulation process,we anticipate that PCZ-NioTherms would serve as a clinically translatable and patient compliant therapeutic intervention for treating FK.
文摘BACKGROUND The gut microbiome is integral to human health,with emerging research underscoring its potential impact on ocular health through the gut-eye axis.Various ocular disorders,such as dry eye syndrome,retinal vascular diseases,macular degeneration,and glaucoma,may be influenced by gut dysbiosis,which could significantly contribute to their development and progression.AIM To evaluate the influence of the gut microbiome on the pathogenesis and progression of various ocular diseases.METHODS An extensive search of the scientific literature was undertaken by adhering to Preferred Reporting Items for Systematic Reviews&Meta-Analyses standards,using PubMed(MEDLINE),Scopus,EMBASE,and the Cochrane Library as sources to locate studies addressing the relationship between the gut microbiome and human health.To capture all relevant publications,search terms were systematically applied across these major databases,without limiting the search by language or publication date.Inclusion criteria covered randomized controlled trials,non-randomized controlled trial,prospective studies,cross-sectional studies,and case-control studies.Out of the 3077 articles,36 full texts were included in the review.RESULTS Ocular health appears to be shaped by the gut microbial community through mechanisms such as immune regulation,preservation of the blood–retinal barrier,and the generation of protective metabolites.Disturbances in this microbial balance can provoke measurable alterations in host immunity,providing a plausible immunopathogenic pathway that connects intestinal dysbiosis with eye disease.Both laboratory models and early human data suggest that targeted interventions,including prebiotics,probiotics,synbiotics,and faecal microbiota transfer,hold therapeutic potential.CONCLUSION The gut–eye relationship reflects a multifaceted interaction in which the intestinal microbiome contributes to ocular health through complex biological pathways.Integrating microbiome assessments into diagnostic methods can revolutionize disease management through early detection and targeted interventions.Further,randomised controlled clinical trials are necessary for ocular diseases to prove causal relationships.
文摘Photobiomodulation has been known to have potential medicinal effects for ages.It involves the use of specific wavelengths to target specific regions in the cell.Different health conditions have been reported to be treated with exposure to light such as cardiovascular conditions,inflammatory diseases,infectious diseases,and most importantly ocular diseases.This review specifically targets the treatment of retinal diseases including age-related macular degeneration,diabetic macular edema,myopia and acute retinal light injury with photobiomodulation.Red light is used in this therapy since this wavelength has lower frequency and hence minimal chance of causing any damage.Red light has the potential to penetrate cellular structures such as mitochondria and facilitate cellular processes.For ocular diseases,the target wavelength ranges between 630 to 800 nm.In most of the cases the primary target for red light is the cytochrome C oxidase enzyme in mitochondria,which alters the gene expression and promotes cellular energy production.Clinical evidence shows improvement of visual activity and reduction in thickness of retina post treatment.Future prospects of photobiomodulation involve target-specific treatment,combinational therapy to treat complex retinal diseases including gene therapy,and longitudinal studies to predict long-term efficacy and the chance of any recurrence in the patients.Hence the future of photobiomodulation holds significant potential in medicine especially in ocular diseases characterized by progress in research,technology,and clinical trials.
基金Supported by Noor Ophthalmology Research Center.
文摘Biomechanical study of the visual system by ocular response analyzer investigates the inter-structural biological relationships,mechanics,and function of the visual system.This review aimed to investigate the changes in corneal biomechanical parameters with age and sex.The articles published in PubMed between 2000 and 2021 were investigated and critiqued,and valid scientific evidence was collected,reviewed and concluded according to the inclusion and exclusion criteria.Most studies showed that corneal biomechanical changes occur infrequently in children up to the age of 20y,and with increasing age and wider age range,there was a significant decrease in corneal biomechanical indices,especially corneal hysteresis.In children and adults,most studies have shown that these biomechanical indicators,especially corneal resistance factor,were higher in females.Although hormonal changes may contribute to this finding,the role of axial length and other biometric indicators should not be ignored.The axial length,the intraocular pressure,and the corneal thickness are other factors associated with biomechanical parameters that should be taken into account in clinical diagnosis and management especially for patients undergoing refractive surgery as well as keratoconus patients.
