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
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
AIM:To investigate the association between active corneal epithelial dendritic cells(CEDCs)and ocular pain in patients with dry eye disease(DED).METHODS:This cross-sectional study enrolled 67 DED patients,who were div...AIM:To investigate the association between active corneal epithelial dendritic cells(CEDCs)and ocular pain in patients with dry eye disease(DED).METHODS:This cross-sectional study enrolled 67 DED patients,who were divided into two groups based on numerical rating scale(NRS)scores:the mild pain group(n=44)and the moderate-to-severe pain group(n=23).In vivo confocal microscopy(IVCM)was used to image the subbasal layer of the central cornea.Corneal nerve characteristics were analyzed using ACCMetrics software,while CEDCs were quantified manually with Image J software.Regression and correlation analyses were performed to assess the impact of active CEDCs on ocular pain.Additionally,the Luminex method was employed to compare the concentrations of inflammation-related cytokines in tears between patients with≥2 CEDCs and those with<2 CEDCs.Differences in cytokine levels between the two groups were analyzed using Student’s t-test.RESULTS:The study included 44 eyes of 44 patients with mild ocular pain(12 males and 32 females)and 23 eyes of 23 patients with moderate-to-severe ocular pain(3 males and 20 females).The mean age was 36.2±13.5y in the mild pain group and 39.7±12.4y in the moderate to severe pain group.There were no significant differences in age or sex between the two groups(P=0.30;P=0.19).Multivariable regression analysis showed that older age[odds ratio(OR)=1.05,95%confidence interval(CI)1.00–1.11]and a higher number of CEDCs(OR=1.80,95%CI 1.17–2.76)were associated with ocular pain.Patients with≥2 CEDCs had significantly higher tear concentrations of interleukin(IL)-6(P<0.05),IL-8(P<0.05),and tumor necrosis factor(TNF)-α(P<0.05)compared to those with<2 active CEDCs.CONCLUSION:The findings suggest that infiltrating CEDCs in the corneal subbasal layer are a potential risk factor for ocular pain in DED.展开更多
Artificial intelligence(AI)has become an indispensable tool in modern health care,offering transformative potential across clinical workflows and diagnostic innovations.This review explores the sation of AI technologi...Artificial intelligence(AI)has become an indispensable tool in modern health care,offering transformative potential across clinical workflows and diagnostic innovations.This review explores the sation of AI technologies in synthesizing and analyzing multimodal data to enhance efficiency and accuracy in health care delivery.Specifically,deep learning models have demonstrated remarkable capabilities in identifying seven categories of hepatobiliary disorders using ocular imaging datasets,including slit-lamp,retinal fundus,and optical coherence tomography images.Leveraging ResNet-101 neural networks,researchers have developed screening models and independent diagnostic tools,showcasing how AI can redefine diagnostic practices and improve accessibility,particularly in resource-limited settings.By examining advancements in AI-driven health care solutions,this article sheds light on both the challenges and opportunities that lie ahead in integrating such technologies into routine clinical practice.展开更多
Background:Vestibular assessments,such as the video ocular counter roll(vOCR)test,offer valuable insights into the interactions between age,otolith function,and vestibular performance.Objective:To analyze the relation...Background:Vestibular assessments,such as the video ocular counter roll(vOCR)test,offer valuable insights into the interactions between age,otolith function,and vestibular performance.Objective:To analyze the relation between age and vOCR gains as a potential marker of age-related otolith degeneration.Methods:A total of 107 participants underwent vOCR testing.Descriptive statistics and simple linear regression analyses were conducted to explore the association between age and vOCR gains.Results were presented using regression coefficients,95%confidence intervals,p-values,and R-squared values.Results:In the overall sample,statistically significant associations were observed between age and vOCR gains in both ears.For the right ear,vOCR gains decreased with increasing age(coefficient:-0.03;95%CI:-0.05 to-0.01;p<0.001;R^(2)=0.08),while the left ear showed a slightly stronger association(coefficient:-0.04;95%CI:-0.07 to-0.02;p<0.001;R²=0.12).These findings indicate a moderate age-related decline in otolith-mediated vestibular responses.Conclusion:vOCR gains appear to decline with age,reflecting potential age-related otolith degeneration.These results support the clinical value of vOCR as a non-invasive method to assess vestibular function and its changes across the lifespan.展开更多
AIM:To analyze ocular parameters and refractive status in children aged 3-12y and to explore differences in these parameters across age groups with identical refractive status for studying refractive progression.METHO...AIM:To analyze ocular parameters and refractive status in children aged 3-12y and to explore differences in these parameters across age groups with identical refractive status for studying refractive progression.METHODS:Demographic characteristics,cycloplegic refraction data,and ocular parameters of the participants were collected.Changes in ocular parameters were described according to different age groups.After adjusting for refractive factors,the relationship between age and ocular parameters was explored.Standard regression coefficients(β)obtained from multiple linear regressions were used to compare the magnitude of the effect of age on the parameters and ocular components on refractive power.RESULTS:Data were collected from the right eyes of 1504 participants.Lens thickness(LT)decreased with age,whereas the axial length(AL)and anterior chamber depth(ACD)increased.In the high-hyperopia group,changes in age were only associated with AL and LT.In the low-myopia group,the increase in age was also associated with corneal astigmatism.In the overall model,theβvalue for LT was the highest at 0.41,whereasβfor ACD and AL was significant in all groups except for the high-hyperopia group.Theβvalue of the LT on refractive power in children was slightly greater in the low age group than in the high age group.CONCLUSION:Among children with the same refractive status,the older the age,the longer the axis length and the thinner the lens.The lens affected refractive power in children in the younger age group more than in the older age group.The ocular parameter most affected by age was LT.展开更多
A structural conjugate(HOC)of polysaccharide,hyaluronic acid(HA)with different ratios of oleic acid(OA)via cystamine(CYS)linker as a new ocular biomaterial was developed.The HOCs with controlled degrees of substitutio...A structural conjugate(HOC)of polysaccharide,hyaluronic acid(HA)with different ratios of oleic acid(OA)via cystamine(CYS)linker as a new ocular biomaterial was developed.The HOCs with controlled degrees of substitution of OA(4.6%,8.3%and 12.2%)were synthesized to form self-assembled HA-CYS-OA nanoparticles(HONs,HON1,HON2,HON3).A poorly water-soluble cyclosporine A(CsA)to be used for the treatment of multifactorial dry eye disease(DED)was chosen as model drug.CsA-loaded HONs exhibited improved solution transparency via solubilizing capacity of HON,and increased in vitro drug permeation compared to Restasis®.The physicochemical properties of CsA-loaded HONs such as nano behaviors,solution transparency,drug release,drug permeation and ocular cytocompatibility were highly variable according to the ratios of OA substitution.Interestingly,this CsA-loaded HON1 as optimal ocular nanoformulation showed markedly augmentedmacrophage polarization into the M2 phenotype,downregulated the expression of proinflammatory cytokines levels in LPS-induced M1 macrophage,and effectively inhibited VEGF-induced endothelial cell proliferation and capillary-like tube formation by the synergistic effect of CsA and HON1 containing OA at the same time.Collectively,the current fatty acid conjugated to HA,named fattigation platform,providing the roles and physicochemical properties via structural features of HA could be a promising co-delivery strategy of drug and fatty acid for DED and other ophthalmic disease treatments.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 analyze the ocular findings of patients who received lifelong leptin therapy due to congenital leptin deficiency(CLD),an extremely rare condition.METHODS:A prospective,cross-sectional comparative study was perf...AIM:To analyze the ocular findings of patients who received lifelong leptin therapy due to congenital leptin deficiency(CLD),an extremely rare condition.METHODS:A prospective,cross-sectional comparative study was performed on six patients with CLD and 13 healthy age-and sex-matched controls.The central corneal thickness(CCT),anterior chamber depth(ACD),axial length(AL),keratometry(K1,K2),optical coherence tomography(OCT),and OCT angiography parameters were compared between the leptin and control groups at the baseline visit.The change in these measurements in leptin patients over a two-year period was analyzed.RESULTS:CLD patients had lower mean AL,ACD,and CCT(P≤0.012 for all).Mean K1,K2(P≤0.047 for both),choroidal thickness(P≤0.001),and central ganglion cell layer(GCL)thickness(P=0.029)were higher in the leptin group.Perifoveal superficial capillary plexus(SCP)density was decreased in all quadrants except the temporal region(P<0.05),and parafoveal deep capillary plexus(DCP)density was decreased in the superior hemisphere,temporal quadrant(P≤0.036 for both)and nasal quadrant(P=0.048)in the leptin group.During the two-year follow-up,no changes in anterior and posterior segment measurements were observed in the leptin patients,except for subfoveal choroidal thickness(P<0.001).CONCLUSION:CLD patients exhibit structural alterations in both the anterior and posterior segments of the eye,including notable changes in retinal and choroidal vasculature.However,there is limited evidence concerning the influence of leptin therapy on the eye.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
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.
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.
基金Supported by the National Natural Science Foundation of China(No.82171022No.81974128).
文摘AIM:To investigate the association between active corneal epithelial dendritic cells(CEDCs)and ocular pain in patients with dry eye disease(DED).METHODS:This cross-sectional study enrolled 67 DED patients,who were divided into two groups based on numerical rating scale(NRS)scores:the mild pain group(n=44)and the moderate-to-severe pain group(n=23).In vivo confocal microscopy(IVCM)was used to image the subbasal layer of the central cornea.Corneal nerve characteristics were analyzed using ACCMetrics software,while CEDCs were quantified manually with Image J software.Regression and correlation analyses were performed to assess the impact of active CEDCs on ocular pain.Additionally,the Luminex method was employed to compare the concentrations of inflammation-related cytokines in tears between patients with≥2 CEDCs and those with<2 CEDCs.Differences in cytokine levels between the two groups were analyzed using Student’s t-test.RESULTS:The study included 44 eyes of 44 patients with mild ocular pain(12 males and 32 females)and 23 eyes of 23 patients with moderate-to-severe ocular pain(3 males and 20 females).The mean age was 36.2±13.5y in the mild pain group and 39.7±12.4y in the moderate to severe pain group.There were no significant differences in age or sex between the two groups(P=0.30;P=0.19).Multivariable regression analysis showed that older age[odds ratio(OR)=1.05,95%confidence interval(CI)1.00–1.11]and a higher number of CEDCs(OR=1.80,95%CI 1.17–2.76)were associated with ocular pain.Patients with≥2 CEDCs had significantly higher tear concentrations of interleukin(IL)-6(P<0.05),IL-8(P<0.05),and tumor necrosis factor(TNF)-α(P<0.05)compared to those with<2 active CEDCs.CONCLUSION:The findings suggest that infiltrating CEDCs in the corneal subbasal layer are a potential risk factor for ocular pain in DED.
文摘Artificial intelligence(AI)has become an indispensable tool in modern health care,offering transformative potential across clinical workflows and diagnostic innovations.This review explores the sation of AI technologies in synthesizing and analyzing multimodal data to enhance efficiency and accuracy in health care delivery.Specifically,deep learning models have demonstrated remarkable capabilities in identifying seven categories of hepatobiliary disorders using ocular imaging datasets,including slit-lamp,retinal fundus,and optical coherence tomography images.Leveraging ResNet-101 neural networks,researchers have developed screening models and independent diagnostic tools,showcasing how AI can redefine diagnostic practices and improve accessibility,particularly in resource-limited settings.By examining advancements in AI-driven health care solutions,this article sheds light on both the challenges and opportunities that lie ahead in integrating such technologies into routine clinical practice.
文摘Background:Vestibular assessments,such as the video ocular counter roll(vOCR)test,offer valuable insights into the interactions between age,otolith function,and vestibular performance.Objective:To analyze the relation between age and vOCR gains as a potential marker of age-related otolith degeneration.Methods:A total of 107 participants underwent vOCR testing.Descriptive statistics and simple linear regression analyses were conducted to explore the association between age and vOCR gains.Results were presented using regression coefficients,95%confidence intervals,p-values,and R-squared values.Results:In the overall sample,statistically significant associations were observed between age and vOCR gains in both ears.For the right ear,vOCR gains decreased with increasing age(coefficient:-0.03;95%CI:-0.05 to-0.01;p<0.001;R^(2)=0.08),while the left ear showed a slightly stronger association(coefficient:-0.04;95%CI:-0.07 to-0.02;p<0.001;R²=0.12).These findings indicate a moderate age-related decline in otolith-mediated vestibular responses.Conclusion:vOCR gains appear to decline with age,reflecting potential age-related otolith degeneration.These results support the clinical value of vOCR as a non-invasive method to assess vestibular function and its changes across the lifespan.
基金Supported by the National Natural Science Foundation of China(No.82171093).
文摘AIM:To analyze ocular parameters and refractive status in children aged 3-12y and to explore differences in these parameters across age groups with identical refractive status for studying refractive progression.METHODS:Demographic characteristics,cycloplegic refraction data,and ocular parameters of the participants were collected.Changes in ocular parameters were described according to different age groups.After adjusting for refractive factors,the relationship between age and ocular parameters was explored.Standard regression coefficients(β)obtained from multiple linear regressions were used to compare the magnitude of the effect of age on the parameters and ocular components on refractive power.RESULTS:Data were collected from the right eyes of 1504 participants.Lens thickness(LT)decreased with age,whereas the axial length(AL)and anterior chamber depth(ACD)increased.In the high-hyperopia group,changes in age were only associated with AL and LT.In the low-myopia group,the increase in age was also associated with corneal astigmatism.In the overall model,theβvalue for LT was the highest at 0.41,whereasβfor ACD and AL was significant in all groups except for the high-hyperopia group.Theβvalue of the LT on refractive power in children was slightly greater in the low age group than in the high age group.CONCLUSION:Among children with the same refractive status,the older the age,the longer the axis length and the thinner the lens.The lens affected refractive power in children in the younger age group more than in the older age group.The ocular parameter most affected by age was LT.
基金supported by a grant from the National Research Foundation of Korea(NRF)funded by the Ministry of Science and ICT(RS-2023-00208240),Republic of Korea.
文摘A structural conjugate(HOC)of polysaccharide,hyaluronic acid(HA)with different ratios of oleic acid(OA)via cystamine(CYS)linker as a new ocular biomaterial was developed.The HOCs with controlled degrees of substitution of OA(4.6%,8.3%and 12.2%)were synthesized to form self-assembled HA-CYS-OA nanoparticles(HONs,HON1,HON2,HON3).A poorly water-soluble cyclosporine A(CsA)to be used for the treatment of multifactorial dry eye disease(DED)was chosen as model drug.CsA-loaded HONs exhibited improved solution transparency via solubilizing capacity of HON,and increased in vitro drug permeation compared to Restasis®.The physicochemical properties of CsA-loaded HONs such as nano behaviors,solution transparency,drug release,drug permeation and ocular cytocompatibility were highly variable according to the ratios of OA substitution.Interestingly,this CsA-loaded HON1 as optimal ocular nanoformulation showed markedly augmentedmacrophage polarization into the M2 phenotype,downregulated the expression of proinflammatory cytokines levels in LPS-induced M1 macrophage,and effectively inhibited VEGF-induced endothelial cell proliferation and capillary-like tube formation by the synergistic effect of CsA and HON1 containing OA at the same time.Collectively,the current fatty acid conjugated to HA,named fattigation platform,providing the roles and physicochemical properties via structural features of HA could be a promising co-delivery strategy of drug and fatty acid for DED and other ophthalmic disease treatments.
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.
文摘AIM:To analyze the ocular findings of patients who received lifelong leptin therapy due to congenital leptin deficiency(CLD),an extremely rare condition.METHODS:A prospective,cross-sectional comparative study was performed on six patients with CLD and 13 healthy age-and sex-matched controls.The central corneal thickness(CCT),anterior chamber depth(ACD),axial length(AL),keratometry(K1,K2),optical coherence tomography(OCT),and OCT angiography parameters were compared between the leptin and control groups at the baseline visit.The change in these measurements in leptin patients over a two-year period was analyzed.RESULTS:CLD patients had lower mean AL,ACD,and CCT(P≤0.012 for all).Mean K1,K2(P≤0.047 for both),choroidal thickness(P≤0.001),and central ganglion cell layer(GCL)thickness(P=0.029)were higher in the leptin group.Perifoveal superficial capillary plexus(SCP)density was decreased in all quadrants except the temporal region(P<0.05),and parafoveal deep capillary plexus(DCP)density was decreased in the superior hemisphere,temporal quadrant(P≤0.036 for both)and nasal quadrant(P=0.048)in the leptin group.During the two-year follow-up,no changes in anterior and posterior segment measurements were observed in the leptin patients,except for subfoveal choroidal thickness(P<0.001).CONCLUSION:CLD patients exhibit structural alterations in both the anterior and posterior segments of the eye,including notable changes in retinal and choroidal vasculature.However,there is limited evidence concerning the influence of leptin therapy on the eye.
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.
