AIM: To study the change in ocular refraction in patients with pediatric cataracts(PCs) after lens extraction. METHODS: A total of 1258 patients who were undergoing cataract extraction with/without intraocular lens(IO...AIM: To study the change in ocular refraction in patients with pediatric cataracts(PCs) after lens extraction. METHODS: A total of 1258 patients who were undergoing cataract extraction with/without intraocular lens(IOL)implantation were recruited during preoperative examinations between Jan 2010 and Oct 2013. Patient ages ranged from 1.5 mo to 14y. Follow-ups were conducted at1 wk, 1, and 3 mo postoperatively and every 3 mo in the first year, then 6 mo thereafter. Ocular refraction [evaluated as spherical equivalent(SE)] and yearly myopic shift(YMS)were recorded and statistically analyzed among patients with age at surgery, baseline ocular refraction, gender,postoperative time and laterality(bilateral vs unilateral). RESULTS: By Dec 31st 2015, 1172 participants had been followed for more than 2y. The median follow-up period was 3y. The critical factors affecting the ocular refraction of PC patients were baseline ocular refraction, postoperative time for both aphakic and pseudophakic eyes. YMS grew most rapidly in young childhood and early adolescence. CONCLUSION: After lens surgeries, ocular refraction in PC patients shows an individual difference of change.Further concerns should be raising to monitor the rapid myopic shift at early adolescence of these patients.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
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
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
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
AIM:To compare objective dry retinoscopy and subjective refraction measurements in patients with mild keratoconus(KCN)and quantify any differences.METHODS:This cross-sectional study was done on 68 eyes of 68 patients ...AIM:To compare objective dry retinoscopy and subjective refraction measurements in patients with mild keratoconus(KCN)and quantify any differences.METHODS:This cross-sectional study was done on 68 eyes of 68 patients diagnosed with mild KCN.Objective dry retinoscopy using autorefractometer and subjective refraction measurements were performed.Sphere,cylinder,J0,J45,and spherical equivalent values were compared between the two techniques.RESULTS:The mean age of 68 patients with mild KCN was 21.32±5.03y(12–35y).There were 37(54.4%)males.Objective refraction yielded significantly more myopic sphere(-1.44 D vs-0.57 D),higher cylinder magnitude(-2.24 D vs-1.48 D),and more myopic spherical equivalent(-2.56 D vs-1.31 D)compared to subjective refraction(all P<0.05).The mean differences were-0.87 D for sphere,-0.76 D for cylinder,and-1.25 D for spherical equivalent.No significant differences were found for J0 and J45 values,indicating agreement in astigmatism axis(P>0.05).CONCLUSION:In patients with mild KCN,objective dry retinoscopy overestimates the degree of myopia and astigmatism compared to subjective refraction.The irregular cornea in KCN likely impacts objective measurements.Subjective refraction allows compensation for irregularity,providing a more accurate correction.When determining refractive targets,the tendency of objective methods to overcorrect should be considered.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
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
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
AIM:To compare the subjective refraction data with autorefraction findings in high astigmatisms.METHODS:In a cross-sectional study,sampling was done from in different geographic regions in Iran using a multistage rand...AIM:To compare the subjective refraction data with autorefraction findings in high astigmatisms.METHODS:In a cross-sectional study,sampling was done from in different geographic regions in Iran using a multistage random cluster sampling method.All study participants underwent cycloplegic auto-refraction and subjective refraction using the red-green test.RESULTS:In this study,277 eyes of 158 students aged 8 to 15y were analyzed.According to the results,the mean difference between subjective refraction and autorefraction in measuring sphere,cylinder,spherical equivalent,J0,and J45 was-0.18±0.76,-0.36±0.40,-0.36±0.79,0.15±0.20,and 0.05±0.21 respectively.The correlation of these two refraction methods in measuring the aforementioned indices was 0.963,0.898,0.960,0.931,and 0.948 respectively.The 95%limits of agreement of the two methods in measuring the above indices were-1.66 to 1.31,-1.14 to 0.42,-1.91 to 1.19,-0.24 to 0.54,and-0.36 to 0.47 respectively.The agreement between the two methods decreased with increasing cylinder power,and the best agreement was found in myopic individuals.CONCLUSION:The measurements obtained by autorefractometer have a significantly higher cylinder average compared to subjective refraction.However,in the cylinder range of 4–5 diopters,the values of J0 and J45 do not have a high correlation.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
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 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
AIM:To compare the changes in preschool refractive status,ocular biological parameters,and higher-order aberrations in children with retinopathy of prematurity(ROP)after retinal laser photocoagulation or anti-vascular...AIM:To compare the changes in preschool refractive status,ocular biological parameters,and higher-order aberrations in children with retinopathy of prematurity(ROP)after retinal laser photocoagulation or anti-vascular endothelial growth factor(anti-VEGF)treatment and explore their underlying factors.METHODS:This observational study involved 118 eyes of 59 children,aged 3 to 6y,with ROP followed up between March 2023 and October 2024.They were divided into the laser,anti-VEGF,and anti-VEGF+laser groups.The laser group received a single session of laser photocoagulation.The anti-VEGF group received a single anti-VEGF treatment.The anti-VEGF+laser group received a single anti-VEGF treatment after birth followed by supplementary laser treatment within 2wk to 6mo.Ocular biological parameters were measured using IOL Master 700 and Pentacam HR.Right-eye higher-order aberrations were measured using the OPD-Scan III.Best-corrected visual acuities(BCVA),refractive statuses,ocular biological parameters,and higherorder aberrations were assessed and compared.Multiple linear regression analysis was conducted to evaluate the relationships among ocular biological parameters,higherorder aberrations,spherical equivalent(SE),and treatment methods.Pearson’s correlation coefficients were used to assess the relationships between the SE and higher-order aberrations.RESULTS:The laser group had a higher incidence of myopia and a lower SE than the anti-VEGF group.The incidence of astigmatism and cylindrical power were significantly lower for the anti-VEGF than for the laser and anti-VEGF+laser groups(P<0.05).The anterior corneal surface astigmatism was higher for the laser and anti-VEGF+laser groups than for the anti-VEGF group.The anterior corneal surface K2 and lens thickness were higher for the laser and anti-VEGF+laser groups than for the anti-VEGF group.The whole-eye higher-order aberration root mean square(RMS)values for the right eye were significantly higher for the laser and anti-VEGF+laser groups than for the anti-VEGF group.The whole-eye trefoil RMS values for the right eye were also significantly higher for the laser and anti-VEGF+laser groups than for the anti-VEGF group(P<0.05).Laser treatment was significantly associated with SE,anterior corneal surface curvature and astigmatism,lens thickness,whole-eye highorder aberrations,and whole-eye trefoil(all P<0.05).CONCLUSION:Children with ROP who received laser treatment have higher myopia and astigmatism than those who received anti-VEGF treatment.Children treated with laser or supplementary laser treatment have higher anterior corneal astigmatism,anterior corneal curvature,thicker lenses,whole-eye higher-order aberrations,and whole-eye trefoil.The cause of myopia in children with ROP after laser treatment is increased anterior corneal surface curvature and lens thickness.展开更多
As cataract surgery progresses from “restoration of sight” to “refractive correction”, precise prediction of intraocular lens (IOL) power is critical for enhancing postoperative visual quality in patients. IOL pow...As cataract surgery progresses from “restoration of sight” to “refractive correction”, precise prediction of intraocular lens (IOL) power is critical for enhancing postoperative visual quality in patients. IOL power calculation methods have evolved and innovated throughout time, from early theoretical and regression formulas to nonlinear formulas for estimating effective lens position (ELP), multivariable formulas, and innovative formulas that use optical principles and AI-based online formulas. This paper thoroughly discusses the development and iteration of traditional IOL calculation formulas, the emergence of new IOL calculation formulas, and the selection of IOL calculation formulas for different patients in the era of refractive cataract surgery, serving as a reference for “personalized” IOL implantation in clinical practice.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
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
AIM:To investigate the ocular surface parameters in patients with moderate to high myopia.METHODS:This prospective study was conducted in May 2023,enrolling patients with moderate to high myopia(spherical equivalent r...AIM:To investigate the ocular surface parameters in patients with moderate to high myopia.METHODS:This prospective study was conducted in May 2023,enrolling patients with moderate to high myopia(spherical equivalent refraction≤-3.0 D).After completing the Ocular Surface Disease Index(OSDI)questionnaire,refractive parameters and non-invasive tear film parameters were measured,followed by the Schirmer I test and fluorescein sodium staining.The diagnosis of dry eye disease was based on OSDI score,non-invasive tear breakup time(NIBUT),Schirmer I test,and fluorescein sodium staining results,according to the 2020 Chinese Expert Consensus on Dry Eye.The Mann-Whitney U test was used to compare ocular surface parameters between moderate and high myopia,as well as between patients with and without dry eye.Pearson correlation analysis was employed to assess the relationship between the lipid/muco-aqueous layers and tear film parameters.A general linear mixed model(GLMM)was used to analyze the impact of refractive parameters on ocular surface parameters after adjusting for age and sex.RESULTS:A total of 35 eyes with moderate to high myopia(12 males;mean age,30.30±5.45y)were included in the study.Among them,26 eyes were classified as normal and 9 as dry eye.Of the 9 dry eye cases,7 were observed in the high myopia group(n=18)and 2 in the moderate myopia group(n=17).Among the enrolled patients,those with high myopia demonstrated significantly higher OSDI scores than those with moderate myopia(P=0.0417).Patients with dry eye exhibited significantly shorter interblink intervals(P=0.0081)and higher OSDI scores(P=0.0001)than those without dry eye.Pearson correlation analysis revealed a significant positive correlation between lipid layer thickness(LLT)and tear meniscus height(r=0.395,P=0.023),and a significant negative correlation between the muco-aqueous layer thickness change rate(MALTR)and OSDI score(r=-0.466,P=0.016).After adjusting for age and sex using the GLMM,spherical refraction(SPH,β=-1.802,P=0.048)and axial length(AL,β=2.784,P=0.048)significantly impacted OSDI score.Corneal front astigmatism significantly influenced Schirmer I test results(β=8.377,P=0.024).The difference between central corneal thickness and the thinnest corneal thickness significantly affected LLT(β=-2.294,P=0.026).White-to-white diameter significantly impacted MALTR(β=-81.758,P=0.037).CONCLUSION:In moderate to high myopia,higher SPH and AL correlate with increased dry eye symptoms,which are associated with muco-aqueous and lipid layer alterations.Corneal regularity and diameter also affect tear film dynamics.展开更多
基金Supported by National Natural Science Foundation of China (No.81873675 No.81770967)+2 种基金National Key R&D Program of China (No.2018YFC0116500 No.2017YFC1104600)Fundamental Research Funds for the Central Universities (No.16ykjc28)
文摘AIM: To study the change in ocular refraction in patients with pediatric cataracts(PCs) after lens extraction. METHODS: A total of 1258 patients who were undergoing cataract extraction with/without intraocular lens(IOL)implantation were recruited during preoperative examinations between Jan 2010 and Oct 2013. Patient ages ranged from 1.5 mo to 14y. Follow-ups were conducted at1 wk, 1, and 3 mo postoperatively and every 3 mo in the first year, then 6 mo thereafter. Ocular refraction [evaluated as spherical equivalent(SE)] and yearly myopic shift(YMS)were recorded and statistically analyzed among patients with age at surgery, baseline ocular refraction, gender,postoperative time and laterality(bilateral vs unilateral). RESULTS: By Dec 31st 2015, 1172 participants had been followed for more than 2y. The median follow-up period was 3y. The critical factors affecting the ocular refraction of PC patients were baseline ocular refraction, postoperative time for both aphakic and pseudophakic eyes. YMS grew most rapidly in young childhood and early adolescence. CONCLUSION: After lens surgeries, ocular refraction in PC patients shows an individual difference of change.Further concerns should be raising to monitor the rapid myopic shift at early adolescence of these patients.
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 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.
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.
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AIM:To compare objective dry retinoscopy and subjective refraction measurements in patients with mild keratoconus(KCN)and quantify any differences.METHODS:This cross-sectional study was done on 68 eyes of 68 patients diagnosed with mild KCN.Objective dry retinoscopy using autorefractometer and subjective refraction measurements were performed.Sphere,cylinder,J0,J45,and spherical equivalent values were compared between the two techniques.RESULTS:The mean age of 68 patients with mild KCN was 21.32±5.03y(12–35y).There were 37(54.4%)males.Objective refraction yielded significantly more myopic sphere(-1.44 D vs-0.57 D),higher cylinder magnitude(-2.24 D vs-1.48 D),and more myopic spherical equivalent(-2.56 D vs-1.31 D)compared to subjective refraction(all P<0.05).The mean differences were-0.87 D for sphere,-0.76 D for cylinder,and-1.25 D for spherical equivalent.No significant differences were found for J0 and J45 values,indicating agreement in astigmatism axis(P>0.05).CONCLUSION:In patients with mild KCN,objective dry retinoscopy overestimates the degree of myopia and astigmatism compared to subjective refraction.The irregular cornea in KCN likely impacts objective measurements.Subjective refraction allows compensation for irregularity,providing a more accurate correction.When determining refractive targets,the tendency of objective methods to overcorrect should be considered.
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Supported by Shahid Beheshti University of Medical Sciences.
文摘AIM:To compare the subjective refraction data with autorefraction findings in high astigmatisms.METHODS:In a cross-sectional study,sampling was done from in different geographic regions in Iran using a multistage random cluster sampling method.All study participants underwent cycloplegic auto-refraction and subjective refraction using the red-green test.RESULTS:In this study,277 eyes of 158 students aged 8 to 15y were analyzed.According to the results,the mean difference between subjective refraction and autorefraction in measuring sphere,cylinder,spherical equivalent,J0,and J45 was-0.18±0.76,-0.36±0.40,-0.36±0.79,0.15±0.20,and 0.05±0.21 respectively.The correlation of these two refraction methods in measuring the aforementioned indices was 0.963,0.898,0.960,0.931,and 0.948 respectively.The 95%limits of agreement of the two methods in measuring the above indices were-1.66 to 1.31,-1.14 to 0.42,-1.91 to 1.19,-0.24 to 0.54,and-0.36 to 0.47 respectively.The agreement between the two methods decreased with increasing cylinder power,and the best agreement was found in myopic individuals.CONCLUSION:The measurements obtained by autorefractometer have a significantly higher cylinder average compared to subjective refraction.However,in the cylinder range of 4–5 diopters,the values of J0 and J45 do not have a high correlation.
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 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 Key Research and Development Program of Shaanxi Province(No.2024SF-YBXM-320)the Clinical Research Project of the Fourth Military Medical University(No.2022LC2247)Medical Staff Training Boosting Project of Xijing Hospital,Air Force Medical University(No.XJZT24CY52).
文摘AIM:To compare the changes in preschool refractive status,ocular biological parameters,and higher-order aberrations in children with retinopathy of prematurity(ROP)after retinal laser photocoagulation or anti-vascular endothelial growth factor(anti-VEGF)treatment and explore their underlying factors.METHODS:This observational study involved 118 eyes of 59 children,aged 3 to 6y,with ROP followed up between March 2023 and October 2024.They were divided into the laser,anti-VEGF,and anti-VEGF+laser groups.The laser group received a single session of laser photocoagulation.The anti-VEGF group received a single anti-VEGF treatment.The anti-VEGF+laser group received a single anti-VEGF treatment after birth followed by supplementary laser treatment within 2wk to 6mo.Ocular biological parameters were measured using IOL Master 700 and Pentacam HR.Right-eye higher-order aberrations were measured using the OPD-Scan III.Best-corrected visual acuities(BCVA),refractive statuses,ocular biological parameters,and higherorder aberrations were assessed and compared.Multiple linear regression analysis was conducted to evaluate the relationships among ocular biological parameters,higherorder aberrations,spherical equivalent(SE),and treatment methods.Pearson’s correlation coefficients were used to assess the relationships between the SE and higher-order aberrations.RESULTS:The laser group had a higher incidence of myopia and a lower SE than the anti-VEGF group.The incidence of astigmatism and cylindrical power were significantly lower for the anti-VEGF than for the laser and anti-VEGF+laser groups(P<0.05).The anterior corneal surface astigmatism was higher for the laser and anti-VEGF+laser groups than for the anti-VEGF group.The anterior corneal surface K2 and lens thickness were higher for the laser and anti-VEGF+laser groups than for the anti-VEGF group.The whole-eye higher-order aberration root mean square(RMS)values for the right eye were significantly higher for the laser and anti-VEGF+laser groups than for the anti-VEGF group.The whole-eye trefoil RMS values for the right eye were also significantly higher for the laser and anti-VEGF+laser groups than for the anti-VEGF group(P<0.05).Laser treatment was significantly associated with SE,anterior corneal surface curvature and astigmatism,lens thickness,whole-eye highorder aberrations,and whole-eye trefoil(all P<0.05).CONCLUSION:Children with ROP who received laser treatment have higher myopia and astigmatism than those who received anti-VEGF treatment.Children treated with laser or supplementary laser treatment have higher anterior corneal astigmatism,anterior corneal curvature,thicker lenses,whole-eye higher-order aberrations,and whole-eye trefoil.The cause of myopia in children with ROP after laser treatment is increased anterior corneal surface curvature and lens thickness.
文摘As cataract surgery progresses from “restoration of sight” to “refractive correction”, precise prediction of intraocular lens (IOL) power is critical for enhancing postoperative visual quality in patients. IOL power calculation methods have evolved and innovated throughout time, from early theoretical and regression formulas to nonlinear formulas for estimating effective lens position (ELP), multivariable formulas, and innovative formulas that use optical principles and AI-based online formulas. This paper thoroughly discusses the development and iteration of traditional IOL calculation formulas, the emergence of new IOL calculation formulas, and the selection of IOL calculation formulas for different patients in the era of refractive cataract surgery, serving as a reference for “personalized” IOL implantation in clinical practice.
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 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.
基金Supported by the Shanghai Natural Science Foundation(No.23ZR1409200).
文摘AIM:To investigate the ocular surface parameters in patients with moderate to high myopia.METHODS:This prospective study was conducted in May 2023,enrolling patients with moderate to high myopia(spherical equivalent refraction≤-3.0 D).After completing the Ocular Surface Disease Index(OSDI)questionnaire,refractive parameters and non-invasive tear film parameters were measured,followed by the Schirmer I test and fluorescein sodium staining.The diagnosis of dry eye disease was based on OSDI score,non-invasive tear breakup time(NIBUT),Schirmer I test,and fluorescein sodium staining results,according to the 2020 Chinese Expert Consensus on Dry Eye.The Mann-Whitney U test was used to compare ocular surface parameters between moderate and high myopia,as well as between patients with and without dry eye.Pearson correlation analysis was employed to assess the relationship between the lipid/muco-aqueous layers and tear film parameters.A general linear mixed model(GLMM)was used to analyze the impact of refractive parameters on ocular surface parameters after adjusting for age and sex.RESULTS:A total of 35 eyes with moderate to high myopia(12 males;mean age,30.30±5.45y)were included in the study.Among them,26 eyes were classified as normal and 9 as dry eye.Of the 9 dry eye cases,7 were observed in the high myopia group(n=18)and 2 in the moderate myopia group(n=17).Among the enrolled patients,those with high myopia demonstrated significantly higher OSDI scores than those with moderate myopia(P=0.0417).Patients with dry eye exhibited significantly shorter interblink intervals(P=0.0081)and higher OSDI scores(P=0.0001)than those without dry eye.Pearson correlation analysis revealed a significant positive correlation between lipid layer thickness(LLT)and tear meniscus height(r=0.395,P=0.023),and a significant negative correlation between the muco-aqueous layer thickness change rate(MALTR)and OSDI score(r=-0.466,P=0.016).After adjusting for age and sex using the GLMM,spherical refraction(SPH,β=-1.802,P=0.048)and axial length(AL,β=2.784,P=0.048)significantly impacted OSDI score.Corneal front astigmatism significantly influenced Schirmer I test results(β=8.377,P=0.024).The difference between central corneal thickness and the thinnest corneal thickness significantly affected LLT(β=-2.294,P=0.026).White-to-white diameter significantly impacted MALTR(β=-81.758,P=0.037).CONCLUSION:In moderate to high myopia,higher SPH and AL correlate with increased dry eye symptoms,which are associated with muco-aqueous and lipid layer alterations.Corneal regularity and diameter also affect tear film dynamics.
