AIM: To investigate the accuracy of intraocular pressure (IOP) as measured by a Reichert Ocular Response Analyzer (ORA), as well as the relationship between central corneal thickness (CCT) and IOP as measured by ORA, ...AIM: To investigate the accuracy of intraocular pressure (IOP) as measured by a Reichert Ocular Response Analyzer (ORA), as well as the relationship between central corneal thickness (CCT) and IOP as measured by ORA, Goldmann applanation tonometry (GAD, and dynamic contour tonometry (DCT). METHODS: A total of 158 healthy individuals (296 eyes) were chosen randomly for measurement of IOP. After CCT was measured using A-ultrasound (A-US), IOP was measured by ORA, GAT, and DCT devices in a randomized order. The IOP values acquired using each of the three tonometries were compared, and the relationship between CCT and IOP values were analyzed separately. Two IOP values, Goldmann-correlated IOP value (IOPg) and corneal-compensated intraocular pressure (IOPcc), were got using ORA. Three groups were defined according to CCT: 1) thin cornea (CCT<520 mu m); 2) normal-thickness cornea (CCT: 520-580 mu m); and 3), thick cornea (CCT>580 mu m) groups. RESULTS: In normal subjects, IOP measurements were 14.95 2.99mmHg with ORA (IOPg), 15.21+/- 2.77mmHg with ORA(IOPcc),1522+/- 2.77mmHg with GAT,and 15.49+/- 2.56mmHg with DCT. Mean differences were 0.01+/- 2.29mmHg between IOPcc and GAT (P >0.05) and 0.28+/- 2.20mmHg between IOPcc and DC (P >0.05). There was a greater correlation between IOPcc and DCT (r =0.946, P =0.000) than that between IOPcc and GAT (r=0.845, P=0.000). DCT had a significant correlation with GAT (r=0.854, P=0.000). GAT was moderately correlated with CCT (r=0.296, P<0.001), while IOPcc showed a weak but significant correlation with CCT (r =0.155, P =0.007). There was a strong negative correlation between CCT and the difference between IOPcc and GAT (r=-0.803, P=0.000), with every 10 m increase in CCT resulting in an increase in this difference of 0.35mmHg. The thick cornea group (CCT>580 mu m) showed the least significant correlation between IOPcc and GAT (r=0.859, 0.000); while the thin cornea group (CCT< 520 mu m) had the most significant correlation between IOPcc and GAT (r= 0.926, P =0.000). The correlated differences between IOPcc and DCT were not significant in any of the three groups (P>0.05). CONCLUSION: Measurement of IOP by ORA has high repeatability and is largely consistent with GAT measurements. Moreover, the ORA measurements are affected only to a small extent by CCT, and are likely to be much closer to the real IOP value than GAT.展开更多
AIM:To compare intraocular pressure(IOP)measurements before and after laser in situ keratomileusis(LASIK)with a femtosecond laser for flap creation using ocular response analyzer(ORA)and Goldmann applanation tonometry...AIM:To compare intraocular pressure(IOP)measurements before and after laser in situ keratomileusis(LASIK)with a femtosecond laser for flap creation using ocular response analyzer(ORA)and Goldmann applanation tonometry,and to identify factors that may influence the preoperative and postoperative IOP.METHODS:A prospective study conducted on myopic patients who underwent LASIK using a femtosecond laser for flap fashioning.Enrolled patients were evaluated preoperatively,6 wk and 3 mo postoperatively for manifest refraction(MR),keratometric(K)readings and central corneal thickness(CCT)using a scheimpflug-based topography.Corneal resistance factor(CRF),corneal hysteresis(CH),Goldmann correlated IOP(IOPg)and corneal compensated IOP(IOPcc)were measured using ORA besides IOP assessment by Goldman applanation tonometry(GAT).RESULTS:There was a statistically significant decrease in measures of IOPg by 3.35±0.83 mm Hg,followed by GAT which decreased by 2.2±0.44 mm Hg,and the least affected by operation was IOPcc which decreased only by 0.87±0.1 mm Hg after 6 wk.After 3 mo follow up there was a statistically significant decrease in IOPcc which decreased only by 0.76±0.4 mm Hg,followed by IOP GAT by 1.6±0.5 mm Hg,and the most affected by operation was IOPg which decreased by 2.3±0.3 mm Hg.Correspondingly,there was a statistically significant decrease in CH and CRF after 6 wk and 3 mo.At 3 mo,the preoperative MR and preoperative GAT were prominent significant predictors of the postoperative GAT changes.The prediction equation was subsumed.CONCLUSION:IOP measurements and corneal biomechanical factors reduce significantly after LASIK with a femtosecond laser for flap creation.The IOPcc values are less influenced by changes in corneal properties than IOPg and GAT,indicating that IOPcc may provide the most reliable measurement of IOP after this procedure.展开更多
BACKGROUND Dry eye disease(DED)is a multifactorial ocular surface disorder with rising prevalence.It is closely related to systemic health and psychological factors,such as sleep and mood disorders,which significantly...BACKGROUND Dry eye disease(DED)is a multifactorial ocular surface disorder with rising prevalence.It is closely related to systemic health and psychological factors,such as sleep and mood disorders,which significantly impact the quality of life of patients.AIM To explore the correlations between ocular surface function,sleep quality,and anxiety/depression in patients with DED.METHODS This was a cross-sectional investigative study that included 358 patients with DED between January 2022 and January 2025.Ocular surface was assessed using the ocular surface disease index(OSDI),tear film break-up time,fluorescein staining score,and Schirmer I test.The Pittsburgh Sleep Quality Index(PSQI),Self-Rating Anxiety Scale(SAS),and Self-Rating Depression Scale(SDS)were used to evaluate sleep quality and anxiety/depression levels.Correlation and linear regression analyses were used to explore the relationships.RESULTS The mean PSQI score of the patients was 9.94±2.18;the mean SAS score was 47.30±4.90,and the mean SDS score was 50.08±5.52.These suggested a prevalence of sleep and psychological abnormalities.There was a significant correlation between the indicators of ocular surface function(OSDI,tear film break-up time,fluorescein staining,and Schirmer I test)and PSQI,SAS,and SDS scores(P<0.05).Moreover,multiple regression revealed that age≥50 years(β=1.55,P=0.029),PSQI scores(β=0.58,P<0.001),SAS scores(β=0.17,P=0.017),and SDS scores(β=0.15,P=0.019)were independent predictors of the OSDI scores.CONCLUSION Ocular surface function in patients with DED is closely related to sleep quality and anxiety/depression,emphasizing the need for holistic clinical management.展开更多
Changes of corneal properties induced by laser in situ keratomileusis （LASIK） results in low inaccurate intraocular pressure （IOP） readings by Goldmann applanation tonometry （GAT）. Before and after LASIK, the ap...Changes of corneal properties induced by laser in situ keratomileusis （LASIK） results in low inaccurate intraocular pressure （IOP） readings by Goldmann applanation tonometry （GAT）. Before and after LASIK, the applied value of IOP, measured by dynamic contour tonometry （DCT） in comparison to GAT, was evaluated. Before and 1, 4 weeks after LASIK, the IOP in 30 cases （60 eyes） was measured by GAT and DCT respectively. The obtained results were statistically processed by SPSSll. 5 statistical software. The results showed that central corneal thickness （CCT） could affect GAT measurements but not DCT measurements. The comparison of IOP one and 4 weeks after LASIK revealed that the readings from GAT was separately decreased by 5.00±1.12 and 5.45±1.13 mmHg as compared with those before LASIK, while those from DCT had no significant difference. It was concluded that LASIK-induced changes of CCT could influence the accuracy of GAT measurements, but had no influence on those from DCT. DCT was more beneficial to the measurements of IOP in normal eyes and those subject to LASIK surgery.展开更多
AIM:To investigate the clinical characteristics and treatment outcomes,including visual function and overall survival(OS)of patients with ocular adnexal diffuse large B-cell lymphoma(OA-DLBCL).METHODS:This retrospecti...AIM:To investigate the clinical characteristics and treatment outcomes,including visual function and overall survival(OS)of patients with ocular adnexal diffuse large B-cell lymphoma(OA-DLBCL).METHODS:This retrospective cohort study enrolled 29 patients diagnosed with OA-DLBCL based on histopathological biopsy between 2006 and 2023.Patients were stratified into two subgroups:primary OA-DLBCL(no prior history of lymphoma)and secondary OA-DLBCL(history of DLBCL at non-ocular adnexal sites).OS was defined as the time interval from OA-DLBCL diagnosis to death from any cause.Survival analysis was performed using the Kaplan–Meier method,and prognostic factors affecting OS were identified using multivariate Cox proportional hazards regression with a stepwise selection approach.RESULTS:The cohort included 24 patients with primary OA-DLBCL(13 males,11 females;mean age:61.36±18.29y)and 5 patients with secondary OA-DLBCL(2 males,3 females;mean age:50.94±18.17y).Among the primary OA-DLBCL subgroup,12 patients(50%)presented with advanced disease(Ann Arbor stage IIIE–IV),and 16 patients(66%)were classified as T4 disease according to the tumor-node-metastasis(TNM)staging system.The mean final visual acuity was 1.72±1.10 in the primary group and 0.90±1.18 in the secondary group.The 5-year OS rate for the entire cohort was 27.7%.Multivariate analysis identified five factors significantly associated with poor survival outcomes:epiphora[adjusted hazard ratio(aHR),36.95],atherosclerotic cardiovascular disease(aHR,10.08),human immunodeficiency virus(HIV)infection(aHR,12.47),M1 stage(aHR,6.99),and secondary OA-DLBCL(aHR,6.03;all P<0.05).The median OS was 1.68y for primary OA-DLBCL and 1.12y for secondary OA-DLBCL.CONCLUSION:A substantial proportion of patients with primary OA-DLBCL present with advanced-stage disease at diagnosis.Epiphora,atherosclerotic cardiovascular disease,HIV infection,M1 stage,and secondary OA-DLBCL are independent prognostic factors for poor survival outcomes.These findings emphasize the urgent need for optimized therapeutic strategies and early screening protocols to improve the management of OA-DLBCL,particularly in developing countries.展开更多
Purpose: The accuracy of Goldmann applanation tonometry (GAT) has been shown to depend on several biomechanical properties of the cornea. Newer tonometry devices (e.g., the Dynamic Contour Tonometer PASCAL? [DCT] and ...Purpose: The accuracy of Goldmann applanation tonometry (GAT) has been shown to depend on several biomechanical properties of the cornea. Newer tonometry devices (e.g., the Dynamic Contour Tonometer PASCAL? [DCT] and the Tono-Pen? XL [TP]) have been designed to accurately measure intraocular pressure (IOP) independent of corneal thickness (CCT) and pathology. This study investigates the influence of corneal pathologies on the accuracy of these IOP measuring devices, and compares this accuracy to that of direct intracameral IOP measurement. Methods: 8 eyes of 8 patients suffering from corneal pathologies scheduled for penetrating keratoplasty, and 10 eyes of 10 patients scheduled for cataract surgery (control group) were examined. Before surgery, the anterior chamber was cannulated at the temporal corneal limbus. In a closed system, the intraocular pressure (IOP) was directly set to 10, 20, and 30 mmHg with a manometric water column. Intraocular pressure measurements taken by GAT, DCT, and TP were compared to intracameral measurements obtained by a precision reference pressure sensor. Results: Control group: All three methods showed good agreement with the intracameral readings (mean deviation of all three devices, -0.9 mmHg). Group with corneal pathologies: The TP yielded the most exact IOP values in the group with corneal pathologies when taking all diagnoses into account. The mean deviations from the intracameral IOP measurements were -0.9 mmHg ± 3.2 mmHg (mean ± SD) for TP, -2.9 mmHg ± 3.3 mmHg for GAT, and -5.0 mmHg ± 7.9 mmHg for DCT. For bullous keratopathy, the most exact IOP readings were obtained by the TP (mean deviation -0.2 mmHg ± 3.5 mmHg). The TP and GAT devices underestimated IOP in the patients with Fuchs’ endothelial dystrophy;all 3 devices underestimated adjusted IOP after keratoplasty. DCT showed the greatest deviations from adjusted IOP in the case of non-herpetic scars. In the control group, none of the devices showed a statistically relevant dependency on CCT. Nevertheless, in the group with corneal pathologies, only TP showed no dependency on CCT. Conclusion: Our results suggest that the Tono-Pen XL? is the most accurate measurement device to determine IOP in patients with corneal pathologies, especially in patients suffering from corneal edema (bullous keratopathy). GAT yielded surprisingly exact IOP values in patients suffering from irregular corneal surface. DCT showed a high degree of deviation from the adjusted IOP, and should not be used to determine IOP in corneas with the disorders listed here.展开更多
AIM:To assess intraocular pressure(IOP)during the daily curve of intraocular pressure(DCPo)in keratoconic eyes and compare Goldmann applanation tonometer(GAT),without and with astigmatism correction(n GAT and c GAT)an...AIM:To assess intraocular pressure(IOP)during the daily curve of intraocular pressure(DCPo)in keratoconic eyes and compare Goldmann applanation tonometer(GAT),without and with astigmatism correction(n GAT and c GAT)and Tono-Pen AVIA(TPA)assessment methods.METHODS:Thirty-nine keratoconic eyes of 24 patients were assessed.DCPo was evaluated with five IOP measurements;four were performed with a GAT(n GAT and c GAT),and a Tono-Pen AVIA(TPA)at various times throughout the day.RESULTS:Mean IOP DCPo values(mm Hg)were:n GAT,9.9±2.6;c GAT,11.3±2.6;TPA 12.3±3.1.Mean IOP DCPo differences(mm Hg)and Spearman’s correlation coefficients were as follows:c GATc-n GAT,1.32±1.31,r_(s)=0.879(P<0.01);c GAT-TPA,-1.02±2.08,r_(s)=0.723(P<0.01);and n GAT-TPA,-2.35±2.23,r_(s)=0.730(P<0.01).Bland-Altman analysis for agreement between c GAT-TPA and n GAT-TPA mean IOP DCPo measurements revealed a mean difference of 1.02(95%CI,0.35-1.70)and 2.35(95%CI,1.62-3.07)mm Hg,respectively.Regression analysis yielded the following equation:TPA IOP=5.49+0.775×c GAT-0.015×ACD-0.299×corneal astig matism,which allowed us to infer TPA IOP values from other parameters.CONCLUSION:In keratoconic eyes,IOP peaks of DCPo measurements are identified at 6 a.m.,independent of the tonometer.The mean DCPo values are:TPA>c GAT>n GAT.IOP TPA measures are predictive of c GAT values,adjusted according to anterior chamber depth and corneal astigmatism.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: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 investigate the outcome of combined anterior corneal elastic sublaminectomy,conjunctival flap,and prosthetic eyepiece for ocular atrophy following foldable capsular vitreous body(FCVB)implantation in severe tra...AIM:To investigate the outcome of combined anterior corneal elastic sublaminectomy,conjunctival flap,and prosthetic eyepiece for ocular atrophy following foldable capsular vitreous body(FCVB)implantation in severe trauma.METHODS:This study conducted a retrospective analysis of 38 patients who underwent conjunctival flap coverage followed by prosthetic eyepiece fitting after developing ocular atrophy secondary to FCVB surgery.Anterior corneal elastic sublaminectomy combined with conjunctival coverage was performed on the FCVBimplanted atrophic eyes.Prosthetic lenses were fitted after complete healing of the stroma and conjunctiva and suture removal.Corneal irritation,eyeball protrusion,axial length,lid height,cosmetic satisfaction,and pain numerical rating scale scores were observed before the conjunctival flap covering and after the prosthetic eyepiece surgery.RESULTS:The ocular protrusion was 11 mm preoperatively and 14 mm postoperatively,with the difference being statistically significant(Z=-5.459,P<0.001).The ocular axis length was 20.82±0.94 mm in the experimental group and 23.57±0.33 mm in the control group,showing a statistically significant difference(t=-20.207,P<0.05).The lid height was 6 mm in the experimental group and 9 mm in the control group,a difference that was statistically significant(Z=-5.326,P<0.001).The appearance satisfaction score was 1 in the experimental group and 4 in the control group,with this difference being statistically significant(Z=-5.447,P=0.001).Regarding the pain numerical rating scale score,the ranges were 0-2 in the experimental group and 0 in the control group.No discomfort was reported after wearing the prosthetic eyepiece,and the difference was not statistically significant(Z=-1.100,P>0.05).There was no statistically significant difference between pre-and post-treatment satisfaction.CONCLUSION:A conjunctival flap covering and a prosthetic eyepiece after FCVB postoperative atrophy can reduce the number of surgeries,alleviate patients’economic burdens,satisfy patients’psychological eyeball retention requirements,and provide better cosmetic efficacies for patients desiring eyeball retention or silicone-oil dependence.展开更多
AIM： To compare IOPen and ICare rebound tonometry to Goldmann applanation tonometry（GAT） according to International Standards Organization（ISO） 8612 criteria.METHODS： Totally 191 eyes（n =107 individuals） were ...AIM： To compare IOPen and ICare rebound tonometry to Goldmann applanation tonometry（GAT） according to International Standards Organization（ISO） 8612 criteria.METHODS： Totally 191 eyes（n =107 individuals） were included. Criteria of ISO 8612 were fulfilled： 3 clusters of IOP, measured by GAT, were formed. The GAT results were given as mean±standard deviation.RESULTS： GAT（19.7±0.5 mm Hg） showed a significant correlation to ICare（19.8±0.5 mm Hg）（r =0.547, P 〈0.001）and IOPen（19.5 ±0.5 mm Hg）（r =0.526, P 〈0.001）.According to ISO 8612 criteria in all 3 IOP groups the number of outliers（of the 95% limits of agreement）exceeded 5% for ICare and IOPen vs GAT： No.1（n =68）29.4% and 22.1%, No.2（n =62） 35.5% and 37.1%, No.3（n =61） 26.2% and 42.6%, respectively.CONCLUSION： The strict requirements of the ISO 8612 are not fulfilled in a glaucoma collective by ICare and IOPen at present. As long as the Goldmann tonometry is applicable it should be used first of all for reproducible IOP readings. ICare and IOPen tonometry should be considered as an alternative tool, if application of Goldmann tonometry is not possible.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
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
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
Posaconazole(PCZ)is a broad-spectrum anti-fungal drug approved by FDA and currently used off-label for the treatment of fungal keratitis(FK).Although ocular route serves as the most bioavailable route for treating FK,...Posaconazole(PCZ)is a broad-spectrum anti-fungal drug approved by FDA and currently used off-label for the treatment of fungal keratitis(FK).Although ocular route serves as the most bioavailable route for treating FK,delivery of PCZ to the eye remains a challenge due to poor permeation though the cornea and rapid elimination from the eye.Here we outline a comprehensive formulation development process,beginning with in silico studies,progressing through in vitro evaluations,and ultimately achieving therapeutic benefits in vivo.We report modified niosome-like surfactant vesicles,hereafter termed as NioTherms,formulated using a novel and simple heat-mix method,encapsulating PCZ for ocular administration in the form of an in situ gel.Excipient screening performed using in silico simulations highly correlate with in vitro studies(R^(2)=0.77),guiding optimization by Quality by Design(QbD)approach for encapsulating PCZ in NioTherms resulting in particles with an average size of 180.7±2.3 nm,zeta potential of +27.5±2.2 mV and entrapment efficiency of 87.6%±1.7%.A 2-fold increase in both mucin binding and cellular uptake indicates a functional role of positive surface charge in enhancingmucoadhesive properties of PCZ-NioTherms.In an in vivo murine ocular keratitis model,we demonstrate a 2-fold enhancement in trans-corneal permeability of PCZ-NioTherms and a 3-fold reduction in fungal burden compared to the control standard of care,the PCZ solution.Owing to a facile formulation process,we anticipate that PCZ-NioTherms would serve as a clinically translatable and patient compliant therapeutic intervention for treating FK.展开更多
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
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
BACKGROUND The gut microbiome is integral to human health,with emerging research underscoring its potential impact on ocular health through the gut-eye axis.Various ocular disorders,such as dry eye syndrome,retinal va...BACKGROUND The gut microbiome is integral to human health,with emerging research underscoring its potential impact on ocular health through the gut-eye axis.Various ocular disorders,such as dry eye syndrome,retinal vascular diseases,macular degeneration,and glaucoma,may be influenced by gut dysbiosis,which could significantly contribute to their development and progression.AIM To evaluate the influence of the gut microbiome on the pathogenesis and progression of various ocular diseases.METHODS An extensive search of the scientific literature was undertaken by adhering to Preferred Reporting Items for Systematic Reviews&Meta-Analyses standards,using PubMed(MEDLINE),Scopus,EMBASE,and the Cochrane Library as sources to locate studies addressing the relationship between the gut microbiome and human health.To capture all relevant publications,search terms were systematically applied across these major databases,without limiting the search by language or publication date.Inclusion criteria covered randomized controlled trials,non-randomized controlled trial,prospective studies,cross-sectional studies,and case-control studies.Out of the 3077 articles,36 full texts were included in the review.RESULTS Ocular health appears to be shaped by the gut microbial community through mechanisms such as immune regulation,preservation of the blood–retinal barrier,and the generation of protective metabolites.Disturbances in this microbial balance can provoke measurable alterations in host immunity,providing a plausible immunopathogenic pathway that connects intestinal dysbiosis with eye disease.Both laboratory models and early human data suggest that targeted interventions,including prebiotics,probiotics,synbiotics,and faecal microbiota transfer,hold therapeutic potential.CONCLUSION The gut–eye relationship reflects a multifaceted interaction in which the intestinal microbiome contributes to ocular health through complex biological pathways.Integrating microbiome assessments into diagnostic methods can revolutionize disease management through early detection and targeted interventions.Further,randomised controlled clinical trials are necessary for ocular diseases to prove causal relationships.展开更多
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
MicroRNAs(miRNAs)are small non-coding RNAs of 20-22 nucleotides in length.They have been identified as major regulators in the secretome of mesenchymal stem cells(MSCs)including adipose tissue,bone marrow,Wharton’s j...MicroRNAs(miRNAs)are small non-coding RNAs of 20-22 nucleotides in length.They have been identified as major regulators in the secretome of mesenchymal stem cells(MSCs)including adipose tissue,bone marrow,Wharton’s jelly,and dental pulp.These MSCs and their secretome with specific miRNAs are known modulators of the immune response,angiogenesis,inflammation,and apoptosis.In this review,the application of MSC-derived miRNAs in treating several ocular conditions including dry eye,glaucoma,and retinal degenerative diseases has been compiled.In addition,the emerging role of MSC-derived extracellular vesicles carrying miRNAs as a major cargo,regulating the target cells in the human eye has been reviewed.Finally,the bioengineering of nanovesicles with specific MSC-derived miRNAs as novel drug therapy has been discussed.展开更多
文摘AIM: To investigate the accuracy of intraocular pressure (IOP) as measured by a Reichert Ocular Response Analyzer (ORA), as well as the relationship between central corneal thickness (CCT) and IOP as measured by ORA, Goldmann applanation tonometry (GAD, and dynamic contour tonometry (DCT). METHODS: A total of 158 healthy individuals (296 eyes) were chosen randomly for measurement of IOP. After CCT was measured using A-ultrasound (A-US), IOP was measured by ORA, GAT, and DCT devices in a randomized order. The IOP values acquired using each of the three tonometries were compared, and the relationship between CCT and IOP values were analyzed separately. Two IOP values, Goldmann-correlated IOP value (IOPg) and corneal-compensated intraocular pressure (IOPcc), were got using ORA. Three groups were defined according to CCT: 1) thin cornea (CCT<520 mu m); 2) normal-thickness cornea (CCT: 520-580 mu m); and 3), thick cornea (CCT>580 mu m) groups. RESULTS: In normal subjects, IOP measurements were 14.95 2.99mmHg with ORA (IOPg), 15.21+/- 2.77mmHg with ORA(IOPcc),1522+/- 2.77mmHg with GAT,and 15.49+/- 2.56mmHg with DCT. Mean differences were 0.01+/- 2.29mmHg between IOPcc and GAT (P >0.05) and 0.28+/- 2.20mmHg between IOPcc and DC (P >0.05). There was a greater correlation between IOPcc and DCT (r =0.946, P =0.000) than that between IOPcc and GAT (r=0.845, P=0.000). DCT had a significant correlation with GAT (r=0.854, P=0.000). GAT was moderately correlated with CCT (r=0.296, P<0.001), while IOPcc showed a weak but significant correlation with CCT (r =0.155, P =0.007). There was a strong negative correlation between CCT and the difference between IOPcc and GAT (r=-0.803, P=0.000), with every 10 m increase in CCT resulting in an increase in this difference of 0.35mmHg. The thick cornea group (CCT>580 mu m) showed the least significant correlation between IOPcc and GAT (r=0.859, 0.000); while the thin cornea group (CCT< 520 mu m) had the most significant correlation between IOPcc and GAT (r= 0.926, P =0.000). The correlated differences between IOPcc and DCT were not significant in any of the three groups (P>0.05). CONCLUSION: Measurement of IOP by ORA has high repeatability and is largely consistent with GAT measurements. Moreover, the ORA measurements are affected only to a small extent by CCT, and are likely to be much closer to the real IOP value than GAT.
文摘AIM:To compare intraocular pressure(IOP)measurements before and after laser in situ keratomileusis(LASIK)with a femtosecond laser for flap creation using ocular response analyzer(ORA)and Goldmann applanation tonometry,and to identify factors that may influence the preoperative and postoperative IOP.METHODS:A prospective study conducted on myopic patients who underwent LASIK using a femtosecond laser for flap fashioning.Enrolled patients were evaluated preoperatively,6 wk and 3 mo postoperatively for manifest refraction(MR),keratometric(K)readings and central corneal thickness(CCT)using a scheimpflug-based topography.Corneal resistance factor(CRF),corneal hysteresis(CH),Goldmann correlated IOP(IOPg)and corneal compensated IOP(IOPcc)were measured using ORA besides IOP assessment by Goldman applanation tonometry(GAT).RESULTS:There was a statistically significant decrease in measures of IOPg by 3.35±0.83 mm Hg,followed by GAT which decreased by 2.2±0.44 mm Hg,and the least affected by operation was IOPcc which decreased only by 0.87±0.1 mm Hg after 6 wk.After 3 mo follow up there was a statistically significant decrease in IOPcc which decreased only by 0.76±0.4 mm Hg,followed by IOP GAT by 1.6±0.5 mm Hg,and the most affected by operation was IOPg which decreased by 2.3±0.3 mm Hg.Correspondingly,there was a statistically significant decrease in CH and CRF after 6 wk and 3 mo.At 3 mo,the preoperative MR and preoperative GAT were prominent significant predictors of the postoperative GAT changes.The prediction equation was subsumed.CONCLUSION:IOP measurements and corneal biomechanical factors reduce significantly after LASIK with a femtosecond laser for flap creation.The IOPcc values are less influenced by changes in corneal properties than IOPg and GAT,indicating that IOPcc may provide the most reliable measurement of IOP after this procedure.
文摘BACKGROUND Dry eye disease(DED)is a multifactorial ocular surface disorder with rising prevalence.It is closely related to systemic health and psychological factors,such as sleep and mood disorders,which significantly impact the quality of life of patients.AIM To explore the correlations between ocular surface function,sleep quality,and anxiety/depression in patients with DED.METHODS This was a cross-sectional investigative study that included 358 patients with DED between January 2022 and January 2025.Ocular surface was assessed using the ocular surface disease index(OSDI),tear film break-up time,fluorescein staining score,and Schirmer I test.The Pittsburgh Sleep Quality Index(PSQI),Self-Rating Anxiety Scale(SAS),and Self-Rating Depression Scale(SDS)were used to evaluate sleep quality and anxiety/depression levels.Correlation and linear regression analyses were used to explore the relationships.RESULTS The mean PSQI score of the patients was 9.94±2.18;the mean SAS score was 47.30±4.90,and the mean SDS score was 50.08±5.52.These suggested a prevalence of sleep and psychological abnormalities.There was a significant correlation between the indicators of ocular surface function(OSDI,tear film break-up time,fluorescein staining,and Schirmer I test)and PSQI,SAS,and SDS scores(P<0.05).Moreover,multiple regression revealed that age≥50 years(β=1.55,P=0.029),PSQI scores(β=0.58,P<0.001),SAS scores(β=0.17,P=0.017),and SDS scores(β=0.15,P=0.019)were independent predictors of the OSDI scores.CONCLUSION Ocular surface function in patients with DED is closely related to sleep quality and anxiety/depression,emphasizing the need for holistic clinical management.
文摘Changes of corneal properties induced by laser in situ keratomileusis （LASIK） results in low inaccurate intraocular pressure （IOP） readings by Goldmann applanation tonometry （GAT）. Before and after LASIK, the applied value of IOP, measured by dynamic contour tonometry （DCT） in comparison to GAT, was evaluated. Before and 1, 4 weeks after LASIK, the IOP in 30 cases （60 eyes） was measured by GAT and DCT respectively. The obtained results were statistically processed by SPSSll. 5 statistical software. The results showed that central corneal thickness （CCT） could affect GAT measurements but not DCT measurements. The comparison of IOP one and 4 weeks after LASIK revealed that the readings from GAT was separately decreased by 5.00±1.12 and 5.45±1.13 mmHg as compared with those before LASIK, while those from DCT had no significant difference. It was concluded that LASIK-induced changes of CCT could influence the accuracy of GAT measurements, but had no influence on those from DCT. DCT was more beneficial to the measurements of IOP in normal eyes and those subject to LASIK surgery.
基金Supported by the Faculty of Medicine,Prince of Songkla University.Wainipitapong S has received grants from the Faculty of Medicine,Prince of Songkla University。
文摘AIM:To investigate the clinical characteristics and treatment outcomes,including visual function and overall survival(OS)of patients with ocular adnexal diffuse large B-cell lymphoma(OA-DLBCL).METHODS:This retrospective cohort study enrolled 29 patients diagnosed with OA-DLBCL based on histopathological biopsy between 2006 and 2023.Patients were stratified into two subgroups:primary OA-DLBCL(no prior history of lymphoma)and secondary OA-DLBCL(history of DLBCL at non-ocular adnexal sites).OS was defined as the time interval from OA-DLBCL diagnosis to death from any cause.Survival analysis was performed using the Kaplan–Meier method,and prognostic factors affecting OS were identified using multivariate Cox proportional hazards regression with a stepwise selection approach.RESULTS:The cohort included 24 patients with primary OA-DLBCL(13 males,11 females;mean age:61.36±18.29y)and 5 patients with secondary OA-DLBCL(2 males,3 females;mean age:50.94±18.17y).Among the primary OA-DLBCL subgroup,12 patients(50%)presented with advanced disease(Ann Arbor stage IIIE–IV),and 16 patients(66%)were classified as T4 disease according to the tumor-node-metastasis(TNM)staging system.The mean final visual acuity was 1.72±1.10 in the primary group and 0.90±1.18 in the secondary group.The 5-year OS rate for the entire cohort was 27.7%.Multivariate analysis identified five factors significantly associated with poor survival outcomes:epiphora[adjusted hazard ratio(aHR),36.95],atherosclerotic cardiovascular disease(aHR,10.08),human immunodeficiency virus(HIV)infection(aHR,12.47),M1 stage(aHR,6.99),and secondary OA-DLBCL(aHR,6.03;all P<0.05).The median OS was 1.68y for primary OA-DLBCL and 1.12y for secondary OA-DLBCL.CONCLUSION:A substantial proportion of patients with primary OA-DLBCL present with advanced-stage disease at diagnosis.Epiphora,atherosclerotic cardiovascular disease,HIV infection,M1 stage,and secondary OA-DLBCL are independent prognostic factors for poor survival outcomes.These findings emphasize the urgent need for optimized therapeutic strategies and early screening protocols to improve the management of OA-DLBCL,particularly in developing countries.
文摘Purpose: The accuracy of Goldmann applanation tonometry (GAT) has been shown to depend on several biomechanical properties of the cornea. Newer tonometry devices (e.g., the Dynamic Contour Tonometer PASCAL? [DCT] and the Tono-Pen? XL [TP]) have been designed to accurately measure intraocular pressure (IOP) independent of corneal thickness (CCT) and pathology. This study investigates the influence of corneal pathologies on the accuracy of these IOP measuring devices, and compares this accuracy to that of direct intracameral IOP measurement. Methods: 8 eyes of 8 patients suffering from corneal pathologies scheduled for penetrating keratoplasty, and 10 eyes of 10 patients scheduled for cataract surgery (control group) were examined. Before surgery, the anterior chamber was cannulated at the temporal corneal limbus. In a closed system, the intraocular pressure (IOP) was directly set to 10, 20, and 30 mmHg with a manometric water column. Intraocular pressure measurements taken by GAT, DCT, and TP were compared to intracameral measurements obtained by a precision reference pressure sensor. Results: Control group: All three methods showed good agreement with the intracameral readings (mean deviation of all three devices, -0.9 mmHg). Group with corneal pathologies: The TP yielded the most exact IOP values in the group with corneal pathologies when taking all diagnoses into account. The mean deviations from the intracameral IOP measurements were -0.9 mmHg ± 3.2 mmHg (mean ± SD) for TP, -2.9 mmHg ± 3.3 mmHg for GAT, and -5.0 mmHg ± 7.9 mmHg for DCT. For bullous keratopathy, the most exact IOP readings were obtained by the TP (mean deviation -0.2 mmHg ± 3.5 mmHg). The TP and GAT devices underestimated IOP in the patients with Fuchs’ endothelial dystrophy;all 3 devices underestimated adjusted IOP after keratoplasty. DCT showed the greatest deviations from adjusted IOP in the case of non-herpetic scars. In the control group, none of the devices showed a statistically relevant dependency on CCT. Nevertheless, in the group with corneal pathologies, only TP showed no dependency on CCT. Conclusion: Our results suggest that the Tono-Pen XL? is the most accurate measurement device to determine IOP in patients with corneal pathologies, especially in patients suffering from corneal edema (bullous keratopathy). GAT yielded surprisingly exact IOP values in patients suffering from irregular corneal surface. DCT showed a high degree of deviation from the adjusted IOP, and should not be used to determine IOP in corneas with the disorders listed here.
文摘AIM:To assess intraocular pressure(IOP)during the daily curve of intraocular pressure(DCPo)in keratoconic eyes and compare Goldmann applanation tonometer(GAT),without and with astigmatism correction(n GAT and c GAT)and Tono-Pen AVIA(TPA)assessment methods.METHODS:Thirty-nine keratoconic eyes of 24 patients were assessed.DCPo was evaluated with five IOP measurements;four were performed with a GAT(n GAT and c GAT),and a Tono-Pen AVIA(TPA)at various times throughout the day.RESULTS:Mean IOP DCPo values(mm Hg)were:n GAT,9.9±2.6;c GAT,11.3±2.6;TPA 12.3±3.1.Mean IOP DCPo differences(mm Hg)and Spearman’s correlation coefficients were as follows:c GATc-n GAT,1.32±1.31,r_(s)=0.879(P<0.01);c GAT-TPA,-1.02±2.08,r_(s)=0.723(P<0.01);and n GAT-TPA,-2.35±2.23,r_(s)=0.730(P<0.01).Bland-Altman analysis for agreement between c GAT-TPA and n GAT-TPA mean IOP DCPo measurements revealed a mean difference of 1.02(95%CI,0.35-1.70)and 2.35(95%CI,1.62-3.07)mm Hg,respectively.Regression analysis yielded the following equation:TPA IOP=5.49+0.775×c GAT-0.015×ACD-0.299×corneal astig matism,which allowed us to infer TPA IOP values from other parameters.CONCLUSION:In keratoconic eyes,IOP peaks of DCPo measurements are identified at 6 a.m.,independent of the tonometer.The mean DCPo values are:TPA>c GAT>n GAT.IOP TPA measures are predictive of c GAT values,adjusted according to anterior chamber depth and corneal astigmatism.
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: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 National Natural Science Foundation of China(No.82260210)General Project of Jiangxi Provincial Traditional Chinese Medicine Science and Technology Plan(No.2023B1368).
文摘AIM:To investigate the outcome of combined anterior corneal elastic sublaminectomy,conjunctival flap,and prosthetic eyepiece for ocular atrophy following foldable capsular vitreous body(FCVB)implantation in severe trauma.METHODS:This study conducted a retrospective analysis of 38 patients who underwent conjunctival flap coverage followed by prosthetic eyepiece fitting after developing ocular atrophy secondary to FCVB surgery.Anterior corneal elastic sublaminectomy combined with conjunctival coverage was performed on the FCVBimplanted atrophic eyes.Prosthetic lenses were fitted after complete healing of the stroma and conjunctiva and suture removal.Corneal irritation,eyeball protrusion,axial length,lid height,cosmetic satisfaction,and pain numerical rating scale scores were observed before the conjunctival flap covering and after the prosthetic eyepiece surgery.RESULTS:The ocular protrusion was 11 mm preoperatively and 14 mm postoperatively,with the difference being statistically significant(Z=-5.459,P<0.001).The ocular axis length was 20.82±0.94 mm in the experimental group and 23.57±0.33 mm in the control group,showing a statistically significant difference(t=-20.207,P<0.05).The lid height was 6 mm in the experimental group and 9 mm in the control group,a difference that was statistically significant(Z=-5.326,P<0.001).The appearance satisfaction score was 1 in the experimental group and 4 in the control group,with this difference being statistically significant(Z=-5.447,P=0.001).Regarding the pain numerical rating scale score,the ranges were 0-2 in the experimental group and 0 in the control group.No discomfort was reported after wearing the prosthetic eyepiece,and the difference was not statistically significant(Z=-1.100,P>0.05).There was no statistically significant difference between pre-and post-treatment satisfaction.CONCLUSION:A conjunctival flap covering and a prosthetic eyepiece after FCVB postoperative atrophy can reduce the number of surgeries,alleviate patients’economic burdens,satisfy patients’psychological eyeball retention requirements,and provide better cosmetic efficacies for patients desiring eyeball retention or silicone-oil dependence.
文摘AIM： To compare IOPen and ICare rebound tonometry to Goldmann applanation tonometry（GAT） according to International Standards Organization（ISO） 8612 criteria.METHODS： Totally 191 eyes（n =107 individuals） were included. Criteria of ISO 8612 were fulfilled： 3 clusters of IOP, measured by GAT, were formed. The GAT results were given as mean±standard deviation.RESULTS： GAT（19.7±0.5 mm Hg） showed a significant correlation to ICare（19.8±0.5 mm Hg）（r =0.547, P 〈0.001）and IOPen（19.5 ±0.5 mm Hg）（r =0.526, P 〈0.001）.According to ISO 8612 criteria in all 3 IOP groups the number of outliers（of the 95% limits of agreement）exceeded 5% for ICare and IOPen vs GAT： No.1（n =68）29.4% and 22.1%, No.2（n =62） 35.5% and 37.1%, No.3（n =61） 26.2% and 42.6%, respectively.CONCLUSION： The strict requirements of the ISO 8612 are not fulfilled in a glaucoma collective by ICare and IOPen at present. As long as the Goldmann tonometry is applicable it should be used first of all for reproducible IOP readings. ICare and IOPen tonometry should be considered as an alternative tool, if application of Goldmann tonometry is not possible.
基金Supported by National Natural Science Foundation of China(No.82160195,No.82460203)Degree and Postgraduate Education Teaching Reform Project of Jiangxi Province(No.JXYJG-2020-026).
文摘AIM:To assess the possibility of using different large language models(LLMs)in ocular surface diseases by selecting five different LLMS to test their accuracy in answering specialized questions related to ocular surface diseases:ChatGPT-4,ChatGPT-3.5,Claude 2,PaLM2,and SenseNova.METHODS:A group of experienced ophthalmology professors were asked to develop a 100-question singlechoice question on ocular surface diseases designed to assess the performance of LLMs and human participants in answering ophthalmology specialty exam questions.The exam includes questions on the following topics:keratitis disease(20 questions),keratoconus,keratomalaciac,corneal dystrophy,corneal degeneration,erosive corneal ulcers,and corneal lesions associated with systemic diseases(20 questions),conjunctivitis disease(20 questions),trachoma,pterygoid and conjunctival tumor diseases(20 questions),and dry eye disease(20 questions).Then the total score of each LLMs and compared their mean score,mean correlation,variance,and confidence were calculated.RESULTS:GPT-4 exhibited the highest performance in terms of LLMs.Comparing the average scores of the LLMs group with the four human groups,chief physician,attending physician,regular trainee,and graduate student,it was found that except for ChatGPT-4,the total score of the rest of the LLMs is lower than that of the graduate student group,which had the lowest score in the human group.Both ChatGPT-4 and PaLM2 were more likely to give exact and correct answers,giving very little chance of an incorrect answer.ChatGPT-4 showed higher credibility when answering questions,with a success rate of 59%,but gave the wrong answer to the question 28% of the time.CONCLUSION:GPT-4 model exhibits excellent performance in both answer relevance and confidence.PaLM2 shows a positive correlation(up to 0.8)in terms of answer accuracy during the exam.In terms of answer confidence,PaLM2 is second only to GPT4 and surpasses Claude 2,SenseNova,and GPT-3.5.Despite the fact that ocular surface disease is a highly specialized discipline,GPT-4 still exhibits superior performance,suggesting that its potential and ability to be applied in this field is enormous,perhaps with the potential to be a valuable resource for medical students and clinicians in the future.
文摘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.
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.
文摘Posaconazole(PCZ)is a broad-spectrum anti-fungal drug approved by FDA and currently used off-label for the treatment of fungal keratitis(FK).Although ocular route serves as the most bioavailable route for treating FK,delivery of PCZ to the eye remains a challenge due to poor permeation though the cornea and rapid elimination from the eye.Here we outline a comprehensive formulation development process,beginning with in silico studies,progressing through in vitro evaluations,and ultimately achieving therapeutic benefits in vivo.We report modified niosome-like surfactant vesicles,hereafter termed as NioTherms,formulated using a novel and simple heat-mix method,encapsulating PCZ for ocular administration in the form of an in situ gel.Excipient screening performed using in silico simulations highly correlate with in vitro studies(R^(2)=0.77),guiding optimization by Quality by Design(QbD)approach for encapsulating PCZ in NioTherms resulting in particles with an average size of 180.7±2.3 nm,zeta potential of +27.5±2.2 mV and entrapment efficiency of 87.6%±1.7%.A 2-fold increase in both mucin binding and cellular uptake indicates a functional role of positive surface charge in enhancingmucoadhesive properties of PCZ-NioTherms.In an in vivo murine ocular keratitis model,we demonstrate a 2-fold enhancement in trans-corneal permeability of PCZ-NioTherms and a 3-fold reduction in fungal burden compared to the control standard of care,the PCZ solution.Owing to a facile formulation process,we anticipate that PCZ-NioTherms would serve as a clinically translatable and patient compliant therapeutic intervention for treating FK.
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.
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BACKGROUND The gut microbiome is integral to human health,with emerging research underscoring its potential impact on ocular health through the gut-eye axis.Various ocular disorders,such as dry eye syndrome,retinal vascular diseases,macular degeneration,and glaucoma,may be influenced by gut dysbiosis,which could significantly contribute to their development and progression.AIM To evaluate the influence of the gut microbiome on the pathogenesis and progression of various ocular diseases.METHODS An extensive search of the scientific literature was undertaken by adhering to Preferred Reporting Items for Systematic Reviews&Meta-Analyses standards,using PubMed(MEDLINE),Scopus,EMBASE,and the Cochrane Library as sources to locate studies addressing the relationship between the gut microbiome and human health.To capture all relevant publications,search terms were systematically applied across these major databases,without limiting the search by language or publication date.Inclusion criteria covered randomized controlled trials,non-randomized controlled trial,prospective studies,cross-sectional studies,and case-control studies.Out of the 3077 articles,36 full texts were included in the review.RESULTS Ocular health appears to be shaped by the gut microbial community through mechanisms such as immune regulation,preservation of the blood–retinal barrier,and the generation of protective metabolites.Disturbances in this microbial balance can provoke measurable alterations in host immunity,providing a plausible immunopathogenic pathway that connects intestinal dysbiosis with eye disease.Both laboratory models and early human data suggest that targeted interventions,including prebiotics,probiotics,synbiotics,and faecal microbiota transfer,hold therapeutic potential.CONCLUSION The gut–eye relationship reflects a multifaceted interaction in which the intestinal microbiome contributes to ocular health through complex biological pathways.Integrating microbiome assessments into diagnostic methods can revolutionize disease management through early detection and targeted interventions.Further,randomised controlled clinical trials are necessary for ocular diseases to prove causal relationships.
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.
文摘MicroRNAs(miRNAs)are small non-coding RNAs of 20-22 nucleotides in length.They have been identified as major regulators in the secretome of mesenchymal stem cells(MSCs)including adipose tissue,bone marrow,Wharton’s jelly,and dental pulp.These MSCs and their secretome with specific miRNAs are known modulators of the immune response,angiogenesis,inflammation,and apoptosis.In this review,the application of MSC-derived miRNAs in treating several ocular conditions including dry eye,glaucoma,and retinal degenerative diseases has been compiled.In addition,the emerging role of MSC-derived extracellular vesicles carrying miRNAs as a major cargo,regulating the target cells in the human eye has been reviewed.Finally,the bioengineering of nanovesicles with specific MSC-derived miRNAs as novel drug therapy has been discussed.
