Tuberculosis(TB)is an airborne infection caused by Mycobacterium tuberculosis that usually affects the lungs.Timely treatment of active TB,diagnosis and prevention of latent TB are very important.However,extrapulmonar...Tuberculosis(TB)is an airborne infection caused by Mycobacterium tuberculosis that usually affects the lungs.Timely treatment of active TB,diagnosis and prevention of latent TB are very important.However,extrapulmonary TB affects almost any tissues around the eye and orbit,and it then requires a high degree of suspicion to accurately diagnose.Diagnostic delays are common and may lead to morbidity.For ophthalmologists and infectious disease specialists,it is important to work together to accurately diagnose and treat ocular tuberculosis(OTB)to prevent vision loss.This review reports the latest advanced diagnostic methods for active TB and latent TB as well as various known manifestations of 0TB.Important elements of diagnosis and treatment are also reviewed.展开更多
Experts lack knowledge of periocular tuberculosis（TB） in China. Nested polymerase chain reaction（PCR） shows advantages in diagnosis of extrapulmonary TB. Our study aims to explore the clinical and laboratory featu...Experts lack knowledge of periocular tuberculosis（TB） in China. Nested polymerase chain reaction（PCR） shows advantages in diagnosis of extrapulmonary TB. Our study aims to explore the clinical and laboratory features of PCR-confirmed periocular TB. We retrospectively reviewed medical records of presumptive periocular TB and performed nested PCR test to confirm diagnosis. Nine cases were recruited. Clinical symptoms were chronic and insidious. Eight cases achieved favorable visual acuity, while one underwent enucleation due to fungalTB panophthalmitis. Sensitivity of caseous necrosis, acidfast bacilli（AFB） staining and interferon γ release assay（T-SPOT） test are 33.3%, 44.4% and 85.7% respectively. Low lymphocyte percentage（P=0.019） and high monocytelymphocyte ratio（P=0.042） positively correlate with AFB staining. Male gender（P=0.048） and Langhans giant cell（P=0.048） positively correlate with caseous necrosis. To conclude, traditional TB ancillary tests are not as sensitive as nested PCR technique. Several factors facilitate diagnosis including male gender, decreased lymphocytes, and typical Langhans giant cells.展开更多
Aim: To study the frequency of various ocular manifestations in diagnosed cases of active pulmonary and extra pulmonary tuberculosis in two different major hospitals in Nepal. Method: A hospital based, cross sectional...Aim: To study the frequency of various ocular manifestations in diagnosed cases of active pulmonary and extra pulmonary tuberculosis in two different major hospitals in Nepal. Method: A hospital based, cross sectional descriptive study was conducted in the National Tuberculosis Centre, Bhaktapur and BP Koirala Lions Center for Ophthalmic Studies (BPKLCOS), Tribhuvan University Teaching Hospital (TUTH), Kathmandu, Nepal during a period of 18 months from February 2010 to August 2011. Diagnosed cases of systemic tuberculosis were evaluated by ophthalmologists for any ophthalmic manifestations. Results: There were 585 cases in the study. 399 (68%) were cases of pulmonary tuberculosis and 186 (32%) were that of extra pulmonary tuberculosis. Ocular manifestations were seen in 2.6% (15 patients) of the study population;1.25% (6 patients) in cases of pulmonary tuberculosis and 5.37% (9 patients) in extra pulmonary tuberculosis cases. Uveitis (40%) followed by papilloedema (33%) were the two most common ocular manifestations. Of the 25 affected eyes of 15 patients, 2 eyes of patients with choroiditis involving the macular area were legally blind. Majority of the affected cases (67%) had bilateral involvement. Conclusion: Ocular manifestations in tuberculosis vary greatly ranging from mild episcleritis to potentially blinding posterior uveitis, clinical acumen being of great importance in timely diagnosis and treatment so that vision threatening complications can be prevented. Ocular manifestations are more common in extra pulmonary tuberculosis cases.展开更多
BACKGROUND Tuberculous osteitis is a chronic,granulomatous bone infection that frequently results in impaired bone healing following surgery.Despite surgical intervention and prolonged anti-tuberculous therapy,complet...BACKGROUND Tuberculous osteitis is a chronic,granulomatous bone infection that frequently results in impaired bone healing following surgery.Despite surgical intervention and prolonged anti-tuberculous therapy,complete bone regeneration often remains unachieved,contributing to subsequent orthopedic complications.AIM To investigate the efficacy and safety of pamidronate in promoting bone regeneration following surgical treatment of experimental animal tuberculous osteitis.METHODS A controlled randomized basic study of rabbit femoral tuberculosis induced by Mycobacterium tuberculosis strain H37Rv included surgical removal of infected tissue and implantation of osteoinductive bone grafts with the following animal allocation to one of three groups:(1)Bisphosphonates alone;(2)Bisphosphonates combined with anti-tuberculous therapy;and(3)Anti-tuberculous therapy alone.The control group consisted of animals that received no surgical or medical treatment.Clinical evaluations,biochemical markers,micro-computed tomography imaging,and histomorphometry analyses were conducted at 3 months and 6 months postoperatively.RESULTS Pamidronate treatment significantly reduced early implant resorption,increased osteoblastic activity,improved trabecular bone regeneration,and maintained graft integrity compared to the anti-tuberculous therapy-only group.Histologically,pamidronate led to enhanced vascular remodeling and increased bone matrix formation.Crucially,bisphosphonate therapy demonstrated safety,compatibility with anti-tuberculous medications,and did not exacerbate tuberculous inflammation.Furthermore,micro-computed tomography analysis revealed a significant increase in trabecular thickness and density in pamidronate-treated groups,underscoring the anabolic effects of bisphosphonates.Morphometric evaluation confirmed a marked reduction in osteoclast number and activity at graft interfaces.These combined radiological,histological,and biochemical data collectively demonstrate the efficacy of pamidronate as an adjunctive agent in enhancing bone repair outcomes following surgical intervention for tuberculous osteitis.CONCLUSION A single intravenous dose of pamidronate significantly enhances bone regeneration and prevents implant resorption following surgical treatment of tuberculous osteitis.The following prospective studies are needed.展开更多
Liver transplantation is a life-saving procedure for patients with end-stage liver diseases and acute liver failure.With advances in surgical techniques and immunosuppressive regimens,patient survival rates have signi...Liver transplantation is a life-saving procedure for patients with end-stage liver diseases and acute liver failure.With advances in surgical techniques and immunosuppressive regimens,patient survival rates have significantly improved.While the systemic complications of post-transplantation are well recognized,ophthalmic manifestations remain underreported.Ophthalmic complications can significantly impair visual function and increase morbidity in these patients.Prolonged immunosuppression makes the patients susceptible to the opportunistic pathogens such as Cytomegalovirus,Candida,Aspergillus,etc.Other common findings include dry eye disease,cataracts and retinal vascular complications which further contribute to the long-term morbidity in these patients.Early ophthalmic evaluation and prompt management are essential to prevent irreversible vision loss and improve post-transplant outcomes.High index of suspicion and multidisciplinary approach is essential to facilitate early diagnosis and treatment.This review highlights the range of ophthalmic complications observed in liver transplant recipients and underscores the need for future research focused on understanding the underlying pathophysiological mechanisms and refining the prophylactic protocols to improve outcomes in this unique patient population.展开更多
BACKGROUND Dry eye disease(DED)is a multifactorial ocular surface disorder with rising prevalence.It is closely related to systemic health and psychological factors,such as sleep and mood disorders,which significantly...BACKGROUND Dry eye disease(DED)is a multifactorial ocular surface disorder with rising prevalence.It is closely related to systemic health and psychological factors,such as sleep and mood disorders,which significantly impact the quality of life of patients.AIM To explore the correlations between ocular surface function,sleep quality,and anxiety/depression in patients with DED.METHODS This was a cross-sectional investigative study that included 358 patients with DED between January 2022 and January 2025.Ocular surface was assessed using the ocular surface disease index(OSDI),tear film break-up time,fluorescein staining score,and Schirmer I test.The Pittsburgh Sleep Quality Index(PSQI),Self-Rating Anxiety Scale(SAS),and Self-Rating Depression Scale(SDS)were used to evaluate sleep quality and anxiety/depression levels.Correlation and linear regression analyses were used to explore the relationships.RESULTS The mean PSQI score of the patients was 9.94±2.18;the mean SAS score was 47.30±4.90,and the mean SDS score was 50.08±5.52.These suggested a prevalence of sleep and psychological abnormalities.There was a significant correlation between the indicators of ocular surface function(OSDI,tear film break-up time,fluorescein staining,and Schirmer I test)and PSQI,SAS,and SDS scores(P<0.05).Moreover,multiple regression revealed that age≥50 years(β=1.55,P=0.029),PSQI scores(β=0.58,P<0.001),SAS scores(β=0.17,P=0.017),and SDS scores(β=0.15,P=0.019)were independent predictors of the OSDI scores.CONCLUSION Ocular surface function in patients with DED is closely related to sleep quality and anxiety/depression,emphasizing the need for holistic clinical management.展开更多
Synaptic plasticity is essential for maintaining neuronal function in the central nervous system and serves as a critical indicator of the effects of neurodegenerative disease.Glaucoma directly impairs retinal ganglio...Synaptic plasticity is essential for maintaining neuronal function in the central nervous system and serves as a critical indicator of the effects of neurodegenerative disease.Glaucoma directly impairs retinal ganglion cells and their axons,leading to axonal transport dysfuntion,subsequently causing secondary damage to anterior or posterior ends of the visual system.Accordingly,recent evidence indicates that glaucoma is a degenerative disease of the central nervous system that causes damage throughout the visual pathway.However,the effects of glaucoma on synaptic plasticity in the primary visual cortex remain unclear.In this study,we established a mouse model of unilateral chronic ocular hypertension by injecting magnetic microbeads into the anterior chamber of one eye.We found that,after 4 weeks of chronic ocular hypertension,the neuronal somas were smaller in the superior colliculus and lateral geniculate body regions of the brain contralateral to the affected eye.This was accompanied by glial cell activation and increased expression of inflammatory factors.After 8 weeks of ocular hypertension,we observed a reduction in the number of excitatory and inhibitory synapses,dendritic spines,and activation of glial cells in the primary visual cortex contralateral to the affected eye.These findings suggest that glaucoma not only directly damages the retina but also induces alterations in synapses and dendritic spines in the primary visual cortex,providing new insights into the pathogenesis of glaucoma.展开更多
AIM:To 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
Detection and treatment of drug resistance in extrapulmonary tuberculosis(EPTB)is a major challenge worldwide.Drug resistance in EPTB has not been studied extensively.However,patients with drug-resistant EPTB have bee...Detection and treatment of drug resistance in extrapulmonary tuberculosis(EPTB)is a major challenge worldwide.Drug resistance in EPTB has not been studied extensively.However,patients with drug-resistant EPTB have been reported to have poor outcomes[1].Rifampicin and isoniazid are the cornerstone drugs in the management of EPTB.Resistance in Mycobacterium(M.)tuberculosis to these drugs commonly arises due to mutations in the‘rpoB’gene and‘katG&inhA’genes,which confer resistance to rifampicin and isoniazid,respectively.Treatment outcomes are affected by the presence of these mutations.In addition,anatomical and physiological barriers impede the effective delivery of drugs to the affected extrapulmonary site[1].An analysis of the frequency of mutations in drug resistant M.tuberculosis strains causing EPTB in our region can help identify patterns of drug resistance.This,in turn,can provide inputs that may be used for modifying standard treatment regimens to make them more effective.The present study aims to identify the frequency and pattern of mutations in the‘rpoB’gene and‘katG&inhA’genes in M.tuberculosis strains isolated from EPTB samples.展开更多
Tuberculosis(TB)remains a critical global health challenge,with 10.8 million new cases and over 1.25 million deaths reported annually,disproportionately affecting low-income regions.Despite its use,the Bacillus Calmet...Tuberculosis(TB)remains a critical global health challenge,with 10.8 million new cases and over 1.25 million deaths reported annually,disproportionately affecting low-income regions.Despite its use,the Bacillus Calmette-Guérin(BCG)vaccine provides limited protection against adult pulmonary TB,necessitating novel solutions.The messenger RNA(mRNA)vaccine technology,proven effective in combating coronavirus disease 2019,offers significant promise for TB prevention.These vaccines elicit robust immune responses by encoding antigens that stimulate humoral and cell-mediated immunity,essential for combating mycobacterium TB.Unlike traditional methods,mRNA vaccines are highly adaptable,scalable,and capable of targeting emerging strains.Preclinical studies highlight the enhanced efficacy of mRNA TB vaccines over BCG,demonstrating their ability to reduce bacterial burdens and generate memory T-cell responses critical for long-term protection.However,challenges persist,including mRNA instability,cold-chain storage needs,and mycobacterium’s complex immune evasion strategies.Innovative solutions,such as lipid nanoparticle delivery systems and selfamplifying mRNA platforms,are being developed to address these barriers.The initiation of clinical trials,notably BioNTech’s BNT164,marks a pivotal advancement in TB vaccine development.These trials focus on safety,immuno genicity,and efficacy,particularly in regions with high TB prevalence.While logistical and financial hurdles remain,mRNA vaccines hold transformative potential to bridge critical gaps in TB prevention.Their adaptability extends to tackling co-infections like human immunodeficiency virus,further amplifying their impact on global health.By integrating mRNA vaccines into existing TB control strategies,these advancements could revolutionize prevention efforts,especially in regions where current solutions fall short.Continued innovation and investment are crucial to harnessing the full potential of mRNA vaccines,positioning them as a cornerstone in the fight against TB and its global eradication.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
BACKGROUND Tuberculosis is among the most devastating infectious diseases worldwide.Spinal tuberculosis is not easy to detect at an early stage,which without effective treatment often leads to spinal deformity and spi...BACKGROUND Tuberculosis is among the most devastating infectious diseases worldwide.Spinal tuberculosis is not easy to detect at an early stage,which without effective treatment often leads to spinal deformity and spinal cord damage which in turn cause complications such as paraplegia and quadriplegia.In this study,we established a model using three concentrations of bacteria and carried out a comprehensive evaluation of the model by imaging,general observations,and histopathological and bacteriological studies.AIM To establish a rabbit model of spinal tuberculosis and examine the effect on the model’s efficacy using different concentrations of Mycobacterium tuberculosis(M.tuberculosis)inoculum.METHODS New Zealand rabbits were randomly divided into experimental,control and blank groups.The experimental and control animals were sensitized with complete Freund′s adjuvant,a hole was drilled beneath the upper endplate of the L6 vertebral body and filled with gelfoam sponge.The experimental group was divided into three subgroups(experimental 1,experimental 2,experimental 3)and infused with M.tuberculosis suspension at various concentrations.The control group was inoculated with saline and the blank group received no treatment.The 12-week post-operative survival rates were 100%,80%and 30%in the experimental groups inoculated with concentrations of 106,107 and 108 CFU/mL bacteria,respectively.RESULTS The survival rate of the control and blank groups was 100%.Vertebral body destruction at 8 weeks in the three experimental groups as determined by X-ray analysis was 33.3%,62.5%and 66.7%,and by computed tomography(CT)and 3-dimensional CT 44.4%,75%and 100%,respectively.At 12 weeks,the figures were 44.4%,75%and 100%by X-ray analysis and 44.4%,100%and 100%by CT and 3-dimensional CT,respectively.All surviving rabbits of the experimental groups had vertebral destruction.The positive bacterial culture rates were 22.2%,75%and 66.7%,respectively,in the experimental groups.After being sensitized with complete Freund's adjuvant,large differences were observed in the extent of spinal tuberculosis after inoculation of the rabbits with different concentrations of H37RV standard M.tuberculosis.CONCLUSION The experimental 1 had a low success rate at establishing an infection.The experimental 3 resulted in high mortality and complication rates.The experimental 2 was optimum for establishing a spinal tuberculosis model based on the high level of symptoms observed and the low rabbit mortality.展开更多
Among critically ill patients,severe pulmonary and extrapulmonary tuberculosis has high morbidity and mortality.Yet,it is a diagnostic challenge given its nonspecific clinical symptoms and signs in early stages of the...Among critically ill patients,severe pulmonary and extrapulmonary tuberculosis has high morbidity and mortality.Yet,it is a diagnostic challenge given its nonspecific clinical symptoms and signs in early stages of the disease.In addition,management of severe pulmonary and extrapulmonary tuberculosis is complicated given the high risk of drug-drug interactions,drug-disease interactions,and adverse drug reactions.To help clinicians acquire an up-to-date approach to severe tuberculosis,this paper will provide a narrative review of contemporary diagnosis and management of severe pulmonary and extrapulmonary tuberculosis in critically ill patients.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
Chronic obstructive pulmonary disease(COPD)and respiratory tuberculosis are important respiratory problems.Meeting together,these diseases can mutually worsen the severity of clinical manifestations and negatively aff...Chronic obstructive pulmonary disease(COPD)and respiratory tuberculosis are important respiratory problems.Meeting together,these diseases can mutually worsen the severity of clinical manifestations and negatively affect prognosis.COPD and tuberculosis share a number of common risk factors and pathogenetic mechanisms involving various immune and non-immune cells.Inflammation,hypoxia,oxidative stress,and lung tissue remodeling play an important role in the comorbid course of COPD and respiratory tuberculosis.These mechanisms are of diagnostic interest and are promising therapeutic targets.Thus,the aim of the current review is to discuss the mechanisms of the comorbid course of chronic obstructive pulmonary disease and respiratory tuberculosis.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 Due to low bacteria count and high likelihood of having extrapulmonary tuberculosis(TB)among patients with advanced human immunodeficiency virus(HIV)disease,the World Health Organization(WHO)recommended the...BACKGROUND Due to low bacteria count and high likelihood of having extrapulmonary tuberculosis(TB)among patients with advanced human immunodeficiency virus(HIV)disease,the World Health Organization(WHO)recommended the use of urine lateral flow urine lipoarabinomannan(LF-LAM)or sputum-Xpert to screen for TB.AIM To estimate pooled prevalence of TB screening uptake,TB diagnosis,TB treatment initiation and mortality among patients with advanced HIV disease in Africa.METHODS PubMed,Cochrane Library and EMBASE were searched for articles published between January 2011 and December 2024.TB screening uptake was defined as percentage of patients with advanced HIV disease(CD4≤200 cells/mm3 or WHO stage III/IV)who tested for TB.Using random effects models,we computed the pooled estimate of TB screening uptake,TB prevalence,TB treatment initiation and mortality and their corresponding 95%CIs.Stratified analysis to compare uptake of TB testing and TB prevalence between children vs adults and multisite vs single site studies was performed.RESULTS A total of nineteen studies with 16065 people with advanced HIV disease were analyzed.The pooled prevalence of TB screening uptake was 64.6%(95%CI:49.2–80.1).The pooled prevalence of TB was 29.4%(95%CI:22.0–36.8),and TB treatment initiation was 77.9%(95%CI:63.9–91.8),and mortality was 19.5%(95%CI:8.9–30.0).The pooled prevalence of TB testing uptake was significantly lower among children compared to adults(28.2%vs 66.4%,P=0.003)and lower for multi-sites compared to single site studies(58.8%vs 82.9%,P=0.002).The pooled prevalence of TB was significantly lower among children compared to adults(24.2%vs 27.6%,P=0.012)and higher among studies that involved multi vs single sites(30.0%vs 21.9%,P=0.001).CONCLUSION Four in ten people with advanced HIV disease were not screened for TB as recommended by the WHO,indicating significant gaps in identifying patients with TB.Excluding patients with evidence of TB is critical to avoid exposing them to subtherapeutic levels of anti TB treatment.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
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
文摘Tuberculosis(TB)is an airborne infection caused by Mycobacterium tuberculosis that usually affects the lungs.Timely treatment of active TB,diagnosis and prevention of latent TB are very important.However,extrapulmonary TB affects almost any tissues around the eye and orbit,and it then requires a high degree of suspicion to accurately diagnose.Diagnostic delays are common and may lead to morbidity.For ophthalmologists and infectious disease specialists,it is important to work together to accurately diagnose and treat ocular tuberculosis(OTB)to prevent vision loss.This review reports the latest advanced diagnostic methods for active TB and latent TB as well as various known manifestations of 0TB.Important elements of diagnosis and treatment are also reviewed.
基金Supported by National Natural Science Foundation of China (No.81800867)
文摘Experts lack knowledge of periocular tuberculosis（TB） in China. Nested polymerase chain reaction（PCR） shows advantages in diagnosis of extrapulmonary TB. Our study aims to explore the clinical and laboratory features of PCR-confirmed periocular TB. We retrospectively reviewed medical records of presumptive periocular TB and performed nested PCR test to confirm diagnosis. Nine cases were recruited. Clinical symptoms were chronic and insidious. Eight cases achieved favorable visual acuity, while one underwent enucleation due to fungalTB panophthalmitis. Sensitivity of caseous necrosis, acidfast bacilli（AFB） staining and interferon γ release assay（T-SPOT） test are 33.3%, 44.4% and 85.7% respectively. Low lymphocyte percentage（P=0.019） and high monocytelymphocyte ratio（P=0.042） positively correlate with AFB staining. Male gender（P=0.048） and Langhans giant cell（P=0.048） positively correlate with caseous necrosis. To conclude, traditional TB ancillary tests are not as sensitive as nested PCR technique. Several factors facilitate diagnosis including male gender, decreased lymphocytes, and typical Langhans giant cells.
文摘Aim: To study the frequency of various ocular manifestations in diagnosed cases of active pulmonary and extra pulmonary tuberculosis in two different major hospitals in Nepal. Method: A hospital based, cross sectional descriptive study was conducted in the National Tuberculosis Centre, Bhaktapur and BP Koirala Lions Center for Ophthalmic Studies (BPKLCOS), Tribhuvan University Teaching Hospital (TUTH), Kathmandu, Nepal during a period of 18 months from February 2010 to August 2011. Diagnosed cases of systemic tuberculosis were evaluated by ophthalmologists for any ophthalmic manifestations. Results: There were 585 cases in the study. 399 (68%) were cases of pulmonary tuberculosis and 186 (32%) were that of extra pulmonary tuberculosis. Ocular manifestations were seen in 2.6% (15 patients) of the study population;1.25% (6 patients) in cases of pulmonary tuberculosis and 5.37% (9 patients) in extra pulmonary tuberculosis cases. Uveitis (40%) followed by papilloedema (33%) were the two most common ocular manifestations. Of the 25 affected eyes of 15 patients, 2 eyes of patients with choroiditis involving the macular area were legally blind. Majority of the affected cases (67%) had bilateral involvement. Conclusion: Ocular manifestations in tuberculosis vary greatly ranging from mild episcleritis to potentially blinding posterior uveitis, clinical acumen being of great importance in timely diagnosis and treatment so that vision threatening complications can be prevented. Ocular manifestations are more common in extra pulmonary tuberculosis cases.
基金Supported by Russian Science Foundation Grant,No.24-15-00185.
文摘BACKGROUND Tuberculous osteitis is a chronic,granulomatous bone infection that frequently results in impaired bone healing following surgery.Despite surgical intervention and prolonged anti-tuberculous therapy,complete bone regeneration often remains unachieved,contributing to subsequent orthopedic complications.AIM To investigate the efficacy and safety of pamidronate in promoting bone regeneration following surgical treatment of experimental animal tuberculous osteitis.METHODS A controlled randomized basic study of rabbit femoral tuberculosis induced by Mycobacterium tuberculosis strain H37Rv included surgical removal of infected tissue and implantation of osteoinductive bone grafts with the following animal allocation to one of three groups:(1)Bisphosphonates alone;(2)Bisphosphonates combined with anti-tuberculous therapy;and(3)Anti-tuberculous therapy alone.The control group consisted of animals that received no surgical or medical treatment.Clinical evaluations,biochemical markers,micro-computed tomography imaging,and histomorphometry analyses were conducted at 3 months and 6 months postoperatively.RESULTS Pamidronate treatment significantly reduced early implant resorption,increased osteoblastic activity,improved trabecular bone regeneration,and maintained graft integrity compared to the anti-tuberculous therapy-only group.Histologically,pamidronate led to enhanced vascular remodeling and increased bone matrix formation.Crucially,bisphosphonate therapy demonstrated safety,compatibility with anti-tuberculous medications,and did not exacerbate tuberculous inflammation.Furthermore,micro-computed tomography analysis revealed a significant increase in trabecular thickness and density in pamidronate-treated groups,underscoring the anabolic effects of bisphosphonates.Morphometric evaluation confirmed a marked reduction in osteoclast number and activity at graft interfaces.These combined radiological,histological,and biochemical data collectively demonstrate the efficacy of pamidronate as an adjunctive agent in enhancing bone repair outcomes following surgical intervention for tuberculous osteitis.CONCLUSION A single intravenous dose of pamidronate significantly enhances bone regeneration and prevents implant resorption following surgical treatment of tuberculous osteitis.The following prospective studies are needed.
文摘Liver transplantation is a life-saving procedure for patients with end-stage liver diseases and acute liver failure.With advances in surgical techniques and immunosuppressive regimens,patient survival rates have significantly improved.While the systemic complications of post-transplantation are well recognized,ophthalmic manifestations remain underreported.Ophthalmic complications can significantly impair visual function and increase morbidity in these patients.Prolonged immunosuppression makes the patients susceptible to the opportunistic pathogens such as Cytomegalovirus,Candida,Aspergillus,etc.Other common findings include dry eye disease,cataracts and retinal vascular complications which further contribute to the long-term morbidity in these patients.Early ophthalmic evaluation and prompt management are essential to prevent irreversible vision loss and improve post-transplant outcomes.High index of suspicion and multidisciplinary approach is essential to facilitate early diagnosis and treatment.This review highlights the range of ophthalmic complications observed in liver transplant recipients and underscores the need for future research focused on understanding the underlying pathophysiological mechanisms and refining the prophylactic protocols to improve outcomes in this unique patient population.
文摘BACKGROUND Dry eye disease(DED)is a multifactorial ocular surface disorder with rising prevalence.It is closely related to systemic health and psychological factors,such as sleep and mood disorders,which significantly impact the quality of life of patients.AIM To explore the correlations between ocular surface function,sleep quality,and anxiety/depression in patients with DED.METHODS This was a cross-sectional investigative study that included 358 patients with DED between January 2022 and January 2025.Ocular surface was assessed using the ocular surface disease index(OSDI),tear film break-up time,fluorescein staining score,and Schirmer I test.The Pittsburgh Sleep Quality Index(PSQI),Self-Rating Anxiety Scale(SAS),and Self-Rating Depression Scale(SDS)were used to evaluate sleep quality and anxiety/depression levels.Correlation and linear regression analyses were used to explore the relationships.RESULTS The mean PSQI score of the patients was 9.94±2.18;the mean SAS score was 47.30±4.90,and the mean SDS score was 50.08±5.52.These suggested a prevalence of sleep and psychological abnormalities.There was a significant correlation between the indicators of ocular surface function(OSDI,tear film break-up time,fluorescein staining,and Schirmer I test)and PSQI,SAS,and SDS scores(P<0.05).Moreover,multiple regression revealed that age≥50 years(β=1.55,P=0.029),PSQI scores(β=0.58,P<0.001),SAS scores(β=0.17,P=0.017),and SDS scores(β=0.15,P=0.019)were independent predictors of the OSDI scores.CONCLUSION Ocular surface function in patients with DED is closely related to sleep quality and anxiety/depression,emphasizing the need for holistic clinical management.
基金supported by the National Natural Science Foundation of China,No.82271115(to MY).
文摘Synaptic plasticity is essential for maintaining neuronal function in the central nervous system and serves as a critical indicator of the effects of neurodegenerative disease.Glaucoma directly impairs retinal ganglion cells and their axons,leading to axonal transport dysfuntion,subsequently causing secondary damage to anterior or posterior ends of the visual system.Accordingly,recent evidence indicates that glaucoma is a degenerative disease of the central nervous system that causes damage throughout the visual pathway.However,the effects of glaucoma on synaptic plasticity in the primary visual cortex remain unclear.In this study,we established a mouse model of unilateral chronic ocular hypertension by injecting magnetic microbeads into the anterior chamber of one eye.We found that,after 4 weeks of chronic ocular hypertension,the neuronal somas were smaller in the superior colliculus and lateral geniculate body regions of the brain contralateral to the affected eye.This was accompanied by glial cell activation and increased expression of inflammatory factors.After 8 weeks of ocular hypertension,we observed a reduction in the number of excitatory and inhibitory synapses,dendritic spines,and activation of glial cells in the primary visual cortex contralateral to the affected eye.These findings suggest that glaucoma not only directly damages the retina but also induces alterations in synapses and dendritic spines in the primary visual cortex,providing new insights into the pathogenesis of glaucoma.
基金Supported by 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Detection and treatment of drug resistance in extrapulmonary tuberculosis(EPTB)is a major challenge worldwide.Drug resistance in EPTB has not been studied extensively.However,patients with drug-resistant EPTB have been reported to have poor outcomes[1].Rifampicin and isoniazid are the cornerstone drugs in the management of EPTB.Resistance in Mycobacterium(M.)tuberculosis to these drugs commonly arises due to mutations in the‘rpoB’gene and‘katG&inhA’genes,which confer resistance to rifampicin and isoniazid,respectively.Treatment outcomes are affected by the presence of these mutations.In addition,anatomical and physiological barriers impede the effective delivery of drugs to the affected extrapulmonary site[1].An analysis of the frequency of mutations in drug resistant M.tuberculosis strains causing EPTB in our region can help identify patterns of drug resistance.This,in turn,can provide inputs that may be used for modifying standard treatment regimens to make them more effective.The present study aims to identify the frequency and pattern of mutations in the‘rpoB’gene and‘katG&inhA’genes in M.tuberculosis strains isolated from EPTB samples.
文摘Tuberculosis(TB)remains a critical global health challenge,with 10.8 million new cases and over 1.25 million deaths reported annually,disproportionately affecting low-income regions.Despite its use,the Bacillus Calmette-Guérin(BCG)vaccine provides limited protection against adult pulmonary TB,necessitating novel solutions.The messenger RNA(mRNA)vaccine technology,proven effective in combating coronavirus disease 2019,offers significant promise for TB prevention.These vaccines elicit robust immune responses by encoding antigens that stimulate humoral and cell-mediated immunity,essential for combating mycobacterium TB.Unlike traditional methods,mRNA vaccines are highly adaptable,scalable,and capable of targeting emerging strains.Preclinical studies highlight the enhanced efficacy of mRNA TB vaccines over BCG,demonstrating their ability to reduce bacterial burdens and generate memory T-cell responses critical for long-term protection.However,challenges persist,including mRNA instability,cold-chain storage needs,and mycobacterium’s complex immune evasion strategies.Innovative solutions,such as lipid nanoparticle delivery systems and selfamplifying mRNA platforms,are being developed to address these barriers.The initiation of clinical trials,notably BioNTech’s BNT164,marks a pivotal advancement in TB vaccine development.These trials focus on safety,immuno genicity,and efficacy,particularly in regions with high TB prevalence.While logistical and financial hurdles remain,mRNA vaccines hold transformative potential to bridge critical gaps in TB prevention.Their adaptability extends to tackling co-infections like human immunodeficiency virus,further amplifying their impact on global health.By integrating mRNA vaccines into existing TB control strategies,these advancements could revolutionize prevention efforts,especially in regions where current solutions fall short.Continued innovation and investment are crucial to harnessing the full potential of mRNA vaccines,positioning them as a cornerstone in the fight against TB and its global eradication.
基金Supported by The Tianjin Health Research Project,No.ZC20069the Foundation of the Committee of Integrated Traditional Chinese and Western Medicine,No.2021011the Science and Technology Foundation of Tianjin Eye Hospital,No.YKYB1901.
文摘BACKGROUND Occult intraocular foreign bodies(IOFBs)can present with atypical symptoms and clinical signs,making diagnosis challenging.We describe a case of an undetected IOFB that was missed on both computed tomography and B-ultrasound,ulti-mately leading to ocular siderosis and secondary glaucoma.CASE SUMMARY A 55-year-old male patient presented to our clinic reporting a one-month history of right ocular discomfort and progressive visual deterioration.The patient had previously received a glaucoma diagnosis at a local healthcare facility.His ocular history included blunt trauma to the affected eye five years prior to presentation.Slit-lamp examination revealed corneal and iris lesions in the right eye.Pupillary dilation facilitated the identification of traumatic lens opacities.Diagnostic imaging modalities,including B-scan ultrasonography and computed tomo-graphy,showed no evidence of retained intraocular foreign material.The patient subsequently underwent uncomplicated pars plana vitrectomy,during which the occult foreign body was successfully extracted.The procedure was completed without intraoperative or immediate postoperative complications.CONCLUSION Awareness of IOFBs in individuals who work in high-risk occupations and prompt referral to a retinal surgeon are very important.
基金Supported by Lanzhou City Science and Technology Development Guiding Plan Project,No.2023-ZD-170Lanzhou Science and Technology Plan Project,No.2023-2-11High-Level Talent Training Project At the 940th Hospital of the Joint Logistics Force,No.2024-G3-5.
文摘BACKGROUND Tuberculosis is among the most devastating infectious diseases worldwide.Spinal tuberculosis is not easy to detect at an early stage,which without effective treatment often leads to spinal deformity and spinal cord damage which in turn cause complications such as paraplegia and quadriplegia.In this study,we established a model using three concentrations of bacteria and carried out a comprehensive evaluation of the model by imaging,general observations,and histopathological and bacteriological studies.AIM To establish a rabbit model of spinal tuberculosis and examine the effect on the model’s efficacy using different concentrations of Mycobacterium tuberculosis(M.tuberculosis)inoculum.METHODS New Zealand rabbits were randomly divided into experimental,control and blank groups.The experimental and control animals were sensitized with complete Freund′s adjuvant,a hole was drilled beneath the upper endplate of the L6 vertebral body and filled with gelfoam sponge.The experimental group was divided into three subgroups(experimental 1,experimental 2,experimental 3)and infused with M.tuberculosis suspension at various concentrations.The control group was inoculated with saline and the blank group received no treatment.The 12-week post-operative survival rates were 100%,80%and 30%in the experimental groups inoculated with concentrations of 106,107 and 108 CFU/mL bacteria,respectively.RESULTS The survival rate of the control and blank groups was 100%.Vertebral body destruction at 8 weeks in the three experimental groups as determined by X-ray analysis was 33.3%,62.5%and 66.7%,and by computed tomography(CT)and 3-dimensional CT 44.4%,75%and 100%,respectively.At 12 weeks,the figures were 44.4%,75%and 100%by X-ray analysis and 44.4%,100%and 100%by CT and 3-dimensional CT,respectively.All surviving rabbits of the experimental groups had vertebral destruction.The positive bacterial culture rates were 22.2%,75%and 66.7%,respectively,in the experimental groups.After being sensitized with complete Freund's adjuvant,large differences were observed in the extent of spinal tuberculosis after inoculation of the rabbits with different concentrations of H37RV standard M.tuberculosis.CONCLUSION The experimental 1 had a low success rate at establishing an infection.The experimental 3 resulted in high mortality and complication rates.The experimental 2 was optimum for establishing a spinal tuberculosis model based on the high level of symptoms observed and the low rabbit mortality.
文摘Among critically ill patients,severe pulmonary and extrapulmonary tuberculosis has high morbidity and mortality.Yet,it is a diagnostic challenge given its nonspecific clinical symptoms and signs in early stages of the disease.In addition,management of severe pulmonary and extrapulmonary tuberculosis is complicated given the high risk of drug-drug interactions,drug-disease interactions,and adverse drug reactions.To help clinicians acquire an up-to-date approach to severe tuberculosis,this paper will provide a narrative review of contemporary diagnosis and management of severe pulmonary and extrapulmonary tuberculosis in critically ill patients.
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Chronic obstructive pulmonary disease(COPD)and respiratory tuberculosis are important respiratory problems.Meeting together,these diseases can mutually worsen the severity of clinical manifestations and negatively affect prognosis.COPD and tuberculosis share a number of common risk factors and pathogenetic mechanisms involving various immune and non-immune cells.Inflammation,hypoxia,oxidative stress,and lung tissue remodeling play an important role in the comorbid course of COPD and respiratory tuberculosis.These mechanisms are of diagnostic interest and are promising therapeutic targets.Thus,the aim of the current review is to discuss the mechanisms of the comorbid course of chronic obstructive pulmonary disease and respiratory tuberculosis.
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 Due to low bacteria count and high likelihood of having extrapulmonary tuberculosis(TB)among patients with advanced human immunodeficiency virus(HIV)disease,the World Health Organization(WHO)recommended the use of urine lateral flow urine lipoarabinomannan(LF-LAM)or sputum-Xpert to screen for TB.AIM To estimate pooled prevalence of TB screening uptake,TB diagnosis,TB treatment initiation and mortality among patients with advanced HIV disease in Africa.METHODS PubMed,Cochrane Library and EMBASE were searched for articles published between January 2011 and December 2024.TB screening uptake was defined as percentage of patients with advanced HIV disease(CD4≤200 cells/mm3 or WHO stage III/IV)who tested for TB.Using random effects models,we computed the pooled estimate of TB screening uptake,TB prevalence,TB treatment initiation and mortality and their corresponding 95%CIs.Stratified analysis to compare uptake of TB testing and TB prevalence between children vs adults and multisite vs single site studies was performed.RESULTS A total of nineteen studies with 16065 people with advanced HIV disease were analyzed.The pooled prevalence of TB screening uptake was 64.6%(95%CI:49.2–80.1).The pooled prevalence of TB was 29.4%(95%CI:22.0–36.8),and TB treatment initiation was 77.9%(95%CI:63.9–91.8),and mortality was 19.5%(95%CI:8.9–30.0).The pooled prevalence of TB testing uptake was significantly lower among children compared to adults(28.2%vs 66.4%,P=0.003)and lower for multi-sites compared to single site studies(58.8%vs 82.9%,P=0.002).The pooled prevalence of TB was significantly lower among children compared to adults(24.2%vs 27.6%,P=0.012)and higher among studies that involved multi vs single sites(30.0%vs 21.9%,P=0.001).CONCLUSION Four in ten people with advanced HIV disease were not screened for TB as recommended by the WHO,indicating significant gaps in identifying patients with TB.Excluding patients with evidence of TB is critical to avoid exposing them to subtherapeutic levels of anti TB treatment.
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.
