Good vision is fundamental to human experience,profoundly influencing educational attainment,economic productivity and overall quality of life.Currently,it is estimated that at least 2.2 billion people globally suffer...Good vision is fundamental to human experience,profoundly influencing educational attainment,economic productivity and overall quality of life.Currently,it is estimated that at least 2.2 billion people globally suffer from vision impairment(VI),with over 1 billion of these cases being preventable or treatable yet remaining unaddressed.Despite significant advancements in global eye care services over the past few decades,which have yielded considerable benefits,the challenges continue to mount.展开更多
Achieving universal eye health remains a global challenge,particularly in low-and middle-income countries where visual impairment and blindness are prevalent.While advances in tertiary eye care have improved outcomes,...Achieving universal eye health remains a global challenge,particularly in low-and middle-income countries where visual impairment and blindness are prevalent.While advances in tertiary eye care have improved outcomes,access to primary eye care(PEC)continues to be inadequate in rural and underserved regions.This gap necessitates innovative,scalable models that provide accessible,affordable,and comprehensive eye care.The Vision Centre(VC)model,pioneered by the Aravind Eye Care System(AECS),exemplifies a sustainable approach to delivering PEC.Designed as permanent facilities in rural communities,VCs are equipped with state-of-the-art diagnostic tools and staffed by trained allied ophthalmic personnel.The integration of teleophthalmology,electronic medical records,and artificial intelligence enhances the model’s capacity to address complex conditions like diabetic retinopathy and glaucoma.VCs have demonstrated significant impact in improving accessibility,reducing financial burdens,and increasing utilization of eye care services.In the fiscal year 2023-2024,AECS VCs recorded nearly one million outpatient visits,achieving a 25%population coverage rate and generating substantial cost savings of ₹647 million(US$7.8 million)for patients.The model's success is underpinned by community engagement,a focus on operational excellence,and a robust referral system to tertiary hospitals.This review explores the evolution,implementation,and impact of the AECS VC model,emphasizing its alignment with the Sustainable Development Goals and Universal Health Coverage.By addressing accessibility and affordability,the VC model serves as a scalable template for primary eye care delivery in resource-limited settings globally.展开更多
As we all know,eyes are the windows of our souls.They make us see the colorful world and understand others’feelings.However,by①the wide use of digital devices like smartphones and computers,many of us are facing eye...As we all know,eyes are the windows of our souls.They make us see the colorful world and understand others’feelings.However,by①the wide use of digital devices like smartphones and computers,many of us are facing eye problems.So,it's important to protect our eyes。展开更多
Age-related macular degeneration is a serious neurodegenerative disease of the retina that significantly impacts vision.Unfortunately,the specific pathogenesis remains unclear,and effective early treatment options are...Age-related macular degeneration is a serious neurodegenerative disease of the retina that significantly impacts vision.Unfortunately,the specific pathogenesis remains unclear,and effective early treatment options are consequently lacking.The microbiome is defined as a large ecosystem of microorganisms living within and coexisting with a host.The intestinal microbiome undergoes dynamic changes owing to age,diet,genetics,and other factors.Such dysregulation of the intestinal flora can disrupt the microecological balance,resulting in immunological and metabolic dysfunction in the host,and affecting the development of many diseases.In recent decades,significant evidence has indicated that the intestinal flora also influences systems outside of the digestive tract,including the brain.Indeed,several studies have demonstrated the critical role of the gut-brain axis in the development of brain neurodegenerative diseases,including Alzheimer’s disease and Parkinson’s disease.Similarly,the role of the“gut-eye axis”has been confirmed to play a role in the pathogenesis of many ocular disorders.Moreover,age-related macular degeneration and many brain neurodegenerative diseases have been shown to share several risk factors and to exhibit comparable etiologies.As such,the intestinal flora may play an important role in age-related macular degeneration.Given the above context,the present review aims to clarify the gut-brain and gut-eye connections,assess the effect of intestinal flora and metabolites on age-related macular degeneration,and identify potential diagnostic markers and therapeutic strategies.Currently,direct research on the role of intestinal flora in age-related macular degeneration is still relatively limited,while studies focusing solely on intestinal flora are insufficient to fully elucidate its functional role in age-related macular degeneration.Organ-on-a-chip technology has shown promise in clarifying the gut-eye interactions,while integrating analysis of the intestinal flora with research on metabolites through metabolomics and other techniques is crucial for understanding their potential mechanisms.展开更多
Objective:The aim of this study was to evaluate the synergistic effect of eye care and drug therapy in patients with dry eye.Methods:A total of 59 patients with dry eye diagnosed and treated in our hospital were rando...Objective:The aim of this study was to evaluate the synergistic effect of eye care and drug therapy in patients with dry eye.Methods:A total of 59 patients with dry eye diagnosed and treated in our hospital were randomly divided into the reference group(29 cases)and the experimental group(30 cases).Patients in the reference group received only the usual medication,while the experimental group received additional eye care.The treatment response and the improvement of quality of life were evaluated by comparing the treatment excellence rate,quality of life score,and nursing satisfaction score of the two groups.Results:The rate of excellent treatment in the experimental group was 93.33%,which was significantly higher than that in the reference group(68.97%)(P=0.013).The quality of life scores in social function,psychological function and physiological function of the experimental group were significantly higher than those of the reference group(P<0.003),the nursing satisfaction score and symptom score were also improved more significantly(P<0.003),and the SAS score was decreased more(P<0.003).Conclusion:The synergistic effect of comprehensive eye care and drug therapy on patients with dry eye can significantly improve the rate of good treatment and quality of life score,increase the nursing satisfaction of patients,and have potential benefits to improve psychological status,providing an effective way for the management of dry eye.展开更多
Dear Editor,We present the reported case of rapid onset bull’s eye maculopathy.Chloroquine(CQ)and its safer,more widely used analogue,hydroxychloroquine(HCQ),were originally developed as antimalarial medications.Howe...Dear Editor,We present the reported case of rapid onset bull’s eye maculopathy.Chloroquine(CQ)and its safer,more widely used analogue,hydroxychloroquine(HCQ),were originally developed as antimalarial medications.However,they have since become essential in the treatment of various autoimmune disorders due to their anti-inflammatory and immunomodulatory properties.HCQ is also being investigated for potential applications in diabetes mellitus,coronavirus disease 2019,heart disease,and as an adjunct in cancer therapy^([1-2]).展开更多
Eyespots have been shown to perform an anti-predator function by intimidating predators.However,whether predators are deterred by the eyespots’mimicking eyes of higher-order predators,or by the conspicuousness of the...Eyespots have been shown to perform an anti-predator function by intimidating predators.However,whether predators are deterred by the eyespots’mimicking eyes of higher-order predators,or by the conspicuousness of the spots,is still being debated.The anti-predator mechanism of eyespots,which involves the predator’s visual perception and cognition,urges to be examined.To explore the“eye mimicry hypothesis”and“conspicuous signal hypothesis,”we designed prey with deceptive eyespots eliciting 2-dimensional(2D)or 3-dimensional(3D)visual illusions for domestic chicks(as predators).For 2D visual illusion,we provided prey with occluded eyespots for chicks.Chicks can“complete”the occluded eyespots into a full 2D concentric circle by the amodal completion mechanism,that is,one of visual illusion.For 3D visual illusion,we created the crescent-shaped sparkles on the eyespots to simulate a visually 3D eye.Our result indicated that(1)2D:chicks hesitated more when facing preys with occluded eyespots than facing preys with broken eyespots and(2)3D:compared to prey with no-sparkle eyespots,chicks spent more time approaching prey with sparkle eyespots and were more likely to approach them tangentially.Thus,the visual illusion perceived by chicks would impact the anti-predation effectiveness of eyespots.Eyespots that more closely resemble the real eyes,especially those with 3-dimensionality,provided more effective protection.Our study supported the eye mimicry hypothesis from the perspective of visual illusion.展开更多
Dry eye disease(DED)is a multifactorial disorder that disturbs ocular surface equilibrium,considerably diminishing quality of life.Present therapies only offer symptomatic alleviation.Stem cell treatment,especially me...Dry eye disease(DED)is a multifactorial disorder that disturbs ocular surface equilibrium,considerably diminishing quality of life.Present therapies only offer symptomatic alleviation.Stem cell treatment,especially mesenchymal stem cells(MSCs),has surfaced as a viable approach for tissue regeneration and immunological regulation in DED.Preclinical and early clinical investigations indicate that MSCs can improve lacrimal gland functionality,diminish inflammation,and facilitate corneal regeneration.Nonetheless,obstacles persist in enhancing MSC viability,determining the optimal MSC source,and guaranteeing sustained therapeutic effectiveness.Additional extensive randomized clinical trials are required to confirm the efficacy of MSC-based therapies for severe DED.展开更多
Although eye problems can occur at any age, they are often common from the age of 40. Eye diseases with a prevalence associated with age and aging will continue to increase in the coming years. Most studies conducted ...Although eye problems can occur at any age, they are often common from the age of 40. Eye diseases with a prevalence associated with age and aging will continue to increase in the coming years. Most studies conducted on problems in middle-aged people have focused on visual disorders without taking into account all the ocular morbidities that may affect this segment of the population, hence the present study, the aim of which is to determine the proportions of different eye diseases in people aged 40 and over. Materials and Methods: This was a descriptive cross-sectional study carried out in the ophthalmology department covering the period from January 1 to December 31, 2020. Results: In total, we collected 828 patients aged 40 and over out of 1811 patients who received ophthalmological consultation during the study period, representing 45.72%. The most represented age group was 40 - 50 years, with an average age of 58.84 years and a maximum of 93 years. There were slightly more women (62.3%) than men (37.7%). The main reasons for consultation were decreased visual acuity (26.4%) and pruritus (19.9%). The main eye diseases diagnosed were cataracts (23%), allergic conjunctivitis (21.1%), and bacterial conjunctivitis (14.2%). Discussions: The predominance of cataracts in the diagnosed diseases confirms the literature data, according to which the main eye morbidities in middle-aged and elderly people are cataracts, glaucoma, and age-related macular degeneration. Conclusion: It is crucial to have a mastery of these epidemiological data of eye diseases in order to adapt the technical platforms of eye care structures to the needs of different segments of the population.展开更多
Background:Early identification of concussion-related vision disorders(CRVDs)may improve outcomes by enabling earlier management,referral,and treatment.Objective eye tracking may provide additional data to support the...Background:Early identification of concussion-related vision disorders(CRVDs)may improve outcomes by enabling earlier management,referral,and treatment.Objective eye tracking may provide additional data to support the diagnose of CRVDs.The purpose of this study was to determine the utility of objective infrared eye tracking in identifying CRVDs among adolescents experiencing persisting post-concussive symptoms(PPCS)more than 28 days after injury.Methods:This was a prospective study of adolescents with PPCS evaluated with visio-vestibular examination(VVE),comprehensive vision examination,and an eye tracking device.Results:Of the 108 adolescents enrolled,67(62%)were diagnosed with a CRVD by comprehensive vision examination.On VVE,the near point of convergence break(5.5±3.2 cm vs.3.9±1.7 cm(mean±SD),p<0.001)and recovery(8.1±3.3 cm vs.6.8±2.3 cm,p=0.02)distinguished between those with and without CRVD.Concussion symptom provocation on VVE with horizontal saccades(35(52%)vs.12(29%),p=0.02)and horizontal vestibulo-ocular reflex testing(37(55%)vs.14(34%),p=0.03),and sway on tandem gait under the forward eyes closed condition(25(37%)vs.6(15%),p=0.01)also identified those with CRVD.From the eye tracking device,the BOX score(8.1±5.8 vs.5.2±4.1,p=0.007)and a metric of the left eye tracking along the bottom of the visual target(0.094±0.500 vs.-0.124±0.410,p=0.02)identified those with CRVD,with a multivariable receiver operating characteristic curve analysis,including the BOX score,achieving an area under the receiver operating characteristic curve of 0.7637.Conclusion:CRVDs are common in those with PPCS,with impact on recovery after concussion.Novel eye-tracking metrics can serve as an aid in the identification of those with CRVDs who would benefit from referral for comprehensive diagnosis and treatment.展开更多
Memory is a cognitive process through which past experiences are encoded,stored,and retrieved,playing a crucial role in intelligent behavior.It is well established that the hippocampus continues to reactivate memories...Memory is a cognitive process through which past experiences are encoded,stored,and retrieved,playing a crucial role in intelligent behavior.It is well established that the hippocampus continues to reactivate memories for several days after learning,and this process primarily occurs during sleep[1,2].The prevailing view suggests that sharp-wave ripples(SWRs)during non-rapid eye movement(NREM)sleep serve as key electrophysiological signatures of memory replay[3,4].However,only a small portion of SWRs contain memory replay[5].The direct relationship among SWRs,memory replay,and memory consolidation remains an open question.Another unresolved issue is how the hippocampus simultaneously reactivates both new and old memories while preventing interference.展开更多
BACKGROUND Emergency medical care is essential in preventing morbidity and mortality,especially when interventions are time-sensitive and require immediate access to supplies and trained personnel.AIM To assess the tr...BACKGROUND Emergency medical care is essential in preventing morbidity and mortality,especially when interventions are time-sensitive and require immediate access to supplies and trained personnel.AIM To assess the treatment rates of eye emergencies in Africa.Ocular emergencies are particularly delicate due to the eye’s intricate structure and the necessity for its refractive components to remain transparent.METHODS This review examines the low treatment rates of eye emergencies in Africa,drawing on 96 records extracted from the PubMed database using predetermined search criteria.RESULTS The epidemiology of ocular injuries,as detailed in the studies,reveals significant relationships between the incidence and prevalence of eye injuries and factors such as age,gender,and occupation.The causes of eye emergencies range from accidents to gender-based violence and insect or animal attacks.Management approaches reported in the review include both surgical and non-surgical interventions,from medication to evisceration or enucleation of the eye.Preventive measures emphasize eye health education and the use of protective eyewear and facial protection.However,inadequate healthcare infrastructure and personnel,cultural and geographical barriers,and socioeconomic and behavioral factors hinder the effective prevention,service uptake,and management of eye emergencies.CONCLUSION The authors recommend developing eye health policies,enhancing community engagement,improving healthcare personnel training and retention,and increasing funding for eye care programs as solutions to address the low treatment rate of eye emergencies in Africa.展开更多
AIM:To provide a comprehensive review of the advances in research on diabetes-associated dry eye(DADE),highlighting its pathophysiological mechanisms,risk factors,and demographic characteristics,laying the foundation ...AIM:To provide a comprehensive review of the advances in research on diabetes-associated dry eye(DADE),highlighting its pathophysiological mechanisms,risk factors,and demographic characteristics,laying the foundation for further investigation into its pathogenesis and treatment strategies.METHODS:A systemic review of the documents related to DADE had been performed based on the Web of Science database prior to achieving the plain text files of authors,titles,journals,and abstracts which afterwards had been imported into Citespace and VOSviewer software for data cleansing.The visual analysis was implemented from the following aspects:journals’publications,author and national cooperation,keyword co-occurrence,timeline analysis,and burst detection.RESULTS:The 318 documents in 167 journals had been incorporated with the overall annual citations and annual publications respectively growing significantly since 2014 and 2016.The keyword co-occurrence networks formed 4 clusters,with the representative keywords being dry eye,diabetes mellitus,prevalence,and diabetic retinopathy.Both the timeline map and the burst detection demonstrated that in the exploration of the pathogenesis of DADE,initial research was dedicated to Sjögren’s syndrome,followed by cross-sectional statistical analysis of the pertinent contributing factors of DADE using online databases.Precisely the oxidative stress seemed to surge into the research spotlight presently.The key pathogenic mechanisms of DADE include inflammation,oxidative stress and corneal neuropathy,contributing to the development of dry eye symptoms.CONCLUSION:Age,gender,diabetes duration,and diabetic retinopathy are strongly associated with the development of DADE,but the impact of other systemic factors require further investigation.With high prevalence of dry eye in Asia,valuable resources like the Korea National Health and Nutrition Examination Survey(KNHANES)database offer crucial data for developing risk prediction models for DADE.Building risk prediction models using machine learning algorithms is a promising future research direction,enabling physicians to identify high-risk individuals and implement early interventions.展开更多
BACKGROUND Uveitis associated with juvenile idiopathic arthritis(U-JIA)is a vision-threatening condition.Estimates of prevalence of uveitis in patients with known juvenile idiopathic arthritis range from 11.6%to 30.0%...BACKGROUND Uveitis associated with juvenile idiopathic arthritis(U-JIA)is a vision-threatening condition.Estimates of prevalence of uveitis in patients with known juvenile idiopathic arthritis range from 11.6%to 30.0%.First-line treatment includes topical glucocorticoids;methotrexate(MTX)is used if topical corticosteroids are ineffective.In severe cases biological therapy like adalimumab may be prescribed.Complications,including vision loss,may be related to the disease and the ongoing treatment(topical corticosteroids).In severe cases surgical intervention is often necessary and is typically associated with poor vision outcomes.AIM To highlight the characteristics of operated U-JIA and to identify predictors of treatment failure.METHODS A retrospective cohort study analyzed data from 68 pediatric patients(under 18 years old)with U-JIA between 2007 and 2023.The study focused on demographic,clinical,treatment,and outcome variables.Survival analysis using Kaplan-Meier curves and the Cox proportional hazards model was performed to estimate the impact of surgical intervention on the course of uveitis and to identify predictors of treatment failure.RESULTS Eye surgery was performed on 17(25%)patients with U-JIA.It was associated with an earlier onset of uveitis(P=0.017),lower uveitis remission rate[odds ratio=5.29,95%confidence interval(CI):1.23-24.90,P=0.015],longer time to remission(P=0.036),reduced probability of achieving remission on MTX(P=0.033),and the necessity of the following treatment with biological diseasemodifying antirheumatic drugs(odds ratio=5.60;95%CI:1.11-55.19,P=0.021)with similar efficacy with biological treatments in operated and non-operated cases.Kaplan-Meier curves showed a borderline difference in time to surgical intervention based on the MTX initiation cutoff(P=0.065)although earlier MTX initiation might be associated with a higher likelihood of deferred surgery.CONCLUSION Operated patients exhibited an aggressive early-onset uveitis profile that needed early and more intensive treatment.Delayed and failed MTX treatment as well as delayed switching to biologics often required subsequent eye surgery.展开更多
Eye depth is an important agronomic trait affecting tubers'appearance,quality,and processing suitability.Hence,cultivating varieties with uniform shapes and shallow eye depth are important goals for potato breedin...Eye depth is an important agronomic trait affecting tubers'appearance,quality,and processing suitability.Hence,cultivating varieties with uniform shapes and shallow eye depth are important goals for potato breeding.In this study,based on the primary mapping of the tuber eyedepth locus using a small primary-segregating population,a large secondary-segregating population with 2100 individuals was used to map the eye-depth locus further.A major quantitative trait locus for eye-depth on chromosome 10 was identified(designated qEyd10.1)using BSAseq and traditional QTL mapping methods.The qEyd10.1 could explain 55.0%of the eye depth phenotypic variation and was further narrowed to a 309.10 kb interval using recombinant analysis.To predict candidate genes,tissue sectioning and RNA-seq of the specific tuber tissues were performed.Genes encoding members of the peroxidase superfamily with likely roles in indole acetic acid regulation were considered the most promising candidates.These results will facilitate marker-assisted selection for the shallow-eye trait in potato breeding and provide a solid basis for eye-depth gene cloning and the analysis of tuber eye-depth regulatory mechanisms.展开更多
Many applications,including security systems,medical diagnostics,and human-computer interfaces,depend on eye gaze recognition.However,due to factors including individual variations,occlusions,and shifting illumination...Many applications,including security systems,medical diagnostics,and human-computer interfaces,depend on eye gaze recognition.However,due to factors including individual variations,occlusions,and shifting illumination conditions,real-world scenarios continue to provide difficulties for accurate and consistent eye gaze recognition.This work is aimed at investigating the potential benefits of employing transfer learning to improve eye gaze detection ability and efficiency.Transfer learning is the process of fine-tuning pre-trained models on smaller,domain-specific datasets after they have been trained on larger datasets.We study several transfer learning algorithms and evaluate their effectiveness on eye gaze identification,including both Regression and Classification tasks,using a range of deep learning architectures,namely AlexNet,Visual Geometry Group(VGG),InceptionV3,and ResNet.In this study,we evaluate the effectiveness of transfer learning-basedmodels against models that were trained fromscratch using eye-gazing datasets on grounds of various performance and loss metrics such as Precision,Accuracy,and Mean Absolute Error.We investigate the effects of different pre-trainedmodels,dataset sizes,and domain gaps on the transfer learning process,and the findings of our study clarify the efficacy of transfer learning for eye gaze detection and offer suggestions for the most successful transfer learning strategies to apply in real-world situations.展开更多
AIM:To identify differences in clinical features between thyroid eye disease(TED)patients with and without strabismus.METHODS:This retrospective,single-center,consecutive case series study was conducted on TED patient...AIM:To identify differences in clinical features between thyroid eye disease(TED)patients with and without strabismus.METHODS:This retrospective,single-center,consecutive case series study was conducted on TED patients who were determined to be surgical candidates.The patients’cohort were divided into two groups based on the presence or absence of strabismus.Demographics and complete eye examinations were recorded and compared between the TED and TED with strabismus groups.RESULTS:A total of 76 patients with TED were enrolled,including 58 males(76.3%)with a mean age of 52.68±10.45y.The 55 patients(male:female=2:1)were found to have TED with strabismus,while the remaining 21 patients(male:female=4:1)had TED without strabismus.There was nearly a four times greater likelihood of lid retraction being associated with TED without strabismus(OR=4.1,P=0.018)and they showed higher prevalence of proptosis(95.2%)than the TED strabismus group(63.6%,P<0.001).In the TED-strabismus group,20%of patients had abnormal head posture(AHP),while none were identified in the TED group(P=0.029).Despite the higher incidence of vision-threatening complications such as dysthyroid optic neuropathy(19%vs 8.1%)and exposure keratopathy(4.8%vs 1.8%)in the TED group than in the TED-strabismus group,the difference did not reach statistical significance(P>0.05).The most common types of strabismus were hypotropia(36%)and esotropia(29%),respectively.CONCLUSION:Strabismus-associated TED is characterized by a lower prevalence of proptosis and lid retraction,but a higher incidence of compensatory AHP.Identifying these differences may aid in risk stratification and early intervention for TED patients,particularly those at risk for restrictive strabismus.展开更多
AIM:To characterize the ocular surface characteristics in the Nepalese population across all age groups who have used digital screens for extended durations over several years.METHODS:In a cross-sectional,observationa...AIM:To characterize the ocular surface characteristics in the Nepalese population across all age groups who have used digital screens for extended durations over several years.METHODS:In a cross-sectional,observational study,144 digital screen users were assessed for dry eye disease(DED)using subjective and objective measures.The Ocular Surface Disease Index(OSDI)Questionnaire evaluated symptoms,followed by clinical assessments,including slit lamp biomicroscopy,tear breakup time(TBUT),Oxford Scheme grading,and Schirmer I test.DED was diagnosed if a patient had an OSDI score over 13 and at least two clinical signs(OSDI,Schirmer I test,or ocular staining).The prevalence of DED was calculated based on the proportion of patients meeting these criteria.RESULTS:Of the 144 participants(mean age:34.6±15.2y),78(54.2%)were female.The use of digital screens varied between 2-8h(mean duration:4.1±2.7h)per day.The mean OSDI score,TBUT score,and the Schirmer I scores were 22.7±10.5(max-min:24.4-20.9),6.8±4.2s(max-min:7.5-6.1),and 12.3±4.6 mm(max-min:13.1-11.5)respectively with 95%confidence interval(β=1.96),and a two-tailed statistical significance level of 5%(α=0.05).With increased screen use,TBUT shortened and OSDI scores increased significantly(P<0.01),though Schirmer I scores were unaffected(P>0.05).The prevalence of DED ranged from 6.3%to 22.9%in those using screens for more than 2h,with an overall prevalence of 67.4%among digital screen users.CONCLUSION:There is a significant association between prolonged use of digital screens and clinical markers of dry eye signs and symptoms.展开更多
文摘Good vision is fundamental to human experience,profoundly influencing educational attainment,economic productivity and overall quality of life.Currently,it is estimated that at least 2.2 billion people globally suffer from vision impairment(VI),with over 1 billion of these cases being preventable or treatable yet remaining unaddressed.Despite significant advancements in global eye care services over the past few decades,which have yielded considerable benefits,the challenges continue to mount.
文摘Achieving universal eye health remains a global challenge,particularly in low-and middle-income countries where visual impairment and blindness are prevalent.While advances in tertiary eye care have improved outcomes,access to primary eye care(PEC)continues to be inadequate in rural and underserved regions.This gap necessitates innovative,scalable models that provide accessible,affordable,and comprehensive eye care.The Vision Centre(VC)model,pioneered by the Aravind Eye Care System(AECS),exemplifies a sustainable approach to delivering PEC.Designed as permanent facilities in rural communities,VCs are equipped with state-of-the-art diagnostic tools and staffed by trained allied ophthalmic personnel.The integration of teleophthalmology,electronic medical records,and artificial intelligence enhances the model’s capacity to address complex conditions like diabetic retinopathy and glaucoma.VCs have demonstrated significant impact in improving accessibility,reducing financial burdens,and increasing utilization of eye care services.In the fiscal year 2023-2024,AECS VCs recorded nearly one million outpatient visits,achieving a 25%population coverage rate and generating substantial cost savings of ₹647 million(US$7.8 million)for patients.The model's success is underpinned by community engagement,a focus on operational excellence,and a robust referral system to tertiary hospitals.This review explores the evolution,implementation,and impact of the AECS VC model,emphasizing its alignment with the Sustainable Development Goals and Universal Health Coverage.By addressing accessibility and affordability,the VC model serves as a scalable template for primary eye care delivery in resource-limited settings globally.
文摘As we all know,eyes are the windows of our souls.They make us see the colorful world and understand others’feelings.However,by①the wide use of digital devices like smartphones and computers,many of us are facing eye problems.So,it's important to protect our eyes。
基金supported by the National Natural Science Foundation of China,No.82171080Nanjing Medical Science and Technology Development Project,No.YKK23264Postgraduate Research&Practice Innovation Program of Jiangsu Province,Nos.JX10414151,JX10414152(all to KL)。
文摘Age-related macular degeneration is a serious neurodegenerative disease of the retina that significantly impacts vision.Unfortunately,the specific pathogenesis remains unclear,and effective early treatment options are consequently lacking.The microbiome is defined as a large ecosystem of microorganisms living within and coexisting with a host.The intestinal microbiome undergoes dynamic changes owing to age,diet,genetics,and other factors.Such dysregulation of the intestinal flora can disrupt the microecological balance,resulting in immunological and metabolic dysfunction in the host,and affecting the development of many diseases.In recent decades,significant evidence has indicated that the intestinal flora also influences systems outside of the digestive tract,including the brain.Indeed,several studies have demonstrated the critical role of the gut-brain axis in the development of brain neurodegenerative diseases,including Alzheimer’s disease and Parkinson’s disease.Similarly,the role of the“gut-eye axis”has been confirmed to play a role in the pathogenesis of many ocular disorders.Moreover,age-related macular degeneration and many brain neurodegenerative diseases have been shown to share several risk factors and to exhibit comparable etiologies.As such,the intestinal flora may play an important role in age-related macular degeneration.Given the above context,the present review aims to clarify the gut-brain and gut-eye connections,assess the effect of intestinal flora and metabolites on age-related macular degeneration,and identify potential diagnostic markers and therapeutic strategies.Currently,direct research on the role of intestinal flora in age-related macular degeneration is still relatively limited,while studies focusing solely on intestinal flora are insufficient to fully elucidate its functional role in age-related macular degeneration.Organ-on-a-chip technology has shown promise in clarifying the gut-eye interactions,while integrating analysis of the intestinal flora with research on metabolites through metabolomics and other techniques is crucial for understanding their potential mechanisms.
文摘Objective:The aim of this study was to evaluate the synergistic effect of eye care and drug therapy in patients with dry eye.Methods:A total of 59 patients with dry eye diagnosed and treated in our hospital were randomly divided into the reference group(29 cases)and the experimental group(30 cases).Patients in the reference group received only the usual medication,while the experimental group received additional eye care.The treatment response and the improvement of quality of life were evaluated by comparing the treatment excellence rate,quality of life score,and nursing satisfaction score of the two groups.Results:The rate of excellent treatment in the experimental group was 93.33%,which was significantly higher than that in the reference group(68.97%)(P=0.013).The quality of life scores in social function,psychological function and physiological function of the experimental group were significantly higher than those of the reference group(P<0.003),the nursing satisfaction score and symptom score were also improved more significantly(P<0.003),and the SAS score was decreased more(P<0.003).Conclusion:The synergistic effect of comprehensive eye care and drug therapy on patients with dry eye can significantly improve the rate of good treatment and quality of life score,increase the nursing satisfaction of patients,and have potential benefits to improve psychological status,providing an effective way for the management of dry eye.
文摘Dear Editor,We present the reported case of rapid onset bull’s eye maculopathy.Chloroquine(CQ)and its safer,more widely used analogue,hydroxychloroquine(HCQ),were originally developed as antimalarial medications.However,they have since become essential in the treatment of various autoimmune disorders due to their anti-inflammatory and immunomodulatory properties.HCQ is also being investigated for potential applications in diabetes mellitus,coronavirus disease 2019,heart disease,and as an adjunct in cancer therapy^([1-2]).
基金financially supported by the National Natural Science Foundation of China(Grant No.32471564)。
文摘Eyespots have been shown to perform an anti-predator function by intimidating predators.However,whether predators are deterred by the eyespots’mimicking eyes of higher-order predators,or by the conspicuousness of the spots,is still being debated.The anti-predator mechanism of eyespots,which involves the predator’s visual perception and cognition,urges to be examined.To explore the“eye mimicry hypothesis”and“conspicuous signal hypothesis,”we designed prey with deceptive eyespots eliciting 2-dimensional(2D)or 3-dimensional(3D)visual illusions for domestic chicks(as predators).For 2D visual illusion,we provided prey with occluded eyespots for chicks.Chicks can“complete”the occluded eyespots into a full 2D concentric circle by the amodal completion mechanism,that is,one of visual illusion.For 3D visual illusion,we created the crescent-shaped sparkles on the eyespots to simulate a visually 3D eye.Our result indicated that(1)2D:chicks hesitated more when facing preys with occluded eyespots than facing preys with broken eyespots and(2)3D:compared to prey with no-sparkle eyespots,chicks spent more time approaching prey with sparkle eyespots and were more likely to approach them tangentially.Thus,the visual illusion perceived by chicks would impact the anti-predation effectiveness of eyespots.Eyespots that more closely resemble the real eyes,especially those with 3-dimensionality,provided more effective protection.Our study supported the eye mimicry hypothesis from the perspective of visual illusion.
文摘Dry eye disease(DED)is a multifactorial disorder that disturbs ocular surface equilibrium,considerably diminishing quality of life.Present therapies only offer symptomatic alleviation.Stem cell treatment,especially mesenchymal stem cells(MSCs),has surfaced as a viable approach for tissue regeneration and immunological regulation in DED.Preclinical and early clinical investigations indicate that MSCs can improve lacrimal gland functionality,diminish inflammation,and facilitate corneal regeneration.Nonetheless,obstacles persist in enhancing MSC viability,determining the optimal MSC source,and guaranteeing sustained therapeutic effectiveness.Additional extensive randomized clinical trials are required to confirm the efficacy of MSC-based therapies for severe DED.
文摘Although eye problems can occur at any age, they are often common from the age of 40. Eye diseases with a prevalence associated with age and aging will continue to increase in the coming years. Most studies conducted on problems in middle-aged people have focused on visual disorders without taking into account all the ocular morbidities that may affect this segment of the population, hence the present study, the aim of which is to determine the proportions of different eye diseases in people aged 40 and over. Materials and Methods: This was a descriptive cross-sectional study carried out in the ophthalmology department covering the period from January 1 to December 31, 2020. Results: In total, we collected 828 patients aged 40 and over out of 1811 patients who received ophthalmological consultation during the study period, representing 45.72%. The most represented age group was 40 - 50 years, with an average age of 58.84 years and a maximum of 93 years. There were slightly more women (62.3%) than men (37.7%). The main reasons for consultation were decreased visual acuity (26.4%) and pruritus (19.9%). The main eye diseases diagnosed were cataracts (23%), allergic conjunctivitis (21.1%), and bacterial conjunctivitis (14.2%). Discussions: The predominance of cataracts in the diagnosed diseases confirms the literature data, according to which the main eye morbidities in middle-aged and elderly people are cataracts, glaucoma, and age-related macular degeneration. Conclusion: It is crucial to have a mastery of these epidemiological data of eye diseases in order to adapt the technical platforms of eye care structures to the needs of different segments of the population.
基金supported by funding from the National Institution of Neurological Disorders and Stroke(1R41NS103698-01A1 to CLM)。
文摘Background:Early identification of concussion-related vision disorders(CRVDs)may improve outcomes by enabling earlier management,referral,and treatment.Objective eye tracking may provide additional data to support the diagnose of CRVDs.The purpose of this study was to determine the utility of objective infrared eye tracking in identifying CRVDs among adolescents experiencing persisting post-concussive symptoms(PPCS)more than 28 days after injury.Methods:This was a prospective study of adolescents with PPCS evaluated with visio-vestibular examination(VVE),comprehensive vision examination,and an eye tracking device.Results:Of the 108 adolescents enrolled,67(62%)were diagnosed with a CRVD by comprehensive vision examination.On VVE,the near point of convergence break(5.5±3.2 cm vs.3.9±1.7 cm(mean±SD),p<0.001)and recovery(8.1±3.3 cm vs.6.8±2.3 cm,p=0.02)distinguished between those with and without CRVD.Concussion symptom provocation on VVE with horizontal saccades(35(52%)vs.12(29%),p=0.02)and horizontal vestibulo-ocular reflex testing(37(55%)vs.14(34%),p=0.03),and sway on tandem gait under the forward eyes closed condition(25(37%)vs.6(15%),p=0.01)also identified those with CRVD.From the eye tracking device,the BOX score(8.1±5.8 vs.5.2±4.1,p=0.007)and a metric of the left eye tracking along the bottom of the visual target(0.094±0.500 vs.-0.124±0.410,p=0.02)identified those with CRVD,with a multivariable receiver operating characteristic curve analysis,including the BOX score,achieving an area under the receiver operating characteristic curve of 0.7637.Conclusion:CRVDs are common in those with PPCS,with impact on recovery after concussion.Novel eye-tracking metrics can serve as an aid in the identification of those with CRVDs who would benefit from referral for comprehensive diagnosis and treatment.
基金supported by the National Natural Science Foundation of China(32371028,32300822,U24A20373,and 82071177)the Shanghai Rising-Star Program(24QA2704800)+2 种基金the Shanghai Jiao Tong University 2030 InitiativeShanghai Municipal Health Commission(202340046)the Fund for Excellent Young Scholars of Shanghai Ninth People's Hospital,Shanghai Jiao Tong University School of Medicine.
文摘Memory is a cognitive process through which past experiences are encoded,stored,and retrieved,playing a crucial role in intelligent behavior.It is well established that the hippocampus continues to reactivate memories for several days after learning,and this process primarily occurs during sleep[1,2].The prevailing view suggests that sharp-wave ripples(SWRs)during non-rapid eye movement(NREM)sleep serve as key electrophysiological signatures of memory replay[3,4].However,only a small portion of SWRs contain memory replay[5].The direct relationship among SWRs,memory replay,and memory consolidation remains an open question.Another unresolved issue is how the hippocampus simultaneously reactivates both new and old memories while preventing interference.
文摘BACKGROUND Emergency medical care is essential in preventing morbidity and mortality,especially when interventions are time-sensitive and require immediate access to supplies and trained personnel.AIM To assess the treatment rates of eye emergencies in Africa.Ocular emergencies are particularly delicate due to the eye’s intricate structure and the necessity for its refractive components to remain transparent.METHODS This review examines the low treatment rates of eye emergencies in Africa,drawing on 96 records extracted from the PubMed database using predetermined search criteria.RESULTS The epidemiology of ocular injuries,as detailed in the studies,reveals significant relationships between the incidence and prevalence of eye injuries and factors such as age,gender,and occupation.The causes of eye emergencies range from accidents to gender-based violence and insect or animal attacks.Management approaches reported in the review include both surgical and non-surgical interventions,from medication to evisceration or enucleation of the eye.Preventive measures emphasize eye health education and the use of protective eyewear and facial protection.However,inadequate healthcare infrastructure and personnel,cultural and geographical barriers,and socioeconomic and behavioral factors hinder the effective prevention,service uptake,and management of eye emergencies.CONCLUSION The authors recommend developing eye health policies,enhancing community engagement,improving healthcare personnel training and retention,and increasing funding for eye care programs as solutions to address the low treatment rate of eye emergencies in Africa.
基金Supported by the Exploratory Project of The Second Affiliated Hospital of Xi’an Jiaotong University[No.2020YJ(ZYTS)154].
文摘AIM:To provide a comprehensive review of the advances in research on diabetes-associated dry eye(DADE),highlighting its pathophysiological mechanisms,risk factors,and demographic characteristics,laying the foundation for further investigation into its pathogenesis and treatment strategies.METHODS:A systemic review of the documents related to DADE had been performed based on the Web of Science database prior to achieving the plain text files of authors,titles,journals,and abstracts which afterwards had been imported into Citespace and VOSviewer software for data cleansing.The visual analysis was implemented from the following aspects:journals’publications,author and national cooperation,keyword co-occurrence,timeline analysis,and burst detection.RESULTS:The 318 documents in 167 journals had been incorporated with the overall annual citations and annual publications respectively growing significantly since 2014 and 2016.The keyword co-occurrence networks formed 4 clusters,with the representative keywords being dry eye,diabetes mellitus,prevalence,and diabetic retinopathy.Both the timeline map and the burst detection demonstrated that in the exploration of the pathogenesis of DADE,initial research was dedicated to Sjögren’s syndrome,followed by cross-sectional statistical analysis of the pertinent contributing factors of DADE using online databases.Precisely the oxidative stress seemed to surge into the research spotlight presently.The key pathogenic mechanisms of DADE include inflammation,oxidative stress and corneal neuropathy,contributing to the development of dry eye symptoms.CONCLUSION:Age,gender,diabetes duration,and diabetic retinopathy are strongly associated with the development of DADE,but the impact of other systemic factors require further investigation.With high prevalence of dry eye in Asia,valuable resources like the Korea National Health and Nutrition Examination Survey(KNHANES)database offer crucial data for developing risk prediction models for DADE.Building risk prediction models using machine learning algorithms is a promising future research direction,enabling physicians to identify high-risk individuals and implement early interventions.
文摘BACKGROUND Uveitis associated with juvenile idiopathic arthritis(U-JIA)is a vision-threatening condition.Estimates of prevalence of uveitis in patients with known juvenile idiopathic arthritis range from 11.6%to 30.0%.First-line treatment includes topical glucocorticoids;methotrexate(MTX)is used if topical corticosteroids are ineffective.In severe cases biological therapy like adalimumab may be prescribed.Complications,including vision loss,may be related to the disease and the ongoing treatment(topical corticosteroids).In severe cases surgical intervention is often necessary and is typically associated with poor vision outcomes.AIM To highlight the characteristics of operated U-JIA and to identify predictors of treatment failure.METHODS A retrospective cohort study analyzed data from 68 pediatric patients(under 18 years old)with U-JIA between 2007 and 2023.The study focused on demographic,clinical,treatment,and outcome variables.Survival analysis using Kaplan-Meier curves and the Cox proportional hazards model was performed to estimate the impact of surgical intervention on the course of uveitis and to identify predictors of treatment failure.RESULTS Eye surgery was performed on 17(25%)patients with U-JIA.It was associated with an earlier onset of uveitis(P=0.017),lower uveitis remission rate[odds ratio=5.29,95%confidence interval(CI):1.23-24.90,P=0.015],longer time to remission(P=0.036),reduced probability of achieving remission on MTX(P=0.033),and the necessity of the following treatment with biological diseasemodifying antirheumatic drugs(odds ratio=5.60;95%CI:1.11-55.19,P=0.021)with similar efficacy with biological treatments in operated and non-operated cases.Kaplan-Meier curves showed a borderline difference in time to surgical intervention based on the MTX initiation cutoff(P=0.065)although earlier MTX initiation might be associated with a higher likelihood of deferred surgery.CONCLUSION Operated patients exhibited an aggressive early-onset uveitis profile that needed early and more intensive treatment.Delayed and failed MTX treatment as well as delayed switching to biologics often required subsequent eye surgery.
基金funded by the National Natural Science Foundation of China(Grant No.31801421)the Chinese Academy of Agricultural Sciences Innovation Project(Grant No.CAAS-ASTIPIVFCAAS).
文摘Eye depth is an important agronomic trait affecting tubers'appearance,quality,and processing suitability.Hence,cultivating varieties with uniform shapes and shallow eye depth are important goals for potato breeding.In this study,based on the primary mapping of the tuber eyedepth locus using a small primary-segregating population,a large secondary-segregating population with 2100 individuals was used to map the eye-depth locus further.A major quantitative trait locus for eye-depth on chromosome 10 was identified(designated qEyd10.1)using BSAseq and traditional QTL mapping methods.The qEyd10.1 could explain 55.0%of the eye depth phenotypic variation and was further narrowed to a 309.10 kb interval using recombinant analysis.To predict candidate genes,tissue sectioning and RNA-seq of the specific tuber tissues were performed.Genes encoding members of the peroxidase superfamily with likely roles in indole acetic acid regulation were considered the most promising candidates.These results will facilitate marker-assisted selection for the shallow-eye trait in potato breeding and provide a solid basis for eye-depth gene cloning and the analysis of tuber eye-depth regulatory mechanisms.
文摘Many applications,including security systems,medical diagnostics,and human-computer interfaces,depend on eye gaze recognition.However,due to factors including individual variations,occlusions,and shifting illumination conditions,real-world scenarios continue to provide difficulties for accurate and consistent eye gaze recognition.This work is aimed at investigating the potential benefits of employing transfer learning to improve eye gaze detection ability and efficiency.Transfer learning is the process of fine-tuning pre-trained models on smaller,domain-specific datasets after they have been trained on larger datasets.We study several transfer learning algorithms and evaluate their effectiveness on eye gaze identification,including both Regression and Classification tasks,using a range of deep learning architectures,namely AlexNet,Visual Geometry Group(VGG),InceptionV3,and ResNet.In this study,we evaluate the effectiveness of transfer learning-basedmodels against models that were trained fromscratch using eye-gazing datasets on grounds of various performance and loss metrics such as Precision,Accuracy,and Mean Absolute Error.We investigate the effects of different pre-trainedmodels,dataset sizes,and domain gaps on the transfer learning process,and the findings of our study clarify the efficacy of transfer learning for eye gaze detection and offer suggestions for the most successful transfer learning strategies to apply in real-world situations.
文摘AIM:To identify differences in clinical features between thyroid eye disease(TED)patients with and without strabismus.METHODS:This retrospective,single-center,consecutive case series study was conducted on TED patients who were determined to be surgical candidates.The patients’cohort were divided into two groups based on the presence or absence of strabismus.Demographics and complete eye examinations were recorded and compared between the TED and TED with strabismus groups.RESULTS:A total of 76 patients with TED were enrolled,including 58 males(76.3%)with a mean age of 52.68±10.45y.The 55 patients(male:female=2:1)were found to have TED with strabismus,while the remaining 21 patients(male:female=4:1)had TED without strabismus.There was nearly a four times greater likelihood of lid retraction being associated with TED without strabismus(OR=4.1,P=0.018)and they showed higher prevalence of proptosis(95.2%)than the TED strabismus group(63.6%,P<0.001).In the TED-strabismus group,20%of patients had abnormal head posture(AHP),while none were identified in the TED group(P=0.029).Despite the higher incidence of vision-threatening complications such as dysthyroid optic neuropathy(19%vs 8.1%)and exposure keratopathy(4.8%vs 1.8%)in the TED group than in the TED-strabismus group,the difference did not reach statistical significance(P>0.05).The most common types of strabismus were hypotropia(36%)and esotropia(29%),respectively.CONCLUSION:Strabismus-associated TED is characterized by a lower prevalence of proptosis and lid retraction,but a higher incidence of compensatory AHP.Identifying these differences may aid in risk stratification and early intervention for TED patients,particularly those at risk for restrictive strabismus.
文摘AIM:To characterize the ocular surface characteristics in the Nepalese population across all age groups who have used digital screens for extended durations over several years.METHODS:In a cross-sectional,observational study,144 digital screen users were assessed for dry eye disease(DED)using subjective and objective measures.The Ocular Surface Disease Index(OSDI)Questionnaire evaluated symptoms,followed by clinical assessments,including slit lamp biomicroscopy,tear breakup time(TBUT),Oxford Scheme grading,and Schirmer I test.DED was diagnosed if a patient had an OSDI score over 13 and at least two clinical signs(OSDI,Schirmer I test,or ocular staining).The prevalence of DED was calculated based on the proportion of patients meeting these criteria.RESULTS:Of the 144 participants(mean age:34.6±15.2y),78(54.2%)were female.The use of digital screens varied between 2-8h(mean duration:4.1±2.7h)per day.The mean OSDI score,TBUT score,and the Schirmer I scores were 22.7±10.5(max-min:24.4-20.9),6.8±4.2s(max-min:7.5-6.1),and 12.3±4.6 mm(max-min:13.1-11.5)respectively with 95%confidence interval(β=1.96),and a two-tailed statistical significance level of 5%(α=0.05).With increased screen use,TBUT shortened and OSDI scores increased significantly(P<0.01),though Schirmer I scores were unaffected(P>0.05).The prevalence of DED ranged from 6.3%to 22.9%in those using screens for more than 2h,with an overall prevalence of 67.4%among digital screen users.CONCLUSION:There is a significant association between prolonged use of digital screens and clinical markers of dry eye signs and symptoms.
