AIM: To measure and analysis axial length(AL)/corneal radius of curvature(CRC) ratio and other refractive parameters, provide a medical reference range for refractive development evaluation and earlier visual impairme...AIM: To measure and analysis axial length(AL)/corneal radius of curvature(CRC) ratio and other refractive parameters, provide a medical reference range for refractive development evaluation and earlier visual impairment screening of 3 to 4 y kindergarten students.METHODS: Between April and June 2017, a total of 4350 participants aged 3-to 4-year-old(8700 eyes) from 10 cluster random sampling kindergartens in Shanghai, Pudong District were involved. According to the measurement and analysis of the unaided visual acuity(VA), AL, CRC, AL/CRC ratio, astigmatism and other refractive parameters, the data distribution and reference range were obtained.RESULTS: Uncorrected VA of examined children was 0.23±0.08(logMAR, mean±SD) [95% confidence interval(CI) range ≤0.36];AL was 22.10±0.79 mm(95%CI 20.55-23.65);CRC was 7.86±0.26 mm(95%CI, 7.35-8.37);AL/CRC ratio was 2.81±0.12(95%CI, 2.57-3.05). The median of astigmatism was-0.5 D, a total of 56.3% had astigmatism <-0.50 D, 85.3%<-1.00 D, 6.7%>-1.50 D;71% were astigmatism with the rule. Eye-specific analyses were conducted. Statistical difference of VA was in right and left eyes. There were no significant differences between two eyes of AL, CRC, AL/CRC ratio and astigmatism(P>0.05).CONCLUSION: VA and AL/CRC ratio reference could be used to assess refractive development in children and screening uncorrected refractive errors or amblyopia. Astigmatism needs to be considered in the diagnosis.展开更多
Objective:To investigate the influence of axial length(AL),corneal curvature(CR),and the ratio of axial length to corneal radius of curvature(AL/CR)on myopia in children,and to evaluate the accuracy and specificity of...Objective:To investigate the influence of axial length(AL),corneal curvature(CR),and the ratio of axial length to corneal radius of curvature(AL/CR)on myopia in children,and to evaluate the accuracy and specificity of AL/CR in diagnosing myopia in children.Methods:A cross-sectional study was conducted.A total of 200 children(400 eyes)aged 6-12 years were recruited from the ophthalmology outpatient clinic of Fuling District People’s Hospital from December 2022 to December 2023.AL,CR,and AL/CR were measured,and comprehensive optometry was performed under cycloplegia,with the results recorded in spherical equivalent(SE)form.Results:A total of 200 subjects(400 eyes)were included in this study,of which 330 eyes(82.50%)were myopic.No significant differences in CR were observed among different refractive groups,while significant differences were noted in SE,AL,and AL/CR.The AL and AL/CR ratios were higher in myopic eyes compared to emmetropic and hyperopic eyes.Using cycloplegia as the gold standard,SE in the myopia group was correlated with AL,AL/CR,and CR,with stronger correlations observed with AL and AL/CR.An AL/CR value>3 demonstrated a sensitivity of 0.918,specificity of 0.786,misdiagnosis rate of 0.214,missed diagnosis rate of 0.082,and accuracy of 89.5%in diagnosing myopia.Conclusion:AL and AL/CR values are highly correlated with SE,with the strongest correlation observed in the myopia group.The AL/CR value exhibits high diagnostic value in determining myopia in children.展开更多
AIM:To characterize the distribution of persistent fetal vasculature(PFV)subtypes and to evaluate corneal astigmatism(CA)in children with unilateral PFV.METHODS:The medical records of patients diagnosed with PFV betwe...AIM:To characterize the distribution of persistent fetal vasculature(PFV)subtypes and to evaluate corneal astigmatism(CA)in children with unilateral PFV.METHODS:The medical records of patients diagnosed with PFV between January 2014 and August 2021 were retrospectively reviewed.Corneal keratometry parameters were measured using IOLMaster or a handheld keratometer.Differences in CA between the affected and fellow eyes were analyzed in 52 unilateral PFV patients with available examination data.RESULTS:Totally 133 patients diagnosed with PFV were retrospectively reviewed.The male-to-female ratio was 73/60.Median age at surgery was 38.03mo(interquartile range 58.27mo).Among the PFV patients,32(24.06%)had anterior PFV,2(1.50%)had posterior PFV,and 99(74.44%)had combined anterior-posterior PFV.Mild combined PFV was the most common subtype.In unilateral PFV cases,the mean CA in the affected eye was 2.29±1.11 D,and 59.62%(31 eyes)had CA≥2.0 D.The mean CA in the affected eyes was significantly higher than in the fellow eyes(1.37±0.77 D;P<0.001).Among PFV-affected eyes with CA≥2.0 D,the steepest corneal meridian was vertically oriented in 30 cases(96.77%),while only 1 case(3.23%)had the steepest meridian oriented horizontally.CONCLUSION:In children with unilateral PFV,CA is significantly higher in the affected eyes than in the fellow eyes,and the steepest corneal meridian was predominantly oriented vertically.展开更多
The retrospective study by Edwar et al reinforces the role of therapeutic penetrating keratoplasty(PK)as a vital intervention in severe,treatment-resistant infectious keratitis.In advanced cases—often complicated by ...The retrospective study by Edwar et al reinforces the role of therapeutic penetrating keratoplasty(PK)as a vital intervention in severe,treatment-resistant infectious keratitis.In advanced cases—often complicated by trauma,delayed presentation,and corneal perforation—PK restores globe integrity and provides limited visual recovery.However,its application is constrained by graft-related complications and donor shortages,particularly in low-resource settings.These limitations highlight the need for earlier,globe-sparing strategies to prevent progression and reduce surgical demand.Photoactivated chromophore for infectious keratitis-corneal collagen cross-linking(PACK-CXL)has emerged as a promising adjunct or alternative.With both antimicrobial and tissue-stabilizing effects,PACK-CXL may control infection and preserve corneal structure in earlier stages.A layered treatment framework that incorporates PACK-CXL as an initial intervention and reserves PK for refractory cases may help improve clinical outcomes.Further studies are needed to define their best use in practice.展开更多
The onset,cessation,and length of the rainy season are crucial for global water resources,agricultural practices,and food security.However,the response of precipitation seasonality to global warming remains uncertain....The onset,cessation,and length of the rainy season are crucial for global water resources,agricultural practices,and food security.However,the response of precipitation seasonality to global warming remains uncertain.In this study,we analyze how global warming levels(GWLs)of 1.5℃ and 2℃ could affect the timing of rainfall onset(RODs),rainfall cessation(RCDs),and the overall duration of the rainy season(LRS)over global land monsoon(GLM)regions using simulations from CMIP6 under the SSP2-4.5 and SSP5-8.5 scenarios.With high model consensus,our results reveal that RODs are projected to occur later over Southern Africa,North Africa,and South America,but earlier over South Asia and Australia,in a warmer climate.The projected early RODs in Australia are more pronounced at the 2℃ GWL under SSP5-8.5.On the other hand,early RCDs are projected over South America and East Asia,while late RCDs are projected over North Africa,with high inter-model agreement.These changes are associated with a future decrease in LRS in most GLM regions.Additionally,we found that continuous warming over 1.5℃ will further reduce the length of the rainy season,especially over the South America,North Africa,and Southern Africa monsoon regions.The findings underscore the urgent need to mitigate global warming.展开更多
Purpose: To examine the influence of central corneal thickness (CCT), corneal curvature (CC), and axial length (AL) on intraocular pressure (IOP).Methods: Eighty-one clinically normal eyes were included in our study. ...Purpose: To examine the influence of central corneal thickness (CCT), corneal curvature (CC), and axial length (AL) on intraocular pressure (IOP).Methods: Eighty-one clinically normal eyes were included in our study. The IOP, CCT, CC, AL were measured using a Goldmann applanation tonometer, optical pachymeter, keratometer and A-scan ultrasound biometer respectively in all subjects.Results: A highly significant positive correlation was identified between IOP and CCT. Linear regression analysis suggests that an increase in CCT of 0. 010 mm is associated with a 4. 946 mmHg increment in IOP. No significant positive correlation was identified between IOP and CC. P values are 0. 724 and 0.414 respectively for vertical and horizontal readings. A paradoxically reversed correlation was present between IOP and axial length.Conclusion: Corneal thickness is a very important confounding factor in the measurement of intraocular pressure, which warrants further attention in our clinical practice.展开更多
AIM:To investigate whether the axial length(AL)/total corneal refractive power(TCRP)ratio is a sensitive and simple factor that can be used for the early diagnosis of Marfan’s syndrome(MFS)in children.METHODS:The rel...AIM:To investigate whether the axial length(AL)/total corneal refractive power(TCRP)ratio is a sensitive and simple factor that can be used for the early diagnosis of Marfan’s syndrome(MFS)in children.METHODS:The relationship between the AL/TCRP ratio and the diagnosis of MFS for 192 eyes in 97 children were evaluate.The biological characteristics,including age,sex,AL,and TCRP,were collected from medical records.Receiver operating characteristic(ROC)curve analysis was performed to investigate whether the AL/TCRP ratio effectively distinguishes MFS from other subjects.The Youden index was used to re-divide the whole population into two groups according to an AL/TCRP ratio of 0.59.RESULTS:Of 96 subjects(mean age 7.46±3.28 y)evaluated,56(110 eyes)had a definite diagnosis of MFS in childhood based on the revised Ghent criteria,41(82 eyes)with diagnosis of congenital ectopia lentis(EL)were included as a control group.AL was negatively correlated with TCRP,with a linear regression coefficient of-0.36(R2=0.08).A significant correlation was found between age and the AL/TCRP ratio(P=0.023).ROC curve analysis showed that the AL/TCRP ratio distinguished MFS from the other patients at a threshold of 0.59.MFS patients were present in 24/58(41.38%)patients with an AL/TCRP ratio of≤0.59 and in 34/39(87.18%)patients with an AL/TCRP ratio of>0.59.CONCLUSION:An AL/TCRP ratio of>0.59 is significantly associated with the risk of MFS.The AL/TCRP ratio should be measured as a promising marker for the prognosis of children MFS.Changes in the AL/TCRP ratio should be monitored over time.展开更多
Purpose: To evaluate axial length before and after the photorefractive keratectomy (PRK) and laser in situ keratomileusis (LASIK). Setting: Alhokama Eye Center, Riyadh Saudi Arabia. Design: A cross-sectional study. Me...Purpose: To evaluate axial length before and after the photorefractive keratectomy (PRK) and laser in situ keratomileusis (LASIK). Setting: Alhokama Eye Center, Riyadh Saudi Arabia. Design: A cross-sectional study. Methods: The study sample was comprised of 106 eyes of 54 patients. Patients were divided into 2 groups based on whether they had photorefractive surgery (PRK group) or laser in situ keratomiluesis (LASIK group). The intra-group comparison was performed of the changes in axial length before and after surgery using IOLMaster. P Results: There were 76 eyes (39 patients) in the PRK group with the mean age of 25.10 ± 3.47 years, the mean preoperative spherical equivalent of -3.16 ± 1.75 D, and the mean preoperative axial length of 24.79 ± 1.02 mm. In the LASIK group, there were 30 eyes (15 patients) with the mean age of 25.13 ± 4.91 years and the mean preoperative spherical equivalent of -5.58 ± 1.98 D and the mean preoperative axial length of 25.67 ± 1.35 mm. Postoperatively, the mean axial length was 24.70 ± 1.14 mm in the PRK group and 25.60 ± 1.33 mm in the LASIK group. The mean change between the preoperative and postoperative axial length was statically significant in both groups (P Conclusion: There was a statically significant decrease in the axial length measurements after PRK or LASIK for myopia.展开更多
Diabetic corneal neuropathy and diabetic retinopathy are ocular complications occurring in the context of diabetes mellitus.Diabetic corneal neuropathy refers to the progressive damage of corneal nerves.Diabetic retin...Diabetic corneal neuropathy and diabetic retinopathy are ocular complications occurring in the context of diabetes mellitus.Diabetic corneal neuropathy refers to the progressive damage of corneal nerves.Diabetic retinopathy has traditionally been considered as damage to the retinal microvasculature.However,growing evidence suggests that diabetic retinopathy is a complex neurovascular disorder resulting from dysfunction of the neurovascular unit,which includes both the retinal vascular structures and neural tissues.Diabetic retinopathy is one of the leading causes of blindness and is frequently screened for as part of diabetic ocular screening.However,diabetic corneal neuropathy is commonly overlooked and underdiagnosed,leading to severe ocular surface impairment.Several studies have found that these two conditions tend to occur together,and they share similarities in their pathogenesis pathways,being triggered by a status of chronic hyperglycemia.This review aims to discuss the interconnection between diabetic corneal neuropathy and diabetic retinopathy,whether diabetic corneal neuropathy precedes diabetic retinopathy,as well as the relation between the stage of diabetic retinopathy and the severity of corneal neuropathy.We also endeavor to explore the relevance of a corneal screening in diabetic eyes and the possibility of using corneal nerve measurements to monitor the progression of diabetic retinopathy.展开更多
BACKGROUND Corneal ulcers are a major cause of visual impairment in developing countries.In Indonesia,severe infective ulcers often require keratoplasty(KP)to preserve ocular integrity and improve outcomes.AIM To dete...BACKGROUND Corneal ulcers are a major cause of visual impairment in developing countries.In Indonesia,severe infective ulcers often require keratoplasty(KP)to preserve ocular integrity and improve outcomes.AIM To determine demographic,clinical and microbiological characteristics,complications,and KP outcomes in patients with moderate to severe infective corneal ulcers.METHODS A retrospective review was conducted on patients with moderate to severe infective corneal ulcers who underwent KP between January 1,2018 and December 31,2020,with a minimum follow-up period of 3 weeks at the Ocular Infection and Immunology clinic of a tertiary referral hospital in Jakarta.Data were extracted from medical records.RESULTS A total of 99 eyes from 99 patients with a mean age of 41.7±16.2 years were included.Eight-nine eyes of corneal cases were located at the central cornea with>6 mm lesion size(forty-one eyes).The culture positivity rate was 33%,primarily composed of Staphylococcus epidermidis.Eyeball integrity was maintained in all patients.Mean uncorrected visual acuity(VA)before KP was 2.50 and improved to 2.04 after 3 months of follow-up.Twenty patients with a cornea that was kept transparent achieved a VA of 0.40.Complications after KP appeared in 60 eyes,while secondary glaucoma was the most common complication(28 eyes),followed by graft failure(24 eyes)and graft rejection(14 eyes).CONCLUSION Corneal ulcers are a common problem in Indonesia following eye trauma.Therapeutic and tectonic KP can preserve the integrity of the eyeball in moderate to severe cases,although complications are common.展开更多
Background:It is found to have association of facial parameters with trisomy 21 fetuses(T 21).We have compared prenasal thickness(PNT),nasal bone length(NBL),and the PNT:NBL ratio of normal fetuses with fetuses with t...Background:It is found to have association of facial parameters with trisomy 21 fetuses(T 21).We have compared prenasal thickness(PNT),nasal bone length(NBL),and the PNT:NBL ratio of normal fetuses with fetuses with trisomy 21(T 21)between 16 and 25 weeks of gestation as a diagnostic tool for T 21.Methods:Facial profile images in the two dimensional(2D)gray scale were assessed to measure fetal NBL and PNT between 16 and 25 weeks of gestation.The PNT:NBL ratio of the fetuses was calculated.Nomograms were constructed from the data of morphologically normal fetuses at live birth.The PNT,NBL,and PNT:NBL ratio of fetuses with confirmed T 21(n=31)and morphologically normal fetuses at live birth(controls,n=3485)were compared.Results:Nomograms for PNT,NBL,and the PNT:NBL ratio were constructed.In T 21 fetuses,PNT(>95th percentile),NBL(<5th percentile),and the PNT:NBL ratio(>95th percentile)showed a sensitivity of 25%,29%,and 45%for PNT,NBL,and PNT:NBL,respectively,and specificity of 95%,96%,and 94%,for PNT,NBL,and PNT:NBL,respectively.All of these markers showed a negative predictive value of 99%.Conclusion:PNT,NBL,and the PNT:NBL ratio have high diagnostic value for fetuses with Down syndrome and can be incorporated easily in the current second trimester screening protocol for T 21.PNT,NBL,and the PNT:NBL ratio are more specific markers for Down syndrome than those used in previous studies.展开更多
Objective To identify risk factors contributing to prolonged postoperative length of stay(LOS)in very elderly patients following hip fracture surgery,with a focus on postoperative complications and the impact of diffe...Objective To identify risk factors contributing to prolonged postoperative length of stay(LOS)in very elderly patients following hip fracture surgery,with a focus on postoperative complications and the impact of different anesthesia approaches.Methods This retrospective single-center cohort study enrolled patients aged 90 years or older who underwent hip fracture surgery at Peking Union Medical College Hospital between January 31,2013 and December 31,2023.Relevant perioperative data were collected.The primary outcome was postoperative LOS,and the study cohort was divided into two groups:postoperative LOS≤7 days and LOS>7 days.Logistic regression was performed to identify factors related to prolonged postoperative LOS.Results A total of 155 patients were included.The average age was 92.7±2.6 years.There were 73(47%)patients with postoperative LOS>7 days.Postoperative pneumonia was the only factor associated with a prolonged postoperative LOS(OR=2.12,95%CI[1.09,4.16],P=0.028).Neither the type of anesthesia(regional vs.general anesthesia,OR=1.00,95%CI[0.53,1.90],P=0.993)nor the method of airway management(laryngeal mask ventilation vs.spontaneous breathing,OR=1.46,95%CI[0.58,3.76],P=0.424;endotracheal intubation vs.spontaneous breathing,OR=0.82,95%CI[0.39,1.69],P=0.592)showed a significant association with a prolonged postoperative LOS.Preoperative chronic obstructive pulmonary disease(OR=2.78,95%CI[1.05,7.65],P=0.040)and preoperative neutrophil count(OR=1.13,95%CI[1.01,1.26],P=0.029)were both significantly associated with the occurrence of postoperative pneumonia,while anesthesia type and airway management method were not.Conclusions Postoperative pneumonia was associated with prolonged postoperative LOS in very elderly patients undergoing hip fracture surgery,whereas anesthesia types and airway management methods show no association with prolonged postoperative LOS or postoperative pneumonia.Preoperative comorbidities,especially respiratory conditions and systemic inflammation,potentially play a substantial role in postoperative recovery.展开更多
AIM:To assess the corneal biometric parameters and endothelial cell characteristics in microcornea patients,and exploring their correlations.METHODS:This cross-sectional study included 28 patients of microcornea with ...AIM:To assess the corneal biometric parameters and endothelial cell characteristics in microcornea patients,and exploring their correlations.METHODS:This cross-sectional study included 28 patients of microcornea with uveal coloboma(MCUC),13 patients of microcornea without coloboma(MCNC),and 30 age-matched healthy individuals(the control group).Corneal biometric parameters such as axial length(AL),anterior chamber depth(ACD),and white-to-white corneal diameter(WTW)were measured using the IOL Master.The corneal endothelial cell density(ECD),percentage of hexagonal cells(6A),average cell area(AVE),maximum cell area(MAX),minimum cell area(MIN),cell area standard deviation(SD),and coefficient of variation(CV)were collected by specular microscopy.RESULTS:This study included MCUC and MCNC patients with age-and sex-matched controls.All patients exhibited significantly reduced WTW(MCUC:8.51±0.71 mm;MCNC:9.08±0.42 mm)and worse logMAR BCVA(MCUC 0.62±0.43;MCNC 0.46±0.28)compared to controls(both P<0.001).The ECD was 3106.32±336.80 cells/mm²in the MCUC group and 2906.92±323.53 cells/mm²in the MCNC group,both significantly higher than the control group(2647.43±203.06 cells/mm²,P<0.05).In contrast,the CV,AVE,SD,and ACD in the MCUC and MCNC groups were significantly lower compared to controls(P<0.01).In patients with microcornea,the WTW was negatively correlated with the ECD and 6A,but positively with the CV,MAX,AVE,and SD.The ACD was negatively linked to the ECD,but positively to the AVE.CONCLUSION:The corneal ECD and 6A are increased,while the CV is decreased in patients with microcornea,particularly in those accompanied by uveal coloboma.The ECD and morphology demonstrate close correlations with the WTW and ACD.展开更多
AIM:To investigate the relationship between preoperative corneal biomechanical properties and corneal tomographic properties in cataract patients.METHODS:The study consisted of 59 eyes of 30 participants who were diag...AIM:To investigate the relationship between preoperative corneal biomechanical properties and corneal tomographic properties in cataract patients.METHODS:The study consisted of 59 eyes of 30 participants who were diagnosed as cataract in Peking University Third Hospital between September 2019 and November 2019.Stepwise multivariable linear regression analysis was calculated to determine the relationship between corneal biomechanical parameters and tomographic parameters.The patients were classified into three groups of with the rule(WTR)astigmatism,against the rule astigmatism and oblique astigmatism.And the differences in corneal parameters among different groups were compared.RESULTS:There were significant differences in the first applanation time(A1T),the first applanation length(A1L),corneal velocity during the first applanation(Vin),the second applanation time(A2T),highest concavity(HC)radius,displacement amount(DA),DA ratio,stiffness parameter A1(SPA1)and integrated radius(IR)between oblique astigmatism patients and the other two groups.Total corneal steep meridian(K2)was negatively associated with A1L,A1T and corneal velocity during the second applanation(Vout).Patients with higher anterior corneal curvature had lower HC radius and central corneal thickness(CCT;P=0.001 and 0.006,respectively),while the Ambrosio relational thickness to the horizontal profile(ARTh)was higher than those with lower anterior corneal curvature(P=0.009).CONCLUSION:The study reveals that the elasticity of corneal collagen fibers is greater,but the viscoelasticity of cornea is smaller in patients with oblique astigmatism.There is no significant difference in ARTh between patients with different types of astigmatism,that is,the corneal biomechanical specificity of oblique astigmatism group is probably not caused by corneal thickness.Moreover,we find patients with higher anterior corneal curvature has lower HC radius and CCT but higher ARTh than those with lower anterior corneal curvature.展开更多
AIM:To evaluate changes in corneal light scattering and anterior segment parameters in newly diagnosed rheumatoid arthritis(RA)patients who achieved remission with systemic treatment,compared to healthy controls.METHO...AIM:To evaluate changes in corneal light scattering and anterior segment parameters in newly diagnosed rheumatoid arthritis(RA)patients who achieved remission with systemic treatment,compared to healthy controls.METHODS:A cross-sectional study was conducted at a tertiary care hospital,in ophthalmology,and rheumatology departments.A total of 42 RA patients(13 men and 29 women)and 56 healthy individuals(23 men 33 women)underwent comprehensive ophthalmologic evaluations,including Scheimpflug corneal densitometry and Pentacam HR measurements.Those who initiated systemic treatment for RA were monitored at first,third,and sixth-month follow-ups.Participants who achieved remission at each follow-up assessment were included.RESULTS:Significant differences in corneal densitometry were observed,with higher values in RA patients,particularly in the middle and posterior layers.Anterior segment parameters such as anterior chamber volume and angle were significantly reduced in RA patients compared to other groups(P<0.001).Following systemic treatment and achievement of remission,these parameters showed regression toward normal values.CONCLUSION:The study underscores the potential utility of corneal densitometry and anterior segment analysis as sensitive indicators of subclinical ocular involvement in RA,offering insights into disease progression and treatment efficacy.These findings highlight the importance of early detection and regular monitoring in preventing vision-threatening complications in RA patients.展开更多
Dear Editor,Recurrent corneal erosion(RCE)is a common clinical condition characterized by repeated episodes of eye redness,pain,foreign-body sensation,photophobia,and tearing[1].The causes of RCE include trauma,chemic...Dear Editor,Recurrent corneal erosion(RCE)is a common clinical condition characterized by repeated episodes of eye redness,pain,foreign-body sensation,photophobia,and tearing[1].The causes of RCE include trauma,chemical and thermal injuries,previous herpetic keratitis,epithelial basement membrane dystrophy,and systemic conditions like epidermolysis bullosa[2-3].展开更多
AIM:To investigate the clinical signs of blepharokeratoconjunctivitis(BKC)and evaluate the efficacy of penetrating keratoplasty(PKP)for the disease.METHODS:Sixteen patients(16 eyes)with BKC complicated by corneal perf...AIM:To investigate the clinical signs of blepharokeratoconjunctivitis(BKC)and evaluate the efficacy of penetrating keratoplasty(PKP)for the disease.METHODS:Sixteen patients(16 eyes)with BKC complicated by corneal perforation hospitalised at Shandong Eye Hospital were retrospectively analyzed.All patients received PKP.Participants were assessed for symptoms,clinical manifestations,the activity and damage grading of BKC.A paired t-test was used to compare the uncorrected visual acuity(UCVA)before and after surgery for the perforated eye.RESULTS:The mean age of the patients was 16.3y.Blurred vision is the most common discomfort,followed by redness,and then photophobia.The duration of ocular discomfort lasted for 3.2y,on average.Three(18.8%)participants were associated with rosacea,while 11(68.8%)patients had recurrent chalazion or hordeolum.Demodex in eyelash follicles was positive in 11(68.8%)cases.All corneal perforations were≤3.0 mm in diameter.The perforation was located mainly in the inferior cornea(68.8%).The mean area of corneal vascularisation was 3.0 quadrants.All patients manifested bilateral BKC,with the perforated eyes ranked as severely damaged and presenting with severe inflammation.Most contralateral eyes manifested mild damage with no active inflammation.Majority(68.8%)of the perforated eyes were treated with PKP using a minimal graft.The UCVA increased significantly at the final follow-up(mean,21mo;P<0.001),with the manifestation of BKC alleviated greatly.None of the patients developed immune rejection or other serious complications.CONCLUSION:BKC combined with corneal perforation occurs mainly among young people with a long history of ocular discomfort.PKP,especially using a minimal graft,is an effective and safe option for treating the disease.展开更多
Introduction Fuchs endothelial corneal dystrophy(FECD)is an inherited,degenerative disease of the corneal endothelial cells(CECs).It is characterized by a progressive deterioration of endothelial cells,altered extrace...Introduction Fuchs endothelial corneal dystrophy(FECD)is an inherited,degenerative disease of the corneal endothelial cells(CECs).It is characterized by a progressive deterioration of endothelial cells,altered extracellular matrix(ECM)production,and development of guttae(1,2).The presence of guttae has been shown to significantly impair corneal endothelial function,leading to corneal oedema and visual impairment.展开更多
AIM:To assess the visual outcomes and corneal biomechanical properties of myopia patients between laser in situ keratomileusis(LASIK)and LASIK combined with accelerated corneal crosslinking(LASIK Xtra).METHODS:This pr...AIM:To assess the visual outcomes and corneal biomechanical properties of myopia patients between laser in situ keratomileusis(LASIK)and LASIK combined with accelerated corneal crosslinking(LASIK Xtra).METHODS:This prospective study analyzed 52 consecutive myopia patients treated with LASIK Xtra and 45 consecutive myopia patients treated with LASIK.Only the right eyes in the two groups were analyzed.The uncorrected distance visual acuity(UDVA),keratometry values,postoperative central corneal thickness(CCT),corneal demarcation line depth,the corneal compensated intraocular pressure(IOPcc),Goldmann-correlated IOP(IOPg),corneal resistance factor(CRF)and corneal hysteresis(CH)from Ocular Response Analyzer(ORA)were analyzed.Further,the correlation between the demarcation line depth and ORA-related biomechanical parameters were analyzed.RESULTS:No significant differences in UDVA,postoperative CCT,or mean K values were found between the 2 groups at 1 to 12mo postoperative follow-up(all P>0.05).The changes of CRF was significantly lower in the LASIK Xtra group compared to the LASIK group(all P<0.05)at all the postoperative visits.The changes of CH were significantly higher in the LASIK Xtra group(all P<0.05).No significant differences were discovered regarding the changes of IOPcc and IOPg posperatively(all P>0.05).Out of 52 cases in the LASIK Xtra group,the demarcation line was present in 40 eyes(77%).The average depth of the demarcation was 220.73±42.70μm(136 to 288μm).No significant correlation was observed between the depth of the demarcation line and any of the ORA-related biomechanical parameters such as IOPcc,IOPg,CRF and CH at 12mo(all P>0.05).CONCLUSION:Both procedures demonstrate comparable outcomes in terms of visual acuity,refraction and ablation predictability.This study confirms that corneal biomechanical properties of the included patients weakened after both procedures,but the cornea after LASIK Xtra are stiffer than conventional LASIK.展开更多
Background:Besides seizures,a myriad of overlapping neuropsychiatric and cognitive comorbidities occur in patients with epilepsy,which further debilitates their quality of life.This study provides an in-depth characte...Background:Besides seizures,a myriad of overlapping neuropsychiatric and cognitive comorbidities occur in patients with epilepsy,which further debilitates their quality of life.This study provides an in-depth characterization of the impact of brivaracetam and rufinamide individually and in combination at 10 and 20 mg/kg doses,respec-tively,on corneal kindling-induced generalized seizures and behavioral alterations.Furthermore,observed convulsive frequency and behavioral changes were corre-lated to post-kindling-induced changes in the activity of markers of oxidative stress.Methods:Adult C57BL/6 mice were kindled via twice-daily transcorneal 50-Hz elec-trical stimulations(3 mA)for 3 s for 12 days until animals reached a fully kindled state.After the kindling procedure,animals were tested using a set of behavioral tests,and neurochemical alterations were assessed.Results:Corneal-kindled animals exhibited intense generalized convulsions,altered behavioral phenotypes typified by positive symptoms(hyperlocomotion),negative symptoms(anxiety and anhedonia),and deficits in semantic and working memory.BRV 10+RFM 20 dual regime increased convulsive threshold and propensity toward the start of stage 4–5 seizures and improved phenotypical deficits,that is,anxiety,depression,and memory impairments.Moreover,this combination therapy mitigated kindling-induced redox impairments as evidenced by reduced malondialdehyde and acetylcholinesterase levels and increased glutathione antioxidant activity in the brain of animals subjected to repetitive brain insult.Conclusion:Based on our outcomes,this dual therapy provides supporting evidence in alleviating epilepsy-induced neurobehavioral comorbidities and changes in redox homeostasis.展开更多
基金Supported by the National Natural Science Foundation of China(No.81371040)Shanghai Smart Medical Special Research Project(No.2018ZHYL0221)+1 种基金Shanghai Municipal Education Commission-Gaofeng Clinical Medicine Grant Support(No.20181810)the Science and Technology Commission of Shanghai(No.17DZ2260100)
文摘AIM: To measure and analysis axial length(AL)/corneal radius of curvature(CRC) ratio and other refractive parameters, provide a medical reference range for refractive development evaluation and earlier visual impairment screening of 3 to 4 y kindergarten students.METHODS: Between April and June 2017, a total of 4350 participants aged 3-to 4-year-old(8700 eyes) from 10 cluster random sampling kindergartens in Shanghai, Pudong District were involved. According to the measurement and analysis of the unaided visual acuity(VA), AL, CRC, AL/CRC ratio, astigmatism and other refractive parameters, the data distribution and reference range were obtained.RESULTS: Uncorrected VA of examined children was 0.23±0.08(logMAR, mean±SD) [95% confidence interval(CI) range ≤0.36];AL was 22.10±0.79 mm(95%CI 20.55-23.65);CRC was 7.86±0.26 mm(95%CI, 7.35-8.37);AL/CRC ratio was 2.81±0.12(95%CI, 2.57-3.05). The median of astigmatism was-0.5 D, a total of 56.3% had astigmatism <-0.50 D, 85.3%<-1.00 D, 6.7%>-1.50 D;71% were astigmatism with the rule. Eye-specific analyses were conducted. Statistical difference of VA was in right and left eyes. There were no significant differences between two eyes of AL, CRC, AL/CRC ratio and astigmatism(P>0.05).CONCLUSION: VA and AL/CRC ratio reference could be used to assess refractive development in children and screening uncorrected refractive errors or amblyopia. Astigmatism needs to be considered in the diagnosis.
基金Chongqing Fuling District Science and Health Joint Medical Research Project(2022KWLH069)。
文摘Objective:To investigate the influence of axial length(AL),corneal curvature(CR),and the ratio of axial length to corneal radius of curvature(AL/CR)on myopia in children,and to evaluate the accuracy and specificity of AL/CR in diagnosing myopia in children.Methods:A cross-sectional study was conducted.A total of 200 children(400 eyes)aged 6-12 years were recruited from the ophthalmology outpatient clinic of Fuling District People’s Hospital from December 2022 to December 2023.AL,CR,and AL/CR were measured,and comprehensive optometry was performed under cycloplegia,with the results recorded in spherical equivalent(SE)form.Results:A total of 200 subjects(400 eyes)were included in this study,of which 330 eyes(82.50%)were myopic.No significant differences in CR were observed among different refractive groups,while significant differences were noted in SE,AL,and AL/CR.The AL and AL/CR ratios were higher in myopic eyes compared to emmetropic and hyperopic eyes.Using cycloplegia as the gold standard,SE in the myopia group was correlated with AL,AL/CR,and CR,with stronger correlations observed with AL and AL/CR.An AL/CR value>3 demonstrated a sensitivity of 0.918,specificity of 0.786,misdiagnosis rate of 0.214,missed diagnosis rate of 0.082,and accuracy of 89.5%in diagnosing myopia.Conclusion:AL and AL/CR values are highly correlated with SE,with the strongest correlation observed in the myopia group.The AL/CR value exhibits high diagnostic value in determining myopia in children.
基金Supported by the National Natural Science Foundation of China(No.82070942,No.81970780,No.81770907,No.81670835).
文摘AIM:To characterize the distribution of persistent fetal vasculature(PFV)subtypes and to evaluate corneal astigmatism(CA)in children with unilateral PFV.METHODS:The medical records of patients diagnosed with PFV between January 2014 and August 2021 were retrospectively reviewed.Corneal keratometry parameters were measured using IOLMaster or a handheld keratometer.Differences in CA between the affected and fellow eyes were analyzed in 52 unilateral PFV patients with available examination data.RESULTS:Totally 133 patients diagnosed with PFV were retrospectively reviewed.The male-to-female ratio was 73/60.Median age at surgery was 38.03mo(interquartile range 58.27mo).Among the PFV patients,32(24.06%)had anterior PFV,2(1.50%)had posterior PFV,and 99(74.44%)had combined anterior-posterior PFV.Mild combined PFV was the most common subtype.In unilateral PFV cases,the mean CA in the affected eye was 2.29±1.11 D,and 59.62%(31 eyes)had CA≥2.0 D.The mean CA in the affected eyes was significantly higher than in the fellow eyes(1.37±0.77 D;P<0.001).Among PFV-affected eyes with CA≥2.0 D,the steepest corneal meridian was vertically oriented in 30 cases(96.77%),while only 1 case(3.23%)had the steepest meridian oriented horizontally.CONCLUSION:In children with unilateral PFV,CA is significantly higher in the affected eyes than in the fellow eyes,and the steepest corneal meridian was predominantly oriented vertically.
文摘The retrospective study by Edwar et al reinforces the role of therapeutic penetrating keratoplasty(PK)as a vital intervention in severe,treatment-resistant infectious keratitis.In advanced cases—often complicated by trauma,delayed presentation,and corneal perforation—PK restores globe integrity and provides limited visual recovery.However,its application is constrained by graft-related complications and donor shortages,particularly in low-resource settings.These limitations highlight the need for earlier,globe-sparing strategies to prevent progression and reduce surgical demand.Photoactivated chromophore for infectious keratitis-corneal collagen cross-linking(PACK-CXL)has emerged as a promising adjunct or alternative.With both antimicrobial and tissue-stabilizing effects,PACK-CXL may control infection and preserve corneal structure in earlier stages.A layered treatment framework that incorporates PACK-CXL as an initial intervention and reserves PK for refractory cases may help improve clinical outcomes.Further studies are needed to define their best use in practice.
基金supported by the Australian Research Council(Grant No.CE230100012)。
文摘The onset,cessation,and length of the rainy season are crucial for global water resources,agricultural practices,and food security.However,the response of precipitation seasonality to global warming remains uncertain.In this study,we analyze how global warming levels(GWLs)of 1.5℃ and 2℃ could affect the timing of rainfall onset(RODs),rainfall cessation(RCDs),and the overall duration of the rainy season(LRS)over global land monsoon(GLM)regions using simulations from CMIP6 under the SSP2-4.5 and SSP5-8.5 scenarios.With high model consensus,our results reveal that RODs are projected to occur later over Southern Africa,North Africa,and South America,but earlier over South Asia and Australia,in a warmer climate.The projected early RODs in Australia are more pronounced at the 2℃ GWL under SSP5-8.5.On the other hand,early RCDs are projected over South America and East Asia,while late RCDs are projected over North Africa,with high inter-model agreement.These changes are associated with a future decrease in LRS in most GLM regions.Additionally,we found that continuous warming over 1.5℃ will further reduce the length of the rainy season,especially over the South America,North Africa,and Southern Africa monsoon regions.The findings underscore the urgent need to mitigate global warming.
文摘Purpose: To examine the influence of central corneal thickness (CCT), corneal curvature (CC), and axial length (AL) on intraocular pressure (IOP).Methods: Eighty-one clinically normal eyes were included in our study. The IOP, CCT, CC, AL were measured using a Goldmann applanation tonometer, optical pachymeter, keratometer and A-scan ultrasound biometer respectively in all subjects.Results: A highly significant positive correlation was identified between IOP and CCT. Linear regression analysis suggests that an increase in CCT of 0. 010 mm is associated with a 4. 946 mmHg increment in IOP. No significant positive correlation was identified between IOP and CC. P values are 0. 724 and 0.414 respectively for vertical and horizontal readings. A paradoxically reversed correlation was present between IOP and axial length.Conclusion: Corneal thickness is a very important confounding factor in the measurement of intraocular pressure, which warrants further attention in our clinical practice.
基金Supported by the National Natural Science Foundation of China(No.81770908)the Shanghai Science and Technology Commission(Scientific Innovation Project,No.20Y11911000)。
文摘AIM:To investigate whether the axial length(AL)/total corneal refractive power(TCRP)ratio is a sensitive and simple factor that can be used for the early diagnosis of Marfan’s syndrome(MFS)in children.METHODS:The relationship between the AL/TCRP ratio and the diagnosis of MFS for 192 eyes in 97 children were evaluate.The biological characteristics,including age,sex,AL,and TCRP,were collected from medical records.Receiver operating characteristic(ROC)curve analysis was performed to investigate whether the AL/TCRP ratio effectively distinguishes MFS from other subjects.The Youden index was used to re-divide the whole population into two groups according to an AL/TCRP ratio of 0.59.RESULTS:Of 96 subjects(mean age 7.46±3.28 y)evaluated,56(110 eyes)had a definite diagnosis of MFS in childhood based on the revised Ghent criteria,41(82 eyes)with diagnosis of congenital ectopia lentis(EL)were included as a control group.AL was negatively correlated with TCRP,with a linear regression coefficient of-0.36(R2=0.08).A significant correlation was found between age and the AL/TCRP ratio(P=0.023).ROC curve analysis showed that the AL/TCRP ratio distinguished MFS from the other patients at a threshold of 0.59.MFS patients were present in 24/58(41.38%)patients with an AL/TCRP ratio of≤0.59 and in 34/39(87.18%)patients with an AL/TCRP ratio of>0.59.CONCLUSION:An AL/TCRP ratio of>0.59 is significantly associated with the risk of MFS.The AL/TCRP ratio should be measured as a promising marker for the prognosis of children MFS.Changes in the AL/TCRP ratio should be monitored over time.
文摘Purpose: To evaluate axial length before and after the photorefractive keratectomy (PRK) and laser in situ keratomileusis (LASIK). Setting: Alhokama Eye Center, Riyadh Saudi Arabia. Design: A cross-sectional study. Methods: The study sample was comprised of 106 eyes of 54 patients. Patients were divided into 2 groups based on whether they had photorefractive surgery (PRK group) or laser in situ keratomiluesis (LASIK group). The intra-group comparison was performed of the changes in axial length before and after surgery using IOLMaster. P Results: There were 76 eyes (39 patients) in the PRK group with the mean age of 25.10 ± 3.47 years, the mean preoperative spherical equivalent of -3.16 ± 1.75 D, and the mean preoperative axial length of 24.79 ± 1.02 mm. In the LASIK group, there were 30 eyes (15 patients) with the mean age of 25.13 ± 4.91 years and the mean preoperative spherical equivalent of -5.58 ± 1.98 D and the mean preoperative axial length of 25.67 ± 1.35 mm. Postoperatively, the mean axial length was 24.70 ± 1.14 mm in the PRK group and 25.60 ± 1.33 mm in the LASIK group. The mean change between the preoperative and postoperative axial length was statically significant in both groups (P Conclusion: There was a statically significant decrease in the axial length measurements after PRK or LASIK for myopia.
文摘Diabetic corneal neuropathy and diabetic retinopathy are ocular complications occurring in the context of diabetes mellitus.Diabetic corneal neuropathy refers to the progressive damage of corneal nerves.Diabetic retinopathy has traditionally been considered as damage to the retinal microvasculature.However,growing evidence suggests that diabetic retinopathy is a complex neurovascular disorder resulting from dysfunction of the neurovascular unit,which includes both the retinal vascular structures and neural tissues.Diabetic retinopathy is one of the leading causes of blindness and is frequently screened for as part of diabetic ocular screening.However,diabetic corneal neuropathy is commonly overlooked and underdiagnosed,leading to severe ocular surface impairment.Several studies have found that these two conditions tend to occur together,and they share similarities in their pathogenesis pathways,being triggered by a status of chronic hyperglycemia.This review aims to discuss the interconnection between diabetic corneal neuropathy and diabetic retinopathy,whether diabetic corneal neuropathy precedes diabetic retinopathy,as well as the relation between the stage of diabetic retinopathy and the severity of corneal neuropathy.We also endeavor to explore the relevance of a corneal screening in diabetic eyes and the possibility of using corneal nerve measurements to monitor the progression of diabetic retinopathy.
文摘BACKGROUND Corneal ulcers are a major cause of visual impairment in developing countries.In Indonesia,severe infective ulcers often require keratoplasty(KP)to preserve ocular integrity and improve outcomes.AIM To determine demographic,clinical and microbiological characteristics,complications,and KP outcomes in patients with moderate to severe infective corneal ulcers.METHODS A retrospective review was conducted on patients with moderate to severe infective corneal ulcers who underwent KP between January 1,2018 and December 31,2020,with a minimum follow-up period of 3 weeks at the Ocular Infection and Immunology clinic of a tertiary referral hospital in Jakarta.Data were extracted from medical records.RESULTS A total of 99 eyes from 99 patients with a mean age of 41.7±16.2 years were included.Eight-nine eyes of corneal cases were located at the central cornea with>6 mm lesion size(forty-one eyes).The culture positivity rate was 33%,primarily composed of Staphylococcus epidermidis.Eyeball integrity was maintained in all patients.Mean uncorrected visual acuity(VA)before KP was 2.50 and improved to 2.04 after 3 months of follow-up.Twenty patients with a cornea that was kept transparent achieved a VA of 0.40.Complications after KP appeared in 60 eyes,while secondary glaucoma was the most common complication(28 eyes),followed by graft failure(24 eyes)and graft rejection(14 eyes).CONCLUSION Corneal ulcers are a common problem in Indonesia following eye trauma.Therapeutic and tectonic KP can preserve the integrity of the eyeball in moderate to severe cases,although complications are common.
文摘Background:It is found to have association of facial parameters with trisomy 21 fetuses(T 21).We have compared prenasal thickness(PNT),nasal bone length(NBL),and the PNT:NBL ratio of normal fetuses with fetuses with trisomy 21(T 21)between 16 and 25 weeks of gestation as a diagnostic tool for T 21.Methods:Facial profile images in the two dimensional(2D)gray scale were assessed to measure fetal NBL and PNT between 16 and 25 weeks of gestation.The PNT:NBL ratio of the fetuses was calculated.Nomograms were constructed from the data of morphologically normal fetuses at live birth.The PNT,NBL,and PNT:NBL ratio of fetuses with confirmed T 21(n=31)and morphologically normal fetuses at live birth(controls,n=3485)were compared.Results:Nomograms for PNT,NBL,and the PNT:NBL ratio were constructed.In T 21 fetuses,PNT(>95th percentile),NBL(<5th percentile),and the PNT:NBL ratio(>95th percentile)showed a sensitivity of 25%,29%,and 45%for PNT,NBL,and PNT:NBL,respectively,and specificity of 95%,96%,and 94%,for PNT,NBL,and PNT:NBL,respectively.All of these markers showed a negative predictive value of 99%.Conclusion:PNT,NBL,and the PNT:NBL ratio have high diagnostic value for fetuses with Down syndrome and can be incorporated easily in the current second trimester screening protocol for T 21.PNT,NBL,and the PNT:NBL ratio are more specific markers for Down syndrome than those used in previous studies.
文摘Objective To identify risk factors contributing to prolonged postoperative length of stay(LOS)in very elderly patients following hip fracture surgery,with a focus on postoperative complications and the impact of different anesthesia approaches.Methods This retrospective single-center cohort study enrolled patients aged 90 years or older who underwent hip fracture surgery at Peking Union Medical College Hospital between January 31,2013 and December 31,2023.Relevant perioperative data were collected.The primary outcome was postoperative LOS,and the study cohort was divided into two groups:postoperative LOS≤7 days and LOS>7 days.Logistic regression was performed to identify factors related to prolonged postoperative LOS.Results A total of 155 patients were included.The average age was 92.7±2.6 years.There were 73(47%)patients with postoperative LOS>7 days.Postoperative pneumonia was the only factor associated with a prolonged postoperative LOS(OR=2.12,95%CI[1.09,4.16],P=0.028).Neither the type of anesthesia(regional vs.general anesthesia,OR=1.00,95%CI[0.53,1.90],P=0.993)nor the method of airway management(laryngeal mask ventilation vs.spontaneous breathing,OR=1.46,95%CI[0.58,3.76],P=0.424;endotracheal intubation vs.spontaneous breathing,OR=0.82,95%CI[0.39,1.69],P=0.592)showed a significant association with a prolonged postoperative LOS.Preoperative chronic obstructive pulmonary disease(OR=2.78,95%CI[1.05,7.65],P=0.040)and preoperative neutrophil count(OR=1.13,95%CI[1.01,1.26],P=0.029)were both significantly associated with the occurrence of postoperative pneumonia,while anesthesia type and airway management method were not.Conclusions Postoperative pneumonia was associated with prolonged postoperative LOS in very elderly patients undergoing hip fracture surgery,whereas anesthesia types and airway management methods show no association with prolonged postoperative LOS or postoperative pneumonia.Preoperative comorbidities,especially respiratory conditions and systemic inflammation,potentially play a substantial role in postoperative recovery.
基金Supported by the National Natural Science Foundation of China(No.82271052No.82201154)+2 种基金Shandong Provincial Key Research and Development Program(No.2024CXGC010617)Taishan Scholar Program(No.tstp20240858)Educational and Teaching Reform Research Project of Shandong First Medical University(No.XM2024001).
文摘AIM:To assess the corneal biometric parameters and endothelial cell characteristics in microcornea patients,and exploring their correlations.METHODS:This cross-sectional study included 28 patients of microcornea with uveal coloboma(MCUC),13 patients of microcornea without coloboma(MCNC),and 30 age-matched healthy individuals(the control group).Corneal biometric parameters such as axial length(AL),anterior chamber depth(ACD),and white-to-white corneal diameter(WTW)were measured using the IOL Master.The corneal endothelial cell density(ECD),percentage of hexagonal cells(6A),average cell area(AVE),maximum cell area(MAX),minimum cell area(MIN),cell area standard deviation(SD),and coefficient of variation(CV)were collected by specular microscopy.RESULTS:This study included MCUC and MCNC patients with age-and sex-matched controls.All patients exhibited significantly reduced WTW(MCUC:8.51±0.71 mm;MCNC:9.08±0.42 mm)and worse logMAR BCVA(MCUC 0.62±0.43;MCNC 0.46±0.28)compared to controls(both P<0.001).The ECD was 3106.32±336.80 cells/mm²in the MCUC group and 2906.92±323.53 cells/mm²in the MCNC group,both significantly higher than the control group(2647.43±203.06 cells/mm²,P<0.05).In contrast,the CV,AVE,SD,and ACD in the MCUC and MCNC groups were significantly lower compared to controls(P<0.01).In patients with microcornea,the WTW was negatively correlated with the ECD and 6A,but positively with the CV,MAX,AVE,and SD.The ACD was negatively linked to the ECD,but positively to the AVE.CONCLUSION:The corneal ECD and 6A are increased,while the CV is decreased in patients with microcornea,particularly in those accompanied by uveal coloboma.The ECD and morphology demonstrate close correlations with the WTW and ACD.
基金Supported by China Primary Health Care Foundation(No.MTP2022C025)Beijing Natural Science Foundation of China(No.7242168).
文摘AIM:To investigate the relationship between preoperative corneal biomechanical properties and corneal tomographic properties in cataract patients.METHODS:The study consisted of 59 eyes of 30 participants who were diagnosed as cataract in Peking University Third Hospital between September 2019 and November 2019.Stepwise multivariable linear regression analysis was calculated to determine the relationship between corneal biomechanical parameters and tomographic parameters.The patients were classified into three groups of with the rule(WTR)astigmatism,against the rule astigmatism and oblique astigmatism.And the differences in corneal parameters among different groups were compared.RESULTS:There were significant differences in the first applanation time(A1T),the first applanation length(A1L),corneal velocity during the first applanation(Vin),the second applanation time(A2T),highest concavity(HC)radius,displacement amount(DA),DA ratio,stiffness parameter A1(SPA1)and integrated radius(IR)between oblique astigmatism patients and the other two groups.Total corneal steep meridian(K2)was negatively associated with A1L,A1T and corneal velocity during the second applanation(Vout).Patients with higher anterior corneal curvature had lower HC radius and central corneal thickness(CCT;P=0.001 and 0.006,respectively),while the Ambrosio relational thickness to the horizontal profile(ARTh)was higher than those with lower anterior corneal curvature(P=0.009).CONCLUSION:The study reveals that the elasticity of corneal collagen fibers is greater,but the viscoelasticity of cornea is smaller in patients with oblique astigmatism.There is no significant difference in ARTh between patients with different types of astigmatism,that is,the corneal biomechanical specificity of oblique astigmatism group is probably not caused by corneal thickness.Moreover,we find patients with higher anterior corneal curvature has lower HC radius and CCT but higher ARTh than those with lower anterior corneal curvature.
文摘AIM:To evaluate changes in corneal light scattering and anterior segment parameters in newly diagnosed rheumatoid arthritis(RA)patients who achieved remission with systemic treatment,compared to healthy controls.METHODS:A cross-sectional study was conducted at a tertiary care hospital,in ophthalmology,and rheumatology departments.A total of 42 RA patients(13 men and 29 women)and 56 healthy individuals(23 men 33 women)underwent comprehensive ophthalmologic evaluations,including Scheimpflug corneal densitometry and Pentacam HR measurements.Those who initiated systemic treatment for RA were monitored at first,third,and sixth-month follow-ups.Participants who achieved remission at each follow-up assessment were included.RESULTS:Significant differences in corneal densitometry were observed,with higher values in RA patients,particularly in the middle and posterior layers.Anterior segment parameters such as anterior chamber volume and angle were significantly reduced in RA patients compared to other groups(P<0.001).Following systemic treatment and achievement of remission,these parameters showed regression toward normal values.CONCLUSION:The study underscores the potential utility of corneal densitometry and anterior segment analysis as sensitive indicators of subclinical ocular involvement in RA,offering insights into disease progression and treatment efficacy.These findings highlight the importance of early detection and regular monitoring in preventing vision-threatening complications in RA patients.
基金Supported by the National High-Level Hospital Clinical Research Funding(No.2022-PUMCH-A-198).
文摘Dear Editor,Recurrent corneal erosion(RCE)is a common clinical condition characterized by repeated episodes of eye redness,pain,foreign-body sensation,photophobia,and tearing[1].The causes of RCE include trauma,chemical and thermal injuries,previous herpetic keratitis,epithelial basement membrane dystrophy,and systemic conditions like epidermolysis bullosa[2-3].
基金Supported by Key Technology Research and Development Program of Shandong Province(No.2022CXGC010505)Natural Science Foundation of Shandong Province(No.ZR2019BH065)+1 种基金Taishan Scholars Program(No.20221110)the Innovation Project of Shandong Academy of Medical Sciences.
文摘AIM:To investigate the clinical signs of blepharokeratoconjunctivitis(BKC)and evaluate the efficacy of penetrating keratoplasty(PKP)for the disease.METHODS:Sixteen patients(16 eyes)with BKC complicated by corneal perforation hospitalised at Shandong Eye Hospital were retrospectively analyzed.All patients received PKP.Participants were assessed for symptoms,clinical manifestations,the activity and damage grading of BKC.A paired t-test was used to compare the uncorrected visual acuity(UCVA)before and after surgery for the perforated eye.RESULTS:The mean age of the patients was 16.3y.Blurred vision is the most common discomfort,followed by redness,and then photophobia.The duration of ocular discomfort lasted for 3.2y,on average.Three(18.8%)participants were associated with rosacea,while 11(68.8%)patients had recurrent chalazion or hordeolum.Demodex in eyelash follicles was positive in 11(68.8%)cases.All corneal perforations were≤3.0 mm in diameter.The perforation was located mainly in the inferior cornea(68.8%).The mean area of corneal vascularisation was 3.0 quadrants.All patients manifested bilateral BKC,with the perforated eyes ranked as severely damaged and presenting with severe inflammation.Most contralateral eyes manifested mild damage with no active inflammation.Majority(68.8%)of the perforated eyes were treated with PKP using a minimal graft.The UCVA increased significantly at the final follow-up(mean,21mo;P<0.001),with the manifestation of BKC alleviated greatly.None of the patients developed immune rejection or other serious complications.CONCLUSION:BKC combined with corneal perforation occurs mainly among young people with a long history of ocular discomfort.PKP,especially using a minimal graft,is an effective and safe option for treating the disease.
文摘Introduction Fuchs endothelial corneal dystrophy(FECD)is an inherited,degenerative disease of the corneal endothelial cells(CECs).It is characterized by a progressive deterioration of endothelial cells,altered extracellular matrix(ECM)production,and development of guttae(1,2).The presence of guttae has been shown to significantly impair corneal endothelial function,leading to corneal oedema and visual impairment.
基金Supported by Wu Jieping Medical Foundation(No.320.6750.2021-04-15).
文摘AIM:To assess the visual outcomes and corneal biomechanical properties of myopia patients between laser in situ keratomileusis(LASIK)and LASIK combined with accelerated corneal crosslinking(LASIK Xtra).METHODS:This prospective study analyzed 52 consecutive myopia patients treated with LASIK Xtra and 45 consecutive myopia patients treated with LASIK.Only the right eyes in the two groups were analyzed.The uncorrected distance visual acuity(UDVA),keratometry values,postoperative central corneal thickness(CCT),corneal demarcation line depth,the corneal compensated intraocular pressure(IOPcc),Goldmann-correlated IOP(IOPg),corneal resistance factor(CRF)and corneal hysteresis(CH)from Ocular Response Analyzer(ORA)were analyzed.Further,the correlation between the demarcation line depth and ORA-related biomechanical parameters were analyzed.RESULTS:No significant differences in UDVA,postoperative CCT,or mean K values were found between the 2 groups at 1 to 12mo postoperative follow-up(all P>0.05).The changes of CRF was significantly lower in the LASIK Xtra group compared to the LASIK group(all P<0.05)at all the postoperative visits.The changes of CH were significantly higher in the LASIK Xtra group(all P<0.05).No significant differences were discovered regarding the changes of IOPcc and IOPg posperatively(all P>0.05).Out of 52 cases in the LASIK Xtra group,the demarcation line was present in 40 eyes(77%).The average depth of the demarcation was 220.73±42.70μm(136 to 288μm).No significant correlation was observed between the depth of the demarcation line and any of the ORA-related biomechanical parameters such as IOPcc,IOPg,CRF and CH at 12mo(all P>0.05).CONCLUSION:Both procedures demonstrate comparable outcomes in terms of visual acuity,refraction and ablation predictability.This study confirms that corneal biomechanical properties of the included patients weakened after both procedures,but the cornea after LASIK Xtra are stiffer than conventional LASIK.
基金The authors extend their appreciation to the Distinguished Scientist Fellowship program at King Saud University,Riyadh,Saudi Arabia,for funding this work through Research Supporting Project Number RSP2024R131.
文摘Background:Besides seizures,a myriad of overlapping neuropsychiatric and cognitive comorbidities occur in patients with epilepsy,which further debilitates their quality of life.This study provides an in-depth characterization of the impact of brivaracetam and rufinamide individually and in combination at 10 and 20 mg/kg doses,respec-tively,on corneal kindling-induced generalized seizures and behavioral alterations.Furthermore,observed convulsive frequency and behavioral changes were corre-lated to post-kindling-induced changes in the activity of markers of oxidative stress.Methods:Adult C57BL/6 mice were kindled via twice-daily transcorneal 50-Hz elec-trical stimulations(3 mA)for 3 s for 12 days until animals reached a fully kindled state.After the kindling procedure,animals were tested using a set of behavioral tests,and neurochemical alterations were assessed.Results:Corneal-kindled animals exhibited intense generalized convulsions,altered behavioral phenotypes typified by positive symptoms(hyperlocomotion),negative symptoms(anxiety and anhedonia),and deficits in semantic and working memory.BRV 10+RFM 20 dual regime increased convulsive threshold and propensity toward the start of stage 4–5 seizures and improved phenotypical deficits,that is,anxiety,depression,and memory impairments.Moreover,this combination therapy mitigated kindling-induced redox impairments as evidenced by reduced malondialdehyde and acetylcholinesterase levels and increased glutathione antioxidant activity in the brain of animals subjected to repetitive brain insult.Conclusion:Based on our outcomes,this dual therapy provides supporting evidence in alleviating epilepsy-induced neurobehavioral comorbidities and changes in redox homeostasis.
