AIM:To investigate the impact of depression-like behavior on ocular surface homeostasis in a mouse model,with a focus on dry eye-like alterations.METHODS:Male C57BL/6J mice(10-12 weeks old)were randomly assigned to co...AIM:To investigate the impact of depression-like behavior on ocular surface homeostasis in a mouse model,with a focus on dry eye-like alterations.METHODS:Male C57BL/6J mice(10-12 weeks old)were randomly assigned to control or restraint stress(RS)groups.The RS group underwent three intermittent 24-hour restraint sessions to induce depressive-like behavior.Behavioral testing,tear secretion measurement,and corneal Oregon Green Dextran(OGD)staining were performed.Postmortem analyses included histological evaluation of lacrimal glands,goblet cell quantification using periodic acid-Schiff staining,and assessment of key inflammatory and apoptotic markers:interleukin(IL)-17,matrix metalloproteinases(MMP)-3,MMP-9,IL-13,interferon(IFN)-γ,and cleaved caspase-3 and-8.RESULTS:Repeated RS induced depression-like behavior and significant ocular surface changes.RStreated mice showed increased corneal OGD uptake and upregulation of gene/protein expression of IL-17,MMP-3,and MMP-9(P<0.05).Goblet cell density and IL-13 protein expression were reduced,while IFN-γprotein expression was elevated(P<0.05).Cleaved caspase-3 and-8 levels were significantly increased in both cornea and conjunctiva.Tear volume and lacrimal gland size were unchanged;however,mild inflammatory infiltration was observed in lacrimal glands.CONCLUSION:Repeated RS leads to ocular surface inflammation and dry eye-like pathology,including corneal barrier disruption,goblet cell loss,and epithelial apoptosis.These findings suggest that depression contributes to the pathogenesis of dry eye disease via immune-mediated mechanisms.展开更多
BACKGROUND Dry eye disease(DED)is a multifactorial ocular surface disorder with rising prevalence.It is closely related to systemic health and psychological factors,such as sleep and mood disorders,which significantly...BACKGROUND Dry eye disease(DED)is a multifactorial ocular surface disorder with rising prevalence.It is closely related to systemic health and psychological factors,such as sleep and mood disorders,which significantly impact the quality of life of patients.AIM To explore the correlations between ocular surface function,sleep quality,and anxiety/depression in patients with DED.METHODS This was a cross-sectional investigative study that included 358 patients with DED between January 2022 and January 2025.Ocular surface was assessed using the ocular surface disease index(OSDI),tear film break-up time,fluorescein staining score,and Schirmer I test.The Pittsburgh Sleep Quality Index(PSQI),Self-Rating Anxiety Scale(SAS),and Self-Rating Depression Scale(SDS)were used to evaluate sleep quality and anxiety/depression levels.Correlation and linear regression analyses were used to explore the relationships.RESULTS The mean PSQI score of the patients was 9.94±2.18;the mean SAS score was 47.30±4.90,and the mean SDS score was 50.08±5.52.These suggested a prevalence of sleep and psychological abnormalities.There was a significant correlation between the indicators of ocular surface function(OSDI,tear film break-up time,fluorescein staining,and Schirmer I test)and PSQI,SAS,and SDS scores(P<0.05).Moreover,multiple regression revealed that age≥50 years(β=1.55,P=0.029),PSQI scores(β=0.58,P<0.001),SAS scores(β=0.17,P=0.017),and SDS scores(β=0.15,P=0.019)were independent predictors of the OSDI scores.CONCLUSION Ocular surface function in patients with DED is closely related to sleep quality and anxiety/depression,emphasizing the need for holistic clinical management.展开更多
AIM:To assess the possibility of using different large language models(LLMs)in ocular surface diseases by selecting five different LLMS to test their accuracy in answering specialized questions related to ocular surfa...AIM:To assess the possibility of using different large language models(LLMs)in ocular surface diseases by selecting five different LLMS to test their accuracy in answering specialized questions related to ocular surface diseases:ChatGPT-4,ChatGPT-3.5,Claude 2,PaLM2,and SenseNova.METHODS:A group of experienced ophthalmology professors were asked to develop a 100-question singlechoice question on ocular surface diseases designed to assess the performance of LLMs and human participants in answering ophthalmology specialty exam questions.The exam includes questions on the following topics:keratitis disease(20 questions),keratoconus,keratomalaciac,corneal dystrophy,corneal degeneration,erosive corneal ulcers,and corneal lesions associated with systemic diseases(20 questions),conjunctivitis disease(20 questions),trachoma,pterygoid and conjunctival tumor diseases(20 questions),and dry eye disease(20 questions).Then the total score of each LLMs and compared their mean score,mean correlation,variance,and confidence were calculated.RESULTS:GPT-4 exhibited the highest performance in terms of LLMs.Comparing the average scores of the LLMs group with the four human groups,chief physician,attending physician,regular trainee,and graduate student,it was found that except for ChatGPT-4,the total score of the rest of the LLMs is lower than that of the graduate student group,which had the lowest score in the human group.Both ChatGPT-4 and PaLM2 were more likely to give exact and correct answers,giving very little chance of an incorrect answer.ChatGPT-4 showed higher credibility when answering questions,with a success rate of 59%,but gave the wrong answer to the question 28% of the time.CONCLUSION:GPT-4 model exhibits excellent performance in both answer relevance and confidence.PaLM2 shows a positive correlation(up to 0.8)in terms of answer accuracy during the exam.In terms of answer confidence,PaLM2 is second only to GPT4 and surpasses Claude 2,SenseNova,and GPT-3.5.Despite the fact that ocular surface disease is a highly specialized discipline,GPT-4 still exhibits superior performance,suggesting that its potential and ability to be applied in this field is enormous,perhaps with the potential to be a valuable resource for medical students and clinicians in the future.展开更多
AIM:To investigate the ocular surface parameters in patients with moderate to high myopia.METHODS:This prospective study was conducted in May 2023,enrolling patients with moderate to high myopia(spherical equivalent r...AIM:To investigate the ocular surface parameters in patients with moderate to high myopia.METHODS:This prospective study was conducted in May 2023,enrolling patients with moderate to high myopia(spherical equivalent refraction≤-3.0 D).After completing the Ocular Surface Disease Index(OSDI)questionnaire,refractive parameters and non-invasive tear film parameters were measured,followed by the Schirmer I test and fluorescein sodium staining.The diagnosis of dry eye disease was based on OSDI score,non-invasive tear breakup time(NIBUT),Schirmer I test,and fluorescein sodium staining results,according to the 2020 Chinese Expert Consensus on Dry Eye.The Mann-Whitney U test was used to compare ocular surface parameters between moderate and high myopia,as well as between patients with and without dry eye.Pearson correlation analysis was employed to assess the relationship between the lipid/muco-aqueous layers and tear film parameters.A general linear mixed model(GLMM)was used to analyze the impact of refractive parameters on ocular surface parameters after adjusting for age and sex.RESULTS:A total of 35 eyes with moderate to high myopia(12 males;mean age,30.30±5.45y)were included in the study.Among them,26 eyes were classified as normal and 9 as dry eye.Of the 9 dry eye cases,7 were observed in the high myopia group(n=18)and 2 in the moderate myopia group(n=17).Among the enrolled patients,those with high myopia demonstrated significantly higher OSDI scores than those with moderate myopia(P=0.0417).Patients with dry eye exhibited significantly shorter interblink intervals(P=0.0081)and higher OSDI scores(P=0.0001)than those without dry eye.Pearson correlation analysis revealed a significant positive correlation between lipid layer thickness(LLT)and tear meniscus height(r=0.395,P=0.023),and a significant negative correlation between the muco-aqueous layer thickness change rate(MALTR)and OSDI score(r=-0.466,P=0.016).After adjusting for age and sex using the GLMM,spherical refraction(SPH,β=-1.802,P=0.048)and axial length(AL,β=2.784,P=0.048)significantly impacted OSDI score.Corneal front astigmatism significantly influenced Schirmer I test results(β=8.377,P=0.024).The difference between central corneal thickness and the thinnest corneal thickness significantly affected LLT(β=-2.294,P=0.026).White-to-white diameter significantly impacted MALTR(β=-81.758,P=0.037).CONCLUSION:In moderate to high myopia,higher SPH and AL correlate with increased dry eye symptoms,which are associated with muco-aqueous and lipid layer alterations.Corneal regularity and diameter also affect tear film dynamics.展开更多
Dry eye(DE),a multifactorial ocular surface disease,is predominantly characterized by inflammation as a central pathological factor.Ursolic acid(UA),a pentacyclic triterpenoid with well-documented anti-inflammatory pr...Dry eye(DE),a multifactorial ocular surface disease,is predominantly characterized by inflammation as a central pathological factor.Ursolic acid(UA),a pentacyclic triterpenoid with well-documented anti-inflammatory properties,was evaluated in this study for its therapeutic effects on ocular surface dysfunction associated with DE and its underlying mechanisms.A hyperosmotic stress model(500 mOsM)using human corneal epithelial cells(HCEs)and an animal model of DE was established to assess UA's protective effects on both cellular and organismal levels.Comprehensive assessments,including phenol-red cotton tests and slit-lamp examinations,were performed to evaluate ocular surface damage in the DE mouse model.Potential UA-related targets and their relevance to DE pathology were identified through database mining.Protein-protein interaction(PPI)network construction and pathway enrichment analysis using the Metascape platform highlighted core targets and signaling pathways.Molecular docking simulations using AutoDock and PyMOL further elucidated the interaction modes between UA and its targets.To validate the molecular mechanisms underlying UA's therapeutic effects,integrative analyses were conducted using single-cell sequencing data from the Single Cell Portal and RNA sequencing of tissue samples.The results demonstrated that UA eye drops significantly preserved ocular surface functional units and alleviated DE symptoms,through modulation of the epidermal growth factor receptor(EGFR)/rat sarcoma(RAS)/rapidly accelerated fibrosarcoma(RAF)/mitogen-activated protein kinase(MAPK)kinase 1(MAP2K1)/MAPK1 signaling pathway,as supported by network pharmacological analysis.Single-cell sequencing localized the distribution of key pathway proteins to the anterior ocular segment,particularly the cornea.In vivo experiments confirmed the therapeutic efficacy of UA eye drops via the EGFR/RAS/RAF/MAP2K1/MAPK1 pathway.Collectively,these findings underscore the potential of UA eye drops as a promising therapeutic approach for managing ocular surface disorders in DE.展开更多
BACKGROUND High-resolution optical coherence tomography(HR-OCT)has become an essential instrument in the screening and diagnosis of ocular surface neoplasms.Research demonstrates that HR-OCT possesses a diagnostic sen...BACKGROUND High-resolution optical coherence tomography(HR-OCT)has become an essential instrument in the screening and diagnosis of ocular surface neoplasms.Research demonstrates that HR-OCT possesses a diagnostic sensitivity ranging from 85%to 90%for ocular surface squamous neoplasia(OSSN).The connections between HR-OCT features and histological findings have consistently shown robustness,hence increasing the reliability of clinical diagnosis.AIM To examine the existing HR-OCT indicators employed in the identification of common non-benign ocular surface tumors,namely,basal cell carcinoma,OSSN,and melanocytic conjunctival lesions,and to assess their diagnostic efficacy,benefits,and prospective developments.METHODS A thorough literature review was performed to assess the published research on HR-OCT in the diagnosis of ocular surface cancers.Significant attention was given to research that compares HR-OCT characteristics with histopath-ologic validation,as well as on publications addressing the integration of emerging technologies and artificial intelligence in ocular oncology imaging.RESULTS HR-OCT exhibits elevated diagnostic sensitivity(85%-90%)for identifying OSSN and presents distinct imaging patterns that align closely with histology results.This approach has substantial clinical advantages due to its non-invasive characteristics,improved axial resolution,and real-time imaging capabilities.HR-OCT has demonstrated potential in assessing various lesions,including basal cell carcinoma and melanocytic conjunctival malignancies.CONCLUSION HR-OCT assumes an increasingly vital role in the early identification and clinical management of ocular surface malignancies.With advancements in imaging technology and the integration of artificial intelligence,HR-OCT is anticipated to enhance individualized diagnosis and treatment planning in ocular oncology,hence improving patient outcomes.展开更多
The occurrence and development of ocular surface diseases are closely related to oxidative stress.Excessive accumulation of reactive oxygen species(ROS)can lead to ocular surface cell damage and inflammatory responses...The occurrence and development of ocular surface diseases are closely related to oxidative stress.Excessive accumulation of reactive oxygen species(ROS)can lead to ocular surface cell damage and inflammatory responses.As a new type of antioxidant,hydrogen-rich water(HRW)has shown intervention potential in ocular surface diseases such as dry eye and conjunctivitis by selectively scavenging toxic ROS,inhibiting inflammatory pathways,and protecting ocular surface cells.Combining basic mechanisms and clinical evidence,this article explores the application value of hydrogen-rich water in ocular surface diseases,providing new ideas for the prevention and treatment of oxidative stress-related eye diseases.展开更多
Viral infections of the ocular surface significantly contribute to morbidity and visual impairment globally.The herpes simplex virus(HSV),adenovirus,cytomegalovirus(CMV),and human papillomavirus(HPV)are predominant pa...Viral infections of the ocular surface significantly contribute to morbidity and visual impairment globally.The herpes simplex virus(HSV),adenovirus,cytomegalovirus(CMV),and human papillomavirus(HPV)are predominant pathogens impacting the cornea and conjunctiva,resulting in recurrent illness,epidemic outbreaks,and virus-associated neoplasia.Progress in virology,immunology,and molecular diagnostics has enhanced comprehension of host–virus interactions and introduced novel therapeutic opportunities.A narrative literature review was performed utilizing PubMed,Scopus,and Web of Science,encompassing papers published from 2000 to 2025,with a specific focus on research from 2020 onwards.Eligible publications were peer-reviewed clinical and experimental investigations,together with reviews that focused on epidemiology,etiology,diagnostic methodologies,and therapeutic alternatives.Research indicates that HSV keratitis is the predominant infectious cause of corneal blindness in high-income nations,although adenovirus persists in instigating epidemics of keratoconjunctivitis in the absence of licensed antiviral treatments.CMV keratitis,previously confined to immunocompromised persons,is now acknowledged in immunocompetent patients as a causative agent of corneal endotheliitis.HPV is associated with ocular surface squamous neoplasia,especially in areas with elevated ultraviolet exposure and high human immunodeficiency virus prevalence.Innovative molecular diagnostics,innovative antiviral agents,immunomodulatory approaches,and immunization initiatives signify significant progress that could enhance preventative and therapeutic results.展开更多
AIM:To evaluate the demographics,clinical characteristics,treatments,and outcomes of patients with ocular surface squamous neoplasia(OSSN)at the Philippine General Hospital.METHODS:This was a single-center,11-year ret...AIM:To evaluate the demographics,clinical characteristics,treatments,and outcomes of patients with ocular surface squamous neoplasia(OSSN)at the Philippine General Hospital.METHODS:This was a single-center,11-year retrospective,cross sectional case series on 18 cases of OSSN seen between January 2012 to June 2023.The patient’s demographics,presenting symptoms,tumor characteristics,histopathologic diagnosis,treatment,outcomes,and duration of follow-up were reviewed.RESULTS:Out of 33 identified cases of OSSN,only 18 were eligible for inclusion in the study.Mean age was 60.78y(range 31 to 80),with male predominance(66.67%).The left eye was most commonly affected(61.11%)with most presenting with fleshy mass(83.33%).Most tumors were located nasally(66.67%)and were predominantly papilliform(44.44%)in morphology with associated hyperpigmentation(38.89%).Squamous cell carcinoma(SCCA)was the most common histopathologic diagnosis(72.22%).The main primary treatment was surgical excision(94.44%)with or without adjunctive therapy,with only 1 patient undergoing first-line topical chemotherapy.Only 3 recurrences(16.67%)were noted with a median followup of 7.5mo.A statistically significant recurrence-free odds leaning towards the utilization of cryotherapy was noted.CONCLUSION:OSSN seen at the Philippine General Hospital is presented as a limbal papilliform mass,most commonly affecting elderly males.Surgical excision with adjuvant cryotherapy and/or chemotherapy is the preferred mode of treatment.展开更多
Topical chemotherapy is increasingly used to treat ocular surface tumors as a primary therapy and an adjuvant treatment after surgical excision.The most employed topical agents include mitomycin C(MMC),5-fluorouracil(...Topical chemotherapy is increasingly used to treat ocular surface tumors as a primary therapy and an adjuvant treatment after surgical excision.The most employed topical agents include mitomycin C(MMC),5-fluorouracil(5-FU),and interferon alpha-2b(IFNα2b),each with distinctmechanisms of action,efficacy profiles,and toxicity risks.Although these agents offer effective tumor control and allow for a non-invasive approach in many cases,ocular surface complications requiring medical or surgical management can occur.This summarizes the adverse effect and outilines practical strategies for their prevention and treatment.MMC is the most potent agent but also the most toxic,with reported complications such as limbal stemcell deficiency,punctal stenosis,and persistent epithelial defects.5-FU demonstrates a more favorable safety profile,although rare cases of corneal ulceration have been described.IFNα2b is well tolerated and associated primarily with mild,reversible reactions.The choice of the proper agent should be tailored according to patient’s clinical presentation,ocular surface status,and ability to adhere to therapy and followup.Timely recognition and management of complications are essential to minimize long-term sequelae.Reliance on compounded formulations highlights the need for stable,standardized,and commercially available topical agents specifically designed for ocular use to ensure safety,reproducibility,and global accessibility.展开更多
AIM:To investigate the effects of a Chinese medicine formula“Qingxuan Runmu Yin”(QRY)on ocular surface inflammation in a rat model of dry eye,and its mechanism via the toll-like receptor 4(TLR4)/transforming growth ...AIM:To investigate the effects of a Chinese medicine formula“Qingxuan Runmu Yin”(QRY)on ocular surface inflammation in a rat model of dry eye,and its mechanism via the toll-like receptor 4(TLR4)/transforming growth factor kinase 1(TAK1)/p38 mitogen-activated protein kinase(p38MAPK)signaling pathway.METHODS:Seventy-two Sprague-Dawley rats were randomly divided into six groups(n=12 each):the control group,model group,3 groups of QRY(with low-,medium-,and high-doses),and SB203580 group.Dry eye was induced using benzalkonium chloride.Schirmer’s test(SIT)and corneal fluorescein staining(CFS)were performed every 14d throughout the experiment.Histopathological changes in corneal and conjunctival tissues were observed using hematoxylin and eosin(HE)and periodic acid-Schiff(PAS)staining.Protein expression levels of key inflammatory markers and signaling pathway targets were assessed via immunohistochemistry,ELISA,and Western blotting.RESULTS:Compared to the control group,the model group showed significant reductions in SIT and increases in CFS scores,alongside structural disorganization of corneal/conjunctival tissues,decreased conjunctival goblet cell(CGC)numbers,and elevated expression of inflammatory markers[interleukin(IL)-1β,IL-6,tumor necrosis factoralpha(TNF-α),matrix metalloproteinase-9(MMP9)]and pathway proteins(TLR4,p-TAK1,p-p38MAPK;P<0.05).Treatment with QRY(low,medium,and high doses)and SB203580 significantly improved SIT scores,reduced CFS scores,restored corneoconjunctival structure,increased CGC numbers,and decreased expression levels of IL-1β,IL-6,TNF-α,MMP9,TLR4,p-TAK1,and p-p38MAPK proteins compared to the model group(P<0.05).CONCLUSION:QRY may alleviate ocular surface inflammation associated with dry eye by inhibiting the TLR4/TAK1/p38MAPK signaling pathway,highlighting its potential therapeutic efficacy for dry eye.展开更多
AIM:To investigate the effects of estrogen replacement therapy (ERT) on apoptosis and vascular endothelial growth factor (VEGF) expression in ocular surface in an experimental rat model.· METHODS:Forty female,Wis...AIM:To investigate the effects of estrogen replacement therapy (ERT) on apoptosis and vascular endothelial growth factor (VEGF) expression in ocular surface in an experimental rat model.· METHODS:Forty female,Wistar rats were randomized in 4 groups in the study.Subcutaneous ERT (17β-estradiol,10g/kg/day) was administered to the first group without ovariectomy and to the second group with ovariectomy for three months.Third group had only ovariectomy and fourth group had sham operation.All rats were sacrificed in estrous cycles determined by vaginal smear test and their right eyes were enucleated at the end of the third month.Enucleated eyes were analyzed by immunohistochemical method for expressions of caspase-3,bcl-2,VEGF and TUNEL assay.· RESULTS:Caspase-3 expression of conjunctival epithelium was significantly higher in group 3 than group 1 (P =0.005),and group 2 (P =0.007).TUNEL score of conjunctival epithelium was significantly higher in group 3 than group 1 (P =0.006).TUNEL score of corneal epithelium was significantly higher in group 3 than group 2 (P =0.012),and group 4 (P =0.002).There was no significant difference between groups in that bcl-2 and VEGF expressions.· CONCLUSION:We determined increased apoptosis in ocular surface epithelial cells in ovariectomized rats.ERT and endogen estrogen decreased the apoptosis,and did not result in difference in VEGF expression between the groups.Estrogen may be beneficial for the treatment of apoptosis-mediated ocular surface disorders such as dry eye.Further studies are needed on this subject for a better understanding of the role of estrogen and to provide a new insight for treatment and prevention of apoptosis-mediated ocular surface disorders.展开更多
AIM: To detect and analyze the changes on ocular surface and tear function in type II diabetic patients with proliferative diabetic retinopathy(PDR), an advanced stage of diabetic retinopathy(DR), using conventional o...AIM: To detect and analyze the changes on ocular surface and tear function in type II diabetic patients with proliferative diabetic retinopathy(PDR), an advanced stage of diabetic retinopathy(DR), using conventional ophthalmic tests and the high-resolution laser scanning confocal microscopy.METHODS: Fifty-eight patients with type II diabetes were selected. Based on the diagnostic criteria and stage classification of DR, the patients were divided into the non-DR(NDR) group and the PDR group. Thirty-six patients with cataract but no other ocular and systemic disease were included as non-diabetic controls. All the patients were subjected to the conventional clinical tests of corneal sensitivity, Schirmer I test, and corneal fluorescein staining. The non-invasive tear film break-up time(NIBUT) and tear interferometry were conducted by a Tearscope Plus. The morphology of corneal epithelia and nerve fibers was examined using the high-resolution confocal microscopy.RESULTS: The NDR group exhibited significantly declined corneal sensitivity and Schirmer I test value, as compared to the non-diabetic controls(P 【0.001). The PDR group showed significantly reduced corneal sensitivity, Schirmer I test value, and NIBUT in comparison to the non-diabetic controls(P 【0.001).Corneal fluorescein staining revealed the progressively injured corneal epithelia in the PDR patients. Moreover,significant decrease in the corneal epithelial density andmorphological abnormalities in the corneal epithelia and nerve fibers were also observed in the PDR patients.CONCLUSION: Ocular surface changes, including blunted corneal sensitivity, reduced tear secretion, tear film dysfunction, progressive loss of corneal epithelia and degeneration of nerve fibers, are common in type II diabetic patients, particularly in the diabetic patients with PDR. The corneal sensitivity, fluorescein staining scores,and the density of corneal epithelial cells and nerve fibers in the diabetic patients correlate with the duration of diabetes. Therefore, ocular surface of the patients with PDR should be examined regularly by conventional approaches and confocal microscopy to facilitate early diagnosis and treatment of keratopathy.展开更多
AIM: To observe the changes in ocular surface and the dry eye symptoms following femtosecond laser-assisted cataract surgery(FLACS). METHODS: Patients with no eye signs or symptoms in Guangzhou Aier Eye Hospital betwe...AIM: To observe the changes in ocular surface and the dry eye symptoms following femtosecond laser-assisted cataract surgery(FLACS). METHODS: Patients with no eye signs or symptoms in Guangzhou Aier Eye Hospital between October 2017 and September 2018, who underwent FLACS and intraocular lens(IOL) implantation for age-related cataract were enrolled. Tear film stability assessed with OCULUS Keratograph 5 M, Schirmer’s I test(SIT), and corneal fluorescein staining(CFS) were evaluated before and after surgery at 1 d, 1 wk, 1, and 3 mo in order. Ocular Surface Disease Index scores(OSDI) and Subjective Symptom Questionnaires(SSQs) were recorded at the same time point.RESULTS: Thirty-eight eyes of 38 patients were enrolled. The noninvasive tear film break-up time(first break-up time and average break-up time) decreased in a peak at the 1 wk visit, and then increased to basic levels at 1 mo. The tear meniscus height(TMH) increased transiently at 1 d, and declined in the following 3 mo visits. The SIT had a transient increase at 1 d(P=0.357) and a decrease at 1 wk and 1 mo(both P<0.05) but returned to the preoperative levels at 3 mo after surgery(P=0.062). CFS scores were significantly improved compared with those before surgery, and had a statistical difference(P<0.05). OSDI scores and SSQs after surgery were obviously higher, and had a statistical difference(P<0.001) but didn’t return to the basic level by 3 mo. CONCLUSION: Dry eye signs and symptoms can occur immediately following FLACS and have a peak severity on day 7 postoperatively. Most signs of dry eye can return to preoperative basic levels within 3 mo postoperatively. However, all cases can not recover from CFS and dry eye symptoms at 3 mo postoperatively.展开更多
AIM： To investigate the association between ocular demodex folliculorum infestation and ocular surface manifestations in meibomian gland dysfunction（MGD）.METHODS： Eight-six patients with MGD were enrolled. All enr...AIM： To investigate the association between ocular demodex folliculorum infestation and ocular surface manifestations in meibomian gland dysfunction（MGD）.METHODS： Eight-six patients with MGD were enrolled. All enrolled subjects were tested in the following sequence： ocular surface disease index（OSDI）, slit-lamp biomicroscope examination, corneal surface regularity index（SRI） and surface asymmetry index（SAI）, tear fluid collection, fluorescein tear film break-up time（F-BUT）, corneal fluorescein staining（CFS）, Schirmer I test（SIT） and demodex folliculorum counting. Tear matrix metalloproteinase（MMP）-9 activity was assessed using MMP-9 activity assay kit.RESULTS： Among 86 MGD patients, 40 were positive for demodex. The ocular demodex-positive group showed significantly increased scores of OSDI（25.96±13.74 vs 18.07±11.55, P=0.01）, lid margin abnormality（2.38±0.87 vs 1.98±0.91, P=0.04） and CFS（1.28±2.00 vs 0.94±1.36, P=0.01） compared to the ocular demodex-free group. The tear MMP-9 activity was higher in the ocular demodex-positive group（102.9±32.4 ng/mL） than the ocular demodex-free group（46.2±19.2 ng/mL, P=0.03）. There was no significant difference in meibum quality and expressibility, SRI, SAI, F-BUT and SIT between the two groups（P〉0.05 for each）. No significant correlation was noted between the number of demodex and ocular surface parameters in demodexpositive MGD group（P〉0.05 for each）.CONCLUSION： Ocular demodex folliculorum infestation may be associated with ocular discomfort and ocular surface damage in MGD.展开更多
AIM: To examine the α-Gal gene expression and distribution in the different species/genus and developing phase animal ocular surface tissue.METHODS: α-Gal binding assay were carried out on various animal eye section...AIM: To examine the α-Gal gene expression and distribution in the different species/genus and developing phase animal ocular surface tissue.METHODS: α-Gal binding assay were carried out on various animal eye sections. Photograph, slit-lamp observation on various eye showed normal corneal transparence.RESULTS: A strong α-Gal expression in invertebrates and some vertebrates ocular tissue, but no α-Gal binding in birds, fish and mammal. α-Gal expression change in the development of mice ocular surface tissue (except sclera) and display genus dependency in the different murine ocular surface tissue.CONCLUSION: This study identified specific α-Gal epitopes binding area in the ocular surface of several species and may solve the problem that naive ocular surface may be used as natural α-Gal gene knockout model/high risk immunologic rejection model or ocular surface scaffold material.展开更多
AIM: To evaluate the risk factors leading to recurrence in patients with ocular surface squamous neoplasia(OSSN)METHODS: The records of 112 patients with OSSN who underwent treatment and follow-up between February 199...AIM: To evaluate the risk factors leading to recurrence in patients with ocular surface squamous neoplasia(OSSN)METHODS: The records of 112 patients with OSSN who underwent treatment and follow-up between February 1999 and August 2018 were reviewed retrospectively.RESULTS: Totally 67 patients(59.8%) were male and 45 patients(40.2%) were female. The mean age at presentation was 63.7 y(range 22-87 y). Partial lamellar scleroconjunctivectomy(PLSC) was performed in 105(93.7%) cases and enucleation was performed in 7(6.3%) cases due to bulbus invasion as the first step treatment. Treatments used in addition to PLSC included cryotherapy in 78 eyes(74.3%), alcohol epitheliectomy in 57 eyes(54.3%) for presence of corneal involvement, and amniotic membrane transplantation in 17 eyes(16.2%) for ocular surface reconstruction. Topical mitomycin C was used in 10 patients(9.5%) and strontium-90(Str-90) treatment in 4(3.8%) patients because surgical margins were tumor positive at the histopathological examination. Postoperative histopathologic diagnoses were squamous cell carcinoma(52 cases), carcinoma in situ(44 cases), moderate conjunctival intraepithelial neoplasia(11 cases), and mild conjunctiva intraepithelial neoplasia(5 cases). At a mean follow-up of 20.1 mo, tumor recurrence was observed in 21(18.8%) cases. The rate of recurrence was found to be lower in cases that underwent supplemental cryotherapy compared to those that did not(P<0.001). There was no metastasis in any case. CONCLUSION: In our series, the recurrence rate is 18.8% and overall globe salvage rate is 90.2% for OSSN at relatively short-term follow-up.展开更多
AIM： To investigate the early changes in dry eye symptoms, tear function and ocular surface following small-incision lenticule extraction（SMILE） for myopia.·METHODS： Ninety-seven consecutive patients（193 eye...AIM： To investigate the early changes in dry eye symptoms, tear function and ocular surface following small-incision lenticule extraction（SMILE） for myopia.·METHODS： Ninety-seven consecutive patients（193 eyes）who underwent SMILE for myopia were observed in this longitudinal and retrospective study. Parameters evaluated included： subjective dry eye symptoms（dryness, foreign body sensation and photophobia）, tear film breakup time（TBUT）, Schirmer Ⅰ test without anesthesia（S Ⅰ T）, tear meniscus height（TMH） and corneal fluorescein staining. Each parameter was evaluated before, and subsequently at 1d, 1wk, 1 and3 mo after surgery.·RESULTS： Compared with preoperative data, dryness was noted to be significantly increased at 1wk and 1mo postoperatively（P 〈0.01）. Symptoms of photophobia and foreign body sensation demonstrated significant differences at 1d and 1wk as compared with preoperative scores respectively（P 〈0.01）. These values were decreased at 1 and 3mo post-surgery（P 〉0.05）.Conversely the corneal staining scores were higher than the preoperative data at 1d, 1wk and 1mo（P 〈0.01）, but were close to the preoperative level at 3mo postoperatively. There was a significant decrease in TMH at 1wk and 1mo（P 〈0.01）, but the value was close to the preoperative level at 3mo postoperatively（P =0.16）. The examination outcomes of S Ⅰ T were significantly increased at 1d then reduced at 1wk after surgery（P 〈0.01）. Each value subsequently returned to the baseline value at 1 and 3mo（P 〉0.05）. TBUT was significantly decreased at all postoperative time points（P 〈0.01）.· CONCLUSION： SMILE resulted in mild dry eye symptoms, tear film instability and ocular surface damages; however, these complications can recover in a short period of time.展开更多
AIM: To assess and compare the impact of a daily disposable contact lens(CL) with high water content on the ocular surface and comfort of the presbyopic and nonpresbyopic population after one day of use. METHODS: Tota...AIM: To assess and compare the impact of a daily disposable contact lens(CL) with high water content on the ocular surface and comfort of the presbyopic and nonpresbyopic population after one day of use. METHODS: Totally 20 presbyopes and 30 non-presbyopes non-contact wearers were fitted with nesofilcon A CLs. CL thickness was measured to assess material stability during daily wear, and ocular surface parameters were also assessed. Optical quality was analyzed for all cases. In addition, CL comfort was rated.RESULTS: No significant differences were found in CL thickness, tear film osmolarity, average tear break-up time, bulbar redness, central corneal thickness, corneal volume, root-mean-square of higher-order aberrations(RMS of HOAs) and vertical and horizontal coma, either as a function of the group or time of use. A significant decrease in tear meniscus height and first break-up of the tear film was found in the presbyopic group(P=0.038; P=0.007 respectively). A decrease in spherical aberration coefficient was found after CL insertion(P=0.031 monofocal CL; P=0.023 low addition multifocal CL; P=0.016 high addition multifocal CL). Multifocal CL were thicker than monofocal CL(P=0.045). Comparison between groups showed more discomfort in presbyopes than non-presbyopes(P=0.003).CONCLUSION: This study evidence that the behavior of the daily disposable CL with high water content seems to be stable during the day of use. Ocular parameters measured during wear show that CL behavior is the same for presbyopes and non-presbyopes, being more uncomfortable for presbyopes.展开更多
AIM:To investigate the change of ocular surface and corneal nerve and their correlation in patients suffering from type 2 diabetes mellitus under different degrees of retinopathy.METHODS:Totally 129 type 2 diabetes me...AIM:To investigate the change of ocular surface and corneal nerve and their correlation in patients suffering from type 2 diabetes mellitus under different degrees of retinopathy.METHODS:Totally 129 type 2 diabetes mellitus patients(257 eyes)were included.They were divided into three groups:no diabetic retinopathy(NDR)group(33 cases,66 eyes),non-proliferative diabetic retinopathy(NPDR)group(32 cases,64 eyes),and proliferative diabetic retinopathy(PDR)group(34 cases,67 eyes).Healthy normal individuals were enrolled as controls(30 cases,60 eyes).Ocular Surface Disease Index(OSDI)questionnaire was completed by all subjects,and dry eye analyzer was applied to examine tear meniscus height(TMH),first tear break-up time(FTBUT),average tear break-up time(ATBUT),tear film lipid layer thickness classification,and meibomian gland loss(MGL)score.Corneal nerve fiber density(CNFD),corneal nerve branch density(CNBD),corneal nerve fiber length(CNFL),and corneal nerve fiber tortuosity(CNFT)were examined by in vivo confocal microscopy(IVCM).The differences and correlation among these parameters were analyzed.RESULTS:Total OSDI score,TMH,FTBUT,ATBUT,tear film lipid layer thickness,MGL score,CNFD,CNBD,CNFL,and CNFT were statistically different among the four groups(P<0.05).In NDR group,CNFL was positively correlated with TMH(r=0.493,both P<0.01)and ATBUT(r=0.437,P<0.05).CNFL in NPDR group was positively correlated with TMH(r=0.642,P<0.01)and ATBUT(r=0.6,P<0.01).CNFL in PDR group was positively correlated with TMH(r=0.364,P<0.05)and ATBUT(r=0.589,P<0.01),with low negative correlation with MGL score(r=-0.331,P<0.05).CONCLUSION:With the progression of diabetic retinopathy,TMH,BUT,lipid layer thickness,CNFL,CNFD,and CNBD gradually decreased,while total OSDI score,MGL score,and CNFT increased.CNFL is correlated with TMH and ATBUT in diabetic patients.展开更多
基金Supported by the Key Program of the National Natural Science Foundation of China(No.82530034)the National Natural Science Foundation of China(No.82271054)the Nature Science Foundation of Xiamen,China(No.3502Z20227121).
文摘AIM:To investigate the impact of depression-like behavior on ocular surface homeostasis in a mouse model,with a focus on dry eye-like alterations.METHODS:Male C57BL/6J mice(10-12 weeks old)were randomly assigned to control or restraint stress(RS)groups.The RS group underwent three intermittent 24-hour restraint sessions to induce depressive-like behavior.Behavioral testing,tear secretion measurement,and corneal Oregon Green Dextran(OGD)staining were performed.Postmortem analyses included histological evaluation of lacrimal glands,goblet cell quantification using periodic acid-Schiff staining,and assessment of key inflammatory and apoptotic markers:interleukin(IL)-17,matrix metalloproteinases(MMP)-3,MMP-9,IL-13,interferon(IFN)-γ,and cleaved caspase-3 and-8.RESULTS:Repeated RS induced depression-like behavior and significant ocular surface changes.RStreated mice showed increased corneal OGD uptake and upregulation of gene/protein expression of IL-17,MMP-3,and MMP-9(P<0.05).Goblet cell density and IL-13 protein expression were reduced,while IFN-γprotein expression was elevated(P<0.05).Cleaved caspase-3 and-8 levels were significantly increased in both cornea and conjunctiva.Tear volume and lacrimal gland size were unchanged;however,mild inflammatory infiltration was observed in lacrimal glands.CONCLUSION:Repeated RS leads to ocular surface inflammation and dry eye-like pathology,including corneal barrier disruption,goblet cell loss,and epithelial apoptosis.These findings suggest that depression contributes to the pathogenesis of dry eye disease via immune-mediated mechanisms.
文摘BACKGROUND Dry eye disease(DED)is a multifactorial ocular surface disorder with rising prevalence.It is closely related to systemic health and psychological factors,such as sleep and mood disorders,which significantly impact the quality of life of patients.AIM To explore the correlations between ocular surface function,sleep quality,and anxiety/depression in patients with DED.METHODS This was a cross-sectional investigative study that included 358 patients with DED between January 2022 and January 2025.Ocular surface was assessed using the ocular surface disease index(OSDI),tear film break-up time,fluorescein staining score,and Schirmer I test.The Pittsburgh Sleep Quality Index(PSQI),Self-Rating Anxiety Scale(SAS),and Self-Rating Depression Scale(SDS)were used to evaluate sleep quality and anxiety/depression levels.Correlation and linear regression analyses were used to explore the relationships.RESULTS The mean PSQI score of the patients was 9.94±2.18;the mean SAS score was 47.30±4.90,and the mean SDS score was 50.08±5.52.These suggested a prevalence of sleep and psychological abnormalities.There was a significant correlation between the indicators of ocular surface function(OSDI,tear film break-up time,fluorescein staining,and Schirmer I test)and PSQI,SAS,and SDS scores(P<0.05).Moreover,multiple regression revealed that age≥50 years(β=1.55,P=0.029),PSQI scores(β=0.58,P<0.001),SAS scores(β=0.17,P=0.017),and SDS scores(β=0.15,P=0.019)were independent predictors of the OSDI scores.CONCLUSION Ocular surface function in patients with DED is closely related to sleep quality and anxiety/depression,emphasizing the need for holistic clinical management.
基金Supported by National Natural Science Foundation of China(No.82160195,No.82460203)Degree and Postgraduate Education Teaching Reform Project of Jiangxi Province(No.JXYJG-2020-026).
文摘AIM:To assess the possibility of using different large language models(LLMs)in ocular surface diseases by selecting five different LLMS to test their accuracy in answering specialized questions related to ocular surface diseases:ChatGPT-4,ChatGPT-3.5,Claude 2,PaLM2,and SenseNova.METHODS:A group of experienced ophthalmology professors were asked to develop a 100-question singlechoice question on ocular surface diseases designed to assess the performance of LLMs and human participants in answering ophthalmology specialty exam questions.The exam includes questions on the following topics:keratitis disease(20 questions),keratoconus,keratomalaciac,corneal dystrophy,corneal degeneration,erosive corneal ulcers,and corneal lesions associated with systemic diseases(20 questions),conjunctivitis disease(20 questions),trachoma,pterygoid and conjunctival tumor diseases(20 questions),and dry eye disease(20 questions).Then the total score of each LLMs and compared their mean score,mean correlation,variance,and confidence were calculated.RESULTS:GPT-4 exhibited the highest performance in terms of LLMs.Comparing the average scores of the LLMs group with the four human groups,chief physician,attending physician,regular trainee,and graduate student,it was found that except for ChatGPT-4,the total score of the rest of the LLMs is lower than that of the graduate student group,which had the lowest score in the human group.Both ChatGPT-4 and PaLM2 were more likely to give exact and correct answers,giving very little chance of an incorrect answer.ChatGPT-4 showed higher credibility when answering questions,with a success rate of 59%,but gave the wrong answer to the question 28% of the time.CONCLUSION:GPT-4 model exhibits excellent performance in both answer relevance and confidence.PaLM2 shows a positive correlation(up to 0.8)in terms of answer accuracy during the exam.In terms of answer confidence,PaLM2 is second only to GPT4 and surpasses Claude 2,SenseNova,and GPT-3.5.Despite the fact that ocular surface disease is a highly specialized discipline,GPT-4 still exhibits superior performance,suggesting that its potential and ability to be applied in this field is enormous,perhaps with the potential to be a valuable resource for medical students and clinicians in the future.
基金Supported by the Shanghai Natural Science Foundation(No.23ZR1409200).
文摘AIM:To investigate the ocular surface parameters in patients with moderate to high myopia.METHODS:This prospective study was conducted in May 2023,enrolling patients with moderate to high myopia(spherical equivalent refraction≤-3.0 D).After completing the Ocular Surface Disease Index(OSDI)questionnaire,refractive parameters and non-invasive tear film parameters were measured,followed by the Schirmer I test and fluorescein sodium staining.The diagnosis of dry eye disease was based on OSDI score,non-invasive tear breakup time(NIBUT),Schirmer I test,and fluorescein sodium staining results,according to the 2020 Chinese Expert Consensus on Dry Eye.The Mann-Whitney U test was used to compare ocular surface parameters between moderate and high myopia,as well as between patients with and without dry eye.Pearson correlation analysis was employed to assess the relationship between the lipid/muco-aqueous layers and tear film parameters.A general linear mixed model(GLMM)was used to analyze the impact of refractive parameters on ocular surface parameters after adjusting for age and sex.RESULTS:A total of 35 eyes with moderate to high myopia(12 males;mean age,30.30±5.45y)were included in the study.Among them,26 eyes were classified as normal and 9 as dry eye.Of the 9 dry eye cases,7 were observed in the high myopia group(n=18)and 2 in the moderate myopia group(n=17).Among the enrolled patients,those with high myopia demonstrated significantly higher OSDI scores than those with moderate myopia(P=0.0417).Patients with dry eye exhibited significantly shorter interblink intervals(P=0.0081)and higher OSDI scores(P=0.0001)than those without dry eye.Pearson correlation analysis revealed a significant positive correlation between lipid layer thickness(LLT)and tear meniscus height(r=0.395,P=0.023),and a significant negative correlation between the muco-aqueous layer thickness change rate(MALTR)and OSDI score(r=-0.466,P=0.016).After adjusting for age and sex using the GLMM,spherical refraction(SPH,β=-1.802,P=0.048)and axial length(AL,β=2.784,P=0.048)significantly impacted OSDI score.Corneal front astigmatism significantly influenced Schirmer I test results(β=8.377,P=0.024).The difference between central corneal thickness and the thinnest corneal thickness significantly affected LLT(β=-2.294,P=0.026).White-to-white diameter significantly impacted MALTR(β=-81.758,P=0.037).CONCLUSION:In moderate to high myopia,higher SPH and AL correlate with increased dry eye symptoms,which are associated with muco-aqueous and lipid layer alterations.Corneal regularity and diameter also affect tear film dynamics.
基金the support provided by grants from the National Natural Science Foundation of China(Grant Nos.:82271054 and 82401321)the China Postdoctoral Science Foundation(Grant No.:2023M741608)the Natural Science Foundation of Hunan Province,China(Grant No.:2024JJ6402).
文摘Dry eye(DE),a multifactorial ocular surface disease,is predominantly characterized by inflammation as a central pathological factor.Ursolic acid(UA),a pentacyclic triterpenoid with well-documented anti-inflammatory properties,was evaluated in this study for its therapeutic effects on ocular surface dysfunction associated with DE and its underlying mechanisms.A hyperosmotic stress model(500 mOsM)using human corneal epithelial cells(HCEs)and an animal model of DE was established to assess UA's protective effects on both cellular and organismal levels.Comprehensive assessments,including phenol-red cotton tests and slit-lamp examinations,were performed to evaluate ocular surface damage in the DE mouse model.Potential UA-related targets and their relevance to DE pathology were identified through database mining.Protein-protein interaction(PPI)network construction and pathway enrichment analysis using the Metascape platform highlighted core targets and signaling pathways.Molecular docking simulations using AutoDock and PyMOL further elucidated the interaction modes between UA and its targets.To validate the molecular mechanisms underlying UA's therapeutic effects,integrative analyses were conducted using single-cell sequencing data from the Single Cell Portal and RNA sequencing of tissue samples.The results demonstrated that UA eye drops significantly preserved ocular surface functional units and alleviated DE symptoms,through modulation of the epidermal growth factor receptor(EGFR)/rat sarcoma(RAS)/rapidly accelerated fibrosarcoma(RAF)/mitogen-activated protein kinase(MAPK)kinase 1(MAP2K1)/MAPK1 signaling pathway,as supported by network pharmacological analysis.Single-cell sequencing localized the distribution of key pathway proteins to the anterior ocular segment,particularly the cornea.In vivo experiments confirmed the therapeutic efficacy of UA eye drops via the EGFR/RAS/RAF/MAP2K1/MAPK1 pathway.Collectively,these findings underscore the potential of UA eye drops as a promising therapeutic approach for managing ocular surface disorders in DE.
文摘BACKGROUND High-resolution optical coherence tomography(HR-OCT)has become an essential instrument in the screening and diagnosis of ocular surface neoplasms.Research demonstrates that HR-OCT possesses a diagnostic sensitivity ranging from 85%to 90%for ocular surface squamous neoplasia(OSSN).The connections between HR-OCT features and histological findings have consistently shown robustness,hence increasing the reliability of clinical diagnosis.AIM To examine the existing HR-OCT indicators employed in the identification of common non-benign ocular surface tumors,namely,basal cell carcinoma,OSSN,and melanocytic conjunctival lesions,and to assess their diagnostic efficacy,benefits,and prospective developments.METHODS A thorough literature review was performed to assess the published research on HR-OCT in the diagnosis of ocular surface cancers.Significant attention was given to research that compares HR-OCT characteristics with histopath-ologic validation,as well as on publications addressing the integration of emerging technologies and artificial intelligence in ocular oncology imaging.RESULTS HR-OCT exhibits elevated diagnostic sensitivity(85%-90%)for identifying OSSN and presents distinct imaging patterns that align closely with histology results.This approach has substantial clinical advantages due to its non-invasive characteristics,improved axial resolution,and real-time imaging capabilities.HR-OCT has demonstrated potential in assessing various lesions,including basal cell carcinoma and melanocytic conjunctival malignancies.CONCLUSION HR-OCT assumes an increasingly vital role in the early identification and clinical management of ocular surface malignancies.With advancements in imaging technology and the integration of artificial intelligence,HR-OCT is anticipated to enhance individualized diagnosis and treatment planning in ocular oncology,hence improving patient outcomes.
文摘The occurrence and development of ocular surface diseases are closely related to oxidative stress.Excessive accumulation of reactive oxygen species(ROS)can lead to ocular surface cell damage and inflammatory responses.As a new type of antioxidant,hydrogen-rich water(HRW)has shown intervention potential in ocular surface diseases such as dry eye and conjunctivitis by selectively scavenging toxic ROS,inhibiting inflammatory pathways,and protecting ocular surface cells.Combining basic mechanisms and clinical evidence,this article explores the application value of hydrogen-rich water in ocular surface diseases,providing new ideas for the prevention and treatment of oxidative stress-related eye diseases.
文摘Viral infections of the ocular surface significantly contribute to morbidity and visual impairment globally.The herpes simplex virus(HSV),adenovirus,cytomegalovirus(CMV),and human papillomavirus(HPV)are predominant pathogens impacting the cornea and conjunctiva,resulting in recurrent illness,epidemic outbreaks,and virus-associated neoplasia.Progress in virology,immunology,and molecular diagnostics has enhanced comprehension of host–virus interactions and introduced novel therapeutic opportunities.A narrative literature review was performed utilizing PubMed,Scopus,and Web of Science,encompassing papers published from 2000 to 2025,with a specific focus on research from 2020 onwards.Eligible publications were peer-reviewed clinical and experimental investigations,together with reviews that focused on epidemiology,etiology,diagnostic methodologies,and therapeutic alternatives.Research indicates that HSV keratitis is the predominant infectious cause of corneal blindness in high-income nations,although adenovirus persists in instigating epidemics of keratoconjunctivitis in the absence of licensed antiviral treatments.CMV keratitis,previously confined to immunocompromised persons,is now acknowledged in immunocompetent patients as a causative agent of corneal endotheliitis.HPV is associated with ocular surface squamous neoplasia,especially in areas with elevated ultraviolet exposure and high human immunodeficiency virus prevalence.Innovative molecular diagnostics,innovative antiviral agents,immunomodulatory approaches,and immunization initiatives signify significant progress that could enhance preventative and therapeutic results.
文摘AIM:To evaluate the demographics,clinical characteristics,treatments,and outcomes of patients with ocular surface squamous neoplasia(OSSN)at the Philippine General Hospital.METHODS:This was a single-center,11-year retrospective,cross sectional case series on 18 cases of OSSN seen between January 2012 to June 2023.The patient’s demographics,presenting symptoms,tumor characteristics,histopathologic diagnosis,treatment,outcomes,and duration of follow-up were reviewed.RESULTS:Out of 33 identified cases of OSSN,only 18 were eligible for inclusion in the study.Mean age was 60.78y(range 31 to 80),with male predominance(66.67%).The left eye was most commonly affected(61.11%)with most presenting with fleshy mass(83.33%).Most tumors were located nasally(66.67%)and were predominantly papilliform(44.44%)in morphology with associated hyperpigmentation(38.89%).Squamous cell carcinoma(SCCA)was the most common histopathologic diagnosis(72.22%).The main primary treatment was surgical excision(94.44%)with or without adjunctive therapy,with only 1 patient undergoing first-line topical chemotherapy.Only 3 recurrences(16.67%)were noted with a median followup of 7.5mo.A statistically significant recurrence-free odds leaning towards the utilization of cryotherapy was noted.CONCLUSION:OSSN seen at the Philippine General Hospital is presented as a limbal papilliform mass,most commonly affecting elderly males.Surgical excision with adjuvant cryotherapy and/or chemotherapy is the preferred mode of treatment.
文摘Topical chemotherapy is increasingly used to treat ocular surface tumors as a primary therapy and an adjuvant treatment after surgical excision.The most employed topical agents include mitomycin C(MMC),5-fluorouracil(5-FU),and interferon alpha-2b(IFNα2b),each with distinctmechanisms of action,efficacy profiles,and toxicity risks.Although these agents offer effective tumor control and allow for a non-invasive approach in many cases,ocular surface complications requiring medical or surgical management can occur.This summarizes the adverse effect and outilines practical strategies for their prevention and treatment.MMC is the most potent agent but also the most toxic,with reported complications such as limbal stemcell deficiency,punctal stenosis,and persistent epithelial defects.5-FU demonstrates a more favorable safety profile,although rare cases of corneal ulceration have been described.IFNα2b is well tolerated and associated primarily with mild,reversible reactions.The choice of the proper agent should be tailored according to patient’s clinical presentation,ocular surface status,and ability to adhere to therapy and followup.Timely recognition and management of complications are essential to minimize long-term sequelae.Reliance on compounded formulations highlights the need for stable,standardized,and commercially available topical agents specifically designed for ocular use to ensure safety,reproducibility,and global accessibility.
基金Supported by National Natural Science Foundation of China(No.81973908)Natural Science Foundation of Heilongjiang Province(No.PL2024H224)Postgraduate Innovation Fund of Heilongjiang University of Chinese Medicine(No.2023yjscx018).
文摘AIM:To investigate the effects of a Chinese medicine formula“Qingxuan Runmu Yin”(QRY)on ocular surface inflammation in a rat model of dry eye,and its mechanism via the toll-like receptor 4(TLR4)/transforming growth factor kinase 1(TAK1)/p38 mitogen-activated protein kinase(p38MAPK)signaling pathway.METHODS:Seventy-two Sprague-Dawley rats were randomly divided into six groups(n=12 each):the control group,model group,3 groups of QRY(with low-,medium-,and high-doses),and SB203580 group.Dry eye was induced using benzalkonium chloride.Schirmer’s test(SIT)and corneal fluorescein staining(CFS)were performed every 14d throughout the experiment.Histopathological changes in corneal and conjunctival tissues were observed using hematoxylin and eosin(HE)and periodic acid-Schiff(PAS)staining.Protein expression levels of key inflammatory markers and signaling pathway targets were assessed via immunohistochemistry,ELISA,and Western blotting.RESULTS:Compared to the control group,the model group showed significant reductions in SIT and increases in CFS scores,alongside structural disorganization of corneal/conjunctival tissues,decreased conjunctival goblet cell(CGC)numbers,and elevated expression of inflammatory markers[interleukin(IL)-1β,IL-6,tumor necrosis factoralpha(TNF-α),matrix metalloproteinase-9(MMP9)]and pathway proteins(TLR4,p-TAK1,p-p38MAPK;P<0.05).Treatment with QRY(low,medium,and high doses)and SB203580 significantly improved SIT scores,reduced CFS scores,restored corneoconjunctival structure,increased CGC numbers,and decreased expression levels of IL-1β,IL-6,TNF-α,MMP9,TLR4,p-TAK1,and p-p38MAPK proteins compared to the model group(P<0.05).CONCLUSION:QRY may alleviate ocular surface inflammation associated with dry eye by inhibiting the TLR4/TAK1/p38MAPK signaling pathway,highlighting its potential therapeutic efficacy for dry eye.
基金Supported by the Research Fund of Adnan Menderes University,Aydin,Turkey
文摘AIM:To investigate the effects of estrogen replacement therapy (ERT) on apoptosis and vascular endothelial growth factor (VEGF) expression in ocular surface in an experimental rat model.· METHODS:Forty female,Wistar rats were randomized in 4 groups in the study.Subcutaneous ERT (17β-estradiol,10g/kg/day) was administered to the first group without ovariectomy and to the second group with ovariectomy for three months.Third group had only ovariectomy and fourth group had sham operation.All rats were sacrificed in estrous cycles determined by vaginal smear test and their right eyes were enucleated at the end of the third month.Enucleated eyes were analyzed by immunohistochemical method for expressions of caspase-3,bcl-2,VEGF and TUNEL assay.· RESULTS:Caspase-3 expression of conjunctival epithelium was significantly higher in group 3 than group 1 (P =0.005),and group 2 (P =0.007).TUNEL score of conjunctival epithelium was significantly higher in group 3 than group 1 (P =0.006).TUNEL score of corneal epithelium was significantly higher in group 3 than group 2 (P =0.012),and group 4 (P =0.002).There was no significant difference between groups in that bcl-2 and VEGF expressions.· CONCLUSION:We determined increased apoptosis in ocular surface epithelial cells in ovariectomized rats.ERT and endogen estrogen decreased the apoptosis,and did not result in difference in VEGF expression between the groups.Estrogen may be beneficial for the treatment of apoptosis-mediated ocular surface disorders such as dry eye.Further studies are needed on this subject for a better understanding of the role of estrogen and to provide a new insight for treatment and prevention of apoptosis-mediated ocular surface disorders.
基金Supported by Shanxi China Scientific and Technological Project(No.2007031096-1)Ph.D.Program Foundation of Ministry of Education of China(No.20111202110008)
文摘AIM: To detect and analyze the changes on ocular surface and tear function in type II diabetic patients with proliferative diabetic retinopathy(PDR), an advanced stage of diabetic retinopathy(DR), using conventional ophthalmic tests and the high-resolution laser scanning confocal microscopy.METHODS: Fifty-eight patients with type II diabetes were selected. Based on the diagnostic criteria and stage classification of DR, the patients were divided into the non-DR(NDR) group and the PDR group. Thirty-six patients with cataract but no other ocular and systemic disease were included as non-diabetic controls. All the patients were subjected to the conventional clinical tests of corneal sensitivity, Schirmer I test, and corneal fluorescein staining. The non-invasive tear film break-up time(NIBUT) and tear interferometry were conducted by a Tearscope Plus. The morphology of corneal epithelia and nerve fibers was examined using the high-resolution confocal microscopy.RESULTS: The NDR group exhibited significantly declined corneal sensitivity and Schirmer I test value, as compared to the non-diabetic controls(P 【0.001). The PDR group showed significantly reduced corneal sensitivity, Schirmer I test value, and NIBUT in comparison to the non-diabetic controls(P 【0.001).Corneal fluorescein staining revealed the progressively injured corneal epithelia in the PDR patients. Moreover,significant decrease in the corneal epithelial density andmorphological abnormalities in the corneal epithelia and nerve fibers were also observed in the PDR patients.CONCLUSION: Ocular surface changes, including blunted corneal sensitivity, reduced tear secretion, tear film dysfunction, progressive loss of corneal epithelia and degeneration of nerve fibers, are common in type II diabetic patients, particularly in the diabetic patients with PDR. The corneal sensitivity, fluorescein staining scores,and the density of corneal epithelial cells and nerve fibers in the diabetic patients correlate with the duration of diabetes. Therefore, ocular surface of the patients with PDR should be examined regularly by conventional approaches and confocal microscopy to facilitate early diagnosis and treatment of keratopathy.
基金Supported by Medical Science and Technology Research Foundation Project of Guangdong Province(No.C2017029)Science and Technology Project of Yuexiu District,Guangzhou(No.2017-WS-013)
文摘AIM: To observe the changes in ocular surface and the dry eye symptoms following femtosecond laser-assisted cataract surgery(FLACS). METHODS: Patients with no eye signs or symptoms in Guangzhou Aier Eye Hospital between October 2017 and September 2018, who underwent FLACS and intraocular lens(IOL) implantation for age-related cataract were enrolled. Tear film stability assessed with OCULUS Keratograph 5 M, Schirmer’s I test(SIT), and corneal fluorescein staining(CFS) were evaluated before and after surgery at 1 d, 1 wk, 1, and 3 mo in order. Ocular Surface Disease Index scores(OSDI) and Subjective Symptom Questionnaires(SSQs) were recorded at the same time point.RESULTS: Thirty-eight eyes of 38 patients were enrolled. The noninvasive tear film break-up time(first break-up time and average break-up time) decreased in a peak at the 1 wk visit, and then increased to basic levels at 1 mo. The tear meniscus height(TMH) increased transiently at 1 d, and declined in the following 3 mo visits. The SIT had a transient increase at 1 d(P=0.357) and a decrease at 1 wk and 1 mo(both P<0.05) but returned to the preoperative levels at 3 mo after surgery(P=0.062). CFS scores were significantly improved compared with those before surgery, and had a statistical difference(P<0.05). OSDI scores and SSQs after surgery were obviously higher, and had a statistical difference(P<0.001) but didn’t return to the basic level by 3 mo. CONCLUSION: Dry eye signs and symptoms can occur immediately following FLACS and have a peak severity on day 7 postoperatively. Most signs of dry eye can return to preoperative basic levels within 3 mo postoperatively. However, all cases can not recover from CFS and dry eye symptoms at 3 mo postoperatively.
基金Supported by the National Natural Science Foundation of China(No.81500693)
文摘AIM： To investigate the association between ocular demodex folliculorum infestation and ocular surface manifestations in meibomian gland dysfunction（MGD）.METHODS： Eight-six patients with MGD were enrolled. All enrolled subjects were tested in the following sequence： ocular surface disease index（OSDI）, slit-lamp biomicroscope examination, corneal surface regularity index（SRI） and surface asymmetry index（SAI）, tear fluid collection, fluorescein tear film break-up time（F-BUT）, corneal fluorescein staining（CFS）, Schirmer I test（SIT） and demodex folliculorum counting. Tear matrix metalloproteinase（MMP）-9 activity was assessed using MMP-9 activity assay kit.RESULTS： Among 86 MGD patients, 40 were positive for demodex. The ocular demodex-positive group showed significantly increased scores of OSDI（25.96±13.74 vs 18.07±11.55, P=0.01）, lid margin abnormality（2.38±0.87 vs 1.98±0.91, P=0.04） and CFS（1.28±2.00 vs 0.94±1.36, P=0.01） compared to the ocular demodex-free group. The tear MMP-9 activity was higher in the ocular demodex-positive group（102.9±32.4 ng/mL） than the ocular demodex-free group（46.2±19.2 ng/mL, P=0.03）. There was no significant difference in meibum quality and expressibility, SRI, SAI, F-BUT and SIT between the two groups（P〉0.05 for each）. No significant correlation was noted between the number of demodex and ocular surface parameters in demodexpositive MGD group（P〉0.05 for each）.CONCLUSION： Ocular demodex folliculorum infestation may be associated with ocular discomfort and ocular surface damage in MGD.
基金National Natural Science Foundation of China (No. 81160118)Natural Science Foundation of Jiangxi Province (No. 20114BAB215029)+3 种基金Technology Foundation of Jiangxi Province (No. 20111BBG70026-2)Health Department Science and Technology Foundation(No.20121026)Education Department Youth Scientific Research Foundation (No. JJJ12158)National High Technology Research of China (863 project) (No. 2006AA02A131)
文摘AIM: To examine the α-Gal gene expression and distribution in the different species/genus and developing phase animal ocular surface tissue.METHODS: α-Gal binding assay were carried out on various animal eye sections. Photograph, slit-lamp observation on various eye showed normal corneal transparence.RESULTS: A strong α-Gal expression in invertebrates and some vertebrates ocular tissue, but no α-Gal binding in birds, fish and mammal. α-Gal expression change in the development of mice ocular surface tissue (except sclera) and display genus dependency in the different murine ocular surface tissue.CONCLUSION: This study identified specific α-Gal epitopes binding area in the ocular surface of several species and may solve the problem that naive ocular surface may be used as natural α-Gal gene knockout model/high risk immunologic rejection model or ocular surface scaffold material.
文摘AIM: To evaluate the risk factors leading to recurrence in patients with ocular surface squamous neoplasia(OSSN)METHODS: The records of 112 patients with OSSN who underwent treatment and follow-up between February 1999 and August 2018 were reviewed retrospectively.RESULTS: Totally 67 patients(59.8%) were male and 45 patients(40.2%) were female. The mean age at presentation was 63.7 y(range 22-87 y). Partial lamellar scleroconjunctivectomy(PLSC) was performed in 105(93.7%) cases and enucleation was performed in 7(6.3%) cases due to bulbus invasion as the first step treatment. Treatments used in addition to PLSC included cryotherapy in 78 eyes(74.3%), alcohol epitheliectomy in 57 eyes(54.3%) for presence of corneal involvement, and amniotic membrane transplantation in 17 eyes(16.2%) for ocular surface reconstruction. Topical mitomycin C was used in 10 patients(9.5%) and strontium-90(Str-90) treatment in 4(3.8%) patients because surgical margins were tumor positive at the histopathological examination. Postoperative histopathologic diagnoses were squamous cell carcinoma(52 cases), carcinoma in situ(44 cases), moderate conjunctival intraepithelial neoplasia(11 cases), and mild conjunctiva intraepithelial neoplasia(5 cases). At a mean follow-up of 20.1 mo, tumor recurrence was observed in 21(18.8%) cases. The rate of recurrence was found to be lower in cases that underwent supplemental cryotherapy compared to those that did not(P<0.001). There was no metastasis in any case. CONCLUSION: In our series, the recurrence rate is 18.8% and overall globe salvage rate is 90.2% for OSSN at relatively short-term follow-up.
基金Supported by Project of National Clinical Key Discipline of Chinese Ministry of Health,Zhejiang Key Laboratory Fund of China(No.2011E10006)
文摘AIM： To investigate the early changes in dry eye symptoms, tear function and ocular surface following small-incision lenticule extraction（SMILE） for myopia.·METHODS： Ninety-seven consecutive patients（193 eyes）who underwent SMILE for myopia were observed in this longitudinal and retrospective study. Parameters evaluated included： subjective dry eye symptoms（dryness, foreign body sensation and photophobia）, tear film breakup time（TBUT）, Schirmer Ⅰ test without anesthesia（S Ⅰ T）, tear meniscus height（TMH） and corneal fluorescein staining. Each parameter was evaluated before, and subsequently at 1d, 1wk, 1 and3 mo after surgery.·RESULTS： Compared with preoperative data, dryness was noted to be significantly increased at 1wk and 1mo postoperatively（P 〈0.01）. Symptoms of photophobia and foreign body sensation demonstrated significant differences at 1d and 1wk as compared with preoperative scores respectively（P 〈0.01）. These values were decreased at 1 and 3mo post-surgery（P 〉0.05）.Conversely the corneal staining scores were higher than the preoperative data at 1d, 1wk and 1mo（P 〈0.01）, but were close to the preoperative level at 3mo postoperatively. There was a significant decrease in TMH at 1wk and 1mo（P 〈0.01）, but the value was close to the preoperative level at 3mo postoperatively（P =0.16）. The examination outcomes of S Ⅰ T were significantly increased at 1d then reduced at 1wk after surgery（P 〈0.01）. Each value subsequently returned to the baseline value at 1 and 3mo（P 〉0.05）. TBUT was significantly decreased at all postoperative time points（P 〈0.01）.· CONCLUSION： SMILE resulted in mild dry eye symptoms, tear film instability and ocular surface damages; however, these complications can recover in a short period of time.
文摘AIM: To assess and compare the impact of a daily disposable contact lens(CL) with high water content on the ocular surface and comfort of the presbyopic and nonpresbyopic population after one day of use. METHODS: Totally 20 presbyopes and 30 non-presbyopes non-contact wearers were fitted with nesofilcon A CLs. CL thickness was measured to assess material stability during daily wear, and ocular surface parameters were also assessed. Optical quality was analyzed for all cases. In addition, CL comfort was rated.RESULTS: No significant differences were found in CL thickness, tear film osmolarity, average tear break-up time, bulbar redness, central corneal thickness, corneal volume, root-mean-square of higher-order aberrations(RMS of HOAs) and vertical and horizontal coma, either as a function of the group or time of use. A significant decrease in tear meniscus height and first break-up of the tear film was found in the presbyopic group(P=0.038; P=0.007 respectively). A decrease in spherical aberration coefficient was found after CL insertion(P=0.031 monofocal CL; P=0.023 low addition multifocal CL; P=0.016 high addition multifocal CL). Multifocal CL were thicker than monofocal CL(P=0.045). Comparison between groups showed more discomfort in presbyopes than non-presbyopes(P=0.003).CONCLUSION: This study evidence that the behavior of the daily disposable CL with high water content seems to be stable during the day of use. Ocular parameters measured during wear show that CL behavior is the same for presbyopes and non-presbyopes, being more uncomfortable for presbyopes.
文摘AIM:To investigate the change of ocular surface and corneal nerve and their correlation in patients suffering from type 2 diabetes mellitus under different degrees of retinopathy.METHODS:Totally 129 type 2 diabetes mellitus patients(257 eyes)were included.They were divided into three groups:no diabetic retinopathy(NDR)group(33 cases,66 eyes),non-proliferative diabetic retinopathy(NPDR)group(32 cases,64 eyes),and proliferative diabetic retinopathy(PDR)group(34 cases,67 eyes).Healthy normal individuals were enrolled as controls(30 cases,60 eyes).Ocular Surface Disease Index(OSDI)questionnaire was completed by all subjects,and dry eye analyzer was applied to examine tear meniscus height(TMH),first tear break-up time(FTBUT),average tear break-up time(ATBUT),tear film lipid layer thickness classification,and meibomian gland loss(MGL)score.Corneal nerve fiber density(CNFD),corneal nerve branch density(CNBD),corneal nerve fiber length(CNFL),and corneal nerve fiber tortuosity(CNFT)were examined by in vivo confocal microscopy(IVCM).The differences and correlation among these parameters were analyzed.RESULTS:Total OSDI score,TMH,FTBUT,ATBUT,tear film lipid layer thickness,MGL score,CNFD,CNBD,CNFL,and CNFT were statistically different among the four groups(P<0.05).In NDR group,CNFL was positively correlated with TMH(r=0.493,both P<0.01)and ATBUT(r=0.437,P<0.05).CNFL in NPDR group was positively correlated with TMH(r=0.642,P<0.01)and ATBUT(r=0.6,P<0.01).CNFL in PDR group was positively correlated with TMH(r=0.364,P<0.05)and ATBUT(r=0.589,P<0.01),with low negative correlation with MGL score(r=-0.331,P<0.05).CONCLUSION:With the progression of diabetic retinopathy,TMH,BUT,lipid layer thickness,CNFL,CNFD,and CNBD gradually decreased,while total OSDI score,MGL score,and CNFT increased.CNFL is correlated with TMH and ATBUT in diabetic patients.
