Cytomegalovirus (CMV) retinitis is a significant yet infrequent complication inpediatric hematopoietic stem cell transplant recipients, occurring in approximately4% of cases. Its presentation typically coincides with ...Cytomegalovirus (CMV) retinitis is a significant yet infrequent complication inpediatric hematopoietic stem cell transplant recipients, occurring in approximately4% of cases. Its presentation typically coincides with immune reconstitution,between 6 weeks to 6 months post-transplant, emphasizing the need fortimely detection. Symptoms often develop insidiously, underscoring the role offundus examinations during episodes of CMV viremia. However, the low incidencechallenges the necessity of routine screenings, as they may strain clinicalresources without clear benefits to patient outcomes. Management includes systemicand intravitreal antivirals, such as ganciclovir and foscarnet, and adoptiveT-cell therapy for refractory cases. Tailored follow-up strategies are crucial, withconsiderations for lesion activity and CMV viremia status to determine theduration of therapy. Baseline and post-transplant screenings remain a topic ofdebate, with evolving guidelines needed to balance patient safety and clinicalfeasibility. Future research is needed to address optimal screening intervals andinvestigate the role of pre-existing CMV serostatus in transplant eligibility andoutcomes.展开更多
AIM:To investigate the capabilities of large language models(LLM)for providing information and diagnoses in the field of neuro-ophthalmology by comparing the performances of ChatGPT-3.5 and-4.0,Bard,and Bing.METHODS:E...AIM:To investigate the capabilities of large language models(LLM)for providing information and diagnoses in the field of neuro-ophthalmology by comparing the performances of ChatGPT-3.5 and-4.0,Bard,and Bing.METHODS:Each chatbot was evaluated for four criteria,namely diagnostic success rate for the described case,answer quality,response speed,and critical keywords for diagnosis.The selected topics included optic neuritis,nonarteritic anterior ischemic optic neuropathy,and Leber hereditary optic neuropathy.RESULTS:In terms of diagnostic success rate for the described cases,Bard was unable to provide a diagnosis.The success rates for the described cases increased in the order of Bing,ChatGPT-3.5,and ChatGPT-4.0.Further,ChatGPT-4.0 and-3.5 provided the most satisfactory answer quality for judgment by neuro-ophthalmologists,with their sets of answers resembling the sample set most.Bard was only able to provide ten differential diagnoses in three trials.Bing scored the lowest for the satisfactory standard.A Mann-Whitney test indicated that Bard was significantly faster than ChatGPT-4.0(Z=-3.576,P=0.000),ChatGPT-3.5(Z=-3.576,P=0.000)and Bing(Z=-2.517,P=0.011).ChatGPT-3.5 and-4.0 far exceeded the other two interfaces at providing diagnoses and were thus used to find the critical keywords for diagnosis.CONCLUSION:ChatGPT-3.5 and-4.0 are better than Bard and Bing in terms of answer success rate,answer quality,and critical keywords for diagnosis in ophthalmology.This study has broad implications for the field of ophthalmology,providing further evidence that artificial intelligence LLM can aid clinical decision-making through free-text explanations.展开更多
Background:With the rapid development of artificial intelligence(AI),large language models(LLMs)have emerged as a potent tool for invigorating ophthalmology across clinical,educational,and research fields.Their accura...Background:With the rapid development of artificial intelligence(AI),large language models(LLMs)have emerged as a potent tool for invigorating ophthalmology across clinical,educational,and research fields.Their accuracy and reliability have undergone tested.This bibliometric analysis aims to provide an overview of research on LLMs in ophthalmology from both thematic and geographical perspectives.Methods:All existing and highly cited LLM-related ophthalmology research papers published in English up to 24th April 2025 were sourced from Scopus,PubMed,and Web of Science.The characteristics of these publications,including publication output,authors,journals,countries,institutions,citations,and research domains,were analyzed using Biblioshiny and VOSviewer software.Results:A total of 277 articles from 1,459 authors and 89 journals were included in this study.Although relevant publications began to appear in 2019,there was a significant increase starting from 2023.He M and Shi D are the most prolific authors,while Investigative Ophthalmology&Visual Science stands out as the most prominent journal.Most of the top-publishing countries are high-income economies,with the USA taking the lead,and the University of California is the leading institution.VOSviewer identified 5 clusters in the keyword co-occurrence analysis,indicating that current research focuses on the clinical applications of LLMs,particularly in diagnosis and patient education.Conclusions:While LLMs have demonstrated effectiveness in retaining knowledge,their accuracy in image-based diagnosis remains limited.Therefore,future research should investigate fine-tuning strategies and domain-specific adaptations to close this gap.Although research on the applications of LLMs in ophthalmology is still in its early stages,it holds significant potential for advancing the field.展开更多
Virtual Reality(VR)technology is widely recognized as a prominent technological paradigm.Its potential and promise in the domain of ophthalmology are substantial,and the evolution of VR technology has significantly in...Virtual Reality(VR)technology is widely recognized as a prominent technological paradigm.Its potential and promise in the domain of ophthalmology are substantial,and the evolution of VR technology has significantly influenced the contemporary landscape of ophthalmology.Numerous empirical studies have validated the practical utility of VR technology in domains such as ophthalmic disease treatment and surgery training.This paper offers a comprehensive overview of VR technology's utilization in ophthalmic disease treatment,student education,and surgery training,expands the application of VR technology in ophthalmic evaluation and disease diagnosis,discusses the challenges and limitations of VR technology in ophthalmology,and expounds on emerging trends and future developments of VR technology in ophthalmology.This endeavor aims to provide readers with an in-depth comprehension of the current status and future prospects of VR technology application in ophthalmology,with the ultimate objective of fostering more effective advancements and applications of VR technology in the realm of ophthalmology.展开更多
Glaucoma,a prevalent and debilitating eye disease,has long been associated with vision impairment and blindness.However,recent research has shed light on the often-underestimated psychological dimensions of this condi...Glaucoma,a prevalent and debilitating eye disease,has long been associated with vision impairment and blindness.However,recent research has shed light on the often-underestimated psychological dimensions of this condition.Anxiety and depression,two pervasive psychiatric comorbidities,have been increasingly recognized among glaucoma patients.This comprehensive review aims to explore the intricate relationship between psychiatry and ophthalmology,in the context of managing depression and anxiety in glaucoma patients.By meticulously examining peer-reviewed literature,we synthesize current knowledge on the prevalence,risk factors,and underlying mechanisms of anxiety and depression in glaucoma.The evidence reveals that glaucoma patients face an elevated risk of experiencing these mood disorders.Factors such as progressive vision loss,complex medication regimens,and the fear of further visual deterioration contribute to their vulnerability.Moreover,we delve into the bidirectional relationship between glaucoma and mood disorders,shedding light on the complex interplay between ocular and emotional health.Our review investigates the implications of anxiety and depression on glaucoma management,including their potential impact on treatment adherence,disease progression,and overall quality of life.We also explore the neurobiological pathways linking glaucoma and mood disorders,providing a foundation for future research and potential therapeutic interventions.In conclusion,recognizing the psychological burden carried by glaucoma patients is essential for holistic and patient-centered care.This review underscores the pressing need for integrated approaches that bring together ophthalmological and psychiatric expertise to optimize the well-being of individuals facing the challenges of glaucoma.By addressing anxiety and depression in glaucoma care,healthcare providers can enhance the overall quality of life for these patients,ultimately leading to improved outcomes and a brighter future for those affected by this condition.This review offers valuable insight for healthcare practitioners and researchers,providing a concise overview of key topics and research in the field of managing depression and anxiety in glaucoma patients.展开更多
Background and Objective:Social media(SoMe)has emerged as a tool in health professions education(HPE),particularly amidst the challenges posed by the coronavirus disease 2019(COVID-19)pandemic.Despite the academia’s ...Background and Objective:Social media(SoMe)has emerged as a tool in health professions education(HPE),particularly amidst the challenges posed by the coronavirus disease 2019(COVID-19)pandemic.Despite the academia’s initial skepticism SoMe has been gaining traction in supporting learning communities,and offering opportunities for innovation in HPE.Our study aims to explore the integration of SoMe in HPE.Four key components were outlined as necessary for a successful integration,and include designing learning experiences,defining educator roles,selecting appropriate platforms,and establishing educational objectives.Methods:This article stemmed from the online Teaching Skills Series module on SoMe in education from the Ophthalmology Foundation,and drew upon evidence supporting learning theories relevant to SoMe integration and models of education.Additionally,we conducted a literature review considering Englishlanguage articles on the application of SoMe in ophthalmology from PubMed over the past decade.Key Content and Findings:Early adopters of SoMe platforms in HPE have leveraged these tools to enhance learning experiences through interaction,dialogue,content sharing,and active learning strategies.By integrating SoMe into educational programs,both online and in-person,educators can overcome time and geographical constraints,fostering more diverse and inclusive learning communities.Careful consideration is,however,necessary to address potential limitations within HPE.Conclusions:This article lays groundwork for expanding SoMe integration in HPE design,emphasizing the supportive scaffold of various learning theories,and the need of furthering robust research on examining its advantages over traditional educational formats.Our literature review underscores an ongoing multifaceted,random application of SoMe platforms in ophthalmology education.We advocate for an effective incorporation of SoMe in HPE education,with the need to comply with good educational practice.展开更多
AIM:To evaluate residents’perceptions and attitudes toward the various aspects of a comprehensive ophthalmic examination,and to determine if these factors correlate with their choices for fellowship and future career...AIM:To evaluate residents’perceptions and attitudes toward the various aspects of a comprehensive ophthalmic examination,and to determine if these factors correlate with their choices for fellowship and future career plans.METHODS:This is a cross-sectional study.A questionnaire on the perception of the ophthalmic exam was sent via SurveyMonkey to ophthalmology residents throughout Israel.Eighty of them(one-half of all ophthalmology residents in 2019)completed it.The first part related to how they perceived each component of the ophthalmic evaluation.The second part related to their future fellowship plans.The Chi-squared test was used to compare categorical variables and Student’s t-test and One-way ANOVA were used to compare continuous variables.Multivariate logistic regression analysis was applied as needed to detect interactions between variables and to exclude confounder effects.RESULTS:Slit-lamp examination of the anterior and posterior segments ranked as the most likeable aspects,whereas gonioscopy,ocular motility examination and visual acuity assessment were least likeable.Anterior segment and retina subspecialties were the ones most sought after.Forty-nine respondents(61.3%)noted a direct correlation between their preferred parts of comprehensive ophthalmic evaluations and their choice of subspecialty.Perceptions of selected components of those evaluations were significantly associated with responders’intentions to pursue anterior segment,retina,or oculoplastic fellowships(P<0.05).CONCLUSION:Perspectives of residents toward the ophthalmic examination,and most specifically its individual components,play an important role in their choice of subspecialty training.展开更多
The use of interactive audience software,such as audience response systems(ARS),in medical education has become increasingly popular in recent years.This technology allows instructors to engage students in real time,e...The use of interactive audience software,such as audience response systems(ARS),in medical education has become increasingly popular in recent years.This technology allows instructors to engage students in real time,encouraging active participation and promoting effective learning.The benefits of interactive audience software in medical education include increased student engagement,promotion of active learning,and enhanced learning outcomes.However,there are also several challenges to its implementation,including technical difficulties,careful planning and preparation,over-reliance on technology,and ethical concerns related to privacy and data security.The cost of implementing interactive audience software may also be a barrier for some institutions.This paper specifically reviews six interactive software platforms,including Socrative,Quizizz,Pear Deck,Slido,Wooclap and ClassPoint.These platforms allow for real-time assessment of student understanding,feedback,and participation.They also enable instructors to adjust their teaching strategies based on student responses and feedback.Overall,interactive audience software has shown great potential to enhance learning and engagement in medical education.It is important for instructors to carefully consider the benefits and challenges of its implementation.While the cost of implementing interactive audience software may be a barrier for some institutions,there are free and low-cost options available.展开更多
Our goal as medical educators is for our students to learn what they need to know and competently perform ophthalmic procedures.In addition,the students need to have good communication skills and behave professionally...Our goal as medical educators is for our students to learn what they need to know and competently perform ophthalmic procedures.In addition,the students need to have good communication skills and behave professionally and ethically(1,2).Most medical educators are not taught how to teach but rather learn by role-modeling their mentors.This can be good or bad depending on the mentor!In addition,the amount of knowledge and numbers of surgical procedures is ever increasing and yet,in most countries,the amount of time to train and become competent is not changing.Thus,our goal of creating competent ophthalmologists is ever more challenging.展开更多
Background and Objective:Advances in teleophthalmology and artificial intelligence(AI)for diabetic retinal screening is of growing public health interest.Currently,only 30–40%of patients with diabetes adhere to recom...Background and Objective:Advances in teleophthalmology and artificial intelligence(AI)for diabetic retinal screening is of growing public health interest.Currently,only 30–40%of patients with diabetes adhere to recommended diabetes screening guidelines.To enhance early detection and reduce vision threatening complications,there has been a growing number of teleophthalmology programs and novel AI algorithms with the aim to improve eye care access.The purpose of this review is to assess current literature on teleophthalmology and AI for use in diabetic retinopathy(DR)screening,and to discuss advances and barriers to these innovative technologies.Methods:Literature review involving teleophthalmology and AI for DR screening,with focus on the past decade.Key Content and Findings:Teleophthalmology has demonstrated the ability to increase DR screening rates,enable earlier eye care access,and reduce healthcare costs.Novel AI-based DR screening programs appear accurate and effective,but detection of other ocular pathologies is still under development and not yet approved in the United States.Logistical,technological,financial,and legal barriers limit widespread adoption and long-term sustainability of teleophthalmology programs.Conclusions:The use of teleophthalmology and AI algorithms expands eye care access and helps prevent vision loss from DR and potentially other sight threatening conditions.Transparency in the process utilized for arriving at a particular diagnosis or decision to refer,often referred to as the“black box”,remains a multifaceted issue within the field of telemedicine for developing trust and improving patient-centered outcomes.展开更多
This paper analyzes the current status,technological developments,academic exchange platforms,and future challenges and solutions in the field of intelligent ophthalmology(IO)in China.In terms of technology,significan...This paper analyzes the current status,technological developments,academic exchange platforms,and future challenges and solutions in the field of intelligent ophthalmology(IO)in China.In terms of technology,significant progress has been made in various areas,including diabetic retinopathy,fundus image analysis,quality assessment of medical artificial intelligence products,clinical research methods,technical evaluation,and industry standards.Researchers continually enhance the safety and standardization of IO technology by formulating a series of clinical application guidelines and standards.The establishment of domestic and international academic exchange platforms provides extensive collaboration opportunities for professionals in various fields,and various academic journals serve as publication platforms for IO research.However,challenges such as technological innovation,data privacy and security,lagging regulations,and talent shortages still pose obstacles to future development.To address these issues,future efforts should focus on strengthening technological research and development,regulatory framework construction,talent cultivation,and increasing patient awareness and acceptance of new technologies.By comprehensively addressing these challenges,IO in China is poised to further lead the industry’s development on a global scale,bringing more innovation and convenience to the field of ophthalmic healthcare.展开更多
Background and Objective:TriNetX is a global,federated,health research network that has become increasingly utilized in academic medicine.In the last 2 years,the field of ophthalmology has seen an uptick in the number...Background and Objective:TriNetX is a global,federated,health research network that has become increasingly utilized in academic medicine.In the last 2 years,the field of ophthalmology has seen an uptick in the number of publications of TriNetX analyses.The objective of this review is to summarize the process of conducting a TriNetX study,the trends in TriNetX use,and the utility of TriNetX in ophthalmology research.Additionally,the strengths and limitations of TriNetX use in ophthalmology research will be discussed.Methods:A PubMed and Scopus literature search was performed using the search terms:“TriNetX”and“Ophthalmology”or“Eye”.Included articles were English language only from the years 1994 to June 1,2024.The twenty-one included articles were analyzed for trends in study design,strengths,and weaknesses.Additionally,a mock study was performed to describe the process of completing a TriNetX study.Key Content and Findings:The literature search revealed a marked increase in TriNetX publications in ophthalmology journals in the years 2023 to 2024.Using a methodology similar to the studies identified in the literature search,a mock investigation of the relationship between cataract removal and hip fracture was detailed from start to finish,providing a framework for the use of TriNetX in ophthalmology research.The mock study provided results consistent with previously reported findings.Lastly,a thorough review of the strengths and limitations of TriNetX identified major considerations in study design,coding,data availability,propensity score matching,bias,and analytical challenges that researchers must be aware of when conducting research with TriNetX.However,many of the discussed limitations can be circumvented with careful and informed use of the platform.Conclusions:TriNetX is a powerful research tool that offers volumetric advantages and time efficiency,making it an attractive option for conducting observational studies.Despite its strengths,caution must be exercised when designing studies to ensure their validity and quality.With careful informed use,TriNetX is a valuable resource in ophthalmology research.展开更多
Retroperitoneal soft tissue sarcomas in the retroperitoneal/intra-abdominal regions represent 10% - 15% of all cases of soft tissue sarcoma. Liposarcomas, which are the most common histological type, account for 20% -...Retroperitoneal soft tissue sarcomas in the retroperitoneal/intra-abdominal regions represent 10% - 15% of all cases of soft tissue sarcoma. Liposarcomas, which are the most common histological type, account for 20% - 45% of retroperitoneal/intra-abdominal sarcoma cases, and 20% of liposarcomas cases are primary retroperitoneal liposarcomas. Surgical resection in case of malignancy remains the treatment of choice for liposarcomas, according to the guidelines of most major international companies. Our goal was to improve the management of retroperitoneal liposarcoma. This was a 65-year-old patient, with no medical or surgical history, who was referred to us for abdominal swelling, in whom clinical and paraclinical examination found retroperitoneal liposarcoma stage IV, and the surgical treatment consisted in making a tumor reduction. Conclusion: Retro-peritoneal liposarcoma is an undervalued malignant tumor, and the diagnosis is often late.展开更多
Age-related macular degeneration is a serious neurodegenerative disease of the retina that significantly impacts vision.Unfortunately,the specific pathogenesis remains unclear,and effective early treatment options are...Age-related macular degeneration is a serious neurodegenerative disease of the retina that significantly impacts vision.Unfortunately,the specific pathogenesis remains unclear,and effective early treatment options are consequently lacking.The microbiome is defined as a large ecosystem of microorganisms living within and coexisting with a host.The intestinal microbiome undergoes dynamic changes owing to age,diet,genetics,and other factors.Such dysregulation of the intestinal flora can disrupt the microecological balance,resulting in immunological and metabolic dysfunction in the host,and affecting the development of many diseases.In recent decades,significant evidence has indicated that the intestinal flora also influences systems outside of the digestive tract,including the brain.Indeed,several studies have demonstrated the critical role of the gut-brain axis in the development of brain neurodegenerative diseases,including Alzheimer’s disease and Parkinson’s disease.Similarly,the role of the“gut-eye axis”has been confirmed to play a role in the pathogenesis of many ocular disorders.Moreover,age-related macular degeneration and many brain neurodegenerative diseases have been shown to share several risk factors and to exhibit comparable etiologies.As such,the intestinal flora may play an important role in age-related macular degeneration.Given the above context,the present review aims to clarify the gut-brain and gut-eye connections,assess the effect of intestinal flora and metabolites on age-related macular degeneration,and identify potential diagnostic markers and therapeutic strategies.Currently,direct research on the role of intestinal flora in age-related macular degeneration is still relatively limited,while studies focusing solely on intestinal flora are insufficient to fully elucidate its functional role in age-related macular degeneration.Organ-on-a-chip technology has shown promise in clarifying the gut-eye interactions,while integrating analysis of the intestinal flora with research on metabolites through metabolomics and other techniques is crucial for understanding their potential mechanisms.展开更多
The organotypic retinal explant culture has been established for more than a decade and offers a range of unique advantages compared with in vivo experiments and cell cultures.However,the lack of systematic and contin...The organotypic retinal explant culture has been established for more than a decade and offers a range of unique advantages compared with in vivo experiments and cell cultures.However,the lack of systematic and continuous comparison between in vivo retinal development and the organotypic retinal explant culture makes this model controversial in postnatal retinal development studies.Thus,we aimed to verify the feasibility of using this model for postnatal retinal development studies by comparing it with the in vivo retina.In this study,we showed that postnatal retinal explants undergo normal development,and exhibit a consistent structure and timeline with retinas in vivo.Initially,we used SOX2 and PAX6 immunostaining to identify retinal progenitor cells.We then examined cell proliferation and migration by immunostaining with Ki-67 and doublecortin,respectively.Ki-67-and doublecortin-positive cells decreased in both in vivo and explants during postnatal retinogenesis,and exhibited a high degree of similarity in abundance and distribution between groups.Additionally,we used Ceh-10 homeodomain-containing homolog,glutamate-ammonia ligase(glutamine synthetase),neuronal nuclei,and ionized calcium-binding adapter molecule 1 immunostaining to examine the emergence of bipolar cells,Müller glia,mature neurons,and microglia,respectively.The timing and spatial patterns of the emergence of these cell types were remarkably consistent between in vivo and explant retinas.Our study showed that the organotypic retinal explant culture model had a high degree of consistency with the progression of in vivo early postnatal retina development.The findings confirm the accuracy and credibility of this model and support its use for long-term,systematic,and continuous observation.展开更多
AIM:To investigate the value of optical coherence tomography angiography(OCTA)indicators in the diagnosis of diabetic retinopathy(DR),and to provide patients with diabetic nephropathy(DN)with more sensitive OCTA scree...AIM:To investigate the value of optical coherence tomography angiography(OCTA)indicators in the diagnosis of diabetic retinopathy(DR),and to provide patients with diabetic nephropathy(DN)with more sensitive OCTA screening indicators to detect concurrent DR at an early stage.METHODS:A total of 200 patients who treated in the ophthalmology department of the Seventh Affiliated Hospital,Sun Yat-sen University from 2022 to 2023 were included,including 95 first-diagnosed DR patients and 105 patients without DR,and all patients underwent OCTA examination and a collection of demographics and renal function parameters.After a quality check,automated measurements of the foveal avascular zone area,vessel density(VD),and perfusion density(PD)of both 3 mm×3 mm and 6 mm×6 mm windows were obtained.RESULTS:Using random forest and multivariate Logistic regression methods,we developed a diagnostic model for DR based on 12 variables(age,FBG,SBP,DBP,HbA1c,ALT,ALP,urea/Scr,DM duration,HUA,DN,and CMT).Adding specific OCTA parameters enhanced the efficacy of the existing diagnostic model for DR(outer vessel density in 6 mm×6 mm window,AUC=0.837 vs 0.819,P=0.03).In the study of DN patients,the parameters in the 6 mm×6 mm window improved the diagnostic efficacy of DR(inner VD;outer VD;full VD;outer PD;full PD).CONCLUSION:The outer VD in the 6 mm×6 mm window can enhance the efficacy of the traditional DR diagnostic model.Meanwhile,compared with the 3 mm×3 mm window,the microvascular parameters in the 6 mm×6 mm window focusing on DN patients can be more sensitive to diagnosing the occurrence of DR.展开更多
AIM:To evaluate the visual outcomes of implantable collamer lenses(ICLs)and identify the possible risk factors for ICL axis misalignment,and consequently,repositioning,explanting,or exchanging at a specialized eye hos...AIM:To evaluate the visual outcomes of implantable collamer lenses(ICLs)and identify the possible risk factors for ICL axis misalignment,and consequently,repositioning,explanting,or exchanging at a specialized eye hospital in Saudi Arabia.METHODS:The medical records of 813 eyes with different refractive errors corrected with ICL implantation were identified and included in this single-arm retrospective cohort study.The following data were collected:demographic characteristics,primary diagnosis,preoperative refraction,anterior chamber depth(ACD),white-to-white(WTW)measurement,endothelial cell density(ECD),and axial length.Patients’satisfaction and complaints,and their postoperative refraction,vault depth,and axis alignment with the preoperative target,were reviewed during the postoperative period.Collectively,these data were correlated with symptomatic axis rotation and the need for repositioning,explantation,or exchange due to high or low ICL vaults.RESULTS:Of 813 eyes,27(3.32%),13(1.59%),and 11(1.35%)required ICL repositioning,ICL explantation only without exchange,and ICL explantation with the placement of a new ICL,respectively.The mean follow-up period was 37.5mo.The main cause of explanation or exchange was incorrect WTW measurement in seven(29.17%)eyes,followed by high vault in four(16.56%)eyes.ICL repositioning was required in 27(3.32%)eyes with considerable rotation.Only 2(0.24%)eyes developed cataracts that required ICL removal,and retinal complications were reported in 7(0.86%)eyes.Long-term glaucoma and corneal decompensation were not observed in this cohort.CONCLUSION:With a high safety profile and reversibility,ICL implantation is a good alternative to corneal-based refractive surgery in eyes unsuitable for laser vision correction.The rate of secondary procedures in our study was 6.26%.Old age is a risk factor for secondary surgical interventions in the repositioning group,whereas abnormal vault and toric ICL rotation in the explantation group necessitated subsequent surgical procedures.Overall,ICL implantation demonstrates a good efficacy index and safety profile in patients with diverse refractive errors.展开更多
AIM:To compare the clinical outcomes of extended depth-of-focus intraocular lenses(EDOF IOLs)using either micromonovision implantation or mixed implantation of EDOF and diffractive bifocal IOLs.METHODS:This retrospect...AIM:To compare the clinical outcomes of extended depth-of-focus intraocular lenses(EDOF IOLs)using either micromonovision implantation or mixed implantation of EDOF and diffractive bifocal IOLs.METHODS:This retrospective clinical trial included 130 patients(260 eyes),who were divided into two groups.Group RR comprised 70 patients(140 eyes)bilaterally implanted with ZXR00 IOLs(Tecnis ZXR00,where one target was-0.5 D to-0.75 D and the other was 0 to-0.25 D).Group RM comprised 60 patients(120 eyes)unilaterally implanted with both ZXR00 and ZMB00 IOLs(Tecnis ZMB00,0 to-0.25 D).Postoperative outcomes were compared after 3 mo,including visual acuity,defocus curves,stereoacuity,modulation transfer functions(MTFs),higher-order aberrations,and Visual Function-14(VF-14)questionnaire responses.RESULTS:Group RR had superior bilateral intermediate vision,while the group RM had superior bilateral near vision(both P<0.05).Group RM also exhibited superior MTFs and reduced higher-order aberrations(both P<0.05).Stereoacuity and VF-14 questionnaire results showed no statistically significant difference between groups(P>0.05).CONCLUSION:The implantation of micromonovision has significantly improved near vision.IOLs and their collocation can be customized according to individual patient needs to achieve precise treatment and provide cataract patients with high-quality vision.展开更多
AIM:To explore the morphological and functional parameters to evaluate the effectiveness of intravitreal injections of ranibizumab(IVR)in treating macular edema(ME)secondary to retinal vein occlusion(RVO).METHODS:This...AIM:To explore the morphological and functional parameters to evaluate the effectiveness of intravitreal injections of ranibizumab(IVR)in treating macular edema(ME)secondary to retinal vein occlusion(RVO).METHODS:This retrospective study involved 65 RVO patients(65 eyes)who received IVR and were followedup for more than 3mo.ME was categorized into cystoid macular edema(CME),diffuse retinal thickening(DRT),and serous retinal detachment(SRD)according to optical coherence tomography(OCT)images.The comparison of best corrected visual acuity(BCVA;logMAR)and central macular thickness(CMT)among different follow-up points and those among 3 groups were performed by Kruskal-Wallis test.The correlation between BCVA and baseline parameters during treatment was analyzed using Spearman correlation analysis.RESULTS:BCVA tended to improve in all groups,with marked improvement in CME and DRT groups.CMT showed the greatest reduction after 1wk,and remained stable over the following 3mo.DRT patients had the worst BCVA and the highest CMT at baseline,but the differences became smaller after IVR treatment.CMT in SRD group was significantly better than in CME and DRT groups 3mo after IVR.Most patients of CME and SRD groups transitioned to a normal pattern at 3mo follow-up.DRT patients were most likely to transform into the other morphological groups,while SRD patients showed minimal transitions.BCVA at baseline was identified as the most important prognostic indicator in all 3 groups.Additionally,DRT patients with a longer clinical course,higher CMT and central retinal vein occlusion(CRVO)tend to exhibit worse BCVA after treatment.In addition,CRVO patients are more likely to have worse BCVA at 2 and 3mo follow-up compared with branch retinal vein occlusion(BRVO)patients in CME group.SRD patients with higher baseline CMT were prone to experiencing worse BCVA after treatment.CONCLUSION:The effectiveness of IVR is strongly correlated with baseline BCVA in all 3 groups.Baseline parameters including clinical course,CMT,and RVO position are also useful in predicting the BCVA at different time points after treatment.展开更多
AIM:To assess the relationship between serological parameters and the prognosis of young patients with retinal vein occlusion(RVO)after intravitreal conbercept injection(IVC).METHODS:This study enrolled 100 young pati...AIM:To assess the relationship between serological parameters and the prognosis of young patients with retinal vein occlusion(RVO)after intravitreal conbercept injection(IVC).METHODS:This study enrolled 100 young patients(≤50 years old)diagnosed with RVO-related macular edema(RVO-ME)who had been undergoing IVC at the 474 Hospital in Xinjiang between January 2022 and October 2023.Patients were categorized into two groups:70 eyes in the effective group and 30 eyes in the ineffective group.The effective group comprised patients exhibiting a visual acuity improvement of≥2 lines at the last follow-up,with resolved ME and central macular thickness(CMT)<300μm.Conversely,the ineffective group included patients with visual acuity improvement of<1 line,persistent ME,and CMT≥300μm at the last follow-up.Serological parameters,including white blood cell count,neutrophil count,lymphocyte count,monocyte count,and mean platelet volume were assessed before treatment.The correlation between bestcorrected visual acuity(BCVA)and neutrophil-to-lymphocyte ratio(NLR),platelet-to-lymphocyte ratio(PLR),systemic immune inflammation index(SII),and systemic immune response index(SIRI)was analyzed.Additionally,the association between these serological parameters and the efficacy of IVC was explored.RESULTS:Three months after treatment,the effective group demonstrated a significant improvement in BCVA from 0.82±0.20 to 0.36±0.10,with a concurrent decrease in CMT from 661.28±163.90 to 200.61±82.45μm(P<0.001).Conversely,the ineffective group exhibited minimal changes in BCVA(0.86±0.25 to 0.82±0.14)and CMT(669.84±164.95 to 492.13±138.67μm,P<0.001).The differences in BCVA and CMT between the two groups were statistically significant(P<0.001).According to subgroup analysis,in patients with central RVO(CRVO),BCVA improved from 0.82±0.23 to 0.49±0.12 in the effective group and from 0.80±0.18 to 0.76±0.22 in the ineffective group(P<0.001).The CMT changes followed a similar pattern.In patients with branch RVO(BRVO),comparable trends in BCVA and CMT changes were observed between the effective and ineffective groups(P<0.001).Additionally,the effective group exhibited higher PLR and SII values than the ineffective group(P<0.05).Further CRVO and BRVO subgroups analysis exhibited consistent PLR and SII value trends.CONCLUSION:Compared to other inflammatory factors,elevated PLR and SII levels before treatment are better predictors of outcomes in young RVO-ME patients undergoing IVC treatment.展开更多
文摘Cytomegalovirus (CMV) retinitis is a significant yet infrequent complication inpediatric hematopoietic stem cell transplant recipients, occurring in approximately4% of cases. Its presentation typically coincides with immune reconstitution,between 6 weeks to 6 months post-transplant, emphasizing the need fortimely detection. Symptoms often develop insidiously, underscoring the role offundus examinations during episodes of CMV viremia. However, the low incidencechallenges the necessity of routine screenings, as they may strain clinicalresources without clear benefits to patient outcomes. Management includes systemicand intravitreal antivirals, such as ganciclovir and foscarnet, and adoptiveT-cell therapy for refractory cases. Tailored follow-up strategies are crucial, withconsiderations for lesion activity and CMV viremia status to determine theduration of therapy. Baseline and post-transplant screenings remain a topic ofdebate, with evolving guidelines needed to balance patient safety and clinicalfeasibility. Future research is needed to address optimal screening intervals andinvestigate the role of pre-existing CMV serostatus in transplant eligibility andoutcomes.
文摘AIM:To investigate the capabilities of large language models(LLM)for providing information and diagnoses in the field of neuro-ophthalmology by comparing the performances of ChatGPT-3.5 and-4.0,Bard,and Bing.METHODS:Each chatbot was evaluated for four criteria,namely diagnostic success rate for the described case,answer quality,response speed,and critical keywords for diagnosis.The selected topics included optic neuritis,nonarteritic anterior ischemic optic neuropathy,and Leber hereditary optic neuropathy.RESULTS:In terms of diagnostic success rate for the described cases,Bard was unable to provide a diagnosis.The success rates for the described cases increased in the order of Bing,ChatGPT-3.5,and ChatGPT-4.0.Further,ChatGPT-4.0 and-3.5 provided the most satisfactory answer quality for judgment by neuro-ophthalmologists,with their sets of answers resembling the sample set most.Bard was only able to provide ten differential diagnoses in three trials.Bing scored the lowest for the satisfactory standard.A Mann-Whitney test indicated that Bard was significantly faster than ChatGPT-4.0(Z=-3.576,P=0.000),ChatGPT-3.5(Z=-3.576,P=0.000)and Bing(Z=-2.517,P=0.011).ChatGPT-3.5 and-4.0 far exceeded the other two interfaces at providing diagnoses and were thus used to find the critical keywords for diagnosis.CONCLUSION:ChatGPT-3.5 and-4.0 are better than Bard and Bing in terms of answer success rate,answer quality,and critical keywords for diagnosis in ophthalmology.This study has broad implications for the field of ophthalmology,providing further evidence that artificial intelligence LLM can aid clinical decision-making through free-text explanations.
基金supported by Health and Medical Research Fund,Hong Kong(11220386,12230246).
文摘Background:With the rapid development of artificial intelligence(AI),large language models(LLMs)have emerged as a potent tool for invigorating ophthalmology across clinical,educational,and research fields.Their accuracy and reliability have undergone tested.This bibliometric analysis aims to provide an overview of research on LLMs in ophthalmology from both thematic and geographical perspectives.Methods:All existing and highly cited LLM-related ophthalmology research papers published in English up to 24th April 2025 were sourced from Scopus,PubMed,and Web of Science.The characteristics of these publications,including publication output,authors,journals,countries,institutions,citations,and research domains,were analyzed using Biblioshiny and VOSviewer software.Results:A total of 277 articles from 1,459 authors and 89 journals were included in this study.Although relevant publications began to appear in 2019,there was a significant increase starting from 2023.He M and Shi D are the most prolific authors,while Investigative Ophthalmology&Visual Science stands out as the most prominent journal.Most of the top-publishing countries are high-income economies,with the USA taking the lead,and the University of California is the leading institution.VOSviewer identified 5 clusters in the keyword co-occurrence analysis,indicating that current research focuses on the clinical applications of LLMs,particularly in diagnosis and patient education.Conclusions:While LLMs have demonstrated effectiveness in retaining knowledge,their accuracy in image-based diagnosis remains limited.Therefore,future research should investigate fine-tuning strategies and domain-specific adaptations to close this gap.Although research on the applications of LLMs in ophthalmology is still in its early stages,it holds significant potential for advancing the field.
基金supported by the Fujian Provincial Undergraduate Teaching Reform Project(J21008)Teaching Research Program for Undergraduate Education at Fujian Medical University(J24030).
文摘Virtual Reality(VR)technology is widely recognized as a prominent technological paradigm.Its potential and promise in the domain of ophthalmology are substantial,and the evolution of VR technology has significantly influenced the contemporary landscape of ophthalmology.Numerous empirical studies have validated the practical utility of VR technology in domains such as ophthalmic disease treatment and surgery training.This paper offers a comprehensive overview of VR technology's utilization in ophthalmic disease treatment,student education,and surgery training,expands the application of VR technology in ophthalmic evaluation and disease diagnosis,discusses the challenges and limitations of VR technology in ophthalmology,and expounds on emerging trends and future developments of VR technology in ophthalmology.This endeavor aims to provide readers with an in-depth comprehension of the current status and future prospects of VR technology application in ophthalmology,with the ultimate objective of fostering more effective advancements and applications of VR technology in the realm of ophthalmology.
文摘Glaucoma,a prevalent and debilitating eye disease,has long been associated with vision impairment and blindness.However,recent research has shed light on the often-underestimated psychological dimensions of this condition.Anxiety and depression,two pervasive psychiatric comorbidities,have been increasingly recognized among glaucoma patients.This comprehensive review aims to explore the intricate relationship between psychiatry and ophthalmology,in the context of managing depression and anxiety in glaucoma patients.By meticulously examining peer-reviewed literature,we synthesize current knowledge on the prevalence,risk factors,and underlying mechanisms of anxiety and depression in glaucoma.The evidence reveals that glaucoma patients face an elevated risk of experiencing these mood disorders.Factors such as progressive vision loss,complex medication regimens,and the fear of further visual deterioration contribute to their vulnerability.Moreover,we delve into the bidirectional relationship between glaucoma and mood disorders,shedding light on the complex interplay between ocular and emotional health.Our review investigates the implications of anxiety and depression on glaucoma management,including their potential impact on treatment adherence,disease progression,and overall quality of life.We also explore the neurobiological pathways linking glaucoma and mood disorders,providing a foundation for future research and potential therapeutic interventions.In conclusion,recognizing the psychological burden carried by glaucoma patients is essential for holistic and patient-centered care.This review underscores the pressing need for integrated approaches that bring together ophthalmological and psychiatric expertise to optimize the well-being of individuals facing the challenges of glaucoma.By addressing anxiety and depression in glaucoma care,healthcare providers can enhance the overall quality of life for these patients,ultimately leading to improved outcomes and a brighter future for those affected by this condition.This review offers valuable insight for healthcare practitioners and researchers,providing a concise overview of key topics and research in the field of managing depression and anxiety in glaucoma patients.
文摘Background and Objective:Social media(SoMe)has emerged as a tool in health professions education(HPE),particularly amidst the challenges posed by the coronavirus disease 2019(COVID-19)pandemic.Despite the academia’s initial skepticism SoMe has been gaining traction in supporting learning communities,and offering opportunities for innovation in HPE.Our study aims to explore the integration of SoMe in HPE.Four key components were outlined as necessary for a successful integration,and include designing learning experiences,defining educator roles,selecting appropriate platforms,and establishing educational objectives.Methods:This article stemmed from the online Teaching Skills Series module on SoMe in education from the Ophthalmology Foundation,and drew upon evidence supporting learning theories relevant to SoMe integration and models of education.Additionally,we conducted a literature review considering Englishlanguage articles on the application of SoMe in ophthalmology from PubMed over the past decade.Key Content and Findings:Early adopters of SoMe platforms in HPE have leveraged these tools to enhance learning experiences through interaction,dialogue,content sharing,and active learning strategies.By integrating SoMe into educational programs,both online and in-person,educators can overcome time and geographical constraints,fostering more diverse and inclusive learning communities.Careful consideration is,however,necessary to address potential limitations within HPE.Conclusions:This article lays groundwork for expanding SoMe integration in HPE design,emphasizing the supportive scaffold of various learning theories,and the need of furthering robust research on examining its advantages over traditional educational formats.Our literature review underscores an ongoing multifaceted,random application of SoMe platforms in ophthalmology education.We advocate for an effective incorporation of SoMe in HPE education,with the need to comply with good educational practice.
文摘AIM:To evaluate residents’perceptions and attitudes toward the various aspects of a comprehensive ophthalmic examination,and to determine if these factors correlate with their choices for fellowship and future career plans.METHODS:This is a cross-sectional study.A questionnaire on the perception of the ophthalmic exam was sent via SurveyMonkey to ophthalmology residents throughout Israel.Eighty of them(one-half of all ophthalmology residents in 2019)completed it.The first part related to how they perceived each component of the ophthalmic evaluation.The second part related to their future fellowship plans.The Chi-squared test was used to compare categorical variables and Student’s t-test and One-way ANOVA were used to compare continuous variables.Multivariate logistic regression analysis was applied as needed to detect interactions between variables and to exclude confounder effects.RESULTS:Slit-lamp examination of the anterior and posterior segments ranked as the most likeable aspects,whereas gonioscopy,ocular motility examination and visual acuity assessment were least likeable.Anterior segment and retina subspecialties were the ones most sought after.Forty-nine respondents(61.3%)noted a direct correlation between their preferred parts of comprehensive ophthalmic evaluations and their choice of subspecialty.Perceptions of selected components of those evaluations were significantly associated with responders’intentions to pursue anterior segment,retina,or oculoplastic fellowships(P<0.05).CONCLUSION:Perspectives of residents toward the ophthalmic examination,and most specifically its individual components,play an important role in their choice of subspecialty training.
文摘The use of interactive audience software,such as audience response systems(ARS),in medical education has become increasingly popular in recent years.This technology allows instructors to engage students in real time,encouraging active participation and promoting effective learning.The benefits of interactive audience software in medical education include increased student engagement,promotion of active learning,and enhanced learning outcomes.However,there are also several challenges to its implementation,including technical difficulties,careful planning and preparation,over-reliance on technology,and ethical concerns related to privacy and data security.The cost of implementing interactive audience software may also be a barrier for some institutions.This paper specifically reviews six interactive software platforms,including Socrative,Quizizz,Pear Deck,Slido,Wooclap and ClassPoint.These platforms allow for real-time assessment of student understanding,feedback,and participation.They also enable instructors to adjust their teaching strategies based on student responses and feedback.Overall,interactive audience software has shown great potential to enhance learning and engagement in medical education.It is important for instructors to carefully consider the benefits and challenges of its implementation.While the cost of implementing interactive audience software may be a barrier for some institutions,there are free and low-cost options available.
文摘Our goal as medical educators is for our students to learn what they need to know and competently perform ophthalmic procedures.In addition,the students need to have good communication skills and behave professionally and ethically(1,2).Most medical educators are not taught how to teach but rather learn by role-modeling their mentors.This can be good or bad depending on the mentor!In addition,the amount of knowledge and numbers of surgical procedures is ever increasing and yet,in most countries,the amount of time to train and become competent is not changing.Thus,our goal of creating competent ophthalmologists is ever more challenging.
文摘Background and Objective:Advances in teleophthalmology and artificial intelligence(AI)for diabetic retinal screening is of growing public health interest.Currently,only 30–40%of patients with diabetes adhere to recommended diabetes screening guidelines.To enhance early detection and reduce vision threatening complications,there has been a growing number of teleophthalmology programs and novel AI algorithms with the aim to improve eye care access.The purpose of this review is to assess current literature on teleophthalmology and AI for use in diabetic retinopathy(DR)screening,and to discuss advances and barriers to these innovative technologies.Methods:Literature review involving teleophthalmology and AI for DR screening,with focus on the past decade.Key Content and Findings:Teleophthalmology has demonstrated the ability to increase DR screening rates,enable earlier eye care access,and reduce healthcare costs.Novel AI-based DR screening programs appear accurate and effective,but detection of other ocular pathologies is still under development and not yet approved in the United States.Logistical,technological,financial,and legal barriers limit widespread adoption and long-term sustainability of teleophthalmology programs.Conclusions:The use of teleophthalmology and AI algorithms expands eye care access and helps prevent vision loss from DR and potentially other sight threatening conditions.Transparency in the process utilized for arriving at a particular diagnosis or decision to refer,often referred to as the“black box”,remains a multifaceted issue within the field of telemedicine for developing trust and improving patient-centered outcomes.
基金Supported by National Nature Science Foundation of China(No.62306254)SanMing Project of Medicine in Shenzhen(No.SZSM202311012)+1 种基金Shenzhen Fund for Guangdong Provincial High-level Clinical Key Specialties(No.SZGSP014)Shenzhen Science and Technology Program(No.KCXFZ20211020163813019).
文摘This paper analyzes the current status,technological developments,academic exchange platforms,and future challenges and solutions in the field of intelligent ophthalmology(IO)in China.In terms of technology,significant progress has been made in various areas,including diabetic retinopathy,fundus image analysis,quality assessment of medical artificial intelligence products,clinical research methods,technical evaluation,and industry standards.Researchers continually enhance the safety and standardization of IO technology by formulating a series of clinical application guidelines and standards.The establishment of domestic and international academic exchange platforms provides extensive collaboration opportunities for professionals in various fields,and various academic journals serve as publication platforms for IO research.However,challenges such as technological innovation,data privacy and security,lagging regulations,and talent shortages still pose obstacles to future development.To address these issues,future efforts should focus on strengthening technological research and development,regulatory framework construction,talent cultivation,and increasing patient awareness and acceptance of new technologies.By comprehensively addressing these challenges,IO in China is poised to further lead the industry’s development on a global scale,bringing more innovation and convenience to the field of ophthalmic healthcare.
文摘Background and Objective:TriNetX is a global,federated,health research network that has become increasingly utilized in academic medicine.In the last 2 years,the field of ophthalmology has seen an uptick in the number of publications of TriNetX analyses.The objective of this review is to summarize the process of conducting a TriNetX study,the trends in TriNetX use,and the utility of TriNetX in ophthalmology research.Additionally,the strengths and limitations of TriNetX use in ophthalmology research will be discussed.Methods:A PubMed and Scopus literature search was performed using the search terms:“TriNetX”and“Ophthalmology”or“Eye”.Included articles were English language only from the years 1994 to June 1,2024.The twenty-one included articles were analyzed for trends in study design,strengths,and weaknesses.Additionally,a mock study was performed to describe the process of completing a TriNetX study.Key Content and Findings:The literature search revealed a marked increase in TriNetX publications in ophthalmology journals in the years 2023 to 2024.Using a methodology similar to the studies identified in the literature search,a mock investigation of the relationship between cataract removal and hip fracture was detailed from start to finish,providing a framework for the use of TriNetX in ophthalmology research.The mock study provided results consistent with previously reported findings.Lastly,a thorough review of the strengths and limitations of TriNetX identified major considerations in study design,coding,data availability,propensity score matching,bias,and analytical challenges that researchers must be aware of when conducting research with TriNetX.However,many of the discussed limitations can be circumvented with careful and informed use of the platform.Conclusions:TriNetX is a powerful research tool that offers volumetric advantages and time efficiency,making it an attractive option for conducting observational studies.Despite its strengths,caution must be exercised when designing studies to ensure their validity and quality.With careful informed use,TriNetX is a valuable resource in ophthalmology research.
文摘Retroperitoneal soft tissue sarcomas in the retroperitoneal/intra-abdominal regions represent 10% - 15% of all cases of soft tissue sarcoma. Liposarcomas, which are the most common histological type, account for 20% - 45% of retroperitoneal/intra-abdominal sarcoma cases, and 20% of liposarcomas cases are primary retroperitoneal liposarcomas. Surgical resection in case of malignancy remains the treatment of choice for liposarcomas, according to the guidelines of most major international companies. Our goal was to improve the management of retroperitoneal liposarcoma. This was a 65-year-old patient, with no medical or surgical history, who was referred to us for abdominal swelling, in whom clinical and paraclinical examination found retroperitoneal liposarcoma stage IV, and the surgical treatment consisted in making a tumor reduction. Conclusion: Retro-peritoneal liposarcoma is an undervalued malignant tumor, and the diagnosis is often late.
基金supported by the National Natural Science Foundation of China,No.82171080Nanjing Medical Science and Technology Development Project,No.YKK23264Postgraduate Research&Practice Innovation Program of Jiangsu Province,Nos.JX10414151,JX10414152(all to KL)。
文摘Age-related macular degeneration is a serious neurodegenerative disease of the retina that significantly impacts vision.Unfortunately,the specific pathogenesis remains unclear,and effective early treatment options are consequently lacking.The microbiome is defined as a large ecosystem of microorganisms living within and coexisting with a host.The intestinal microbiome undergoes dynamic changes owing to age,diet,genetics,and other factors.Such dysregulation of the intestinal flora can disrupt the microecological balance,resulting in immunological and metabolic dysfunction in the host,and affecting the development of many diseases.In recent decades,significant evidence has indicated that the intestinal flora also influences systems outside of the digestive tract,including the brain.Indeed,several studies have demonstrated the critical role of the gut-brain axis in the development of brain neurodegenerative diseases,including Alzheimer’s disease and Parkinson’s disease.Similarly,the role of the“gut-eye axis”has been confirmed to play a role in the pathogenesis of many ocular disorders.Moreover,age-related macular degeneration and many brain neurodegenerative diseases have been shown to share several risk factors and to exhibit comparable etiologies.As such,the intestinal flora may play an important role in age-related macular degeneration.Given the above context,the present review aims to clarify the gut-brain and gut-eye connections,assess the effect of intestinal flora and metabolites on age-related macular degeneration,and identify potential diagnostic markers and therapeutic strategies.Currently,direct research on the role of intestinal flora in age-related macular degeneration is still relatively limited,while studies focusing solely on intestinal flora are insufficient to fully elucidate its functional role in age-related macular degeneration.Organ-on-a-chip technology has shown promise in clarifying the gut-eye interactions,while integrating analysis of the intestinal flora with research on metabolites through metabolomics and other techniques is crucial for understanding their potential mechanisms.
基金supported by the National Natural Science Foundation of China,Nos.81901156(to ZZ),82271200(to ZZ),82171308(to XC)the Fundamental Research Funds for the Central Universities,No.xzy012022035(to ZZ)+1 种基金the Natural Science Foundation of Shaanxi Province,Nos.2021JM-261(to QK),2023-YBSF-303(to ZZ)Traditional Chinese Medicine Project of Shaanxi Province,No.2019-ZZ-JC047(to QK)。
文摘The organotypic retinal explant culture has been established for more than a decade and offers a range of unique advantages compared with in vivo experiments and cell cultures.However,the lack of systematic and continuous comparison between in vivo retinal development and the organotypic retinal explant culture makes this model controversial in postnatal retinal development studies.Thus,we aimed to verify the feasibility of using this model for postnatal retinal development studies by comparing it with the in vivo retina.In this study,we showed that postnatal retinal explants undergo normal development,and exhibit a consistent structure and timeline with retinas in vivo.Initially,we used SOX2 and PAX6 immunostaining to identify retinal progenitor cells.We then examined cell proliferation and migration by immunostaining with Ki-67 and doublecortin,respectively.Ki-67-and doublecortin-positive cells decreased in both in vivo and explants during postnatal retinogenesis,and exhibited a high degree of similarity in abundance and distribution between groups.Additionally,we used Ceh-10 homeodomain-containing homolog,glutamate-ammonia ligase(glutamine synthetase),neuronal nuclei,and ionized calcium-binding adapter molecule 1 immunostaining to examine the emergence of bipolar cells,Müller glia,mature neurons,and microglia,respectively.The timing and spatial patterns of the emergence of these cell types were remarkably consistent between in vivo and explant retinas.Our study showed that the organotypic retinal explant culture model had a high degree of consistency with the progression of in vivo early postnatal retina development.The findings confirm the accuracy and credibility of this model and support its use for long-term,systematic,and continuous observation.
文摘AIM:To investigate the value of optical coherence tomography angiography(OCTA)indicators in the diagnosis of diabetic retinopathy(DR),and to provide patients with diabetic nephropathy(DN)with more sensitive OCTA screening indicators to detect concurrent DR at an early stage.METHODS:A total of 200 patients who treated in the ophthalmology department of the Seventh Affiliated Hospital,Sun Yat-sen University from 2022 to 2023 were included,including 95 first-diagnosed DR patients and 105 patients without DR,and all patients underwent OCTA examination and a collection of demographics and renal function parameters.After a quality check,automated measurements of the foveal avascular zone area,vessel density(VD),and perfusion density(PD)of both 3 mm×3 mm and 6 mm×6 mm windows were obtained.RESULTS:Using random forest and multivariate Logistic regression methods,we developed a diagnostic model for DR based on 12 variables(age,FBG,SBP,DBP,HbA1c,ALT,ALP,urea/Scr,DM duration,HUA,DN,and CMT).Adding specific OCTA parameters enhanced the efficacy of the existing diagnostic model for DR(outer vessel density in 6 mm×6 mm window,AUC=0.837 vs 0.819,P=0.03).In the study of DN patients,the parameters in the 6 mm×6 mm window improved the diagnostic efficacy of DR(inner VD;outer VD;full VD;outer PD;full PD).CONCLUSION:The outer VD in the 6 mm×6 mm window can enhance the efficacy of the traditional DR diagnostic model.Meanwhile,compared with the 3 mm×3 mm window,the microvascular parameters in the 6 mm×6 mm window focusing on DN patients can be more sensitive to diagnosing the occurrence of DR.
文摘AIM:To evaluate the visual outcomes of implantable collamer lenses(ICLs)and identify the possible risk factors for ICL axis misalignment,and consequently,repositioning,explanting,or exchanging at a specialized eye hospital in Saudi Arabia.METHODS:The medical records of 813 eyes with different refractive errors corrected with ICL implantation were identified and included in this single-arm retrospective cohort study.The following data were collected:demographic characteristics,primary diagnosis,preoperative refraction,anterior chamber depth(ACD),white-to-white(WTW)measurement,endothelial cell density(ECD),and axial length.Patients’satisfaction and complaints,and their postoperative refraction,vault depth,and axis alignment with the preoperative target,were reviewed during the postoperative period.Collectively,these data were correlated with symptomatic axis rotation and the need for repositioning,explantation,or exchange due to high or low ICL vaults.RESULTS:Of 813 eyes,27(3.32%),13(1.59%),and 11(1.35%)required ICL repositioning,ICL explantation only without exchange,and ICL explantation with the placement of a new ICL,respectively.The mean follow-up period was 37.5mo.The main cause of explanation or exchange was incorrect WTW measurement in seven(29.17%)eyes,followed by high vault in four(16.56%)eyes.ICL repositioning was required in 27(3.32%)eyes with considerable rotation.Only 2(0.24%)eyes developed cataracts that required ICL removal,and retinal complications were reported in 7(0.86%)eyes.Long-term glaucoma and corneal decompensation were not observed in this cohort.CONCLUSION:With a high safety profile and reversibility,ICL implantation is a good alternative to corneal-based refractive surgery in eyes unsuitable for laser vision correction.The rate of secondary procedures in our study was 6.26%.Old age is a risk factor for secondary surgical interventions in the repositioning group,whereas abnormal vault and toric ICL rotation in the explantation group necessitated subsequent surgical procedures.Overall,ICL implantation demonstrates a good efficacy index and safety profile in patients with diverse refractive errors.
文摘AIM:To compare the clinical outcomes of extended depth-of-focus intraocular lenses(EDOF IOLs)using either micromonovision implantation or mixed implantation of EDOF and diffractive bifocal IOLs.METHODS:This retrospective clinical trial included 130 patients(260 eyes),who were divided into two groups.Group RR comprised 70 patients(140 eyes)bilaterally implanted with ZXR00 IOLs(Tecnis ZXR00,where one target was-0.5 D to-0.75 D and the other was 0 to-0.25 D).Group RM comprised 60 patients(120 eyes)unilaterally implanted with both ZXR00 and ZMB00 IOLs(Tecnis ZMB00,0 to-0.25 D).Postoperative outcomes were compared after 3 mo,including visual acuity,defocus curves,stereoacuity,modulation transfer functions(MTFs),higher-order aberrations,and Visual Function-14(VF-14)questionnaire responses.RESULTS:Group RR had superior bilateral intermediate vision,while the group RM had superior bilateral near vision(both P<0.05).Group RM also exhibited superior MTFs and reduced higher-order aberrations(both P<0.05).Stereoacuity and VF-14 questionnaire results showed no statistically significant difference between groups(P>0.05).CONCLUSION:The implantation of micromonovision has significantly improved near vision.IOLs and their collocation can be customized according to individual patient needs to achieve precise treatment and provide cataract patients with high-quality vision.
基金Supported by the Suzhou Medical Innovation Application Research Project(SZM2023027).
文摘AIM:To explore the morphological and functional parameters to evaluate the effectiveness of intravitreal injections of ranibizumab(IVR)in treating macular edema(ME)secondary to retinal vein occlusion(RVO).METHODS:This retrospective study involved 65 RVO patients(65 eyes)who received IVR and were followedup for more than 3mo.ME was categorized into cystoid macular edema(CME),diffuse retinal thickening(DRT),and serous retinal detachment(SRD)according to optical coherence tomography(OCT)images.The comparison of best corrected visual acuity(BCVA;logMAR)and central macular thickness(CMT)among different follow-up points and those among 3 groups were performed by Kruskal-Wallis test.The correlation between BCVA and baseline parameters during treatment was analyzed using Spearman correlation analysis.RESULTS:BCVA tended to improve in all groups,with marked improvement in CME and DRT groups.CMT showed the greatest reduction after 1wk,and remained stable over the following 3mo.DRT patients had the worst BCVA and the highest CMT at baseline,but the differences became smaller after IVR treatment.CMT in SRD group was significantly better than in CME and DRT groups 3mo after IVR.Most patients of CME and SRD groups transitioned to a normal pattern at 3mo follow-up.DRT patients were most likely to transform into the other morphological groups,while SRD patients showed minimal transitions.BCVA at baseline was identified as the most important prognostic indicator in all 3 groups.Additionally,DRT patients with a longer clinical course,higher CMT and central retinal vein occlusion(CRVO)tend to exhibit worse BCVA after treatment.In addition,CRVO patients are more likely to have worse BCVA at 2 and 3mo follow-up compared with branch retinal vein occlusion(BRVO)patients in CME group.SRD patients with higher baseline CMT were prone to experiencing worse BCVA after treatment.CONCLUSION:The effectiveness of IVR is strongly correlated with baseline BCVA in all 3 groups.Baseline parameters including clinical course,CMT,and RVO position are also useful in predicting the BCVA at different time points after treatment.
基金Supported by Youth Cultivation Research Program of Beijing Road Medical Area,Xinjiang Military Region General Hospital,Xinjiang,China(No.2022jzbj105)Science and Technology Program of Urumqi Municipal Health and Wellness Commission(No.202360).
文摘AIM:To assess the relationship between serological parameters and the prognosis of young patients with retinal vein occlusion(RVO)after intravitreal conbercept injection(IVC).METHODS:This study enrolled 100 young patients(≤50 years old)diagnosed with RVO-related macular edema(RVO-ME)who had been undergoing IVC at the 474 Hospital in Xinjiang between January 2022 and October 2023.Patients were categorized into two groups:70 eyes in the effective group and 30 eyes in the ineffective group.The effective group comprised patients exhibiting a visual acuity improvement of≥2 lines at the last follow-up,with resolved ME and central macular thickness(CMT)<300μm.Conversely,the ineffective group included patients with visual acuity improvement of<1 line,persistent ME,and CMT≥300μm at the last follow-up.Serological parameters,including white blood cell count,neutrophil count,lymphocyte count,monocyte count,and mean platelet volume were assessed before treatment.The correlation between bestcorrected visual acuity(BCVA)and neutrophil-to-lymphocyte ratio(NLR),platelet-to-lymphocyte ratio(PLR),systemic immune inflammation index(SII),and systemic immune response index(SIRI)was analyzed.Additionally,the association between these serological parameters and the efficacy of IVC was explored.RESULTS:Three months after treatment,the effective group demonstrated a significant improvement in BCVA from 0.82±0.20 to 0.36±0.10,with a concurrent decrease in CMT from 661.28±163.90 to 200.61±82.45μm(P<0.001).Conversely,the ineffective group exhibited minimal changes in BCVA(0.86±0.25 to 0.82±0.14)and CMT(669.84±164.95 to 492.13±138.67μm,P<0.001).The differences in BCVA and CMT between the two groups were statistically significant(P<0.001).According to subgroup analysis,in patients with central RVO(CRVO),BCVA improved from 0.82±0.23 to 0.49±0.12 in the effective group and from 0.80±0.18 to 0.76±0.22 in the ineffective group(P<0.001).The CMT changes followed a similar pattern.In patients with branch RVO(BRVO),comparable trends in BCVA and CMT changes were observed between the effective and ineffective groups(P<0.001).Additionally,the effective group exhibited higher PLR and SII values than the ineffective group(P<0.05).Further CRVO and BRVO subgroups analysis exhibited consistent PLR and SII value trends.CONCLUSION:Compared to other inflammatory factors,elevated PLR and SII levels before treatment are better predictors of outcomes in young RVO-ME patients undergoing IVC treatment.
