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
Ischemia–reperfusion injury is a common pathophysiological mechanism in retinal degeneration.PANoptosis is a newly defined integral form of regulated cell death that combines the key features of pyroptosis,apoptosis,...Ischemia–reperfusion injury is a common pathophysiological mechanism in retinal degeneration.PANoptosis is a newly defined integral form of regulated cell death that combines the key features of pyroptosis,apoptosis,and necroptosis.Oligomerization of mitochondrial voltage-dependent anion channel 1 is an important pathological event in regulating cell death in retinal ischemia–reperfusion injury.However,its role in PANoptosis remains largely unknown.In this study,we demonstrated that voltage-dependent anion channel 1 oligomerization-mediated mitochondrial dysfunction was associated with PANoptosis in retinal ischemia–reperfusion injury.Inhibition of voltage-dependent anion channel 1 oligomerization suppressed mitochondrial dysfunction and PANoptosis in retinal cells subjected to ischemia–reperfusion injury.Mechanistically,mitochondria-derived reactive oxygen species played a central role in the voltagedependent anion channel 1-mediated regulation of PANoptosis by promoting PANoptosome assembly.Moreover,inhibiting voltage-dependent anion channel 1 oligomerization protected against PANoptosis in the retinas of rats subjected to ischemia–reperfusion injury.Overall,our findings reveal the critical role of voltage-dependent anion channel 1 oligomerization in regulating PANoptosis in retinal ischemia–reperfusion injury,highlighting voltage-dependent anion channel 1 as a promising therapeutic target.展开更多
The intersection of visual impairment and mental health has profound effects on quality of life and warrants attention from healthcare providers,educators,and policymakers.With 20 million children under the age of 14 ...The intersection of visual impairment and mental health has profound effects on quality of life and warrants attention from healthcare providers,educators,and policymakers.With 20 million children under the age of 14 affected globally,older adults also experience significant psychological impact including depression,anxiety,and cognitive impairment.The implications of vision-related challenges extend far beyond mere sight.Depression and anxiety,exacerbated by social isolation and reduced physical activity,underscore the need for comprehensive interventions that address both medical and psychosocial dimensions.By recognizing the profound impact of ocular morbidities like strabismus,myopia,glaucoma,and age-related macular degeneration on mental health and investing in effective treatments and inclusive practices,society can pave the way for a healthier,more equitable future for affected individuals.There is evidence that myopic children experience a higher prevalence of depressive symptoms compared to their normal peers,and interventions like the correction of strabismus can enhance psychological outcome-demonstrating the value of an integrated management approach.展开更多
Dear Editor,We present this case report which discusses a patient who underwent flap amputation after repeated attempts to resolve persistent and severe epithelial ingrowth following laser-assisted in situ keratomileu...Dear Editor,We present this case report which discusses a patient who underwent flap amputation after repeated attempts to resolve persistent and severe epithelial ingrowth following laser-assisted in situ keratomileusis(LASIK)surgery.Epithelial ingrowth is a known complication of LASIK surgery,typically manageable with minimal measures.However,severe cases may necessitate more aggressive interventions,such as flap amputation[1].LASIK is a widely performed refractive surgery with high success rates and excellent visual outcome[2].展开更多
Tunneling nanotubes are crucial structures for cellular communication and are observed in a variety of cell types.Glial cells,the most abundant cells in the nervous system,play a vital role in intercellular signaling ...Tunneling nanotubes are crucial structures for cellular communication and are observed in a variety of cell types.Glial cells,the most abundant cells in the nervous system,play a vital role in intercellular signaling and can show abnormal activation under pathological conditions.Our bibliometric analysis indicated a substantial increase in research on tunneling nanotubes over the past two decades,highlighting their important role in cellular communication.This review focuses on the formation of tunneling nanotubes in various types of glial cells,including astrocytes,microglia,glioma cells,and Schwann cells,as well as their roles in cellular communication and cargo transport.We found that glial cells influence the stability of the neural system and play a role in nerve regeneration through tunneling nanotubes.Tunneling nanotubes facilitate the transmission and progression of diseases by transporting pathogens and harmful substances.However,they are also involved in alleviating cellular stress by removing toxins and delivering essential nutrients.Understanding the interactions between glial cells through tunneling nanotubes could provide valuable insights into the complex neural networks that govern brain function and responses to injury.展开更多
Retinal ganglion cells,a crucial component of the central nervous system,are often affected by irreversible visual impairment due to various conditions,including trauma,tumors,ischemia,and glaucoma.Studies have shown ...Retinal ganglion cells,a crucial component of the central nervous system,are often affected by irreversible visual impairment due to various conditions,including trauma,tumors,ischemia,and glaucoma.Studies have shown that the optic nerve crush model and glaucoma model are commonly used to study retinal ganglion cell injury.While these models differ in their mechanisms,both ultimately result in retinal ganglion cell injury.With advancements in high-throughput technologies,techniques such as microarray analysis,RNA sequencing,and single-cell RNA sequencing have been widely applied to characterize the transcriptomic profiles of retinal ganglion cell injury,revealing underlying molecular mechanisms.This review focuses on optic nerve crush and glaucoma models,elucidating the mechanisms of optic nerve injury and neuron degeneration induced by glaucoma through single-cell transcriptomics,transcriptome analysis,and chip analysis.Research using the optic nerve crush model has shown that different retinal ganglion cell subtypes exhibit varying survival and regenerative capacities following injury.Single-cell RNA sequencing has identified multiple genes associated with retinal ganglion cell protection and regeneration,such as Gal,Ucn,and Anxa2.In glaucoma models,high-throughput sequencing has revealed transcriptomic changes in retinal ganglion cells under elevated intraocular pressure,identifying genes related to immune response,oxidative stress,and apoptosis.These genes are significantly upregulated early after optic nerve injury and may play key roles in neuroprotection and axon regeneration.Additionally,CRISPR-Cas9 screening and ATAC-seq analysis have identified key transcription factors that regulate retinal ganglion cell survival and axon regeneration,offering new potential targets for neurorepair strategies in glaucoma.In summary,single-cell transcriptomic technologies provide unprecedented insights into the molecular mechanisms underlying optic nerve injury,aiding in the identification of novel therapeutic targets.Future researchers should integrate advanced single-cell sequencing with multi-omics approaches to investigate cell-specific responses in retinal ganglion cell injury and regeneration.Furthermore,computational models and systems biology methods could help predict molecular pathways interactions,providing valuable guidance for clinical research on optic nerve regeneration and repair.展开更多
AIM:To investigate the efficacy and safety of 90°inferonasal sectoral goniotomy with an micro-vitreoretinal(MVR)blade in patients with mild-to-moderate primary open-angle glaucoma(POAG)and pseudoexfoliation glauc...AIM:To investigate the efficacy and safety of 90°inferonasal sectoral goniotomy with an micro-vitreoretinal(MVR)blade in patients with mild-to-moderate primary open-angle glaucoma(POAG)and pseudoexfoliation glaucoma(PEXG).METHODS:This retrospective study included data from 60 patients(60 eyes)who underwent stand-alone goniotomy or goniotomy with phacoemulsification between August 2021 and January 2023,and 45 eyes underwent goniotomy combined with phacoemulsification,and 15 eyes underwent goniotomy as a stand-alone procedure.Postoperatively,intraocular pressure(IOP)and the number of medications were collected at 1,3,6,and 12 mo.The side effects of surgery were recorded 1 d,1 wk,and 1,3,6,and 12 mo postoperatively.The primary outcomes were a reduction in IOP of at least 20%from baseline and a decrease in the number of antiglaucomatous medications in 1 a postoperatively.The secondary outcome was surgical success,defined as an IOP<18 mmHg with(qualified)or without(complete)antiglaucomatous medication at 1 a postoperatively.RESULTS:At the end of 1 a,78%of patients achieved both a>20%reduction in IOP and a reduction in the number of medications used.Overall success was achieved in 63%of patients.Microhyphaema was the most common complication,none of the patients experienced a complication requiring surgical intervention.CONCLUSION:Sectoral inferonasal goniotomy with an MVR blade significantly reduced IOP and the number of medications required in patients with POAG and PEXG,and 1-year follow-up after goniotomy showed that the need for filtering surgery was either eliminated or delayed in a significant number of patients.展开更多
AIM:To investigate the effects of chronic alcohol consumption on retinal microcirculation by comparing different alcohol-consuming groups using optical coherence tomography(OCT)and OCT angiography(OCTA).METHODS:This o...AIM:To investigate the effects of chronic alcohol consumption on retinal microcirculation by comparing different alcohol-consuming groups using optical coherence tomography(OCT)and OCT angiography(OCTA).METHODS:This observational clinical study utilized a cross-sectional and prospective design,focusing on chronic alcohol consumers alongside a non-consuming control group.OCT/OCTA imaging parameters including central retinal subfield thickness(CST),subfoveal choroidal thickness(SCT),foveal avascular zone(FAZ)and vessel density(VD)in the superficial and deep capillary plexuses in both the macular and optic disc(OD)regions were recorded.Data were analyzed using SPSS 15.0;descriptive statistics were reported,group comparisons were performed with Chisquare,Kruskal–Wallis,and Bonferroni-corrected Mann–Whitney U tests,and relationships were assessed using Spearman correlation,with statistical significance set at P<0.05.RESULTS:A total of 160 eyes of 160 participants(110 females and 50 males with mean age 38.7±9.9y)who don’t smoke were divided into five groups:never,occasional,monthly,weekly and daily drinkers.The mean CST was 216.6±14.2μm and the mean SCT was 358.9±84.5μm.There was no statistically significantly difference in CST and SCT among the groups(P=0.890,0.799).Foveal superficial capillary plexuses(SCPs)VD was higher in monthly drinkers compared to occasional drinkers(P=0.015).Foveal VD in deep capillary plexus was also higher in monthly drinkers than in never and occasional drinkers(P=0.004,0.006).Nasal SCPs VD at the OD was higher in monthly drinkers compared to never drinkers(P=0.005).There was no significant difference FAZ area among the groups(P=0.071).CONCLUSION:Both superficial and deep microvascular structures in the inferior quadrants of macula are positively correlated with frequency of alcohol use.Also in our study results is that the monthly drinker group has uniquely higher VDs in both macula and OD.This leads us to consider moderate alcohol consumption may also have protective effects on retinal microcirculation.展开更多
AIM:To identify key genes and inflammatory signaling pathways involved in the anti-inflammatory effects of Hedysarum polybotrys polysaccharide(HPS)in a rat model of endotoxin-induced uveitis(EIU).METHODS:EIU was induc...AIM:To identify key genes and inflammatory signaling pathways involved in the anti-inflammatory effects of Hedysarum polybotrys polysaccharide(HPS)in a rat model of endotoxin-induced uveitis(EIU).METHODS:EIU was induced in Wistar rats through subcutaneous injection of lipopolysaccharide(LPS,200μg)and the rats were then randomly assigned to EIU group(n=5)and the HPS intervention group(n=5).HPS(400 mg/kg,intraperitoneally)or its carrier was administered 24h and 1h prior to EIU induction.Eyes were examined and enucleated 24h post-induction,and total RNA was extracted from the iris-ciliary body.Gene expression microarrays were used to identify differentially expressed genes(DEGs),followed by bioinformatics analyses,including gene ontology(GO)and pathway analysis.Key findings were not experimentally validated at the mRNA or protein level.RESULTS:A total of 322 DEGs were identified,comprising 254 mRNA and 68 lncRNA genes.GO analysis revealed significant functional categories,including response to LPS.Pathway analysis identified key signaling pathways involved in uveitis,such as cytokine-cytokine receptor interactions.Notably,16 mRNA and 7 lncRNA DEGs emerged as central nodes in the gene correlation network.CONCLUSION:HPS exerts its anti-inflammatory effects through coordinated signaling pathways,offering insights into potential therapeutic targets for managing uveitis.展开更多
Dear Editor,Ciliary body masses are diagnostically challenging due to their hidden location,diverse pathologies,and limited examination methods[1].We report a case of a ciliary body inflammatory mass treated with tran...Dear Editor,Ciliary body masses are diagnostically challenging due to their hidden location,diverse pathologies,and limited examination methods[1].We report a case of a ciliary body inflammatory mass treated with trans-scleral excision and antiinflammatory therapy,preserving functional vision.展开更多
AIM:To investigate age-related differences in the irislens angle(ILA)among patients with age-related cortical cataracts and elucidate the impact of age on lens stability.METHODS:A prospective observational study was c...AIM:To investigate age-related differences in the irislens angle(ILA)among patients with age-related cortical cataracts and elucidate the impact of age on lens stability.METHODS:A prospective observational study was conducted on patients with age-related cortical cataracts scheduled for phacoemulsification surgery.Preoperative ultrasound biomicroscopy(UBM)images were collected and analyzed.Initially,patients were stratified into two age groups:<60y and≥60y,with no significant intergroup differences in sex or eye laterality.For further analysis,participants were subdivided into three age strata:<60y,60-75y,and>75y.The ILA was measured in four quadrants(superior,inferior,nasal,and temporal).Intergroup differences in ILA were compared,and correlations between age and ILA parameters were analyzed using statistical methods.RESULTS:The sample data were categorized into three groups according to age,<60y(113 patients;55.8%female),60–75y(245 patients;61.0%female),and>75y(70 patients;50.2%female).The superior quadrant ILA increased progressively with age stratification(P=0.02),and the maximum ILA difference(ΔILA)was significantly higher in patients over 75y(P<0.01).Simple linear regression analysis demonstrated a positive correlation between age and ILA in the superior(Y=7.487+0.096X,R=0.191,P<0.001)and temporal(Y=10.254+0.052X,R=0.104,P=0.032)quadrants.Additionally,the mean ILA across all quadrants(ILAmean)andΔILA were positively correlated with age(ILAmean:Y=9.721+0.055X,R=0.138,P=0.004;ΔILA:Y=3.267+0.044X,R=0.006,P<0.05).CONCLUSION:In patients with age-related cortical cataracts,ILA increases with age,particularly in the superior and temporal quadrants,suggesting that advanced age is associated with greater lens deviation and decreased lens stability.UBM imaging can effectively evaluate the status of the zonule and lens stability,providing crucial evidence for personalized surgical planning based on patients’age.展开更多
Objective:To compare the clinical efficacy and safety of intravitreal injection of faricimab and conbercept in the treatment of diabetic macular edema(DME).Methods:A total of 50 patients diagnosed with DME in our hosp...Objective:To compare the clinical efficacy and safety of intravitreal injection of faricimab and conbercept in the treatment of diabetic macular edema(DME).Methods:A total of 50 patients diagnosed with DME in our hospital from January 2023 to May 2025 were selected and randomly divided into an observation group and a control group,with 25 cases in each group,using a random number table method.The observation group received intravitreal injection of faricimab,while the control group received intravitreal injection of conbercept.Both groups adopted a loading phase plus maintenance phase treatment regimen.The best-corrected visual acuity(BCVA,expressed in logMAR)and central subfield thickness(CST)of the two groups were compared before treatment and at 1,3,and 6 months after treatment,and the incidence of adverse events during treatment was recorded.Results:The logMAR BCVA in the observation group was lower than that in the control group at 3 and 6 months after treatment(both p<0.05).The CST in the observation group was smaller than that in the control group at 1,3,and 6 months after treatment(all p<0.05).There was no statistically significant difference in the overall incidence of adverse events between the two groups(χ^(2)=0.189,p=0.663).Conclusion:Both intravitreal injections of faricimab and conbercept are effective in improving visual acuity and reducing macular edema in patients with DME,with good safety profiles.However,faricimab demonstrates superior efficacy in the medium to long term(3 and 6 months)compared to conbercept,making it more suitable for long-term treatment of patients with DME.展开更多
AIM:To clarify the clinical correlations and causal relationships between lipid metabolism and the progression of thyroid-associated ophthalmopathy(TAO).METHODS:This case-control study retrieved clinical data from 201...AIM:To clarify the clinical correlations and causal relationships between lipid metabolism and the progression of thyroid-associated ophthalmopathy(TAO).METHODS:This case-control study retrieved clinical data from 2018 to 2023.A total of 2591 patients were enrolled,including 197 patients with TAO(case group)and 2394 patients with hyperthyroidism without TAO(control group).Serum lipid parameters,including triglycerides,total cholesterol,high-density lipoprotein(HDL),low-density lipoprotein(LDL),and the HDL/total cholesterol ratio,as well as thyroid function markers,were compared between the two groups.Correlation analyses were performed to evaluate the associations between serum lipid levels and key ocular manifestations of TAO,including exophthalmos degree,clinical activity score,and disease severity.Furthermore,Mendelian randomization(MR)analysis was conducted using genome-wide association study(GWAS)datasets,with hyperthyroidism as the exposure variable and serum lipid parameters as the outcome variables,to infer the causal relationship between hyperthyroidism,lipid metabolism,and TAO progression.RESULTS:The TAO group consisted of 101 males and 96 females,while the hyperthyroidism group included 706 males and 1688 females.Compared with the control group,patients with TAO had significantly higher levels of triglycerides(1.83±1.21 vs 1.40±1.08 mmol/L,P<0.01),total cholesterol,LDL,and HDL.Correlation analysis showed that triglyceride levels were positively correlated with exophthalmos degree,whereas HDL levels were inversely correlated with exophthalmos degree.No significant associations were found between serum lipid levels and clinical activity score(P>0.1).MR analysis confirmed that hyperthyroidism exerted a causal effect in reducing serum triglycerides[inverse-variance weighting odds ratio(OR)=0.035,95%confidence interval(CI):0.01-0.12]and total cholesterol(OR=0.085,95%CI:0.02-0.34),with no evidence of horizontal pleiotropy(MR-PRESSO P>0.05).CONCLUSION:Elevated serum triglyceride levels are an independent risk factor for TAO severity,especially exophthalmos,and triglyceride metabolism is inversely regulated by thyroid function.展开更多
AIM:To ascertain the pattern of ocular morbidity in a population of primary school children in rural Kenya as it is a prerequisite for planning effective preventive and therapeutic strategies.METHODS:A cross-sectional...AIM:To ascertain the pattern of ocular morbidity in a population of primary school children in rural Kenya as it is a prerequisite for planning effective preventive and therapeutic strategies.METHODS:A cross-sectional survey of ocular symptoms and clinical eye examinations were performed in a sample of 35 rural primary schools in the semi-arid region of Kajiado West sub-county in S.W.Kenya,amongst a seminomadic tribe(Maasai).Students in Grades 1-8 were included.Visual acuity was measured using the Snellen“tumbling E”chart at 6 m.Children with symptoms of refractive error underwent non-cycloplegic refraction.RESULTS:A total of 2036 children(1084 males)between the ages of 4-20y were examined.Conjunctival actinic changes were present in 22%(442/2036).Nine cases were seen with a potential squamous carcinoma.No overt classical ocular signs of vitamin A deficiency were noted,although 181(8.9%)children complained of nyctalopia.Three hundred thirty-six(16.5%)children had a visual acuity worse than 6/12 in either eye,were unable to read N10 near text at 40 cm or had symptoms suggestive of refractive error.Refractive data led to an estimate of hyperopia of+1.00 D or more in 3.9%and of myopia of-0.50 D or more in either eye in 3.0%of the study population.CONCLUSION:Solar exposure-and dust-related conjunctival pathology is common.As this may develop into potentially sight-or even life-threatening conditions,it warrants further study,and preventive strategies may be needed.Complaints of nyctalopia were common and could suggest vitamin A deficiency.The prevalence of refractive errors is low in this rural African population.展开更多
AIM:To report and analyze cases of sterile intraocular inflammation(IOI)following intravitreal faricimab injections in patients treated for neovascular age-related macular degeneration(nAMD)and diabetic macular edema(...AIM:To report and analyze cases of sterile intraocular inflammation(IOI)following intravitreal faricimab injections in patients treated for neovascular age-related macular degeneration(nAMD)and diabetic macular edema(DME).METHODS:This double-center case series included nine eyes of six patients who developed uveitis after faricimab therapy.Comprehensive clinical evaluation was performed,including slit-lamp examination,intraocular pressure(IOP)measurement,fluorescein and indocyanine green angiography(ICGA),and laboratory tests.Inflammatory responses were treated with topical or systemic corticosteroids,and patients were monitored for visual acuity and inflammatory activity.RESULTS:The incidence of IOI was 0.8%per patient(Innsbruck)and 0.23%(Czechia),with inflammation typically occurring between the third and sixth injection(mean interval:10d post-injection).Inflammator y presentations ranged from anterior uveitis to posterior segment involvement.One notable case demonstrated novel choroidal hypofluorescent lesions on angiography,suggesting deeper ocular involvement.The mean patient age was 76y;five of six affected patients were female.All cases responded to local and systemic corticosteroids,with full recovery of initial visual acuity.CONCLUSION:Sterile IOI after faricimab appears to be a rare but relevant adverse event.Although the incidence falls within expected ranges for anti-vascular endothelial growth factor(anti-VEGF)agents,the observed choroidal involvement represents a potentially new safety signal.Prompt diagnosis and corticosteroid therapy are effective in all cases.Our findings support the need for vigilant post-marketing surveillance and further studies to better understand the underlying mechanisms and risk factors of faricimab-associated inflammation.展开更多
AIM:To evaluate the therapeutic effects of ranibizumab on optic disc and macular microvascular perfusion in central retinal vein occlusion(CRVO)with macular edema(ME).METHODS:Optical coherence tomography angiology(OCT...AIM:To evaluate the therapeutic effects of ranibizumab on optic disc and macular microvascular perfusion in central retinal vein occlusion(CRVO)with macular edema(ME).METHODS:Optical coherence tomography angiology(OCTA)parameters,including optic disc vessel density(VD;including whole-disc VD,intra-disc VD,and peripapillary VD),superficial/deep capillary plexus(SCP/DCP)VD,and central macular thickness(CMT)were analyzed.Additional assessments included best-corrected visual acuity(BCVA)via Early Treatment Diabetic Retinopathy Study(ETDRS)chart and hemorheological profiling.CRVO patients received monthly intravitreal ranibizumab injections for three consecutive months.Pre-and post-treatment parameters were statistically compared.RESULTS:The study comprised 60 CRVO-ME patients(28 males;32 females),aged 50-78y(mean 63.3±7.6y)and 60 age-/sex-matched healthy controls.As compared with participants exhibiting normal funduscopic findings,CRVO patients demonstrated significantly elevated levels of low-shear-rate whole blood viscosity(LSR-WBV),high-shearrate whole blood viscosity(HSR-WBV),and aggregation index(AI,all P<0.05).In CRVO-affected eyes,vertical cupto-disc(C/D)ratio and optic cup volume were significantly smaller,whereas retinal nerve fiber layer(RNFL)thickness was significantly greater,compared to both unaffected contralateral eyes and normal control eyes(all P<0.05).Following treatment,VD of the entire optic disc(P<0.05),intra-disc VD(P<0.05),and peripapillary VD(P<0.05)all increased significantly relative to baseline.CMT decreased significantly(P<0.05),whereas macular SCP-VD and macular DCP-VD showed non-significant slight reductions(P>0.05).At baseline,BCVA of CRVO eyes correlated with whole-disc VD(r=-0.276,P=0.033),intra-disc VD(r=-0.342,P=0.009),and peripapillary VD(r=-0.335,P=0.007),with intra-disc VD demonstrating the strongest association.Besides,BCVA improvement,after the treatment,correlated positively with whole-disc VD(r=0.342,P=0.008)and intradisc VD(r=0.396,P=0.002).CONCLUSION:Optic disc blood perfusion is more closely associated with visual acuity than macular perfusion,suggesting intra-disc VD may serve as a potential biomarker for monitoring visual acuity changes in CRVO.Multiple ranibizumab injections significantly improve optic disc perfusion but may have exerted detrimental effects on the macula.CRVO patients shows higher hemorheological parameters than those with normal fundi.Reduced vertical C/D ratio and optic cup volume may be linked to CRVO incidence,potentially acting as susceptibility factors.展开更多
AIM:To investigate the underlying causes of surgical failure and reoperation management in patients with rhegmatogenous retinal detachment(RRD)who underwent scleral buckle surgery at our institution.METHODS:This was a...AIM:To investigate the underlying causes of surgical failure and reoperation management in patients with rhegmatogenous retinal detachment(RRD)who underwent scleral buckle surgery at our institution.METHODS:This was a single-center,retrospective,descriptive study.The clinical data of 368 patients(387 eyes)with RRD who underwent scleral buckling(SB)surgery between August 2013 and July 2023 at our institution were collected.The aim was to analyze the causes of recurrence and the rationale for selecting reoperation methods.RESULTS:Totally 368 patients(387 eyes)were included in the analysis,comprising 222 males and 146 females.The average age was 30.26±14.18 years,and the mean follow-up duration was(48.33±20.39)mo.The success rate of SB surgery was 90.2%.Recurrent retinal detachment occurred in 38 eyes.Based on surgical records,the causes of SB failure were analyzed.The recurrence causes included abnormal compression ridge position(position,height,or width)in 14 eyes(36.8%,14/38),hole omission in 11 eyes(29.0%,11/38),proliferative vitreoretinopathy(PVR)in 10 eyes(26.3%,10/38),and new holes in 3 eyes(7.9%,3/38).Among these,8 eyes(21.1%,8/38)underwent repeat SB surgery,while the remaining 30 eyes(78.9%,30/38)underwent pars plana vitrectomy(PPV).Regarding tamponade agents,silicone oil was used in 11 eyes(36.7%,11/30),C_(3)F_(8) gas in 12 eyes(40.0%,12/30),and sterile air in 7 eyes(23.3%,7/30).CONCLUSION:SB surgery demonstrates a high success rate in the treatment of RRD.However,abnormal compression ridge position,missed holes during surgery,and PVR are the primary causes of SB failure.After addressing the reasons for failure,re-SB surgery or PPV can be effective alternatives.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.
基金supported by the National Natural Science Foundation of China,Nos.82172196(to KX),82372507(to KX)the Natural Science Foundation of Hunan Province,China,No.2023JJ40804(to QZ)the Key Laboratory of Emergency and Trauma(Hainan Medical University)of the Ministry of Education,China,No.KLET-202210(to QZ)。
文摘Ischemia–reperfusion injury is a common pathophysiological mechanism in retinal degeneration.PANoptosis is a newly defined integral form of regulated cell death that combines the key features of pyroptosis,apoptosis,and necroptosis.Oligomerization of mitochondrial voltage-dependent anion channel 1 is an important pathological event in regulating cell death in retinal ischemia–reperfusion injury.However,its role in PANoptosis remains largely unknown.In this study,we demonstrated that voltage-dependent anion channel 1 oligomerization-mediated mitochondrial dysfunction was associated with PANoptosis in retinal ischemia–reperfusion injury.Inhibition of voltage-dependent anion channel 1 oligomerization suppressed mitochondrial dysfunction and PANoptosis in retinal cells subjected to ischemia–reperfusion injury.Mechanistically,mitochondria-derived reactive oxygen species played a central role in the voltagedependent anion channel 1-mediated regulation of PANoptosis by promoting PANoptosome assembly.Moreover,inhibiting voltage-dependent anion channel 1 oligomerization protected against PANoptosis in the retinas of rats subjected to ischemia–reperfusion injury.Overall,our findings reveal the critical role of voltage-dependent anion channel 1 oligomerization in regulating PANoptosis in retinal ischemia–reperfusion injury,highlighting voltage-dependent anion channel 1 as a promising therapeutic target.
文摘The intersection of visual impairment and mental health has profound effects on quality of life and warrants attention from healthcare providers,educators,and policymakers.With 20 million children under the age of 14 affected globally,older adults also experience significant psychological impact including depression,anxiety,and cognitive impairment.The implications of vision-related challenges extend far beyond mere sight.Depression and anxiety,exacerbated by social isolation and reduced physical activity,underscore the need for comprehensive interventions that address both medical and psychosocial dimensions.By recognizing the profound impact of ocular morbidities like strabismus,myopia,glaucoma,and age-related macular degeneration on mental health and investing in effective treatments and inclusive practices,society can pave the way for a healthier,more equitable future for affected individuals.There is evidence that myopic children experience a higher prevalence of depressive symptoms compared to their normal peers,and interventions like the correction of strabismus can enhance psychological outcome-demonstrating the value of an integrated management approach.
文摘Dear Editor,We present this case report which discusses a patient who underwent flap amputation after repeated attempts to resolve persistent and severe epithelial ingrowth following laser-assisted in situ keratomileusis(LASIK)surgery.Epithelial ingrowth is a known complication of LASIK surgery,typically manageable with minimal measures.However,severe cases may necessitate more aggressive interventions,such as flap amputation[1].LASIK is a widely performed refractive surgery with high success rates and excellent visual outcome[2].
基金supported by the National Natural Science Foundation of China,No.82101115(to JY)the Wuhan University Independent Innovation Fund Youth Project,No.2042021kf0094(to JY).
文摘Tunneling nanotubes are crucial structures for cellular communication and are observed in a variety of cell types.Glial cells,the most abundant cells in the nervous system,play a vital role in intercellular signaling and can show abnormal activation under pathological conditions.Our bibliometric analysis indicated a substantial increase in research on tunneling nanotubes over the past two decades,highlighting their important role in cellular communication.This review focuses on the formation of tunneling nanotubes in various types of glial cells,including astrocytes,microglia,glioma cells,and Schwann cells,as well as their roles in cellular communication and cargo transport.We found that glial cells influence the stability of the neural system and play a role in nerve regeneration through tunneling nanotubes.Tunneling nanotubes facilitate the transmission and progression of diseases by transporting pathogens and harmful substances.However,they are also involved in alleviating cellular stress by removing toxins and delivering essential nutrients.Understanding the interactions between glial cells through tunneling nanotubes could provide valuable insights into the complex neural networks that govern brain function and responses to injury.
基金supported by the National Natural Science Foundation of China,Nos.82471123,82171053the Jilin Province Special Project for Talent in Medical and Health Sciences,No.2024WSXK-E01the Natural Science Foundation of Jilin Province,YDZJ202501ZYTS318(all to GL).
文摘Retinal ganglion cells,a crucial component of the central nervous system,are often affected by irreversible visual impairment due to various conditions,including trauma,tumors,ischemia,and glaucoma.Studies have shown that the optic nerve crush model and glaucoma model are commonly used to study retinal ganglion cell injury.While these models differ in their mechanisms,both ultimately result in retinal ganglion cell injury.With advancements in high-throughput technologies,techniques such as microarray analysis,RNA sequencing,and single-cell RNA sequencing have been widely applied to characterize the transcriptomic profiles of retinal ganglion cell injury,revealing underlying molecular mechanisms.This review focuses on optic nerve crush and glaucoma models,elucidating the mechanisms of optic nerve injury and neuron degeneration induced by glaucoma through single-cell transcriptomics,transcriptome analysis,and chip analysis.Research using the optic nerve crush model has shown that different retinal ganglion cell subtypes exhibit varying survival and regenerative capacities following injury.Single-cell RNA sequencing has identified multiple genes associated with retinal ganglion cell protection and regeneration,such as Gal,Ucn,and Anxa2.In glaucoma models,high-throughput sequencing has revealed transcriptomic changes in retinal ganglion cells under elevated intraocular pressure,identifying genes related to immune response,oxidative stress,and apoptosis.These genes are significantly upregulated early after optic nerve injury and may play key roles in neuroprotection and axon regeneration.Additionally,CRISPR-Cas9 screening and ATAC-seq analysis have identified key transcription factors that regulate retinal ganglion cell survival and axon regeneration,offering new potential targets for neurorepair strategies in glaucoma.In summary,single-cell transcriptomic technologies provide unprecedented insights into the molecular mechanisms underlying optic nerve injury,aiding in the identification of novel therapeutic targets.Future researchers should integrate advanced single-cell sequencing with multi-omics approaches to investigate cell-specific responses in retinal ganglion cell injury and regeneration.Furthermore,computational models and systems biology methods could help predict molecular pathways interactions,providing valuable guidance for clinical research on optic nerve regeneration and repair.
文摘AIM:To investigate the efficacy and safety of 90°inferonasal sectoral goniotomy with an micro-vitreoretinal(MVR)blade in patients with mild-to-moderate primary open-angle glaucoma(POAG)and pseudoexfoliation glaucoma(PEXG).METHODS:This retrospective study included data from 60 patients(60 eyes)who underwent stand-alone goniotomy or goniotomy with phacoemulsification between August 2021 and January 2023,and 45 eyes underwent goniotomy combined with phacoemulsification,and 15 eyes underwent goniotomy as a stand-alone procedure.Postoperatively,intraocular pressure(IOP)and the number of medications were collected at 1,3,6,and 12 mo.The side effects of surgery were recorded 1 d,1 wk,and 1,3,6,and 12 mo postoperatively.The primary outcomes were a reduction in IOP of at least 20%from baseline and a decrease in the number of antiglaucomatous medications in 1 a postoperatively.The secondary outcome was surgical success,defined as an IOP<18 mmHg with(qualified)or without(complete)antiglaucomatous medication at 1 a postoperatively.RESULTS:At the end of 1 a,78%of patients achieved both a>20%reduction in IOP and a reduction in the number of medications used.Overall success was achieved in 63%of patients.Microhyphaema was the most common complication,none of the patients experienced a complication requiring surgical intervention.CONCLUSION:Sectoral inferonasal goniotomy with an MVR blade significantly reduced IOP and the number of medications required in patients with POAG and PEXG,and 1-year follow-up after goniotomy showed that the need for filtering surgery was either eliminated or delayed in a significant number of patients.
文摘AIM:To investigate the effects of chronic alcohol consumption on retinal microcirculation by comparing different alcohol-consuming groups using optical coherence tomography(OCT)and OCT angiography(OCTA).METHODS:This observational clinical study utilized a cross-sectional and prospective design,focusing on chronic alcohol consumers alongside a non-consuming control group.OCT/OCTA imaging parameters including central retinal subfield thickness(CST),subfoveal choroidal thickness(SCT),foveal avascular zone(FAZ)and vessel density(VD)in the superficial and deep capillary plexuses in both the macular and optic disc(OD)regions were recorded.Data were analyzed using SPSS 15.0;descriptive statistics were reported,group comparisons were performed with Chisquare,Kruskal–Wallis,and Bonferroni-corrected Mann–Whitney U tests,and relationships were assessed using Spearman correlation,with statistical significance set at P<0.05.RESULTS:A total of 160 eyes of 160 participants(110 females and 50 males with mean age 38.7±9.9y)who don’t smoke were divided into five groups:never,occasional,monthly,weekly and daily drinkers.The mean CST was 216.6±14.2μm and the mean SCT was 358.9±84.5μm.There was no statistically significantly difference in CST and SCT among the groups(P=0.890,0.799).Foveal superficial capillary plexuses(SCPs)VD was higher in monthly drinkers compared to occasional drinkers(P=0.015).Foveal VD in deep capillary plexus was also higher in monthly drinkers than in never and occasional drinkers(P=0.004,0.006).Nasal SCPs VD at the OD was higher in monthly drinkers compared to never drinkers(P=0.005).There was no significant difference FAZ area among the groups(P=0.071).CONCLUSION:Both superficial and deep microvascular structures in the inferior quadrants of macula are positively correlated with frequency of alcohol use.Also in our study results is that the monthly drinker group has uniquely higher VDs in both macula and OD.This leads us to consider moderate alcohol consumption may also have protective effects on retinal microcirculation.
基金Supported by the National Natural Science Fundation of China(No.82101107No.81471575).
文摘AIM:To identify key genes and inflammatory signaling pathways involved in the anti-inflammatory effects of Hedysarum polybotrys polysaccharide(HPS)in a rat model of endotoxin-induced uveitis(EIU).METHODS:EIU was induced in Wistar rats through subcutaneous injection of lipopolysaccharide(LPS,200μg)and the rats were then randomly assigned to EIU group(n=5)and the HPS intervention group(n=5).HPS(400 mg/kg,intraperitoneally)or its carrier was administered 24h and 1h prior to EIU induction.Eyes were examined and enucleated 24h post-induction,and total RNA was extracted from the iris-ciliary body.Gene expression microarrays were used to identify differentially expressed genes(DEGs),followed by bioinformatics analyses,including gene ontology(GO)and pathway analysis.Key findings were not experimentally validated at the mRNA or protein level.RESULTS:A total of 322 DEGs were identified,comprising 254 mRNA and 68 lncRNA genes.GO analysis revealed significant functional categories,including response to LPS.Pathway analysis identified key signaling pathways involved in uveitis,such as cytokine-cytokine receptor interactions.Notably,16 mRNA and 7 lncRNA DEGs emerged as central nodes in the gene correlation network.CONCLUSION:HPS exerts its anti-inflammatory effects through coordinated signaling pathways,offering insights into potential therapeutic targets for managing uveitis.
基金Supported by National Natural Science Foundation of China(No.82101113).
文摘Dear Editor,Ciliary body masses are diagnostically challenging due to their hidden location,diverse pathologies,and limited examination methods[1].We report a case of a ciliary body inflammatory mass treated with trans-scleral excision and antiinflammatory therapy,preserving functional vision.
文摘AIM:To investigate age-related differences in the irislens angle(ILA)among patients with age-related cortical cataracts and elucidate the impact of age on lens stability.METHODS:A prospective observational study was conducted on patients with age-related cortical cataracts scheduled for phacoemulsification surgery.Preoperative ultrasound biomicroscopy(UBM)images were collected and analyzed.Initially,patients were stratified into two age groups:<60y and≥60y,with no significant intergroup differences in sex or eye laterality.For further analysis,participants were subdivided into three age strata:<60y,60-75y,and>75y.The ILA was measured in four quadrants(superior,inferior,nasal,and temporal).Intergroup differences in ILA were compared,and correlations between age and ILA parameters were analyzed using statistical methods.RESULTS:The sample data were categorized into three groups according to age,<60y(113 patients;55.8%female),60–75y(245 patients;61.0%female),and>75y(70 patients;50.2%female).The superior quadrant ILA increased progressively with age stratification(P=0.02),and the maximum ILA difference(ΔILA)was significantly higher in patients over 75y(P<0.01).Simple linear regression analysis demonstrated a positive correlation between age and ILA in the superior(Y=7.487+0.096X,R=0.191,P<0.001)and temporal(Y=10.254+0.052X,R=0.104,P=0.032)quadrants.Additionally,the mean ILA across all quadrants(ILAmean)andΔILA were positively correlated with age(ILAmean:Y=9.721+0.055X,R=0.138,P=0.004;ΔILA:Y=3.267+0.044X,R=0.006,P<0.05).CONCLUSION:In patients with age-related cortical cataracts,ILA increases with age,particularly in the superior and temporal quadrants,suggesting that advanced age is associated with greater lens deviation and decreased lens stability.UBM imaging can effectively evaluate the status of the zonule and lens stability,providing crucial evidence for personalized surgical planning based on patients’age.
文摘Objective:To compare the clinical efficacy and safety of intravitreal injection of faricimab and conbercept in the treatment of diabetic macular edema(DME).Methods:A total of 50 patients diagnosed with DME in our hospital from January 2023 to May 2025 were selected and randomly divided into an observation group and a control group,with 25 cases in each group,using a random number table method.The observation group received intravitreal injection of faricimab,while the control group received intravitreal injection of conbercept.Both groups adopted a loading phase plus maintenance phase treatment regimen.The best-corrected visual acuity(BCVA,expressed in logMAR)and central subfield thickness(CST)of the two groups were compared before treatment and at 1,3,and 6 months after treatment,and the incidence of adverse events during treatment was recorded.Results:The logMAR BCVA in the observation group was lower than that in the control group at 3 and 6 months after treatment(both p<0.05).The CST in the observation group was smaller than that in the control group at 1,3,and 6 months after treatment(all p<0.05).There was no statistically significant difference in the overall incidence of adverse events between the two groups(χ^(2)=0.189,p=0.663).Conclusion:Both intravitreal injections of faricimab and conbercept are effective in improving visual acuity and reducing macular edema in patients with DME,with good safety profiles.However,faricimab demonstrates superior efficacy in the medium to long term(3 and 6 months)compared to conbercept,making it more suitable for long-term treatment of patients with DME.
基金Supported by the National Natural Science Foundation of China(No.82371104)the Natural Science Foundation of Hunan Province(No.2023JJ30851).
文摘AIM:To clarify the clinical correlations and causal relationships between lipid metabolism and the progression of thyroid-associated ophthalmopathy(TAO).METHODS:This case-control study retrieved clinical data from 2018 to 2023.A total of 2591 patients were enrolled,including 197 patients with TAO(case group)and 2394 patients with hyperthyroidism without TAO(control group).Serum lipid parameters,including triglycerides,total cholesterol,high-density lipoprotein(HDL),low-density lipoprotein(LDL),and the HDL/total cholesterol ratio,as well as thyroid function markers,were compared between the two groups.Correlation analyses were performed to evaluate the associations between serum lipid levels and key ocular manifestations of TAO,including exophthalmos degree,clinical activity score,and disease severity.Furthermore,Mendelian randomization(MR)analysis was conducted using genome-wide association study(GWAS)datasets,with hyperthyroidism as the exposure variable and serum lipid parameters as the outcome variables,to infer the causal relationship between hyperthyroidism,lipid metabolism,and TAO progression.RESULTS:The TAO group consisted of 101 males and 96 females,while the hyperthyroidism group included 706 males and 1688 females.Compared with the control group,patients with TAO had significantly higher levels of triglycerides(1.83±1.21 vs 1.40±1.08 mmol/L,P<0.01),total cholesterol,LDL,and HDL.Correlation analysis showed that triglyceride levels were positively correlated with exophthalmos degree,whereas HDL levels were inversely correlated with exophthalmos degree.No significant associations were found between serum lipid levels and clinical activity score(P>0.1).MR analysis confirmed that hyperthyroidism exerted a causal effect in reducing serum triglycerides[inverse-variance weighting odds ratio(OR)=0.035,95%confidence interval(CI):0.01-0.12]and total cholesterol(OR=0.085,95%CI:0.02-0.34),with no evidence of horizontal pleiotropy(MR-PRESSO P>0.05).CONCLUSION:Elevated serum triglyceride levels are an independent risk factor for TAO severity,especially exophthalmos,and triglyceride metabolism is inversely regulated by thyroid function.
基金Supported by Vision International Eye Missions-USA,“One Drop for All”,Italy,and Private Donors in the Netherlands.
文摘AIM:To ascertain the pattern of ocular morbidity in a population of primary school children in rural Kenya as it is a prerequisite for planning effective preventive and therapeutic strategies.METHODS:A cross-sectional survey of ocular symptoms and clinical eye examinations were performed in a sample of 35 rural primary schools in the semi-arid region of Kajiado West sub-county in S.W.Kenya,amongst a seminomadic tribe(Maasai).Students in Grades 1-8 were included.Visual acuity was measured using the Snellen“tumbling E”chart at 6 m.Children with symptoms of refractive error underwent non-cycloplegic refraction.RESULTS:A total of 2036 children(1084 males)between the ages of 4-20y were examined.Conjunctival actinic changes were present in 22%(442/2036).Nine cases were seen with a potential squamous carcinoma.No overt classical ocular signs of vitamin A deficiency were noted,although 181(8.9%)children complained of nyctalopia.Three hundred thirty-six(16.5%)children had a visual acuity worse than 6/12 in either eye,were unable to read N10 near text at 40 cm or had symptoms suggestive of refractive error.Refractive data led to an estimate of hyperopia of+1.00 D or more in 3.9%and of myopia of-0.50 D or more in either eye in 3.0%of the study population.CONCLUSION:Solar exposure-and dust-related conjunctival pathology is common.As this may develop into potentially sight-or even life-threatening conditions,it warrants further study,and preventive strategies may be needed.Complaints of nyctalopia were common and could suggest vitamin A deficiency.The prevalence of refractive errors is low in this rural African population.
文摘AIM:To report and analyze cases of sterile intraocular inflammation(IOI)following intravitreal faricimab injections in patients treated for neovascular age-related macular degeneration(nAMD)and diabetic macular edema(DME).METHODS:This double-center case series included nine eyes of six patients who developed uveitis after faricimab therapy.Comprehensive clinical evaluation was performed,including slit-lamp examination,intraocular pressure(IOP)measurement,fluorescein and indocyanine green angiography(ICGA),and laboratory tests.Inflammatory responses were treated with topical or systemic corticosteroids,and patients were monitored for visual acuity and inflammatory activity.RESULTS:The incidence of IOI was 0.8%per patient(Innsbruck)and 0.23%(Czechia),with inflammation typically occurring between the third and sixth injection(mean interval:10d post-injection).Inflammator y presentations ranged from anterior uveitis to posterior segment involvement.One notable case demonstrated novel choroidal hypofluorescent lesions on angiography,suggesting deeper ocular involvement.The mean patient age was 76y;five of six affected patients were female.All cases responded to local and systemic corticosteroids,with full recovery of initial visual acuity.CONCLUSION:Sterile IOI after faricimab appears to be a rare but relevant adverse event.Although the incidence falls within expected ranges for anti-vascular endothelial growth factor(anti-VEGF)agents,the observed choroidal involvement represents a potentially new safety signal.Prompt diagnosis and corticosteroid therapy are effective in all cases.Our findings support the need for vigilant post-marketing surveillance and further studies to better understand the underlying mechanisms and risk factors of faricimab-associated inflammation.
基金Central High-Level Traditional Chinese Medicine Hospital Project of Eye Hospital China Academy of Chinese Medical Science(No.GSP5-83,No.GSP4-02No.GSP5-06)+1 种基金Supported by National Natural Science Foundation of China(General ProgramNo.82474582).
文摘AIM:To evaluate the therapeutic effects of ranibizumab on optic disc and macular microvascular perfusion in central retinal vein occlusion(CRVO)with macular edema(ME).METHODS:Optical coherence tomography angiology(OCTA)parameters,including optic disc vessel density(VD;including whole-disc VD,intra-disc VD,and peripapillary VD),superficial/deep capillary plexus(SCP/DCP)VD,and central macular thickness(CMT)were analyzed.Additional assessments included best-corrected visual acuity(BCVA)via Early Treatment Diabetic Retinopathy Study(ETDRS)chart and hemorheological profiling.CRVO patients received monthly intravitreal ranibizumab injections for three consecutive months.Pre-and post-treatment parameters were statistically compared.RESULTS:The study comprised 60 CRVO-ME patients(28 males;32 females),aged 50-78y(mean 63.3±7.6y)and 60 age-/sex-matched healthy controls.As compared with participants exhibiting normal funduscopic findings,CRVO patients demonstrated significantly elevated levels of low-shear-rate whole blood viscosity(LSR-WBV),high-shearrate whole blood viscosity(HSR-WBV),and aggregation index(AI,all P<0.05).In CRVO-affected eyes,vertical cupto-disc(C/D)ratio and optic cup volume were significantly smaller,whereas retinal nerve fiber layer(RNFL)thickness was significantly greater,compared to both unaffected contralateral eyes and normal control eyes(all P<0.05).Following treatment,VD of the entire optic disc(P<0.05),intra-disc VD(P<0.05),and peripapillary VD(P<0.05)all increased significantly relative to baseline.CMT decreased significantly(P<0.05),whereas macular SCP-VD and macular DCP-VD showed non-significant slight reductions(P>0.05).At baseline,BCVA of CRVO eyes correlated with whole-disc VD(r=-0.276,P=0.033),intra-disc VD(r=-0.342,P=0.009),and peripapillary VD(r=-0.335,P=0.007),with intra-disc VD demonstrating the strongest association.Besides,BCVA improvement,after the treatment,correlated positively with whole-disc VD(r=0.342,P=0.008)and intradisc VD(r=0.396,P=0.002).CONCLUSION:Optic disc blood perfusion is more closely associated with visual acuity than macular perfusion,suggesting intra-disc VD may serve as a potential biomarker for monitoring visual acuity changes in CRVO.Multiple ranibizumab injections significantly improve optic disc perfusion but may have exerted detrimental effects on the macula.CRVO patients shows higher hemorheological parameters than those with normal fundi.Reduced vertical C/D ratio and optic cup volume may be linked to CRVO incidence,potentially acting as susceptibility factors.
文摘AIM:To investigate the underlying causes of surgical failure and reoperation management in patients with rhegmatogenous retinal detachment(RRD)who underwent scleral buckle surgery at our institution.METHODS:This was a single-center,retrospective,descriptive study.The clinical data of 368 patients(387 eyes)with RRD who underwent scleral buckling(SB)surgery between August 2013 and July 2023 at our institution were collected.The aim was to analyze the causes of recurrence and the rationale for selecting reoperation methods.RESULTS:Totally 368 patients(387 eyes)were included in the analysis,comprising 222 males and 146 females.The average age was 30.26±14.18 years,and the mean follow-up duration was(48.33±20.39)mo.The success rate of SB surgery was 90.2%.Recurrent retinal detachment occurred in 38 eyes.Based on surgical records,the causes of SB failure were analyzed.The recurrence causes included abnormal compression ridge position(position,height,or width)in 14 eyes(36.8%,14/38),hole omission in 11 eyes(29.0%,11/38),proliferative vitreoretinopathy(PVR)in 10 eyes(26.3%,10/38),and new holes in 3 eyes(7.9%,3/38).Among these,8 eyes(21.1%,8/38)underwent repeat SB surgery,while the remaining 30 eyes(78.9%,30/38)underwent pars plana vitrectomy(PPV).Regarding tamponade agents,silicone oil was used in 11 eyes(36.7%,11/30),C_(3)F_(8) gas in 12 eyes(40.0%,12/30),and sterile air in 7 eyes(23.3%,7/30).CONCLUSION:SB surgery demonstrates a high success rate in the treatment of RRD.However,abnormal compression ridge position,missed holes during surgery,and PVR are the primary causes of SB failure.After addressing the reasons for failure,re-SB surgery or PPV can be effective alternatives.
