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: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
Calcium (Ca^(2+)) is a key intracellular messenger involved in a variety of cellular functions.Intracellular Ca^(2+)dysregulation drives neuron cell death in multiple degenerative diseases and traumatic conditions.Ret...Calcium (Ca^(2+)) is a key intracellular messenger involved in a variety of cellular functions.Intracellular Ca^(2+)dysregulation drives neuron cell death in multiple degenerative diseases and traumatic conditions.Retinal ganglion cell(RGC) degeneration occurs in blinding diseases such as glaucoma and other optic neuropathies.展开更多
AIM:To evaluate the demographics,clinical characteristics,treatments,and outcomes of patients with ocular surface squamous neoplasia(OSSN)at the Philippine General Hospital.METHODS:This was a single-center,11-year ret...AIM:To evaluate the demographics,clinical characteristics,treatments,and outcomes of patients with ocular surface squamous neoplasia(OSSN)at the Philippine General Hospital.METHODS:This was a single-center,11-year retrospective,cross sectional case series on 18 cases of OSSN seen between January 2012 to June 2023.The patient’s demographics,presenting symptoms,tumor characteristics,histopathologic diagnosis,treatment,outcomes,and duration of follow-up were reviewed.RESULTS:Out of 33 identified cases of OSSN,only 18 were eligible for inclusion in the study.Mean age was 60.78y(range 31 to 80),with male predominance(66.67%).The left eye was most commonly affected(61.11%)with most presenting with fleshy mass(83.33%).Most tumors were located nasally(66.67%)and were predominantly papilliform(44.44%)in morphology with associated hyperpigmentation(38.89%).Squamous cell carcinoma(SCCA)was the most common histopathologic diagnosis(72.22%).The main primary treatment was surgical excision(94.44%)with or without adjunctive therapy,with only 1 patient undergoing first-line topical chemotherapy.Only 3 recurrences(16.67%)were noted with a median followup of 7.5mo.A statistically significant recurrence-free odds leaning towards the utilization of cryotherapy was noted.CONCLUSION:OSSN seen at the Philippine General Hospital is presented as a limbal papilliform mass,most commonly affecting elderly males.Surgical excision with adjuvant cryotherapy and/or chemotherapy is the preferred mode of treatment.展开更多
Sir Nicholas Harold Lloyd Ridley has revolutionized the practice of ophthalmology by performing the firstintraocular lens （IOL） implantation in 1949. His scientific achievement was acknowledged thirty years later, w...Sir Nicholas Harold Lloyd Ridley has revolutionized the practice of ophthalmology by performing the firstintraocular lens （IOL） implantation in 1949. His scientific achievement was acknowledged thirty years later, which led to US Food and Drug Administration approval in 1981. Although the basic principles of IOL implantation have not changed since, many efforts have been invested in perfecting IOL design during the past decades.展开更多
AIM:To evaluate the recently described optical coherence tomography(OCT)based classification of epiretinal membrane(ERM)and its usefulness in predicting the functional outcome.METHODS:A retrospective observational rev...AIM:To evaluate the recently described optical coherence tomography(OCT)based classification of epiretinal membrane(ERM)and its usefulness in predicting the functional outcome.METHODS:A retrospective observational review of OCT scans of patients with the diagnosis of idiopathic ERM was carried out from January 2016 to June 2021.All consecutive images diagnosed with any stage of idiopathic ERM and fulfilled the eligibility criteria were included in the analysis.ERM was identified on OCT scans as a thin hyperreflective layer over the inner layers of retina.OCT scans of patients with ERM who underwent vitrectomy,were independently staged as per the new classification by two independent retinal surgeons to form a consensus on stage.Best corrected visual acuity(BCVA)in logMAR scale and central subfield thickness(CST)on pre-and post-operative spectral domain OCT scans were the variables noted for all patients at the time of diagnosis and at 6 and 12 mo follow up visit after undergoing intervention.Partial correlation coefficient was computed between BCVA(logMAR)and CST by ERM stage adjusting by baseline measures.RESULTS:Clinical charts of 74 patients with idiopathic ERM were assessed.Clinically significant improvement in BCVA overtime was observed with significant difference in median visual acuity of patients with StageⅡ-ⅣERM with P<0.001.The median CST of all patients with stageⅡ-ⅣERM showed similar consistent improvement with P<0.001 from baseline to 12^(th)month.Our results showed not only gain in visual acuity but also shift from baseline to anatomical normalization of CST in stageⅡ.We found a decrease in CST with difference of 166μm and 151μm in stageⅢand stageⅣrespectively.Our results remained consistent with the hypothesis of improved visual outcomes with all stages of ERM with adjusted moderate linear correlation between visual acuity and CST in stageⅡ-Ⅳ(r>0.3).CONCLUSION:Equally significant visual outcomes of patients with ERM stagedⅡ-Ⅳand therefore can be counselled for improved visual acuity after surgical removal of ERM with improvement up to 5 lines on Snellen's chart from the baseline.展开更多
AIM:To investigate the long-term results of penetrating keratoplasty(PK)in patients with keratoconus(KC)and to evaluate factors that might influence the final visual outcome.METHODS:We retrospectively reviewed the dat...AIM:To investigate the long-term results of penetrating keratoplasty(PK)in patients with keratoconus(KC)and to evaluate factors that might influence the final visual outcome.METHODS:We retrospectively reviewed the data of all patients with clinical KC who had undergone PK by a single corneal surgeon in a single center from May 1980to December 2005.The age of the patients,preoperative best-corrected visual acuity(BCVA),corneal thickness,death to preservation time,and preservation to transplantation time were recorded.Additionally,postoperative complications such as graft rejection,development of glaucoma and specular microscopy were checked during the follow-up.RESULTS:Sixty-nineeyesfrom69patientswerefinally included.The follow-up period was 8.64±6.13y.Graft rejection occurred in 4 eyes of 69 cases(5.8%),and the time to graft rejection was 2.1±1.3y.A Kaplan-Meier survival analysis showed that the estimated cumulative probability of graft rejection at 6,13,and 17y after PK were 95.6%,90.0%,and 78.8%,respectively.When we evaluated factors that might influence final BCVA in eyes,no disparity donor-host trephine size(same graft size)as well as higher spherical equivalent,and average Kvalue were associated with higher final BCVA.(P=0.006,0.051,0.092,and 0.021 in eyes with follow-up【8y;P=0.068,0.065,and 0.030 in eyes with follow-up≥8y,respectively).CONCLUSION:The long-term results of PK in patients with KC were favorable with a high percentage of good BCVA.Less myopic change and low average K-reading,as well as a surgical technique using the same size donor-recipient button may provide better visual outcomes particularly in patients with KC.展开更多
AIM:To investigate the visual impact of sub-Tenon anesthesia during combined phacoemulsification and vitrectomy surgery.METHODS:In this prospective case series, consecutive patients who underwent combined phacoemulsif...AIM:To investigate the visual impact of sub-Tenon anesthesia during combined phacoemulsification and vitrectomy surgery.METHODS:In this prospective case series, consecutive patients who underwent combined phacoemulsification and pars plana vitrectomy(PPV) under sub-Tenon anesthesia between October 2008 and September 2009 were enrolled. The patients were asked whether they could see the light of the operating microscope or not between various surgical steps with their contralateral eye being covered.RESULTS:A total of 163 eyes of 163 patients were enrolled in this study. After their contralateral eyes were covered, 152(93.3%) patients said that they could not see any light at least during one of the surgical steps. All eyes recovered to at least light perception on the first postoperative day. The incidence of no light perception during the surgery was not related to demographic factors, including age, gender, or type of ocular diseases.CONCLUSION:The incidence of no light perception during combined phacoemulsification and vitrectomy under sub-Tenon anesthesia was high in our study.Patients should be duly informed about this temporary but potential intraoperative event.展开更多
AIMTo evaluate Jordanian ophthalmology residency programs in achieving competencies outlined by the International Council of Ophthalmology (ICO) and residents' satisfaction with available training programs in Jord...AIMTo evaluate Jordanian ophthalmology residency programs in achieving competencies outlined by the International Council of Ophthalmology (ICO) and residents' satisfaction with available training programs in Jordan, and to highlight weakness points that may be improved and strengthened.展开更多
AIM:To assess the repeatability,interocular correlation,and agreement of quantitative swept-source optical coherence tomography angiography(OCTA)optic nerve head(ONH)parameters in healthy subjects.METHODS:Thir ty-thre...AIM:To assess the repeatability,interocular correlation,and agreement of quantitative swept-source optical coherence tomography angiography(OCTA)optic nerve head(ONH)parameters in healthy subjects.METHODS:Thir ty-three healthy subjects were enrolled.The ONH of both eyes were imaged four times by a swept-source-OCTA using a 3 mm×3 mm scanning protocol.Images of the radial peripapillary capillary were analyzed by a customized Matlab program,and the vessel density,fractal dimension,and vessel diameter index were measured.The repeatability of the four scans was determined by the intraclass correlation coefficient(ICC).The most well-centered optic disc from the four repeated scans was then selected for the interocular correlation and agreement analysis using the Pearson correlation coefficient,ICC and Bland-Altman plots.RESULTS:All swept-source-OCTA ONH parameters exhibited certain repeatability,with ICC>0.760 and coefficient of variation(CoV)≤7.301%.The obvious interocular correlation was observed for papillary vessel density(ICC=0.857),vessel diameter index(ICC=0.857)and fractal dimension(ICC=0.906),while circumpapillary vessel density exhibited moderate interocular correlation(ICC=0.687).Bland-Altman plots revealed an agreement range of-5.26%to 6.21%for circumpapillary vessel density.CONCLUSION:OCTA ONH parameters demonstrate good repeatability in healthy subjects.The interocular correlations of papillary vessel density,fractal dimension and vessel diameter index are high,but the correlation for circumpapillary vessel density is moderate.展开更多
AIM:To review international guidelines and to share our infection control experience during the coronavirus disease 2019(COVID-19)pandemic at a tertiary eye centre in Hong Kong.METHODS:Infection control guidelines and...AIM:To review international guidelines and to share our infection control experience during the coronavirus disease 2019(COVID-19)pandemic at a tertiary eye centre in Hong Kong.METHODS:Infection control guidelines and recommendations from international ophthalmological bodies are reviewed and discussed.The measures at our hospital were drawn up as per international and local health authorities’guidelines and implemented with the collaboration of doctors,nurses and administrative staff.RESULTS:The aims of our infection control measures are to 1)minimize cross-infection within the hospital;2)protect and support hospital staff;3)ensure environmental control.To minimize the risk of cross-infection,outpatient attendance and elective surgery have been reduced by 40%,and general anesthesia procedures were reduced by 90%.Patients entering the hospital are screened for fever,travel history,contact and cluster history,and COVID-19 related symptoms.To protect and support hospital staff,we ensure provision of adequate personal protective equipment(PPE)and provide clear guidelines on the level of PPE needed,depending on the clinical situation.Other protective measures include provision of work uniforms,easy access to alcohol-based hand rub,opening new lunch areas,implementation of self-monitoring and self-reporting systems,and communication via online education and updates.Finally,environmental control is achieved by ensuring regular disinfection of the hospital premise,enhancing ventilation,and usage of disposable ophthalmic instruments.CONCLUSION:Our multi-pronged approach to infection control is,so far,successful in minimizing infection risks,while allowing the maintenance of essential ophthalmic services.展开更多
AIM:To investigate the clinical features of the ocular surface in patients with different degrees of myopia.METHODS:A cross-sectional study was conducted involving 122 participants with myopia in Beijing Tongren Hospi...AIM:To investigate the clinical features of the ocular surface in patients with different degrees of myopia.METHODS:A cross-sectional study was conducted involving 122 participants with myopia in Beijing Tongren Hospital from February to June,2023.After completing the Ocular Surface Disease Index(OSDI)score scale,measurements were taken for refraction,biometric parameters and ocular surface parameters.The prevalence,severity and related parameters of the dry eye among different groups based on axial length(AL)were compared.Correlation analysis was performed between ocular surface parameters and refraction/biometric measurement parameters.RESULTS:Statistically significant differences were observed in refractive error,corneal thickness,anterior chamber depth,and subfoveal choroidal thickness among the groups(all P<0.05).With the increase in AL,the incidence and severity of dry eye increased significantly(P<0.05).Moreover,the tear film break-up time(BUT)shortened(P<0.05),and the corneal fluorescein staining(CFS)points increased significantly(P<0.05).OSDI scores were positively correlated with AL and spherical equivalent(SE;both P<0.05);BUT was negatively correlated with AL,SE,and corneal astigmatism(AST;all P<0.05);Schirmer I test(SIT)results were negatively correlated with AL and SE(both P<0.05).CONCLUSION:AL elongation is a risk factor for dry eye onset in myopic participants.The longer the AL,the more severe the dry eye is,with the increased CFS spots and tear film instability.Additionally,SE and AST exhibit negative correlations with dry eye symptom scores and ocular surface parameters.展开更多
BACKGROUND Stem cells are undifferentiated cells that possess the potential for self-renewal with the capacity to differentiate into multiple lineages.In humans,their limited numbers pose a challenge in fulfilling the...BACKGROUND Stem cells are undifferentiated cells that possess the potential for self-renewal with the capacity to differentiate into multiple lineages.In humans,their limited numbers pose a challenge in fulfilling the necessary demands for the regeneration and repair of damaged tissues or organs.Studies suggested that mesenchymal stem cells(MSCs),necessary for repair and regeneration via transplantation,require doses ranging from 10 to 400 million cells.Furthermore,the limited expansion of MSCs restricts their therapeutic application.AIM To optimize a novel protocol to achieve qualitative and quantitative expansion of MSCs to reach the targeted number of cells for cellular transplantation and minimize the limitations in stem cell therapy protocols.METHODS Human umbilical cord(hUC)tissue derived MSCs were obtained and re-cultured.These cultured cells were subjected to the following evaluation pro-cedures:Immunophenotyping,immunocytochemical staining,trilineage differentiation,population doubling time and number,gene expression markers for proliferation,cell cycle progression,senescence-associatedβ-galactosidase assay,human telomerase reverse transcriptase(hTERT)expression,mycoplasma,cytomegalovirus and endotoxin detection.RESULTS Analysis of pluripotent gene markers Oct4,Sox2,and Nanog in recultured hUC-MSC revealed no significant differences.The immunophenotypic markers CD90,CD73,CD105,CD44,vimentin,CD29,Stro-1,and Lin28 were positively expressed by these recultured expanded MSCs,and were found negative for CD34,CD11b,CD19,CD45,and HLA-DR.The recultured hUC-MSC population continued to expand through passage 15.Proliferative gene expression of Pax6,BMP2,and TGFb1 showed no significant variation between recultured hUC-MSC groups.Nevertheless,a significant increase(P<0.001)in the mitotic phase of the cell cycle was observed in recultured hUC-MSCs.Cellular senescence markers(hTERT expression andβ-galactosidase activity)did not show any negative effect on recultured hUC-MSCs.Additionally,quality control assessments consistently confirmed the absence of mycoplasma,cytomegalovirus,and endotoxin contamination.CONCLUSION This study proposes the development of a novel protocol for efficiently expanding stem cell population.This would address the growing demand for larger stem cell doses needed for cellular transplantation and will significantly improve the feasibility of stem cell based therapies.展开更多
Dear Editor,Herein,we provide a commentary on the recently published article by Zeng QZ and Yu WZ[1].This case report provides interesting novel insights into the recurrence of epiretinal membrane(ERM)following self-s...Dear Editor,Herein,we provide a commentary on the recently published article by Zeng QZ and Yu WZ[1].This case report provides interesting novel insights into the recurrence of epiretinal membrane(ERM)following self-separation in a young patient.In addition to the study,we have been investigating spontaneous ERM release for many years and have recently published a related paper[2].展开更多
Dear Editor,We read with interest the article by Han et al[1]in which they retrospectively assessed the effect of bicanalicular intubation for functional epiphora after a failed endoscopic dacryocystorhinostomy(DCR).T...Dear Editor,We read with interest the article by Han et al[1]in which they retrospectively assessed the effect of bicanalicular intubation for functional epiphora after a failed endoscopic dacryocystorhinostomy(DCR).They confirmed the post-DCR“functional obstruction”based on fluorescein dye disappearance(FDDT)and irrigation test[1].展开更多
Background:The incidence of syphilis has been increasing in the United States over the last two decades,with a more recent increase among women.Ocular syphilis is an uncommon but important complication of syphilis,mos...Background:The incidence of syphilis has been increasing in the United States over the last two decades,with a more recent increase among women.Ocular syphilis is an uncommon but important complication of syphilis,most often presenting as posterior or panuveitis in late or latent syphilis of unknown duration.Untreated ocular syphilis may lead to permanent vision loss,underscoring the importance of appropriate evaluation and treatment of ocular syphilis.Case Description:In a retrospective,non-contiguous case series,we highlight four patients diagnosed and treated with ocular syphilis at a single institution.Four presentations of ocular syphilis are illustrated:anterior and intermediate uveitis,optic neuritis,posterior uveitis,and panuveitis.All patients initially presented with a decreased visual acuity(VA).One patient had a previous diagnosis of human immunodeficiency virus(HIV).Three patients were treated with intravenous(IV)penicillin and one patient with IV ceftriaxone.All had a return to their baseline VA after their course of treatment.Conclusions:Syphilis may go undetected without a high index of clinical suspicion due to its nonspecific presentations.All patients with ocular inflammation should have syphilis testing as a part of their infectious workup with both treponemal and non-treponemal testing.Patients diagnosed with syphilis and are not known to be HIV-negative should undergo testing for HIV due to the high rate of co-infection.Early diagnosis and prompt treatment after onset of symptoms may contribute to a more favorable prognosis for ocular syphilis.展开更多
Ocular surface disease(OSD)encompasses a diverse range of disorders that impact the ocular tear film and integrity of the ocular surface including the cornea,conjunctiva,lacrimal glands,tear film and eyelids.As the ma...Ocular surface disease(OSD)encompasses a diverse range of disorders that impact the ocular tear film and integrity of the ocular surface including the cornea,conjunctiva,lacrimal glands,tear film and eyelids.As the main functions of the ocular surface are to maintain corneal transparency and hydration and protection of the corneal and conjunctival epithelium,the loss of ocular homeostasis leads to serious clinical manifestations.展开更多
Background and Objective:Neurotrophic keratitis(NK)is a neurodegenerative corneal disease characterized by decreased corneal sensitivity caused by damage to the trigeminal nerve,leading to reduced corneal sensitivity ...Background and Objective:Neurotrophic keratitis(NK)is a neurodegenerative corneal disease characterized by decreased corneal sensitivity caused by damage to the trigeminal nerve,leading to reduced corneal sensitivity and increased risk of trauma,infection,and ulceration.Although prior reviews on NK exist,most focus on traditional diagnostic and treatment modalities,with limited coverage of recent advances that target the underlying neuropathology.There remains a need for an updated synthesis of current literature that not only highlights emerging diagnostic technologies but also integrates key findings from recent clinical trials,retrospective studies,and prospective investigations.This review addresses that need by providing a comprehensive,data-driven framework to support informed clinical decision-making in the management of NK.Methods:A literature review was conducted using PubMed and Google Scholar,focusing on peer-reviewed articles,clinical guidelines,and meta-analyses from ophthalmic and neurological sources.Relevant literatures written in English were used.The timeframe included all papers up until August of 2024.Key Content and Findings:Corneal sensitivity testing remains the cornerstone of NK diagnosis,using both qualitative and quantitative methods.Recent innovations,such as the Brill Engines noncontact esthesiometer,offer a portable,noninvasive option for early detection.Although no single standard therapy exists,treatment spans from conservative approaches[artificial tears,bandage contact lenses(BCLs)]to biologics such as cenegermin[nerve growth factor(NGF)drops].Surgical strategies,including amniotic membrane transplantation,tarsorrhaphy,and conjunctival flaps,provide alternatives for refractory cases.Corneal neurotization is a novel technique showing promise in restoring innervation and reducing reliance on chronic therapy.Due to NK’s heterogeneous nature,treatment is individualized and often involves trial and error.Conclusions:NK is a relatively rare yet debilitating corneal disease.Clinicians should have a low threshold of suspicion for pursuing diagnostic tests in patients presenting classic and atypical symptoms.While recent advances in medical and surgical management have improved outlooks,continued research is essential to further optimize outcomes and prevent vision loss.展开更多
AIM:To evaluate visual outcomes of pars plana vitrectomy(PPV)combined with tissue plasminogen activator(tPA)-induced clot lysis and pneumatic displacement for submacular hemorrhage(SMH)in a cohort of closed-globe trau...AIM:To evaluate visual outcomes of pars plana vitrectomy(PPV)combined with tissue plasminogen activator(tPA)-induced clot lysis and pneumatic displacement for submacular hemorrhage(SMH)in a cohort of closed-globe trauma patients.METHODS:A retrospective,multicenter interventional case series involving 7 eyes of 7 patients who underwent PPV with subretinal tPA administration for SMH secondary to closed-globe injury were conducted.The primary outcome measure was the change in Snellen visual acuity.RESULTS:The mean age of patients was 32y(range:21-51y),with a mean follow-up duration of 4.6mo(range:1.1-14.9mo).The average best-corrected visual acuity(BCVA)was 20/1020 at baseline and 20/114 at the final visit,respectively(P=0.025).Preoperative BCVA was not a significant predictor of final BCVA(r=0.102,P=0.827).Final BCVA did not differ significantly between patients who underwent PPV within 14d of symptom onset and those who underwent surgery after 14d(P=0.57).All eyes received SF6 or C3F8 gas tamponade.CONCLUSION:Surgical intervention involving tPAmediated clot lysis and pneumatic displacement may yield visual benefits in trauma-induced SMH without underlying retinal vascular disease;however,larger prospective studies are warranted to confirm these findings.展开更多
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.
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.
文摘Calcium (Ca^(2+)) is a key intracellular messenger involved in a variety of cellular functions.Intracellular Ca^(2+)dysregulation drives neuron cell death in multiple degenerative diseases and traumatic conditions.Retinal ganglion cell(RGC) degeneration occurs in blinding diseases such as glaucoma and other optic neuropathies.
文摘AIM:To evaluate the demographics,clinical characteristics,treatments,and outcomes of patients with ocular surface squamous neoplasia(OSSN)at the Philippine General Hospital.METHODS:This was a single-center,11-year retrospective,cross sectional case series on 18 cases of OSSN seen between January 2012 to June 2023.The patient’s demographics,presenting symptoms,tumor characteristics,histopathologic diagnosis,treatment,outcomes,and duration of follow-up were reviewed.RESULTS:Out of 33 identified cases of OSSN,only 18 were eligible for inclusion in the study.Mean age was 60.78y(range 31 to 80),with male predominance(66.67%).The left eye was most commonly affected(61.11%)with most presenting with fleshy mass(83.33%).Most tumors were located nasally(66.67%)and were predominantly papilliform(44.44%)in morphology with associated hyperpigmentation(38.89%).Squamous cell carcinoma(SCCA)was the most common histopathologic diagnosis(72.22%).The main primary treatment was surgical excision(94.44%)with or without adjunctive therapy,with only 1 patient undergoing first-line topical chemotherapy.Only 3 recurrences(16.67%)were noted with a median followup of 7.5mo.A statistically significant recurrence-free odds leaning towards the utilization of cryotherapy was noted.CONCLUSION:OSSN seen at the Philippine General Hospital is presented as a limbal papilliform mass,most commonly affecting elderly males.Surgical excision with adjuvant cryotherapy and/or chemotherapy is the preferred mode of treatment.
基金Supported in part by an unrestricted grant from Research to Prevent Blindness,Inc.The American Physician Fellowship for Medicine in Israel
文摘Sir Nicholas Harold Lloyd Ridley has revolutionized the practice of ophthalmology by performing the firstintraocular lens （IOL） implantation in 1949. His scientific achievement was acknowledged thirty years later, which led to US Food and Drug Administration approval in 1981. Although the basic principles of IOL implantation have not changed since, many efforts have been invested in perfecting IOL design during the past decades.
文摘AIM:To evaluate the recently described optical coherence tomography(OCT)based classification of epiretinal membrane(ERM)and its usefulness in predicting the functional outcome.METHODS:A retrospective observational review of OCT scans of patients with the diagnosis of idiopathic ERM was carried out from January 2016 to June 2021.All consecutive images diagnosed with any stage of idiopathic ERM and fulfilled the eligibility criteria were included in the analysis.ERM was identified on OCT scans as a thin hyperreflective layer over the inner layers of retina.OCT scans of patients with ERM who underwent vitrectomy,were independently staged as per the new classification by two independent retinal surgeons to form a consensus on stage.Best corrected visual acuity(BCVA)in logMAR scale and central subfield thickness(CST)on pre-and post-operative spectral domain OCT scans were the variables noted for all patients at the time of diagnosis and at 6 and 12 mo follow up visit after undergoing intervention.Partial correlation coefficient was computed between BCVA(logMAR)and CST by ERM stage adjusting by baseline measures.RESULTS:Clinical charts of 74 patients with idiopathic ERM were assessed.Clinically significant improvement in BCVA overtime was observed with significant difference in median visual acuity of patients with StageⅡ-ⅣERM with P<0.001.The median CST of all patients with stageⅡ-ⅣERM showed similar consistent improvement with P<0.001 from baseline to 12^(th)month.Our results showed not only gain in visual acuity but also shift from baseline to anatomical normalization of CST in stageⅡ.We found a decrease in CST with difference of 166μm and 151μm in stageⅢand stageⅣrespectively.Our results remained consistent with the hypothesis of improved visual outcomes with all stages of ERM with adjusted moderate linear correlation between visual acuity and CST in stageⅡ-Ⅳ(r>0.3).CONCLUSION:Equally significant visual outcomes of patients with ERM stagedⅡ-Ⅳand therefore can be counselled for improved visual acuity after surgical removal of ERM with improvement up to 5 lines on Snellen's chart from the baseline.
文摘AIM:To investigate the long-term results of penetrating keratoplasty(PK)in patients with keratoconus(KC)and to evaluate factors that might influence the final visual outcome.METHODS:We retrospectively reviewed the data of all patients with clinical KC who had undergone PK by a single corneal surgeon in a single center from May 1980to December 2005.The age of the patients,preoperative best-corrected visual acuity(BCVA),corneal thickness,death to preservation time,and preservation to transplantation time were recorded.Additionally,postoperative complications such as graft rejection,development of glaucoma and specular microscopy were checked during the follow-up.RESULTS:Sixty-nineeyesfrom69patientswerefinally included.The follow-up period was 8.64±6.13y.Graft rejection occurred in 4 eyes of 69 cases(5.8%),and the time to graft rejection was 2.1±1.3y.A Kaplan-Meier survival analysis showed that the estimated cumulative probability of graft rejection at 6,13,and 17y after PK were 95.6%,90.0%,and 78.8%,respectively.When we evaluated factors that might influence final BCVA in eyes,no disparity donor-host trephine size(same graft size)as well as higher spherical equivalent,and average Kvalue were associated with higher final BCVA.(P=0.006,0.051,0.092,and 0.021 in eyes with follow-up【8y;P=0.068,0.065,and 0.030 in eyes with follow-up≥8y,respectively).CONCLUSION:The long-term results of PK in patients with KC were favorable with a high percentage of good BCVA.Less myopic change and low average K-reading,as well as a surgical technique using the same size donor-recipient button may provide better visual outcomes particularly in patients with KC.
基金Supported in part by Science and Technology Project of Guangdong Province(No.2011B031800369)
文摘AIM:To investigate the visual impact of sub-Tenon anesthesia during combined phacoemulsification and vitrectomy surgery.METHODS:In this prospective case series, consecutive patients who underwent combined phacoemulsification and pars plana vitrectomy(PPV) under sub-Tenon anesthesia between October 2008 and September 2009 were enrolled. The patients were asked whether they could see the light of the operating microscope or not between various surgical steps with their contralateral eye being covered.RESULTS:A total of 163 eyes of 163 patients were enrolled in this study. After their contralateral eyes were covered, 152(93.3%) patients said that they could not see any light at least during one of the surgical steps. All eyes recovered to at least light perception on the first postoperative day. The incidence of no light perception during the surgery was not related to demographic factors, including age, gender, or type of ocular diseases.CONCLUSION:The incidence of no light perception during combined phacoemulsification and vitrectomy under sub-Tenon anesthesia was high in our study.Patients should be duly informed about this temporary but potential intraoperative event.
基金Supported in part by an unrestricted grant from Research to Prevent Blindness,Inc.New York,N.Y,USA
文摘AIMTo evaluate Jordanian ophthalmology residency programs in achieving competencies outlined by the International Council of Ophthalmology (ICO) and residents' satisfaction with available training programs in Jordan, and to highlight weakness points that may be improved and strengthened.
基金Natural Science Foundation of Guangdong Province(No.2018A0303130306)Shantou Science and Technology Program(No.190917085269835,No.200629165261641).
文摘AIM:To assess the repeatability,interocular correlation,and agreement of quantitative swept-source optical coherence tomography angiography(OCTA)optic nerve head(ONH)parameters in healthy subjects.METHODS:Thir ty-three healthy subjects were enrolled.The ONH of both eyes were imaged four times by a swept-source-OCTA using a 3 mm×3 mm scanning protocol.Images of the radial peripapillary capillary were analyzed by a customized Matlab program,and the vessel density,fractal dimension,and vessel diameter index were measured.The repeatability of the four scans was determined by the intraclass correlation coefficient(ICC).The most well-centered optic disc from the four repeated scans was then selected for the interocular correlation and agreement analysis using the Pearson correlation coefficient,ICC and Bland-Altman plots.RESULTS:All swept-source-OCTA ONH parameters exhibited certain repeatability,with ICC>0.760 and coefficient of variation(CoV)≤7.301%.The obvious interocular correlation was observed for papillary vessel density(ICC=0.857),vessel diameter index(ICC=0.857)and fractal dimension(ICC=0.906),while circumpapillary vessel density exhibited moderate interocular correlation(ICC=0.687).Bland-Altman plots revealed an agreement range of-5.26%to 6.21%for circumpapillary vessel density.CONCLUSION:OCTA ONH parameters demonstrate good repeatability in healthy subjects.The interocular correlations of papillary vessel density,fractal dimension and vessel diameter index are high,but the correlation for circumpapillary vessel density is moderate.
文摘AIM:To review international guidelines and to share our infection control experience during the coronavirus disease 2019(COVID-19)pandemic at a tertiary eye centre in Hong Kong.METHODS:Infection control guidelines and recommendations from international ophthalmological bodies are reviewed and discussed.The measures at our hospital were drawn up as per international and local health authorities’guidelines and implemented with the collaboration of doctors,nurses and administrative staff.RESULTS:The aims of our infection control measures are to 1)minimize cross-infection within the hospital;2)protect and support hospital staff;3)ensure environmental control.To minimize the risk of cross-infection,outpatient attendance and elective surgery have been reduced by 40%,and general anesthesia procedures were reduced by 90%.Patients entering the hospital are screened for fever,travel history,contact and cluster history,and COVID-19 related symptoms.To protect and support hospital staff,we ensure provision of adequate personal protective equipment(PPE)and provide clear guidelines on the level of PPE needed,depending on the clinical situation.Other protective measures include provision of work uniforms,easy access to alcohol-based hand rub,opening new lunch areas,implementation of self-monitoring and self-reporting systems,and communication via online education and updates.Finally,environmental control is achieved by ensuring regular disinfection of the hospital premise,enhancing ventilation,and usage of disposable ophthalmic instruments.CONCLUSION:Our multi-pronged approach to infection control is,so far,successful in minimizing infection risks,while allowing the maintenance of essential ophthalmic services.
基金Supported by the Capital Health Development Scientific Research.
文摘AIM:To investigate the clinical features of the ocular surface in patients with different degrees of myopia.METHODS:A cross-sectional study was conducted involving 122 participants with myopia in Beijing Tongren Hospital from February to June,2023.After completing the Ocular Surface Disease Index(OSDI)score scale,measurements were taken for refraction,biometric parameters and ocular surface parameters.The prevalence,severity and related parameters of the dry eye among different groups based on axial length(AL)were compared.Correlation analysis was performed between ocular surface parameters and refraction/biometric measurement parameters.RESULTS:Statistically significant differences were observed in refractive error,corneal thickness,anterior chamber depth,and subfoveal choroidal thickness among the groups(all P<0.05).With the increase in AL,the incidence and severity of dry eye increased significantly(P<0.05).Moreover,the tear film break-up time(BUT)shortened(P<0.05),and the corneal fluorescein staining(CFS)points increased significantly(P<0.05).OSDI scores were positively correlated with AL and spherical equivalent(SE;both P<0.05);BUT was negatively correlated with AL,SE,and corneal astigmatism(AST;all P<0.05);Schirmer I test(SIT)results were negatively correlated with AL and SE(both P<0.05).CONCLUSION:AL elongation is a risk factor for dry eye onset in myopic participants.The longer the AL,the more severe the dry eye is,with the increased CFS spots and tear film instability.Additionally,SE and AST exhibit negative correlations with dry eye symptom scores and ocular surface parameters.
基金Supported by Higher Education Commission,Islamabad,Pakistan grant,No.20-17590/NRPU/R&D/HEC/20212021.
文摘BACKGROUND Stem cells are undifferentiated cells that possess the potential for self-renewal with the capacity to differentiate into multiple lineages.In humans,their limited numbers pose a challenge in fulfilling the necessary demands for the regeneration and repair of damaged tissues or organs.Studies suggested that mesenchymal stem cells(MSCs),necessary for repair and regeneration via transplantation,require doses ranging from 10 to 400 million cells.Furthermore,the limited expansion of MSCs restricts their therapeutic application.AIM To optimize a novel protocol to achieve qualitative and quantitative expansion of MSCs to reach the targeted number of cells for cellular transplantation and minimize the limitations in stem cell therapy protocols.METHODS Human umbilical cord(hUC)tissue derived MSCs were obtained and re-cultured.These cultured cells were subjected to the following evaluation pro-cedures:Immunophenotyping,immunocytochemical staining,trilineage differentiation,population doubling time and number,gene expression markers for proliferation,cell cycle progression,senescence-associatedβ-galactosidase assay,human telomerase reverse transcriptase(hTERT)expression,mycoplasma,cytomegalovirus and endotoxin detection.RESULTS Analysis of pluripotent gene markers Oct4,Sox2,and Nanog in recultured hUC-MSC revealed no significant differences.The immunophenotypic markers CD90,CD73,CD105,CD44,vimentin,CD29,Stro-1,and Lin28 were positively expressed by these recultured expanded MSCs,and were found negative for CD34,CD11b,CD19,CD45,and HLA-DR.The recultured hUC-MSC population continued to expand through passage 15.Proliferative gene expression of Pax6,BMP2,and TGFb1 showed no significant variation between recultured hUC-MSC groups.Nevertheless,a significant increase(P<0.001)in the mitotic phase of the cell cycle was observed in recultured hUC-MSCs.Cellular senescence markers(hTERT expression andβ-galactosidase activity)did not show any negative effect on recultured hUC-MSCs.Additionally,quality control assessments consistently confirmed the absence of mycoplasma,cytomegalovirus,and endotoxin contamination.CONCLUSION This study proposes the development of a novel protocol for efficiently expanding stem cell population.This would address the growing demand for larger stem cell doses needed for cellular transplantation and will significantly improve the feasibility of stem cell based therapies.
文摘Dear Editor,Herein,we provide a commentary on the recently published article by Zeng QZ and Yu WZ[1].This case report provides interesting novel insights into the recurrence of epiretinal membrane(ERM)following self-separation in a young patient.In addition to the study,we have been investigating spontaneous ERM release for many years and have recently published a related paper[2].
文摘Dear Editor,We read with interest the article by Han et al[1]in which they retrospectively assessed the effect of bicanalicular intubation for functional epiphora after a failed endoscopic dacryocystorhinostomy(DCR).They confirmed the post-DCR“functional obstruction”based on fluorescein dye disappearance(FDDT)and irrigation test[1].
文摘Background:The incidence of syphilis has been increasing in the United States over the last two decades,with a more recent increase among women.Ocular syphilis is an uncommon but important complication of syphilis,most often presenting as posterior or panuveitis in late or latent syphilis of unknown duration.Untreated ocular syphilis may lead to permanent vision loss,underscoring the importance of appropriate evaluation and treatment of ocular syphilis.Case Description:In a retrospective,non-contiguous case series,we highlight four patients diagnosed and treated with ocular syphilis at a single institution.Four presentations of ocular syphilis are illustrated:anterior and intermediate uveitis,optic neuritis,posterior uveitis,and panuveitis.All patients initially presented with a decreased visual acuity(VA).One patient had a previous diagnosis of human immunodeficiency virus(HIV).Three patients were treated with intravenous(IV)penicillin and one patient with IV ceftriaxone.All had a return to their baseline VA after their course of treatment.Conclusions:Syphilis may go undetected without a high index of clinical suspicion due to its nonspecific presentations.All patients with ocular inflammation should have syphilis testing as a part of their infectious workup with both treponemal and non-treponemal testing.Patients diagnosed with syphilis and are not known to be HIV-negative should undergo testing for HIV due to the high rate of co-infection.Early diagnosis and prompt treatment after onset of symptoms may contribute to a more favorable prognosis for ocular syphilis.
文摘Ocular surface disease(OSD)encompasses a diverse range of disorders that impact the ocular tear film and integrity of the ocular surface including the cornea,conjunctiva,lacrimal glands,tear film and eyelids.As the main functions of the ocular surface are to maintain corneal transparency and hydration and protection of the corneal and conjunctival epithelium,the loss of ocular homeostasis leads to serious clinical manifestations.
基金supported by the Walter G.Ross Foundation(to R.K.L.)partly supported by the Camiener Foundation Glaucoma Research Fund and the Gutierrez Family Research Fund.
文摘Background and Objective:Neurotrophic keratitis(NK)is a neurodegenerative corneal disease characterized by decreased corneal sensitivity caused by damage to the trigeminal nerve,leading to reduced corneal sensitivity and increased risk of trauma,infection,and ulceration.Although prior reviews on NK exist,most focus on traditional diagnostic and treatment modalities,with limited coverage of recent advances that target the underlying neuropathology.There remains a need for an updated synthesis of current literature that not only highlights emerging diagnostic technologies but also integrates key findings from recent clinical trials,retrospective studies,and prospective investigations.This review addresses that need by providing a comprehensive,data-driven framework to support informed clinical decision-making in the management of NK.Methods:A literature review was conducted using PubMed and Google Scholar,focusing on peer-reviewed articles,clinical guidelines,and meta-analyses from ophthalmic and neurological sources.Relevant literatures written in English were used.The timeframe included all papers up until August of 2024.Key Content and Findings:Corneal sensitivity testing remains the cornerstone of NK diagnosis,using both qualitative and quantitative methods.Recent innovations,such as the Brill Engines noncontact esthesiometer,offer a portable,noninvasive option for early detection.Although no single standard therapy exists,treatment spans from conservative approaches[artificial tears,bandage contact lenses(BCLs)]to biologics such as cenegermin[nerve growth factor(NGF)drops].Surgical strategies,including amniotic membrane transplantation,tarsorrhaphy,and conjunctival flaps,provide alternatives for refractory cases.Corneal neurotization is a novel technique showing promise in restoring innervation and reducing reliance on chronic therapy.Due to NK’s heterogeneous nature,treatment is individualized and often involves trial and error.Conclusions:NK is a relatively rare yet debilitating corneal disease.Clinicians should have a low threshold of suspicion for pursuing diagnostic tests in patients presenting classic and atypical symptoms.While recent advances in medical and surgical management have improved outlooks,continued research is essential to further optimize outcomes and prevent vision loss.
基金Supportea by DeNardo Education and Research Foundation GrantJeffrey T.Fort Innovation Fund+3 种基金Siteman Retina Research FundResearch to Prevent Blindness IncGetahun H is supported by Washington University in St.Louis School of Medicine Dean’s Medical Student Research Fellowship for the MD5 Yearlong Research ProgramGetahun H is also a recipient of a Research to Prevent Blindness Medical Student Eye Research Fellowship.
文摘AIM:To evaluate visual outcomes of pars plana vitrectomy(PPV)combined with tissue plasminogen activator(tPA)-induced clot lysis and pneumatic displacement for submacular hemorrhage(SMH)in a cohort of closed-globe trauma patients.METHODS:A retrospective,multicenter interventional case series involving 7 eyes of 7 patients who underwent PPV with subretinal tPA administration for SMH secondary to closed-globe injury were conducted.The primary outcome measure was the change in Snellen visual acuity.RESULTS:The mean age of patients was 32y(range:21-51y),with a mean follow-up duration of 4.6mo(range:1.1-14.9mo).The average best-corrected visual acuity(BCVA)was 20/1020 at baseline and 20/114 at the final visit,respectively(P=0.025).Preoperative BCVA was not a significant predictor of final BCVA(r=0.102,P=0.827).Final BCVA did not differ significantly between patients who underwent PPV within 14d of symptom onset and those who underwent surgery after 14d(P=0.57).All eyes received SF6 or C3F8 gas tamponade.CONCLUSION:Surgical intervention involving tPAmediated clot lysis and pneumatic displacement may yield visual benefits in trauma-induced SMH without underlying retinal vascular disease;however,larger prospective studies are warranted to confirm these findings.
