ChatGPT technology based on large language models(LLM)shows great potential in improving the quality of medical care,assisting clinical decision making and optimizing patient communication.The role of ChatGPT in ophth...ChatGPT technology based on large language models(LLM)shows great potential in improving the quality of medical care,assisting clinical decision making and optimizing patient communication.The role of ChatGPT in ophthalmology is still in its infancy.This review aims to explore the application prospect of ChatGPT in ophthalmology.Relevant literature was reviewed and analyzed,and the application prospects of LLM represented by ChatGPT in ophthalmology were summarized,including clinical assisted diagnosis,patient education and communication,history collection and text writing,clinical research,and medical education,etc.At the same time,the challenges and solutions faced by ChatGPT in ophthalmology were pointed out.Its safety,efficacy and ethics remain controversial in practical applications.Therefore,it is necessary to strengthen the supervision and research on its application to ensure safety and effectiveness.In the future,with the development of technology,ChatGPT is expected to play a greater role in ophthalmology and enhance the medical experience.展开更多
Synaptic plasticity is essential for maintaining neuronal function in the central nervous system and serves as a critical indicator of the effects of neurodegenerative disease.Glaucoma directly impairs retinal ganglio...Synaptic plasticity is essential for maintaining neuronal function in the central nervous system and serves as a critical indicator of the effects of neurodegenerative disease.Glaucoma directly impairs retinal ganglion cells and their axons,leading to axonal transport dysfuntion,subsequently causing secondary damage to anterior or posterior ends of the visual system.Accordingly,recent evidence indicates that glaucoma is a degenerative disease of the central nervous system that causes damage throughout the visual pathway.However,the effects of glaucoma on synaptic plasticity in the primary visual cortex remain unclear.In this study,we established a mouse model of unilateral chronic ocular hypertension by injecting magnetic microbeads into the anterior chamber of one eye.We found that,after 4 weeks of chronic ocular hypertension,the neuronal somas were smaller in the superior colliculus and lateral geniculate body regions of the brain contralateral to the affected eye.This was accompanied by glial cell activation and increased expression of inflammatory factors.After 8 weeks of ocular hypertension,we observed a reduction in the number of excitatory and inhibitory synapses,dendritic spines,and activation of glial cells in the primary visual cortex contralateral to the affected eye.These findings suggest that glaucoma not only directly damages the retina but also induces alterations in synapses and dendritic spines in the primary visual cortex,providing new insights into the pathogenesis of glaucoma.展开更多
AIM： To characterize the proliferative capacity of pterygial epithelium in different regions（head, neck and body） of pterygium and explore the function of transcription factor 4（TCF4） in pterygium proliferation.M...AIM： To characterize the proliferative capacity of pterygial epithelium in different regions（head, neck and body） of pterygium and explore the function of transcription factor 4（TCF4） in pterygium proliferation.METHODS： Thirty pterygium tissues and 10 normal conjunctival tissues were obtained from Zhongshan Ophthalmic Center（ZOC） and Guangdong Eye Bank, respectively. Proliferative capacity of head, neck and body in pterygial epithelium was measured using clonal analysis, fold growth analysis and expression profile of proliferative markers revealed by immunofluorescent staining and real-time PCR. The expression of TCF4 was highlighted by double immunofluorescent staining with other proliferation related markers such as proliferating cell nuclear antigen（PCNA） and ATP-binding cassette subfamily G member 2（ABCG2）.RESULTS： The proliferative potential of pterygial epithelium was higher than that of normal conjunctival epithelium. High expression levels of proliferative markers（P63α, PCNA and ABCG2） in pterygial body epithelium were observed in immunofluorescent staining and real-time PCR（P〈0.05）. Also, epithelial cells isolated from pterygial body demonstrated higher proliferative capacity in clonal analysis and fold growth analysis, than those isolated from the head and neck regions. The TCF4 expression in pterygial epithelium was similar to other proliferative markers（P63α, PCNA and ABCG2）, as higher in pterygial body than head and neck. Moreover, TCF4 showed coexpression with other proliferation-related markers（PCNA and ABCG2） in the double immunofluorescent staining experiment.CONCLUSION： The proliferative capacity in pterygial body epithelium is prominent than the head and neck regions, and upregulated TCF4 may be associated with enhanced proliferation in the pterygium.展开更多
Background:The“flipped classroom”is a learner-centered approach that centers on delivering videos,podcasts or slide-based material to learners prior to a lecture or class session.The class session is then dedicated ...Background:The“flipped classroom”is a learner-centered approach that centers on delivering videos,podcasts or slide-based material to learners prior to a lecture or class session.The class session is then dedicated to discussion,analysis,and problem-solving activities.The aim of this study was to investigate whether the flipped classroom could be adapted to medical(ophthalmology)students learning about ocular trauma and to assess the impact of the flipped classroom on those students’performance and attitudes.Methods:Questionnaires(using a 4-point scale)were distributed to 93 fifth-year medical students at Sun Yat-sen University,and the data showed that the majority of students preferred the flipped classroom approach to the traditional lecture method.Results:The results of pre-and post-test scores were 14.35±3.404 and 20.37±4.356,which showed a significant improvement in students’performance after the flipped classroom was introduced(P<0.05).Conclusions:Student response to the flipped classroom strategy was largely positive,indicating that the strategy received a high level of approval in an ophthalmology clerkship course taken by medical students in China.展开更多
AIM: To determine the progression of parameters from optical coherence tomography(OCT) in chronic elevated intraocular pressure(IOP) monkeys.METHODS: A chronic elevated IOP model of rhesus monkeys was induced by laser...AIM: To determine the progression of parameters from optical coherence tomography(OCT) in chronic elevated intraocular pressure(IOP) monkeys.METHODS: A chronic elevated IOP model of rhesus monkeys was induced by laser photocoagulation. Representative OCT parameters, including the average and four-quadrant retinal nerve fiber layer(RNFL) thickness, and parameters from optic nerve head(ONH) analysis were collected before and after laser treatments biweekly for up to 28 wk. The performance of each parameter for early progression detection was analyzed. The progressive trends toward elevated IOP were analyzed using a linear mixed-effects model.RESULTS: There were 10 successfully maintained high IOP eyes in 7 monkeys. The follow-up time was 24±5.37 wk. With cumulative IOP elevation, the cup area, rim area and C/D area ratio were statistically significantly changed as early as 2 wk after elevated IOP induction(P<0.05). The quadrant RNFL thickness changed at 6wk after high IOP induction, and the superior and inferior RNFL thicknesses exhibited more obvious reductions than other quadrants. The average RNFL thickness was the last one to show a significant decrease at 8wk.CONCLUSION: The parameters of ONH are most sensitive to elevated IOP in a primate glaucomatous model. These findings suggest that we should focus on those parameters instead of RNFL thickness in patients with elevated IOP, as they might present with earlier glaucomatous changes.展开更多
Background:A variety of experimental animal models are used in basic ophthalmological research to elucidate physiological mechanisms of vision and disease pathogenesis.The choice of animal model is based on the measur...Background:A variety of experimental animal models are used in basic ophthalmological research to elucidate physiological mechanisms of vision and disease pathogenesis.The choice of animal model is based on the measurability of specific parameters or structures,the applicability of clinical measurement technologies,and the similarity to human eye function.Studies of eye pathology usually compare optical parameters between a healthy and altered state,so accurate baseline assessments are critical,but few reports have comprehensively examined the normal anatomical structures and physiological functions in these models.Methods:Three cynomolgus monkeys,six New Zealand rabbits,ten Sprague Dawley(SD)rats,and BALB/c mice were examined by fundus photography(FP),fundus fluorescein angiography(FFA),and optical coherence tomography(OCT).Results:Most retinal structures of cynomolgus monkey were anatomically similar to the corresponding human structures as revealed by FP,FFA,and OCT.New Zealand rabbits have large eyeballs,but they have large optic disc and myelinated retinal nerve fibers in their retinas,and the growth pattern of retinal vessels were also different to the human retinas.Unlike monkeys and rabbits,the retinal vessels of SD rats and BALB/c mice were widely distributed and clear.The OCT performance of them were similar with human beings except the macular.Conclusions:Monkey is a good model to study changes in retinal structure associated with fundus disease,rabbits are not suitable for studies on retinal vessel diseases and optic nerve diseases,and rats and mice are good models for retinal vascular diseases.These measures will help guide the choice of model and measurement technology and reduce the number of experimental animals required.展开更多
The visual cortex is an essential part of the brain for processing visual information.It exhibits structural and functional plasticity,which is crucial for adapting to complex visual environments.The quintessential ma...The visual cortex is an essential part of the brain for processing visual information.It exhibits structural and functional plasticity,which is crucial for adapting to complex visual environments.The quintessential manifestation of visual cortical plasticity is ocular dominance plasticity during the critical period,which involves numerous cellular and molecular events.While previous studies have emphasized the role of visual cortical neurons and their associated functional molecules in visual plasticity,recent findings have revealed that structural factors such as the extracellular matrix and glia are also involved.Investigating how these molecules interact to form a complex network that facilitates plasticity in the visual cortex is crucial to our understanding of the development of the visual system and the advancement of therapeutic strategies for visual disorders like amblyopia.展开更多
Several studies have found that transplantation of neural progenitor cells(NPCs)promotes the survival of injured neurons.However,a poor integration rate and high risk of tumorigenicity after cell transplantation limit...Several studies have found that transplantation of neural progenitor cells(NPCs)promotes the survival of injured neurons.However,a poor integration rate and high risk of tumorigenicity after cell transplantation limits their clinical application.Small extracellular vesicles(sEVs)contain bioactive molecules for neuronal protection and regeneration.Previous studies have shown that stem/progenitor cell-derived sEVs can promote neuronal survival and recovery of neurological function in neurodegenerative eye diseases and other eye diseases.In this study,we intravitreally transplanted sEVs derived from human induced pluripotent stem cells(hiPSCs)and hiPSCs-differentiated NPCs(hiPSC-NPC)in a mouse model of optic nerve crush.Our results show that these intravitreally injected sEVs were ingested by retinal cells,especially those localized in the ganglion cell layer.Treatment with hiPSC-NPC-derived sEVs mitigated optic nerve crush-induced retinal ganglion cell degeneration,and regulated the retinal microenvironment by inhibiting excessive activation of microglia.Component analysis further revealed that hiPSC-NPC derived sEVs transported neuroprotective and anti-inflammatory miRNA cargos to target cells,which had protective effects on RGCs after optic nerve injury.These findings suggest that sEVs derived from hiPSC-NPC are a promising cell-free therapeutic strategy for optic neuropathy.展开更多
The immune system is involved in many age-related pathological changes,also plays an important role in tissue regeneration after injury.But no immune involvement has been discussed regarding cataract since it is presu...The immune system is involved in many age-related pathological changes,also plays an important role in tissue regeneration after injury.But no immune involvement has been discussed regarding cataract since it is presumed that lens has no source of immune cells as an avascular zone.Latest research has challenged the longstanding view of the lens as an immune-privileged tissue,revealing the presence of resident immune cells and active immune responses within the lens.Thus,we summarized the immune involvement in maintaining lens homeostasis,which may be a deleterious role in the induction of lens opacification if inappropriately activated.Furthermore,bioengineer-based immunomodulatory therapies to fine-tune the micro immune environment within lens may be future strategies for in situ lens regeneration,as a novel treatment for cataract.展开更多
Background: Glaucoma is a leading cause of irreversible blindness worldwide, characterized by progressive optic nerve damage and visual field loss, often associated with elevated intraocular pressure (IOP). Traditiona...Background: Glaucoma is a leading cause of irreversible blindness worldwide, characterized by progressive optic nerve damage and visual field loss, often associated with elevated intraocular pressure (IOP). Traditional treatment options include medications and surgical interventions;however, many patients experience refractory glaucoma that does not respond adequately to standard therapies. Ultrasound cycloplasty has emerged as a promising alternative for managing refractory glaucoma by reducing IOP through targeted tissue ablation. Due to the limited relevant research on the perioperative nursing of UCP, this study explores the key nursing points during the perioperative period of ultrasound cycloplasty. Methods: A retrospective analysis was conducted on the clinical data of 53 glaucoma patients, including preoperative and postoperative intraocular pressure (IOP) changes, use of antiglaucoma medications, and ocular pain scores. Preoperative nursing includes medical history assessment, surgical explanation, and ocular examination. Postoperatively, IOP monitoring and medication guidance were provided. Results: Postoperative IOP was significantly reduced, the number of antiglaucoma medications used decreased, and ocular pain scores were notably lower. At three months postoperatively, 96.23% of patients exhibited a decrease in IOP. Ultrasound Cycloplasty effectively lowered IOP, alleviated ocular pain, and reduced the use of antiglaucoma medications in patients with various types of glaucoma. Conclusion: Ultrasound Cycloplasty is a safe and effective minimally invasive procedure for treating glaucoma. Proper clinical nursing plays a crucial role in the success of the surgery and the patient’s recovery, including preoperative communication and education, intraoperative monitoring and technical proficiency, as well as postoperative IOP monitoring and care. Long-term IOP monitoring and regular nursing assessments are recommended for patients undergoing this procedure to ensure the durability and safety of the treatment outcomes.展开更多
Objective:Evidence pertaining to the associations between hyperuricemia and diabetic microvascular complications is limited and inconclusive.In this study,we aimed to prospectively investigate the independent associat...Objective:Evidence pertaining to the associations between hyperuricemia and diabetic microvascular complications is limited and inconclusive.In this study,we aimed to prospectively investigate the independent associations of hyperuricemia and retinopathy,nephropathy and neuropathy in individuals with type 2 diabetes mellitus(T2DM).Methods:This cohort study enrolled 25,094 participants from UK Biobank with T2DM and without microvascular complications at baseline.Hyperuricemia was defined as serum uric acid(SUA)higher than 420μmol/L.The incidence of diabetic microvascular complications was identified from hospital inpatient records that were coded according to the International Classification of Diseases(ICD)-10 coding system.Multivariable adjusted Cox proportional hazards regression models were used to calculate adjusted hazard ratios(aHR).Results:Among all participants,3,844(15.3%)were classified as having hyperuricemia at baseline.During a median follow-up of 14.0 years,555(14.4%)individuals with hyperuricemia developed diabetic microvascular complications,compared with 12.6%of individuals without hyperuricemia(P=0.002).In the multivariable-adjusted model accounted for socioeconomic status,lifestyle factors,physical and biochemical measurements,and medication use,when compared with individuals of T2DM who had a normal SUA level,those with hyperuricemia had an 82.9%higher risk of developing diabetic nephropathy(95%CI:1.41-2.38,P<0.001),and a 30.2%higher risk of diabetic neuropathy(95%CI:1.06-1.60,P=0.011).However,the association between hyperuricemia and diabetic retinopathy was not statistically significant(aHR:1.070,95%CI:0.94-1.22,P=0.320).Conclusions:Hyperuricemia was independently associated with diabetic nephropathy and neuropathy but not retinopathy in individuals with T2DM.These findings underscore the importance of monitoring SUA level in prevention of certain microvascular complications.展开更多
Myopia,a common cause of visual impairment,together with the global decline in physical fitness and increasing prevalence of childhood obesity,has become a prominent global health problem.The beneficial effect of incr...Myopia,a common cause of visual impairment,together with the global decline in physical fitness and increasing prevalence of childhood obesity,has become a prominent global health problem.The beneficial effect of increasing the time of outdoor activities on the incidence of myopia and physical well-being in children has been widely recognized.However,in countries with highly competitive education systems,such as China,parents and school administrators may be reluctant to increase their children's time for extracurricular outdoor activities for fear of affecting their academic performance.Therefore,it is crucial to accurately assess the role of after-school outdoor activities in preventing and controlling myopia,as well as in promoting the physical and mental development of adolescents.Schools and families should be encouraged to collaboratively support children’s engagement in outdoor activities to foster their healthy growth.Given the dual benefits of outdoor activities-improving visual health and promoting overall physical and mental well-being-it is essential to encourage schools and families to work together to support children's engagement in such activities.By doing so,it is hoped that a balanced environment can be created,one that values both academic achievement and healthy development.Policymakers,educators,and parents must recognize the long-term advantages of integrating outdoor activities into children's daily lives,as this approach can help alleviate the burden of myopia,enhance physical fitness,and support emotional and cognitive development.Ultimately,fostering a culture that views outdoor activities as an essential component of education and health will be key to ensuring the well-rounded development of future generations.展开更多
AIM:To describe the clinical manifestations,imaging features and surgical treatments in 5 cases of extraocular muscle(EOM)dysplasia presenting as orbital spaceoccupying lesions(SOL).METHODS:Records from the 5 cases wi...AIM:To describe the clinical manifestations,imaging features and surgical treatments in 5 cases of extraocular muscle(EOM)dysplasia presenting as orbital spaceoccupying lesions(SOL).METHODS:Records from the 5 cases with EOM dysplasia between 2004 and 2016 were retrospectively reviewed and clinical data were recorded including family history,age at onset,age at surgery,visual acuity,cycloplegic refraction,ocular alignment and motility,stereoacuity,exophthalmos,anterior segment and fundus,orbital computed tomography(CT)or magnetic resonance imaging(MRI)scan,surgical methods and final outcomes.RESULTS:All 5 cases(1 male,4 females)were unilateral(3 right,2 left eyes).The average age was 5.4y(range 4-6y)with no family history.Patients had unilateral strabismus(horizontal and vertical),restricted eye movement,and eyelid changes(abnormal fissures,lagophthalmos,and/or entropion)in the affected eye.None had proptosis;1 had 2-mm enophthalmos.Orbital CT/MRI showed irregular,ill-defined masses in EOM.Two anterior orbitotomies and 3 strabismus surgeries were performed,and pathology confirmed EOM dysplasia.After surgery,horizontal deviations,which ranged from exotropia(XT)10 prism diopter(PD)to esotropia(ET)10 PD(average 6 PD),decreased by an average of 18 PD,while vertical deviations,which ranged from 4 PD to 20 PD(mean 9.8 PD),decreased by an average of 23.2 PD.CONCLUSION:SOL from EOM dysplasia is non-familial and typically presenting unilaterally characterized by an irregular,diffusely infiltrating mass within the EOM.EOM involvement causes strabismus,restricted eye movement,eyelid changes,and enophthalmos likely due to cicatricial processes.展开更多
Objective:Strabismus is associated with a higher prevalence of idiopathic thoracic scoliosis(ITS)in children.This study aims to investigate whether superior oblique palsy(SOP)poses a higher risk for developing ITS amo...Objective:Strabismus is associated with a higher prevalence of idiopathic thoracic scoliosis(ITS)in children.This study aims to investigate whether superior oblique palsy(SOP)poses a higher risk for developing ITS among children and adolescents.Methods:A cross-sectional study.The study group comprised 347 consecutive candidates for SOP surgery aged 4 to 18 years;Patients within the same age range with ocular trauma were enrolled as the control group.Preoperative chest plain radiographs were used to measure the Cobb angle.Demographic information and clinical data,including diopter,best corrected visual acuity,deviation degree,and binocular function,were analyzed.Results:A significantly higher prevalence of ITS was found in study group compared with control group(12.68%vs 4.18%,P<0.001).Additionally,the mean Cobb angle was lagger in SOP group than that in control group(5.02°±3.87°vs 3.84°±3.09°,P<0.001).Males in SOP group showed a higher prevalence of ITS(12.9%vs 2.87%,P=0.007),but there was no significant difference in females between two groups(12.3%vs 7.69%,P=0.295).Good near stereopsis acuity was significantly associated with high prevalence of thoracic scoliosis(P<0.001).Multivariate logistic regression analysis revealed that a large distant magnitude of deviation(>20 PD)and near stereoacuity were significantly associated with ITS.Conclusions:Patients with SOP have a significantly higher risk of developing idiopathic thoracic scoliosis,especially those with good near stereoscopic and large distant magnitude of deviation.展开更多
Pediatric cataract,a leading cause of blindness in children globally,imposing a significant financial burden on both families and society.The extensive phenotypic heterogeneity of this condition means that the underly...Pediatric cataract,a leading cause of blindness in children globally,imposing a significant financial burden on both families and society.The extensive phenotypic heterogeneity of this condition means that the underlying mechanisms remain poorly understood,limiting the development of precise and effective treatments.The advent of omics technologies has provided potent tools for unraveling the pathogenesis of pediatric cataract.By mapping expression profiles across various molecular levels,these omics approaches enhance our understanding of the disease’s etiological mechanisms,aid in the identification of novel biomarkers and key pathways,and offer researchers new insights for the innovative strategies in disease diagnosis and targeted therapies.In this review,we summarize the application of omics approaches in clinical and basic research on pediatric cataract over the past decade,encompassing genomics,transcriptomics,proteomics,and metabolomics.Furthermore,we discuss the current challenges and future prospects of omics analyses in pediatric cataract studies.展开更多
Objective:To evaluate the performance of orthokeratology(ortho-k)lens reordering using software-designed system,so as to determine the feasibility of ortho-k lens reordering without discontinuing lens wear.Methods:Thi...Objective:To evaluate the performance of orthokeratology(ortho-k)lens reordering using software-designed system,so as to determine the feasibility of ortho-k lens reordering without discontinuing lens wear.Methods:This study is a retrospective analysis of data of ortho-k lens wearers who had a history of short-term discontinuation of lens wear.A total of 94 individuals aged over 8 years with spherical equivalent refraction ranging from-0.50 to-6.50 diopters were included.The corneal topography data at baseline(before ortho-k)and after lens wear discontinuation(cessation of ortho-k treatment)were imported separately into the lens-design software,along with corresponding refraction data.Subsequently,corneal and lens parameters were generated and compared.Intraclass correlation coefficients(ICC)were calculated,and Bland and Altman analyses were conducted.Results:All 94 children were involved in the retrospective analysis.Compared with baseline data,there was a high level of consistency between Rwo(without discontinuation)and Rwith(with discontinuation),with an ICC of 0.96(P<0.001).Furthermore,the comparison of lens parameters generated by the Easyfit software between baseline and after short-term discontinuation showed a high degree of consistency,with all of the ICC values exceeding 0.90.Similar results were obtained using the WAVE software,as both ICC values and Bland-Altman plots demonstrated a high level of consistency in lens parameters between two conditions(nearly all data points fell within the 95%LoAs).Conclusions:It is feasible to directly reorder new ortho-k lenses using software fitting approaches.However,further investigations are necessary to validate their practicability in a clinical setting.展开更多
AIM:To evaluate the accuracy of intraocular lens(IOL)power calculation formulas with/without preoperative aphakic anterior chamber depth(aph-ACD)in pediatric aphakia.METHODS:A total of 102 pediatric patients(150 eyes)...AIM:To evaluate the accuracy of intraocular lens(IOL)power calculation formulas with/without preoperative aphakic anterior chamber depth(aph-ACD)in pediatric aphakia.METHODS:A total of 102 pediatric patients(150 eyes)undergoing secondary IOL implantation were divided into two groups(in-the-bag or ciliary sulcus).Prediction error was calculated for 9 IOL power calculation formulas,including:1)not requiring ACD:Hoffer Q,Holladay 1,SRK/T;2)usable without or with entering ACD:Barrett Universal II(BUII),Emmetropia Verifying Optical(EVO)2.0,and Ladas Artificial Intelligence Super(Ladas AI);3)requiring ACD:Haigis,Kane,and Pearl-DGS.Mean prediction error(ME),mean absolute error(MAE),median absolute error(MedAE)and the percentage of eyes within±0.25,±0.50,±0.75,and±1.00 D were calculated.RESULTS:For the BUII,EVO 2.0,and Ladas AI,with aph-ACD demonstrated a higher MedAE compared to without aph-ACD(BUII:1.27 vs 1.13 D,EVO 2.0:1.26 vs 1.06 D,Ladas AI:1.30 vs 1.10 D;all P<0.05).Formulas requiring ACD(Haigis,Kane,and Pearl-DGS)exhibited larger MedAE than those not requiring aph-ACD(Hoffer Q,Holladay 1,and SRK/T;P<0.05).In the capsular group,the percentage of eyes within±1.00 D ranged from 44.83%to 74.14%,and it was 19.57%to 32.61%in the sulcus group.CONCLUSION:The introduction of aph-ACD does not improve the accuracy of IOL calculation for pediatric aphakia,regardless of in-the-bag or sulcus IOL secondary implantation.The relationship between aph-ACD and effective lens position in pediatric aphakia warrants further study.展开更多
Objective:Fengqing County,situated in Yunnan Province,is a high-altitude region known for its ethnic diversity and a notably high prevalence of pterygium.As a key area for Sun Yat-sen University's poverty alleviat...Objective:Fengqing County,situated in Yunnan Province,is a high-altitude region known for its ethnic diversity and a notably high prevalence of pterygium.As a key area for Sun Yat-sen University's poverty alleviation initiatives,this study aims to investigate the unique characteristics of pterygium in specific region.Methods:We analyzed data from hospitalized patients admitted to the Ophthalmology department of the People's Hospital of Fengqing in 2023.The data were extracted from medical records through the hospital information system.The chi-square test was used for statistical comparison,and multivariate logistic regression analysis was conducted to explore the factors influencing the onset of pterygium.A significance level of P<0.005 was set.Results:In 2023,out of 1137 ophthalmic inpatients,207(18.2%)underwent pterygium surgery.There was a significant female predominance,with a female-to-male ratio of 6.67:1(P<0.001).However,no significant ethnic variation was observed(P=0.57).The majority of patients were in the 46-55 age group(36.71%),and the recurrence rate was low at 1.71%.Female gender,increasing age,diabetes mellitus,age-related cataract,and meibomian gland dysfunction were identified as independent risk factors for pterygium in this region.Conclusion:Fengqing is likely to have intricate connections between the occurrence and treatment of pterygium and its local geography,culture,and socio-economic conditions.Medical assistance programs should take these factors into account and prioritize them in poverty alleviation initiatives.展开更多
Objective:Accurate intraocular pressure(IOP)measurement is a cornerstone of glaucoma diagnosis and management.While Goldmann applanation tonometry(GAT)remains the accepted gold standard,technological advancements have...Objective:Accurate intraocular pressure(IOP)measurement is a cornerstone of glaucoma diagnosis and management.While Goldmann applanation tonometry(GAT)remains the accepted gold standard,technological advancements have introduced alternative methods such as noncontact tonometry(NCT)and the dynamic Scheimpflug-based Corvis ST(CST).This study aims to conduct a rigorous comparative analysis of IOP measurements obtained by NCT,GAT,and CST across a wide spectrum of intraocular pressures.The primary objectives were to evaluate the performance of these devices in both healthy and glaucomatous eyes,assess their intra-and interobserver variability,and determine their level of agreement with the established reference.Methods:In this prospective,comparative study,a total of 212 eyes from 212 subjects were enrolled,comprising 137 eyes of patients with glaucoma and 75 eyes of healthy individuals.All participants underwent IOP measurement using the three devices in a randomized order to minimize bias.Based on the initial GAT readings,eyes were systematically classified into one of four predefined IOP levels:Level A(low,<10 mmHg),Level B(normal range,10-21 mmHg),Level C(moderately elevated,>21 to 40 mmHg),and Level D(severely elevated,>40 mmHg).A mixed-model analysis of variance(ANOVA)was employed to statistically analyze the differences in IOP measurements among the three tonometers at each distinct pressure level.The agreement between each pair of devices(CST vs.GAT,CST vs.NCT,and NCT vs.GAT)was meticulously assessed using Bland-Altman plots,which provide metrics for bias(mean difference)and the 95%limits of agreement(LoA).Results:CST and GAT exhibited better intra-and interobserver variability compared to NCT.Significant differences in IOP measurements were observed among CST,NCT,and GAT at levels A and D(P<0.001,P=0.030).Bland-Altman analysis revealed biases between CST and GAT,CST and NCT,and NCT and GAT at different levels(level A:-0.61,0.94,and-1.55 mmHg;level B:0.16,-0.7,and 0.8;level C:0.5,0.5,and-0.1;level D:0.83,-3.4,and 4.2).Notably,NCT tended to overestimate IOP more at higher levels(level D)and underestimate at lower levels(level A)compared to CST.CST demonstrated better agreement with GAT than NCT did.Conclusions:This study confirms that the Corvis ST(CST)shows superior agreement with the Goldmann applanation tonometer than noncontact tonometry,particularly at low and high IOP ranges.It also exhibits greater measurement consistency.While NCT remains a useful screening tool,its significant over-and underestimation at pressure extremes is a critical limitation.The findings strongly suggest that CST may serve as a more suitable and reliable alternative to NCT for measuring IOP across a broad clinical range.However,the results underscore that these three methods are not directly interchangeable.Clinicians must therefore exercise careful interpretation of IOP values,taking into account the specific tonometer used and the patient's probable pressure level for accurate diagnosis and management of glaucoma.展开更多
Dear Editor,Traumatic optic neuropathy(TON)is a severe vision-threatening condition,with an incidence rate ranging from 0.7% to 2.5%[1].The limited regenerative capacity of the optic nerve and the challenges of nerve ...Dear Editor,Traumatic optic neuropathy(TON)is a severe vision-threatening condition,with an incidence rate ranging from 0.7% to 2.5%[1].The limited regenerative capacity of the optic nerve and the challenges of nerve transplantation result in substantial and irreversible visual loss in patients with TON.展开更多
基金Supported by the Hainan Provincial Natural Science Foundation of China(No.825RC898)and Hainan Province Clinical Medical Center.
文摘ChatGPT technology based on large language models(LLM)shows great potential in improving the quality of medical care,assisting clinical decision making and optimizing patient communication.The role of ChatGPT in ophthalmology is still in its infancy.This review aims to explore the application prospect of ChatGPT in ophthalmology.Relevant literature was reviewed and analyzed,and the application prospects of LLM represented by ChatGPT in ophthalmology were summarized,including clinical assisted diagnosis,patient education and communication,history collection and text writing,clinical research,and medical education,etc.At the same time,the challenges and solutions faced by ChatGPT in ophthalmology were pointed out.Its safety,efficacy and ethics remain controversial in practical applications.Therefore,it is necessary to strengthen the supervision and research on its application to ensure safety and effectiveness.In the future,with the development of technology,ChatGPT is expected to play a greater role in ophthalmology and enhance the medical experience.
基金supported by the National Natural Science Foundation of China,No.82271115(to MY).
文摘Synaptic plasticity is essential for maintaining neuronal function in the central nervous system and serves as a critical indicator of the effects of neurodegenerative disease.Glaucoma directly impairs retinal ganglion cells and their axons,leading to axonal transport dysfuntion,subsequently causing secondary damage to anterior or posterior ends of the visual system.Accordingly,recent evidence indicates that glaucoma is a degenerative disease of the central nervous system that causes damage throughout the visual pathway.However,the effects of glaucoma on synaptic plasticity in the primary visual cortex remain unclear.In this study,we established a mouse model of unilateral chronic ocular hypertension by injecting magnetic microbeads into the anterior chamber of one eye.We found that,after 4 weeks of chronic ocular hypertension,the neuronal somas were smaller in the superior colliculus and lateral geniculate body regions of the brain contralateral to the affected eye.This was accompanied by glial cell activation and increased expression of inflammatory factors.After 8 weeks of ocular hypertension,we observed a reduction in the number of excitatory and inhibitory synapses,dendritic spines,and activation of glial cells in the primary visual cortex contralateral to the affected eye.These findings suggest that glaucoma not only directly damages the retina but also induces alterations in synapses and dendritic spines in the primary visual cortex,providing new insights into the pathogenesis of glaucoma.
基金Supported by National Natural Science Foundation of China(No.81670823)
文摘AIM： To characterize the proliferative capacity of pterygial epithelium in different regions（head, neck and body） of pterygium and explore the function of transcription factor 4（TCF4） in pterygium proliferation.METHODS： Thirty pterygium tissues and 10 normal conjunctival tissues were obtained from Zhongshan Ophthalmic Center（ZOC） and Guangdong Eye Bank, respectively. Proliferative capacity of head, neck and body in pterygial epithelium was measured using clonal analysis, fold growth analysis and expression profile of proliferative markers revealed by immunofluorescent staining and real-time PCR. The expression of TCF4 was highlighted by double immunofluorescent staining with other proliferation related markers such as proliferating cell nuclear antigen（PCNA） and ATP-binding cassette subfamily G member 2（ABCG2）.RESULTS： The proliferative potential of pterygial epithelium was higher than that of normal conjunctival epithelium. High expression levels of proliferative markers（P63α, PCNA and ABCG2） in pterygial body epithelium were observed in immunofluorescent staining and real-time PCR（P〈0.05）. Also, epithelial cells isolated from pterygial body demonstrated higher proliferative capacity in clonal analysis and fold growth analysis, than those isolated from the head and neck regions. The TCF4 expression in pterygial epithelium was similar to other proliferative markers（P63α, PCNA and ABCG2）, as higher in pterygial body than head and neck. Moreover, TCF4 showed coexpression with other proliferation-related markers（PCNA and ABCG2） in the double immunofluorescent staining experiment.CONCLUSION： The proliferative capacity in pterygial body epithelium is prominent than the head and neck regions, and upregulated TCF4 may be associated with enhanced proliferation in the pterygium.
基金All the procedures in this study were approved by the Institutional Review Board of Zhongshan Ophthalmic Center of Sun Yat-sen University(Ethic ID:2016MEKY062).Informed consent was obtained from each student.
文摘Background:The“flipped classroom”is a learner-centered approach that centers on delivering videos,podcasts or slide-based material to learners prior to a lecture or class session.The class session is then dedicated to discussion,analysis,and problem-solving activities.The aim of this study was to investigate whether the flipped classroom could be adapted to medical(ophthalmology)students learning about ocular trauma and to assess the impact of the flipped classroom on those students’performance and attitudes.Methods:Questionnaires(using a 4-point scale)were distributed to 93 fifth-year medical students at Sun Yat-sen University,and the data showed that the majority of students preferred the flipped classroom approach to the traditional lecture method.Results:The results of pre-and post-test scores were 14.35±3.404 and 20.37±4.356,which showed a significant improvement in students’performance after the flipped classroom was introduced(P<0.05).Conclusions:Student response to the flipped classroom strategy was largely positive,indicating that the strategy received a high level of approval in an ophthalmology clerkship course taken by medical students in China.
基金Supported by National Natural Science Foundation of China(No.81470627 No.81600726)+2 种基金Shandong Province Natural Science Foundation(No.ZR2016HB53)Natural Science Foundation of Guangdong Province(No.2018A030310185)the Research Funding of Guangzhou Medical University(No.2016C21)
文摘AIM: To determine the progression of parameters from optical coherence tomography(OCT) in chronic elevated intraocular pressure(IOP) monkeys.METHODS: A chronic elevated IOP model of rhesus monkeys was induced by laser photocoagulation. Representative OCT parameters, including the average and four-quadrant retinal nerve fiber layer(RNFL) thickness, and parameters from optic nerve head(ONH) analysis were collected before and after laser treatments biweekly for up to 28 wk. The performance of each parameter for early progression detection was analyzed. The progressive trends toward elevated IOP were analyzed using a linear mixed-effects model.RESULTS: There were 10 successfully maintained high IOP eyes in 7 monkeys. The follow-up time was 24±5.37 wk. With cumulative IOP elevation, the cup area, rim area and C/D area ratio were statistically significantly changed as early as 2 wk after elevated IOP induction(P<0.05). The quadrant RNFL thickness changed at 6wk after high IOP induction, and the superior and inferior RNFL thicknesses exhibited more obvious reductions than other quadrants. The average RNFL thickness was the last one to show a significant decrease at 8wk.CONCLUSION: The parameters of ONH are most sensitive to elevated IOP in a primate glaucomatous model. These findings suggest that we should focus on those parameters instead of RNFL thickness in patients with elevated IOP, as they might present with earlier glaucomatous changes.
基金This study was funded by Science and Technology Projects of Guangdong Province(Nos.2019A030317002,2017A030303013,2013B060300003).
文摘Background:A variety of experimental animal models are used in basic ophthalmological research to elucidate physiological mechanisms of vision and disease pathogenesis.The choice of animal model is based on the measurability of specific parameters or structures,the applicability of clinical measurement technologies,and the similarity to human eye function.Studies of eye pathology usually compare optical parameters between a healthy and altered state,so accurate baseline assessments are critical,but few reports have comprehensively examined the normal anatomical structures and physiological functions in these models.Methods:Three cynomolgus monkeys,six New Zealand rabbits,ten Sprague Dawley(SD)rats,and BALB/c mice were examined by fundus photography(FP),fundus fluorescein angiography(FFA),and optical coherence tomography(OCT).Results:Most retinal structures of cynomolgus monkey were anatomically similar to the corresponding human structures as revealed by FP,FFA,and OCT.New Zealand rabbits have large eyeballs,but they have large optic disc and myelinated retinal nerve fibers in their retinas,and the growth pattern of retinal vessels were also different to the human retinas.Unlike monkeys and rabbits,the retinal vessels of SD rats and BALB/c mice were widely distributed and clear.The OCT performance of them were similar with human beings except the macular.Conclusions:Monkey is a good model to study changes in retinal structure associated with fundus disease,rabbits are not suitable for studies on retinal vessel diseases and optic nerve diseases,and rats and mice are good models for retinal vascular diseases.These measures will help guide the choice of model and measurement technology and reduce the number of experimental animals required.
基金supported by the National Natural Science Foundation of China(81770956,81371049,32471055 and 82171090)Project of Tianjin 131 Innovative Talent Team(201936)+4 种基金the Science and Technology Planning Project of Tianjin(21JCYBJC00780)the Science and Technology Fund for Health of Tianjin(TJWJ2023ZD008)Shanghai Municipal Science and Technology Major Project(2018SHZDZX01)ZJLab,Shanghai Center for Brain Science and Brain-Inspired Technology,the Lingang Laboratory(LG-QS-202203-12)Tianjin Key Medical Discipline(Specialty)Construction Project(TJYXZDXK‑016A).
文摘The visual cortex is an essential part of the brain for processing visual information.It exhibits structural and functional plasticity,which is crucial for adapting to complex visual environments.The quintessential manifestation of visual cortical plasticity is ocular dominance plasticity during the critical period,which involves numerous cellular and molecular events.While previous studies have emphasized the role of visual cortical neurons and their associated functional molecules in visual plasticity,recent findings have revealed that structural factors such as the extracellular matrix and glia are also involved.Investigating how these molecules interact to form a complex network that facilitates plasticity in the visual cortex is crucial to our understanding of the development of the visual system and the advancement of therapeutic strategies for visual disorders like amblyopia.
基金supported by the National Natural Science Foundation of China,No.82271114the Natural Science Foundation of Zhejiang Province of China,No.LZ22H120001(both to ZLC).
文摘Several studies have found that transplantation of neural progenitor cells(NPCs)promotes the survival of injured neurons.However,a poor integration rate and high risk of tumorigenicity after cell transplantation limits their clinical application.Small extracellular vesicles(sEVs)contain bioactive molecules for neuronal protection and regeneration.Previous studies have shown that stem/progenitor cell-derived sEVs can promote neuronal survival and recovery of neurological function in neurodegenerative eye diseases and other eye diseases.In this study,we intravitreally transplanted sEVs derived from human induced pluripotent stem cells(hiPSCs)and hiPSCs-differentiated NPCs(hiPSC-NPC)in a mouse model of optic nerve crush.Our results show that these intravitreally injected sEVs were ingested by retinal cells,especially those localized in the ganglion cell layer.Treatment with hiPSC-NPC-derived sEVs mitigated optic nerve crush-induced retinal ganglion cell degeneration,and regulated the retinal microenvironment by inhibiting excessive activation of microglia.Component analysis further revealed that hiPSC-NPC derived sEVs transported neuroprotective and anti-inflammatory miRNA cargos to target cells,which had protective effects on RGCs after optic nerve injury.These findings suggest that sEVs derived from hiPSC-NPC are a promising cell-free therapeutic strategy for optic neuropathy.
基金Supported by the National Natural Science Foundation of China(No.82271063No.82471054)Central Guidance for Local Scientific and Technological Development Funding Projects(No.2024ZY01057).
文摘The immune system is involved in many age-related pathological changes,also plays an important role in tissue regeneration after injury.But no immune involvement has been discussed regarding cataract since it is presumed that lens has no source of immune cells as an avascular zone.Latest research has challenged the longstanding view of the lens as an immune-privileged tissue,revealing the presence of resident immune cells and active immune responses within the lens.Thus,we summarized the immune involvement in maintaining lens homeostasis,which may be a deleterious role in the induction of lens opacification if inappropriately activated.Furthermore,bioengineer-based immunomodulatory therapies to fine-tune the micro immune environment within lens may be future strategies for in situ lens regeneration,as a novel treatment for cataract.
文摘Background: Glaucoma is a leading cause of irreversible blindness worldwide, characterized by progressive optic nerve damage and visual field loss, often associated with elevated intraocular pressure (IOP). Traditional treatment options include medications and surgical interventions;however, many patients experience refractory glaucoma that does not respond adequately to standard therapies. Ultrasound cycloplasty has emerged as a promising alternative for managing refractory glaucoma by reducing IOP through targeted tissue ablation. Due to the limited relevant research on the perioperative nursing of UCP, this study explores the key nursing points during the perioperative period of ultrasound cycloplasty. Methods: A retrospective analysis was conducted on the clinical data of 53 glaucoma patients, including preoperative and postoperative intraocular pressure (IOP) changes, use of antiglaucoma medications, and ocular pain scores. Preoperative nursing includes medical history assessment, surgical explanation, and ocular examination. Postoperatively, IOP monitoring and medication guidance were provided. Results: Postoperative IOP was significantly reduced, the number of antiglaucoma medications used decreased, and ocular pain scores were notably lower. At three months postoperatively, 96.23% of patients exhibited a decrease in IOP. Ultrasound Cycloplasty effectively lowered IOP, alleviated ocular pain, and reduced the use of antiglaucoma medications in patients with various types of glaucoma. Conclusion: Ultrasound Cycloplasty is a safe and effective minimally invasive procedure for treating glaucoma. Proper clinical nursing plays a crucial role in the success of the surgery and the patient’s recovery, including preoperative communication and education, intraoperative monitoring and technical proficiency, as well as postoperative IOP monitoring and care. Long-term IOP monitoring and regular nursing assessments are recommended for patients undergoing this procedure to ensure the durability and safety of the treatment outcomes.
基金supported by the Guangzhou Basic Research Program,City&University(Institute)Joint Funding Project(2023A03J0174).
文摘Objective:Evidence pertaining to the associations between hyperuricemia and diabetic microvascular complications is limited and inconclusive.In this study,we aimed to prospectively investigate the independent associations of hyperuricemia and retinopathy,nephropathy and neuropathy in individuals with type 2 diabetes mellitus(T2DM).Methods:This cohort study enrolled 25,094 participants from UK Biobank with T2DM and without microvascular complications at baseline.Hyperuricemia was defined as serum uric acid(SUA)higher than 420μmol/L.The incidence of diabetic microvascular complications was identified from hospital inpatient records that were coded according to the International Classification of Diseases(ICD)-10 coding system.Multivariable adjusted Cox proportional hazards regression models were used to calculate adjusted hazard ratios(aHR).Results:Among all participants,3,844(15.3%)were classified as having hyperuricemia at baseline.During a median follow-up of 14.0 years,555(14.4%)individuals with hyperuricemia developed diabetic microvascular complications,compared with 12.6%of individuals without hyperuricemia(P=0.002).In the multivariable-adjusted model accounted for socioeconomic status,lifestyle factors,physical and biochemical measurements,and medication use,when compared with individuals of T2DM who had a normal SUA level,those with hyperuricemia had an 82.9%higher risk of developing diabetic nephropathy(95%CI:1.41-2.38,P<0.001),and a 30.2%higher risk of diabetic neuropathy(95%CI:1.06-1.60,P=0.011).However,the association between hyperuricemia and diabetic retinopathy was not statistically significant(aHR:1.070,95%CI:0.94-1.22,P=0.320).Conclusions:Hyperuricemia was independently associated with diabetic nephropathy and neuropathy but not retinopathy in individuals with T2DM.These findings underscore the importance of monitoring SUA level in prevention of certain microvascular complications.
文摘Myopia,a common cause of visual impairment,together with the global decline in physical fitness and increasing prevalence of childhood obesity,has become a prominent global health problem.The beneficial effect of increasing the time of outdoor activities on the incidence of myopia and physical well-being in children has been widely recognized.However,in countries with highly competitive education systems,such as China,parents and school administrators may be reluctant to increase their children's time for extracurricular outdoor activities for fear of affecting their academic performance.Therefore,it is crucial to accurately assess the role of after-school outdoor activities in preventing and controlling myopia,as well as in promoting the physical and mental development of adolescents.Schools and families should be encouraged to collaboratively support children’s engagement in outdoor activities to foster their healthy growth.Given the dual benefits of outdoor activities-improving visual health and promoting overall physical and mental well-being-it is essential to encourage schools and families to work together to support children's engagement in such activities.By doing so,it is hoped that a balanced environment can be created,one that values both academic achievement and healthy development.Policymakers,educators,and parents must recognize the long-term advantages of integrating outdoor activities into children's daily lives,as this approach can help alleviate the burden of myopia,enhance physical fitness,and support emotional and cognitive development.Ultimately,fostering a culture that views outdoor activities as an essential component of education and health will be key to ensuring the well-rounded development of future generations.
基金Supported by the National Natural Science Foundation of China(No.81670885).
文摘AIM:To describe the clinical manifestations,imaging features and surgical treatments in 5 cases of extraocular muscle(EOM)dysplasia presenting as orbital spaceoccupying lesions(SOL).METHODS:Records from the 5 cases with EOM dysplasia between 2004 and 2016 were retrospectively reviewed and clinical data were recorded including family history,age at onset,age at surgery,visual acuity,cycloplegic refraction,ocular alignment and motility,stereoacuity,exophthalmos,anterior segment and fundus,orbital computed tomography(CT)or magnetic resonance imaging(MRI)scan,surgical methods and final outcomes.RESULTS:All 5 cases(1 male,4 females)were unilateral(3 right,2 left eyes).The average age was 5.4y(range 4-6y)with no family history.Patients had unilateral strabismus(horizontal and vertical),restricted eye movement,and eyelid changes(abnormal fissures,lagophthalmos,and/or entropion)in the affected eye.None had proptosis;1 had 2-mm enophthalmos.Orbital CT/MRI showed irregular,ill-defined masses in EOM.Two anterior orbitotomies and 3 strabismus surgeries were performed,and pathology confirmed EOM dysplasia.After surgery,horizontal deviations,which ranged from exotropia(XT)10 prism diopter(PD)to esotropia(ET)10 PD(average 6 PD),decreased by an average of 18 PD,while vertical deviations,which ranged from 4 PD to 20 PD(mean 9.8 PD),decreased by an average of 23.2 PD.CONCLUSION:SOL from EOM dysplasia is non-familial and typically presenting unilaterally characterized by an irregular,diffusely infiltrating mass within the EOM.EOM involvement causes strabismus,restricted eye movement,eyelid changes,and enophthalmos likely due to cicatricial processes.
基金the National Natural Science Foundation of China grant NSFC(82070995).
文摘Objective:Strabismus is associated with a higher prevalence of idiopathic thoracic scoliosis(ITS)in children.This study aims to investigate whether superior oblique palsy(SOP)poses a higher risk for developing ITS among children and adolescents.Methods:A cross-sectional study.The study group comprised 347 consecutive candidates for SOP surgery aged 4 to 18 years;Patients within the same age range with ocular trauma were enrolled as the control group.Preoperative chest plain radiographs were used to measure the Cobb angle.Demographic information and clinical data,including diopter,best corrected visual acuity,deviation degree,and binocular function,were analyzed.Results:A significantly higher prevalence of ITS was found in study group compared with control group(12.68%vs 4.18%,P<0.001).Additionally,the mean Cobb angle was lagger in SOP group than that in control group(5.02°±3.87°vs 3.84°±3.09°,P<0.001).Males in SOP group showed a higher prevalence of ITS(12.9%vs 2.87%,P=0.007),but there was no significant difference in females between two groups(12.3%vs 7.69%,P=0.295).Good near stereopsis acuity was significantly associated with high prevalence of thoracic scoliosis(P<0.001).Multivariate logistic regression analysis revealed that a large distant magnitude of deviation(>20 PD)and near stereoacuity were significantly associated with ITS.Conclusions:Patients with SOP have a significantly higher risk of developing idiopathic thoracic scoliosis,especially those with good near stereoscopic and large distant magnitude of deviation.
基金supported by the General Program of Natural Science Foundation of Guangdong Province(2023A1515011102).
文摘Pediatric cataract,a leading cause of blindness in children globally,imposing a significant financial burden on both families and society.The extensive phenotypic heterogeneity of this condition means that the underlying mechanisms remain poorly understood,limiting the development of precise and effective treatments.The advent of omics technologies has provided potent tools for unraveling the pathogenesis of pediatric cataract.By mapping expression profiles across various molecular levels,these omics approaches enhance our understanding of the disease’s etiological mechanisms,aid in the identification of novel biomarkers and key pathways,and offer researchers new insights for the innovative strategies in disease diagnosis and targeted therapies.In this review,we summarize the application of omics approaches in clinical and basic research on pediatric cataract over the past decade,encompassing genomics,transcriptomics,proteomics,and metabolomics.Furthermore,we discuss the current challenges and future prospects of omics analyses in pediatric cataract studies.
基金supported by the National Natural Science Foundation of China(82371089).
文摘Objective:To evaluate the performance of orthokeratology(ortho-k)lens reordering using software-designed system,so as to determine the feasibility of ortho-k lens reordering without discontinuing lens wear.Methods:This study is a retrospective analysis of data of ortho-k lens wearers who had a history of short-term discontinuation of lens wear.A total of 94 individuals aged over 8 years with spherical equivalent refraction ranging from-0.50 to-6.50 diopters were included.The corneal topography data at baseline(before ortho-k)and after lens wear discontinuation(cessation of ortho-k treatment)were imported separately into the lens-design software,along with corresponding refraction data.Subsequently,corneal and lens parameters were generated and compared.Intraclass correlation coefficients(ICC)were calculated,and Bland and Altman analyses were conducted.Results:All 94 children were involved in the retrospective analysis.Compared with baseline data,there was a high level of consistency between Rwo(without discontinuation)and Rwith(with discontinuation),with an ICC of 0.96(P<0.001).Furthermore,the comparison of lens parameters generated by the Easyfit software between baseline and after short-term discontinuation showed a high degree of consistency,with all of the ICC values exceeding 0.90.Similar results were obtained using the WAVE software,as both ICC values and Bland-Altman plots demonstrated a high level of consistency in lens parameters between two conditions(nearly all data points fell within the 95%LoAs).Conclusions:It is feasible to directly reorder new ortho-k lenses using software fitting approaches.However,further investigations are necessary to validate their practicability in a clinical setting.
基金Supported by the Joint Funding Project of Municipal Schools(Colleges)of Science and Technology Program of Guangzhou,China(No.2023A03J0188)the Construction Project of High-Level Hospitals in Guangdong Province(No.303020102)the Natural Science Fund of Guangdong Province(No.2023A1515011102).
文摘AIM:To evaluate the accuracy of intraocular lens(IOL)power calculation formulas with/without preoperative aphakic anterior chamber depth(aph-ACD)in pediatric aphakia.METHODS:A total of 102 pediatric patients(150 eyes)undergoing secondary IOL implantation were divided into two groups(in-the-bag or ciliary sulcus).Prediction error was calculated for 9 IOL power calculation formulas,including:1)not requiring ACD:Hoffer Q,Holladay 1,SRK/T;2)usable without or with entering ACD:Barrett Universal II(BUII),Emmetropia Verifying Optical(EVO)2.0,and Ladas Artificial Intelligence Super(Ladas AI);3)requiring ACD:Haigis,Kane,and Pearl-DGS.Mean prediction error(ME),mean absolute error(MAE),median absolute error(MedAE)and the percentage of eyes within±0.25,±0.50,±0.75,and±1.00 D were calculated.RESULTS:For the BUII,EVO 2.0,and Ladas AI,with aph-ACD demonstrated a higher MedAE compared to without aph-ACD(BUII:1.27 vs 1.13 D,EVO 2.0:1.26 vs 1.06 D,Ladas AI:1.30 vs 1.10 D;all P<0.05).Formulas requiring ACD(Haigis,Kane,and Pearl-DGS)exhibited larger MedAE than those not requiring aph-ACD(Hoffer Q,Holladay 1,and SRK/T;P<0.05).In the capsular group,the percentage of eyes within±1.00 D ranged from 44.83%to 74.14%,and it was 19.57%to 32.61%in the sulcus group.CONCLUSION:The introduction of aph-ACD does not improve the accuracy of IOL calculation for pediatric aphakia,regardless of in-the-bag or sulcus IOL secondary implantation.The relationship between aph-ACD and effective lens position in pediatric aphakia warrants further study.
基金supported by Guangdong Basic Research Center of Excellence for Major Blinding Eye Diseases Prevention and Treatment(2024-YXGG-016).
文摘Objective:Fengqing County,situated in Yunnan Province,is a high-altitude region known for its ethnic diversity and a notably high prevalence of pterygium.As a key area for Sun Yat-sen University's poverty alleviation initiatives,this study aims to investigate the unique characteristics of pterygium in specific region.Methods:We analyzed data from hospitalized patients admitted to the Ophthalmology department of the People's Hospital of Fengqing in 2023.The data were extracted from medical records through the hospital information system.The chi-square test was used for statistical comparison,and multivariate logistic regression analysis was conducted to explore the factors influencing the onset of pterygium.A significance level of P<0.005 was set.Results:In 2023,out of 1137 ophthalmic inpatients,207(18.2%)underwent pterygium surgery.There was a significant female predominance,with a female-to-male ratio of 6.67:1(P<0.001).However,no significant ethnic variation was observed(P=0.57).The majority of patients were in the 46-55 age group(36.71%),and the recurrence rate was low at 1.71%.Female gender,increasing age,diabetes mellitus,age-related cataract,and meibomian gland dysfunction were identified as independent risk factors for pterygium in this region.Conclusion:Fengqing is likely to have intricate connections between the occurrence and treatment of pterygium and its local geography,culture,and socio-economic conditions.Medical assistance programs should take these factors into account and prioritize them in poverty alleviation initiatives.
文摘Objective:Accurate intraocular pressure(IOP)measurement is a cornerstone of glaucoma diagnosis and management.While Goldmann applanation tonometry(GAT)remains the accepted gold standard,technological advancements have introduced alternative methods such as noncontact tonometry(NCT)and the dynamic Scheimpflug-based Corvis ST(CST).This study aims to conduct a rigorous comparative analysis of IOP measurements obtained by NCT,GAT,and CST across a wide spectrum of intraocular pressures.The primary objectives were to evaluate the performance of these devices in both healthy and glaucomatous eyes,assess their intra-and interobserver variability,and determine their level of agreement with the established reference.Methods:In this prospective,comparative study,a total of 212 eyes from 212 subjects were enrolled,comprising 137 eyes of patients with glaucoma and 75 eyes of healthy individuals.All participants underwent IOP measurement using the three devices in a randomized order to minimize bias.Based on the initial GAT readings,eyes were systematically classified into one of four predefined IOP levels:Level A(low,<10 mmHg),Level B(normal range,10-21 mmHg),Level C(moderately elevated,>21 to 40 mmHg),and Level D(severely elevated,>40 mmHg).A mixed-model analysis of variance(ANOVA)was employed to statistically analyze the differences in IOP measurements among the three tonometers at each distinct pressure level.The agreement between each pair of devices(CST vs.GAT,CST vs.NCT,and NCT vs.GAT)was meticulously assessed using Bland-Altman plots,which provide metrics for bias(mean difference)and the 95%limits of agreement(LoA).Results:CST and GAT exhibited better intra-and interobserver variability compared to NCT.Significant differences in IOP measurements were observed among CST,NCT,and GAT at levels A and D(P<0.001,P=0.030).Bland-Altman analysis revealed biases between CST and GAT,CST and NCT,and NCT and GAT at different levels(level A:-0.61,0.94,and-1.55 mmHg;level B:0.16,-0.7,and 0.8;level C:0.5,0.5,and-0.1;level D:0.83,-3.4,and 4.2).Notably,NCT tended to overestimate IOP more at higher levels(level D)and underestimate at lower levels(level A)compared to CST.CST demonstrated better agreement with GAT than NCT did.Conclusions:This study confirms that the Corvis ST(CST)shows superior agreement with the Goldmann applanation tonometer than noncontact tonometry,particularly at low and high IOP ranges.It also exhibits greater measurement consistency.While NCT remains a useful screening tool,its significant over-and underestimation at pressure extremes is a critical limitation.The findings strongly suggest that CST may serve as a more suitable and reliable alternative to NCT for measuring IOP across a broad clinical range.However,the results underscore that these three methods are not directly interchangeable.Clinicians must therefore exercise careful interpretation of IOP values,taking into account the specific tonometer used and the patient's probable pressure level for accurate diagnosis and management of glaucoma.
基金supported by Guangzhou Key Projects of Brain Science and Brain-Like Intelligence Technology(20200730009)the National Natural Science Foundation of China(81870656)the Natural Science Foundation of Guangdong Province of China(2017A030313610 and 2023A1515012397).
文摘Dear Editor,Traumatic optic neuropathy(TON)is a severe vision-threatening condition,with an incidence rate ranging from 0.7% to 2.5%[1].The limited regenerative capacity of the optic nerve and the challenges of nerve transplantation result in substantial and irreversible visual loss in patients with TON.
