Objective:The aim of this study is to explore the clinical efficacy of Gabor based visual perception learning in the treatment of refractory amblyopia.Methods:Seventy-six amblyopia patients (152 eyes) who did not improve their best corrected visual acuity (BCVA) after 12 months of traditional amblyopia treatment or whose age has exceeded the visual sensitivity period from January 2021 to December 2021 in the Pediatric Ophthalmology Department of Shenzhen Eye Hospital were collected. Among them, there were 44 males (88 eyes) and 32 females (64 eyes) with an average age of (10.6±7.0) years-old (ranged from 5 to 33 years-old). All patients′ amblyopic eyes were trained systematically using Gabor based visual perception learning software. The BCVA before and after training using a standard logarithmic visual acuity chart was examined, and the treatment effectiveness based on the average improvement in BCVA before and after training was evaluated. The patients′ BCVA with overall and anisometropic amblyopia did not conform to normal distribution through normality testing, and were described using median and upper and lower quartiles [M (P25, P75)]. The BCVA of patients with ametropic amblyopia, strabismus amblyopia, and form deprivation amblyopia were described by the number of cases (eyes) and percentage. The BCVA between healthy and weak eyes in patients with overall and anisometropic amblyopia was compared using Mann-Whitney U rank sum test, and before and after training was compared using the wilconxon signed rank sum test. The method of correlation analysis was to use Pearson linear correlation analysis for data that conforms to a normal distribution, ortherwise was used by Spearman rank correlation analysis.Results:The median BCVA of the overall patient before and after training was 0.5 (0.3, 0.7), and 0.7 (0.5, 0.9), respectively. After training, the BCVA of the overall patient increased, and the difference was statistically significant (Z=7.282, P<0.05). Among them, there were 9 cases (18 eyes) with ametropic amblyopia, 12 cases (14 eyes) with strabismus amblyopia, 10 cases (12 eyes) with form deprivation amblyopia. After training, there were 8 cases (15 eyes) with improvement in BCVA for ametropic amblyopia, 10 cases (11 eyes) for strabismus amblyopia, 6 cases (8 eyes) for form deprivation amblyopia, accounting for 83.3% (15/18), 78.6% (11/14), 66.7% (8/12), respectively. The BCVA of patients for 43 cases (43 eyes) with anisometropic amblyopia before and after training was 0.50 (0.16, 0.70), 0.70 (0.50, 0.90), respectively. After training, the BCVA increased compared to before training, and the difference was statistically significant (Z=5.106, P<0.05). There were 2 cases (4 eyes) of other patients with concomitant nystagmus, which were not analyzed separately. The correlation analysis between the increase in BCVA and the age of all patients, the baseline BCVA showed a negative correlation (r=-0.350, -0.396; P<0.05); the number of training sessions was positively correlated with the increase in BCVA (r=0.480, P<0.05).Conclusions:Visual perception learning therapy based on Gabor visual standard can improve BCVA of amblyopia in patients with refractory amblyopia. However, for different types of refractory amblyopia, the average improvement and treatment effectiveness is various. Patients with younger the age during training, the lower the baseline BCVA, and the more training times, show the higher the improvement in BCVA after training.
In recent years, deep learning has become an important cutting-edge field of computer science research, which has been widely used in image recognition, speech recognition and natural language processing. But its lateral integration on the medical field has not been yet fully developped. The application of deep learning in ophthalmic examinations including fundus photography, optical coherence tomography and visual field examination can effectively screen and evaluate a variety of common blinding eye diseases including glaucoma, cataract, age-related macular degeneration and diabetic retinopathy. Currently, it has been fully proved its practicability in the screening and diagnosis of common ophthalmic diseases. In this paper, the application of deep learning technology in the screening, diagnosis of glaucoma and the future research direction was reviewed.
患者男性，35岁。因左眼视力突然下降2周，于2022年2月就诊于哈尔滨医科大学附属第四医院眼科。患者2周前出现左眼视力突然下降，期间视力偶有好转，无头痛、眼痛及畏光流泪等症状，否认高血压、糖尿病及冠心病病史。患者初次就诊时，左眼最佳矫正视力0.02，结膜无充血，角膜透明，前房清晰中等深度，瞳孔中等散大，直接光反射迟钝，晶状体透明，视盘充血水肿，视网膜动脉细，静脉迂曲，黄斑区水肿，呈暗红色改变。荧光素眼底血管造影检查结果显示左眼视盘晚期呈高荧光，视网膜可见动静脉交叉压迹，动静脉充盈迟缓，动脉血管纤细，静脉迂曲扩张，点片状荧光遮蔽，晚期视网膜荧光渗漏。见图1A~图1F。采用光学相干断层成像扫描仪检查结果显示左眼黄斑区视网膜结构紊乱，黄斑区水肿，上方可见线状高反射信号。见图B1。光学相干断层血管成像显示黄斑区毛细血管迂曲扩张，深层血管因出血不清晰，浅层血流密度明显降低，黄斑中心凹厚度显著增厚。见图2A~图2C。颈部血管超声、头部磁共振平扫、脑动脉血管磁共振成像均无异常。初步诊断为左眼视网膜中央动脉阻塞合并视网膜中央静脉阻塞。予以球后注射阿托品联合地塞米松治疗，建议行玻璃体腔内注射雷珠单抗，患者拒绝。1个月后复诊时，患者左眼最佳矫正视力指数/20 cm，眼压39 mmHg(1 mmHg＝0.133 kPa)，结膜无充血，角膜透明，前房清晰中等深度，虹膜发现新生血管，瞳孔中等散大，直接光反射消失，晶状体透明，视盘界清色淡，血管可见白壳。诊断为左眼视网膜中央动脉合并中央静脉阻塞并发新生血管性青光眼。患者要求外院治疗，自述于外院行玻璃体腔内注射雷珠单抗注射液及口服苯丁酸氮芥1片联合强的松20 mg/d治疗，同时予以酒石酸溴莫尼定滴眼液2次/d点眼。患病3个月时再次复诊，患者左眼最佳矫正视力指数/20 cm，眼压28 mmHg，结膜无充血，角膜透明，前房清晰中等深度，虹膜新生血管消退，瞳孔中等散大，直接光反射消失，晶状体透明，视盘色苍白，血管白线化。诊断为左眼新生血管性青光眼，左眼视神经萎缩。荧光素眼底血管造影检查结果显示左眼视盘晚期呈高荧光，视网膜可见动静脉交叉压迹，动静脉充盈迟缓，动脉血管纤细，静脉迂曲扩张，后极部片状出血灶及大面积无灌注区。见图3A~图3D。光学相干断层扫描成像显示。黄斑水肿基本消退，外界膜及光感受各层不规则。见图4A~图4B。再次予以玻璃体腔内注射雷珠单抗注射液，并建议患者行全视网膜激光光凝治疗。
Objective:The aim of this study is to investigate the effects of aquaporin 1 (AQP1) on proliferation, migration and function maintenance of human corneal endothelial (HCE) cells and its related mechanisms.Methods:pcDNA3.1 as a carrier, AQP1 overexpression plasmid (pcDNA3.1-AQP1), empty control plasmid (pcDNA3.1-NC), AQP1 small interfering ribonucleic acid sequence (siRNA-AQP1), and control sequence (siRNA-NC) were transfected into HCE cells, respectively. According to transfection types, cells were divided into non transfection control group (Control group), pcDNA3.1-AQP1 group, pcDNA3.1-NC group, siRNA-AQP1 group, and siRNA-NC group. The effect of AQP1 on the proliferation, migration, and apoptosis of HCE cells were evaluated.The expression of AQP1 mRNA in cells was detected by qRT-PCR. The ability of cell proliferation was detected by EdU assay. The cell migration ability was detected by Transwell chamber method. The apoptosis was detected by flow cytometry.To clarify the role of p38 mitogen activated protein kinase (p38 MAPK) signaling pathways in its mechanisms, p38 MAPK activator 10 μmol/L anisomycin was added to the pcDNA3.1-AQP1 group and called the pcDNA3.1-AQP1+ anisomycin group. The protein expression levels of human tight junction protein 1 (TJP1), sodium potassium triphosphate adenylase (Na+ /K+ -ATPase), p38 MAPK, and phosphorylated p38 MAPK in HCE cells were detected by Western blot.The relative expression level of AQP1 mRNA, cell proliferation activity, migration rate, apoptosis rate, the expression level of TJP1 and sodium potassium triphosphatase protein, and phosphorylation p38 MAPK/p38 MAPK ratio in each group of cells conformed to the homogeneity of variance and normal distribution, represented by ±s, and independent sample t-test was used for intergroup comparison.Results:The relative expression of AQP1 mRNA of Control group, pcDNA3.1-NC group, siRNA-NC group, pcDNA3.1-AQP1 group and siRNA-AQP1 group were (1.00±0.08), (1.05±0.07), (0.97±0.07), (2.14±0.12) and (0.33±0.02). Compared with the Control group, there were no both signifcant differences between pcDNA3.1-NC group and siRNA-NC group (t=0.653, 0.684; P>0.05), indicating that cells with pcDNA3.1-NC and siRNA-NC were not affected, thus other indices of these cells were not detected again. The cell proliferation activity, the cell migration ratio, the apoptosis rate, the expression TJP1, Na+ /K+ -ATPase protein, and the ratio of phosphorylated p38 MAPK/p38 MAPK of pcDNA3.1-AQP1 group were (63.31±7.35)%, (74.28±7.04)%, (3.64±1.48)%, (1.73±0.13), (2.04±0.15) and (0.18±0.02), respectively; those of siRNA-AQP1 group were(22.15±3.26)%, (35.73±3.86)%, (20.35±2.83)%, (0.23±0.02), (0.21±0.02) and (0.75±0.09), respectively; those of pcDNA3.1-AQP1+ anisomycin group were (52.35±4.38)%, (58.74±5.42), (6.73±0.53)%, (1.38±0.21), (1.18±0.19) and (0.33±0.03), respectively. There were signifcant differences in all indices between pcDNA3.1-AQP1 group and Control group (t=3.844, 3.534, 3.253, 4.253, 4.753, 4.321; P<0.05); between siRNA-AQP1 group and Control group (t=4.136, 3.741, 3.621, 3.426, 4.122, 4.894, 3.795; P<0.05); between pcDNA3.1-AQP1 group and pcDNA3.1-AQP1+ anisomycin group(t=3.251, 3.363, 3.053, 3.242, 3.674, 4.264; P<0.05).Conclusions:AQP1 overexpression can promote HCE cell proliferation and migration, inhibit apoptosis, and participate in the maintenance of HCE cell function, which may be relevant with the inhibition of p38 MAPK signaling pathway activation.
Objective:To explore the clinical efficacy of intense pulsed light (IPL) in the treatment of chalazion in children.Methods:A total of 21 children (33 eyes) with idiopathic chalazion diagnosed and treated with IPL in the Dry Eye Center of the First Affiliated Hospital of Zhengzhou University from December 2022 to March 2023 were collected. Among them, there were 8 males (13 eyes) and 13 females (20 eyes) with an average age of (4.0±2.3) years (ranged from 2 to 12 years). All patients were treated with IPL around the eyes, and referred to before and after the treatment and follow-up phone call for patients′ parents, the real description was obtained. The treatment results of chalazion were graded as follows: cure (chalazion subsided), improvement (chalazion reduction), invalid (no change). The base information of patients′gender, age, eye type, the onset time of chalazion, the location of chalazion, the size of chalazion and the treatment results were recorded. Data was described by the number of cases (eyes) and percentage.Results:All 21 patients (33 eyes) underwent IPL treatment. There were 13 cases (20 eyes) with cure, 8 cases (13 eyes) with improvement, 0 (0 eyes) with invalid, accounting for 60.6%, 39.4% and 0.0%, respectively. Among patients with chalazion, 5 patients (10 eyes) had a history of chalazion for less than <4 weeks before treatment, accounting for 30.30%. Among them, there were 2 cases (4 eyes) with cure, 3 cases (6 eyes) with improvement, 0 case (0 eye) with invalid, accounting for 40.0% (4/10), 60.0% (6/10), 0.0% (0/10), respectively. There were 13 cases (19 eyes) with a history of chalazion for ≥4 weeks and <8 weeks before treatment, accounting for 57.58%. Among them, there were 10 cases (15 eyes) with cure, 3 cases (4 eyes) with improvement, 0 case (0 eye) with invalid, accounting for 78.9% (15/19), 21.1% (4/19), 0.0% (0/19), respectively. Before treatment, 3 cases (4 eyes) had chalazion for ≥8 weeks, accounting for 12.12%. Among them, there were 1 case (1 eye) with cure, 2 cases (3 eyes) with improvement, 0 case (0 eye) with invalid, accounting for 25.0% (1/4), 75.0% (3/4), 0.0% (0/4), respectively. Of the 21 patients (33 eyes) with chalazion, 8 patients (13 eyes) with skin-type chalazion, accounting for 39.39%. Among them, there were 6 cases (10 eyes) with cure, 2 cases (3 eyes) with improvement, 0 case (0 eye) with invalid, accounting for 76.9% (10/13), 23.1% (3/13), 0.0% (0/13), respectively. There were 12 cases (18 eyes) of chalazion type on the conjunctival surface, accounting for 54.55%. Among them, there were 7 cases (10 eyes) with cure, 4 cases (8 eyes) with improvement, 0 case (0 eye) with invalid, accounting for 55.6% (10/18), 44.4% (8/18), 0.0% (0/18), respectively. There were 2 cases (2 eyes) of chalazion type near the eyelid margin, accounting for 6.06%. Among them, there were 0 case (0 eye) with cure, 2 cases (2 eyes) with improvement, 0 case (0 eye) with invalid, accounting for 0.0% (0/2), 100.0% (2/2) and 0.0% (0/2).Conclusions:IPL has a definite therapeutic effect in the treatment of chalazion in children. The cure rate of chalazion on the skin surface is higher than that on the conjunctiva surface. Patients with chalazion for ≥4 weeks and <8 weeks before treatment have a higher cure rate, and no serious adverse reactions were observed during the IPL treatment.
Posterior cataract (PCO) is the main complication after extracapsular cataract extraction and phacoemulsification. It has demonstrated that residual lens epithelial cell epithelial mesenchymal transition (EMT) after surgery is the main cause of PCO formation, and its pathogenesis involves the involvement of numerous signaling pathways, cytokines, growth factors, proteases, and integrins. The existing methods for preventing and controlling PCO include laser therapy, drug therapy, modification of intraocular lens (IOL) materials, and gene therapy. The current pathogenesis and prevention and control measures of posterior cataract were reviewed in this paper.
Presbyopia is the irreversible loss of the accommodative ability of the eye that occurs due to ageing, which severely affects patients′ visual quality. Globally, presbyopia without proper correction is the primary cause of visual impairment. Despite widespread use of glasses, surgery and contact lens, there has been an increasing demand for novel treatment strategies. Recently, the pharmacological treatments for presbyopia provide an alternative strategy. The current status and evolving strategies of pharmacological approaches to the treatment of presbyopia were reviewed, aiming to compare the safety and efficiency of current therapies and put forward potential drug candidates.
Coherent optical tomography (OCT) is a new non-invasive imaging diagnostic technology developed in the early 1990s. It has the characteristics of non-contact, non-invasive, and high-resolution, and has played its unique advantages in the diagnosis of many ophthalmic diseases. In recent years, with the increase of the incidence rate of myopia and the development of refractive surgery technology, more and more people choose corneal refractive surgery to correct their vision, so as to remove glasses and improve their beauty. However, patients with concomitant keratoconus, glaucoma, dry eye, and some fundus diseases are not suitable for corneal refractive surgery. Therefore, it is particularly important to screen and detect these diseases before surgery. The application of OCT in preoperative screening and evaluation of common and unsuitable diseases for corneal refractive surgery were reviewed in this paper, emphasizing the advantages of this examination technique in clinical application, in order to avoid various postoperative complications and improve the safety of corneal refractive surgery.
Currently, cataract surgery has shifted from restoration surgery to refractive surgery, and the issue of correcting astigmatism has was paid more attention. Since 1990, seamless transparent corneal incision has become the standard choice for cataract surgery to minimize postoperative astigmatism and promote rapid recovery of vision. It has been shown the astigmatism correction intraocular lens (Toric IOL) had the good effects on astigmatism correct. The research progress on precise measurement of astigmatism and reduction of surgical induced astigmatism in the field of cataract surgery in recent years was reviewed.
Objective:To investigate the levels of serum trace element in patients with Sj?gren′s Syndrome (SS) and its correlations with the severity of SS.Methods:Sixty-five dry eye patients (65 eyes) registered the Eye Center of Beijing Tongren Hospital affiliated to Capital Medical University from October 2022 to August 2023 were selected. Among them, there were 5 males (5 eyes) and 60 females (60 eyes), aged 39 to 75 years, with an average age of (54.3±18.4) years. According to the classification standards of the American Rheumatology Society and the European Rheumatology Alliance (ACR-EULAR), they were divided into SS group and the control group. All patients were scored with the eye surface disease index (OSDI) and ACR-EULAR scores, and the central tear river height (TMH) and tear film rupture time (TBUT) of the lower eyelid were measured. The serum trace elements such as copper, zinc, iron, calcium, and magnesium were detected by chemical tests. Age, OSDI score, TMH, TBUT, tear secretion test (ST), eye surface staining score (OSS), and serum trace element concentration conforming to normal distribution were described by ±s, and compared by independent sample t test for groups. Gender was described using case numbers, and compared by chi square tests. The correlation between serum trace element concentrations and OSDI scores, TMH, TBUT, ST, and OSS was analyzed using Pearson analysis. The correlation between serum trace element concentrations and anti Sjogren′s syndrome A antibodies, anti Sjogren′s syndrome B antibodies, rheumatoid factor (RF), antinuclear antibodies (ANA), labial gland biopsy, and salivary gland flow rate was analyzed using Spearman analysis.Results:The serum copper levels in SS group and control group were (1.67±0.32)μg/ml and (1.12±0.51) μg/ml, respectively; the former concentration was higher than the latter. There was a statistically significant difference in the serum copper levels between groups (t=2.817, P<0.05). The serum zinc levels of patients in SS group and control group were (0.88±0.15)μg/ml and (0.99±0.13)μg/ml, respectively; the former concentration was lower than the latter. There was a statistically significant difference in the serum copper levels between groups (t=-2.245, P<0.05). The serum iron levels of patients in SS group and control group were (0.87±0.12)μg/ml and (1.04±0.24) μg/ml, respectively; the former concentration was lower than the latter. There was a statistically significant difference in the serum iron levels between groups (t=-2.087, P<0.05). The serum calcium levels of patients in SS and control group were (77.22±12.15)μg/ml and (92.07±15.42) μg/ml, respectively; the former concentration was lower than the latter. There was a statistically significant difference in the serum calcium levels between groups (t=-2.312, P<0.05). The serum magnesium levels in SS group and control group were (17.33±2.12)μg/ml and (20.51±3.14) μg/ml, respectively; the former concentration was lower than the latter. There was a statistically significant difference in the serum magnesium levels between groups (t=-3.507, P<0.05). Serum copper was positively correlated with labial gland biopsy and OSDI, and the correlation was statistically significant (r=0.325, 0.389; P<0.05). There was a negative correlation with ST, TMH, and TBUT, and the correlation was statistically significant (r=-0.471, -0.340, -0.408; P<0.05). Serum calcium was negatively correlated with OSS and TBUT, and the correlation was statistically significant (r=-0.389, -0.428; P<0.05). Serum magnesium was positively correlated with ST, salivary gland flow rate, TMH, and TBUT, and the correlation was statistically significant (r=0.316, 0.405, 0.322, 0.479; P<0.05). There was a negative correlation with anti Sjogren′s syndrome A antibodies, RF, labial gland biopsy, OSS, and OSDI, and the correlation was statistically significant (r=-0.351, -0.324, -0.429, -0.298, -0.422; P<0.05). Serum iron was negatively correlated with lip gland biopsy and OSS, and the correlation was statistically significant (r=-0.320, -0.356; P<0.05).Conclusions:The levels of trace element were related to the severity of SS, monitoring changes in trace elements can help understand the severity of the disease and guide treatment.
In recent years, eye health issues have become increasingly prominent, with the prevalence of myopia, strabismus and other common blinding eye diseases rising, while treatment compliance and out-of-hospital management are poor. Digital therapeutics (DTx) is an evidence-based remote intervention, mainly in the form of software, for the prevention, treatment or management of disease. The combination of DTx and the field of eye health is of great benefit for the remote treatment of visually dysfunctional eye diseases and the out-of-hospital management of chronic eye diseases to compensate for the growing need to maintain eye health. In this paper, the relevant research of DTx and their application in the field of eye health were reviewed.
Objective:The aim of this study is to evaluate the efficacy of pure perfluoropropane (C3F8) tamponade combined with vitrectomy (PPV) in the treatment of retinal detachment (RD).Methods:Ninety-seven patients (97 eyes) with RD who underwent 23G PPV combined with C3F8 tamponade at the Department of Ophthalmology of Peking University Third Hospital from March to November 2022 were selected as the research subjects. Among them, there were 45 males (45 eyes) and 52 females (52 eyes) ranged from 41 to 71 years with an average age of (56.5±15.2) years. According to the gas tamponade type, the patients were divided into pure gas group with 33 cases (33 eyes) and mixed gas group with 64 cases (64 eyes). All patients were treated by gas tamponade combined with PPV, and the pure gas group was given an appropriate amount of 100% C3F8, and the mixed gas group was given a mixture of non-expanding concentration of C3F8 and sterile air. The best corrected visual acuity (BCVA), intraocular pressure, axial length, the last retinal reattachment rate after operation and postoperative ocular inflammation were determined and recorded. The BCVA, intraocular pressure, axial length were in accordance with the normal distribution, described by ±s, and compared by the independent sample t test for inter-group and paired sample t test for intra-group before and after operation. The range of intraocular pressure and postoperative ocular inflammation in the two groups were described by the eyes number and percentage and compared by rank sum test for inter-group. Fisher′s exact test was used for the last retinal reattachment rate after operation. Repeated measurement data at multiple time points were analyzed by repeated measures ANOVA.Results:In the pure gas group, the time for intraocular gas preparation, gas injection and C3F8 consumption were (2.48±0.51)s, (5.09±1.21)s and (0.64±0.20)ml, respectively. In the mixed gas group, those were (16.62±6.20)s, (180.34±34.30)s and (4.69±2.59)ml, respectively, and the differences were statistically significant (t= -18.207, -40.836, -12.41; P<0.05). The last retinal reattachment rate was 97.0% in pure gas group and 98.4% in mixed gas group after operation for 6 months, and the difference was not statistically significant (P>0.05). There was no significant difference in the group effect of intraocular pressure between the two groups before surgery, immediately after surgery, after surgery for 1 day and 1 month (Fgroup=0.032, P>0.05). The time effect was statistically significant (Ftime=23.215, P<0.05). The interaction effect was not statistically significant (Finteraction=1.735, P>0.05). In the pure gas group, there were 8 cases (8 eyes) with the highest intraocular pressure < 21 mmHg(1 mmHg=0.133 kPa), 14 cases (14 eyes) with the highest intraocular pressure from 21 mmHg to 30 mmHg, and 11 cases (11 eyes) with the highest intraocular pressure ≥30 mmHg, accounting for 24.2%, 42.4% and 33.3%, respectively. In the mixed gas group, there were 18 cases (18 eyes) with the highest intraocular pressure < 21 mmHg, 32 cases (32 eyes) with the highest intraocular pressure from 21 mmHg to 30 mmHg, and 14 cases (14 eyes) with the highest intraocular pressure ≥30 mmHg, accounting for 28.1%, 50.0% and 21.9%, respectively. There was no significant difference in the distribution of the highest intraocular pressure between the two groups (Z= -0.979, P>0.05). The BCVA of the pure gas group was better than that of the mixed gas group at the last follow-up, and the difference was statistically significant (t= -2.497, P<0.05). There was no significant difference in postoperative ocular inflammation between the pure gas group and the mixed gas group (Z= -1.430, P> 0.05).Conclusions:Compared with the mixed gas tamponade group, the pure gas group has a better RD efficacy, no postoperative complications, and shows better postoperative BCVA. It can shorten the time of intraocular gas preparation and injection and reduce the dosage of C3F8.
Recently, it has been demonstrated that iris pigment epithelial cells of human uveal have had inherent pattern recognition receptors for the lipopolysaccharide response (LPS), such as Toll-like receptor (TLR)4, myeloid differential protein (MD)-2 and cluster of differentiation (CD)14, which expanding the current understanding of microbial triggers and uveal innate immune in the pathogenesis of acute anterior uveitis. The result point out components of the LPS receptor complex may serve as effective targets for the treatment. The research status of LPS receptor complex in human iris pigment epithelial cells and uveitis in animal models were reviewed.
Artificial intelligence technology (AI) based on deep learning (DL) has shown good results and great potential in the application research of diabetes retinopathy (DR). Combining with telemedicine technology can significantly improve the work efficiency for grassroots screening and monitoring DR patients. At present, the application of DL in DR research still faces issues such as matching clinical needs, interpretability, technical bottlenecks, and the acceptance of DL systems by physicians and patients. The research progress of DL technology in DR screening, rating, prediction, and optimization management in recent years was reviewed in this paper.
Objective:The aim of this study is to investigate the clinical efficacy of a novel goniosynechialysis (GSL) with cataract phacoemulsification for primary angle-closure glaucoma (PACG).Methods:Forty-five patients (60 eyes) diagnosed as PACG complicated with cataract in Department of Glaucomatology of Weifang Eye Hospital from October 2021 to September 2022 were selected. Among them, there were 23 cases (28 eyes) male and 22 cases (32 eyes) female with the mean age of (67.5±14.7) years (ranged from 53 to 81 years). They were divided into experimental group 25 cases (30 eyes) and control group 20 cases (30 eyes) according to the random number table method. They all underwent cataract phacoemulsification, then a novel GSL and a conventional method was used for patients of experimental group and control group, respectively. The range of peripheral anterior synechia (PAS) were recorded before, during and postoperation. The volume of viscoelastic used, GSL time and complications were recorded during operation in the two groups. The number of antiglaucoma medications were recorded, intraocular pressure, the count of aqueous flare, best corrected visual acuity, anterior chamber depth and corneal endothelial cell density were measured before operation and after operation for 1 week, 1 month, 3 months, 6 months.The PAS was counted as the number and percentage of eyes, and used to compare by the rank sum test. The volume of viscoelastic used, GSL time, anterior chamber depth, intraocular pressure, best corrected visual acuity, the count of aqueous flare, corneal endothelial cell density were in accordance with normal distribution, and expressed as ±s, and used to compare by the independent samples t test between groups, and used to compare by repeated measures variance analysis at multiple time points. The number of postoperative medications was expressed as M (Q1, Q3), and used to compare by the Mann-Whitney U test between groups.Results:The GSL time and the volume of viscoelastic used in the experimental group were (1.07±0.77) min and (48.86±11.44) μL, respectively, while those in the control group were (1.07±0.77) min and (119.07±14.08) μL, respectively with the significant difference (t=-10.00, -21.20; P<0.05). The intraocular pressure of the experimental group were (25.30±10.63)mmHg (1 mmHg=0.133 kPa), (17.23±3.20)mmHg, (16.80±2.38)mmHg, (16.97±1.87)mmHg, (17.83±2.56)mmHg after operation for 1 week, 1 month, 3 months, 6 months, respectively; anterior chamber depth were (2.31±0.25)mm, (4.38±0.17)mm, (4.36±0.15)mm, (4.33±0.12)mm and (4.26±0.12)mm, respectively; the count of aqueous flare were (13.67±7.26)pc/ms, (28.01±15.72)pc/ms, (15.81±8.30)pc/ms, (12.12±5.32)pc/ms, (10.63±4.47)pc/ms, respectively; the best corrected visual acuity were (0.37±0.43), (0.15±0.27), (0.14±0.32), (0.16±0.33) and (0.15±0.28), respectively; the corneal endothelial cell density were (2624.07±277.29)mm2, (2375.70±321.45) mm2, (2310.13±277.00)mm2, (2311.80±243.03)mm2, (2311.10±333.54)mm2, respectively. There was significant difference in anterior chamber depth, intraocular pressure, the best corrected visual acuity, the count of aqueous flare, and the corneal endothelial cell density at each time point after surgery (F=1.62, 1.53, 1.41, 0.80, 0.25; P>0.05). In the experimental group, there were 16 cases (18 eyes), 5 (8 eyes), 4 cases (4 eyes) in the range of PAS with 0°, 0°to 90°, ≥90° after operation for 1 month, accounting for 60.0%, 26.7%, 13.3%, respectively; were 11 cases (13 eyes), 8 cases (11 eyes), 6 cases (6 eyes) after operation for 6 months, accounting for 43.3%, 43.3%, 20.0%, respectively. There was no statistical difference in the PAS between two groups (Z= -1.65, -0.90; P>0.05). There was no statistical difference in the number of antiglaucoma medications of patients with experimental group and control group after operation for 1 month, 3 months, 6 months (Z=-1.04, -1.25, -0.95; P>0.05); there was no statistical difference in the complication rate between them (χ2=2.04, P>0.05).Conclusions:A novel GSL is equal to trational method in the clinical efficacy. The novel GSL has the advantages of time saving, less consumables, easy performing and more efficient, which deserve to be widely applied.
The occurrence and development of thyroid associated ophthalmopathy (TAO) is related to the differential gene expression caused by DNA methylation, non coding RNA regulation, microRNA (miRNA). The miRNA-155 and miRNA-146a participated in the pathological process by participating in immune inflammation and the proliferation and differentiation of adipose tissue. The expression of miRNA-21 was correlated with the activity and severity of TAO. The miRNA-130a and miRNA-27 play an important role in the adipogenic differentiation of TAO orbital fibroblasts and the proliferation of adipose tissue. The miRNA-199a-3p and 5p increased tissue oxidative stress and angiogenesis in orbital adipocytes of TAO patients. The expression of miRNA-183 and miRNA-96 was increased in peripheral blood CD4+ T cells of TAO patients, which regulate immunity to participate in the progression. The miRNA-29 inhibits cell fibrosis by restricting transforming growth factor-β1 Signal path. The miRNA-143 regulates the inflammatory response by directly targeting insulin like growth factor-1 receptor and indirectly reducing thyrotropin receptor and nucleotide oligomerization domain-like receptor thermal protein domain associated protein 3 levels. In addition, the epigenetic regulation of long chain non coding RNAs, circular RNAs, transfer RNA derived fragments, and histone modification inactivation are also related to the pathogenesis of TAO.
Objective:The aim of this study is to analyze the early clinical efficacy of topography-guided customized ablation treatment (T-CAT) refractive surgery for correcting myopia and astigmatism.Methods:Retrospective analysis of clinical data of 90 cases (154 eyes) with myopia and astigmatism registered at the Ophthalmology Department of Shijiazhuang People′s Hospital from January 2020 to January 2022. Among them, there were 49 males (83 eyes) and 41 females (71 eyes) ranged from 18 to 40 years with an average age of (25.4±2.5) years. According to the random number table method, patients were divided into control group with 45 cases (78 eyes) and testing group with 45 cases (76 eyes). The control group underwent T-CAT contoura vision-laser epithelial keratomileusis (CV-LASEK), while the testing group underwent T-CAT small incision lenticule extraction (SMILE). Naked eye visual acuity, anterior corneal surface aberration, spherical aberration, spherical degree, cylindrical degree, equivalent spherical degree, correction index (CI), index of success (IOS), flattening index (FI), corneal hysteresis (CH), and corneal resistance factor (CRF) according with normal distribution were expressed as ±s, and compared by t test between the two groups, by paired sample t test before and after surgery. The postoperative complications were expressed as eyes number and percentage and compared by χ2 test.Results:After surgery for 7 days, the naked eye visual acuity, coma and spherical aberration, spherical, cylindrical and equivalent spherical degree, CI, IOS, FI, CH and CRF of patients in the testing group were (0.85±0.12) logMAR, (0.30±0.07)μm, (0.45±0.05)μm, (0.19±0.07)D, (-0.39±0.10)D, (-0.39±011)D, (0.95±0.15)D, (0.44±0.17)D, (2.58±0.25)D, (6.06±0.58)mmHg(1 mmHg=0.133 kPa) and (5.22±0.51)mmHg, respectively; those of patients in the control group were (0.72±0.14)logMAR, (0.38±0.09)μm, (0.59±0.06)μm, (0.21±0.09)D, (-0.40±0.12)D, (-0.40±0.10)D, (0.96±0.17)D, (0.42±0.18)D, (2.56±0.24)D, (6.18±0.63)mmHg and (5.36±0.56)mmHg, respectively. There were significantly differences in the naked eye visual acuity, coma and spherical aberration between the two groups (t=6.180, 6.147, 15.709; P<0.05). There were no significant differences in the others (t=1.537, 0.561, 0.591, 0.387, 0.709, 0.507, 1.229, 1.621; P>0.05). The incidence of postoperative complications in the testing group and the control group were 13.16% and 26.92%, respectively. There were significantly difference in them between the two groups (χ2=4.507, P<0.05).Conclusions:T-CAT SMILE has good early effectiveness and stability in correcting myopia and astigmatism, with fewer postoperative complications and high safety, and is worth promoting.
Objective:To discuss the clinical effect of Berger′s space vitrectomy assisted by optical coherence tomography (OCT) in posterior capsular lens.Methods:A study was conducted on 73 patients (73 eyes) who underwent phacoemulsification cataract extraction combined with intraocular lens implantation and vitrectomy at the Ophthalmology Department of Tongji Hospital affiliated to Tongji University from January 2020 to April 2021. Among them, there were 37 males (37 eyes) and 36 females (36 eyes). The age ranges from 59 to 79 years, with an average of (65.1±4.2) years. According to the different treatment of Berger gap, they were divided into traditional group and Berger resection group. All affected eyes underwent silicone oil filling at the same time. Patients of Berger resection group underwent a thorough resection of the anterior vitreous cortex within a range of 8 mm centered behind the posterior capsule of the lens during the first stage of surgery, with alternating negative pressure suction and cutting during the resection. Patients of traditional group underwent traditional surgery without managing the Berger gap. The gender, age, glycosylated hemoglobin, fasting blood glucose, cataract nucleus grading, preoperative intravitreal injection frequency, intraocular pressure, best corrected visual acuity (BCVA), axial length, surgical time, degree of opacification in the posterior capsule area after silicone oil removal, and optical density values of the two groups of patients were recorded. Age, axial length, glycosylated hemoglobin, fasting blood glucose, preoperative intravitreal injection frequency, intraocular pressure, surgical time, and posterior capsule optical density values conforming to a normal distribution, were expressed by ±s and compared by two ways repeated measurement ANOVA for inter group at each time point, and independent sample t test between groups. Gender, proportion of hypertension, cataract nuclear grading were described in terms of number and percentage of cases, and chi square test was used for inter group comparison. The degree of posterior capsule opacification was expressed in quartiles and median, and rank sum test was used for inter group comparison.Results:The minimum resolution angle logarithmic visual acuity (logMAR) BCVA of the affected eyes in the Berger resection group were (0.93±0.73), (0.62±0.18), (0.50±0.08), and (0.48±0.08) before surgery, after primary surgery for 1 month, before secondary oil removal, and after secondary oil removal for 3 months, respectively. Those of the traditional group were (0.90±0.10), (0.69±0.14), (0.56±0.12), and (0.52±0.61), respectively. After two ways repeated ANOVA, the differences between the two groups were statistically significant (F=19.35, P<0.05), and the interaction was not statistically significant (F=0.113, P>0.05). The differences between the groups were statistically significant (t=-2.36, P<0.05) after the second phase of oil extraction for 3 months. The iOCT optical density value of the Berger resection group was (0.60±0.03), while that of the traditional group was (0.86±0.04). The former was lower than the latter with a statistically significant difference between groups (t=20.04, P<0.05). The pentacam optical density values of the Berger resection group and the traditional group after oil extraction for 3 months were (4.21±0.51) and (5.37±1.28), respectively. There was a statistically significant difference between groups (t=-3.29, P<0.05). The primary stage surgical time in the Berger resection group and the traditional group were (60.33±10.08) min and (57.22±9.89) min, respectively. There was no statistically significant difference between the groups (t=0.89, P>0.05). After secondary oil removal for 3 months, the quartiles (median) of posterior capsule opacity in the Berger resection group and the traditional group were 1.00 (1.00) and 2.00 (2.00), respectively. The Berger resection group was lighter than the traditional group, and the difference was statistically significant (Z=3.27, P<0.05).Conclusions:Complete resection of the vitreous cortex behind the posterior capsule of the lens can brighten posterior capsular opacity in the axial region after silicone oil removal surgery.
Intermittent exotropia (IXT) is a common clinical eye disease with large changes in strabismus angle and different degrees of stereopsis impairment. There are still many problems in its diagnosis and treatment. Correct understanding of the development and prognosis of the disease, selection of reasonable treatment methods, timely visual training, and improvement of diagnostic efficiency are all crucial to improving the quality of life and reducing recurrence for patients with IXT. The damage and reconstruction of stereoscopic function, the interaction with myopia, the integrated application of observation and follow-up treatment, and artificial intelligence diagnosis and treatment are new hot issues in the current IXT research. The research progress of these issuses were reviewed in this paper, aiming to provide the reference for diagnosis and treatment of IXT.
Myopia is an eye disease with high incidence rate and threatening vision. Although the decrease in vision caused by myopia can be improved through corneal contact lenses, frame glasses, or refractive surgery, changes in the fundus of highly myopic eyes can increase the risk of complications. It is widely believed in the industry that attention should be paid to the prevention and control of the occurrence and development of myopia in children, and it is particularly important to find safe and effective control methods. In recent years, with the recognition of light exposure and the development of myopia in the industry, it has been found that red light therapy can delay the development of myopia caused by axial growth. In this article, the author reviews recent domestic and international research on the correlation between red light and myopia, as well as the mechanism, effectiveness, and safety of red light therapy in the prevention and control of myopia in children.
