Purpose To examine the association between central adiposity, assessed by waist‐to‐height ratio (WHtR), and tear film stability in adults with obesity. Methods This cross‐sectional observational study included 269 adults with BMI ≥ 28 kg/m 2 . WHtR and noninvasive tear breakup time (NIBUT) were the primary exposure and outcome. Models adjusted for age, sex, education, systemic diseases, myopia, display exposure, smoking, alcohol consumption, and sleep problems. Secondary outcomes were Ocular Surface Disease Index (OSDI) and dry eye disease (DED) status; other adiposity indices were examined in separate models. Results Each 1‐SD higher WHtR was associated with shorter NIBUT (adjusted β −0.341 s; 95% CI −0.612–−0.071; p = 0.014). The highest versus lowest WHtR tertile differed by −0.961 s (95% CI −1.696–−0.227). BMI had a numerically larger coefficient (−0.591 s; 95% CI −0.842–−0.339). DED was present in 208 participants (77.3%). The WHtR–DED association was nominally significant (OR 1.630; 95% CI 1.072–2.477; p = 0.022) but did not survive false discovery rate correction ( q = 0.061). Conclusions Higher WHtR was associated with modestly shorter NIBUT among adults with obesity, while BMI showed a numerically larger association. These findings support considering overall and abdominal adiposity in the clinical assessment of ocular surface function.
Artificial intelligence (AI) is being investigated across the cataract care pathway, but the maturity of the evidence varies substantially between technical benchmark studies, externally validated models, prospective clinical evaluations and tools used in routine care. This narrative review critically summarises AI applications in cataract detection, intraocular lens (IOL) power calculation, perioperative risk assessment, intraoperative support and postoperative follow-up, with particular emphasis on evidence quality, external validity and clinical readiness. A structured search of PubMed/MEDLINE was conducted for English-language publications from 1 January 2018 through 31 March 2025, with selective retention of earlier seminal studies relevant to cataract risk prediction, force feedback and ophthalmic robotics. Evidence was classified by maturity, from technical proof of concept and retrospective internal validation to external or multicentre validation, prospective clinical evaluation and demonstrated workflow or patient-level benefit. The strongest evidence for cataract detection comes from large externally validated image-based models, whereas smartphone systems remain sensitive to image quality, case mix and deployment setting. Data-driven IOL formulas can improve refractive prediction in selected datasets, but comparisons are affected by constant optimisation, axial-length distribution, IOL model, measurement device and paired-eye dependence. Intraoperative AI remains dominated by phase recognition, segmentation and technical performance assessment, with limited evidence of direct clinical benefit. Postoperative conversational AI has reached multicentre prospective clinical evaluation, although safety depends on escalation pathways, human oversight and local workflow design. Clinical translation of AI in cataract care is therefore emerging but uneven: a limited number of applications have reached external or prospective clinical validation, while many remain retrospective or technical proof-of-concept systems. Future adoption should be based on external validation, transparent reporting, prospective clinical utility, postdeployment monitoring and clear regulatory and medicolegal accountability rather than benchmark performance alone.
Purpose To compare the structural and functional outcomes of pars plana vitrectomy (PPV) with or without aspiration of fluid from inside the macular hole for primary full‐thickness macular holes (FTMHs). Methods We retrospectively analyzed the hole closure rate, the integrity of the ellipsoid zone (EZ), central retinal thickness (CRT), and best‐corrected visual acuity (BCVA) from 101 eyes of 101 patients with primary medium‐to‐large FTMH who underwent PPV with aspiration or nonaspiration technique within 1 month. Results At 1 month postoperatively, Type 1 closure rates were 81.4% (48/59) in the aspiration cohort and 83.3% (35/42) in the non‐aspiration cohort; U‐type closure rates were 49.2% (29/59) and 52.4% (22/42), respectively. After the 1‐month visit, 61 of the 101 eyes (60.4%) were lost to follow‐up; the remaining 40 eyes (24 in the aspiration cohort and 16 in the nonaspiration cohort) were also analyzed at 3–6 months postoperatively. At 3–6 months postoperatively, Type 1 closure rates were 75.0% (18/24) in the aspiration cohort and 87.5% (14/16) in the non‐aspiration cohort; U‐type closure rates were 58.3% (14/24) and 62.5% (10/16), respectively. No significant between‐cohort differences were found in the unadjusted analyses; multivariable models likewise showed no significant association of aspiration with closure or BCVA. BCVA of the 40 eyes (Cohort 1 + Cohort 2) showed no significant change from baseline (1.00 logMAR [Q1–Q3: 0.92–1.40]) to 1 month postoperatively (1.05 logMAR [Q1–Q3: 0.92–1.49 logMAR]) and improved significantly at 3–6 months postoperatively (0.82 logMAR [Q1–Q3: 0.52–1.00 logMAR]) ( p < 0.001), which was correlated with a significant decrease in the EZ defect from 1443.50 μm (Q1–Q3: 1053.50–1875.50 μm) at 1 month to 797.00 μm (Q1–Q3: 264.75–1610.00 μm) at 3–6 months ( p = 0.003). Conclusion Aspiration of fluid from inside the macular hole seems to provide no additional benefit in this retrospective study for the surgical treatment of medium‐to‐large primary FTMHs. Improvement in postoperative visual function occurs simultaneously with the reduction of EZ defects.
Purpose To characterize cataract‐related visual impairment and clinical features in adults aged 18–50 years and to compare unilateral and bilateral cataract cases. Methods This single‐center retrospective cohort study reviewed data from patients aged 18–50 years who were diagnosed with cataract between January 2016 and October 2024. Demographic characteristics, systemic and ocular comorbidities, medication history, lifestyle‐related factors, cataract subtype, and ophthalmic examination findings were collected and compared between unilateral and bilateral cases. Results A total of 623 patients were included, comprising 272 patients with unilateral cataracts and 351 with bilateral cataracts. The mean age was 40.73 ± 7.55 years, and 278 patients were female. Frequently observed comorbid conditions included hyperlipidemia, high myopia, prior vitrectomy, prior excimer laser surgery, prior trabeculectomy, and uveitis. Posterior subcapsular cataract was the most common subtype in both unilateral and bilateral cases. Compared with bilateral cataract patients, unilateral cataract patients were diagnosed at a younger age, had worse best‐corrected visual acuity (BCVA) at presentation, and had higher rates of prior vitrectomy and uveitis. Conclusions Cataract in working‐age adults was frequently accompanied by metabolic and ocular comorbidities. Unilateral cataracts were characterized by younger age at diagnosis and poorer BCVA at presentation. Prior vitrectomy remained associated with unilateral cataract after multivariable adjustment. These findings may help ophthalmologists and clinicians identify younger cataract patients who require closer monitoring and individualized assessment.
This study elucidates the therapeutic mechanisms of Jianpi Huazhuo formula (JHF) in suppressing laser-induced choroidal neovascularization (CNV) through the modulation of the AKT1/MAPK3/IL6 signaling pathway. Utilizing a murine CNV model, JHF administration markedly attenuated vascular leakage, as evidenced by fluorescein angiography, optical coherence tomography, and fundus imaging. Integrated network pharmacology pinpointed AKT1, MAPK3, and IL6 as pivotal targets, with functional enrichment analyses highlighting their roles in key processes such as reactive oxygen species response and inflammatory regulation, particularly within the PI3K-Akt and IL-17 pathways. Molecular docking validated robust interactions between JHF-derived compounds (e.g., luteolin and quercetin) and these targets, exhibiting binding energies ranging from −4.0 to −7.41 kcal/mol. Subsequent molecular assays confirmed that JHF significantly reduced AKT1, MAPK3, and IL6 expression at transcriptional and translational levels in RPE-choroid tissues. Time-dependent expression profiling further revealed sustained suppression of these targets throughout CNV progression, and in vitro validation in an oxidative stress-induced ARPE-19 cell model confirmed the direct regulatory effect of JHF on this signaling axis. These findings demonstrate that JHF exerts its antiangiogenic effects via a multitarget network centered on the AKT1/MAPK3/IL6 axis. The study innovatively delineates JHF’s polypharmacological mode of action, offering novel insights for leveraging traditional Chinese medicine in managing neovascular ocular diseases.
