PurposeTo investigate aqueous humor cytokine profile changes in neovascular age-related macular degeneration (nAMD) patients before and after intravitreal faricimab injection, and their correlation with biomarkers.MethodsTwenty-three nAMD patients and 10 cataract controls were enrolled. Aqueous humor was collected from nAMD patients at baseline and 12 weeks post-faricimab injection, and from controls during phacoemulsification. Twelve cytokines were quantified via multiplex bead-based immunoassay. OCTA measured central macular thickness (CMT) and retinal vessel density in nAMD eyes.ResultsBaseline vascular endothelial growth factor (VEGF), Angiopoietin-2 (Ang-2) and HGF levels were higher in nAMD patients than controls. Post-treatment, VEGF and Ang-2 decreased below control levels, while hepatocyte growth factor (HGF) and interferon gamma protein 10 (IP-10) increased significantly. Reductions in Ang-2/VEGF correlated positively with decreased CMT and whole retinal thickness, with concurrent improvements in best-corrected visual acuity. Elevated IP-10 showed a correlative association with reduced superficial foveal vessel density.ConclusionFaricimab dual-blockades VEGF/Ang-2, reducing their aqueous levels, improving CMT/whole retinal thickness and visual acuity. However, post-treatment HGF/IP-10 upregulation indicates compensatory inflammatory-angiogenic remodeling. IP-10 may serve as a potential correlative biomarker linked to subclinical capillary rarefaction. Future studies should explore combined anti-IP-10 therapy or extended dosing intervals to preserve foveal vasculature while maintaining anti-leakage efficacy.

PurposeTo investigate dynamic changes in aqueous humor cytokines and retinal vessel density during aflibercept loading in treatment-naive neovascular age-related macular degeneration (nAMD), and to analyze their associations with visual improvement.MethodsThis single-center retrospective clinical study included 20 treatment-naive patients with nAMD (20 eyes) and 20 patients with cataracts (20 eyes). In the nAMD group, aqueous humor samples were collected at baseline and at the time of the third intravitreal aflibercept injection, while samples from the cataract control group were obtained before surgery. Relevant aqueous humor cytokines were measured using the Bio-Plex suspension bead array system. In the nAMD group, best-corrected visual acuity (BCVA) and optical coherence tomography angiography (OCTA) examinations were performed at baseline and at 1 and 2 months after treatment. Longitudinal changes in OCTA parameters were analyzed using mixed-effects models, followed by correlation analyses. According to the final BCVA outcome, eyes in the nAMD group were further classified into an obvious-improvement group and a non-obvious-improvement group for exploratory subgroup comparison.ResultsCompared with the cataract control group, eyes with nAMD showed significant differences in baseline aqueous humor levels of Ang-2, HGF, VEGF-C, IP-10, HB-EGF, IL-8, and PlGF. During aflibercept loading, aqueous humor levels of Ang-2, HGF, and IP-10 increased, whereas IL-8 decreased. At month 2, the superficial parafoveal vessel density and the superficial and deep perifoveal vessel density decreased significantly compared with baseline, while BCVA improved significantly. Baseline Ang-2, bFGF, and IL-8 showed nominal exploratory associations with OCTA changes, but these associations did not remain significant after FDR correction. In subgroup analysis of the nAMD cohort, only the change in deep perifoveal vessel density differed significantly between the obvious-improvement group and the non-obvious-improvement group.ConclusionTreatment-naive nAMD eyes exhibited differential changes in aqueous humor cytokines during aflibercept loading, consistent with possible non-VEGF pathway involvement. Meanwhile, regional remodeling of retinal microcirculation was observed, and changes in deep perifoveal vessel density showed a trend consistent with short-term visual improvement.

Purpose: To depict an atlas of stage-stratified gut microbiota (GM) signatures and intermediatory metabolites, inflammatory proteins, and immune cell traits, governing the AMD trajectory. Methods: We deployed bidirectional two-sample Mendelian randomization (TSMR) integrating GWAS data of 207 GM taxa from the Dutch Microbiome Project (N = 7,738), and multiple AMD stages/subtypes, including 'Macular degeneration (senile) of retina', 'Early AMD', 'Disease progression to GA/CNV', 'Dry AMD includes GA', and 'Wet AMD', encapsulating the disease trajectory (N > 410,000), complemented by multivariable MR (MVMR) mediation analysis of 1,400 circulating metabolites, 731 immune cell traits, and 91 inflammatory proteins. Results: We identified 12/8/5/2/9/8 genetically predicted causal GM taxa of various AMD stages/subtypes as a stage-stratified GM signature across the AMD trajectory, among which g.Ruminococcaceae and s.Ruminococcaceae_bacterium_D16 were the sole shared GM taxa in triple AMD stages, while s.Bacteroides eggerthii, c.Gammaproteobacteria, s.Dorea and s.Ruminococcus_obeum influence dual AMD stages. Bidirectional analysis revealed that f.Streptococcaceae, g.Erysipelotrichaceae_noname, g.Streptococcus, s.Streptococcus_ thermophilus, g.Ruminococcaceae_noname, and s.Ruminococcaceae_bacterium_D16 exhibited genetically reciprocal causation with AMD. We also proposed that Firmicutes may exhibit stage-specific duality depending on their constituent members and AMD stages. Several understudied GM from p.Actinobacteria and p.Verrucomicrobia have been implicated as AMD-associated taxa for the first time. Key metabolites, immune cell traits, and inflammatory proteins were established as significant mediators of GM-AMD links. Conclusions: This first phased atlas uncovers GM effects over the AMD course, identifying potential microbial and biochemical targets for intervening in disease development.

The quantification of retinal lesions is crucial for the diagnosis and intervention of related diseases. Currently, most deep learning based methods for retinal lesion segmentation in optical coherence tomography (OCT) images rely on large-scale datasets with high-quality annotations, which require significant human and financial resources to obtain. This paper focuses on label-efficient methods for lesion segmentation in retinal OCT images. First, we introduce the label refinement based local feature enhancement network (LifeNet). It incorporates the superpixel-based pseudo-label generation and refinement strategy and an improved encoder-decoder structure with neighborhood feature enhancement and multi-scale feature subtraction, which work in synergy in extracting abundant and representative lesion features from point labels. Next, we extend the LifeNet and design the parameter-decoupled cross supervision mean teacher network (PassionNet), which incorporates pixel-level annotations alongside with point annotations, balancing annotation cost and model performance. The PassionNet integrates the parameter decoupling optimization strategy, with cross supervision attention and pseudo-label deep supervision, to alleviate discrepancies in hybrid supervision data, further enhancing segmentation performance. The proposed networks were evaluated on two public OCT lesion segmentation datasets. Experimental results demonstrate that our methods outperform existing weak or hybrid supervision segmentation methods. The proposed methods effectively reduce annotation costs while maintaining high segmentation performance. It possesses important practical value in training automatic segmentation models for medical images. The code is available at: https://github.com/duanchang107-art/LifeNet-PassionNet.

ObjectiveTo explore how intravitreal faricimab reshapes aqueous humor cytokines in diabetic macular edema (DME), and analyze correlations between cytokine shifts and clinical efficacy.MethodsThis prospective study recruited 10 DME patients and 10 age-matched cataract controls. Aqueous humor was harvested from DME patients at baseline and 12 weeks after three faricimab injections, and from controls during cataract surgery. Multiplex immunoassay measured 12 aqueous cytokines. Clinical indicators included best-corrected visual acuity (BCVA), central macular thickness (CMT) and retinal vessel density detected by spectral-domain OCTA.ResultsBaseline aqueous VEGF, Ang-2, IL-8 and PlGF were markedly higher in DME eyes (all p < 0.05). Post-treatment, VEGF and Ang-2 fell below control levels, whereas HGF, IP-10, IL-8 and PlGF further increased (all p < 0.05). Longitudinal analysis validated reduced VEGF/Ang-2 and elevated HGF after intervention. The original tight cytokine correlations (Ang-2-VEGF, Spearman’s ρ = 0.890, raw p = 0.001) were disrupted, while new associations such as HGF-IL-6 (Spearman’s ρ = 0.888, raw p = 0.001) formed. CMT decreased and BCVA improved significantly (both p < 0.05); declines in Ang-2 and VEGF strongly correlated with CMT thinning (Spearman’s ρ = 0.824, raw p = 0.003; Spearman’s ρ = 0.660, raw p = 0.034).ConclusionFaricimab potently remodels DME aqueous cytokine microenvironment via inhibiting the VEGF/Ang-2 pathway and upregulating HGF, restructuring cytokine crosstalk. There was a significant correlation between reduced target cytokines and improved macular anatomy, which provides preliminary observational evidence supporting dual-pathway inhibition in DME.

Multimodal imaging has become an essential tool in clinical ophthalmology, offering complementary perspectives for disease diagnosis. However, current automated diagnostic approaches often fail to fully exploit the rich, complementary information provided by different imaging modalities. In this paper, to advance automated ophthalmic disease diagnosis through effective multimodal data integration, we propose the OphFusionNet, a novel multimodal learning framework based on uncertainty-driven multi-scale multimodal feature fusion. Drawing inspiration from clinical observations that ophthalmic lesions often appear at multiple spatial scales, we design a multi-scale feature fusion module with sparse self-attention (MSFF-SSA). This module captures hierarchical representations while suppressing redundancy, thereby enhancing both the expressiveness and efficiency of the extracted features. To further improve multimodal fusion, we introduce an uncertainty-aware multimodal fusion module with a game-theoretic selection strategy (UMF-GTSS). This component estimates the uncertainty associated with different features and adaptively weights them based on their relative reliability, yielding more robust and trustworthy diagnostic outcomes. To mitigate the tendency to over-rely on dominant modalities and underutilize the informative potential of subordinate ones, we propose a modality distillation strategy (MDS), which leverages multimodal features to guide and refine the learning of single-modal representations. This strategy enhances generalization and boosts the discriminative capacity of each individual modality. The OphFusionNet was evaluated on four publicly available ophthalmic datasets. Extensive experiments demonstrate that our approach achieves superior multimodal integration, resulting in state-of-the-art (SOTA) performance in multi-modal ophthalmic disease diagnosis. The code will be available at: https://github.com/wb66715/OphFusionNet.

OBJECTIVE:Deep neural networks are widely used in the field of optical coherence tomography (OCT) to screen some common retinal diseases. However, for rare diseases with fewer cases for model training, it is challenging to achieve automatic diagnosis using traditional deep learning. Meta-learning based few-shot learning can be used to address the problem of insufficient training data. METHODS:We propose a novel algorithm for few-shot OCT image classification, where meta-learning is used to fine-tune the pre-trained model and obtain good initialization for task generalization. Unsupervised learning based on query data is for the first time introduced in meta-learning. Cross-set consistency learning is proposed to reduce the gap between meta-knowledge learned from support and query data. Data mixup is also integrated to generate virtual samples and enhance data variety. RESULTS:A lightweight subset was constructed based on a public OCT dataset and extensive experiments were performed. The classification accuracy of the proposed method was higher than existing few-shot learning methods. To show the generalization of the proposed method, experiments were also performed on a histological image dataset, and superior performance was also achieved. CONCLUSION:The proposed strategies help the model to fully utilize the limited data and to explore hidden information, improving its generalization to unseen tasks. SIGNIFICANCE:The proposed method has great value in training deep learning models for diagnosis of rare diseases.

We report a rare case of senile-onset Coats disease presenting with severe macular exudation and subretinal fluid in a 70-year-old male who experienced progressive vision loss. Multimodal imaging excluded other exudative maculopathies and confirmed the diagnosis, guiding a personalized sequential therapeutic strategy. Initial intravitreal dexamethasone induction facilitated rapid reduction of subretinal fluid and inflammation, permitting targeted high-frequency fractionated laser photocoagulation of telangiectatic retinal vessels. Follow-up intravitreal aflibercept injections were administered to stabilize vascular permeability and maintain retinal dryness. Over 12 months, structural and functional outcomes were monitored with fundus photography, optical coherence tomography, and angiographic imaging. Best-corrected visual acuity improved from counting fingers at 20 cm to 0.15, while imaging demonstrated sustained resolution of macular edema, marked reduction of lipid exudation, and stable retinal architecture without active leakage. This case highlights the potential contribution of inflammatory processes in the pathogenesis of senile-onset Coats disease and suggests that an imaging-guided, multimodal approach combining corticosteroid induction, precise laser ablation, and anti-vascular endothelial growth factor therapy can achieve durable anatomical and functional stabilization in elderly patients with advanced exudative disease.

ObjectiveTo assess the global, regional, and national burden of cataract among individuals aged 60 years and older from 1990 to 2021, and to examine disparities by age, sex, socio-demographic level, and geographic region using data from the Global Burden of Disease Study (GBD) 2021.MethodsWe extracted cataract prevalence data for 204 countries from GBD 2021 and analyzed age-standardized prevalence rates (ASPRs) across regions and Socio-demographic Index (SDI) levels. Sex- and age-specific patterns were assessed. Age-period-cohort modeling, decomposition analysis, absolute and relative inequality metrics, and frontier analysis were applied to assess temporal trends, demographic drivers, and disparities.ResultsIn 2021, the global ASPR of cataract among the elderly was 7,748.5 per 100,000, with significantly higher rates in South Asia. Females had consistently higher ASPRs than males across all age groups and regions. Prevalence increased with age, peaking in those aged ≥95 years. Age-period-cohort (APC) analysis revealed that aging is the dominant driver of burden, with minor period and cohort effects. Decomposition showed that global prevalence increases were largely driven by population growth (87.4%), with smaller contributions from aging and epidemiological change. Substantial inequality persisted: low-SDI countries bore disproportionately higher burdens, with minimal improvement from 1990 to 2021. Frontier analysis revealed large performance gaps even among similarly developed countries.ConclusionCataract remains a major and unequal public health burden among older adults, particularly in low- and middle-SDI settings. Addressing service delivery inefficiencies, expanding surgical coverage, and implementing equitable aging-focused eye care policies are essential to reduce avoidable visual impairment globally.

This case report describes a 39-year-old male presenting with serous retinal detachment (SRD) who was initially misdiagnosed with acute central serous chorioretinopathy (CSC). CSC is typically a self-limiting condition, but recurrence occurs in approximately 30-50 % of patients depending on risk factors and disease chronicity. He received antibiotics for suspected infection, but his symptoms persisted without corticosteroid use. After referral to our hospital, posterior scleritis was confirmed through inflammation signs, multimodal imaging (showing optic disc edema, extending SRD, thickened eyewall, and ciliary body detachment), and elevated systemic inflammatory biomarkers. Methylprednisolone therapy relieved symptoms within four days. Follow-up at four months showed complete SRD resolution and choroidal fold regression. This case highlights the diagnostic challenge in patients with SRD, where demographic assumptions-such as the tendency to associate CSC with young males-may delay recognition of inflammatory etiologies like posterior scleritis. Corticosteroids, which may worsen CSC, are essential for treating posterior scleritis-highlighting the critical need for accurate differentiation to avoid therapeutic missteps and irreversible vision loss. Definitive diagnosis necessitates synthesizing ocular examination findings, systemic biomarkers, and multimodal imaging. Clinicians must prioritize integrating clinical, imaging, and laboratory data over relying on isolated SRD or demographic stereotypes to guide management in complex ophthalmic cases.

Background:Eye cancer is a significant threat to vision and survival because of its location, diagnostic challenges, and aggressive nature. However, its global epidemiology, especially regarding differences across countries, age groups, and sex, is not well-studied. Methods:This study analyzed data from the Global Burden of Disease Study 2021 to evaluate trends in eye cancer, focusing on incidence, prevalence, mortality, and disability-adjusted life years (DALYs) across 204 countries from 1990 to 2021. Age-standardized rates and estimated annual percentage changes were used to assess trends over time. Disparities were examined by sociodemographic index (SDI), sex, and age, with concentration and slope index analyses assessing development-and sex-related inequalities. Results:From 1990 to 2021, the global burden of eye cancer showed an overall increase in incidence and prevalence, with notable geographic and sociodemographic variations. Sociodemographic analysis revealed persistent inequalities, with higher detection-related prevalence and incidence in developed regions and greater mortality and disability in less developed areas. Age-specific prevalence demonstrated a rightward shift, with older populations, particularly those aged ≥65 years, carrying the largest burden. Sex disparities were also evident, as men generally exhibited higher incidence and prevalence rates, while women in low-SDI regions faced a disproportionate share of mortality and DALY burden. Conclusion:This study highlights significant global disparities in eye cancer, influenced by sociodemographic factors, sex, and age. Urgent investment in diagnostic infrastructure, equitable care, and sex-sensitive measures is essential to reduce preventable vision loss and cancer deaths.

BACKGROUND:Deep learning-based segmentation methods for optical coherence tomography (OCT) have demonstrated outstanding performance. However, the stochastic distribution of training data and the inherent limitations of deep neural networks introduce uncertainty into the segmentation process. Accurately estimating this uncertainty is essential for generating reliable confidence assessments and improving model predictions. PURPOSE:To address these challenges, we propose a novel uncertainty-guided cross-layer fusion network (UGCFNet) for retinal OCT segmentation. UGCFNet integrates uncertainty quantification into the training process of deep neural networks and leverages this uncertainty to enhance segmentation accuracy. METHODS:Our model employs an encoder-decoder architecture that quantitatively assesses uncertainty at multiple stages, directing the network's focus toward regions with higher uncertainty. By facilitating cross-layer feature fusion, UGCFNet enhances the comprehensive understanding of both semantic information and morphological details. Additionally, we incorporate an improved Bayesian neural network loss function alongside an uncertainty-aware loss function, enabling the network to effectively utilize these mechanisms for better uncertainty modeling. RESULTS:We conducted extensive experiments on the publicly available AI-Challenger and OIMHS OCT segmentation datasets. The training, validation, and testing sets of the AI-Challenger dataset are comprised of 32, 8, and 43 OCT volumes, yielding a total of 4096, 1024, and 5504 B-scans, respectively. The training, validation, and testing sets of the OIMHS dataset consist of 100, 25, and 25 OCT volumes, resulting in 2,310, 798, and 751 B-scans, respectively. The results demonstrate that UGCFNet achieves state-of-the-art performance, with average Dice similarity coefficients of 79.47% and 93.22% on the respective datasets. CONCLUSION:Our proposed UGCFNet significantly advances retinal OCT segmentation by integrating uncertainty guidance and cross-level feature fusion, offering more reliable and accurate segmentation outcomes.

Purpose:To investigate the associations between urinary enterolignans concentration and oral probiotic ingestion using nationally representative data from the United States population. Methods:We analyzed dietary recall data and urinary enterolignans concentrations from 12,358 eligible participants in the National Health and Nutrition Examination Survey (NHANES) 1999-2010. Linear regression models with comprehensive covariate adjustments were employed to assess associations, accounting for demographic, socioeconomic, health status, and lifestyle factors. Results:Participants with dietary probiotic ingestion had higher urinary concentrations of enterolignans, and probiotic ingestion showed robust and profound positive correlations with enterolignans after fully adjusted with multiple confounders (all p values<0.05). Frequent probiotic consumption exerts a more profound and positive impact on enterolignans concentrations than Infrequent probiotic consumption, according to correlation coefficient values in both univariate and multivariate analyses. Conclusion:Dietary probiotic consumption was significantly associated with elevated urinary enterolignans concentrations in the U.S. population, with high-frequency intake demonstrating a stronger dose-response relationship compared to low-frequency consumption.

Growing evidence suggests that gut microbiota (GM) plays a role in diabetic retinopathy (DR), but the causal microbial drivers and their stage-dependent roles during DR progression remain poorly characterised. Using genetic causality methods, we aim to depict a longitudinal GM mapping and stage-stratified GM signatures across the DR trajectory, spanning initial background DR (BDR) through non-proliferative form (NPDR), to advanced proliferative stage (PDR). GWAS data of 207 GM taxa (from phylum to species) were acquired from the Dutch Microbiome Project (N = 7,824), and DR from FinnGen (over 300,000 individuals). A bidirectional two-sample Mendelian Randomization (TSMR) analysis was conducted to elucidate directional causality between GM and DR. Multiple sensitivity evaluations were performed for pleiotropy, heterogeneity, and stability. Additionally, two-step MR and multivariable MR (MVMR) were performed to dissect causal GM-DR relationships using 1400 candidate circulating metabolite level/ratio data from a Canadian cohort (N = 8,299). We identified 11 causal GM taxa (1 family, 3 genera, and 7 species) during the progression of DR. Notably, species_Bacteroides_dorei and species_Dorea_longicatena demonstrated pan-stage pathogenicity (BDR and PDR, all OR>1, PIVW<0.05), while family_Clostridiaceae (OR = 1.540, 95

ObjectiveTo systematically characterize the global research landscape of metabolism-related intraocular malignancies and to validate the robustness of findings through a multi-database comparative approach.MethodsPublications from January 1, 1990, to July 31, 2025, were retrieved from the Web of Science Core Collection (WoSCC). To ensure the stability and generalizability of results, equivalent searches were performed in Scopus and PubMed, applying the same keyword set, time frame, and eligibility criteria. Bibliometric analyses were conducted using VOSviewer, CiteSpace, and GraphPad Prism to evaluate publication trends, geographic and institutional contributions, journal and author influence, keyword co-occurrence, co-citation patterns, and emerging research fronts. Cross-database validation assessed concordance in temporal trends, thematic focuses, and country rankings.ResultsA total of 1,745 WoSCC publications were included, authored by researchers from 69 countries. Global output has increased markedly since 2010, peaking in 2021. Uveal melanoma consistently emerged as the dominant intraocular tumor type in metabolic research. Major thematic clusters encompassed oxidative stress, apoptosis, hypoxia, lipid metabolism, and metabolic reprogramming, with recent shifts toward long noncoding RNA, immune infiltration, and metabolomics, signaling a transition to precision oncology. Importantly, multi-database validation demonstrated high concordance in annual publication trends, as well as strong overlap in top keywords and stability in geographical and disease foci.ConclusionThis study provides a multi-database bibliometric assessment of metabolism-related intraocular malignancy research, with offering a reliable foundation for guiding future basic and translational research in ocular oncology.

Objective To investigate differential associations of traditional and novel adiposity indices with visual impairment (VI) in the middle-aged and older Chinese population.Methods and analysis Based on the China Health and Retirement Longitudinal Study, 7750 Chinese older adults aged over 45 were included at baseline 2011, and 4133 participants who accomplished all three interviews from 2011 to 2015 were adapted for longitudinal analyses. We enrolled six adiposity indices, including the body mass index (BMI), waist-to-height ratio (WHtR), weight-adjusted-waist index (WWI), a body shape index (ABSI), body roundness index (BRI) and conicity index (ConI). Visual status and other covariates included sociodemographic characteristics, medical supports and lifestyle-related factors. Cross-sectional correlations were assessed using univariate and multivariate logistic regression analyses. For longitudinal analysis, generalised linear models with generalised estimating equations were used to determine the association between time-varying adiposity and visual status.Results Higher levels of WHtR/WWI/ABSI/BRI/ConI were significantly associated with an increased prevalence of VI, whereas a higher BMI was associated with a decreased prevalence of VI. Only WWI was significantly related to the prevalence of VI after adjustment for multiple confounders in both cross-sectional and longitudinal analyses (all p values <0.05). The multivariable-adjusted OR (95% CI) of VI associated with the highest (vs lowest) quintile of WWI was 1.900 (1.407 to 2.565).Conclusion WWI is a reliable alternative adiposity index that exhibits a dose–response association with the prevalence of VI in the Chinese population. The WWI-VI correlation may eliminate the obesity paradox in the ophthalmic epidemiological area and indicate the detrimental impact of changes in body composition on VI.

A 46-year-old male patient visited our clinic with a complaint of blurred vision in the right eye accompanied by headache and insomnia. The fundus examination showed three bullous retinal detachments in the right eye. Considering the prodromal symptoms and other fundus characteristics such as vitreous cells in the posterior pole and multifocal fluorescence leakages on fundus fluorescein angiography (FFA), initial diagnosis was considered as Vogt-Koyanagi-Harada (VKH). However, oral glucocorticoids didn't improve patient's vision. Further enhanced depth imaging (EDI)-optical coherence tomography (OCT) scan displayed hyper-reflective lesions at the choroidal layer. We proposed that hyper-reflective lesions at the choroidal layer on EDI-OCT may characterize the bullous variant of central serous chorioretinopathy (CSC). After fundus photocoagulation treatment, the patient's vision improved.

AimsTo investigate the association between socioeconomic position (SEP) and sensory impairments (SIs).MethodsWe used data from the China Health and Retirement Longitudinal Study (CHARLS) (2015). Logistic regressions estimated the odds ratio for associations of SEP with SIs. In addition, Mendelian randomization (MR) analysis was conducted to assess the causal relationship between them with the inverse variance weighting (IVW) estimator. MR-Egger, simple median, weighted median, maximum likelihood, and robust adjusted profile score were employed for sensitivity analyses.ResultsIn the observational survey, we enrolled 19,690 individuals aged 45 and above. SEP was negatively associated with SIs. Adjusted odds of vision impairment were higher for illiterate (1.50; 95%CI: 1.19, 1.91), less than elementary school diploma (1.76; 95%CI: 1.39, 2.25), middle school diploma (1.53; 95%CI: 1.21, 1.93) and lower income (all p < 0.001). The odds of hearing impairment were significantly higher for people with less than a high school diploma than those with a college degree or higher diploma, for agricultural workers than non-agricultural workers, and for people in low-income families (p < 0.01). The MR analysis also showed that occupation was associated with HI (1.04, 95%CI: 1.01, 1.09, p < 0.05) using IVW.ConclusionWe found that both observational and causal evidence supports the theory that SEP can result in SIs and that timely discovery, targeted management, and education can prevent SIs among middle-aged and older adults.

Aims:Our aim was to investigate the prevalence, incidence, and persistence of visual impairment (VI) and their correlates among the Chinese population with diabetes mellitus (DM) over 3 years.Materials and methods:The China Health and Retirement Longitudinal Survey is the first nationally representative longitudinal survey of the Chinese population. A cross-sectional analysis of prevalent VI in 2015 consisted of 2,173 participants with DM. A longitudinal observation of incident and persistent VI consisted of 1,633 participants from 2015 to 2018. Risk factors of VI were identified via univariate and multivariate logistic regression analyses.Results:Among our study population with DM, 11.8% reported VI in 2015, 4.5% had persistent VI from 2015 to 2018, and 8.9% developed VI in 2018. Factors identified to be correlated to VI (p < 0.05) were older age, being a woman, lower educational attainment, living in a rural area, application of DM medication and non-pharmacological treatment, receiving DM-related tests, use of spectacles, and poorer health status.Conclusion:This most recent national data provides a baseline for future public health initiatives on VI among the Chinese population with DM. With multiple risk factors identified, these could provide concurrent targets for various public health strategies and interventions with the aim of reducing the burden of VI among the population with DM in China.

PurposeAge-related macular degeneration (AMD) is the leading cause of vision loss in those over the age of 50. Recently, intestinal microbiota has been reported to be involved in the pathogenesis of ocular diseases. The purpose of this study was to discover more about the involvement of the intestinal microbiota in AMD patients.MethodsFecal samples from 30 patients with AMD (AMD group) and 17 age- and sex-matched healthy controls (control group) without any fundus disease were collected. DNA extraction, PCR amplification, and 16S rRNA gene sequencing of the samples were performed to identify intestinal microbial alterations. Further, we used BugBase for phenotypic prediction and PICRUSt2 for KEGG Orthology (KO) as well as metabolic feature prediction.ResultsThe intestinal microbiota was found to be significantly altered in the AMD group. The AMD group had a significantly lower level of Firmicutes and relatively higher levels of Proteobacteria and Bacteroidota compared to those in the control group. At the genus level, the AMD patient group showed a considerably higher proportion of Escherichia-Shigella and lower proportions of Blautia and Anaerostipes compared with those in the control group. Phenotypic prediction revealed obvious differences in the four phenotypes between the two groups. PICRUSt2 analysis revealed KOs and pathways associated with altered intestinal microbiota. The abundance of the top eight KOs in the AMD group was higher than that in the control group. These KOs were mainly involved in lipopolysaccharide biosynthesis.ConclusionThe findings of this study indicated that AMD patients had different gut microbiota compared with healthy controls, and that AMD pathophysiology might be linked to changes in gut-related metabolic pathways. Therefore, intestinal microbiota might serve as non-invasive indicators for AMD clinical diagnosis and possibly also as AMD treatment targets.