To describe the surgical technique of Macula-Vitreous Interface Vitrectomy (MVIV), and report its clinical outcomes in pediatric patients with non-inflammatory epiretinal membrane (ERM). This single-center retrospective case series included 42 pediatric patients (3 to 14 years) with unilateral non-inflammatory ERM who underwent MVIV between 2018 and 2023. MVIV involved selective removal of vitreous adjacent to the vitreomacular interface, primarily around the optic disc and macula within the vascular arcades, while preserving the central and peripheral vitreous. Outcomes included best-corrected visual acuity (BCVA), optical coherence tomography (OCT) parameters [central foveal thickness (CFT) or lesion thickness (LT)], intraocular pressure (IOP), and postoperative complications. Mean age at surgery was 7.63 ± 2.97 years, with mean follow-up of 22.96 ± 11.43 months. BCVA improved from a median of 0.82 (IQR, 0.70–1.30) to 0.70 (IQR, 0.49–0.85), at 12 months (Hodges–Lehmann estimate, -0.20 logMAR; 95

PURPOSE:To compare the visual and anatomic outcomes of pars plana vitrectomy between myopic maculoschisis with and without macular detachment (MD). METHODS:This retrospective comparative study included 38 eyes of 38 patients who received pars plana vitrectomy for myopic maculoschisis between July 2021 and July 2022. Two groups were identified based on whether preoperative MD was detected via optical coherence tomography: 16 eyes with MD and 22 eyes without MD. Surgical effects were assessed by the final best-corrected visual acuity, ellipsoid zone (EZ) state, and the rate of complete fovea relief. RESULTS:The postoperative follow-up was 15.25 ± 3.70 and 15.55 ± 3.39 months in the groups with and without MD, respectively ( P = 0.800). The preoperative logarithm of the minimal angle of resolution best-corrected visual acuity was 1.21 ± 0.65 and 0.55 ± 0.37 in the groups with and without MD, respectively ( P = 0.001). Nevertheless, no difference existed in the postoperative best-corrected visual acuity at final visit between the groups with and without MD (0.51 ± 0.29 logarithm of the minimal angle of resolution, ∼20/64 VS . 0.40 ± 0.41 logarithm of the minimal angle of resolution, ∼20/50, P = 0.345). During the follow-up period, the rates of EZ band reconstruction were 40.00% (6/15) and 33.33% (2/6) in the groups with and without MD, respectively ( P = 0.590). Finally, a total of 33 eyes achieved complete fovea relief, including 13 eyes (81.25%) in the group with MD and 20 eyes (90.91%) in the group without MD ( P = 0.701). CONCLUSION:In myopic maculoschisis eyes, the presence of MD did not significantly affect postoperative visual or anatomical outcomes in our cohort.

BACKGROUND/AIMS:Retinopathy of prematurity (ROP) zone classification guides disease severity assessment and Early Treatment for Retinopathy of Prematurity (ETROP)-based treatment decisions but remains subjective, particularly in the peripheral retina. We developed and validated an anatomically derived quantitative ROP zone reference map to standardise zone assessment in wide-field paediatric retinal images. METHODS:A reference map was constructed using optic disc-fovea distance and multimodal anatomical data, then applied to RetCam panoramic images generated with a robust deep learning registration pipeline. Four ophthalmologists evaluated 85 ROP examinations with and without the reference map in a crossover reader study. Reader-reference and interobserver agreement for zone classification and zone-dependent ETROP decisions were assessed using kappa statistics. RESULTS:The reference map improved reader-reference agreement for zone classification from 0.58 to 0.92 and interobserver agreement from 0.47 to 0.86. In a Zone III versus non-Zone III analysis, reader-reference agreement improved from 0.40 to 0.88. In 20 zone-dependent ETROP observations, agreement improved from 0.85 to complete concordance within this subset. CONCLUSION:The quantitative ROP zone reference map improved reliability of zone classification and supported more consistent ETROP guideline application in this retrospective reader study.

PURPOSE:To characterize bullous peripheral retinoschisis (BPR) using Ultrawide-Field swept source optical coherence tomography (UWF SS-OCT) and evaluate its association with complications in X-linked retinoschisis (XLRS). DESIGN:Retrospective cross-sectional study. SUBJECTS:A total of 145 eyes from 80 genetically confirmed XLRS patients. METHODS:Eighty male patients (145 eyes) with genetically confirmed XLRS underwent UWF SS-OCT imaging. BPR parameters (horizontal/vertical maximum angle of peripheral retinoschisis, area ratio, distance to fovea) were quantified. Factors associated with complications (vitreous hemorrhage, choroidal neovascularization, macular atrophy/fold, and secondary cataract) were analyzed. RESULTS:BPR prevalence was 65.5% (95/145 eyes), predominantly involving the inferotemporal retina (97.9% inferior, 100% temporal), with 52.6% spanning three quadrants. Eyes with complications (26.2%, 38/145) presented younger (4.0 [IQR: 3.3-5.8] vs 5.0 [IQR: 4.0-8.0] years; P = .019), worse best corrected visual acuity (1.12 ± 0.67 vs 0.72 ± 0.44 logarithm of the minimal angle of resolution, P < .001), larger horizontal maximum angle of peripheral retinoschisis and vertical maximum angle of peripheral retinoschisis (60.18 ± 28.80° vs 30.61 ± 30.30°, P < .001; 54.42 ± 22.21° vs 31.90 ± 32.27°, P < .001), higher BPR-to-fundus area ratio (0.40 ± 0.15 vs 0.27 ± 0.18; P < .001), and shorter BPR-to-fovea distance (2897.24 ± 2184.48 µm vs 4776.7 ± 2431 µm, P < .001). BPR prevalence was higher in the complication group (89.5% vs 57.0%, P < .001). Receiver operating characteristic analysis revealed BPR discriminated vitreous hemorrhage with area under the curve 0.789 (95% CI: 0.710-0.869). Choroidal neovascularization exclusively co-occurred with BPR and correlated with proximity to fovea (P = .041). Genetic variants showed no association with complications. CONCLUSIONS:BPR is a hallmark of pediatric XLRS, strongly linked to complications via structural severity (angles, area, foveal proximity). UWF SS-OCT enables early detection and risk stratification, guiding targeted monitoring.

Purpose:To characterize changes in the retinal pigment epithelium (RPE) in pediatric combined hamartoma of the retina and RPE (CHRRPE) using wide-field swept-source optical coherence tomography (SS-OCT) and to identify factors associated with RPE involvement. Methods:We conducted a retrospective study of children with CHRRPE diagnosed between 2018 and 2023 at Zhongshan Ophthalmic Center and imaged with wide-field SS-OCT. RPE alterations were defined using OCT features and classified as RPE deformation without discontinuity or RPE disruption with secondary changes. Factors associated with RPE involvement were evaluated using multivariable logistic regression analyses. Results:Forty-one eyes from 38 children (21 boys; median age, 7 years) were included. OCT showed preretinal fibrosis in 21 of 41 eyes (51%), mini-folds in 38 of 41 eyes (93%), and maxi-folds in 32 of 41 (78%). RPE involvement was detected in 11 of 41 eyes (27%), including RPE-originated vertical striae (8/41 [20%]), outer retinal hyper-reflective pigment clumps (7/41 [17%]), RPE protrusion (6/41 [15%]), RPE rupture (5/41 [12%]), and choroidal neovascularization (5/41 [12%]). RPE alterations occurred in all peripheral lesions (3/3), 50% of peripapillary lesions (3/6), and 16% of macular lesions (5/32). Multivariable analysis indicated extramacular location (odds ratio, 11.29; 95% confidence interval, 1.45-87.81; P = 0.021) and preretinal fibrosis (odds ratio, 7.08; 95% confidence interval, 1.14-44.00; P = 0.036) were associated with RPE involvement. Conclusions:In pediatric CHRRPE, RPE involvement was not uncommon and was associated with extramacular location and preretinal fibrosis. Wide-field SS-OCT may help to identify structural features in pediatric CHRRPE. Translational Relevance:Characterizing swept-source optical coherence tomography patterns in children with combined hamartoma of the retina and retinal pigment epithelium links retinal pigment epithelium damage to inner retinal contraction and supports risk stratification and follow-up planning.

Retinal neovascular diseases, such as retinopathy of prematurity and diabetic retinopathy, threaten vision by disrupting retinal structure and function through pathological neovascularisation and chronic inflammation. Existing anti-VEGF therapies primarily target angiogenesis, offering limited control over inflammation and requiring repeated administration. Here, we developed a resveratrol (RSV)-loaded tetrahedral framework nucleic acid nanostructure (tFNAs-RSV) to achieve concurrent anti-angiogenic and anti-inflammatory effects. tFNAs provided a biocompatible, stable and penetration-efficient carrier that enhanced RSV ocular delivery and bioactivity. In hypoxia-induced retinal neovascularisation models, tFNAs-RSV markedly reduced neovascular lesion area, vascular leakage and retinal inflammatory cell infiltration. Mechanistically, tFNAs-RSV suppressed HIF-1 signalling and inhibited the p38 MAPK pathway and NF-κB p65 pathway. Collectively, these results validate tFNAs-RSV as a promising nanoplatform for treating retinal neovascular diseases, with an emphasis on inhibiting neovascularisation and inflammation.

Ocular neovascular and neurodegenerative diseases, such as diabetic retinopathy and age-related macular degeneration, are characterized by abnormal angiogenesis, vascular leakage, and progressive retinal neurodegeneration, ultimately leading to irreversible vision loss. Here, we present a tetrahedral framework DNA-based bioswitchable Tri-miR-22 mimic delivery system (BiRDS), which is specifically engineered for extraocular administration. In vitro, BiRDS can penetrate the cell membrane within 24 h and accumulate extensively in the cytoplasm. Through transscleral-choroidal-retinal penetration, BiRDS achieves robust delivery to the choroid and retina within 18 h without the need for intravitreal injection in mice. The BiRDS can effectively inhibit the proliferation, tube formation and migration abilities of human umbilical vein endothelial cells. In murine models of choroidal neovascularization and oxygen-induced retinopathy, BiRDS not only suppresses retinal pathological neovascularization with efficacy comparable to that of current anti-VEGF agents, but also possesses unique effects that current agents lack, such as improved retinal perfusion and preserved neuronal integrity, thereby contributing to the protection of visual function. Furthermore, transcriptomic profiling and molecular validation revealed that BiRDS exerts its therapeutic efficacy by inhibiting the Wnt/β-catenin pathway, a key driver of mediating the aforementioned pathological processes. This study highlights BiRDS as a next-generation RNA nanotherapy with broad clinical potential, offering site specific, multitargeted modulation via a minimally invasive and patient-friendly route.

This chapter delves into various genetic pathways associated with inherited retinal diseases (IRDs). It discusses the heterogeneity within this group of disorders and the importance of understanding the genetic landscape to identify underlying mechanisms and possible therapeutic targets. The clinical facets of IRDs take center stage as the chapter outlines the broad spectrum of visual manifestations. From the early signs to advanced visual symptoms, the nuances of each subtype are elucidated, providing a holistic perspective on the challenges faced by individuals affected by IRDs. The pivotal role of new diagnostic technologies and genetic testing for accurate and early diagnosis is explained. The efficacy and value of therapeutic interventions, including gene therapies and emerging molecular strategies, offer hope for halting or reversing these debilitating diseases.

ImportancePattern recognition of pediatric retinal diseases can streamline the workup and guide the prognosis.ObjectiveTo characterize the clinical features, retinal imaging findings, and 1-year prognosis of pediatric patients who experienced sudden, severe bilateral vision loss with diffuse ellipsoid zone (EZ) and external limiting membrane (ELM) disruptions after fever.Design, Setting, and ParticipantsThis multicenter case series included 8 pediatric patients (16 eyes) who presented with an unusual set of clinical symptoms, including sudden, severe bilateral vision loss; nyctalopia; and diffuse EZ and ELM disruptions, subsequent to a febrile illness. The patients visited or were referred to a pediatric retina service between November 2022 and May 2023.Main Outcome MeasuresChanges in visual acuity, visual field, electroretinography (ERG) results, and presence of characteristic retinal imaging signs during follow-up.ResultsA total of 16 eyes from 8 children (6 boys and 2 girls) were included in this study; the patients’ mean (SD) age was 5.1 (1.2) years (range, 3-7 years; median, 5.0 years). Their sudden bilateral vision loss occurred a mean of 16.1 days after fever onset. Initial symptoms included sudden vision loss, visual field constriction, nyctalopia, and dyschromatopsia. Baseline visual acuity was predominantly below counting fingers. A sudden, diffuse loss of the EZ and ELM was observed in all eyes with gradual recovery beginning around the fourth week. After 1 year, visual acuity showed substantial improvement in most cases, with 7 of 8 patients (88%) achieving 20/40 or better, including 4 patients (50%) achieving 20/25 or better. The macular EZ and ELM appeared intact in 12 eyes (75%) and 14 eyes (88%), respectively, while the extrafoveal regions remained absent of EZ and ELM. ERG revealed extinguished cone and rod responses in 8 patients (100%), and multifocal ERG remained extinguished despite the recovery of visual acuity in all 8 patients (100%).Conclusions and RelevanceThis case series identifies a potentially underrecognized disease in pediatric patients after fever characterized by sudden vision loss, diffuse EZ and ELM disruption, and distinct retinal imaging features. The term hyperacute outer retinal dysfunction is recommended as descriptive while further investigations are recommended to better understand its pathophysiology and optimal management strategies.

To our knowledge, this is the first head-to-head study to evaluate QuantiFERON-TB Gold Plus, QuantiFERON-TB Gold In-Tube, ESAT6-CFP10, and tuberculin skin test among adolescents. Our study highlights the value of QFT-Plus in detecting Mtb infection among high school freshmen when compared to QFT-GIT. No head-to-head studies have simultaneously compared the performances of QuantiFERON-TB Gold In-Tube (QFT-GIT), QuantiFERON-TB Gold Plus (QFT-Plus), ESAT6-CFP10 (EC) skin test, and Tuberculin skin test (TST) in adolescents. This study aimed to conduct a comparative assessment of QFT-GIT and QFT-Plus for detecting Mycobacterium tuberculosis(Mtb) infection in high school freshmen. We concurrently administered QFT-GIT, QFT-Plus, EC skin test, and TST to first-year high school students. Blood samples were obtained for the QFT-GIT and QFT-Plus assays before the administration of the EC skin test and TST. The diagnostic values were compared. Discrepancies between the tests were quantified using Cohen’s kappa coefficient. A total of 787 freshmen were recruited in this study. Among 787 subjects, EC was positive in 0.8

Familial exudative vitreoretinopathy (FEVR) is a genetically complex retinal vascular disorder, often manifesting in infancy or early childhood, and characterized by peripheral retinal avascularity, neovascularization, and retinal detachment. The disease, predominantly inherited in an autosomal dominant manner, is associated with mutations in genes such as LRP5, FZD4, and TSPAN12, which disrupt the Wnt/β-catenin and Norrin signaling pathways, critical for retinal vascular development. FEVR's clinical spectrum ranges from asymptomatic cases to severe vision loss, making early diagnosis and intervention essential for preserving sight. Management strategies include laser photocoagulation, anti-VEGF therapy, and surgery, tailored to disease stage and patient age. The future of FEVR treatment lies in predictive genetics, early screening, and proactive therapy. Ongoing research into the molecular mechanisms of FEVR offers the potential for transforming this progressive disease into a preventable one, improving outcomes for affected individuals.

AIMS:To investigate the relationship between retinal structure symmetry and metamorphopsia in idiopathic epiretinal membrane (ERM) patients. METHODS:181 consecutive ERM patients were divided into four groups based on vertical/horizontal metamorphopsia (MV/MH) presence. Clinical data, including best-corrected visual acuity (BCVA), metamorphopsia scores and optical coherence tomography (OCT)-assessed macular structure, were analysed. The Asymmetry Index (ASI), defined as the thickness difference ratio between corresponding retinal layers, was introduced. Univariate and multivariate linear regression explored relationships among BCVA, metamorphopsia and OCT patterns. Receiver operating characteristic (ROC) curves evaluated the discriminatory ability of OCT parameters for metamorphopsia. RESULTS:Vertical ASI (ASI-V) of the Ganglion cell layer and Inner plexiform layer complex (GCL+IPL) layer was significantly higher in MH groups (p<0.0001), while Horizontal ASI (ASI-H) was elevated in MV groups (p=0.0001). Strong correlations were found between MH and ASI-V (p<0.0001, R2=0.4536), and MV and ASI-H (p<0.0001, R2=0.4870). Multivariate analysis showed a positive association between average metamorphopsia scores and ASI-T of the GCL+IPL layer (standardised beta=0.633, p<0.001). ROC analysis demonstrated good diagnostic accuracy of ASI-V for MH (area under the curve=0.823, Youden's Index=0.669). CONCLUSIONS:Vertical and horizontal asymmetric thickening of the GCL+IPL layer correlates with respective metamorphopsia types. The ASI of the GCL+IPL shows diagnostic superiority for metamorphopsia and may serve as a novel biomarker. These findings suggest that asymmetric thickening of the GCL+IPL layer, rather than overall thickening per se, may serve as the pathological basis for the development of metamorphopsia in ERM patients.

The low positive predictive value of tuberculin skin tests and interferon-γ release assays often results in unnecessary prophylaxis. This study aimed to identify antigen-specific biomarkers with high accuracy for predicting progression to active tuberculosis (ATB). QuantiFERON supernatants from a school tuberculosis outbreak cohort were analyzed, tracking students over two years to identify ATB cases. We assessed 67 cytokines using the Luminex Multiplex Array kit and applied LASSO and multivariate logistic regression to select predictors. A nomogram was developed from the coefficients of top predictors. Model performance was evaluated by AUC, C-index, and AIC. The levels of FGFbasic, GM-CSF, MPIF-1/CCL23, as well as the combinations of ratios of FGFbasic/GM-CSF and FGFbasic/MPIF-1/CCL23 were significantly associated with the risk of ATB. AUC values for the prediction models based on individual cytokines ranged from 0.607 to 0.713, notably lower than those of the fixed models based on the logistic regression (0.932) and LASSO regression (0.939). The LASSO regression model exhibited the best predictive performance, with a higher sensitivity (0.858 vs. 0.818) and specificity (0.949 vs.0.923), lower AIC (36.323 vs. 38.232), and equivalent C-index (0.939) compared to the traditional logistic regression model. The biomarkers identified in this study offer valuable insights for developing a more precise tool to identify individuals at high risk for rapid progression to ATB disease, enabling targeted interventions. The combination of multiple immune indicators shows significant promise in improving diagnostic accuracy.

Introduction No direct comparative study assessing QuantiFERON-TB Gold In-Tube (QFT-GIT) and QuantiFERON-TB Gold Plus (QFT-Plus) for Mycobacterium tuberculosis infection among persons living with HIV (PLHIV) in China has been conducted. Methods Simultaneous QFT-GIT and QFT-Plus tests were conducted on PLHIV in a prison hospital. Positivity and negativity results from both assays were compared, and their diagnostic agreement was assessed. Results A total of 232 PLHIV individuals were included in this study. Among them, 57 patients (24.6%) and 56 patients (24.1%) were diagnosed with Mycobacterium tuberculosis infection based on QFT-GIT results and QFT-Plus, respectively. The overall agreement between the two assays was 98.3%, with a Cohen’s kappa value of 0.954. Consistency rates were observed between QFT-GIT plus, QFT-Plus TB1 and TB2 with QFT-GIT were 98.3%, 97.4% and 97.8%. The IFN-γ levels measured in QFT-GIT were found to surpass those in QFT-Plus TB1 (P = 0.04), while the difference compared to QFT-Plus TB2 exhibited a marginal trend (P = 0.134). Among the subgroup of 52 individuals who underwent dual QFT-GIT tests, a significant proportion of 23.1% (12 individuals) experienced a change in their QFT-GIT results, transitioning from a positive to a negative outcome. Conclusions The diagnostic performance of QFT-GIT and QFT-Plus for Mycobacterium tuberculosis infection among PLHIV with relatively higher CD4 counts was found to be comparable. Additionally, our investigation revealed that irrespective of the treatment regimen, whether it involved chemotherapy or immunotherapy, preventive Mycobacterium tuberculosis infection interventions among PLHIV consistently led to a reduction in IFN-γ levels.

PURPOSE. To assess the efficacy of tetrahedral framework nucleic acids (tFNAs) as a delivery system for small interfering RNA (siRNA) targeting RUNX1 (siRUNX1) in inhibiting retinal neovascularization (RNV) and restoring vascular integrity via the Dll4/Notch1 signaling pathway. METHODS. tFNAs and tFNAs-siRUNX1 were synthesized using annealing of single-stranded DNAs and characterized by PAGE and high-performance capillary electrophoresis. Human umbilical vein endothelial cells were treated under hypoxic conditions with tFNAs-siRUNX1, and cellular uptake was evaluated using fluorescence microscopy and flow cytometry. Angiogenesis was assessed through EdU proliferation, tube formation, and wound-healing assays. In vivo experiments used oxygen-induced retinopathy (OIR) and laser-induced choroidal neovascularization (CNV) models in mice, with subsequent imaging by optical coherence tomography (OCT) and fundus fluorescence angiography. Gene and protein expression were analyzed by RT-PCR and Western blotting, focusing on the Dll4/Notch1 pathway and apoptosis markers. RESULTS. tFNAs-siRUNX1 effectively inhibited endothelial cell proliferation, migration, and tube formation in vitro. In OIR and CNV models, it reduced neovascularization, nonperfusion areas, and vascular leakage. The mechanism involved modulation of the Dll4/Notch1 pathway, with decreased Dll4, Notch1, and Hes1 and increased Nts expression. tFNAs-siRUNX1 also reduced endothelial cell apoptosis via the Bcl-2/Bax pathway. CONCLUSIONS. tFNAs-siRUNX1 is a promising delivery system for targeting RNV, inhibiting neovascularization, and restoring retinal vascular integrity, providing a potential therapeutic alternative to anti-VEGF treatments.

Purpose: Familial exudative vitreoretinopathy (FEVR) is a genetically heterogeneous retinal vascular disorder, with nearly half of the cases attributed to mutations in genes involved in the Norrin/β-catenin signaling pathway. This study aimed to identify and functionally characterize novel FZD4 variants in patients with FEVR. Methods: Genetic sequencing of FZD4 was performed in a cohort of FEVR families, leading to the identification of five novel variants: c.434G ​> ​A, c.610T ​> ​G, c.844T ​> ​C, c.277C ​> ​T, and c.1155delC. Bioinformatic predictions, comprehensive clinical evaluations, and dual-luciferase reporter assays were conducted to assess the functional impact and pathogenicity of these variants. Results: All five FZD4 variants were found to significantly reduce β-catenin signaling activity compared to wild-type FZD4. Among them, two variants previously classified as variants of uncertain significance (VUS) demonstrated functional impairment and clinical segregation consistent with pathogenicity, supporting their reclassification as disease-causing mutations. Conclusions: These findings expand the known mutational spectrum of FZD4 in FEVR and highlight the critical role of functional validation in the interpretation of novel and uncertain variants. Incorporating experimental assays can improve diagnostic accuracy and inform clinical genetic counseling.

Purpose To investigate the ability to quantify fundus curvature and detect posterior staphyloma using widefield optical coherence tomography (OCT). Design Cross-sectional diagnostic evaluation. Methods This study reviewed 205 highly myopic eyes of 205 participants. The Gaussian curvature map of the fundus was automatically calculated from 2 million scan points over an area of 24 mm x 20 mm, visualizing localized deformations in the posterior region. Two fovea-centered areas were designated as follows: a 6 mm x 6 mm macular region and an 8 mm x 16 mm posterior region. Macular mean curvature, macular curvature deviation, posterior mean curvature, posterior curvature deviation (PCD), and maximum posterior curvature were calculated. The relationship between curvature indices, ocular parameters, and myopic complications was investigated. The diagnostic ability of curvature indices for posterior staphyloma was evaluated. Results The mean (SD) age of 205 participants was 34.06 (12.74) years, with 107 being female (52.2%). Posterior staphyloma was found in 33 of 205 (16.1%) eyes. The curvature value map and curvature deviation map revealed detailed morphologic patterns of posterior staphyloma. Eyes with staphyloma had a steeper and more irregular fundus than eyes without staphyloma, with a larger maximum posterior curvature (20.420 x 10(-3) mm(-2) vs 10.925 x 10(-3) mm(-2), P < .001), posterior mean curvature (6.754 x 10(-3) mm(-2) vs 5.352 x 10(-3) mm(-2), P = .002), macular curvature deviation (1.889 x 10(-3) mm(-2) vs 1.078 x 10(-3) mm(-2), P < .001), and PCD (3.894 x 10(-3) mm(-2) vs 1.683 x 10(-3) mm(-2), P < .001). However, no difference in macular mean curvature was found between eyes with and without posterior staphyloma. Larger maximum posterior curvature, macular curvature deviation, and PCD were associated with greater degrees of myopia, more severe myopic maculopathy, and worse best-corrected visual acuity (all P < .05). PCD demonstrated the ability to discriminate the presence of posterior staphyloma (area under the curve 0.909 [95% CI 0.854-0.963; P < .001]). The optimal cutoff value of PCD was 3.060 x 10(-3) mm(-2) (Youden index = 0.725), with a specificity of 90.7% and a sensitivity of 81.8%. Conclusion Widefield OCT-based analysis of fundus curvature enhances detection and quantitative assessment of posterior staphyloma in high myopia. (c) 2024 Elsevier Inc. All rights are reserved, including those for text and data mining, AI training, and similar technologies.)

Choroidal neovascularization (CNV), characterized by abnormal vessel growth and vascular leakage, is the hallmark of wet age-related macular degeneration (wAMD) and a leading cause of irreversible vision loss. Although anti-vascular endothelial growth factor (VEGF) therapies remain the current standard, their frequent administration and limited long-term efficacy highlight the need for novel treatments. Here, we developed a miR-22-3p-loaded tetrahedral framework nucleic acids (tFNAs-miR22) nanostructure and evaluated its efficacy in CNV suppression. The nanocomplex was structurally validated, exhibiting high assembly fidelity and superior intraocular stability compared to serum conditions. In a laser-induced CNV mouse model, a single intravitreal injection of tFNAs-miR22 significantly reduced lesion size and leakage by day 10, with efficacy comparable to aflibercept. In a rat model of stable and long-lasting CNV, tFNAs-miR22 demonstrated durable inhibition of vascular leakage by Day 21, showing greater persistence compared to aflibercept. This effect was dose-dependent, with the high-dose group outperforming aflibercept in suppressing leakage. Transcriptomic profiling of hypoxia-challenged HUVECs further revealed that tFNAs-miR22 modulates angiogenic pathways, including suppression of the phosphoinositide 3-kinase (PI3K)/protein kinase B (AKT)/mechanistic target of rapamycin (mTOR) axis. These findings demonstrate the potent and long-lasting therapeutic effects of tFNAs-miR22, supporting its promise as a next-generation, gene-regulatory nanotherapy for sustained inhibition of CNV.

Purpose:To evaluate the caregiver burden and its associated factors among patients receiving anti-VEGF intravitreal injections for age-related macular degeneration (AMD) and diabetic retinopathy (DR) in a tertiary hospital in Guangzhou, China. Methods:This cross-sectional study recruited 88 patients who received intravitreal anti-VEGF injections and their primary caregivers. Patients completed the Activities of Daily Living (ADL) scale, while caregivers completed the Zarit Burden Interview (ZBI) and the Connor-Davidson Resilience Scale (CD-RISC). One-way ANOVA and Pearson correlation analysis were conducted to assess the associations between patient function, caregiver burden, and related sociodemographic factors. Results:The mean ADL score of patients was 18.99 ± 8.34, while the mean caregiver burden score was 18.22 ± 18.04. A significant positive correlation was found between the patient's ADL score and caregiver burden (r = 0.405, p < 0.01). Caregivers who were employed part-time or not cohabiting with patients reported significantly higher burden scores (p = 0.034 and p = 0.03, respectively). Additionally, the caregiver burden among DR patients was higher than among AMD patients (p = 0.026). Conclusion:Significant caregiver burden exists among those assisting patients receiving intravitreal injections, especially for DR patients and those with reduced ADL function. Caregiver availability and living arrangements should be considered in the design of follow-up schedules to improve treatment adherence and outcomes.

Multidrug-resistant or rifampicin-resistant tuberculosis (MDR/RR-TB) remains a critical global health threat. While novel regimens offer promise, the impact of socioeconomic determinants and clinical factors on treatment success is inadequately characterized, hindering targeted interventions. A prospective cohort study was conducted across 13 TB-designated hospitals in Jiangsu Province, China from 2021 to 2022. Binary logistic regression identified predictors of treatment success, with model performance assessed via Receiver Operating Characteristic (ROC) curves assessing predictive performance. The overall treatment success rate for patients with MDR/RR-TB was 67.38%, with the short-term regimen achieving a success rate of 74.4%, new long-term oral regimens at 66.7%, new long-term injectable regimens at 71.0%, traditional long-term regimens at 60.3%, though differences were not statistically significant (P = 0.454). Patients educated at the junior and senior high school levels (OR = 3.95, 95% CI: 1.70, 9.19, P = 0.001) and at the college level or above (OR = 3.13, 95% CI: 1.03, 9.51, P = 0.044) exhibited significantly higher success rates compared to those with primary school education or lower. Moreover, it underscores the irrelevance of cost to treatment outcomes. Additionally, urban workers (OR = 4.53, 95% CI: 1.22, 16.86, P = 0.024), urban residents (OR = 4.61, 95% CI: 1.25, 17.04, P = 0.022), and individuals covered by other medical insurance, including public medical insurance (OR = 8.82, 95% CI: 1.50, 51.76, P = 0.016), demonstrated higher treatment success rates compared to those without medical insurance. Conversely, hypokalemia (OR = 0.12, 95% CI: 0.02, 0.61, P = 0.010) was identified as a risk factor for successful treatment. Treatment costs demonstrated no significant association with outcomes (OR = 1.06, 95%CI: 0.96, 1.17, P = 0.284). Prioritizing health literacy programs, insurance expansion, and hypokalemia monitoring is essential for improving treatment success.