Background:This systematic review and meta-analysis aimed to compare outcomes of 0.01% atropine with orthokeratology (AOK) vs. orthokeratology (OK) alone for slowing the progression of myopia in children. Methods:MEDLINE via PubMed, Embase, Scopus, Web of Science, CENTRAL (Cochrane Central Register of Controlled Trials), Chinese electronic databases of VIP, and Wanfang were searched from inception until 19th August 2024 for randomized controlled trials (RCTs) about the review topic. The primary outcome was a change in axial length (AL) (mm). Secondary outcomes were spherical equivalent refraction (SER) (Diopter), pupil diameter (PD) (mm), amplitude of accommodation (AA) (Diopter), and intraocular pressure (IOP) (mmHg). Results:10 articles corresponding to eight RCTs were included. Meta-analysis found that change in AL was significantly reduced with AOK as compared to OK alone at 6 months (MD: -0.10 95% CI: -0.14, -0.06 I2 = 48%), 12 months (MD: -0.08 95% CI: -0.10, -0.07 I2 = 0%) and 24 months (MD: -0.14 95% CI: -0.19, -0.08 I2 = 0%). Pooled analysis found that AOK did not reduce the progression of SER (MD: 0.06 95% CI: -0.00, 0.12 I2 = 7%) and increased PD (MD: 0.63 95% CI: 0.40, 0.85 I2 = 86%) as compared to OK alone. Pooled analysis also found a tendency of reduced AA with AOK as compared to OK alone but without significant results (MD: -0.45 95% CI: -1.00, 0.10 I2 = 59%). Meta-analysis failed to show a statistically significant difference in change of IOP between AOK and OK (MD: -0.49 95% CI: -1.48, 0.50 I2 = 51%). Conclusions:AOK seems to be more efficacious in slowing the progression of myopia in children as compared to OK alone.

Background & Objective:Several diabetic macular edema (DME) patients are resistant to anti-vascular endothelial growth factors (VEGF) injections and are treated with corticosteroid implants. Dexamethasone implants (DEXI) are popular, but fluocinolone acetonide implants (FACI) are being used as third-line DME therapy, given their convenience and prolonged action. The efficacy of FACI in patients previously treated with DEXI remains understudied. We collated evidence from single-arm studies examining the efficacy and safety of FACI in DME patients treated with DEXI. Methodology:We explored the websites of Embase, PubMed, PubMed CENTRAL, Web of Science, and Scopus up to January 15, 2025. Pre and post-FACI best-corrected visual acuity (BCVA), central retinal thickness (CRT), and intraocular pressure (IOP) were compared. Results:Eight studies with 365 eyes were included. Meta-analysis showed that use of FACI was associated with statistically significant improvement in BCVA (letters) at three months (MD: 5.40 95% CI: 0.13, 10.67 I2= 78%) but not at six months (MD: 5.43 95% CI: 1.79, 12.64 I2=86%), and 12 months (MD: 3.39 95% CI: 3.12, 9.91 I>2=84%). The pooled analysis indicated a statistically significant reduction in CRT after administration of FACI at 3 months (MD: 118.11 95% CI: 211.62, -24.61 I2=93%), six months (MD: 121.79 95% CI: 212.35, -31.24 I2=94%), and 12 months (MD: 108.33 95% CI: 175.47, -41.2 I2=92%). No significant change in IOP was noted at all follow-up intervals. Conclusions:Use of FACI in patients previously treated with DEXI results in anatomical improvement but may be associated with limited visual gain. The use of FACI seems safe without significant change in IOP. Registration: PROSPERO CRD42025635691.

特发性黄斑前膜(IERM)为不明原因的黄斑区视网膜前无血管纤维组织膜形成,对视网膜存在切线及前后方向的牵拉力,能引起视网膜组织扭曲、增厚,是一种临床上常见的导致视力下降及视物变形的黄斑部疾病[1].目前IERM尚无有效的药物治疗,手术剥膜仍是唯一有效的治疗方法.大多数术者习惯性玻璃体腔填充气体,配合患者俯卧位,可以有效顶压眼球后极部,从而有利于减轻黄斑水肿,改善患者的视力[2].但对于高龄、肥胖及基础疾病等全身因素患者,增加了术后俯卧位的风险,给患者的工作、生活带来极大的不便[3].相对于气体填充,平衡液填充不需要俯卧位,对于部分不能耐受俯卧的患者非常有利,但缺少气体的顶压效果,目前是否需要气体填充仍存在争议[4].本研究旨在比较玻璃体切除术联合消毒空气或平衡液填充治疗IERM的疗效,报道如下.

目的 探讨不同鼻用敷料对内镜泪囊鼻腔吻合术疗效的影响.方法 收集 2018 年 1 月至 2021 年 12 月绍兴文理学院附属医院眼科因慢性泪囊炎行内镜泪囊鼻腔吻合术患者(60 眼)的临床资料,进行回顾性分析.根据术中选用不同的鼻用敷料分为透明质酸酯组(23 眼)、明胶海绵组(18 眼)、凝胶组(19 眼),比较各组术后 1 年回访时的溢泪、泪道冲洗及鼻内镜检查情况.结果 透明质酸酯组有效率为 95.7%,明胶海绵组有效率为 77.8%,凝胶组有效率为 84.2%,三组间比较差异无统计学意义(P＞0.05);透明质酸酯组治愈率为 78.3%,明胶海绵组治愈率为 66.7%,凝胶组治愈率为 63.2%,三组间比较差异无统计学意义(P＞0.05).结论 不同鼻用敷料对手术有效率及治愈率影响差异不大.

目的 比较Pentacam与iTrace两种仪器测量白内障患者术前角膜生物学参数的差异.方法 回顾性分析2021年6月-2021年12月浙江省绍兴文理学院附属医院分别行Pentacam和iTrace两种仪器检查的白内障患者86例(122眼),记录其测量的平坦轴角膜曲率(K1)、陡峭轴角膜曲率(K2)、平均角膜曲率(Km)、散光值(A)、角膜球差(SphA)和Kappa角,分析两者的差异性.结果 两种仪器测量的Kappa角差异有统计学意义(P＜0.05),K1、K2、Km、A和SphA差异均无统计学意义(P＞0.05).相关性分析结果显示,两种仪器测量的K1、K2、Km、A、SphA、Kappa角均具有相关性,其中K1、K2、Km和SphA呈高度相关(r＞0.5,P＜0.01).结论 Pentacam与iTrace测量的Kappa角存在差异,不可随意替代,其余参数均具有相关性,临床使用中可相互参考.

BACKGROUND:Myopic foveoschisis (MF) is a common complication of pathological myopia. A macular hole (MH) usually results from the natural progression of MF and is a common complication of vitrectomy. Vitrectomy combined with residual internal limiting membrane (ILM) covering and autologous blood was effective for closing a secondary MH.CASE SUMMARY:A 52-year-old woman presented to our clinic with a complaint of blurred vision in the right eye for 7 years. Her best corrected visual acuity (BCVA) was 20/100, axial length was 25.79 mm and standard equivalent refractive error was -10.5 dioptres. Preoperative optical coherence tomography revealed foveoschisis in the right eye. Vitrectomy with fovea-sparing ILM peeling was performed. An MH developed and gradually expanded 5 mo after the initial vitrectomy. Vitrectomy with residual ILM covering and autologous blood was performed. The MH closed 3 wk after the second vitrectomy.CONCLUSION:Fovea-sparing ILM peeling can provide residual ILM for the treatment of MH secondary to vitrectomy for MF. Vitrectomy combined with residual ILM covering and autologous blood is effective for closing secondary MH and improving BCVA.

目的 观察不同黄斑中心凹形态对特发性黄斑前膜(IERM)手术预后的影响.方法 收集确诊为IERM的66例患者70只眼,根据光学相干断层扫描(OCT)图像测量黄斑中心凹厚度(CMT)和距其水平1mm处视网膜厚度,计算两者比值对黄斑中心凹形态进行分级,根据分级将患眼分成平坦组和隆起组.所有患眼均行最佳矫正视力(BCVA)、OCT检查及玻璃体切割手术.分别记录手术前及手术后1、3个月BCVA、CMT及黄斑中心凹形态,对比观察其变化情况,分析手术前黄斑中心凹形态对IERM手术预后的影响.结果 手术后3个月,黄斑中心凹形态分级变化与手术前差异有统计学意义(P＜0.05).两组1ogMAR BCVA及CMT手术后3个月与手术前差异均有统计学意义(均P＜ 0.05).两组logMAR BCVA差异无统计学意义(P＞0.05).两组手术后3个月CMT差异有统计学意义(P＜0.05).手术后3个月患眼logMAR BCVA与手术前CMT呈负相关(P＜0.05).结论 不同黄斑中心凹形态的IERM患眼早期手术预后存在差异,平坦型优于隆起型.

目的:探讨中医创新管理理念下医学全方位管理的主要方法和管理效果.方法:随机选取2019年1月～2020年5月在医院就诊并接受眼科手术治疗的150例患者为研究对象,随机均分为观察组与对照组各75例.对照组采用常规专科管理模式,观察组采用中医创新管理理念下的专科管理模式,比较两组患者的管理效果.结果:观察组患者的疾病相关知识知晓率、症状控制率、健康教育有效率等,均显著高于对照组(P＜0.05).观察组患者的服药依从、生活质量、自我管理等评分,均显著高于对照组(P＜0.05).结论:从中医创新管理角度出发进行疾病的管理,能够加强专科管理水平,改善医患沟通模式,提升患者的自我管理水平,有助于提升疾病的综合管理质量.

目的 探讨并分析细菌性角膜炎病原学特征、药物敏感性特点及其变迁.方法 回顾性病例研究.收集2011年6月至2018年6月浙江大学附属第二医院眼科中心拟诊感染性角膜炎的培养标本951份,总结并分析患者的一般资料、细菌病原学及药物敏感性试验结果.结果 共收集送检角膜培养标本951份,细菌培养阳性标本105份,占11.0％,其中来自男性患者70份,女性患者35份,男女比例为21,年龄13～82(54.3±17.2)岁.培养阳性的细菌中,革兰阳性球菌59株,占56.2％,革兰阴性杆菌32株,占30.5％.肺炎链球菌(29.5％)最常见,铜绿假单胞菌(19.0％)次之.细菌对10种抗菌药体外药物敏感性试验结果显示,万古霉素、左旋氧氟沙星敏感率高,头孢曲松敏感率低于其他药物.多重耐药菌占总细菌的13.3％,其中葡萄球菌属(43.5％)中多重耐药菌显著高于假单胞菌属(5.0％)(χ2=8.320,P=0.004)及链球菌属(2.8％)(χ2=15.327,P=0.000).结论 近年来,引起角膜感染的细菌种类在发生变化,肺炎链球菌为最常见细菌.角膜细菌对左旋氧氟沙星的敏感率最高,多重耐药菌主要发现于葡萄球菌属中.

Purpose We reported previously that changes in dopamine receptor (DR) subtype activation modulate spontaneous myopia progression in albino guinea pigs. To determine if DR control of refractive error development is different than in its normal counterpart, we evaluated the contribution of dopaminergic pathways to emmetropization and form deprivation myopia (FDM) progression in pigmented guinea pigs. Methods Monocular myopia was induced by unilateral form-deprivation (FD). The effects of agonists of D1R (SKF38393) and D2R (quinpirole), the corresponding antagonists (SCH23390 and sulpiride), and vehicle were tested by peribulbar injection around FD or untreated control eyes. High-performance liquid chromatography with electrochemical detection quantified retinal and vitreous dopamine (DA) and 4-dihydroxyphenylacetic acid (DOPAC) levels. Ocular refraction and axial dimensions were measured using eccentric infrared photoretinoscopy (EIR) and A-scan ultrasonography, respectively, initially and after 2 or 4 weeks of treatment. Results After treatment with any of these four agents for 2 weeks, retinal and vitreal DA and DOPAC levels were not significantly different in drug- and vehicle-treated eyes. Neither agonism nor antagonism of D1R or D2R activity affected emmetropization. In contrast, D1R activation by SKF38393 inhibited FDM progression, while D2R activation by quinpirole augmented this response. On the other hand, D2R antagonism with sulpiride slowed FDM progression while D1R antagonism with SCH23390 had no effect. Conclusions In pigmented guinea pigs, D1R activation inhibited, whereas D2R activation enhanced, FDM. These results closely mirror previous findings in albino animals and offer further evidence that DA and its cognate receptors affect refractive error regulation in guinea pigs.

Objective To investigate the effects of different seasons and time points to outpatient intraocular pressure(IOP) measurements and to guide the IOP measurements of outpatients.Methods A total of 73,520 outpatients IOP measurements in Eye Hospital of Wenzhou Medical University from the beginning of 2013 spring to the beginning of 2014 spring were analyzed.IOP measurements were discussed with the change of seasons and different measurement time points.After Kolmogorov-Smirnov test,the IOP measurements were shown to be non-normal distributed,difference between IOP ofdifferent seasons and different time points were compared using Kruskal-Wallis test.Difference between IOP of right eye and left eyes were compared using Wilcoxon signed ranks test.Results There was a significant difference between IOP of different seasons,measurements were significantly higher in winter than in summer.Median IOP difference between winter and summer was about 1.5 mmHg.In spring,IOP wasrelatively stable,but in other days,IOP was volatile,especially in winter when the greatest volatility occurred.The median IOP fluctuation in winter was about 1.6mmHg.Conclusions The measurements of IOP are relatively stable and reliable in spring.Inother days IOP measurements are volatile,theyshould be measured at multiple time points to better understand of their situations.

PURPOSE. To compare the effects of daily injection versus continuous infusion of a nonspecific dopamine agonist, apomorphine (APO), on refraction and ocular growth in normal postnatal mice and mice with form-deprivation myopia (FDM).METHODS. The C57BL/6 mice were subjected (or not) to monocular FD by covering the left eye with a frosted goggle and leaving the right (fellow) eye uncovered. During postnatal days 28 to 56, both groups received APO (5 mg/kg/d) or vehicle either as daily intraperitoneal injection or by continuous subcutaneous infusion with mini-pumps. After these treatments, binocular refractions were measured by photoretinoscopy and binocular ocular dimensions were measured by optical coherence tomography. Monocular photopic flash electroretinograms were recorded from non-FD mice.RESULTS. In normal mice, daily injection or continuous infusion of APO did not affect normal postnatal development of refraction. However, in the FD group, daily APO-injection attenuated ocular growth and also myopia development, as reflected in the interocular differences for APO-injected mice compared with vehicle-injected mice: (1) refraction, -1.04 +/- 0.37 diopter (D) (APO-injection) compared with -4.14 +/- 0.77 D (vehicle-injection) (P < 0.05); (2) vitreous chamber depth: -0.002 +/- 0.005 mm compared with 0.032 +/- 0.009 mm (P < 0.05); and (3) axial length: 0.000 +/- 0.005 mm compared with 0.057 +/- 0.007 mm (P < 0.05). By contrast, continuous APO-infusion failed to affect these biometric parameters. Furthermore, daily APO-injection decreased the ERG a- and b-wave amplitudes, whereas continuous APO-infusion increased these responses.CONCLUSIONS. In monocularly FD mice, daily APO-injection, but not continuous infusion, attenuated myopia development. Therefore, evaluating different dopamine agonist administration paradigms is important for identifying effective dopamine-based treatment for myopia.

PURPOSEDisruption of dopaminergic signaling has been implicated in the abnormalities of ocular development in albinism, and many experiments have shown that retinal dopamine is a major regulator of postnatal eye growth and myopia in animal models. Therefore, in the present study we investigated whether progressive myopia, which can occur in albino guinea pigs without experimental manipulation of visual conditions, is affected by dopaminergic agents.METHODSTwo-week-old albino guinea pigs, selected for being myopic (range refractive error [RE], -2 to -10 diopters [D]), received unilateral peribulbar injections of apomorphine (nonselective dopamine receptor agonist; 0, 7.5, 25, 75, 250, 750, and 2500 ng; n = 112), SKF38393 (D1-like agonist; 0, 10, 100, 1000 ng; n = 63), SCH23390 (D1-like antagonist; 0, 2500 ng; n = 27), quinpirole (D2-like agonist; 0, 10, 100, 1000 ng; n = 58), or sulpiride (D2-like antagonist; 0, 2500 ng; n = 24) once a day for four weeks. One noninjected group (n = 19) served as untreated control. Refractive states and axial dimensions of the eyes were measured without cycloplegia or general anesthetic, using eccentric infrared photoretinoscopy and A-scan ultrasonography, respectively, before treatment, and after 2 and 4 weeks of treatment. The main drug effects were analyzed by paired t-test or 2-way repeated measures ANOVA, as required.RESULTSThe naturally occurring progression of myopic RE was inhibited by apomorphine at relatively high doses (250 and 750 ng), SKF38393 at 100 ng (D1-like agonist), and sulpiride at 2500 ng (D2-like antagonist), but promoted by apomorphine at a lower dose (25 ng), quinpirole at 100 ng (D2-like agonist), and SCH23390 at 2500 ng (D1-like antagonist). All drugs affected primarily vitreous chamber depth, rather than anterior segment dimensions.CONCLUSIONSOur data suggest that the activation of D1-like receptors inhibits, whereas activation of D2-like receptors promotes, progressive myopia in this animal model. The robust effects of antagonists suggest that ocular dopamine receptors in these albinos may be in a chronic state of partial excitation. The precise location and identity of the receptors responsible for these effects remain to be determined.

Objective To investigate the changes in refraction and ocular biometric parameters in form-deprivation myopia; to try to find the changes in mRNA and methylation in the promoter of the COL1α2 gene during the form deprivation and recovery periods.Methods This was an experimental study to establish the C57BL/6 mouse animal model for form-deprivation myopia and recovery.Mice in the form-deprivation group wore a diffuser on a randomly chosen eye for 4 weeks (n=48) and another group underwent 4 weeks of monocular diffuser treatment followed by 7 days of recovery (n=24).An additional 36 mice without any treatment were the normal control group.Refraction was measured by photoretinoscopy.Vitreous chamber depth (VCD) and axial length (AL) were measured by optical coherence tomography (OCT) with focal plane advancement.The COL1α2 mRNA level in the sclera was determined by real-time PCR and the COL1α2 methylation state was observed by bisulfite DNA sequencing.Data were analyzed using t test.Results After 4 weeks of form deprivation,a significant myopic shift had been induced in the treated eyes compared with the fellow eyes.Before and after the experiment,refractions were-1.89±1.97 D and-3.18±1.09 D (P＜0.05).After 28 days of monocular deprivation (MD),the promoter region of COL1α2 was methylated more frequently in the deprived eyes than in the controls.However,there were no significant differences among the form deprived,fellow and normal control eyes.Conclusion Form-deprivation myopia can be induced in C57BL/6 mice.Scleral COL1α2 mRNA was reduced in MD eyes compared with normal controls,but this change and its gene promoter-region methylation status of CpG island are not related.