Ocular graft-versus-host disease (oGVHD) is an immune disease that occurs in the eye after allogeneic hematopoietic stem cell transplantation and seriously affects the vision and quality of life of patients. Current treatment modalities are inadequate, and new treatment options and targets are required to improve the therapeutic efficacy of oGVHD. In recent years, a large number of studies have shown that exosomes, as important mediators of cell-to-cell communication, have important research value in the pathogenesis, diagnosis, and treatment of oGVHD. This article reviews the research progress on exosomes from different sources of oGVHD.

Retinal ischemia‐reperfusion (RIR) injury induces oxidative stress, excitotoxicity, inflammation, and ferroptosis, which interact through complex crosstalk, forming a retinal pathological microenvironment (RPMe) that drives retinal ganglion cell (RGC) death. Central to these processes is the dysregulation of the neuroimmune microenvironment (NiMe), characterized by aberrant microglial activation around RGCs and immune signaling imbalances. Here, through analysis of single‐cell RNA sequencing, it identifies significant activation of the sphingolipid signaling pathway in RIR‐injured retinal microglia, which crosstalks with immune signaling pathways. This crosstalk disrupts NiMe homeostasis. To address this, a biomimetic nanoparticle system coated with retinal precursor cell membranes is developed. This system co‐delivers a CRISPR/Cas9‐based Acyl‐CoA synthetase long‐chain family member 4 (ACSL4) inhibitor to suppress ferroptosis and sphingolipid signaling and isorhamnetin, a natural molecule is identified to directly bind protein kinase A to inhibit the glutamatergic synapse signaling pathway involved in oxidative stress. By targeting sphingolipid signaling and its crosstalk with PI3K/AKT and ASK1/JNK/NF‐κB pathways in microglia, as well as glutamatergic synapse signaling and ferroptosis in RGCs, this system restores NiMe balance. The retinal precursor cell membrane‐coated nanoparticle offers a novel, synergistic, and targeted therapeutic strategy for RIR‐related retinal diseases by integrating CRISPR/Cas9 technology with natural product molecule therapy.

Ocular diseases associated with fundus damage, such as age-related macular degeneration, diabetic retinopathy, and retinal neovascularization, represent significant contributors to severe vision impairment globally. Traditional treatment methods often face challenges, including low drug delivery efficiency, poor bioavailability, and substantial side effects. Nanozymes, a class of enzymatically active nanomaterials, have recently emerged as a promising therapeutic approach to ocular diseases. These nanozymes can effectively alleviate oxidative stress, modulate local immune responses, and inhibit pathological angiogenesis by scavenging reactive oxygen species and regulating inflammasome activation. This review aims to elucidate the mechanisms of action of various types of nanozymes as well as the pathophysiological mechanisms underlying ocular diseases that cause fundus damage. Furthermore, it discusses recent advancements in the use of nanozymes for treating fundus-related ocular disorders. Finally, this review highlights the current limitations and future directions for nanozymes in the treatment of fundus injury-associated diseases.

BackgroundGraft-versus-host disease (GVHD) is a life-threatening complication of allogeneic hematopoietic stem cell transplantation that impairs clinical outcomes. Existing classification systems for GVHD biomarkers remain fragmented, which limits cross-study data integration and clinical translation, creating an urgent need for a systematic classification framework.Materials and methodsIn this review, a predefined search strategy was used to systematically evaluate the classification systems of GVHD biomarkers. For the search, a systematic literature retrieval was conducted in the PubMed and Web of Science databases, covering the time range from 2012 to 2025, with keywords including “GVHD,” “biomarkers,” and “classification and summarization.” The inclusion criteria for studies were as follows, focusing on the classification or clinical application of GVHD biomarkers: peer-reviewed original articles, reviews, or multicenter trials, and human subjects or well-validated mouse models. After screening, a total of 139 articles were included in this review.ConclusionThis review integrates GVHD biomarkers into a three-dimensional system, including pathophysiological mechanisms, clinical application scenarios, and molecular characteristics. It identifies key challenges in biomarker research and application, and proposes feasible integration pathways. This work provides a foundational framework for precision medicine in GVHD management.

OBJECTIVE:This study aims to present a unique case of acanthamoeba keratitis (AK) with a delayed diagnosis and prolonged usage of glucocorticoid eye drops. Subsequently, the patient developed cytomegalovirus corneal endotheliitis (CMVCE), leading to severe ocular complications. To the best of our knowledge, this is the first documented case of confirmed CMVCE subsequent to AK. METHODS:A 32-year-old male patient with a history of contact lens usage and extended administration of glucocorticoid eye drops for keratitis underwent deep anterior lamellar keratoplasty (DALK) in the left eye. The diagnosis of AK was delayed by 4 months. Following corneal endothelial decompensation, penetrating keratoplasty (PKP) was performed 5-month post-DALK. Intraoperatively, the presence of CMV in aqueous humor and corneal tissue was confirmed using multiplex qPCR, validating the diagnosis of CMVCE. Despite aggressive antiviral therapy, the patient's left-eye condition continued to worsen, leading to a combined phacoemulsification and trabeculectomy in the left eye, as well as supplementary Ahmed valve drainage. RESULTS:Following four surgical procedures and subsequent follow-up, the patient's left-corneal graft remained clear, intraocular pressure was well-regulated, the eye was preserved, and some degree of vision was retained. CONCLUSION:CMVCE subsequent to AK represents a severe form of infectious corneal keratopathy. In AK patients experiencing unexplained corneal endothelial decompensation, mydriasis, iris atrophy, concurrent cataract, and secondary glaucoma post-keratoplasty, a reoccurrence of AK should not be considered in isolation. CMV infection should also be suspected, and an aqueous humor test should be conducted to confirm the diagnosis.

This case report discusses a diagnosis of thelaziasis in a female patient aged 81 years who presented with a foreign body sensation in the left eye for 1 month.

To the Editor : Post-vitrectomy vitreous hemorrhage (PVH) is one of the most common complications of vitrectomy. [1-3] Unfortunately, there have been no studies on how to adopt a conservative approach to PVH. We describe a method that eliminates the need to go to the operating room and mechanically accelerates the removal of PVH. This was a prospective study of 15 patients with unexplained PVH who were treated with a three-step method of mydriasis in the prone position followed by anterior chamber (AC) paracentesis. This study was approved by the EthicsCommittee of WeifangEye Hospital and conducted in accordance with the Declaration of Helsinki . All the patients signed an informed written consent form. All consecutive patients met the following inclusioncriteria:(1)grade1or2vitreoushemorrhage(VH

Inflammation plays a pivotal role in ischemia-induced retinal neovascularization. Targeting microglia/macrophage-based neuroinflammation presents a promising therapeutic strategy. Ferulic acid (FA), a natural and active ingredient in plants, exerts favorable anti-oxidative and anti-inflammatory activities. In this study, we investigated the inhibitory effect of FA against hypoxia-induced retinal angiogenesis using cultured retinal vascular endothelial cells and an oxygen-induced retinopathy mouse (OIR) model. The immunoregulatory effect of FA on microglia/macrophage polarization was evaluated by detecting the expression of specific markers for both pro-inflammatory "M1" and anti-inflammatory "M2" phenotypes using co-immunostaining and polymerase chain reaction assays. The underlying molecular mechanism upon FA treatment was also explored. The results showed that FA supplement markedly inhibited retinal pathological angiogenesis both in vivo and in vitro. In addition, FA switched microglia/macrophage polarization from "M1" towards "M2" phenotype and alleviated the inflammatory response. Mechanically, the anti-angiogenic and anti-inflammatory properties of FA were mainly due to blockade of the ROS/NF-κB pathway. Our data demonstrated an anti-angiogenic effect of FA through regulating M1-to-M2 microglia/macrophage polarization, suggesting a potential therapeutic strategy for retinal neovascular diseases.

1 病历资料 患者男,73岁,因发现糖尿病23年,左眼视物不清1个月,于2017月10月19日住院治疗. 患者既往糖尿病23年,左眼白内障超声乳化联合人工晶体植入术5个月,右眼白内障超声乳化联合人工晶体植入术+玻璃体切割+剥膜+视网膜激光光凝术1个月.入院检查:右眼视力0.4,矫正无助,角膜透明,前房深度可,房水清,虹膜纹理清晰,瞳孔圆,直径约3.0 mm,对光反应灵敏,人工晶体位正,玻璃体腔清,眼底视盘界清色可,黄斑中心凹反射未见,视网膜在位,可见散在出血,陈旧性激光斑可见,眼压15.0 mmHg. 左眼视力0.4,矫正无助,角膜透明,前房深度可,房水清,虹膜纹理清晰,瞳孔圆,直径约3.0 mm,对光反应灵敏,人工晶体位正,玻璃体积血、增殖,眼底视盘界清色可,黄斑中心凹反射未见,后极部及下方视网膜前可见增殖膜牵连,陈旧性激光斑可见,眼压13. 0 mmHg.2017年10月19日眼部B超示左眼玻璃体腔探及密集弱点状低回声,伴有明显玻璃体机化、少许牵连改变,视网膜平伏. 初步诊断:玻璃体积血(左眼),糖尿病性视网膜病变(左眼),白内障超声+人工晶体植入+眼内激光术后(左眼),糖尿病性视网膜病变玻璃体切割+白内障超声乳化+人工晶体植入+眼内激光术后(右眼) ,2型糖尿病,高血压2级.

The authors describe a patient with Parry-Romberg syndrome (PRS) who had acquired monocular elevation deficit (MED), ptosis, and facial hemiatrophy. A 12-year-old female patient manifested progressive ptosis and hypotropia companied with progressive hemifacial atrophy was conducted to the ophthalmology clinic for diagnosis and treatment. Forced duction and generation testing confirmed that her incomitant hypotropia was caused by paralytic muscles and not due to restriction, so it was diagnosed as MED. Knapp procedure was conducted to correct her eye positions. Six months later, the frontal muscle suspension surgery was performed to treat her ptosis. Postoperatively, the patient had orthotropia without residual left hypotropia in the primary position and her left upper eyelid function improved significantly. The ocular motor defect, in this case, is best explained by nerve paresis rather than muscle fibrosis.

This study aimed to evaluate the effect of a combined fascia sheath (CFS) suspension for treating moderate to severe ptosis and analyze the effect of the two surgical methods on postoperative upper eyelid movement. A total of 150 patients with moderate to severe ptosis of the upper eyelid were included. The CFS suspension was used in the study group, while the frontal muscle flap suspension was used in the control group. The total effective correction rate was significantly higher in the study group than in the control group (94.67% vs 66.67%; P < 0.001). The range of upper eyelid movement and tear film distribution were significantly better in the study group than in the control group 1 week, 1 month, 3 months, 6 months, and 9 months after the operation (P < 0.001). The incidence of retardation and dysraphism of the upper eyelid was lower in the study group than in the control group (P < 0.001). The total incidence of complications was 6.48% vs 36.11% (study group vs control group). The incidence of complications in the study group was significantly lower than that in the control group (P < 0.001). The CFS suspension was more effective than the frontal muscle flap suspension for correcting moderate to severe ptosis, lifting the upper eyelid, and recovering upper eyelid movement. Its use can effectively reduce adverse reactions and complications, making it worthy of clinical application and recovering upper eyelid movement. Its use can effectively reduce adverse reactions and complications, making it worthy of clinical application and promotion.

Exposure keratitis refers to corneal inflammation caused by corneal dryness, epithelial exfoliation and secondary infection when the cornea loses the protection of the eyelid and is exposed to air. It is a potentially vision-threatening disease and is not uncommon in clinical work, so the treatment and prevention of exposure keratitis remain important. This article reviews the treatment and research progress of exposure keratitis.

Objective To evaluate the efficacy of Knapp procedure (full tendon width vertical transposition of horizontal recti) for the treatment of double elevator palsy (DEP).Methods A retrospective study was taken to analyze the efficacy of the Knapp procedure and the postoperative stability of alignment on the magnitude of correction.Six eyes of six patients with DEP underwent Knapp procedure.Results Postoperatively,the function of eyeball upward movement was improved in 6 eyes.Ocular motility was elevated over midline 15° in 4 eyes and over the midline within 5°-10° in 2 eyes.No case had been limited in downgaze.The preoperative average vertical deviation was (29.2 ± 9.7) PD (prism diopter) (range 20-45 PD).Four eyes were corrected within 5 PD of orthophoria and no one was found with overcorrection over 12-24 months follow-up.The average vertical correction of Knapp procedure was (24.5 ± 7.1) PD.The mean postoperative deviation in 1 month and over 12 months were (11.7 ± 6.1)PD and (4.7 ± 2.9) PD respectively (P ＜ 0.05).The average magnitude of drift was (7.0 ± 5.4) PD.Conclusion The Knapp procedure can effectively correct the hypotropia in patients with DEP and it has an increased effect over time.

痛性眼肌麻痹综合征（Tolosa-Hunt 综合征，TS H）特指因海绵窦、眶上裂或眶尖部非特异性肉芽肿性炎症导致的痛性眼肌麻痹，主要表现为一侧眶周痛或头痛伴同侧眼球运动神经麻痹、眼交感神经麻痹以及三叉神经眼支和上颌支分布区感觉减退，糖皮质激素治疗有效，有复发和缓解过程，该病在临床中较少见［1］，发病机制不明确，推测与病毒感染及感染后神经脱髓鞘关系密切［2］。临床症状易与动脉瘤、海绵窦病变、眶上裂肿瘤和炎症混淆，在眼科较为少见。

Previous studies suggested that neurotrophins play a role in the diabetic retinopathy (DR). We therefore evaluated the role of plasma brain derived neurotrophic factor (BDNF) levels in Chinese type 2 diabetic patients with and without diabetic retinopathy (DR). Plasma levels of BDNF were determined in type 2 diabetic patients (N=344). At baseline, the demographical and clinical data were taken. Multivariate analyses were performed using logistic regression models. Receiver operating characteristic curves (ROC) was used to test the overall predict accuracy of BDNF and other markers. Diabetic patients with DR and vision-threatening diabetic retinopathy (VTDR) had significantly lower BDNF levels on admission (P<0.0001 both). BDNF improved the area under the receiver operating characteristic curve of the diabetes duration for DR from 0.76 (95% confidence interval [CI], 0.71-0.82) to 0.89 (95% CI, 0.82-0.95; P<0.01) and for VDTR from 0.84 (95% CI, 0.78-0.92) to 0.95 (95% CI, 0.90-0.98; P<0.01). Multivariate logistic regression analysis adjusted for common risk factors showed that plasma BDNF levels≤12.4 ng/mL(1(rd) quartiles) was an independent marker of DR (OR=3.92; 95%CI: 2.31-6.56) and VTDR (OR=4.88; 95%CI: 2.21-9.30). The present study demonstrated that decreased plasma levels of BDNF were independent markers for DR and VDTR in Chinese type 2 diabetic patients, suggesting a possible role of BDNF in the pathogenesis of DR complications.

患者，女，68岁，因“左眼球胀痛伴视物模糊2 d”就诊于我院。入院查体：左眼视力：眼前手动，左眼混合充血，角膜水肿，前房极浅，周边小于1／4CT，左眼瞳孔中度散大，晶体混浊膨胀，眼底看不见。眼压大于60 mmHg。诊断为“左眼原发性闭角型青光眼急性发作期、左眼老年性白内障膨胀期”。入院后给予静脉滴用甘露醇、口服醋甲唑胺，局部给予毛果芸香碱、噻码洛尔、哌立明眼液滴眼，第2天眼压无明显缓解，即给予左眼 YAG 激光虹膜周切术治疗，第3天眼压控制仍不明显，患者仍然眼球胀痛、头痛，即在裂隙灯下给予左眼前房穿刺放液，一日2次，患者症状轻度好转。第4天患者角膜仍然水肿明显，前房浅，瞳孔中度散大，晶体混浊。考虑单纯药物治疗，患者左眼眼压难以控制在正常范围内，遂给予左眼行“复合式小梁切除术”，术中给予前房穿刺放液，并给予填充玻璃酸钠维持前房。

Background: Mannose-binding lectin (MBL) may be implicated in the pathogenesis of diabetic retinopathy (DR) complications. We investigated serum MBL levels in type 2 diabetic patients with and without DR.Method: Serum MBL levels were determined in 184 type 2 diabetic patients with DR and 189 type 2 diabetic patients without DR matched for age, sex, and duration of diabetes. Multivariate analyses were performed using logistic regression models. The diagnostic value of MBL was compared with the HbA1c, Hs-CRP and with other known markers.Results: We found that serum MBL levels were significantly higher in diabetes with DR as compared to without-DR [3456 (IQR, 3128-3800) ug/l and 2432 (IQR, 2100-2670) ug/l, respectively; P < 0.0001]. In multivariate logistic regression analysis, after adjusting for all other significant factors, MBL remained can be seen as an independent DR marker with an adjusted OR of 1.002 (95% CI, 1.001-1.003; P < 0.0001). Based on the ROC curve, the optimal cutoff value of serum MBL levels as an indicator for diagnosis of DR was projected to be 3050 ug/L, which yielded a sensitivity of 82.5% and a specificity of 88.0%, with the area under the curve at 0.907 (95% CI, 0.876-0.938).Conclusion: In type 2 diabetic patients, evaluated serum levels of MBL can be seen as an independent marker of DR even after correcting for possible confounding factors. (C) 2015 Elsevier Inc. All rights reserved.

脉络膜脱离是青光眼滤过术后常见的并发症之一[1-2],虽然绝大多数脉络膜脱离不需要手术干预[3],但对于那些虽经积极保守治疗,脉络膜脱离持续存在超过1周且没有缓解倾向,特别是当出现角膜内皮与晶状体或人工晶体接触时,则往往需要采取手术甚至急症手术干预以恢复其解剖和功能,防止并发症的发生[4-5].本文将介绍玻璃体腔穿刺"两针法"在青光眼术后脉络膜脱离术中的应用.

患者女,69岁.因左眼视力下降2年加重3个月于2009年2月17日以"左眼老年性白内障"收入莱阳市中医医院眼科.眼科检查:右眼视力0.6,左眼视力0.06.Canon非接触眼压计检查:右眼眼压14 mm Hg(14 mm Hg=0.133 kPa),左眼眼压16 mm Hg.裂隙灯显微镜检查:右眼晶状体轻度混浊,左眼晶状体成熟期混浊.2月21日在表面麻醉下行左眼超声乳化白内障吸除手术,植入Canon Staar Ks-X预装式疏水性丙烯酸脂人工晶状体(IOL).