Background: Visual impairment is increasingly prevalent, underscoring the need for effective prevention strategies. This study investigated the association between cardiovascular health and visual impairment using three progressively developed metrics: Life’s Simple 7 (LS7), a cardiovascular health score developed by the American Heart Association based on 7 components, including physical activity, smoking status, body mass index (BMI), diet, blood glucose, blood pressure, and total cholesterol; Life’s Essential 8 (LE8), which adds sleep health as an additional component; and Life’s Crucial 9 (LC9), which further incorporates mental health. We aimed to evaluate whether these expanded metrics provide additional explanatory value and to inform future public health strategies. Objective: To investigate the associations among LS7, LE8, and LC9 cardiovascular health scores and visual impairment in National Health and Nutrition Examination Survey 2013 to 2018, assess the added value of sleep and mental health components, and identify key contributing subcomponents using regression and machine learning methods. Methods: We analyzed data from 9891 participants in the 2013 to 2018 National Health and Nutrition Examination Survey. Multivariable logistic regression, restricted cubic spline modeling, and subgroup analyses were conducted to evaluate the association between cardiovascular health and visual impairment. Machine learning methods, including Random Forest and SHapley Additive exPlanations, a model interpretation approach used to assess feature importance, were applied. The Boruta algorithm, a feature selection method, was used to identify key subcomponents of cardiovascular health. Results: Participants with visual impairment were older, had lower poverty-to-income ratios, and exhibited lower cardiovascular health scores (LS7, LE8, and LC9). Higher cardiovascular health scores were negatively associated with visual impairment. Each one standard deviation increase in LS7, LE8, and LC9 was associated with approximately 8%, 2%, and 3% lower odds of visual impairment, respectively. LS7 showed the strongest negative association, whereas LE8 and LC9 emerged as the most important predictors in the machine learning models. Key subcomponents such as blood glucose, blood pressure, and BMI, as well as mental health status, were strongly associated with visual impairment. Conclusion: Higher cardiovascular health scores were negatively associated with visual impairment. LS7 demonstrated the strongest statistical association, whereas LE8 and LC9 were the most influential features in the machine learning models. Blood glucose, blood pressure, BMI, and mental health status were important correlates of visual impairment. From the perspective of the “prevention and treatment of diseases” in traditional Chinese medicine and the holistic concept, the aforementioned research findings confirm that severe visual impairment is indeed an external manifestation of overall health imbalance (such as organ dysfunction and Qi deficiency and blood stasis). The prevention strategy lies in comprehensively adjusting lifestyle, emotional factors, and metabolic indicators (corresponding to the key factors in the study) to restore the body’s internal balance and achieve prevention before disease arises.

To evaluate the effects and safety of auricular acupressure combined with periocular thumbtack needle (AATN) therapy for premyopia children. This multi-center, randomized, controlled trial was conducted in 8 Chinese hospitals, and 298 premyopic children aged 6 to 10 years were recruited between October 2020 and February 2022. Eligible participants were randomly assigned to the treatment group or the control group via a simple randomization method. All the participants in both groups were provided with standard intensive eye health instruction through phone calls, WeChat or hospital visits once a week, and the children in the treatment group received AATN therapy additionally. Following 12-week treatment, participants were followed up at 3-month intervals, with the entire study extending over a 9-month duration from baseline to the final assessment. The primary outcome was the mean change in spherical equivalent (SE) from baseline to 36 weeks. The secondary outcomes included the rate of children with stable myopia (MSR), uncorrected visual acuity (UCVA), axial length (AL), corneal curvature (CC), accommodative amplitude (AMP) and intraocular pressure (IOP) at baseline, 6,12, 24 and 36 weeks. Safety assessment included analysis of treatment-related adverse events (AEs), such as allergic reactions and skin damage. Totally, 298 children with premyopia were included, 151 in the treatment group and 147 in the control group. At the 36th week, the SE was −0.81±0.55 D in the control group and −0.65±0.44 D in the treatment group (P=0.002). The treatment group demonstrated superior SE control efficacy compared with the control group, with differences of −0.29±0.37 D and −0.49±0.44 D, respectively (P<0.01). The children in the treatment group achieved a MSR of 57.78

Background: The increasing prevalence of myopia among Chinese children and adolescents, especially at younger ages, has emerged as a significant concern in recent years. Pre-myopia is a key period for myopia prevention and control in children and adolescents. Previous studies suggested auricular acupressure (AA) therapy might offer a viable approach to prevent and slow down myopia progression. Nonetheless, these studies lack robust, high-quality, large-scale, multi-center evidence to conclusively support such assertions. The purpose of this research is to evaluate the efficacy, safety, and economic benefits of AA therapy in preventing myopia in Chinese children aged 6–12 years with pre-myopia. Methods: The single-blind, multi-center, parallel-group, randomized controlled trial will involve 318 pre-myopic children from 20 different centers across China. After recruitment, these participants will be randomly assigned to two groups (the AA group and the control group) at a 1:1 ratio. The AA group will receive auricular point sticking therapy along with health education for a period of 24 weeks, while the control group will be provided the sham AA treatment and routine health education. The assessments of outcomes will be conducted at the start of this study, and then after 4, 8, 12, and 24 weeks. The primary outcome is the change in spherical equivalent refraction at various follow-up times. The secondary outcomes include the number of myopia cases, uncorrected visual acuity, axial length, corneal curvature radius, accommodation amplitude, retinal and choroidal thickness, and eye behavior management. In addition, the cost-effectiveness analysis will be used as the evaluation index for economic assessment. Discussion: The results of this research will provide evidence on the efficacy, safety, and economic benefits of AA therapy in preventing myopia among children aged 6–12 years with pre-myopia in China.

OBJECTIVES:To observe the clinical effect and safety of auricular point sticking combined with periocular needle-embedding therapy for pseudomyopia and prevention of true myopia. METHODS:A total of 269 children with pseudomyopia were randomized into an observation group (134 cases, 2 cases dropped out) and a control group (135 cases, 5 cases dropped out). In the control group, the healthy education was provided. In the observation group, besides the intervention as the control group, the auricular point sticking was delivered at gan (CO12), pi (CO13), xin (CO15) and yan (LO5) on one ear in each treatment, combined with periocular needle-embedding technique at bilateral Cuanzhu (BL 2), Yuyao (EX-HN 4) and Sibai (ST 2). There were 2 weeks of interval after 4 weeks of treatment. One course of treatment was composed of 6 weeks and 2 courses were required. Separately, before treatment, after 6 and 12 weeks of treatment, and after 12 weeks (the 1st follow-up visit) and 24 weeks (the 2nd follow-up visit) of treatment completion, the spherical equivalent (SE), SE progression, axial length (AL) progression, accommodative amplitude (AMP), the score of the TCM symptom and the general symptom were observed in the two groups. The safety and compliance were evaluated in the two groups. RESULTS:After 6 and 12 weeks of treatment, and in the 1st and 2nd follow-up visits, SE increased when compared with that before treatment in the two groups (P<0.05), and AMP was larger than that before treatment in the observation group (P<0.05). After 12 weeks of treatment, and in the 1st and 2nd follow-up visits, the progression of SE was slower in the observation group compared with that in the control group (P<0.01, P<0.001). After 6 and 12 weeks of treatment, and in the 1st and 2nd follow-up visits, the progression of AL in the observation group was lower than that of the control group (P<0.05, P<0.01, P<0.001); and in the 1st and 2nd follow-up visits, AMP of the observation group was larger when compared with that in the control group (P<0.05, P<0.001). After 6 and 12 weeks of treatment, and in the 1st and 2nd follow-up visits, the total scores of TCM symptom and general symptom were reduced in comparison with those before treatment in the observation group (P<0.05); after 6 and 12 weeks of treatment, the total scores of TCM symptom and general symptom were lower than those before treatment in the control group (P<0.05). In the 1st and 2nd follow-up visits, the difference of the total score of TCM symptom and general symptom in the observation group was larger than that of the control group (P<0.05). In the observation group, compared with the control group, the scores for pale/dark complexion in the 1st and 2nd follow-up visits and that for lassitude in the 2nd follow-up visit were lower (P<0.05), the score for poor concentration after 12 weeks of treatment and that for poor sleep and memory in the 2nd follow-up visit were lower (P<0.05). There were no adverse reactions in the two groups. The compliance was 98.5% in the observation group and was 96.3% in the control group, without statistical difference (P>0.05). CONCLUSIONS:On the basis of health education, auricular point sticking combined with periocular needle-embedding therapy can effectively prevent from true myopia, control the increase of SE, delay the growth of AL and improve AMP in children with pseudomyopia. This compound therapeutic regimen can relieve the general symptom and comprehensively prevent from myopia through multiple approaches, with high safety and satisfactory compliance.

·Diabetic retinopathy(DR)is one of the major complications of diabetes mellitus,characterized by neurodegeneration and microangiopathy.Currently,the treatment of DR is mainly focused on the management of late complications and has not achieved the desired clinical outcome.Evidence suggests that the PI3K/AKT pathway,as one of the important intracellular signaling pathways during the cell cycle,is involved in the whole process of DR pathogenesis.This article focuses on the structural composition,activation and blocking pathways,conduction pathways,regulatory mechanisms and biological functions of the PI3K/AKT signaling pathway to review its role in DR and to explore the potential of targeting the PI3K/AKT pathway for the treatment of DR.

Introduction: This study aimed to explore the effect and molecular mechanism of Tetrandrine (Tet) onlipopolysaccharide (LPS)-induceduveitis andoptic nerve injury in vivo and in vitro. Methods: Uveitis was induced by LPS injected into the hindlimb foot pad of Wistar rats and was intervened by retroeyeball injection of Tet (100 nM, 1 μM or 10 μM).The anterior segment inflammation was observed by slit lamp. Tunelassay was used to detect the survival state of ganglion cells and nuclear layers of inner and outer. The detection of characteristic markers in different activation states of glial cells were performed by qualitative and quantitative test of immunofluorescence and western blotting. Also, western blotting was used to detect the expression of inflammatory factors in retina and the activation of nuclear factor kappa B (NF-κB) signal pathway. Meanwhile, routine blood test and function of liver and renal were performed. Results: The ciliary hyperemia was obvious, and the iris vessels were dilated and tortuous in rats with LPS-induced uveitis. Tet-pretreated obviously elieved these symptoms. In addition, the dilation and hyperemia in Tet group were alleviated compared with LPS group, and the inflammatory scores in Tetgroup were significantly lower than those of LPS group. TUNEL Staining showed that the number ofretinal ganglion cell (RGCs) in Tetgroup was slightly less than that in normal group, but significantly more than that in LPS group, and the cells arranged orderly. Besides, the number of apoptotic cells was significantly less than that in LPS group. Tet reduced LPS-activated gliocyte in a dose-dependent manner. Tumour necrosis factor alpha (TNF-α), interleukin (IL)-1β, interferon gamma (γ-IFN) and IL-2 in retina were increased by LPS but decreased significantly viaTet-pretreatment. Moreover, LPS activate NF-κB signal pathway, while Tet efficiently inhibited this effect.Furthermore, injection of Tet did not damage theroutineblood, liver and kidney. Conclusions: Retrobulbar injection of Tet significantly alleviatedLPS-induced uveitisand optic nerve injuryof rats by activating gliocyte and NF-κB signaling pathway.

The novel inflammatory markers neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and systemic immunoinflammatory index (SII) have not yet been used in the study of age-related cataracts. The aim of this study was to investigate the possible relationships between the NLR, PLR, and SII and age-related cataracts. In the 2005-2008 National Health and Nutrition Examination Survey (NHANES) cross-sectional surveys, we collected complete information on blood counts, whether cataract surgery had been performed, and baseline information for adults. We investigated the independent interactions between the inflammatory markers NLR, PLR, and SII and age-related cataracts via weighted multivariate regression analyses and subgroup analyses. Smoothed curve fitting was performed to identify nonlinear associations and saturation effects between inflammation indices and cataract risk. Finally, receiver operating characteristic (ROC) curves were plotted for factors significantly associated with the development of cataracts to identify the optimal diagnostic inflammation index. This study included 8887 participants without cataracts and 935 participants with cataracts. Multivariate logistic regression analyses after adjusting for covariates revealed that a high SII (OR = 1.000, 95% CI = 1.000-1.000; P = 0.017) and high NLR (OR = 1.065, 95% CI = 1.000-1.134; P = 0.048) were independent risk factors for cataracts. Subgroup analyses did not reveal interactions between the SII, NLR, or cataract and covariates. Smoothed curve fits of the relationships between the SII or NLR and cataracts did not show positive significant saturating effect values for any of the variables. The ROC curve revealed some diagnostic value for cataracts for both the SII (AUC = 0.549, P < 0.001) and the NLR (AUC = 0.603, P < 0.001), but both had weak diagnostic value. Our study suggests that the SII and NLR are independent risk factors for cataracts in U.S. adults, but no such associations was identified between the PLR and cataracts.

伏邪理论博大精深,源远流长,肇始于《黄帝内经》,发展于王叔和,成熟于明清.从病因学角度而言,眼病的发病多由外邪蛰藏,内因隐伏,诸邪夹杂,应时而动,与伏邪致病有相似之处,如外障眼病之病毒性角膜炎、内障眼病之葡萄膜炎、中心性浆液性脉络膜视网膜病变、青光眼等.本文从伏邪释义、伏邪分类、致病特点、伏邪眼病的病因病机等方面展开论述,提出:正气亏虚是伏邪产生的基础;伏邪致病或由外而感,或由内而生,抑或两者相因为病,共同侵害机体;治疗眼病以祛邪扶正为根本法则;辨证治疗时,需把握好扶正与祛邪的关系,视扶正固本,培补脾肾;须重视从未病先防、已病防变的角度辨治此类眼病,彰显了以预防为先,以防变为要.

随着知识竞争加剧和科技电子化飞速发展,近视已经成为我国乃至全球的重大公共卫生问题,具有低龄、高发、进展快的特点,且病理性近视致盲率高,严重影响国民视觉健康,近视防控已上升为国家重大战略需求.中医药在干预近视各个阶段均独具特色和优势,本文将从病因、病机、治则治法等方面系统地阐述中医眼科学近视"久视伤血"理论,并结合中医治未病思想,未病先防,针对未近视人群,予以生活学习方面的指导建议,预防近视发生.既病防变,针对已近视人群,提出治病求本,行气活血、益气养血、补肾养血的治则治法,灵活运用中医特色适宜技术和各类养血中药复方,控制近视进展,治疗病理性近视并发症.以"久视伤血"理论指导近视全周期干预措施,以期实现近视的早防、早控、早治,降低近视患病率和致盲率.

With the development of society, the incidence of myopia and the population of myopia has increased year by year, which has become a major public health problem. Therefore, the research on the pathogenesis and prevention and control measures of myopia is imminent. In recent years, the role of the biological clock in the development of myopia has gradually attracted scholars interest. Now the author starts from the impact of the biological clock on the axial length, retina and choroid in the development of myopia. In order to provide new ideas for the study of prevention and control measures and the pathogenesis of myopia, a brief review is made from the perspective of contemporary society and disrupted body clock.

翼状胬肉是一种常见的眼表疾病,当其侵犯角膜时会导致视力受损.翼状胬肉发病率高,且术后极易复发.近年来有大量学者从蛋白和基因的角度开展研究,认为遗传因素在翼状胬肉的发病中具有重要作用.本文对当前发现的与翼状胬肉相关的蛋白和基因进行梳理,发现血管内皮生长因子、缺氧诱导因子、酪氨酸激酶受体4、环氧化酶2、转化生长因子、活性氧调节因子、细胞增殖因子、细胞凋亡因子等蛋白和基因与翼状胬肉的发病和复发具有相关性,并简要阐述上述蛋白和基因影响翼状胬肉发病与复发的内在机制,发现将它们作为干预靶点可有效降低发病率及术后的复发率.本研究为精准医学干预在翼状胬肉治疗中提供一定的参考.

和血明目片是治疗眼底出血类疾病的有效方药,具有养肝、明目、和血、止血、清热、行气、祛湿等多种功效.本文就和血明目片的组方特点及临床功效进行总结,发现和血明目片针对糖尿病性视网膜病变、视网膜静脉阻塞、湿性年龄相关性黄斑变性的治疗效果较好.但临床治疗上仍存在不足,尚无相关研究从分子生物学水平阐释和血明目片治疗眼科疾病的药理机制,治疗上对临床患者的中医证候结合不足.

目的:阴阳属性理论源流肇始于先秦,形成于明代,至清朝逐渐系统化.亢泽峰教授创新性地明确提出了目具有"体阴用阳"生理特性,即"目体阴而用阳".生理上表现为"目体"决定"目用","目用"辅助"目体",二者相互为用、互为根本;病理上"目体""目用"相互影响.临床上若目体之真精、真血不足或运行迟缓、目得不到津液之濡养,则目不能视万物而辨五色.若"目用"过度,即如果长时间过用目力则耗伤"目体"之阴血,表现为眼干、眼涩、视物昏花等."目用"影响"目体"还体现在阳气的推动、蒸腾、温煦等作用异常,导致阴血、津液运行的失常.治疗总则可概括为理气血、护气阴、通目络,以维持"目体"(阴)"目用"(阳)的动态平衡为关键所在.

麦粒肿是眼科常见的眼表疾病,由于个人用眼卫生不良及用眼习惯不当,该病常呈反复发作的特点,小儿及免疫力低下者多见.西医在治疗方面主要应用抗生素等药物及外科手术治疗,手术治疗易留瘢痕,且儿童配合较差,存在一定局限性.中医在治疗反复发作的麦粒肿方面具有优势,内治配合外治能够取得明显的疗效.亢泽峰基于"正气存内,邪不可干"等理论,总结多年临床经验,认为其病因多为体内正气不足,风热之邪上扰头目,不能驱邪外出所致,临床上以扶正祛邪为治疗要点,在仙方活命饮的基础上进行加减,配合外用眼膏、热敷等治疗,临床疗效甚佳.此外,指导患者平时多注意用眼卫生及用眼习惯,提高自身抵抗力,避免其反复发作.

亢泽峰教授根据36年的临床经验,以中医理论为指导,继承和发展络病学说,创新性的提出了瞳神络病理论.本文探讨"瞳神络病"理论在糖尿病视网膜病变(DR)诊疗中的作用,抓住瞳神络病"久""瘀""顽""杂""固"的共性特征,通过整体与局部辨证相结合,提出气阴两虚、痰瘀互结、毒积目络、饮停目络虚等病机.针对"虚、实、瘀、热"的病机特点以及病络、败络的病理表现,确立"通目络、调气血、护气阴"的治疗原则,并创新性的提出"治目络八法",与辨证论治相结合治疗本病,用药上重视虫类药物的应用,重视通目络时顾护正气.以期为本病的提供新的治疗思路,取得更好的疗效.

文章以"瞳神络病"理论为指导,探讨络病在视网膜静脉阻塞性黄斑水肿发病中的作用.提出络脉闭阻、血瘀水停的发病机制.在整体与局部辨证相结合的基础上,针对本虚标实,病位在络,络阻水停的病机特点,以通络活血利水为治法,临证重视辛味和虫类药物的应用以及破血行血药物的用量.

目的:系统评价病理性近视黄斑出血中药干预的临床效果及安全性,为病理性近视黄斑出血的中药治疗提供循证依据.方法:计算机检索知网、万方、中国生物医学库(CBM)、维普(VIP)、Pubmed、Embase、Cochrane数据库和手工检索(时间从建库至2020年10月),筛选符合纳入标准的随机对照试验,对纳入研究进行质量评价,采用RevMan5进行Meta分析.结果:纳入的9篇文献共包括686只眼,全部为中文文献.Meta分析结果显示,与对照组相比,中药治疗病理性近视黄斑出血在提高总体疗效(OR=2.73,95％CI[1.77,4.20],P<0.05)、促进黄斑区出血吸收(OR=5.17,95％CI[2.26,11.84],P<0.05)、降低视网膜中心厚度(MD=-1.86,95％CI[-2.49,-1.24],P<0.05)方面差异均有统计学意义(P<0.05).在提高矫正视力(OR=2.82,95％CI[0.91,8.76],P>0.05)方面差异无统计学意义.9个研究主要治法为养血补精,活血行气,其余以活血通络、补脾益气为主.9个研究均未提及有不良反应出现.结论:中药治疗病理性近视黄斑出血能加快吸收黄斑区出血,降低视网膜中心厚度,在治疗病理性近视黄斑出血总体疗效方面有优势,治法多为养血补精,活血行气.中药干预效果优于单纯西药或手术治疗,但需要通过更多高质量试验提高研究水平.

近视是全国乃至世界的重大公共卫生问题,总体呈现出低龄、高发、进展快、并发症严重等特点.目前西医防控方法多样,虽有优点但也存在各种弊端.中医适宜技术内容丰富,历史悠久,广泛应用于各学科领域,在近视防控方面临床应用多年,如耳穴压丸、针灸、穴位按摩、梅花针等,具有疗效好、简便、可操作性强等优势.国内外对其开展了大量临床与基础研究,证实了其有效性与安全性,并揭示了其作用机制,但目前中医适宜技术的临床推广仍不理想.因此,本文系统整理了 5类近视防控的中医适宜技术,分别是针法类、灸法类、手法类、中药外治法与中药内服法,从临床疗效、作用机制、适用范围、操作特点等方面整理国内外最新研究进展并进行综述说明,以期为临床诊疗提供思路.

Coronaviruses are RNA viruses. We should be alerted from the outbreak of the severe acute respiratory syndrome coronavirus (SARS-CoV) in 2003, the discovery of the human coronavirus NL63 (HCoV-NL63) in 2004 and the pneumonia outbreak caused by the novel coronavirus in 2019 (2019-nCoV). Coronaviruses can adhere to mucous membranes of the eye, nose, mouth, respiratory tract and digestive tract through various media, which leads to inflammatory reaction, pulmonary fibrosis, kidney failure and death in severe cases. As an exposed organ, the eye can also be infected. With the progress of molecular technology and the in-depth research of coronaviruses, there have been seven known coronaviruses that can infect humans, among which HCoV-NL63, SARS-CoV and 2019-nCoV can cause eye diseases. This article summarizes and analyzes the latest research results at home and abroad concerning the structural characteristics, transmission routes, ocular pathogenic characteristics and treatment of HCoV-NL63, SARS-CoV and 2019-nCoV, in order to provide reference for clinical diagnosis and treatment. (Chin J Ophthalmol, 2021, 57: 871-875).

目的 系统评价耳穴压丸干预儿童青少年近视的效果,为近视防控提供依据.方法 计算机检索数据库并筛选耳穴压丸治疗儿童青少年近视的临床随机对照试验研究,检索时限为建库至2020年12月.由2位研究者独立筛选文献,评价纳入研究的偏倚风险,提取资料后采用RevMan 5.3软件进行Meta分析.结果 共纳入21篇文献,共计患者2450例(3855只眼),其中耳穴压丸组1995只眼,常规治疗组1860只眼.经Meta分析后结果显示耳穴压丸疗法干预儿童青少年近视的总有效率高于常规治疗,具有统计学意义[OR=2.85,95％CI(2.39,3.41),Z=11.62,P＜0.01].耳穴压丸疗效优于非睫状肌麻痹剂[OR=2.04,95％CI(1.57,2.46),Z=5.37,P＜0.01]和睫状肌麻痹剂[OR=3.80,95％CI(2.96,4.87),Z=10.50,P＜0.01],差异均有统计学意义.在视力、屈光度方面耳穴压丸疗法优于常规治疗.同时耳穴压丸疗法能延缓眼轴增长、降低眼内压及前房深度,对临床症状如视物模糊、异物感、酸胀不适、干涩、流泪方面也均有改善作用.结论 耳穴压丸疗法干预儿童青少年近视疗效显著,且操作简便、安全,患儿依从性好,值得进一步推广.但目前研究质量整体偏低,证据强度不足,因此有必要对其进行大样本、多中心的高质量临床研究,为推广儿童青少年的近视防控提供依据.