Thyroid Eye Disease (TED), also known as Graves’ ophthalmopathy, is an organ-specific inflammatory disorder associated with autoimmune thyroid dysfunction. Its primary pathological features include immune cell infiltration of orbital tissues, fat hyperplasia, and fibrotic remodeling. The pathogenesis centers on abnormal expression of TSHR on orbital fibroblasts and immune attacks mediated by autoantibodies. Recent studies increasingly reveal that infiltrating immune cells, particularly highly plastic macrophages, do not simply divide into static M1/M2 phenotypes. Instead, they exist within a functional continuum precisely regulated by transcriptional and epigenetic mechanisms, dynamically adjusting their functional states in response to microenvironmental signals. Along this continuum, macrophages in early disease stages lean toward the pro-inflammatory pole. Activation of transcription pathways like NF-κB, coupled with concomitant epigenetic remodeling, drives the release of inflammatory mediators such as IL-6 and TNF-α, thereby initiating and amplifying inflammatory cascades. During disease progression, macrophages shift toward the pro-fibrotic end. Their functional state is influenced by the sustained activation of transcriptional programs like TGF-β/Smad and STAT3, as well as the consolidation effects of epigenetic mechanisms such as DNA methylation and histone modifications. This facilitates pathological tissue repair and fibrosis through signaling pathways including GAS6-AXL and PDGF. This review systematically examines the dynamic regulatory role of macrophages in TED, delves into their complex interaction networks with fibroblasts, adipocytes, and lymphocytes. It further envisions novel therapeutic strategies targeting the macrophage functional continuum and its underlying transcriptional and epigenetic regulatory mechanisms. This aims to establish a pathological framework for TED centered on the spatiotemporal evolution of macrophages, providing theoretical foundations and translational perspectives for developing temporal and precision therapies that transcend conventional immunosuppression.

Objective Thyroid eye disease (TED) is an autoimmune condition associated with thyroid dysfunction, often presenting with complex and variable orbital manifestations that pose challenges for early and objective diagnosis. Current diagnostic reliance on clinical assessment and conventional imaging may lack sensitivity or standardization, highlighting an unmet need for quantitative and reproducible tools. To address this gap, this study developed and validated a clinical diagnostic model for TED screening through multidimensional analysis of computed tomography (CT)-derived three-dimensional reconstruction and multiplanar reconstruction data. By systematically screening sensitive imaging indicators across various parameters, the research quantitatively established, expanded, and verified the clinical utility of CT-based measurements in TED detection. Methods Based on orbital CT imaging data, we utilized Mimics and RadiAnt Viewer software to perform semi-automated quantitative measurements of four-dimensional parameters (point: CT values of extraocular muscles, orbital fat, and optic nerves; line: exophthalmos degree and interocular difference; plane: cross-sectional areas of extraocular muscles and optic nerves; volume: volumetric measurements of extraocular muscles, optic nerves, orbital fat, and orbital cavity) in both thyroid eye disease (TED) patients and control subjects. Statistical analyses were conducted using SPSS software and R language. The dataset was randomly split into training and validation sets in a 7:3 ratio. In the training set, least absolute shrinkage and selection operator (LASSO) regression with cross-validation was employed for feature screening to reduce overfitting risk, followed by logistic regression analysis to further determine modeling indicators. Subsequently, a clinical diagnostic model was constructed and visualized as a nomogram. Model performance was evaluated by calculating the area under the receiver operating characteristic (ROC) curve in both training and validation sets. The classification accuracy at different risk cutoff points in the internal validation set was computed to assess model performance across varying risk thresholds. Finally, calibration curves and decision curve analysis (DCA) were performed to validate the probability accuracy and net benefit thresholds ofthe model. Results The distribution of data in the control group was more concentrated and positively skewed than that in the TED group; Among the four-dimensional CT measurements, the most relevant indicator for TED screening was the volume of the inferior rectus muscle (AUC = 0.92). At the two-dimensional level, the maximum cross-sectional area along the long axis of the inferior rectus muscle showed the highest correlation (AUC = 0.84); We successfully developed a highly accurate CT-based TED diagnostic model, achieving AUC values of 0.959 (training set) and 0.918 (validation set). Conclusion The clinical diagnostic model constructed based on CT-derived measurements demonstrates considerable accuracy in TED screening, showing improved performance compared to single screening indicators. This advancement holds significant clinical value. Integrating machine learning, deep learning, and radiomics approaches could further enhance its accuracy, practicality, and clinical workflow efficiency.

Proliferative vitreoretinopathy (PVR) is a common complication following corrective surgery for rhegmatogenous retinal detachment (RRD) that poses a serious threat to patients' vision. The pathogenesis of PVR remains incompletely understood, with oxidative stress and inflammation being key factors during its development. Through bioinformatics analysis, we identified key oxidative stress-related genes in PVR patients. We obtained PVR gene datasets (GSE176513, GSE228934, and GSE128143) from the Gene Expression Omnibus (GEO) database and screened for differentially expressed oxidative stress genes (DEOSGs). Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) analyses were performed to evaluate key pathways. Five machine learning algorithms—LASSO, Random Forest (RF), Gradient Boosting Machine (GBM), k-Nearest Neighbors (KNN), and Decision Tree (DT)—were combined with protein-protein interaction (PPI) networks to identify PVR-associated hub genes. Ultimately, two genes (COL1A1 and MMP2) were identified, both of which were upregulated. ROC analysis demonstrated good diagnostic performance for both genes. KEGG analysis revealed that hub gene expression was significantly associated with the AGE-RAGE signaling pathway, the relaxin signaling pathway in diabetic complications, and the proteoglycan signaling pathway in cancer. Potential therapeutic agents including bisphosphonates, resveratrol, and acetazolamide may exert inhibitory effects on PVR. This study found that COL1A1 and MMP2 genes are closely associated with PVR development and progression and are also linked to oxidative stress pathways.

Orbital fractures are a common type of maxillofacial trauma, and their functional and aesthetic reconstruction has long posed challenges in surgical repair. Traditional implant materials (such as autogenous bone, titanium mesh, and porous polyethylene) carry risks of long-term foreign body retention and associated complications. Absorbable materials overcome the drawbacks of permanent implants by providing temporary mechanical support during healing while gradually degrading, representing a significant advancement in orbital fracture repair. This article systematically reviews the design advancements and current applications of resorbable materials in orbital fracture reconstruction. It covers material classification (including properties of poly-L lactic acid [PLLA], polyglycolic acid, polycaprolactone [PCL], and their composites), biomechanical performance, degradation mechanisms, and their integration with precision technologies such as 3D printing, computer navigation, and external endoscopy for preoperative planning and intraoperative procedures. Clinical studies indicate that absorbable implants achieve repair outcomes comparable to permanent implants in small-to-medium and some complex orbital fractures, with the unique advantage of avoiding interference with growth and development in pediatric patients. Despite challenges including delayed inflammatory responses, mechanical strength limitations, and inadequate radiopacity, novel material designs (e.g., uncalcined hydroxyapatite/PLLA composites) and hybrid technologies (e.g., incorporating functional factors such as bone morphogenetic protein-2) are continuously enhancing their performance. Future directions encompass developing smart biomaterials, deepening digital technology integration, advancing long-term multicenter clinical studies, and optimizing cost-effectiveness strategies. Absorbable materials are poised to become a mainstream choice for orbital fracture repair.Impact StatementThis review highlights the transformative role of absorbable materials in orbital fracture reconstruction. By providing temporary support and then degrading, they eliminate long-term risks of permanent implants. The integration of advanced composites (e.g., u-HA/PLLA) and precision technologies such as 3D printing enables superior, patient-specific outcomes. This research consolidates evidence for their efficacy, particularly in pediatric cases, and charts a future course toward smart biomaterials and deeper digital integration, establishing them as a potential new standard of care and significantly advancing the field of maxillofacial surgery.

The hydroxyapatite orbital implantation is widely used to treat orbital malformation, but delayed postoperative angiogenesis can hinder conjunctival wound healing, potentially leading to implant exposure and prolapse. Low-intensity laser therapy (LLLT) is recognized for its ability to promote tissue regeneration, reduce inflammation, and alleviate pain. This study aims to explore the specific mechanism of miRNAs-VEGFA pathway regulation in early vascularization after orbital implant placement induced by LLLT. A hydroxyapatite orbital implant model was established and treated with LLLT. Vascular tissues surrounding the ocular prosthesis were extracted for high-throughput sequencing to identify differentially expressed miRNAs. miRNAs predicted to bind with VEGFA were selected for validation. GO and KEGG analyses were performed to reveal the functional enrichment of target genes regulated by these miRNAs. Dual luciferase assay, qRT-PCR, and Western blotting were used to verify the targeting relationship between miR-90 and VEGFA. The effects of miR-90 on rabbit microvascular endothelial cell function were assessed through CCK-8 assay, scratch test, and tube formation assay. High-throughput sequencing revealed 32 differentially expressed miRNAs, with 8 upregulated and 24 downregulated. miR-90 was predicted to have a high binding score and expression abundance with VEGFA and was confirmed to regulate VEGFA expression. In vitro functional tests showed that miR-90 inhibited rabbit microvascular endothelial cell proliferation, migration, and tube formation. This study is the first to demonstrate that LLLT regulates ocular prosthesis angiogenesis via the miR-90/VEGFA pathway, providing a new target for treating vascular-dependent diseases.

Thyroid-associated ophthalmopathy (TAO) is a thyroid function-related, organ-specific autoimmune disease that primarily leads to specific reactive changes and tissue remodeling in the periocular region. The exact pathogenesis of TAO remains unclear. High-throughput gene expression datasets related to TAO were comprehensively retrieved from the Gene Expression Omnibus (GEO) database, selecting GSE174139 and GSE158464 for analysis. Differentially expressed genes (DEGs) between TAO patients and healthy controls were identified, and ferroptosis-related genes (FRGs) were obtained from the FerrDb database. The intersection of DEGs and FRGs yielded ferroptosis-related genes associated with TAO.The transcriptional expression of FRGs was validated using real-time quantitative polymerase chain reaction (RT-qPCR) on orbital adipose tissue samples from TAO patients and healthy controls. Single-cell sequencing of six human tissue samples further analyzed changes in cellular subpopulations within the TAO microenvironment.Additionally, a co-culture model of CD163 + macrophages and TAO orbital fibroblasts, along with an in vitro TGF-β1-induced orbital fibroblast (OF) model, was constructed to validate the role of the TGF-β1/SMAD2/3 axis in ferroptosis regulation. Finally, potential clinical drugs targeting CD163 + macrophages with high ferroptosis activity in TAO were predicted using the Random Walk with Restart (RWR) algorithm combined with the DGIdb database. We first utilized TAO-related datasets from the GEO database, combined with the FerrDb ferroptosis database, to identify changes in iron metabolism genes during TAO progression through differential expression analysis, screening 7 key ferroptosis-related proteins. In vitro validation revealed that all but AOPQ and LGMN, which were upregulated, exhibited downregulated expression.Single-cell sequencing of orbital connective tissue from 4 TAO patients and 2 healthy controls identified 16,364 cells spanning 18 cell types. Analysis of the 7 key ferroptosis-related proteins revealed that fibroblasts and macrophages displayed elevated ferroptosis signaling during TAO progression. Subcluster analysis of macrophages identified 4 distinct subpopulations, with the C2 subpopulation—characterized by high expression of CD163 and CCL18—exhibiting prominent ferroptosis activation signals.Further validation using clinical tissue samples, a co-culture model of CD163 + macrophages and TAO orbital fibroblasts, and an in vitro TGF-β1-induced orbital fibroblast (OF) model confirmed aberrant activation of the TGF-β1/SMAD2/3 pathway as a key regulator of ferroptosis. Hub gene analysis of C2 subpopulation marker genes, combined with the DGIdb database, predicted potential clinical drugs targeting the C2 macrophages. This study, integrating single-cell RNA-Seq and bulk transcriptome analysis, revealed the involvement of CD163 + tissue-infiltrating macrophages in regulating ferroptosis of orbital fibroblasts during TAO progression and identified therapeutic candidates targeting macrophage ferroptosis signaling in TAO. Furthermore, in vitro experiments demonstrated that activation of the TGF-β1/SMAD2/3 axis promotes ferroptosis in TAO orbital fibroblasts, highlighting a novel pathway for potential therapeutic intervention.

Systemic lupus erythematosus, Hydroxychloroquine, retinal structure and microcirculation, SS-OCTA. The application of swept-source optical coherence tomography angiography (SS-OCTA) technique is used to detect the effects of long-term use of hydroxychloroquine (HCQ) on retinal structure and microcirculation in patients with systemic lupus erythematosus (SLE) before visual dysfunction occurs. Retrospective case-control study. A total of 73 SLE patients (73 eyes) who had taken HCQ regularly for a long period of time were included as the SLE patient group, while 21 healthy individuals (21 eyes) were included as the control group. Based on the duration of HCQ use (HCQ course), the SLE patient group was divided into baseline group (6 months ≤ medication time < 1 year), low-risk group ( 1 year ≤ medication time < 5 years), and high-risk group (medication time ≥ 5 years). All participants underwent bilateral SS-OCTA macular imaging (6 mm*6 mm), slit-lamp examination, non-contact tonometry, computerized visual field (30 − 2) test, and fundus autofluorescence imaging (FAF). Compared among the groups, the full-layer retinal thickness and superficial blood vessel density of the fovea, below the inner circle, temporal side of the outer circle and above the outer circle decreased in the macular area (6 mm*6 mm) in high-risk group of SLE patients, while the area and circumference of FAZ increased (P < 0.0125). Correlation analysis suggested that the duration of SLE disease and HCQ cumulative dose were negatively correlated with superficial retinal capillary plexus vessel density (SCP-VD) in the three regions of inner retina, full-layer retinal thickness in the fovea, fovea, temporal side of the inner circle, and above the inner circle (r < 0,P < 0.05), and positively correlated with the area and circumference of FAZ (r > 0,P < 0.05). Analysis by SS-OCTA examination showed that long-term HCQ treatment had adverse effects on the inner retina, SCP-VD and FAZ parameters in subclinical SLE patients without visual impairment.

To evaluate the efficacy and safety of endoscopic navigation-guided 3D printing combined with absorbable materials for individualized minimally invasive reconstruction of orbital blowout fractures, comparing outcomes to preformed titanium mesh controls to validate clinical value in achieving anatomical reduction, improving visual function, and reducing complications. This retrospective study enrolled 87 patients receiving absorbable implants (Trial Group) and 19 patients treated with preformed titanium mesh (Control Group). Preoperative CT scans were processed using Mimics 21.0 and Geomagic Studio 12.0 for 3D reconstruction, generating patient-specific guides and 3D-printed orbital models based on mirror-imaged healthy orbits. In the Trial Group, absorbable plates were thermo-molded using surgical guides and implanted; controls underwent titanium mesh trimming followed by screw fixation. Statistical analyses employed SPSS 26.0 with Python-automated covariate control: propensity score weighting (PSW) balanced baseline covariates (gender, age, fracture extent; SMD < 0.1 confirmed balance). Longitudinal continuous data (exophthalmos difference, logMAR BCVA) were analyzed via generalized estimating equations (GEE) modeling time-group interactions, while ordinal outcomes (diplopia severity, ocular motility restriction) used weighted ordinal logistic regression to compute marginal effects. All analyses controlled for timepoint interactions with statistical significance defined at α = 0.05. The absorbable material group demonstrated superior diplopia resolution (residual rate: 9.2

Purpose:To evaluate the diagnostic efficacy of magnetic resonance imaging (MRI)-based signal intensity ratio (SIR) between extraocular muscles and white matter/temporal muscle for staging thyroid eye disease (TED) activity, and to provide a novel approach for diagnosis in active TED patients. Methods:A number of 40 patients with TED (79 eyes) and 65 controls (65 eyes) were recruited. MRI-based parameters of four extraocular muscles, ipsilateral white matter, temporal muscle, and other clinical factors were retrospectively collected. Patients were grouped according to disease activity determined by the Clinical Activity Score (CAS), and intergroup analysis was subsequently performed based on this classification. The signal intensities were measured using fat-suppressed T2-weighted imaging (T2WI-FS) sequences from MRI. The SIR of the extraocular rectus muscle to that of the ipsilateral white matter represents SIR1, while the SIR of the extraocular rectus muscle to that of the ipsilateral temporalis muscle represents SIR2. Results:Active TED group demonstrated elevated SIR1 and SIR2 values across all rectus muscles compared to control group and inactive TED group (P<0.05), with no differences between inactive TED and controls. Receiver operator characteristic (ROC) curve analysis identified SIR2 as superior to SIR1 for most muscles, with inferior rectus SIR1 achieving the highest AUC (0.837). Based on 95% confidence intervals and cutoff values, we propose redefining TED staging: control ranges (0.936-1.019) as absolute inactive phase, active TED ranges (1.210-1.344) as absolute active phase, and transitional values (1.019-1.210) as clinical vigilance phase requiring heightened attention. The model suggests that patients currently defined as "inactive" by CAS may have subclinical inflammation, explaining paradoxical disease progression in some cases. Conclusions:The signal intensity ratio (SIR) from fat-suppressed T2-weighted (T2WI-FS) sequences serves as a reliable predictor for TED activity. The 95% confidence interval (CI) for SIR values can provide a new strategy for early diagnosis.

The first line treatment for moderate to severe active thyroid associated ophthalmopathy is glucocorticoid pulse therapy, but for patients with contraindications to hormone therapy or hormone resistance, it is urgent to find a suitable treatment plan. To find a reliable alternative to hormone pulse therapy for thyroid associated ophthalmopathy by comparing the efficacy with first-line treatment regimens. Search PubMed, Ovid, Web of science, Cochrane library, and Clinical Trials.gov for randomized controlled trials on the treatment of thyroid associated ophthalmopathy published as of July 7, 2024. Quality evaluation and Bayesian network analysis were conducted using RevMan 5.3 software, STATA15.0 software, and ADDIS 1.16.8 software. A total of 666 patients were included in 11 studies and 8 interventions. Network analysis showed that the three interventions of mycophenolate mofetil combined with glucocorticoids, Teprotumumab and 99Tc-MDP were superior to glucocorticoid pulse therapy in improving clinical activity scores and proptosis. The regimen of glucocorticoids combined with statins can improve the quality of life score and diplopia score of patients. Neither methotrexate combined with glucocorticoids nor rituximab alone showed additional advantages when compared with glucocorticoid pulse therapy. Mycophenolate mofetil combined with glucocorticoid therapy is very beneficial for moderate to severe active thyroid associated ophthalmopathy. Mycophenolate mofetil may be a good choice when patients have contraindications to hormone use or hormone resistance. Teprotumumab is very promising and may be able to avoid patients undergoing orbital decompression surgery. The durability and safety of its long-term efficacy need to be further observed.

This study aims to investigate the distribution characteristics and correlations of orbital soft tissue volume expansion in patients with thyroid-associated ophthalmopathy (TAO) by analyzing orbital computed tomography (CT) data and to determine the most appropriate parameters and corresponding cut-off values for imaging classification. Patients with TAO who met the inclusion and exclusion criteria, along with those with lacrimal duct obstruction requiring orbital CT examination, were included in the study. Raw CT data were imported into Mimics and RadiAnt software for analysis, and measurements of orbital volume, orbital fat volume, extraocular muscle volume, optic nerve volume, and exophthalmos were obtained. The results demonstrated that the combination of Mimics and other softwares for processing orbital CT scans allows for the quantitative analysis of various soft tissue volumes within the orbit. The MV/FV ratio was found to effectively reflect the relative changes in extraocular muscle volume, serving as a valuable indicator for identifying different subtypes of TAO and providing significant clinical reference value.

AIM: To explore the combined application of surgical navigation nasal endoscopy (NNE) and three-dimensional printing technology (3DPT) for the adjunctive treatment of orbital blowout fractures (OBF). METHODS: Retrospective analysis was conducted on the data of patients with OBF who underwent surgical treatment at the Affiliated Eye Hospital of Nanchang University between July 2012 and November 2022. The control group consisted of patients who received traditional surgical treatment (n=43), while the new surgical group (n=52) consisted of patients who received NNE with 3DPT. The difference in therapeutic effects between the two groups was evaluated by comparing the duration of the operation, best corrected visual acuity (BCVA), enophthalmos difference, recovery rate of eye movement disorder, recovery rate of diplopia, and incidence of postoperative complications. RESULTS: The study included 95 cases (95 eyes), with 63 men and 32 women. The patients' age ranged from 5 to 67y (35.21±15.75y). The new surgical group and the control group exhibited no statistically significant differences in the duration of the operation, BCVA and enophthalmos difference. The recovery rates of diplopia in the new surgical group were significantly higher than those in the control group at 1mo [OR=0.03, 95%CI (0.01–0.15), P<0.0000] and 3mo [OR=0.11, 95%CI (0.03–0.36), P<0.0000] post-operation. Additionally, the recovery rates of eye movement disorders at 1 and 3mo after surgery were OR=0.08, 95%CI (0.03–0.24), P<0.0000; and OR=0.01, 95%CI (0.00–0.18), P<0.0000. The incidence of postoperative complications was lower in the new surgical group compared to the control group [OR=4.86, 95%CI (0.95–24.78), P<0.05]. CONCLUSION: The combination of NNE and 3DPT can shorten the recovery time of diplopia and eye movement disorder in patients with OBF.

The main treatment for the symptoms of proptosis and optic nerve compression caused by thyroid-associated ophthalmopathy is orbital decompression surgery. Medial inferior wall decompression and balanced decompression are two frequently used surgical procedures. However, there is no unified consensus on how to choose different surgical options for orbital decompression in clinical practice. To compare the effects of medial inferior wall decompression and balanced decompression surgery through meta-analysis and to provide reference for clinical optimal decision making. Databases, including PubMed, Web of Science, Ovid, Cochrane Library, and ClinicalTrials.gov, were searched for randomized controlled trials and cohort studies on decompression surgery for thyroid-associated ophthalmopathy published from inception to March 21, 2023. Using RevMan 5.3 software, a meta-analysis was conducted based on the following outcome indicators: proptosis, diplopia rate, intraocular pressure, visual acuity, and complication rate. Two randomized controlled trials and five cohort studies with a total of 377 patients were included in this analysis. After balanced decompression surgery, patients with thyroid-associated ophthalmopathy experienced a significant decrease in proptosis [MD = 4.92, 95

BackgroundThyroid-associated orbitopathy (TAO) is an autoimmune inflammatory disorder of the orbital adipose tissue, primarily causing oxidative stress injury and tissue remodeling in the orbital connective tissue. Ferroptosis is a form of programmed cell death driven by the accumulation of reactive oxygen species (ROS), iron metabolism disorder, and lipid peroxidation. This study aims to identify and validate the optimal feature genes (OFGs) of ferroptosis with diagnostic and therapeutic potential in TAO orbital adipose tissue through bioinformatics analysis and to assess their correlation with disease-related immune cell infiltration.MethodsSearch of the Gene Expression Omnibus database for TAO-related gene datasets led to the selection of GSE58331 for differential gene expression analysis. WGCNA was employed to identify key disease modules and hub genes. The intersection of DEGs, hub genes and ferroptosis-related gene yielded key genes of ferroptosis. Machine learning algorithms identified OFGs of ferroptosis. Meanwhile, by comparing the expression of FRGs in the orbital adipose tissue and the orbital fibroblasts (OFs) of healthy controls and TAO patients, as well as co-culturing macrophages and OFs in vitro, the influence of macrophages on FRGs in OFs was explored. CIBERSORT analyzed immune cell infiltration to determine proportions of immune cell types in each sample, and Spearman correlation analysis explored relationships between OFGs and infiltrating immune cells. Finally, GSEA determined the function of each key biomarker based on the median expression of OFGs.ResultsThree TAO FRGs (ACO1, MMD, and HCAR1) were screened in the dataset. The ROC results of ACO1 showed that the AUC value was greater than 0.8 in all the datasets, which was the strongest for disease specificity and diagnostic ability. Validation results showed that, in addition to MMD, the expression of ACO1 and HCAR1 in orbital adipose tissue of TAO patients was significantly down-regulated, while M2-type macrophages might be involved in regulating the expression of ACO1 in orbital adipose-derived OFs. CIBERSORT immune cell infiltration analysis showed that in orbital adipose tissue of TAO patients, memory B-lymphocytes, T regulatory cells, NK-cells, M0-type macrophages, M1-type macrophages, resting dendritic cells, activated mast cells, and neutrophils infiltration levels were significantly elevated.ConclusionThrough bioinformatics analysis, this study identified and validated two OFGs of ferroptosis with diagnostic and therapeutic potential in TAO orbital adipose tissue, suggesting that the downregulation of ACO1 and HCAR1 may be potential molecular targets in the pathogenesis of TAO.

To investigate the efficacy of endoscopic membranous nasolacrimal duct resection combined with retrograde lacrimal stent in the treatment of extremely inferior lacrimal duct obstruction. Retrospective cohort study at Nanchang University’s Affiliated Eye Hospital. Experimental Group: Endoscopic membranous nasolacrimal duct resection combined with retrograde lacrimal stent implantation; Control group: Conventional endoscopic dacryocystorhinostomy combined with bicanalicular Silicone Stent implantation.The duration of the surgical procedure, postoperative comfort score, irrigation of the lacrimal passage after extubation, and Munk score of curative effect at six months post-operation were recorded. The data were quantified and analyzed using SPSS 26.0 statistical software. The symptoms of epiphora showed significant improvement following surgery. There were notable differences in operation time and postoperative comfort between the experimental group and the control group who underwent conventional endoscopic dacryocystorhinostomy (P < 0.05). However, there was no significant difference in efficacy and lacrimal duct irrigation after extubation or at six months post-operation (P > 0.05). The cure rate of the experimental group reached 70%, while the control group achieved a cure rate of 78%. Furthermore, the effective rate in the experimental group was found to be 81%, whereas it was 89% in the control group.No evident complications were observed in the experimental group. The combination of endoscopic membranous nasolacrimal duct resection and retrograde lacrimal stent reduces the invasiveness of the lacrimal duct structure, shortens the operation time, improves patient comfort, and achieves favorable therapeutic outcomes. This approach is recommended for patients with extremely Inferior lacrimal duct obstruction .

Background and Objectives: Orbital fractures significantly impact patients' quality of life, yet consensus is lacking on their onset characteristics, diagnosis, and treatment plans. This study aims to explore the epidemiological features and share diagnostic and treatment experiences related to orbital fractures. Methods: Retrospective analysis was conducted on data from patients diagnosed with orbital fractures at the Affiliated Eye Hospital of Nanchang University between May 2012 and May 2022. Attributes such as onset year, patient age, and fracture type were considered to gather information on population baseline, onset causes, surgery timing, surgical approach, repair materials, recovery time, and complications. Statistical analysis was performed using SPSS 23.0. Results: The hospital admitted 329 patients, with a female-to-male ratio of approximately 1:2.656. Traffic accidents were the primary cause of orbital fractures (32.52%), and their incidence increased annually. Among simple orbital wall fractures, the inner orbital wall was more common (27.05%). Early surgical intervention in children with orbital fractures reduced recovery time for eye movement disorders. The use of digital medical three-dimensional printing technology reduced complications in orbital fracture surgery. The odds ratio (OR) and 95% confidence interval (CI) are OR = 0.12, 95% CI (0.04 similar to 0.37), and P = 0.0002<0.05. Conclusion: Enhanced supervision of traffic violations and accident prevention can curb the rising trend of orbital fracture incidence. Utilizing 3D printing technology in orbital fracture repair can contribute to a decreased occurrence of postoperative complications.

BackgroundHome confinement during the epidemic has a significant impact on the lifestyle and behavior of school-aged children, who have exhibited an increase in the prevalence and development of myopia. Our research will look at if home confinement will affect school-aged children on myopia control with orthokeratology.MethodData on axial length was gathered from school-aged children who had received OK lenses treatment. The entire data was separated into subgroups based on gender, age, and initial refraction, and the AL changes for each period were calculated using the formula defined in our study. Finally, the acquired data will be examined using various statistical approaches, and the ideas of slow, moderate, and rapid myopia progression will be applied to our study.ResultA total of 258 study subjects met the requirements to be included in the study. We discovered that the percentage of rapid myopia growth increased during the epidemic. In addition, the AL changes before and during the epidemic were found to be statistically significant in 171 subjects in the overall data. (P = 0.041) In the high age group, the AL changes before and during the epidemic?(P = 0.033) before and after the epidemic (P = 0.023) were found to be statistically significant. The AL changes before and during the epidemic (P = 0.035) were shown to be statistically significant in the moderate myopia group. Finally, we did not find statistically significant results for other groups.ConclusionWe cannot conclude that home confinement did have a negative impact on myopia control with orthokeratology in school-aged children. But we found there was an increase in the percentage of patients with OK treatment that had fast myopia progression during the confinement. We also observed that older children with higher initial refraction were more likely to be affected by home confinement.

Background: Uveal Melanoma (UM) is the most prevalent primary intraocular malignancy in adults. This study assessed the importance of chromatin regulators (CRs) in UM and developed a model to predict UM prognosis. Methods: Gene expression data and clinical information for UM were obtained from public databases. Samples were typed according to the gene expression of CRs associated with UM prognosis. The prognostic key genes were further screened by the protein interaction network, and the risk model was to predict UM prognosis using the least absolute shrinkage and selection operator (LASSO) regression analysis and performed a test of the risk mode. In addition, we performed gene set variation analysis, tumor microenvironment, and tumor immune analysis between subtypes and risk groups to explore the mechanisms influencing the development of UM. Results: We constructed a signature model consisting of three CRs (RUVBL1, SIRT3, and SMARCD3), which was shown to be accurate, and valid for predicting prognostic outcomes in UM. Higher immune cell infiltration in poor prognostic subtypes and risk groups. The Tumor immune analysis and Tumor Immune Dysfunction and Exclusion (TIDE) score provided a basis for clinical immunotherapy in UM. Conclusion: The risk model has prognostic value for UM survival and provides new insights into the treatment of UM.

患者1，女，65岁，因"左眼眼周突发肿胀、疼痛5 d"入院，患者否认眼部及头部外伤史，否认高血压、糖尿病史及血液病病史。既往左眼曾因"年龄相关性白内障"行白内障超声乳化联合人工晶状体（IOL）植入术，自诉术后视力恢复可。眼科专科检查见：右眼裸眼视力（UCVA）0.1，左眼0.3，右眼矫正视力-2.75-1.25×90°=0.7（自然晶状体），左眼-0.75=0.6（人工晶状体）。右眼眼前节仅见晶状体混浊，玻璃体轻度混浊，余（-）；左眼眼睑皮肤轻度肿胀，内眦周围皮肤稍红，压痛（+），结膜充血（+），角膜透明，瞳孔圆，直径约4 mm，直接对光反射稍稍迟钝，间接对光反射可，人工晶状体在位，眼底见视盘稍肿胀，色淡，C/D约0.3，视网膜血管纤细，动静脉管径之比约1：3，视网膜平伏（图1）。眼球向各方向运动均无明显异常，眼球突出度：右眼13 mm，左眼15 mm。入院抽血检查发现血常规、C反应蛋白、凝血功能均在正常值范围内。眼眶CT检查提示：左眼上方及眶骨膜可见一稍高密度的肿物，肿物外围密度稍高。同侧额窦、筛窦均可见与眼眶肿物内相同密度的内容物填充，与此同时，左眼眼眶眶内侧壁还可见部分骨质呈缺损状态，左侧视神经轻度受压移位。眼眶MRI示：左侧额窦-筛窦-眼眶内可见不规则软组织肿块影，边界清楚、信号均匀一致，以稍长T2、短T1信号为主，左眼眼球突出，视神经轻度受压推挤（图2A-C）。

BackgroundThyroid associated ophthalmopathy (TAO) is an organ-specific autoimmune disease that has a significant impact on individuals and society. The etiology of TAO is complicated and poorly understood. Thus, the goal of this study was to use bioinformatics to look into the pathogenesis of TAO and to identify the optimum feature genes (OFGs) and immune infiltration patterns of TAO.MethodsFirstly, the GSE58331 microarray data set was utilized to find 366 differentially expressed genes (DEGs). To find important modular genes, the dataset was evaluated using weighted gene coexpression network analysis (WGCNA). Then, the overlap genes of major module genes and DEGs were further assessed by applying three machine learning techniques to find the OFGs. The CIBERSORT approach was utilized to examine immune cell infiltration in normal and TAO samples, as well as the link between optimum characteristic genes and immune cells. Finally, the related pathways of the OFGs were predicted using single gene set enrichment analysis (ssGSEA).ResultsKLB, TBC1D2B, LINC01140, SGCG, TMEM37, and LINC01697 were the six best feature genes that were employed to create a nomogram with high predictive performance. The immune cell infiltration investigation revealed that the development of TAO may include memory B cells, T cell follicular helper cells, resting NK cells, macrophages of type M0, macrophages of type M1, resting dendritic cells, active mast cells, and neutrophils. In addition, ssGSEA results found that these characteristic genes were closely associated with lipid metabolism pathways.ConclusionIn this research, we found that KLB, TBC1D2B, LINC01140, SGCG, TMEM37, and LINC01697 are intimately associated with the development and progression of TAO, as well as with lipid metabolism pathways.