The rising prevalence of knee osteoarthritis is placing a considerable strain on the global healthcare system. To address this issue, telemedicine-supported multicomponent exercise therapy has emerged as a promising approach. This therapy combines exercise, patient education, and health coaching to empower knee osteoarthritis patients to manage their condition from the comfort of their homes. Nevertheless, there are some existing limitations in the current research on this approach, including challenges related to patient compliance and the absence of objective evaluation methods. Patients diagnosed with knee osteoarthritis, who have not undergone knee surgery in the past year, will be recruited for a randomized controlled trial. The trial will include an intervention group and a control group. The intervention group will receive an mHealth app-based multicomponent exercise therapy, consisting of exercise therapy, patient education, and health coaching. Meanwhile, the control group will receive usual care, involving drug therapy and patient education. The primary outcome of the trial will be the measurement of pain intensity, assessed using a visual analog scale at baseline and at 4, 8, and 12 weeks of the post-intervention. To analyze the data, a two-factor, four-level repeated measures ANOVA will be used if the assumptions of homogeneity of variance and sphericity are met. If not, a mixed effects model will be employed. The aim of the study is to evaluate the effectiveness of multicomponent exercise therapy aimed at enhancing pain self-management for knee osteoarthritis patients in the comfort of their own homes. The intervention incorporate wearable devices equipped with advanced deep learning systems to monitor patients' adherence to the prescribed at-home exercise regimen, as well as to track changes in outcomes before and after the exercise sessions. The findings from this trial have the potential to enhance both the accessibility and quality of care provided to knee osteoarthritis patients, offering valuable insights for future improvements in their treatment and management. Chinese Clinical Trials Registry, ChiCTR2300073688. Registered on 19 July 2023, https://www.chictr.org.cn/bin/project/edit?pid=199707 . World Health Organization International Clinical Trials Registry Platform, https://trialsearch.who.int/Trial2.aspx?TrialID=ChiCTR2300073688 .

目的探讨青少年型开角型青光眼小梁切除术长期疗效。方法回顾性研究收集18岁以内接受小梁切除术联合丝裂霉素C（MMC）的青少年型开角型青光眼共31例55眼，比较手术前后眼压及其他眼部参数。结果所有患者术后眼压比术前明显降低（t=12.254，P＜0.001），手术前后C/D值、眼轴长度、视野MD值、视力及屈光度无明显变化，术后第1、3、6年手术完全成功率分别为92.7%、70.4%、42.6%。手术条件成功率分别为92.7%、81.0%、81.0%。术中及术后未发生严重并发症。结论小梁切除术联合MMC是治疗青少年型开角型青光眼一种较为安全、成功率较高的手术方式。

目的:探讨角膜地形图引导的飞秒LASIK对中高度近视患者的临床疗效.方法:选取2018年7月-2019年6月本院收治的80例近视矫治患者为研究对象,按自愿原则将其分为对照组与观察组,每组40例(80只眼).对照组进行普通飞秒LASIK治疗,观察组进行角膜地形图引导的飞秒LASIK治疗.比较两组手术前后的裸眼视力、最佳矫正视力、球镜度、柱镜度、角膜地形图参数(表面非对称指数及表面规则指数)及调制传递函数.结果:术后1、3个月,两组裸眼视力、最佳矫正视力、球镜度、柱镜度、表面非对称指数、表面规则指数及调制传递函数均优于术前,且观察组均优于对照组,差异均有统计学意义(P<0.05).结论:角膜地形图引导的飞秒LASIK对中高度近视患者的临床疗效较好,对角膜地形图及视觉质量的影响更为积极,应用价值更高.

目的 观察中央孔型有晶状体眼人工晶状体(ICL V4C)植入术治疗中高度近视中的有效性和安全性.方法 选取2017年3月至2018年12月在我院屈光科行ICL/TICL V4C植入术矫治屈光不正的中高度近视患者41例(79只眼)为观察对象,回顾分析患者临床资料,观察患者术前术后视力、屈光度、眼压、角膜内皮计数以及术后拱高等指标.结果 术后1年平均裸眼视力0.97±0.23,较术前最佳矫正视力明显提高(P<0.001).术后平均球镜度(-0.11±0.79)D、柱镜度(0.75±0.65)D,均较术前明显减少(P均<0.001).术后平均眼压(14.11±3.30)mmHg,与术前无明显差异(P=0.801).术后平均角膜内皮细胞计数(2884.52±36.33)个/mm2,较术前减少(P<0.001),角膜内皮细胞丢失率为2.6％.术后1年平均拱高(537.48±23.94)μm(53～1398μm).其中拱高范围为250～750μm者共65只眼(82.3％).所有患者术后未发生眼内炎、青光眼、白内障、角膜内皮失代偿等严重并发症.结论 ICL V4C植入术在矫治中高度近视中安全有效.

Introduction Trabeculotomy and combined trabeculotomy–trabeculectomy (CTT) are major surgical options for primary congenital glaucoma (PCG). However, it is unclear which of these two surgical procedures should be recommended as the optimum first-line treatment for PCG. This trial aims to determine whether the outcomes of trabeculotomy are non-inferior to those of CTT in moderate PCG with a horizontal corneal diameter (HCD) of 12–14 mm. Methods and analysis This is a 3-year, non-inferiority, prospective, randomised controlled trial. We plan to recruite 248 participants (aged ≤3 years) with PCG with an HCD of 12–14 mm from the Department of Glaucoma, Zhongshan Ophthalmic Center, Guangzhou, China. One eye per participant will be randomly (1:1) assigned to receive trabeculotomy or CTT. The primary outcome is the 3-year postoperative success rate in lowering intraocular pressure (IOP), and the secondary clinical outcomes will include IOP reduction, visual acuity, HCD, central corneal thickness, axial length, cup–disc ratio, refractive error and postoperative complications. Data will be analysed by the intention-to-treat principle. Ethical approval and dissemination The study protocol has been approved by the ethics committee of Zhongshan Ophthalmic Center (2014MEKY023) and the ‘5010 Plan’ evaluation committee at Sun Yat-Sen University, Guangzhou, China. The results will be disseminated in international academic meetings and published in peer-reviewed journals. Trial registration number Chinese Clinical Trial Registry, ChiCTR-IOR-14005588; Date registered: 20 November 2014.

目的 分析儿童期青光眼的临床特征及表现.方法 回顾性分析2005年1月至2014年12月在中山大学中山眼科中心青光眼区确诊并收入院的儿童期青光眼患者资料,对其视力、眼压、角膜直径及透明度、眼底C/D、眼轴长度进行分析及比较.结果 244例(404眼)儿童期青光眼中,原发性婴幼儿型青光眼占主要比例(213/404,52.72％),男女比例为1.62∶1,双眼:单眼=1.90∶1.所有患者平均眼压35.09±3.38 (22～71) mmHg.共114眼配合视力检查.视力＜0.05者33眼(28.9％),0.05～＜0.3者32眼(28.1％),≥0.3的49眼(43％).近视为不同类型儿童期青光眼患者的主要屈光状态.77.4％的婴幼儿型青光眼中角膜为中、重度水肿和混浊;62.5％的青光眼合并先天异常和50％的继发性青光眼角膜为重度水肿或者混浊.原发性婴幼儿型青光眼平均角膜横径为12.60±1.12mm,其平均角膜横径大于其他类型儿童期青光眼.结论 儿童期青光眼其视力均较差,大部分是盲和低视力.各类型儿童期青光眼中,原发性婴幼儿型青光眼的平均角膜直径最大;青光眼合并先天异常的角膜混浊程度最重.

Background:Early surgical intervention is required for the primary congenital glaucoma (PCG). There are currently few reports on the surgical outcomes in infants with PCG. This study aimed to evaluate the efficacy and safety of trabeculotomy and the postoperative visual outcomes in Chinese newborns with PCG within 4 weeks of birth. Methods:A total of 21 eyes of 12 patients with PCG who underwent primary trabeculotomy within 4 weeks of birth were retrospectively studied. Preoperative and postoperative intraocular pressure (IOP), corneal clarity and diameter, axial length and optic disc cupping, visual acuity and postoperative refractive error, success rates, and complications were evaluated. Kaplan-Meier survival analysis was applied to evaluate the success rates. Results:The mean follow-up time was 46.9 ± 34.4 months (range: 12–122 months). The postoperative IOP was significantly lower than the preoperative IOP at all of the follow-up visits (P < 0.001). The complete success rates for all eyes at 1, 2, 3, and 5 years postoperatively were 90.5%, 85.7%, 85.7%, and 85.7%, respectively. The IOPs of the three patients who needed antiglaucomatous medications postoperatively were also well controlled. At the last visit, the cornea became clear, and the cup-to-disc ratio decreased significantly (P = 0.01) although the horizontal corneal diameter did not change significantly (P = 0.11). Visual acuities were able to be recorded in eight eyes at the last visit, among which six eyes had a best-corrected visual acuity of 20/40 or better. There were no severe intraoperative or postoperative complications. Conclusions:Trabeculotomy proves to be a safe and effective treatment in reducing IOP in this group of Chinese newborns with PCG. The outcomes of vision function were satisfactory in most of the patients.

Objective To evaluate the repeatability and reproducibility of macular ganglion cell-inner plexiform layer (GCIPL) thickness measurement using spectral-domain optical coherence tomography (Cirrus HD-OCT).Method One hundred and eight eyes of 54 normal subjects (26 males and 28 females) between 19 and 75 years of age [mean age (46.2± 16.5) years] were included.Each eye underwent macular scanning using Cirrus HD-OCT Macular Cube 512 × 128 protocol by two operators.Three scans of each eye were obtained by each operator.For the right eye of each subject,three extra scans were obtained using Macular Cube 200 × 200 protocol by one operator.The average,minimum,superotemporal,superior,superonasal,inferonasal,inferior,and inferotemporal GCIPL thickness was analyzed and the repeatability of GCIPL thickness measurement was evaluated with intra-operator,inter-operator,intra-protocol,and inter-protocol intraclass correlation coefficients (ICC).Ten extra scans were obtained from the left eyes of 10 randomly selected subjects for reproducibility assessment with coefficients of variation (CV).Results The intra-operator ICC of macular GCIPL measurement using Macular Cube 512 × 128 protocol by two operators were 0.959-0.995 and 0.954-0.997,respectively; and the inter-operator ICC were 0.944-0.993.All intra-and inter operator ICC were ＞0.800 with the highest and lowest records of the average and minimum GCIPL thickness,respectively.The intra-protocol ICC of Macular Cube 512 × 128 protocol and Macular Cube 200× 200 protocol were 0.986-0.996 and 0.927-0.997,respectively; and the inter-protocol ICC were 0.966 0.994.All intra-and inter-protocol ICC were ＞0.800.CV of GCIPL thickness measurement using MacularCube 512×128 protocol were (0.70±0.31)％ (1.35±0.86)％.Conclusion Cirrus HDOCT can measure macular GCIPL thickness in normal eyes with excellent repeatability and reproducibility.

Objective To compare the choroidal thickness (CT) of macular and peripapillary area among malignant glaucoma(MG),chronic primary angle-closure glaucoma (CPACG) and normal control eyes.And to investigate the correlation between CT and MG.Methods Sixteen subjects (32 eyes) with MG,31 (31 eyes) with CPACG and 32 (32 eyes) normal controls were collected.MG eyes and the fellow non-MG eyes were included in the MG group.CT of all subjects was measured in the fovea,1mm and 3mm to the fovea and peripapillary area using enhanced-depth imaging technique of optical coherence tomography (OCT-EDI).The average of CT in fovea by horizontal and vertical macular scan was defined as the average CT in fovea.The average of temporal,superior,nasal and inferior CT in 1 mm and 3 mm to the fovea were measured respectively.The average of temporal,superior,nasal and inferior CT was defined as the average CT in peripapillary area.The differences of CT among MG,CPACG and normal controls were compared.And the differences of CT between MG eyes and the fellow non-MG eyes were compared.Results After eliminating the influence of age,the average CT of MG in the fovea,1mm and 3mm to the fovea was significantly thicker than that of CPACG and normal controls (P＜0.05).And the average CT of CPACG in the fovea,1mm and 3mm to the fovea was significantly thicker than that of normal controls (P＜0.05).In peripapillary area,the temporal,superior and inferior CT of MG was significantly thicker than that of CPACG and normal controls (P＜0.05).There was no significant difference of CT in peripapillary area between CPACG and normal controls (P＞0.05).In the fovea,1mm and 3mm to the fovea and peripapillary area,there was no significant difference of CT between MG eye and the fellow non-MG eye in MG group (t=1.029～-0.130,P＞0.05).Conclusions The choroid thickness of macular and peripapillary area in MG eyes is thicker than that of CPACG and the normal controls.An increased CT of macular and peripapillary area may be one of the risk factors for MG.