Glaucoma is a group of irreversible, blinding eye diseases characterized by progressive loss of retinal ganglion cells, leading to gradual visual field defects that severely impact patients' quality of life. Its complex pathophysiological mechanisms remain incompletely understood, limiting the development of early diagnostic and effective therapeutic strategies. Advances in omics technologies have provided new insights into elucidating the pathophysiology of glaucoma. We summarize specific alterations in genomics, transcriptomics, proteomics, metabolomics, epigenomics, and microbiomics associated with glaucoma. We emphasize the systematic analysis of disease mechanisms, identification of clinically applicable biomarkers, and discovery of novel therapeutic targets through the integration of these data. This approach paves new pathways for glaucoma subtype diagnosis and personalized treatment, while also outlining future research directions and challenges.

AIM: To conduct a systematic review and Meta-analysis to determine the differential effects of combined lutein and zeaxanthin supplementation on myopia prevention in teenagers. It also investigates the effects of supplements dosage, intervention duration, and geographical variation on intervention results. METHODS: A systematic search and screening of randomized controlled trials (RCTs) completed between 2014 and 2023 was undertaken using the PubMed, EMBASE, Cochrane Library, and Web of Science databases, in accordance with the PRISMA recommendations. The Cochrane risk of bias method was used to assess the quality of the studies. A Meta-analysis was performed using Stata 17.0 to calculate standardized mean differences (SMDs) and 95% confidence intervals (CIs). Subgroup analyses were performed to look at the effects of different doses, intervention periods, and geographic areas. Additionally, publication bias was assessed using Egger's test. RESULTS: Ten studies including 1035 participants with myopia were analyzed. Supplementation with lutein and zeaxanthin resulted in a significant reduction in axial length elongation among adolescents in the intervention group (SMD=-0.40, P=0.001), an increase in macular pigment optical density (SMD=0.50, P=0.010), and an enhancement in visual sensitivity (SMD=0.53, P=0.008). Subgroup analyses revealed that participants receiving high doses and those undergoing intervention for more than 12mo exhibited significantly improved outcomes compared to those in the low-dose and short-term groups (high-dose vs low-dose: SMD=-0.41 vs -0.22, P=0.003; >12mo vs 6-12mo: SMD=-0.43 vs -0.23, P=0.004, respectively). Furthermore, Egger's test indicated no significant publication bias (P=0.094). CONCLUSION: Combined lutein and zeaxanthin supplementation has a significant effect on myopia prevention in adolescents, with more pronounced benefits observed in high-dose and long-term interventions. The findings provide scientific evidence for its use as an adjunctive approach in myopia control.

The endoplasmic reticulum (ER) is the largest organelle in eukaryotic cells, and it plays a crucial role in regulating various biological processes, including protein folding, translation, and structural maturation. Accurate protein modification is essential for maintaining oxidative stress, apoptosis, and cellular senescence in the organism. The regulation of protein homeostasis involves three biological processes: endoplasmic reticulum stress (ERS), endoplasmic reticulum autophagy (ERPA), and endoplasmic reticulum-associated degradation (ERAD). Retinal degenerative disease (RDD) is a blinding eye conditions that cause severe vision loss. Although the pathogenesis of RDD is complex, previous data suggest that ER plays a key role in the development of a variety of eye diseases, such as diabetic retinopathy (DR), glaucoma, age-related macular degeneration (AMD), and axial myopia. Based on this, this paper will review the process of endoplasmic reticulum quality control (ERQC) and summarize the pathological mechanisms of the aforementioned eye diseases from the perspective of ERQC, providing new insights for the treatment of RDD.

Retinal degenerative diseases (RDD) are a group of age-related blinding eye diseases characterized by progressive degeneration and functional impairment of retinal photoreceptors or ganglion cells, for which there are currently no effective treatments. The complement system is an important innate immune system in the human body, activated through 3 pathways (classical pathway, lectin pathway, and alternative pathway) to ultimately form a membrane attack complex that acts on target cells. Microglia are the innate immune cells of the retina, responsible for maintaining retinal homeostasis. Complement system activation and microglial activation have been identified in RDD. Complement activation products C3 and C5 generate anaphylatoxins C3a and C5a, whose receptors C3aR and C5aR1 can activate microglia. Activated microglia can further produce complement C1q to activate the complement system, forming a positive feedback loop that exacerbates retinal damage. In this review, we focus on the crosstalk between the complement system and microglia in age-related macular degeneration, diabetic retinopathy, glaucoma, and pathological myopia-related retinal degeneration, and summarize clinical studies targeting the complement system and microglia for the treatment of RDD.

Retinal vein occlusion (RVO) represents a prevalent cause of vision impairment within retinal vascular diseases. Although hypoperfusion and inflammation are recognized pathogenic contributors, emerging evidence highlights oxidative stress as a pivotal mediator operating through ischemia-hypoxia-inflammation cascades. We conducted a systematic review of preclinical models and clinical studies examining reactive oxygen species (ROS) mechanisms in RVO pathogenesis. We searched PubMed/MEDLINE™ database for studies published through May 2025, focusing on oxidative stress biomarkers, therapeutic interventions, and neurovascular outcomes. In ischemic retina, ROS accumulation stabilizes hypoxia-inducible factor-1α (HIF-1α) and induces vascular endothelial growth factor (VEGF) expression, promoting vascular hyperpermeability and proinflammatory cytokine release. Bidirectional interactions between ROS signaling and systemic vascular mediators, including hypertension and the renin-angiotensin-aldosterone system (RAAS), disrupt redox homeostasis, increase retinal venous pressure, and impair microvascular perfusion. Oxidative stress-mediated activation of resident microglia and infiltrating macrophages promotes tight-junction protein degradation, resulting in blood-retinal barrier (BRB) breakdown and subsequent neurovascular injury. Patients with elevated systemic oxidative burden frequently present with bilateral, subclinical retinal microvascular impairment. Targeted antioxidant interventions, including nanoparticle-based delivery systems and bioactive phytochemicals, demonstrated efficacy in preclinical models by restoring redox balance, preserving BRB integrity, and reducing neurovascular damage. Oxidative stress represents a critical factor in RVO progression through interconnected vascular, inflammatory, and immune pathways. We propose a comprehensive management framework incorporating multimodal imaging for oxidative biomarker detection, artificial intelligence implementation for risk stratification, and personalized antioxidant therapy guided by validated biomarkers. Future investigations must establish causal relationships and identify specific, noninvasive biomarkers to advance precision prevention and treatment strategies for RVO.

Myopia has emerged as a globally pervasive visual disorder, with its incidence rising steadily, particularly among children and adolescents, posing a significant threat to ocular health. Recent research underscores a strong link between chronic inflammatory processes and both the onset and progression of myopia. As a cornerstone of the innate immune system, the complement cascade plays a pivotal role in mediating ocular inflammatory diseases associated with high myopia, including macular degeneration, glaucoma, allergic conjunctivitis, uveitis, and scleritis. Accumulating evidence indicates that complement activation contributes to myopia pathogenesis by orchestrating local inflammatory responses within the eye. This article is a narrative review that synthesizes current evidence on complement-myopia interactions, with a focus on the underlying biological mechanisms and their potential as therapeutic targets for both preventing and managing myopia.

The cGAS-STING signaling pathway plays a critical role in the immune defense against DNA viruses and in autoimmunity, coordinating a cascade of events that enhance cytokine production, particularly type I interferons. This review summarizes recent advancements in understanding the pathway's impact on various ocular diseases, including age-related macular degeneration (AMD), diabetic retinopathy, and uveitis. Activation of this pathway by cytoplasmic DNA from either damaged retinal cells or external pathogens induces inflammatory responses that may accelerate disease progression. Moreover, the paper explores new therapeutic approaches that target this pathway, offering insights into how modulation of cGAS-STING signaling could reduce inflammation and improve clinical outcomes. The emerging research in this area suggests potential for innovative treatments in ocular inflammation and degenerative conditions.

The occurrence of lacrimal passage obstruction diseases is closely related to the physiological parameters of lacrimal passage. The lacrimal passage is divided into membranous lacrimal passage and bony lacrimal passage. Computed tomography (CT) of lacrimal passage can help us understand the situation of bony lacrimal passage and clarify the impact of individual anatomical differences on the occurrence of diseases. The following chapters present the physiological parameters of lacrimal passage measured by lacrimal passage CT and the impact of anatomical structure of lacrimal sac fossa on endoscopic dacryocystisinostomy, and analyze the relevant anatomical parameters of the dacryocystitis patients, including the angle between the nasolacrimal passage and the nasal plane, and the correlation between the deviation of the nasal septum and the occurrence of dacryocystitis.

Objectives: Chinese patent medicines (CPMs) are commonly prescribed by clinicians in China as adjuvant therapy for diabetic retinopathy (DR). The study of network meta-analysis (NMA) aims to compare the effectiveness and safety of three CPMs plus calcium dobesilate (CD) for DR, and to explore optimal CPM for treatment of DR. Methods. Bayesian network meta-analyses were designed to evaluate the safety and effectiveness of different CPMs for the treatment of DR. Systematic Review Registration CRD42022323996. Results. A total of 23 eligible RCTs involving 1824 patients were enrolled. Compared with CD alone, Cmpound Danshen Dripping Pills (DS) + CD or Qiming Granule (QM) + CD considerably enhanced best corrected visual acuity (BCVA); DS + CD or Compound Xueshuantong Capsule (XST) + CD significantly reduced macular thickness; CPMs + CD significantly reduced the level of VEGF. In addition, DS + CD or XST + CD over QM + CD in reducing macular thickness. As for the adverse events, the differences across different CPMs were not statistically significant, and no statistically significant difference between the CPMs and CD. Conclusion. DS plus CD or QM plus CD may be better effective in improving BCVA; DS plus CD or XST plus CD may be better effective in reducing macular thickness; The combination therapy all may be better effective in reducing the level of VEGF. As for safety profile that CPMs plus CD did not increase the incidence of adverse events. The results of this study might support DS as a relatively prior adjuvant therapy option for patients with DR.

Diabetic retinopathy (DR), a leading cause of visual impairment, demands a profound comprehension of its cellular mechanisms to formulate effective therapeutic strategies. Our study presentes a comprehensive single-cell analysis elucidating the intricate landscape of Müller cells within DR, emphasizing their nuanced involvement. Utilizing scRNA-seq data from both Sprague–Dawley rat models and human patients, we delineated distinct Müller cell clusters and their corresponding gene expression profiles. These findings were further validated through differential gene expression analysis utilizing human transcriptomic data. Notably, certain Müller cell clusters displayed upregulation of the Rho gene, implying a phagocytic response to damaged photoreceptors within the DR microenvironment. This phenomenon was consistently observed across species. Additionally, the co-expression patterns of RHO and PDE6G within Müller cell clusters provided compelling evidence supporting their potential role in maintaining retinal integrity during DR. Our results offer novel insights into the cellular dynamics of DR and underscore Müller cells as promising therapeutic targets for preserving vision in retinal disorders induced by diabetes.

The retinal pigment epithelium (RPE) is a regularly arranged monolayer of cells in the outermost layer of the retina. It is crucial for transporting nutrients and metabolic substances in the retina and maintaining the retinal barrier. RPE dysfunction causes diseases related to vision loss. Thus, understanding the mechanisms involved in normal RPE function is vital. Adenosine monophosphate-activated protein kinase (AMPK) is an RPE energy sensor regulating various signaling and metabolic pathways to maintain cellular energetic homeostasis. AMPK activation is involved in multiple signaling pathways regulated by autophagy in the RPE, thereby protecting the cells from oxidative stress and slowing RPE degeneration. In this review, we attempt to broaden the understanding of the pathogenesis of RPE dysfunction by focusing on the role and mechanism of AMPK regulation of autophagy in the RPE. The correlation between RPE cellular homeostasis and role of AMPK was determined by analyzing the structure and mechanism of AMPK and its signaling pathway in autophagy. The protective effect of AMPK-regulated autophagy on the RPE for gaining insights into the regulatory pathways of RPE dysfunction has been discussed.

Microglia is involved in the occurrence and development of retinal degenerative diseases,thus its activation is a marker for retinal degenerative diseases.Microglia can be activated by different external stimulating factors and polar-ized into two phenotypes with different functional states and surface markers.The classical activation pathway produces M1 phenotype microglia,which mainly exerts pro-inflammatory and neurotoxic effects;the selective activation pathway pro-duces M2 phenotype microglia,which mainly exerts anti-inflammatory and neuroprotective effects.Precise modulation of microglia polarization is a promising approach for treating retinal degenerative diseases.This paper reviews the role of mi-croglia polarization in the pathogenesis of retinal degenerative diseases,aiming to pioneer new avenues and research ideas for treating retinal degenerative diseases.

目的 测量慢性泪囊炎患者患病泪囊顶部及底部至中鼻甲腋平面的距离从而明确泪囊与中鼻甲腋平面的相对位置关系.设计实验研究.研究对象成都中医药大学附属医院191例(216眼)慢性泪囊炎患者的CT泪道造影图像.方法 进行CT泪道造影图像三维重建,选择冠状位上能同时完整显示泪囊及中鼻甲腋平面的图像,运用软件测量工具,对图像上患病泪囊顶部及底部至中鼻甲腋平面的距离进行测量.主要指标泪囊顶部及底部至中鼻甲腋平面的距离.结果 191例216眼中女性153例173眼.所有患者、不同性别之间、不同年龄段之间、不同眼别之间,患病泪囊顶部至中鼻甲腋平面的距离与底部至中鼻甲腋平面的距离比较,除0～20岁年龄组差异无统计学意义(P＞0.05)外,其余均具有统计学意义(P均＜0.05),且泪囊底部至中鼻甲腋平面的距离大于顶部至中鼻甲腋平面的距离.41～60岁组患者底部至中鼻甲腋平面的距离较61～80岁组患者大(P=0.003).结论 慢性泪囊炎患者患病泪囊底部至中鼻甲腋平面的距离大于顶部至中鼻甲腋平面的距离,泪囊大部分位于中鼻甲腋平面的下方.

This paper reports a case of chronic dacryocystitis due to nasal stones. An 84-year-old male patient was admitted to the hospital with chronic dacryocystitis of the right eye due to tearing and purulent discharge from the right eye for more than 1 month. Antibiotic treatments such as gatifloxacin eye drops were given at other hospitals but did not relieve the symptoms. A computed tomography(CT) scan of the lacrimal duct in our department showed a high-density shadow in the right lacrimal sac area, hypertrophy of the right inferior turbinate, and many nasal calculi in the nasal cavity. The patient was transferred to our otolaryngology department for further treatment, and nasal stones were removed under nasal endoscopy. Three days after surgery, the symptoms affecting the patient's right eye gradually resolved. One month after surgery, the patient underwent a follow-up examination in the ophthalmology clinic; there was no lacrimal purulent discharge from the right eye, and the lacrimal duct could be flushed smoothly. Chronic dacryocystitis is often caused by primary nasolacrimal duct obstruction. Cases of chronic dacryocystitis caused by secondary nasolacrimal duct obstruction due to nasal stones are rare in the clinic. This case can serve as a reference for the clinical diagnosis and treatment of chronic dacryocystitis.

This study aims to investigate the potential bidirectional causal relationship between myopia and vitreous disorders from a genetic perspective, as vitreous disorders have been found to be closely associated with myopia development. To achieve this, a two-sample Mendelian randomization (MR) design was employed. The study utilized pooled statistics from independent genome-wide association studies. Myopia was chosen as the exposure factor, while five different vitreous disorders were considered as outcomes. The primary analytical method was the inverse variance weighting (IVW) method, supplemented by sensitivity analysis. The study yielded significant findings indicating a positive association between myopia and vitreous disorders. The genetic prediction of myopia consistently demonstrated a positive correlation with vitreous disorders, as evidenced by IVW (odds ratio [OR] = 18.387; P < 0.01), MR Egger (OR = 2784.954; P < 0.01), weighted median (OR = 30.284; P < 0.01), and weighted mode (OR = 57.381; P < 0.01). All sensitivity analyses further validated these associations. Furthermore, a significant association was observed between myopia and other unspecified vitreous body disorders (IVW: OR = 57.729; P < 0.01). Studies mainly conducted in European populations have confirmed that myopia, extending beyond early high myopia, plays a crucial role in influencing vitreous disorders and that there is a unidirectional causal relationship between myopia and vitreous disorders. Additionally, a causal relationship was identified between myopia and other unspecified vitreous disordes. These findings introduce fresh perspectives for the clinical management of unspecified vitreous disorders and contribute to the understanding of the effect of myopia on vitreous disorders. Myopia prevention and treatment will aid in slowing down the process of vitreous liquefaction and subsequently decrease the incidence of malignant eye conditions.

AIM: To investigate the effects of modified Zhujing Pill on the mitochondrion structure and dynamin-related protein of retinal pigment epithelial cells(RPEs)in mice with form deprivation myopia.METHODS: 3-week-old C57BL/6J mice were randomly divided into control group, model group and Chinese medicine group, with 10 mice in each group. Myopia model of the right eye of mice was established by means of form deprivation in model and Chinese medicine groups. After 4wk, the Chinese medicine group were given intragastric administration of modified Zhujing Pill suspension 0.546g/(kg·d)(0.2mL/d)for 4wk, and same amount of saline was given to mice in other groups at the same time of modeling. The axial length and diopter of the right eye of the mouse were measured before and after the experiment by A-ultrasound and a strip retinoscope respectively. At the end of the experiment, the mitochondrial ultrastructure of RPEs was observed by transmission electron microscope. Western blot, and real-time fluorescent quantitative PCR(q-PCR)were used to detect quantitative and gene expression of mitofusin 1(MFN1), optic atrophy 1(OPA1), and dynamin-related protein 1(DRP1)in retinal tissues respectively.RESULTS: At the beginning of the experiment, there was no statistically significant difference in axial length and diopter of the right eye of the mouse in control, model and Chinese medicine groups(P>0.05). At the end of the experiment, compared with the control group, the mice in the model group and the Chinese medicine group had lower diopter and continuously prolonged axial length(all P<0.05), while the mice in the Chinese medicine group had significantly shorter axial length and higher diopter than the model group(all P<0.05). Western blot and q-PCR results showed that the relative expression of MFN1 and OPA1 decreased and DRP1 increased in both the model group and the Chinese medicine group compared with the control group(all P<0.05), and the relative expression of MFN1 and OPA1 increased in the Chinese medicine group compared with the model group(all P<0.05). The electron microscopic results showed that the mitochondria in the right retina of the mice were only mildly swollen in the Chinese medicine group, while the mitochondria in the model group were obviously swollen and disordered and empty.CONCLUSION: Modified Zhujing Pill could protect the retinal mitochondria by regulating the key proteins of mitochondrial dynamics(MFN1, OPA1, and DRP1), and it has a protective effect on the retina of axial myopic mice.

Diabetic retinopathy (DR) is a microvascular lesion that occurs as a complication of diabetes mellitus. Many studies reveal that retinal neurodegeneration occurs early in its pathogenesis, and abnormal retinal function can occur in patients without any signs of microvascular abnormalities. The gut microbiota is a large, diverse colony of microorganisms that colonize the human intestine. Studies indicated that the gut microbiota is involved in the pathophysiological processes of DR and plays an important role in its development. On the one hand, numerous studies demonstrated the involvement of gut microbiota in retinal neurodegeneration. On the other hand, alterations in gut bacteria in RD patients can cause or exacerbate DR. The present review aims to underline the critical relationship between gut microbiota and DR. After a brief overview of the composition, function, and essential role of the gut microbiota in ocular health, and the review explores the concept of the gut-retina axis and the conditions of the gut-retina axis crosstalk. Because gut dysbiosis has been associated with DR, the review intends to determine changes in the gut microbiome in DR, the hypothesized mechanisms linking to the gut-retina axis, and its predictive potential.

High myopia usually refers to myopia with a diopter greater than-6.00 D and/or a common refractive error with an axial length greater than 26.5 mm, which can cause various ocular complications and fundus degenerative disorders. High myopia is considered to be closely related to the choroid, for the choroid of high myopia patient becomes thinner, which further affects the blood circulation, thus causing the corresponding fundus disorders, that may lead to irreversible visual damage, even blindness. To investigate the close correlation between the two, this paper mainly describes the research progress on high myopia and choroidal microcirculation, including choroidal thickness, choroidal capillaries and related detection techniques.

AIM: To investigate the effect of modified Zhujing pill on retinal autophagy in mice with form deprivation myopia.METHODS: Thirty C57BL/6 mice were randomly divided into a negative control group, a myopia model group and a traditional Chinese medicine intervention group, with 10 mice in each group. Except for the negative control group, all mice in the myopia model group and the traditional Chinese medicine intervention group used translucent EP tubes to cover their right eyes to make a form deprivation myopia(FDM)model; The traditional Chinese medicine intervention group gavage Zhujing pill modified suspension 0.546g/(kg·d)(0.15mL/d), the negative control group and the myopia model group were given an equal amount of normal saline(0.15mL/d)for 4wk. At the beginning and the end of the experiment respectively, the right eye diopter of the mouse was measured with a strip retinoscope, measurement of the axial length of the right eye of mouse by A-ultrasound. At the end of the experiment, the right eyes of all mice were taken for detection, and immunofluorescence method was used to locate and detect the activity and migration of the retinal microglia marker(Iba1); Transmission electron microscope observation of autophagosome formation in retinal pigment epithelial cells; Western Blot, real-time fluorescent quantitative PCR(q-PCR)to detect the autophagy marker LC3Ⅱ and p62 protein quantitative and gene expression in retinal tissues.RESULTS: At the end of the experiment, the refractive power of the right eyes of mice showed that the myopia model group and the traditional Chinese medicine intervention group formed relative myopia, the myopia model group and the traditional Chinese medicine intervention group were significantly lower than those of the negative control group(all P<0.01). At the end of the experiment, the axial length of the myopia model group and the Chinese medicine intervention group were significantly increased compared with the negative control group(P<0.01). Immunofluorescence method for locating and detecting Iba1 showed that the average optical density of Iba1 in the retina of the myopia model group increased the most obviously, followed by the increase in the negative control group, and the decrease in the traditional Chinese medicine intervention group. Compared with the negative control group, the myopia model group increased significantly(P<0.05), and the traditional Chinese medicine intervention group was significantly lower than the myopia model group(P<0.05). It was found that Iba1 migrated to the ganglion cell layer in the myopia model group and the traditional Chinese medicine intervention group. Transmission electron microscopy showed that autophagosomes were observed in the retinal pigment epithelial cells of the myopia model group and the Chinese medicine intervention group. The results of Western Blot and q-PCR showed that the expression of LC3Ⅱ and p62 increased most obviously in the traditional Chinese medicine intervention group, followed by the myopia model group, and the negative control group was the lowest.CONCLUSION: The results of the study show that modified Zhujing pill may enhance retinal autophagy in mice with FDM by inhibiting the activation of microglia.

Abstract Age-related macular degeneration (AMD) is an important cause of visual impairment and even blindness in the elderly. At present, the treatment of AMD mainly focuses on the treatment of Neovascular AMD (nvAMD), by repeatedly injecting anti-vascular endothelial growth factor (anti-VEGF) drugs into the vitreous. Although anti-VEGF drugs are landmark treatment options in the field of nvAMD treatment, multiple injections may cause some patients to respond poorly or even non-responsively and may develop progressive fibrosis. Artemisinin and its derivatives were initially used as antimalarial treatments. In recent years, the role of artemisinin and its derivatives in AMD has attracted great attention. Artemisinin treatment can not only effectively protect pigment epithelial cells in AMD from oxidative damage, reverse pigment epithelial cell mitochondrial dysfunction and anti-angiogenesis, but also effectively reduce pre-corneal injury caused by vitreous injection of anti-VEGF through microparticle drugs (carrying artemisinin). Many experiments have confirmed the therapeutic effect of artemisinin and its derivatives on AMD, but no article has systematically demonstrated the special role of artemisinin in the treatment of AMD. This article reviews the potential therapeutic effects and mechanisms of artemisinin and its derivatives in AMD to provide references for subsequent related studies.