Corneal neuromas,also termed microneuromas,refer to microscopic,irregula rly-shaped enlargements of terminal subbasal nerve endings at sites of nerve damage or injury.The formation of corneal neuromas results from dam...Corneal neuromas,also termed microneuromas,refer to microscopic,irregula rly-shaped enlargements of terminal subbasal nerve endings at sites of nerve damage or injury.The formation of corneal neuromas results from damage to corneal nerves,such as following corneal pathology or corneal or intraocular surge ries.Initially,denervated areas of sensory nerve fibers become invaded by sprouts of intact sensory nerve fibers,and later injured axons regenerate and new sprouts called neuromas develop.In recent years,analysis of corneal nerve abnormalities including corneal neuromas which can be identified using in vivo confocal microscopy,a non-invasive imaging technique with microscopic resolution,has been used to evaluate corneal neuropathy and ocular surface dysfunction.Corneal neuromas have been shown to be associated with clinical symptoms of discomfort and dryness of eyes,and are a promising surrogate biomarker for ocular surface diseases,such as neuropathic corneal pain,dry eye disease,diabetic corneal neuropathy,neurotrophic keratopathy,Sjogren's syndrome,bullous keratopathy,post-refra ctive surgery,and others.In this review,we have summarized the current literature on the association between these ocular surface diseases and the presentation of corneal microneuromas,as well as elaborated on their pathogenesis,visualization via in vivo confocal microscopy,and utility in monitoring treatment efficacy.As current quantitative analysis on neuromas mainly relies on manual annotation and quantification,which is user-dependent and labor-intensive,future direction includes the development of artificial intelligence software to identify and quantify these potential imaging biomarkers in a more automated and sensitive manner,allowing it to be applied in clinical settings more efficiently.Combining imaging and molecular biomarkers may also help elucidate the associations between corneal neuromas and ocular surface diseases.展开更多
Metal–organic frameworks(MOFs)have attracted significant research interest in biomimetic catalysis.However,the modulation of the activity of MOFs by precisely tuning the coordination of metal nodes is still a signifi...Metal–organic frameworks(MOFs)have attracted significant research interest in biomimetic catalysis.However,the modulation of the activity of MOFs by precisely tuning the coordination of metal nodes is still a significant challenge.Inspired by metalloenzymes with well-defined coordination structures,a series of MOFs containing halogen-coordinated copper nodes(Cu-X MOFs,X=Cl,Br,I)are employed to elucidate their structure–activity relationship.Intriguingly,experimental and theoretical results strongly support that precisely tuning the coordination of halogen atoms directly regulates the enzyme-like activities of Cu-X MOFs by influencing the spatial configuration and electronic structure of the Cu active center.The optimal Cu–Cl MOF exhibits excellent superoxide dismutase-like activity with a specific activity one order of magnitude higher than the reported Cu-based nanozymes.More importantly,by performing enzyme-mimicking catalysis,the Cu–Cl MOF nanozyme can significantly scavenge reactive oxygen species and alleviate oxidative stress,thus effectively relieving ocular chemical burns.Mechanistically,the antioxidant and antiapoptotic properties of Cu–Cl MOF are achieved by regulating the NRF2 and JNK or P38 MAPK pathways.Our work provides a novel way to refine MOF nanozymes by directly engineering the coordination microenvironment and,more significantly,demonstrating their potential therapeutic effect in ophthalmic disease.展开更多
The landscape of ophthalmology has obser ved monumental shifts with the advent of artificial intelligence(AI)technologies.This article is devoted to elaborating on the nuanced application of AI in the diagnostic realm...The landscape of ophthalmology has obser ved monumental shifts with the advent of artificial intelligence(AI)technologies.This article is devoted to elaborating on the nuanced application of AI in the diagnostic realm of anterior segment eye diseases,an area ripe with potential yet complex in its imaging characteristics.Historically,AI’s entrenchment in ophthalmology was predominantly rooted in the posterior segment.However,the evolution of machine learning paradigms,particularly with the advent of deep learning methodologies,has reframed the focus.When combined with the exponential surge in available electronic image data pertaining to the anterior segment,AI’s role in diagnosing corneal,conjunctival,lens,and eyelid pathologies has been solidified and has emerged from the realm of theoretical to practical.In light of this transformative potential,collaborations between the Ophthalmic Imaging and Intelligent Medicine Subcommittee of the China Medical Education Association and the Ophthalmology Committee of the International Translational Medicine Association have been instrumental.These eminent bodies mobilized a consortium of experts to dissect and assimilate advancements from both national and international quarters.Their mandate was not limited to AI’s application in anterior segment pathologies like the cornea,conjunctiva,lens,and eyelids,but also ventured into deciphering the existing impediments and envisioning future trajectories.After iterative deliberations,the consensus synthesized herein serves as a touchstone,assisting ophthalmologists in optimally integrating AI into their diagnostic decisions and bolstering clinical research.Through this guideline,we aspire to offer a comprehensive framework,ensuring that clinical decisions are not merely informed but transformed by AI.By building upon existing literature yet maintaining the highest standards of originality,this document stands as a testament to both innovation and academic integrity,in line with the ethos of renowned journals such as Ophthalmology.展开更多
AIM:To describe the prevalence and demographic characteristics of corneal blindness in an urban and rural region of Ningxia,located in the northwest part of China.METHODS:A stratified,randomized sampling procedure was...AIM:To describe the prevalence and demographic characteristics of corneal blindness in an urban and rural region of Ningxia,located in the northwest part of China.METHODS:A stratified,randomized sampling procedure was employed in the study,including urban and rural area of all age group.Visual acuity,anterior segment and ocular fundus were checked.Related factor of corneal disease,including age,gender,education status,ethnic group,location and occupation,were identified according to uniform customized protocol.An eye was defined to be corneal blindness if the visual acuity was<20/400 due to a corneal disease.RESULTS:Three thousand individuals(1290 from urban area and 1710 from rural area)participated in the investigation,with a response rate of 80.380%.The prevalence of corneal blindness was 0.023%in both eyes and 0.733%in at least one eye.The blindness in at least one eye with varied causes was present in 106participants(3.533%)and in bilateral eyes in 34participants(1.133%).The corneal diseases accounted for 20.754%of blindness in at least one eye and 20.588%of bilateral blindness.The prevalence of corneal disease was higher in older and Han ethnic group,especially those who occupied in agriculture and outdoor work.People with corneal blindness were more likely to be older and lower education.Rural population were more likely to suffer from bilateral corneal blindness than the urban population in≥59-year group(χ2=6.716,P=0.019).Infectious,trauma and immune corneal disease were the three leading causes of corneal disease.Trauma cornealdisease was more likely leading to blindness in one eye.However,infectious and immune corneal diseases make more contribution to the bilateral corneal blindness.CONCLUSION:Corneal blindness is a significant burden of in Ningxia population,encompassing a variety of corneal infections and trauma;the majority of those were avoidable.Health promotion strategies and good hygienic conditions have to be developed.展开更多
The number of people with eye diseases has increased with the use of electronics.However,the bioavailability of eye drops remains low owing to the presence of the ocular barrier and other reasons.Although many drug de...The number of people with eye diseases has increased with the use of electronics.However,the bioavailability of eye drops remains low owing to the presence of the ocular barrier and other reasons.Although many drug delivery systems have been developed to overcome these problems,they have certain limitations.In recent years,the development of contact lenses that can deliver drugs for long periods with high bioavailability and without affecting vision has increased the interest in using contact lenses for drug delivery.Hence,a review of the current state of research on drug delivery contact lenses has become crucial.This article reviews the key physical and chemical properties of drug-laden contact lenses,development and classification of contact lenses,and features of the commonly used materials.A review of the methods commonly used in current research to create contact lenses has also been presented.An overview on how drug-laden contact lenses can overcome the problems of high burst and short release duration has been discussed.Overall,the review focuses on drug delivery methods using smart contact lenses,and predicts the future direction of research on contact lenses.展开更多
Infectious keratitis is the most common condition of corneal diseases in which a pathogen grows in the cornea leading to inflammation and destruction of the corneal tissues.Infectious keratitis is a medical emergency ...Infectious keratitis is the most common condition of corneal diseases in which a pathogen grows in the cornea leading to inflammation and destruction of the corneal tissues.Infectious keratitis is a medical emergency for which a rapid and accurate diagnosis is needed to ensure prompt and precise treatment to halt the disease progression and to limit the extent of corneal damage;otherwise,it may develop a sight-threatening and even eye-globe-threatening condition.In this paper,we propose a sequentiallevel deep model to effectively discriminate infectious corneal disease via the classification of clinical images.In this approach,we devise an appropriate mechanism to preserve the spatial structures of clinical images and disentangle the informative features for clinical image classification of infectious keratitis.In a comparison,the performance of the proposed sequential-level deep model achieved 80%diagnostic accuracy,far better than the 49.27%±11.5%diagnostic accuracy achieved by 421 ophthalmologists over 120 test images.展开更多
文摘Corneal neuromas,also termed microneuromas,refer to microscopic,irregula rly-shaped enlargements of terminal subbasal nerve endings at sites of nerve damage or injury.The formation of corneal neuromas results from damage to corneal nerves,such as following corneal pathology or corneal or intraocular surge ries.Initially,denervated areas of sensory nerve fibers become invaded by sprouts of intact sensory nerve fibers,and later injured axons regenerate and new sprouts called neuromas develop.In recent years,analysis of corneal nerve abnormalities including corneal neuromas which can be identified using in vivo confocal microscopy,a non-invasive imaging technique with microscopic resolution,has been used to evaluate corneal neuropathy and ocular surface dysfunction.Corneal neuromas have been shown to be associated with clinical symptoms of discomfort and dryness of eyes,and are a promising surrogate biomarker for ocular surface diseases,such as neuropathic corneal pain,dry eye disease,diabetic corneal neuropathy,neurotrophic keratopathy,Sjogren's syndrome,bullous keratopathy,post-refra ctive surgery,and others.In this review,we have summarized the current literature on the association between these ocular surface diseases and the presentation of corneal microneuromas,as well as elaborated on their pathogenesis,visualization via in vivo confocal microscopy,and utility in monitoring treatment efficacy.As current quantitative analysis on neuromas mainly relies on manual annotation and quantification,which is user-dependent and labor-intensive,future direction includes the development of artificial intelligence software to identify and quantify these potential imaging biomarkers in a more automated and sensitive manner,allowing it to be applied in clinical settings more efficiently.Combining imaging and molecular biomarkers may also help elucidate the associations between corneal neuromas and ocular surface diseases.
基金the National Key R&D Program of China(Grant No.2020YFA0908100)the National Nature Science Foundation(Grant Nos.12274356,82070931,and 82271045)+1 种基金Fundamental Research Funds for the Central Universities(20720220022)the 111 Project(B16029)。
文摘Metal–organic frameworks(MOFs)have attracted significant research interest in biomimetic catalysis.However,the modulation of the activity of MOFs by precisely tuning the coordination of metal nodes is still a significant challenge.Inspired by metalloenzymes with well-defined coordination structures,a series of MOFs containing halogen-coordinated copper nodes(Cu-X MOFs,X=Cl,Br,I)are employed to elucidate their structure–activity relationship.Intriguingly,experimental and theoretical results strongly support that precisely tuning the coordination of halogen atoms directly regulates the enzyme-like activities of Cu-X MOFs by influencing the spatial configuration and electronic structure of the Cu active center.The optimal Cu–Cl MOF exhibits excellent superoxide dismutase-like activity with a specific activity one order of magnitude higher than the reported Cu-based nanozymes.More importantly,by performing enzyme-mimicking catalysis,the Cu–Cl MOF nanozyme can significantly scavenge reactive oxygen species and alleviate oxidative stress,thus effectively relieving ocular chemical burns.Mechanistically,the antioxidant and antiapoptotic properties of Cu–Cl MOF are achieved by regulating the NRF2 and JNK or P38 MAPK pathways.Our work provides a novel way to refine MOF nanozymes by directly engineering the coordination microenvironment and,more significantly,demonstrating their potential therapeutic effect in ophthalmic disease.
基金Supported by National Natural Science Foundation of China(No.82160195,No.81800804,No.82201148)Jiangxi Province Double Thousand Plan Technology Innovation High-end Leading Talent Project(No.jxsq2023201036)+1 种基金Jiangxi Province Major(Key)R&D Special Plan(No.20223BBH80014,No.20181BBG70004,No.20203BBG73059)Jiangxi Province Outstanding Youth Fund(No.20192BCBL23020).
文摘The landscape of ophthalmology has obser ved monumental shifts with the advent of artificial intelligence(AI)technologies.This article is devoted to elaborating on the nuanced application of AI in the diagnostic realm of anterior segment eye diseases,an area ripe with potential yet complex in its imaging characteristics.Historically,AI’s entrenchment in ophthalmology was predominantly rooted in the posterior segment.However,the evolution of machine learning paradigms,particularly with the advent of deep learning methodologies,has reframed the focus.When combined with the exponential surge in available electronic image data pertaining to the anterior segment,AI’s role in diagnosing corneal,conjunctival,lens,and eyelid pathologies has been solidified and has emerged from the realm of theoretical to practical.In light of this transformative potential,collaborations between the Ophthalmic Imaging and Intelligent Medicine Subcommittee of the China Medical Education Association and the Ophthalmology Committee of the International Translational Medicine Association have been instrumental.These eminent bodies mobilized a consortium of experts to dissect and assimilate advancements from both national and international quarters.Their mandate was not limited to AI’s application in anterior segment pathologies like the cornea,conjunctiva,lens,and eyelids,but also ventured into deciphering the existing impediments and envisioning future trajectories.After iterative deliberations,the consensus synthesized herein serves as a touchstone,assisting ophthalmologists in optimally integrating AI into their diagnostic decisions and bolstering clinical research.Through this guideline,we aspire to offer a comprehensive framework,ensuring that clinical decisions are not merely informed but transformed by AI.By building upon existing literature yet maintaining the highest standards of originality,this document stands as a testament to both innovation and academic integrity,in line with the ethos of renowned journals such as Ophthalmology.
基金Supported by Consultation Program of Chinese Academy of Engineering(No.2009-77)Research Program of Ningxia Science and Technology Department(No.NKJ2010-168)
文摘AIM:To describe the prevalence and demographic characteristics of corneal blindness in an urban and rural region of Ningxia,located in the northwest part of China.METHODS:A stratified,randomized sampling procedure was employed in the study,including urban and rural area of all age group.Visual acuity,anterior segment and ocular fundus were checked.Related factor of corneal disease,including age,gender,education status,ethnic group,location and occupation,were identified according to uniform customized protocol.An eye was defined to be corneal blindness if the visual acuity was<20/400 due to a corneal disease.RESULTS:Three thousand individuals(1290 from urban area and 1710 from rural area)participated in the investigation,with a response rate of 80.380%.The prevalence of corneal blindness was 0.023%in both eyes and 0.733%in at least one eye.The blindness in at least one eye with varied causes was present in 106participants(3.533%)and in bilateral eyes in 34participants(1.133%).The corneal diseases accounted for 20.754%of blindness in at least one eye and 20.588%of bilateral blindness.The prevalence of corneal disease was higher in older and Han ethnic group,especially those who occupied in agriculture and outdoor work.People with corneal blindness were more likely to be older and lower education.Rural population were more likely to suffer from bilateral corneal blindness than the urban population in≥59-year group(χ2=6.716,P=0.019).Infectious,trauma and immune corneal disease were the three leading causes of corneal disease.Trauma cornealdisease was more likely leading to blindness in one eye.However,infectious and immune corneal diseases make more contribution to the bilateral corneal blindness.CONCLUSION:Corneal blindness is a significant burden of in Ningxia population,encompassing a variety of corneal infections and trauma;the majority of those were avoidable.Health promotion strategies and good hygienic conditions have to be developed.
基金supported by the Scientific Research Project of Liaoning Province Education Department(2020LJC16)
文摘The number of people with eye diseases has increased with the use of electronics.However,the bioavailability of eye drops remains low owing to the presence of the ocular barrier and other reasons.Although many drug delivery systems have been developed to overcome these problems,they have certain limitations.In recent years,the development of contact lenses that can deliver drugs for long periods with high bioavailability and without affecting vision has increased the interest in using contact lenses for drug delivery.Hence,a review of the current state of research on drug delivery contact lenses has become crucial.This article reviews the key physical and chemical properties of drug-laden contact lenses,development and classification of contact lenses,and features of the commonly used materials.A review of the methods commonly used in current research to create contact lenses has also been presented.An overview on how drug-laden contact lenses can overcome the problems of high burst and short release duration has been discussed.Overall,the review focuses on drug delivery methods using smart contact lenses,and predicts the future direction of research on contact lenses.
基金supported by the Health Commission of Zhejiang Province(WKJ-ZJ-1905 and 2018ZD007)the Key Research and Development Projects of Zhejiang Province(2018C03082)the National Natural Science Foundation of China(61625107)。
文摘Infectious keratitis is the most common condition of corneal diseases in which a pathogen grows in the cornea leading to inflammation and destruction of the corneal tissues.Infectious keratitis is a medical emergency for which a rapid and accurate diagnosis is needed to ensure prompt and precise treatment to halt the disease progression and to limit the extent of corneal damage;otherwise,it may develop a sight-threatening and even eye-globe-threatening condition.In this paper,we propose a sequentiallevel deep model to effectively discriminate infectious corneal disease via the classification of clinical images.In this approach,we devise an appropriate mechanism to preserve the spatial structures of clinical images and disentangle the informative features for clinical image classification of infectious keratitis.In a comparison,the performance of the proposed sequential-level deep model achieved 80%diagnostic accuracy,far better than the 49.27%±11.5%diagnostic accuracy achieved by 421 ophthalmologists over 120 test images.
