AIM:To investigate the efficacy of a new visual acuity(VA)screening method,the baby vision test for young children.METHODS:A total 105 eyes of 65 children aged 2-8y were included in the study.Acuity testing was conduc...AIM:To investigate the efficacy of a new visual acuity(VA)screening method,the baby vision test for young children.METHODS:A total 105 eyes of 65 children aged 2-8y were included in the study.Acuity testing was conducted using a standardized recognition acuity chart(Snellen visual chart:at 3 m)and the baby vision model assessment.The baby vision device includes a screen,a near infrared camera and a computer.Children were seated at a measured distance of 33-40 cm from a display for testing.VA was estimated according to the highest resolution the children could follow.Decimal VA data were converted to logarithm of the minimum angle of resolution(logMAR)for statistical analysis.The VA results for each child were recorded and analyzed for consistency.RESULTS:The mean VA measured using the Snellen visual chart was 0.62±0.32,and that assessed using the baby vision test was 0.66±0.27.The 95%limit of agreement was-0.609 to 0.695,with 95.2%(100/105)plots within the 95%limits of agreement.VA values of the baby vision test were significantly correlated with those of the Snellen chart(R=0.274,P=0.005).CONCLUSION:The baby vision test can be used as a relatively reliable method for estimating VA in young children.This new acuity assessment might be a valid predictor of optotype-measured acuity later in preverbal children.展开更多
AIM:To assess the performance of macular ganglion cell-inner plexiform layer thickness(mGCIPLT)and 10-2 visual field(VF)parameters in detecting early glaucoma and evaluating the severity of advanced glaucoma.METHODS:T...AIM:To assess the performance of macular ganglion cell-inner plexiform layer thickness(mGCIPLT)and 10-2 visual field(VF)parameters in detecting early glaucoma and evaluating the severity of advanced glaucoma.METHODS:Totally 127 eyes from 89 participants(36 eyes of 19 healthy participants,45 eyes of 31 early glaucoma patients and 46 eyes of 39 advanced glaucoma patients)were included.The relationships between the optical coherence tomography(OCT)-derived parameters and VF sensitivity were determined.Patients with early glaucoma were divided into eyes with or without central 10°of the VF damages(CVFDs),and the diagnostic performances of OCT-derived parameters were assessed.RESULTS:In early glaucoma,the mGCIPLT was significantly correlated with 10-2 VF pattern standard deviation(PSD;with average mGCIPLT:β=-0.046,95%CI,-0.067 to-0.024,P<0.001).In advanced glaucoma,the mGCIPLT was related to the 24-2 VF mean deviation(MD;with average mGCIPLT:β=0.397,95%CI,0.199 to 0.595,P<0.001),10-2 VF MD(with average mGCIPLT:β=0.762,95%CI,0.485 to 1.038,P<0.001)and 24-2 VF PSD(with average mGCIPLT:β=0.244,95%CI,0.124 to 0.364,P<0.001).Except for the minimum and superotemporal mGCIPLT,the decrease of mGCIPLT in early glaucomatous eyes with CVFDs was more severe than that of early glaucomatous eyes without CVFDs.The area under the curve(AUC)of the average mGCIPLT(AUC=0.949,95%CI,0.868 to 0.982)was greater than that of the average circumpapillary retinal nerve fiber layer thickness(cpRNFLT;AUC=0.827,95%CI,0.674 to 0.918)and rim area(AUC=0.799,95%CI,0.610 to 0.907)in early glaucomatous eyes with CVFDs versus normal eyes.CONCLUSION:The 10-2 VF and mGCIPLT parameters are complementary to 24-2 VF,cpRNFLT and ONH parameters,especially in detecting early glaucoma with CVFDs and evaluating the severity of advanced glaucoma in group level.展开更多
AIM:To compare the consistency of two autorefractors(Tianle RM-9000 and Topcon KR-800)for school-age myopia children,and to provide a basis for largescale data analysis and comparison.METHODS:The refractive error in 9...AIM:To compare the consistency of two autorefractors(Tianle RM-9000 and Topcon KR-800)for school-age myopia children,and to provide a basis for largescale data analysis and comparison.METHODS:The refractive error in 909 subjects(age 4–18y)were measured using both autorefractors without cycloplegia.The data were analyzed using Fourier decomposition and the correlation coefficients,intraclass correlation coefficients(ICC),and Bland-Altman limits of agreement(LoA)for each parameter were calculated.RESULTS:There was a strong correlation between the spherical equivalent(SE),sphere diopter(DS),and cylinder diopter(DC)readings of the Tianle RM-9000 and those of the Topcon KR-800,with correlation coefficient values of 0.98,0.98 and 0.83 and ICC values of 0.99,0.99 and 0.93,respectively.However,the correlation coefficients and ICC values of J0 and J45 were unreliable(R=-0.004,-0.034;both ICC<0.10).Bland-Altman analysis revealed that SE,DS,and DC measured by the Tianle RM-9000 were significantly biased toward myopia compared with the Topcon KR-800,and the mean differences were-0.072,-0.026,-0.091 D,respectively(all P<0.01).The minimum absolute value of the difference within the 95%LoA for SE,DS,and DC was 0.63 D,0.50 D,0.62 D,respectively;all these values were in the clinically acceptable range.For J0 and J45,the mean differences were close to zero(P=0.43,0.84);however,the 95%LoA were relatively wide(J0 SD:0.53;95%CI:-1.00,1.10;J45 SD:0.52;95%CI:-1.00,1.00).CONCLUSION:The two autorefractors are consistent with each other,as the differences in SE,DS,and DC were within the clinically acceptable range.Readers can compare the data measured by either device in different studies and use the two devices in the same study to generate a dataset that can be analyzed together.However,the J0 and J45 vectors are unreliable and should not be used to assess astigmatism.展开更多
Glycolysis produces large amounts of adenosine triphosphate(ATP)in a short time.The retinal vascular endothelium feeds itself primarily through aerobic glycolysis with less ATP.But when it generates new vessels,aerobi...Glycolysis produces large amounts of adenosine triphosphate(ATP)in a short time.The retinal vascular endothelium feeds itself primarily through aerobic glycolysis with less ATP.But when it generates new vessels,aerobic glycolysis provides rapid and abundant ATP support for angiogenesis,and thus inhibition of glycolysis in endothelial cells can be a target for the treatment of neovascularization.Aerobic glycolysis has a protective effect on Müller cells,and it can provide with a target for visual protection and maintenance of the blood-retinal barrier.Under physiological conditions,the mitochondria of RPE can use lactic acid produced by photoreceptor cells as an energy source to provide ATP for survival.In pathological conditions,because RPE cells avoid their oxidative damage by increasing glycolysis,a large number of glycolysis products accumulate,which in turn has a toxic effect on photoreceptor cells.This shows that stabilizing the function of RPE mitochondria may become a target for the treatment of diseases such as retinal degeneration.The decrease of aerobic glycolysis leads to the decline of photoreceptor cell function and impaired vision;therefore,aerobic glycolysis of stable photoreceptor cells provides a reliable target for delaying vision loss.It is of great significance to study the role of glycolysis in various retinal cells for the targeted treatment of ocular fundus diseases.展开更多
AIM:To evaluate the differences between human lacrimal gland adenoid cystic carcinoma with high-grade transformation(LACC-HGT)primar y cells cultured by high-grade transformation tissue and non-high-grade transformati...AIM:To evaluate the differences between human lacrimal gland adenoid cystic carcinoma with high-grade transformation(LACC-HGT)primar y cells cultured by high-grade transformation tissue and non-high-grade transformation(non-HGT)primary cells cultured by non-highgrade transformation tissue in proliferation,metastasis,drug susceptibility,and genes.METHODS:LACC-HGT primary cells were established by tissue block culture,and the 4^(th)to 10^(th)generation primary cells were selected as research objects.The cells were preliminarily identified by immunofluorescent staining.The differences between non-HGT and LACC-HGT primary cells in terms of proliferation,metastasis,and drug susceptibility were compared by cell counting kit-8(CCK-8)assay,wound healing,and drug sensitivity experiments.Differentially expressed genes were screened using mRNA array.Gene expression was analyzed using real-time quantitative polymerase chain reaction(RT-qPCR).RESULTS:LACC-HGT primary cells were successfully cultured by tissue block culture.Immunofluorescence staining results showed that cytokeratin(CK)and CK7 expression levels were positive in LACC-HGT primary cells.CCK-8 results showed that the proliferation ability of LACCHGT cells was significantly higher than that of non-HGT cells.Wound healing experiment showed that the migration ability of LACC-HGT cells was significantly higher than that of non-HGT cells.LACC-HGT cells were also less sensitive to cisplatin and paclitaxel than non-HGT cells.Compared with non-HGT cells,9566 differentially expressed genes were found in LACC-HGT primary cells,of which 5162 were upregulated and 4404 were down-regulated.The expression of N-acetylneuraminate pyruvate lyase(NPL),MARVEL domain containing 3(MARVELD3),syntabulin(SYBU),and allograft inflammatory factor 1(AIF1)was higher in LACCHGT cells than in non-HGT cells,whereas that of periostin(POSTN)was lower.CONCLUSION:LACC-HGT primary cells have faster proliferation,stronger migration ability,and poorer sensitivity to chemotherapy drugs than non-HGT primary cells.The expression of mRNAs in non-HGT and LACC-HGT primary cells are significantly different.These features are speculated to be the reasons why high-grade transformation tissues exhibit higher malignant degree and poorer prognosis than their counterparts.展开更多
AIM:To investigate the feasibility of endoscopic dacryocystorhinostomy(En-DCR)with bicanalicular silicone tube intubation for treating chronic dacryocystitis secondary to nasolacrimal duct stent(NDS)incarceration.METH...AIM:To investigate the feasibility of endoscopic dacryocystorhinostomy(En-DCR)with bicanalicular silicone tube intubation for treating chronic dacryocystitis secondary to nasolacrimal duct stent(NDS)incarceration.METHODS:En-DCRs were performed on 44 chronic dacryocystitis patients(46 eyes)secondary to NDS incarceration from April 2016 to October 2022.The granuloma and scar tissues were separated,and the removal of NDS incarceration was achieved during the surgery;the flap of the lacrimal sac was trimmed and anastomosed with nasal mucosal,a bicanalicular silicone tube was implanted,and lacrimal size and condition were assessed.The tube was removed 3mo after surgery.During the final follow-up of 12mo when the surgery was completed,the complications and the rates of surgical success were assessed.RESULTS:This study covered 40 patients(42 eyes).Intraoperatively,it was found that the lacrimal sac became small,and the sac wall had granulation and scar tissue attached to the incarcerated NDS in all eyes.At 12mo after surgery completed,the rates of the functional and anatomical success reached 80.95%(34/42)and 83.33%(35/42),respectively.Under the effect of intranasal ostial closure,seven eyes failed to achieve anatomical success.No serious complications(e.g.,visual impairment,sinusitis,and orbital fat prolapse)was observed.CONCLUSION:With the success rate over 80%and no serious complications,En-DCR with bicanalicular silicone tube implantation is effective in treating chronic dacryocystitis secondary to NDS incarceration.展开更多
Dear Editor,Submacular hemorrhage(SMH)is the accumulation of blood in the macular region caused by changes in retinal or choroidal circulation[1].SMH may be caused by age-related macular degeneration(AMD),pathological...Dear Editor,Submacular hemorrhage(SMH)is the accumulation of blood in the macular region caused by changes in retinal or choroidal circulation[1].SMH may be caused by age-related macular degeneration(AMD),pathological myopia,polypoid choroidal angiopathy(PCV)or retinal macroaneurysm[2].展开更多
As an indispensable part of congenital cataract surgery,intraocular lens(IOL)implantation in infantile patients has long-term positive impacts on visual rehabilitation,as well as postoperative complications inevitably...As an indispensable part of congenital cataract surgery,intraocular lens(IOL)implantation in infantile patients has long-term positive impacts on visual rehabilitation,as well as postoperative complications inevitably.Timing of IOL implantation in infantile congenital cataract patients is not simply a point-in-time but a personalized decision that comprehensively takes age at surgery,risks of postoperative complications,and economic condition of family in consideration,and combines with choosing suitable IOL type and power.For infants with well-developed eyeballs and good systemic conditions,IOL implantation at six months of age or older is safe and effective.Otherwise,secondary IOL implantation may be a safer choice.展开更多
AIM:To evaluate the prevalence of refractive errors and ocular biometry in 3573 freshman students at Tianjin Medical University for 4 consecutive years.METHODS:In this university-based, cross-sectional study, comprisi...AIM:To evaluate the prevalence of refractive errors and ocular biometry in 3573 freshman students at Tianjin Medical University for 4 consecutive years.METHODS:In this university-based, cross-sectional study, comprising 3573 students, visual acuity(VA), slitlamp examination, non-cycloplegic auto-refraction, and ocular biometry were recorded.RESULTS:The prevalence of myopia increased annually, from 2017 to 2020 were 93.5%, 94.5%, 95.9%, and 96.2%, respectively(P=0.03), and the prevalence of high myopia was 25.7%, 26.9%, 28.6%, and 28.6%, respectively. Males tended to have a higher percentage of total astigmatism than females, with astigmatism ≥0.75 and ≥1.0 D criteria. The percentage of with-the-rule astigmatism, against-therule astigmatism, and oblique astigmatism was 90.3%, 5.8%, and 3.9%, respectively, with astigmatism ≥1.00 D criteria. The mean spherical equivalent, axial length(AL), central corneal thickness(CCT), anterior chamber depth(ACD), lens thickness(LT), corneal radius(CR), and lens position(LP) were 4.37±2.52 D, 25.28±1.24 mm, 539.49±34.98 μm, 3.31±0.34 mm, 3.47±0.21 mm, 7.8±0.28 mm, and 5.04±0.32 mm, respectively. With diopter increase in myopia, the AL became longer, CR became steeper, ACD became deeper, LT became thinner, and LP became more posterior(all P<0.01). Females had a shorter AL, thinner CCT, smaller CR, shallower ACD, thicker lens, and more anterior LP than males(P<0.01). The 64% of high myopia had AL≥26 mm, meanwhile, 5.8% mild myopia and 21.1% moderate myopia had AL≥26 mm. With AL≥26 mm, mild and moderate myopia compared to high myopia, AL was shorter(26.51±0.46 vs 26.87±0.70 mm), CR was larger(8.10±0.3 vs 7.85±0.23 mm) and LT was thinner(3.39±0.19 vs 3.45±0.19 mm, P<0.001).CONCLUSION:The prevalence of myopia and high myopia is significantly high in freshman students. The majority of astigmatism is with-the-rule. Inconformity of refractive errors and ocular biometry existed in some students. Attention should be paid to the ocular biometry of myopia.展开更多
AIM:To evaluate the efficacy of retinal laser photocoagulation and intravitreal injection of anti-vascular endothelial growth factor(anti-VEGF)for hemorrhagic retinal arterial macroaneurysm(RAM).METHODS:This was a ret...AIM:To evaluate the efficacy of retinal laser photocoagulation and intravitreal injection of anti-vascular endothelial growth factor(anti-VEGF)for hemorrhagic retinal arterial macroaneurysm(RAM).METHODS:This was a retrospective clinical study.Patients with hemorrhagic RAM were divided into 4 groups defined by different treatments:a retinal laser photocoagulation therapy monotherapy group,an anti-VEGF intravitreal injection monotherapy group,a laser and anti-VEGF combination therapy group,and an observation group.Visual acuity(VA),central macular thickness(CMT),and retinal hemorrhage area(RHA)were collected.RESULTS:Forty-seven eyes of 47 patients were enrolled.VA improved and had a significant difference between baseline and final in each treatment group(logMAR;laser group:1.90±0.53 vs 1.05±0.63,P<0.001;anti-VEGF group:1.75±0.63 vs 1.12±0.54,P=0.009;combination group:1.76±0.38 vs 1.01±0.52,P<0.001);however,VA decreased and had no significant difference in observation group(1.63±0.51 vs 1.76±0.61,P=0.660).CMT decreased and had a significant difference between baseline and final in each group(laser group:815.16±310.83 vs 252.05±83.90μm,P<0.001;anti-VEGF group:725.00±290.79 vs 203.56±69.89μm,P=0.001;combination group:595.50±186.51 vs 253.13±55.06μm,P=0.001;observation group:758.88±195.65 vs 267.00±120.90μm,P=0.001).RHA were 28.99±28.15,25.94±11.58,19.64±8.97,and 27.45±13.76 mm^(2) in laser group,anti-VEGF group,combination group and observation group,respectively.RHA was statistically correlated with final VA(P=0.032)in the observation group.CONCLUSION:Both laser and anti-VEGF treatments are effective for hemorrhagic RAM.Combination therapy reduces the number of injections of anti-VEGF.RHA is a visual prognosis predictor in the natural history of hemorrhagic RAM.展开更多
AIM:To assess glaucoma patient satisfaction and follow-up adherence in case management and identify associated predictors to improve healthcare quality and patient outcomes.METHODS:In this cross-sectional study,a tota...AIM:To assess glaucoma patient satisfaction and follow-up adherence in case management and identify associated predictors to improve healthcare quality and patient outcomes.METHODS:In this cross-sectional study,a total of 119 patients completed a Patient Satisfaction Questionnaire-18 and a sociodemographic questionnaire.Clinical data was obtained from the case management system.Follow-up adherence was defined as completing each follow-up within±30d of the scheduled time set by ophthalmologists during the study period.RESULTS:Average satisfaction scored 78.65±7,with an average of 4.39±0.58 across the seven dimensions.Age negatively correlated with satisfaction(P=0.008),whilst patients with follow-up duration of 2 or more years reported higher satisfaction(P=0.045).Multivariate logistics regression analysis revealed that longer follow-up durations were associated with lower follow-up adherence(OR=0.97,95%CI,0.95-1.00,P=0.044).Additionally,patients with suspected glaucoma(OR=2.72,95%CI,1.03-7.20,P=0.044)and those with an annual income over 100000 Chinese yuan demonstrated higher adherence(OR=5.57,95%CI,1.00-30.89,P=0.049).CONCLUSION:The case management model proves effective for glaucoma patients,with positive adherence rates.The implementation of this model can be optimized in the future based on the identified factors and extended to glaucoma patients in more hospitals.展开更多
●AIM:To investigate the molecular diagnosis of a threegeneration Chinese family affected with aniridia,and further to identify clinically a PAX6 missense mutation in members with atypical aniridia.●METHODS:Eleven fa...●AIM:To investigate the molecular diagnosis of a threegeneration Chinese family affected with aniridia,and further to identify clinically a PAX6 missense mutation in members with atypical aniridia.●METHODS:Eleven family members with and without atypical aniridia were recruited.All family members underwent comprehensive ophthalmic examinations.A combination of whole exome sequencing(WES)and direct Sanger sequencing were performed to uncover the causative mutation.●RESULTS:Among the 11 family members,8 were clinically diagnosed with congenital aniridia(atypical aniridia phenotype).A rare heterozygous mutation c.622C>T(p.Arg208Trp)in exon 8 of PAX6 was identified in all affected family members but not in the unaffected members or in healthy control subjects.●CONCLUSION:A rare missense mutation in the PAX6 gene is found in members of a three-generation Chinese family with congenital atypical aniridia.This result contributes to an increase in the phenotypic spectrum caused by PAX6 missense heterozygous variants and provides useful information for the clinical diagnosis of atypical aniridia,which may also contribute to genetic counselling and family planning.展开更多
AIM:To estimate the prevalence of diabetic macular edema(DME) and clinically significant macular edema(CSME),and to assess their risk factors in a population with type 2 diabetic mellitus(T2DM) located in northeast Ch...AIM:To estimate the prevalence of diabetic macular edema(DME) and clinically significant macular edema(CSME),and to assess their risk factors in a population with type 2 diabetic mellitus(T2DM) located in northeast China.METHODS:Patients were included from the Fushun Diabetic Retinopathy Cohort Study(FS-DIRECT),a community-based study conducted in northeast China.The presence of DME and CSME was determined by the Early Treatment Diabetic Retinopathy Study(ETDRS) retinopathy scale of fundus photographs.The age-standardized prevalence of DME and CSME was estimated.The association between DME/CSME and risk factors was analyzed in a multivariate Logistical analysis.RESULTS:A total of 292(15.4%) and 166(8.8%) patients were diagnosed as DME and CSME,yielding the age and sex standardized prevalence of 13.5%(95%CI:11.9%-15.0%),and 7.1%(95%CI:5.9%-8.3%),respectively.Female patients had a higher prevalence of DME compared to their male counterparts(15.7% vs 10.4%,P=0.03).Multivariable Logistic regression analysis showed that younger age,insulin use,proteinuria,longer duration of diabetes,and higher glycosylated hemoglobin A1c,were associated with the prevalence of DME and CSME.Patients with higher fasting plasma glucose,systolic blood pressure,and blood urea nitrogen were also found to be associated with DME.CONCLUSION:Early fundus screening in diabetic patients is invaluable and given the relatively high prevalence of DME and CSME in this study cohort,those with a high risk of sight threatening maculopathy would invariably benefit from earlier detection.展开更多
AIM: To observe the effects of the different extents of internal limiting membrane(ILM) peeling on the surgical success and anatomical and functional outcomes of idiopathic macular hole(IMH).METHODS: In this retrospec...AIM: To observe the effects of the different extents of internal limiting membrane(ILM) peeling on the surgical success and anatomical and functional outcomes of idiopathic macular hole(IMH).METHODS: In this retrospective cohort study, 36 patients were reviewed and divided into two groups according to the extent of ILM peeling: group A(18 patients), with the peeling area within one-half of the optic disc macular distance as the radius;group B(18 patients), with the peeling area larger than that of group A but did not exceed the optic disc macular distance as the radius. The main outcomes included the best corrected visual acuity(BCVA), light-adaptive electroretinography, macular hole(MH) closure rate, central macular thickness(CMT), retinal nerve fiber layer(RNFL) and ganglion cell complex(GCC) thickness [nine regions based on the Early Treatment of Diabetic Retinopathy Study(ETDRS) ring] before and 1, 3, and 6mo after surgery.RESULTS: The closure rate was 94.4%(17/18) both in groups A and B. The BCVA in both groups improved significantly compared with the preoperative values, but there was no difference between the two groups. The b-wave amplitude of the electroretinogram analysis was significantly improved in both groups compared to that of the preoperative period, with a greater increase in group A than in group B at 6mo(P=0.017). The CMT in both groups gradually decreased after surgery, and there was no difference between the two groups. The RNFL thickness of the temporal outer ring region in group B was significantly lower than that in group A at 3 and 6mo after surgery(P=0.010, 0.032). The GCC thickness of the temporal outer ring region in group B was significantly lower than that in group A at 6mo after surgery(P=0.038).CONCLUSION: Enlarging the extent of ILM peeling doesn’t affect the IMH closure rate and visual acuity recovery, but the greater the extent of peeling, the greater the damage to the inner retinal structures.展开更多
AIM: To evaluate related factors with the change of spherical equivalents(ΔSE) and determine the suitable predictor of clinically significant ΔSE(≥0.50 D) with cyclopentolate hydrochloride on Chinese children. METH...AIM: To evaluate related factors with the change of spherical equivalents(ΔSE) and determine the suitable predictor of clinically significant ΔSE(≥0.50 D) with cyclopentolate hydrochloride on Chinese children. METHODS: A total of 145 right eyes of 145 children aged 4 to 15 y were enrolled. Intraocular pressure, axial length and lag of accommodation(LOA) were assessed before cycloplegia induced by 3 drops of 1% cyclopentolate at 5-minute intervals. SE was measured before and 1 h after the first drop of cyclopentolate. ΔSE was compared between different gender groups and among refractive groups. Multivariate linear regression analysis was performed to find related factors with ΔSE. ROC analysis was used to figure out the suitable predictor of clinically significant ΔSE.RESULTS: For the total 145 eyes, the mean SE reached up to-0.70±1.86 D from-1.30±1.62 D, with the mean ΔSE of 0.60±0.55 D. The mean ΔSE were 0.63±0.55 D and 0.57±0.56 D respectively in the male and female group(P=0.40). The mean ΔSE was significantly different among different refractive groups(P<0.0001), with the ΔSE of hyperopia group(1.12±0.64 D) larger than that of the emmetropia(0.56±0.43 D, P=0.001) and myopia group(0.32±0.28 D, P<0.0001). The ΔSE was correlated with LOA(B=-0.54, P<0.0001), cycloplegic SE(B=0.10, P<0.0001) and age(B=-0.04, P=0.015). ROC curve indicated that LOA predicted clinically significant ΔSE by 82% [area under the curve(AUC)=0.82] alone, while the value was slightly improved to 85%(AUC=0.85) in combination with axial length and 86%(AUC=0.86) in association with axial length as well as age.CONCLUSION: After cycloplegia with cyclopentolate, the ΔSE decreases with larger LOA, longer axial length and older age. Specifically, LOA plays a more vital role in predicting clinically significant ΔSE.展开更多
·AIM:To evaluate the role of internal limiting membrane(ILM)peeling in preventing secondary epiretinal membrane(ERM)formation in pars plana vitrectomy(PPV)for proliferative diabetic retinopathy(PDR).·METHODS...·AIM:To evaluate the role of internal limiting membrane(ILM)peeling in preventing secondary epiretinal membrane(ERM)formation in pars plana vitrectomy(PPV)for proliferative diabetic retinopathy(PDR).·METHODS:This retrospective study analyzed the medical records of patients who underwent PPV for PDR and were followed up for minimum 3 mo.ILM peeling was performed based on the intraoperative surgeons’judgments.ERM was assessed by optical coherence tomography photography.The relationship between ILM peeling and postoperative ERM was analyzed.·RESULTS:In total,212 eyes from 197 patients were included in this study.The incidence of secondary ERM in the ILM non-peeling group was significantly higher than that in the ILM peeling group(37.0%vs 14.0%;P<0.001).Multivariate logistical regression revealed that ILM peeling was highly associated with the prevention of secondary ERM development[odds ratio 0.38;95%confidence interval0.17-0.86;P<0.05].·CONCLUSION:ILM peeling during PPV for PDRs can effectively reduce the incidence of secondary ERM development and is worth consideration by vitreoretinal surgeons.展开更多
·AIM:To evaluate morphological changes in the iridocorneal angle after pediatric cataract surgery.·METHODS:Children who underwent primary infantile cataract surgery were included and 64 eyes from 41 children...·AIM:To evaluate morphological changes in the iridocorneal angle after pediatric cataract surgery.·METHODS:Children who underwent primary infantile cataract surgery were included and 64 eyes from 41 children,including 18 with unilateral cataracts(18 eyes)and 23 with bilateral cataracts(46 eyes)were examined.All patients underwent two gonioscopic examinations to evaluate the iridocorneal angle,before the primary lens removal and before the secondary intraocular lens implantation.The anatomical changes in the iridocorneal angle and the relationship between intraocular pressure(IOP)and iridocorneal angle changes were also analyzed.·RESULTS:The iridocorneal angle was wide in 64 eyes before and after surgery.The trabecular meshwork pigmentation,number of iris processes in every quadrant of the iridocorneal angle,and the width of the ciliary body band in the superior and inferior quadrants at the second gonioscopic examination were significantly increased compared to those at the first examination(P<0.001,P<0.05,P<0.05.and P<0.05,respectively).IOP gradually increased at 1 mo after operation,and returned to the preoperative level at 3 mo.However,IOP still increased significantly at 6 and 12 mo.·CONCLUSION:The main changes after pediatric cataract surgery include an increase in trabecular meshwork pigmentation and number of iris processes,IOP gradually increase and has positive correlation with trabecular meshwork pigmentation and anterior insertion of iris process.展开更多
AIM:To evaluate therapeutic outcomes of human umbilical cord-derived mesenchymal stem cells(HUC-MSCs)treatment in patients with refractory uveitis.METHODS:A retrospective and noncomparative review was performed on fou...AIM:To evaluate therapeutic outcomes of human umbilical cord-derived mesenchymal stem cells(HUC-MSCs)treatment in patients with refractory uveitis.METHODS:A retrospective and noncomparative review was performed on four patients with refractory uveitis from December 2013 to December 2017.HUC-MSCs were administered intravenously at a dose of 1×106 cells/kg.Clinical response,relapse rate,change of visual acuity,and other metrics were evaluated.RESULTS:All four patients presented with responses to HUC-MSCs treatment,with three males and one female.The numbers of uveitis attacks per year after the HUCMSCs treatment(0,2,0,0 respectively)all decreased compared with the numbers before the treatment(3,6,4,4 respectively).The oral steroid and immunosuppressive agents were tapered in all patients without recrudescence of ocular inflammation,and three patients discontinued their oral medicine at the last visit.The best corrected visual acuity(BCVA)of 3 patients was improved to varying degrees,and the BCVA of 1 patient remained at 20/20(Snellen chart)from the first to the last consultation.CONCLUSION:The study provides an effective therapy of HUC-MSCs in maintaining remission in patients affected by uveitis refractory to previous immunosuppressant treatments.展开更多
AIM:To investigate time trends in myopia and high myopia prevalence over 6y among young university adults in China.METHODS:This is a 6-year series cross-sectional study from 2016 to 2021.Totally 4910 freshmen were enr...AIM:To investigate time trends in myopia and high myopia prevalence over 6y among young university adults in China.METHODS:This is a 6-year series cross-sectional study from 2016 to 2021.Totally 4910 freshmen were enrolled and completed a questionnaire concerning age,gender,and disease history.Students with eye diseases were excluded after a detailed eye examination.The refractive status was measured by non-cycloplegic objective refraction and ocular parameters were measured by Lenstar 900.The examination followed the same protocol each year.Trends over time in myopia and high myopia prevalence,as well as ocular biometry parameters,were analyzed.RESULTS:From 2016 to 2021,the axial length(AL)and corneal radius(CR)increased significantly(P=0.002 for AL;P=0.04 for CR).However,the spherical equivalent(SE)and the ratio of axial length to the corneal radius(AL/CR)did not change significantly(P=0.59 for SE;P=0.24 for AL/CR).The frequency of AL≥26.0 mm increased from 26.6%in 2016 to 29.3%in 2021(P=0.05 for trend).The prevalence of myopia and high myopia did not change significantly in our study(P≥0.18).Compared to a similar cross-sectional study conducted 10 years ago,the prevalence of myopia decreased significantly(94.9%vs 91.8%,P<0.001).Whereas the prevalence of high myopia increased largely(18.12%vs 27.6%,P<0.001).CONCLUSION:The prevalence of high myopia increases in young university adults during 10y period.Myopia control should begin earlier in childhood.However,these interventions are still needed for high myopia even in young adulthood.展开更多
AIM:To estimate and compare the incidence and characteristics of rhegmatogenous retinal detachments(RRDs)in the Wenzhou area in 2015 to 2019.METHODS:All newly developed RRD cases among residents of the Wenzhou area,fr...AIM:To estimate and compare the incidence and characteristics of rhegmatogenous retinal detachments(RRDs)in the Wenzhou area in 2015 to 2019.METHODS:All newly developed RRD cases among residents of the Wenzhou area,from January 2015 to December 2019,were retrospectively retrieved from hospital records.Annual population data were extracted from the Wenzhou Statistical Yearbook.RESULTS:There were 3629 eligible cases.The average incidence of RRD was 7.79 cases per 100000 population(95%confidence interval,7.24-8.34),and the incidences were 7.99 and 7.56 for males and females,respectively.The annual incidence increased gradually from 7.26 cases per 100000 in 2015 to 10.00 cases per 100000 in 2019,with an overall increase of 37.74%.The highest rate of increase occurred in the age group from 60 to 69 years.Of 2750 eyes with axial length(AL)data,1675(60.91%)had an AL greater than 24 mm.CONCLUSION:A trend to increasing RRD incidence is observed in the Wenzhou area over the past 5-year period.展开更多
文摘AIM:To investigate the efficacy of a new visual acuity(VA)screening method,the baby vision test for young children.METHODS:A total 105 eyes of 65 children aged 2-8y were included in the study.Acuity testing was conducted using a standardized recognition acuity chart(Snellen visual chart:at 3 m)and the baby vision model assessment.The baby vision device includes a screen,a near infrared camera and a computer.Children were seated at a measured distance of 33-40 cm from a display for testing.VA was estimated according to the highest resolution the children could follow.Decimal VA data were converted to logarithm of the minimum angle of resolution(logMAR)for statistical analysis.The VA results for each child were recorded and analyzed for consistency.RESULTS:The mean VA measured using the Snellen visual chart was 0.62±0.32,and that assessed using the baby vision test was 0.66±0.27.The 95%limit of agreement was-0.609 to 0.695,with 95.2%(100/105)plots within the 95%limits of agreement.VA values of the baby vision test were significantly correlated with those of the Snellen chart(R=0.274,P=0.005).CONCLUSION:The baby vision test can be used as a relatively reliable method for estimating VA in young children.This new acuity assessment might be a valid predictor of optotype-measured acuity later in preverbal children.
基金National Natural Science Foundation of China(No.81860170).
文摘AIM:To assess the performance of macular ganglion cell-inner plexiform layer thickness(mGCIPLT)and 10-2 visual field(VF)parameters in detecting early glaucoma and evaluating the severity of advanced glaucoma.METHODS:Totally 127 eyes from 89 participants(36 eyes of 19 healthy participants,45 eyes of 31 early glaucoma patients and 46 eyes of 39 advanced glaucoma patients)were included.The relationships between the optical coherence tomography(OCT)-derived parameters and VF sensitivity were determined.Patients with early glaucoma were divided into eyes with or without central 10°of the VF damages(CVFDs),and the diagnostic performances of OCT-derived parameters were assessed.RESULTS:In early glaucoma,the mGCIPLT was significantly correlated with 10-2 VF pattern standard deviation(PSD;with average mGCIPLT:β=-0.046,95%CI,-0.067 to-0.024,P<0.001).In advanced glaucoma,the mGCIPLT was related to the 24-2 VF mean deviation(MD;with average mGCIPLT:β=0.397,95%CI,0.199 to 0.595,P<0.001),10-2 VF MD(with average mGCIPLT:β=0.762,95%CI,0.485 to 1.038,P<0.001)and 24-2 VF PSD(with average mGCIPLT:β=0.244,95%CI,0.124 to 0.364,P<0.001).Except for the minimum and superotemporal mGCIPLT,the decrease of mGCIPLT in early glaucomatous eyes with CVFDs was more severe than that of early glaucomatous eyes without CVFDs.The area under the curve(AUC)of the average mGCIPLT(AUC=0.949,95%CI,0.868 to 0.982)was greater than that of the average circumpapillary retinal nerve fiber layer thickness(cpRNFLT;AUC=0.827,95%CI,0.674 to 0.918)and rim area(AUC=0.799,95%CI,0.610 to 0.907)in early glaucomatous eyes with CVFDs versus normal eyes.CONCLUSION:The 10-2 VF and mGCIPLT parameters are complementary to 24-2 VF,cpRNFLT and ONH parameters,especially in detecting early glaucoma with CVFDs and evaluating the severity of advanced glaucoma in group level.
基金Supported by the National Natural Science Foundation of China(No.81873683).
文摘AIM:To compare the consistency of two autorefractors(Tianle RM-9000 and Topcon KR-800)for school-age myopia children,and to provide a basis for largescale data analysis and comparison.METHODS:The refractive error in 909 subjects(age 4–18y)were measured using both autorefractors without cycloplegia.The data were analyzed using Fourier decomposition and the correlation coefficients,intraclass correlation coefficients(ICC),and Bland-Altman limits of agreement(LoA)for each parameter were calculated.RESULTS:There was a strong correlation between the spherical equivalent(SE),sphere diopter(DS),and cylinder diopter(DC)readings of the Tianle RM-9000 and those of the Topcon KR-800,with correlation coefficient values of 0.98,0.98 and 0.83 and ICC values of 0.99,0.99 and 0.93,respectively.However,the correlation coefficients and ICC values of J0 and J45 were unreliable(R=-0.004,-0.034;both ICC<0.10).Bland-Altman analysis revealed that SE,DS,and DC measured by the Tianle RM-9000 were significantly biased toward myopia compared with the Topcon KR-800,and the mean differences were-0.072,-0.026,-0.091 D,respectively(all P<0.01).The minimum absolute value of the difference within the 95%LoA for SE,DS,and DC was 0.63 D,0.50 D,0.62 D,respectively;all these values were in the clinically acceptable range.For J0 and J45,the mean differences were close to zero(P=0.43,0.84);however,the 95%LoA were relatively wide(J0 SD:0.53;95%CI:-1.00,1.10;J45 SD:0.52;95%CI:-1.00,1.00).CONCLUSION:The two autorefractors are consistent with each other,as the differences in SE,DS,and DC were within the clinically acceptable range.Readers can compare the data measured by either device in different studies and use the two devices in the same study to generate a dataset that can be analyzed together.However,the J0 and J45 vectors are unreliable and should not be used to assess astigmatism.
文摘Glycolysis produces large amounts of adenosine triphosphate(ATP)in a short time.The retinal vascular endothelium feeds itself primarily through aerobic glycolysis with less ATP.But when it generates new vessels,aerobic glycolysis provides rapid and abundant ATP support for angiogenesis,and thus inhibition of glycolysis in endothelial cells can be a target for the treatment of neovascularization.Aerobic glycolysis has a protective effect on Müller cells,and it can provide with a target for visual protection and maintenance of the blood-retinal barrier.Under physiological conditions,the mitochondria of RPE can use lactic acid produced by photoreceptor cells as an energy source to provide ATP for survival.In pathological conditions,because RPE cells avoid their oxidative damage by increasing glycolysis,a large number of glycolysis products accumulate,which in turn has a toxic effect on photoreceptor cells.This shows that stabilizing the function of RPE mitochondria may become a target for the treatment of diseases such as retinal degeneration.The decrease of aerobic glycolysis leads to the decline of photoreceptor cell function and impaired vision;therefore,aerobic glycolysis of stable photoreceptor cells provides a reliable target for delaying vision loss.It is of great significance to study the role of glycolysis in various retinal cells for the targeted treatment of ocular fundus diseases.
基金Supported by the Tianjin Key Medical Discipline(Specialty)Construction Project(No.TJYXZDXK-037A)Tianjin Medical University Eye Hospital。
文摘AIM:To evaluate the differences between human lacrimal gland adenoid cystic carcinoma with high-grade transformation(LACC-HGT)primar y cells cultured by high-grade transformation tissue and non-high-grade transformation(non-HGT)primary cells cultured by non-highgrade transformation tissue in proliferation,metastasis,drug susceptibility,and genes.METHODS:LACC-HGT primary cells were established by tissue block culture,and the 4^(th)to 10^(th)generation primary cells were selected as research objects.The cells were preliminarily identified by immunofluorescent staining.The differences between non-HGT and LACC-HGT primary cells in terms of proliferation,metastasis,and drug susceptibility were compared by cell counting kit-8(CCK-8)assay,wound healing,and drug sensitivity experiments.Differentially expressed genes were screened using mRNA array.Gene expression was analyzed using real-time quantitative polymerase chain reaction(RT-qPCR).RESULTS:LACC-HGT primary cells were successfully cultured by tissue block culture.Immunofluorescence staining results showed that cytokeratin(CK)and CK7 expression levels were positive in LACC-HGT primary cells.CCK-8 results showed that the proliferation ability of LACCHGT cells was significantly higher than that of non-HGT cells.Wound healing experiment showed that the migration ability of LACC-HGT cells was significantly higher than that of non-HGT cells.LACC-HGT cells were also less sensitive to cisplatin and paclitaxel than non-HGT cells.Compared with non-HGT cells,9566 differentially expressed genes were found in LACC-HGT primary cells,of which 5162 were upregulated and 4404 were down-regulated.The expression of N-acetylneuraminate pyruvate lyase(NPL),MARVEL domain containing 3(MARVELD3),syntabulin(SYBU),and allograft inflammatory factor 1(AIF1)was higher in LACCHGT cells than in non-HGT cells,whereas that of periostin(POSTN)was lower.CONCLUSION:LACC-HGT primary cells have faster proliferation,stronger migration ability,and poorer sensitivity to chemotherapy drugs than non-HGT primary cells.The expression of mRNAs in non-HGT and LACC-HGT primary cells are significantly different.These features are speculated to be the reasons why high-grade transformation tissues exhibit higher malignant degree and poorer prognosis than their counterparts.
文摘AIM:To investigate the feasibility of endoscopic dacryocystorhinostomy(En-DCR)with bicanalicular silicone tube intubation for treating chronic dacryocystitis secondary to nasolacrimal duct stent(NDS)incarceration.METHODS:En-DCRs were performed on 44 chronic dacryocystitis patients(46 eyes)secondary to NDS incarceration from April 2016 to October 2022.The granuloma and scar tissues were separated,and the removal of NDS incarceration was achieved during the surgery;the flap of the lacrimal sac was trimmed and anastomosed with nasal mucosal,a bicanalicular silicone tube was implanted,and lacrimal size and condition were assessed.The tube was removed 3mo after surgery.During the final follow-up of 12mo when the surgery was completed,the complications and the rates of surgical success were assessed.RESULTS:This study covered 40 patients(42 eyes).Intraoperatively,it was found that the lacrimal sac became small,and the sac wall had granulation and scar tissue attached to the incarcerated NDS in all eyes.At 12mo after surgery completed,the rates of the functional and anatomical success reached 80.95%(34/42)and 83.33%(35/42),respectively.Under the effect of intranasal ostial closure,seven eyes failed to achieve anatomical success.No serious complications(e.g.,visual impairment,sinusitis,and orbital fat prolapse)was observed.CONCLUSION:With the success rate over 80%and no serious complications,En-DCR with bicanalicular silicone tube implantation is effective in treating chronic dacryocystitis secondary to NDS incarceration.
文摘Dear Editor,Submacular hemorrhage(SMH)is the accumulation of blood in the macular region caused by changes in retinal or choroidal circulation[1].SMH may be caused by age-related macular degeneration(AMD),pathological myopia,polypoid choroidal angiopathy(PCV)or retinal macroaneurysm[2].
基金the National Natural Science Foundation of China(No.81870680)the Innovation Discipline of Zhejiang Province(lens disease in children)(No.2016cxxk1)。
文摘As an indispensable part of congenital cataract surgery,intraocular lens(IOL)implantation in infantile patients has long-term positive impacts on visual rehabilitation,as well as postoperative complications inevitably.Timing of IOL implantation in infantile congenital cataract patients is not simply a point-in-time but a personalized decision that comprehensively takes age at surgery,risks of postoperative complications,and economic condition of family in consideration,and combines with choosing suitable IOL type and power.For infants with well-developed eyeballs and good systemic conditions,IOL implantation at six months of age or older is safe and effective.Otherwise,secondary IOL implantation may be a safer choice.
基金Science&Technology Development Fund of Tianjin Education Commission for Higher Education of China (No.2018KJ056)。
文摘AIM:To evaluate the prevalence of refractive errors and ocular biometry in 3573 freshman students at Tianjin Medical University for 4 consecutive years.METHODS:In this university-based, cross-sectional study, comprising 3573 students, visual acuity(VA), slitlamp examination, non-cycloplegic auto-refraction, and ocular biometry were recorded.RESULTS:The prevalence of myopia increased annually, from 2017 to 2020 were 93.5%, 94.5%, 95.9%, and 96.2%, respectively(P=0.03), and the prevalence of high myopia was 25.7%, 26.9%, 28.6%, and 28.6%, respectively. Males tended to have a higher percentage of total astigmatism than females, with astigmatism ≥0.75 and ≥1.0 D criteria. The percentage of with-the-rule astigmatism, against-therule astigmatism, and oblique astigmatism was 90.3%, 5.8%, and 3.9%, respectively, with astigmatism ≥1.00 D criteria. The mean spherical equivalent, axial length(AL), central corneal thickness(CCT), anterior chamber depth(ACD), lens thickness(LT), corneal radius(CR), and lens position(LP) were 4.37±2.52 D, 25.28±1.24 mm, 539.49±34.98 μm, 3.31±0.34 mm, 3.47±0.21 mm, 7.8±0.28 mm, and 5.04±0.32 mm, respectively. With diopter increase in myopia, the AL became longer, CR became steeper, ACD became deeper, LT became thinner, and LP became more posterior(all P<0.01). Females had a shorter AL, thinner CCT, smaller CR, shallower ACD, thicker lens, and more anterior LP than males(P<0.01). The 64% of high myopia had AL≥26 mm, meanwhile, 5.8% mild myopia and 21.1% moderate myopia had AL≥26 mm. With AL≥26 mm, mild and moderate myopia compared to high myopia, AL was shorter(26.51±0.46 vs 26.87±0.70 mm), CR was larger(8.10±0.3 vs 7.85±0.23 mm) and LT was thinner(3.39±0.19 vs 3.45±0.19 mm, P<0.001).CONCLUSION:The prevalence of myopia and high myopia is significantly high in freshman students. The majority of astigmatism is with-the-rule. Inconformity of refractive errors and ocular biometry existed in some students. Attention should be paid to the ocular biometry of myopia.
文摘AIM:To evaluate the efficacy of retinal laser photocoagulation and intravitreal injection of anti-vascular endothelial growth factor(anti-VEGF)for hemorrhagic retinal arterial macroaneurysm(RAM).METHODS:This was a retrospective clinical study.Patients with hemorrhagic RAM were divided into 4 groups defined by different treatments:a retinal laser photocoagulation therapy monotherapy group,an anti-VEGF intravitreal injection monotherapy group,a laser and anti-VEGF combination therapy group,and an observation group.Visual acuity(VA),central macular thickness(CMT),and retinal hemorrhage area(RHA)were collected.RESULTS:Forty-seven eyes of 47 patients were enrolled.VA improved and had a significant difference between baseline and final in each treatment group(logMAR;laser group:1.90±0.53 vs 1.05±0.63,P<0.001;anti-VEGF group:1.75±0.63 vs 1.12±0.54,P=0.009;combination group:1.76±0.38 vs 1.01±0.52,P<0.001);however,VA decreased and had no significant difference in observation group(1.63±0.51 vs 1.76±0.61,P=0.660).CMT decreased and had a significant difference between baseline and final in each group(laser group:815.16±310.83 vs 252.05±83.90μm,P<0.001;anti-VEGF group:725.00±290.79 vs 203.56±69.89μm,P=0.001;combination group:595.50±186.51 vs 253.13±55.06μm,P=0.001;observation group:758.88±195.65 vs 267.00±120.90μm,P=0.001).RHA were 28.99±28.15,25.94±11.58,19.64±8.97,and 27.45±13.76 mm^(2) in laser group,anti-VEGF group,combination group and observation group,respectively.RHA was statistically correlated with final VA(P=0.032)in the observation group.CONCLUSION:Both laser and anti-VEGF treatments are effective for hemorrhagic RAM.Combination therapy reduces the number of injections of anti-VEGF.RHA is a visual prognosis predictor in the natural history of hemorrhagic RAM.
基金Supported by the Key Innovation and Guidance Program of the Eye Hospital,School of Ophthalmology&Optometry,Wenzhou Medical University(No.YNZD2201903)the Scientific Research Foundation of the Eye Hospital,School of Ophthalmology&Optometry,Wenzhou Medical University(No.KYQD20180306)the Nursing Project of the Eye Hospital of Wenzhou Medical University(No.YNHL2201908).
文摘AIM:To assess glaucoma patient satisfaction and follow-up adherence in case management and identify associated predictors to improve healthcare quality and patient outcomes.METHODS:In this cross-sectional study,a total of 119 patients completed a Patient Satisfaction Questionnaire-18 and a sociodemographic questionnaire.Clinical data was obtained from the case management system.Follow-up adherence was defined as completing each follow-up within±30d of the scheduled time set by ophthalmologists during the study period.RESULTS:Average satisfaction scored 78.65±7,with an average of 4.39±0.58 across the seven dimensions.Age negatively correlated with satisfaction(P=0.008),whilst patients with follow-up duration of 2 or more years reported higher satisfaction(P=0.045).Multivariate logistics regression analysis revealed that longer follow-up durations were associated with lower follow-up adherence(OR=0.97,95%CI,0.95-1.00,P=0.044).Additionally,patients with suspected glaucoma(OR=2.72,95%CI,1.03-7.20,P=0.044)and those with an annual income over 100000 Chinese yuan demonstrated higher adherence(OR=5.57,95%CI,1.00-30.89,P=0.049).CONCLUSION:The case management model proves effective for glaucoma patients,with positive adherence rates.The implementation of this model can be optimized in the future based on the identified factors and extended to glaucoma patients in more hospitals.
文摘●AIM:To investigate the molecular diagnosis of a threegeneration Chinese family affected with aniridia,and further to identify clinically a PAX6 missense mutation in members with atypical aniridia.●METHODS:Eleven family members with and without atypical aniridia were recruited.All family members underwent comprehensive ophthalmic examinations.A combination of whole exome sequencing(WES)and direct Sanger sequencing were performed to uncover the causative mutation.●RESULTS:Among the 11 family members,8 were clinically diagnosed with congenital aniridia(atypical aniridia phenotype).A rare heterozygous mutation c.622C>T(p.Arg208Trp)in exon 8 of PAX6 was identified in all affected family members but not in the unaffected members or in healthy control subjects.●CONCLUSION:A rare missense mutation in the PAX6 gene is found in members of a three-generation Chinese family with congenital atypical aniridia.This result contributes to an increase in the phenotypic spectrum caused by PAX6 missense heterozygous variants and provides useful information for the clinical diagnosis of atypical aniridia,which may also contribute to genetic counselling and family planning.
基金Supported by the Zhejiang Provincial Natural Science Foundation of China (No.LQ18H120004)Wenzhou Basic Medical and Health Technology Project (No.Y2020364)。
文摘AIM:To estimate the prevalence of diabetic macular edema(DME) and clinically significant macular edema(CSME),and to assess their risk factors in a population with type 2 diabetic mellitus(T2DM) located in northeast China.METHODS:Patients were included from the Fushun Diabetic Retinopathy Cohort Study(FS-DIRECT),a community-based study conducted in northeast China.The presence of DME and CSME was determined by the Early Treatment Diabetic Retinopathy Study(ETDRS) retinopathy scale of fundus photographs.The age-standardized prevalence of DME and CSME was estimated.The association between DME/CSME and risk factors was analyzed in a multivariate Logistical analysis.RESULTS:A total of 292(15.4%) and 166(8.8%) patients were diagnosed as DME and CSME,yielding the age and sex standardized prevalence of 13.5%(95%CI:11.9%-15.0%),and 7.1%(95%CI:5.9%-8.3%),respectively.Female patients had a higher prevalence of DME compared to their male counterparts(15.7% vs 10.4%,P=0.03).Multivariable Logistic regression analysis showed that younger age,insulin use,proteinuria,longer duration of diabetes,and higher glycosylated hemoglobin A1c,were associated with the prevalence of DME and CSME.Patients with higher fasting plasma glucose,systolic blood pressure,and blood urea nitrogen were also found to be associated with DME.CONCLUSION:Early fundus screening in diabetic patients is invaluable and given the relatively high prevalence of DME and CSME in this study cohort,those with a high risk of sight threatening maculopathy would invariably benefit from earlier detection.
基金Supported by a grant from the Natural Science Foundation of Tianjin City (No.20JCZXJC00040)Tianjin Key Medical Discipline (No.Specialty) Construction Project (No.TJYXZDXK-037A)。
文摘AIM: To observe the effects of the different extents of internal limiting membrane(ILM) peeling on the surgical success and anatomical and functional outcomes of idiopathic macular hole(IMH).METHODS: In this retrospective cohort study, 36 patients were reviewed and divided into two groups according to the extent of ILM peeling: group A(18 patients), with the peeling area within one-half of the optic disc macular distance as the radius;group B(18 patients), with the peeling area larger than that of group A but did not exceed the optic disc macular distance as the radius. The main outcomes included the best corrected visual acuity(BCVA), light-adaptive electroretinography, macular hole(MH) closure rate, central macular thickness(CMT), retinal nerve fiber layer(RNFL) and ganglion cell complex(GCC) thickness [nine regions based on the Early Treatment of Diabetic Retinopathy Study(ETDRS) ring] before and 1, 3, and 6mo after surgery.RESULTS: The closure rate was 94.4%(17/18) both in groups A and B. The BCVA in both groups improved significantly compared with the preoperative values, but there was no difference between the two groups. The b-wave amplitude of the electroretinogram analysis was significantly improved in both groups compared to that of the preoperative period, with a greater increase in group A than in group B at 6mo(P=0.017). The CMT in both groups gradually decreased after surgery, and there was no difference between the two groups. The RNFL thickness of the temporal outer ring region in group B was significantly lower than that in group A at 3 and 6mo after surgery(P=0.010, 0.032). The GCC thickness of the temporal outer ring region in group B was significantly lower than that in group A at 6mo after surgery(P=0.038).CONCLUSION: Enlarging the extent of ILM peeling doesn’t affect the IMH closure rate and visual acuity recovery, but the greater the extent of peeling, the greater the damage to the inner retinal structures.
文摘AIM: To evaluate related factors with the change of spherical equivalents(ΔSE) and determine the suitable predictor of clinically significant ΔSE(≥0.50 D) with cyclopentolate hydrochloride on Chinese children. METHODS: A total of 145 right eyes of 145 children aged 4 to 15 y were enrolled. Intraocular pressure, axial length and lag of accommodation(LOA) were assessed before cycloplegia induced by 3 drops of 1% cyclopentolate at 5-minute intervals. SE was measured before and 1 h after the first drop of cyclopentolate. ΔSE was compared between different gender groups and among refractive groups. Multivariate linear regression analysis was performed to find related factors with ΔSE. ROC analysis was used to figure out the suitable predictor of clinically significant ΔSE.RESULTS: For the total 145 eyes, the mean SE reached up to-0.70±1.86 D from-1.30±1.62 D, with the mean ΔSE of 0.60±0.55 D. The mean ΔSE were 0.63±0.55 D and 0.57±0.56 D respectively in the male and female group(P=0.40). The mean ΔSE was significantly different among different refractive groups(P<0.0001), with the ΔSE of hyperopia group(1.12±0.64 D) larger than that of the emmetropia(0.56±0.43 D, P=0.001) and myopia group(0.32±0.28 D, P<0.0001). The ΔSE was correlated with LOA(B=-0.54, P<0.0001), cycloplegic SE(B=0.10, P<0.0001) and age(B=-0.04, P=0.015). ROC curve indicated that LOA predicted clinically significant ΔSE by 82% [area under the curve(AUC)=0.82] alone, while the value was slightly improved to 85%(AUC=0.85) in combination with axial length and 86%(AUC=0.86) in association with axial length as well as age.CONCLUSION: After cycloplegia with cyclopentolate, the ΔSE decreases with larger LOA, longer axial length and older age. Specifically, LOA plays a more vital role in predicting clinically significant ΔSE.
文摘·AIM:To evaluate the role of internal limiting membrane(ILM)peeling in preventing secondary epiretinal membrane(ERM)formation in pars plana vitrectomy(PPV)for proliferative diabetic retinopathy(PDR).·METHODS:This retrospective study analyzed the medical records of patients who underwent PPV for PDR and were followed up for minimum 3 mo.ILM peeling was performed based on the intraoperative surgeons’judgments.ERM was assessed by optical coherence tomography photography.The relationship between ILM peeling and postoperative ERM was analyzed.·RESULTS:In total,212 eyes from 197 patients were included in this study.The incidence of secondary ERM in the ILM non-peeling group was significantly higher than that in the ILM peeling group(37.0%vs 14.0%;P<0.001).Multivariate logistical regression revealed that ILM peeling was highly associated with the prevention of secondary ERM development[odds ratio 0.38;95%confidence interval0.17-0.86;P<0.05].·CONCLUSION:ILM peeling during PPV for PDRs can effectively reduce the incidence of secondary ERM development and is worth consideration by vitreoretinal surgeons.
基金Supported by the National Natural Science Foundation of China(No.81870680)National Science Foundation of Zhejiang Province(No.LQ20H120002)。
文摘·AIM:To evaluate morphological changes in the iridocorneal angle after pediatric cataract surgery.·METHODS:Children who underwent primary infantile cataract surgery were included and 64 eyes from 41 children,including 18 with unilateral cataracts(18 eyes)and 23 with bilateral cataracts(46 eyes)were examined.All patients underwent two gonioscopic examinations to evaluate the iridocorneal angle,before the primary lens removal and before the secondary intraocular lens implantation.The anatomical changes in the iridocorneal angle and the relationship between intraocular pressure(IOP)and iridocorneal angle changes were also analyzed.·RESULTS:The iridocorneal angle was wide in 64 eyes before and after surgery.The trabecular meshwork pigmentation,number of iris processes in every quadrant of the iridocorneal angle,and the width of the ciliary body band in the superior and inferior quadrants at the second gonioscopic examination were significantly increased compared to those at the first examination(P<0.001,P<0.05,P<0.05.and P<0.05,respectively).IOP gradually increased at 1 mo after operation,and returned to the preoperative level at 3 mo.However,IOP still increased significantly at 6 and 12 mo.·CONCLUSION:The main changes after pediatric cataract surgery include an increase in trabecular meshwork pigmentation and number of iris processes,IOP gradually increase and has positive correlation with trabecular meshwork pigmentation and anterior insertion of iris process.
文摘AIM:To evaluate therapeutic outcomes of human umbilical cord-derived mesenchymal stem cells(HUC-MSCs)treatment in patients with refractory uveitis.METHODS:A retrospective and noncomparative review was performed on four patients with refractory uveitis from December 2013 to December 2017.HUC-MSCs were administered intravenously at a dose of 1×106 cells/kg.Clinical response,relapse rate,change of visual acuity,and other metrics were evaluated.RESULTS:All four patients presented with responses to HUC-MSCs treatment,with three males and one female.The numbers of uveitis attacks per year after the HUCMSCs treatment(0,2,0,0 respectively)all decreased compared with the numbers before the treatment(3,6,4,4 respectively).The oral steroid and immunosuppressive agents were tapered in all patients without recrudescence of ocular inflammation,and three patients discontinued their oral medicine at the last visit.The best corrected visual acuity(BCVA)of 3 patients was improved to varying degrees,and the BCVA of 1 patient remained at 20/20(Snellen chart)from the first to the last consultation.CONCLUSION:The study provides an effective therapy of HUC-MSCs in maintaining remission in patients affected by uveitis refractory to previous immunosuppressant treatments.
基金Supported by China Scholarship Council(CSC,No.202006945002)Chunhui Project of China Education Ministry(No.HZKY20220587)+1 种基金Tianjin Health Technology Research Project(No.TJWJ2022MS014)Tianjin Municipal Education Commission Scientific Research Program(Mental Health Education,No.2022ZDGX20).
文摘AIM:To investigate time trends in myopia and high myopia prevalence over 6y among young university adults in China.METHODS:This is a 6-year series cross-sectional study from 2016 to 2021.Totally 4910 freshmen were enrolled and completed a questionnaire concerning age,gender,and disease history.Students with eye diseases were excluded after a detailed eye examination.The refractive status was measured by non-cycloplegic objective refraction and ocular parameters were measured by Lenstar 900.The examination followed the same protocol each year.Trends over time in myopia and high myopia prevalence,as well as ocular biometry parameters,were analyzed.RESULTS:From 2016 to 2021,the axial length(AL)and corneal radius(CR)increased significantly(P=0.002 for AL;P=0.04 for CR).However,the spherical equivalent(SE)and the ratio of axial length to the corneal radius(AL/CR)did not change significantly(P=0.59 for SE;P=0.24 for AL/CR).The frequency of AL≥26.0 mm increased from 26.6%in 2016 to 29.3%in 2021(P=0.05 for trend).The prevalence of myopia and high myopia did not change significantly in our study(P≥0.18).Compared to a similar cross-sectional study conducted 10 years ago,the prevalence of myopia decreased significantly(94.9%vs 91.8%,P<0.001).Whereas the prevalence of high myopia increased largely(18.12%vs 27.6%,P<0.001).CONCLUSION:The prevalence of high myopia increases in young university adults during 10y period.Myopia control should begin earlier in childhood.However,these interventions are still needed for high myopia even in young adulthood.
基金Supported by Zhejiang Provincial Highlevel Health Talents Training Project(No.CZ-RC2022010)Wenzhou Basic Medical and Health Technology Project(No.Y20220779)。
文摘AIM:To estimate and compare the incidence and characteristics of rhegmatogenous retinal detachments(RRDs)in the Wenzhou area in 2015 to 2019.METHODS:All newly developed RRD cases among residents of the Wenzhou area,from January 2015 to December 2019,were retrospectively retrieved from hospital records.Annual population data were extracted from the Wenzhou Statistical Yearbook.RESULTS:There were 3629 eligible cases.The average incidence of RRD was 7.79 cases per 100000 population(95%confidence interval,7.24-8.34),and the incidences were 7.99 and 7.56 for males and females,respectively.The annual incidence increased gradually from 7.26 cases per 100000 in 2015 to 10.00 cases per 100000 in 2019,with an overall increase of 37.74%.The highest rate of increase occurred in the age group from 60 to 69 years.Of 2750 eyes with axial length(AL)data,1675(60.91%)had an AL greater than 24 mm.CONCLUSION:A trend to increasing RRD incidence is observed in the Wenzhou area over the past 5-year period.
