International journal of ophthalmology最新文献

Aim: To investigate age-related differences in the iris-lens angle (ILA) among patients with age-related cortical cataracts and elucidate the impact of age on lens stability.

Methods: A prospective observational study was conducted on patients with age-related cortical cataracts scheduled for phacoemulsification surgery. Preoperative ultrasound biomicroscopy (UBM) images were collected and analyzed. Initially, patients were stratified into two age groups: <60y and ≥60y, with no significant intergroup differences in sex or eye laterality. For further analysis, participants were subdivided into three age strata: <60y, 60-75y, and >75y. The ILA was measured in four quadrants (superior, inferior, nasal, and temporal). Intergroup differences in ILA were compared, and correlations between age and ILA parameters were analyzed using statistical methods.

Results: The sample data were categorized into three groups according to age, <60y (113 patients; 55.8% female), 60-75y (245 patients; 61.0% female), and >75y (70 patients; 50.2% female). The superior quadrant ILA increased progressively with age stratification (P=0.02), and the maximum ILA difference (ΔILA) was significantly higher in patients over 75y (P<0.01). Simple linear regression analysis demonstrated a positive correlation between age and ILA in the superior (Y=7.487+0.096X, R=0.191, P<0.001) and temporal (Y=10.254+0.052X, R=0.104, P=0.032) quadrants. Additionally, the mean ILA across all quadrants (ILA_mean) and ΔILA were positively correlated with age (ILA_mean: Y=9.721+0.055X, R=0.138, P=0.004; ΔILA: Y=3.267+0.044X, R=0.006, P<0.05).

Conclusion: In patients with age-related cortical cataracts, ILA increases with age, particularly in the superior and temporal quadrants, suggesting that advanced age is associated with greater lens deviation and decreased lens stability. UBM imaging can effectively evaluate the status of the zonule and lens stability, providing crucial evidence for personalized surgical planning based on patients' age.

Conventional surgical teaching techniques face several challenges, highlighting a necessity for ongoing innovation in ophthalmology education to align with the evolving demands of clinical practice. The recent rapid advancement of computer technology has enabled the integration of virtual reality (VR) into medical training, thereby revolutionizing ophthalmic surgical education through VR-based educational methods. VR technology offers a safe, risk-free environment for trainees to practice repeatedly, enhancing surgical skills and accelerating the learning curve without compromising patient safety. This research outlines the application of VR technology in ophthalmic surgical skills training, particularly in cataract and vitreoretinal surgery. Including assessing the effectiveness of intraocular surgery training systems, evaluating skills transfer to the operating room, comparing it with wet lab cataract surgery training, and enhancing non-dominant hand training for cataract surgery, among other aspects. Additionally, this paper will identify the limitations of VR technology in ocular surgical skills training, offer improvement strategies, and detail the advantages and prospects, with the objective of guiding subsequent researchers.

Aim: To investigate the long-term outcomes in acute primary angle closure (APAC) patients treated with lens extraction (LE) surgery and to identify risk factors for glaucomatous optic neuropathy (GON).

Methods: In this longitudinal observational study, detailed medical histories of APAC patients and comprehensive ophthalmic examinations at final follow-up were collected. Logistic regression analysis was performed to identify predictors of blindness. Univariate and multivariate linear regression analyses were conducted to determine risk factors associated with visual outcomes.

Results: This study included 39 affected eyes of 31 subjects (26 females) with an average age of 74.1±8.0y. At 6.7±4.2y after APAC attack, 2 (5.7%) eyes had best-corrected visual acuity (VA) worse than 3/60. Advanced glaucomatous visual field loss was observed in 15 (39.5%) affected eyes and 5 (25.0%) fellow eyes. Nine affected eyes (23.7%) had GON, and 11 (28.9%) were blind. Six (15.4%) affected eyes and 2 (9.1%) fellow eyes had suspicious progression. A significantly higher blindness rate in factory workers compared to office workers. Logistic regression identified that worse VA at attack (OR 10.568, 95%CI 1.288-86.695; P=0.028) and worse early postoperative VA (OR 13.214, 95%CI 1.157-150.881; P=0.038) were risk factors for blindness. Multivariate regression showed that longer duration of elevated intraocular pressure (P=0.004) and worse early postoperative VA (P=0.009) were associated with worse visual outcomes.

Conclusion: Despite LE surgery, some APAC patients experience continued visual function deterioration. Lifelong monitoring is necessary. Target pressure and progression rates should be re-evaluated during follow-up.

Aim: To evaluate the agreement of axial length (AL), anterior chamber parameters, and total cornea power obtained by swept-source optical coherence tomography (SS-OCT)-based and Scheimpflug-based optical biometers in myopic children.

Methods: AL, steep keratometry (K), flat K, posterior corneal keratometry (PK), total keratometry (TK), anterior chamber depth (ACD), horizontal corneal diameter (CD), and central corneal thickness (CCT) were obtained using IOL Master 700 and Pentacam AXL. The agreement between the devices was evaluated using intraclass correlation coefficients (ICC), Bland-Altman plots, and astigmatism vector analysis.

Results: Totally 175 myopic children (48.5% male) with a mean age of 10.29±2.14y were enrolled. The ICC and Bland-Altman plots indicated a satisfactory agreement for AL, ACD, and CCT. The mean difference in CD of -0.31±0.30 mm was considered clinically significant (>0.2 mm). Additionally, measurements of K and TK obtained from the IOL Master 700 showed good agreement. Nevertheless, there were clinically significant differences observed in PK, simulated keratometry (simK), total cornea power, and astigmatism (at least 10% of the cases with a difference of >10 degrees in meridian) between the two devices.

Conclusion: The study findings demonstrate a significant difference in K, PK, astigmatism, and CD, indicating that the two optical biometers cannot be considered interchangeable. Therefore, it is recommended to utilize one kind device for follow-up examinations in myopic children.

[This corrects the article DOI: 10.18240/ijo.2025.04.16.].

[This corrects the article DOI: 10.18240/ijo.2026.01.14.].

Aim: To determine whether paeonol (Pae), a naturally occurring phenolic compound, can serve as an effective pharmacological inhibitor of posterior capsular opacification (PCO).

Methods: A rat model of cataract surgery-induced PCO was established, and Pae was administered via anterior chamber injection to evaluate its preventive effect on capsular opacification and fibrotic remodeling. Histological and immunohistochemical analyses were performed to assess epithelial-mesenchymal transition (EMT)-related changes in lens epithelial cells (LECs). Ex vivo lens capsule cultures were employed to examine the expression of Vimentin and Zonula Occludens-1 (ZO-1) by immunofluorescence and immunohistochemistry. In the human LEC line SRA01/04, EMT marker expression at both mRNA and protein levels was analyzed following transforming growth factor beta 2 (TGF-β2) stimulation, with Pae treatment. Western blotting and immunofluorescence were used to investigate the effect of Pae on TGF-β/Smad signaling and AMP-activated protein kinase (AMPK) activation. Molecular docking was performed to predict Pae-AMPK binding, and rescue experiments with AMPK inhibition were conducted to validate the mechanistic pathway.

Results: Pae significantly reduced capsular opacification and fibrotic remodeling in the rat PCO model compared with controls. In LECs, Pae markedly suppressed TGF-β2-induced EMT, evidenced by decreased expression of mesenchymal markers, such as Vimentin, Fibronectin, Collagen 1A1, α-SMA and preserved epithelial junctional protein ZO-1. Mechanistically, Pae was predicted to directly interact with the catalytic pocket of AMPK, which was experimentally confirmed by enhanced AMPK phosphorylation and nuclear translocation (P<0.05). This activation disrupted canonical TGF-β/Smad signaling, leading to suppression of EMT. Rescue experiments using AMPK inhibition abrogated the anti-EMT effect of Pae, further validating the AMPK-dependent mechanism.

Conclusion: Pae exerts a potent inhibitory effect on PCO formation by blocking EMT of LECs through direct activation of AMPK and subsequent disruption of TGF-β/Smad signaling.

Aim: To investigate the clinical characteristics and treatment outcomes, including visual function and overall survival (OS) of patients with ocular adnexal diffuse large B-cell lymphoma (OA-DLBCL).

Methods: This retrospective cohort study enrolled 29 patients diagnosed with OA-DLBCL based on histopathological biopsy between 2006 and 2023. Patients were stratified into two subgroups: primary OA-DLBCL (no prior history of lymphoma) and secondary OA-DLBCL (history of DLBCL at non-ocular adnexal sites). OS was defined as the time interval from OA-DLBCL diagnosis to death from any cause. Survival analysis was performed using the Kaplan-Meier method, and prognostic factors affecting OS were identified using multivariate Cox proportional hazards regression with a stepwise selection approach.

Results: The cohort included 24 patients with primary OA-DLBCL (13 males, 11 females; mean age: 61.36±18.29y) and 5 patients with secondary OA-DLBCL (2 males, 3 females; mean age: 50.94±18.17y). Among the primary OA-DLBCL subgroup, 12 patients (50%) presented with advanced disease (Ann Arbor stage IIIE-IV), and 16 patients (66%) were classified as T4 disease according to the tumor-node-metastasis (TNM) staging system. The mean final visual acuity was 1.72±1.10 in the primary group and 0.90±1.18 in the secondary group. The 5-year OS rate for the entire cohort was 27.7%. Multivariate analysis identified five factors significantly associated with poor survival outcomes: epiphora [adjusted hazard ratio (aHR), 36.95], atherosclerotic cardiovascular disease (aHR, 10.08), human immunodeficiency virus (HIV) infection (aHR, 12.47), M1 stage (aHR, 6.99), and secondary OA-DLBCL (aHR, 6.03; all P<0.05). The median OS was 1.68y for primary OA-DLBCL and 1.12y for secondary OA-DLBCL.

Conclusion: A substantial proportion of patients with primary OA-DLBCL present with advanced-stage disease at diagnosis. Epiphora, atherosclerotic cardiovascular disease, HIV infection, M1 stage, and secondary OA-DLBCL are independent prognostic factors for poor survival outcomes. These findings emphasize the urgent need for optimized therapeutic strategies and early screening protocols to improve the management of OA-DLBCL, particularly in developing countries.

Aim: To investigate the effects of chronic alcohol consumption on retinal microcirculation by comparing different alcohol-consuming groups using optical coherence tomography (OCT) and OCT angiography (OCTA).

Methods: This observational clinical study utilized a cross-sectional and prospective design, focusing on chronic alcohol consumers alongside a non-consuming control group. OCT/OCTA imaging parameters including central retinal subfield thickness (CST), subfoveal choroidal thickness (SCT), foveal avascular zone (FAZ) and vessel density (VD) in the superficial and deep capillary plexuses in both the macular and optic disc (OD) regions were recorded. Data were analyzed using SPSS 15.0; descriptive statistics were reported, group comparisons were performed with Chi-square, Kruskal-Wallis, and Bonferroni-corrected Mann-Whitney U tests, and relationships were assessed using Spearman correlation, with statistical significance set at P<0.05.

Results: A total of 160 eyes of 160 participants (110 females and 50 males with mean age 38.7±9.9y) who don't smoke were divided into five groups: never, occasional, monthly, weekly and daily drinkers. The mean CST was 216.6±14.2 µm and the mean SCT was 358.9±84.5 µm. There was no statistically significantly difference in CST and SCT among the groups (P=0.890, 0.799). Foveal superficial capillary plexuses (SCPs) VD was higher in monthly drinkers compared to occasional drinkers (P=0.015). Foveal VD in deep capillary plexus was also higher in monthly drinkers than in never and occasional drinkers (P=0.004, 0.006). Nasal SCPs VD at the OD was higher in monthly drinkers compared to never drinkers (P=0.005). There was no significant difference FAZ area among the groups (P=0.071).

Conclusion: Both superficial and deep microvascular structures in the inferior quadrants of macula are positively correlated with frequency of alcohol use. Also in our study results is that the monthly drinker group has uniquely higher VDs in both macula and OD. This leads us to consider moderate alcohol consumption may also have protective effects on retinal microcirculation.

Aim: To characterize the distribution of persistent fetal vasculature (PFV) subtypes and to evaluate corneal astigmatism (CA) in children with unilateral PFV.

Methods: The medical records of patients diagnosed with PFV between January 2014 and August 2021 were retrospectively reviewed. Corneal keratometry parameters were measured using IOLMaster or a handheld keratometer. Differences in CA between the affected and fellow eyes were analyzed in 52 unilateral PFV patients with available examination data.

Results: Totally 133 patients diagnosed with PFV were retrospectively reviewed. The male-to-female ratio was 73/60. Median age at surgery was 38.03mo (interquartile range 58.27mo). Among the PFV patients, 32 (24.06%) had anterior PFV, 2 (1.50%) had posterior PFV, and 99 (74.44%) had combined anterior-posterior PFV. Mild combined PFV was the most common subtype. In unilateral PFV cases, the mean CA in the affected eye was 2.29±1.11 D, and 59.62% (31 eyes) had CA≥2.0 D. The mean CA in the affected eyes was significantly higher than in the fellow eyes (1.37±0.77 D; P<0.001). Among PFV-affected eyes with CA≥2.0 D, the steepest corneal meridian was vertically oriented in 30 cases (96.77%), while only 1 case (3.23%) had the steepest meridian oriented horizontally.

Conclusion: In children with unilateral PFV, CA is significantly higher in the affected eyes than in the fellow eyes, and the steepest corneal meridian was predominantly oriented vertically.