中华眼科杂志最新文献

Bacterial keratitis is an acute-onset, rapidly progressive corneal infection that can lead to permanent vision loss. In recent years, shifts in the spectrum of causative pathogens and their antimicrobial resistance have created new challenges for clinical diagnosis and treatment. The Ocular Infection Group of Chinese Ophthalmologist Association has reviewed extensive domestic and international literature and combined the evidence with the expert clinical experience in China to develop a consensus statement. The document addresses the epidemiology, pathogenesis, clinical manifestations, laboratory and ancillary diagnostic methods, differential diagnosis, and therapeutic principles and options of bacterial keratitis, while underscoring the importance of individualized therapy, aiming to provide up-to-date reference and guidance for clinical practice.

Objective: To investigate the osteogenic activity of polyetheretherketone (PEEK) modified with bone morphogenetic protein 2 (BMP2) composite hyaluronic acid hydrogel (HAH) and its feasibility for orbital fracture repair. Methods: An experimental study was conducted from July 2022 to July 2023. PEEK scaffolds were modified with BMP2-loaded HAH to form PEEK-BMP2-HAH specimens. Rat bone marrow mesenchymal cells were transplanted into PEEK or PEEK-BMP2-HAH specimens and cultured for osteogenesis induction. Cell adhesion was observed using scanning electron microscopy (SEM). Cell proliferation was assessed using the Cell Counting Kit-8 (CCK-8). Osteogenic activity was evaluated by alkaline phosphatase (ALP) staining. Mineralized nodule formation was detected by Alizarin red staining. The relative messenger ribonucleic acid (mRNA) expression levels of Runt-related transcription factor 2 (Runx 2), osteoblast-specific transcription factor (Osterix), and osteopontin (OPN) were measured by real-time quantitative polymerase chain reaction (qPCR). A rat orbital defect model was established, and PEEK specimens (PEEK implantation group) and PEEK-BMP2-HAH specimens (PEEK-BMP2-HAH implantation group) were implanted. Bone formation was observed by hematoxylin-eosin (HE) staining, and osteocalcin (OCN) expression was detected by immunohistochemical staining. Results: Bone marrow mesenchymal cells adhered to and grew on the surface of both PEEK and PEEK-BMP2-HAH specimens. After 7 days of osteogenic induction, ALP staining revealed brown-black aggregated areas on PEEK discs, while PEEK-BMP2-HAH discs exhibited distinct black particles. The ALP activity in the PEEK-BMP2-HAH group [(2.36±0.18) μmol·min⁻¹·ng⁻¹ protein] was higher than that in the PEEK group [(1.00±0.18) μmol·min⁻¹·ng⁻¹ protein], with a statistically significant difference (t=12.15, P<0.001). After 14 days of osteogenic induction, Alizarin red staining demonstrated red aggregated areas on PEEK discs, whereas the PEEK-BMP2-HAH group displayed prominent reddish-brown mineralized nodules. The semi-quantitative absorbance value of Alizarin red staining in the PEEK-BMP2-HAH group (0.55±0.05) was more pronounced than that in the PEEK group (0.22±0.03), with a statistically significant difference (t=13.33, P<0.001). After 7 and 14 days of osteogenic induction, the relative mRNA expression of Runx 2 in the PEEK-BMP2-HAH group (3.25±0.22, 2.36±0.14) was significantly higher than that in the PEEK group (1.01±0.05, 1.03±0.07), with statistically significant differences (t=22.33, P<0.001; t=17.50, P<0.001). The relative mRNA expression of OPN in the PEEK-BMP2-HAH group (1.71±0.11, 2.11±0.15) was also significantly higher than that in the PEEK group (1.03±0.08, 1.04±0.10), with statistically significant differences (t=10.47, P<0.001; t=11.10, P<0.001). After 7 days of osteogenic induction, there was no sig

Functional visual disorder (FVD) belongs to functional neurological disorder (FND), and clinical examination and testing are not consistent with clinical ophthalmic or neurological disease.The major clinical manifestations are visual acuity loss and visual field loss.FVD has a serious impact on patients' daily life, and it is difficult to distinguish from other visual disorders by its clinical manifestations. Some patients receive unnecessary treatments, so early diagnosis and accurate treatment are particularly important. This article reviews the clinical characteristics, pathological mechanism, diagnosis and differential diagnosis, auxiliary examination, management and prognosis of FVD in order to improve clinical diagnostic and therapeutic rates and patient prognosis.

A 38-year-old female patient was followed up intermittently for nearly 8 years due to rhegmatogenous retinal detachment (RRD) and severe proliferative vitreoretinopathy (PVR) in the right eye. Seven years prior, the patient was diagnosed with silicone oil-dependent eye after vitrectomy and secondary cataract in the right eye; however, she declined further medical management at that time. At the latest re-evaluation (seven years after the aforementioned diagnosis), the lens that was previously affected by cataract was found to have disappeared spontaneously. The patient confirmed no surgical intervention had been received during this interval, and further examinations verified that the lens had undergone spontaneous absorption.

Nanophthalmos is a rare congenital ocular disorder characterized by the reduction of both the anterior and posterior segments of the eye, occurring without associated ocular malformations. This condition predisposes individuals to secondary angle-closure glaucoma, a leading cause of vision loss. Due to the rarity of nanophthalmos, current research is limited, primarily focusing on its clinical classification, genetic underpinnings, and complications. This review synthesizes existing literature on the pathogenesis, epidemiology, ocular parameter changes related to glaucoma, and surgical interventions for secondary glaucoma in nanophthalmic patients, emphasizing studies from the past five years to enhance understanding in clinical research and management.

Uveitis is an inflammatory disease, mainly involving the iris, ciliary body, choroid, retina, retinal vessels, and sometimes vitreous body. It has various etiologies and types with complex clinical manifestations. Following scientific diagnosis points is usually able to ensure an accurate and timely diagnosis of the disease. The experts in the Ocular Immunology Group of Ophthalmology Society of Chinese Medical Association and the Uveitis and Ocular Immunology Group of Chinese Ophthalmologist Association have developed consensus opinions on the key diagnostic points of uveitis based on an in-depth investigation and literature review, as well as clinical experience, to guide the clinical practice.

Objective: To explore the reliability and validity of the self-reported questionnaire for assessing frame glasses-wearing compliance in myopic children. Methods: The initial item pool of the questionnaire was preliminarily constructed by systematically sorting out the research results related to the compliance of myopic children with spectacle wearing through the literature review method, combined with structured interviews with 5 myopic children. First, 18 experts meeting the specified criteria were selected to conduct 3 rounds of expert consultation to optimize the item pool. Then, 5 experts with a master's degree or above and proficient in scale development methods were selected from them to conduct content validity evaluation. The item-level content validity index (I-CVI) and scale-level content validity index (S-CVI) were calculated to assess the content validity. Meanwhile, the items were optimized in combination with a pilot test (50 myopic children were selected for 3 rounds of pilot surveys) to form the final version of the questionnaire. From November 2022 to January 2023, 494 myopic children aged 10-15 years who wore frame glasses for myopia prevention and control were recruited from urban areas of Ji'an City, Jiangxi Province to conduct a questionnaire survey. For reliability analysis, split-half reliability and Cronbach's α coefficient were used for evaluation; for validity analysis, content validity and construct validity were adopted. Among them, content validity was measured with I-CVI and S-CVI as indicators; construct validity was analyzed through exploratory factor analysis, where the suitability of data was first determined by the Kaiser-Meyer-Olkin (KMO) test and Bartlett's test of sphericity, and then evaluated using indicators including the cumulative variance contribution rate of common factors, item factor loading coefficient, and common factor variance. Results: The final questionnaire consisted of 8 scale items and 1 non-scale item. Exploratory factor analysis of the 8 scale items (KMO=0.713, Bartlett's test of sphericity P<0.001) extracted 3 common factors, with a cumulative variance contribution rate of 62.565%. The factor loading of each item ranged from 0.52 to 0.88, and the common factor variance of all items was>0.5. Based on this, the 3 factors were named as three dimensions: Glasses-Wearing Habits (3 items), Extent of Glasses Usage (3 items), and Self-Monitoring (2 items). The 1 non-scale item was used to explore the barriers to glasses-wearing compliance. In terms of reliability, the Cronbach's α coefficient of the scale was 0.720, and the split-half coefficient was 0.719. In terms of validity, the S-CVI was 0.875, and the I-CVI ranged from 0.800 to 1.000. Conclusion: The questionnaire has good reliability and validity, and can be used as a standardized tool for assessing glasses-wearing compliance in myopic children aged 10-15 years.

A 37-year-old female diabetic patient presented with decreased vision in the right eye for 3 days. Ophthalmic examination revealed milky white turbidity of the aqueous humor in the right eye, accompanied by elevated intraocular pressure. Laboratory tests indicated poor control of blood glucose levels and hyperlipidemia. Subsequently, the left eye showed the same manifestations. The clinical diagnosis was bilateral chylous aqueous humor. Systemic hypoglycemic and lipid-lowering drugs were administered, combined with anterior chamber irrigation of the right eye. Glucocorticoids, cycloplegics and intraocular pressure-lowering drugs were used in both eyes. On the 8th day after the treatment, the ocular and systemic conditions improved significantly.