中华眼科杂志最新文献

Glaucoma, the leading cause of irreversible blindness worldwide, is a chronic and progressive disease requiring lifelong monitoring and treatment. To improve patient adherence and ensure the safe and effective use of multiple medications in the glaucoma management, fixed-combination antiglaucoma medications have emerged as a key therapeutic trend. In 2019, the Glaucoma Group of Ophthalmology Branch of Chinese Medical Association established a consensus on the use of fixed-combination antiglaucoma medications. Upon this foundation, updated consensus recommendations have been formulated through collaboration with the Glaucoma Group of Chinese Ophthalmologist Association. This revision incorporates a comprehensive review of domestic and international research advances over the past five years, along with clinical data analysis and in-depth discussions, aiming to further standardize the clinical practice associated with glaucoma.

Objective: To investigate the treatment approaches for attacking eyes in patients with clinical acute primary angle-closure glaucoma (APACG) and their alignment with the recommendations in the Chinese Glaucoma Guidelines (2020). Methods: A cross-sectional study was conducted, including medical records of consecutive inpatients diagnosed with APACG from 22 ophthalmic centers nationwide during three periods: September 7, 2020, to January 6, 2021; September 7, 2021, to January 6, 2022; and September 7, 2022, to January 6, 2023. For patients meeting the inclusion criteria in both eyes, the right eye was uniformly selected for analysis. Demographic characteristics, medical history, and ocular examination data were collected. Patients were categorized into medication group, laser treatment group, and surgical treatment group based on their final treatment after admission. The proportion of different treatment approaches and their consistency with the Chinese Glaucoma Guidelines (2020) were analyzed. Statistical analysis was performed using the chi-square test. Results: A total of 2 567 patients (2 567 eyes) with APACG were included, with a mean age of (66.7±9.3) years. Among them, 615 (24.0%) were male and 1 952 (76.0%) were female; 1 431 eyes (55.7%) were right eyes and 1 136 eyes (44.3%) were left eyes. There were 83 eyes (3.2%) in the medication group, 256 eyes (10.0%) in the laser treatment group, and 2 228 eyes (86.8%) in the surgical treatment group. In the surgical treatment group, 1 951 eyes (87.6%) underwent cataract extraction, and 1, 300 eyes (58.3%) received phacoemulsification combined with goniosynechialysis as the preferred surgical approach. The rate of complete consistency between the treatment regimens and the recommendations in the Chinese Glaucoma Guidelines (2020) was 52.4% (1 344/2 567), and the rate of partial consistency was 40.3% (1 035/2 567). Conclusions: Phacoemulsification combined with goniosynechialysis has become the mainstream surgical approach for treating attacking eyes in APACG patients in China. Over 90% of APACG patients received treatment consistent with the Chinese Glaucoma Guidelines (2020).

Objective: To assess the current research status of retinal vein occlusion (RVO) and to explore its research trends and hotspots based on bibliometrics. Methods: A bibliometric study was conducted on April 25, 2024, retrieving articles from China National Knowledge Infrastructure (CNKI), Wanfang, and Web of Science Core Collection covering 2014 to 2023. CiteSpace, VOSviewer, and Microsoft Excel were used for visualization and analysis of annual publications, country distribution, author productivity, journals, cited references, and keywords. Results: A total of 1 929 articles in Chinese and 2 764 international publications were identified. The ophthalmology journals dominated the publication venues. Retina-The Journal of Retinal and Vitreous Diseases published the highest number of foreign-language articles (n=178), accounting for 6.44% of the international literature analyzed. International Eye Science published the highest number of Chinese-language articles (n=140), accounting for 7.26% of the Chinese literature analyzed. Research on RVO followed an interdisciplinary development pattern, with research hotspots primarily focused on ophthalmology, molecular biology, and immunology. The U.S. produced the largest volume of papers (659), followed by China (481), while France achieved the highest citation impact (average 28.19 citations per article). Akitaka Tsujikawa was the most prolific foreign author (41 papers, 479 citations, average 10.89 citations per paper). The keyword analysis extracted 373 and 823 keywords from the Chinese and foreign literature, respectively, with major bursts in 2015 and 2020. The early studies focused on clinical and pathological features; recent research emphasized molecular mechanisms, novel drugs, and therapies. The keyword clustering identified 17 and 6 significant clusters in the Chinese and foreign literature, respectively. The topics such as macular edema, ranibizumab, vascular endothelial growth factor, and quality of life emerged in 2015 and remained as central priorities. Conclusion: RVO and macular edema are primary research foci both domestically and internationally. Macular edema, ranibizumab, vascular endothelial growth factor, and quality of life have become enduring hotspots within the field of RVO research over the past decade.

Primary angle-closure glaucoma (PACG) is a prevalent clinical condition. In 2019, the Glaucoma Group of Ophthalmology Branch of Chinese Medical Association released the consensus opinions on the diagnosis and treatment of PACG, providing crucial guidance for clinical practice. Since significant new research on PACG has emerged over the past five years, both the Glaucoma Group of Ophthalmology Branch of Chinese Medical Association and the Glaucoma Group of Chinese Ophthalmologist Association have collaborated to conduct extensive evidence-based discussions to attain an updated consensus on the classification, diagnostic approaches, and treatment principles for PACG in China, which may serve as a reference for clinical practitioners.

Objective: To explore the effects of aging on the stiffness of human scleral fibroblast (HSF) and the remodeling of the extracellular matrix. Methods: This experimental study was conducted from January 2022 to June 2024. HSFs were cultured, and after cell passage, β-galactosidase staining was conducted. The expression levels of aging markers P16 and P21 were detected through Western blotting. To establish a replicative aging model of HSF, cells were divided into two groups: the 4th generation cells as the young control group and the 16th generation cells as the aging experimental group. Atomic force microscopy was used to measure the stiffness of the cell bodies and the extracellular matrix produced by both groups, expressed as Young's modulus, a measure of stiffness. The biological characteristics, including cell contractility, and the expression of extracellular matrix-related proteins in both groups were assessed through collagen gel contraction experiments and Western blotting. The expression levels of protein cross-linking indicators-lysyl oxidase (LOX), lysyl oxidase-like protein 1 (LOXL1), and transglutaminase (TGM2)-were measured at both mRNA and protein levels using quantitative real-time PCR and Western blotting. Statistical analysis was performed using independent samples t-test and Mann-Whitney U test. Results: HSF successfully established a replicative senescence model after passage, and when the cells were passed to the 16th generation, the positive rate of β-galactosidase staining significantly increased, the cell doubling time was prolonged, and the expression of p16 protein in the senescence experimental group (1.40±0.05) was higher than that in the young control group (0.87±0.11); the expression of p21 protein in the senescence experimental group (1.13±0.12) was higher than that in the young control group (0.79±0.04), with statistically significant differences (all P<0.05). The Young's modulus of the cell bodies in the senescent group [2.259 (1.971, 2.745) kPa] was higher than that in the young control group [1.268 (1.068, 1.489) kPa]. Likewise, the Young's modulus of the extracellular matrix in the senescent group [13.598 (9.073, 17.352) kPa] was higher than that in the young control group [10.050 (6.633, 14.999) kPa], with statistically significant differences (both P<0.001). The collagen gel contraction ability of the senescent group was lower than that of the young control group after 12, 24, 36, and 48 hours of culture, with values of 0.803±0.015, 0.773±0.021, 0.713±0.015, and 0.697±0.015 compared to 0.880±0.010, 0.833±0.015, 0.820±0.010, and 0.803±0.006, respectively. These differences were statistically significant (all P<0.05). After 48 hours of culture, the migration distance of cells in the senescence experimental group [(73.33±4.16) μm] was lower than that in the young control group [(187.33±3.06) μm], with a statistically significant difference (P<0

Pathological myopia is one of the primary causes of irreversible visual loss in the population. Myopic maculopathy represents a key feature of pathological myopia, among which macular atrophy is the main contributor to severe visual impairment. The specific mechanism underlying the development of macular atrophy remains unclear. Studies have demonstrated that the formation and progression of choroidal neovascularization are closely linked to the onset of macular atrophy. To date, no effective therapeutic interventions have been identified to delay or reverse the progression of macular atrophy.

Two patients (a 7-year-old female and a 61-year-old male) had poor intraocular pressure control after XEN gel stent implantation. During the process of filtering bleb repair, the XEN gel implant retreated into the anterior chamber, and the limbal and corneal incisions were made. After the implant in the anterior chamber was taken out, it was implanted into the anterior chamber again from the original scleral tunnel for the female patient, while it was re-punctured into the anterior chamber with a 1-ml syringe needle at another site for the male patient. The follow-up examinations at 3 weeks and 6 months after surgery showed good results.