中华眼科杂志最新文献

With the development of medical biotechnology, intraocular biological sample testing and genetic testing are increasingly applied in the diagnosis, treatment, and research of eye diseases. They help to quickly diagnose diseases, but also bring new problems to clinical work. This article summarizes and discusses the current situation, existing problems, and solutions of intraocular biological sample testing and genetic testing in China. It is emphasized that the clinical diagnosis is the key in ophthalmic practice, based on which criteria for intraocular biological sample testing and genetic testing need be established in a standardized manner, so as to reasonably leverage the advantages of the two tests and effectively promote the progress of ophthalmic diagnosis and treatment technology.

Fundus diseases have been among the major causes of blindness in China. Optical coherence tomography (OCT) is an important examination method for fundus diseases. However, there are ongoing challenges in the examination procedure, image interpretation and reporting, and application in screening fundus diseases. Based on research evidence and clinical experience, experts from the Chinese Vitreo-Retina Society of Chinese Medical Association, together with the Fundus Disease Group of Chinese Ophthalmologist Association and Ophthalmology Group of China Alliance for Rare Diseases/Beijing Society of Rare Disease Clinical Care and Accessibility, have developed consensus recommendations on the OCT procedures, quality control and use of images, OCT image characteristics of common fundus diseases, and image interpretation and reporting with a modified Delphi approach to provide guidance and reference for clinical management and scientific research of fundus diseases.

Objective: To investigate the incidence and clinical features of retinopathy of prematurity (ROP) among preterm infants in a neonatal intensive care unit (NICU) of Lhasa, and to explore the screening criteria for ROP in high-altitude areas. Methods: It was a single-center retrospective case study. A total of 166 preterm infants of Tibetan ethnicity admitted to the NICU of Lhasa People's Hospital from May 1, 2020 to June 1, 2022 with a gestational age<36 weeks were enrolled. ROP was screened using the third-generation wide-angle digital pediatric retinal imaging system (RetCam Ⅲ). The ROP detection rate, staging, and zonal distribution were analyzed. Multivariate logistic regression was performed and risk factors for ROP in preterm infants were identified by calculating the odds ratio (OR) and its 95% confidence interval (95%CI). Results: There were 88 males and 78 females, among whom 33 patients (66 eyes) were diagnosed with ROP. The birth gestational age of ROP patients was 30 (29, 31) weeks, and the average birth weight was 1 188.5±219.2 g. The disease was at stage 1 in 48 eyes (72.7%), stage 2 in 16 eyes (24.2%), and stage 3 in 2 eyes (3.0%). Two eyes (3.0%) had zone Ⅰ disease, 26 eyes (39.4%) had zone Ⅱ disease, and 38 eyes (57.6%) had zone Ⅲ disease. Thirty ROP patients (90.9%) had spontaneous regression and vascularization. Three patients (9.1%) developed type Ⅰ ROP, which was treated by anti-VEGF therapy (1 patient) or spontaneously resolved during the follow-up (2 patients). Multiple logistic regression analysis showed that gestational age (OR=0.53, 95%CI: 0.33-0.84, P=0.007), birth weight (OR=0.95, 95%CI: 0.92-0.98, P<0.001), and duration of invasive mechanical ventilation (OR=1.42, 95%CI: 1.06-1.90, P=0.018) were influencing factors of ROP. Conclusions: The detection rate of ROP among Tibetan preterm infants in the single-center neonatal intensive care unit in Lhasa was 19.9%, while the detection rate of type Ⅰ ROP was 1.8%. Preterm infants with shorter gestational age, lower birth weight, and prolonged invasive mechanical ventilation were liable to develop ROP.

Nanophthalmos is an uncommon developmental ocular disorder characterized by a diminutive eye resulting from impaired growth, which may occur sporadically or within familial contexts. Both environmental and genetic factors are implicated in the induction of nanophthalmos. The ocular biometric characteristics associated with nanophthalmos include reduced ocular axis, shallow anterior chamber, thickened scler and microcornea, which may lead to complications such as secondary uveal effusion syndrome and angle-closure glaucoma, as well as comorbidities like congenital cataract. Typically, the diagnosis of nanophthalmos is primarily reliant on the measurement of axial length via ultrasound. This review provides a comprehensive overview of the etiology, clinical manifestations, diagnostic criteria, and therapeutic approaches related to nanophthalmos.

A 14-year-old female patient presented with progressive proptosis of the left eye for four months, accompanied by decreased vision and diplopia for one month. Imaging examinations showed relevant manifestations of the mass in the left orbit. Following a biopsy and left orbital mass resection under general anesthesia, histopathological and immunohistochemical examinations confirmed a diagnosis of left orbital angiomyxoma. At the four-month follow-up, the patient's exophthalmos had significantly improved. However, imaging revealed that while the tumor had shrunk, a portion had invaded the left maxillary sinus. The patient's parents opted for regular follow-up monitoring.

Objective: To investigate the effect of polydatin on retinal ganglion cell (RGC) apoptosis induced by optic nerve injury. Methods: It was an experimental research, conducted from October 2022 to December 2023. Retina-optic nerve explants from C57BL/6 mice were cultured in vitro to simulate optic nerve injury, and a computer-generated random number table was used for complete randomization, assigning the explants to the 0-day uncultured group (immediately detected after sampling), the model group (cultured for 1, 3 or 5 days to establish the injury model), and the polydatin group (with polydatin added throughout the intervention on the basis of the model group). The retinal tissues were collected, and the glial fibrillary acidic protein (GFAP), calcium ion binding protein 1 (Iba1), and ganglion cell marker Brn3a were detected by immunofluorescence staining. The effects of polydatin on the activation of astrocytes and microglia and RGC survival were observed. The expressions of GFAP, Vimentin, Iba1, B-lymphocytoma-2-associated X protein (Bax), lyzed C-caspase 3, and B-lymphocytoma-2 were detected by Western blotting. Real-time fluorescence quantitative PCR was used to detect the mRNA transcription levels of tumor necrosis factor-α (TNF-α), interleukin (IL)-6, and IL-10. One-way analysis of variance and LSD-t test were used for statistical analysis. Results: Immunofluorescence staining showed that compared with the model group, the polydatin group inhibited the activation of astrocytes and microglia and protected the RGCs. With explant culture for 1, 3, and 5 days, the expressions of GFAP (0.74±0.01, 0.70±0.04, 0.68±0.02), Vimentin (0.67±0.02, 1.91±0.09, 1.25±0.05), Iba1 (0.87±0.10, 2.36±0.13, 1.64±0.11), Bax (2.48±0.10, 0.37±0.02, 1.69±0.11), and C-caspase 3 (0.77±0.03, 2.49±0.09, 1.65±0.08) in the polydatin group were lower than those in the model group [GFAP (1.23±0.01, 1.17±0.01, 1.77±0.04), Vimentin (1.21±0.02, 2.67±0.06, 1.42±0.03), Iba1 (1.13±0.02, 3.51±0.07, 2.16±0.08), Bax (3.53±0.12, 1.27±0.06, 3.24±0.15), and C-caspase 3 (1.54±0.08, 3.38±0.17, 2.18±0.08)]. The expression of B-lymphocytoma-2 in the polydatin group (2.41±0.09, 1.67±0.07, 6.84±0.20) was higher than that in the model group (1.73±0.08, 0.96±0.07, 2.36±0.33). The differences were statistically significant (all P<0.05). In addition, the mRNA transcription levels of TNF-α (0.47±0.13, 12.07±0.56, 18.06±2.58) and IL-6 (0.55±0.12, 7.48±1.02, 41.35±7.08) in the polydatin group were lower than those in the model group [TNF-α (4.67±0.52, 26.62±2.62, 42.43±4.97) and IL-6 (1.21±0.06, 15.66±0.62, 67.46±3.78)]. The level of IL-10 (0.52±0.07, 2.98±0.24, 5.61±1.23) in the polydatin group was higher than that in the model group (0.06±0.03, 0.12±0.03, 2.64±0.74). The differences were statistically significant (all P<0.05). Conclusion: Polydatin can inhibit the activation of glial cells and the expression of inflammatory factors induced by

Objective: To systematically evaluate the predictive accuracy of different intraocular lens (IOL) power calculation formulas in cataract patients with short axial length (≤22.5 mm). Methods: This is a meta-analysis. Databases including PubMed, Web of Science, Cochrane Library, Embase, and CNKI (from the establishment of the database to August 2023) were searched, and case-control studies comparing≥2 IOL formulas were included. The literature involves 12 intraocular lens (IOL) power calculation formulas, including Barrett Universal Ⅱ, EVO, Haigis, Hill RBF, Hoffer Q, Holladay 1, Kane, Olsen, PEARL DGS, SRK/T, T2, and VRF. The primary outcome measures were cases with prediction errors within the ranges of±0.25 D,±0.50 D, and ±1.00 D.Two researchers independently screened the literature, extracted data, and evaluated the risk of bias (using the QUADAS-2 tool). Traditional meta-analysis (fixed/random-effect model) was performed using RevMan 5.3, and network meta-analysis was carried out using Stata 14. The proportion of predictive errors within the ranges of ±0.50 D and ±1.00 D were the main indicators. The odds ratio (OR) and its 95% confidence interval (CI) were used to compare and evaluate the predictive error situations of different formulas. Results: A total of 8 studies (785 eyes) were included. Traditional meta-analysis showed that within the ±1.00 D range, Hoffer Q (93.4%; 648/694) and Kane (95.7%; 426/445) were significantly better than SRK/T (OR=1.50, 95%CI: 1.01-2.25, P=0.020; OR=2.00, 1.73-3.43, P=0.007). Kane was signifficantly better than T2 (OR=2.09, 1.15-3.80, P=0.020); within the ±0.50 D range, PEARL-DGS was better than SRK/T (OR=1.34, 1.00-1.80, P=0.050); within the ±0.25 D range, EVO (46.1%; 94/204) had the highest proportion and was significantly better than Hoffer Q (OR=0.62, 0.41-0.91, P=0.020). Network meta-analysis (ranked by the area under the cumulative ranking curve) indicated that EVO (ranked first within ±0.50 D) and Kane (ranked first within ±1.00 D) had the best overall performance, and SRK/T was the worst in all ranges (P<0.05). Conclusion: Among the traditional optical refraction formulas, Haigis and Hoffer Q have good accuracy, and SRK/T is not recommended; the new-generation formulas (EVO, Kane) have better prediction accuracy in patients with short axial length and are recommended for clinical priority selection.

Corneal neovascularization, a severe pathologic change of the ocular surface, is usually caused by complex pathogeneses, and leads to severe vision damage and eventually corneal blindness. The applications of anti-inflammatory and anti-angiogenic drugs as well as keratoplasty have proved to have certain therapeutic effects. However, there are still numerous barriers that have not yet been fully overcome, prompting a trend towards treatment with multidisciplinary techniques. In this review, we summarize the latest research progress and give an overview of the techniques and strategies for treatment of corneal neovascularization in recent years based on the new mechanistic findings, aiming to improve the therapeutic efficiency and precision.

Glaucoma stands as the leading cause of irreversible blindness globally, yet its pathogenesis remains incompletely understood. With the advancements in biomechanical detection technologies, in-vivo biomechanical research on the eyeball has become feasible. An increasing number of researchers have turned their attention to the intricate relationship between the biomechanical properties of the cornea and the onset and progression of glaucoma. This article delves into four crucial aspects: grasping the concepts and detection techniques of corneal biomechanics, exploring the correlation between corneal biomechanics and glaucoma, investigating the influencing factors of corneal biomechanics in glaucoma cases, and understanding the application of corneal biomechanics-corrected intraocular pressure in glaucoma diagnosis and treatment. It emphasizes the need to comprehensively recognize the reference value of corneal biomechanical parameters in glaucoma diagnosis and treatment. The authors aim to collaborate with fellow ophthalmologists in related research, with the ultimate goal of enhancing the diagnostic and therapeutic standards for glaucoma.