Corneal biomechanics and their association with severity of lens dislocation in Marfan syndrome.

PURPOSE: To investigate corneal biomechanical properties and its associations with the severity of lens dislocation in patients with Marfan syndrome. METHODS: A total of 30 patients with Marfan syndrome and 30 age-, sex- and axial length (AL)-matched controls were recruited. Corneal biomechanical parameters of both groups were measured by CorVis ST and were compared between groups. Potential associations between corneal biomechanical parameters and severity of lens dislocation were also investigated. RESULTS: Lower applanation 1 velocity (A1V) (0.13 ± 0.004 vs. 0.15 ± 0.003, P = 0.016), shorter applanation 2 time (A2T)(22.64 ± 0.11 vs. 22.94 ± 0.11, P = 0.013), longer peak distance (PD) (5.03 ± 0.07 vs. 4.81 ± 0.05, P = 0.008), longer radius (R) of highest concavity (7.44 ± 0.16 vs. 6.93 ± 0.14, P = 0.012), greater Ambrosio relational thickness horizontal (ARTh) (603 ± 20 vs. 498 ± 12, P < 0.001), and integrated radius (IR) (8.32 ± 0.25 vs. 8.95 ± 0.21, P = 0.033) were detected among Marfan eyes compared with controls (all P < 0.05). Marfan individuals with more severe lens dislocation tended to have increased stiffness parameter as longer A1T, slower A1V, shorter A2T, slower application 2 velocity (A2V), smaller PD and smaller Distance Amplitude (DA) (P < 0.05). CONCLUSION: Marfan patients were detected to have increased corneal stiffness compared with normal subjects. Corneal biomechanical parameters were significantly associated with the severity of lens dislocation in Marfan patients.

Direct Observation of Large-Scale Screw Dislocation Grids in Oxide Heteroepitaxies.

Screw dislocation is important not only for understanding plastic deformation of crystals but also for optical and electrical properties of materials. However, characterizations of screw dislocations are still challenging since there is almost no atom distortion when viewed along the dislocation line. In particular, although it is theoretically known that shear strains in heteroepitaxy systems may be relaxed via screw dislocation grids, the specific structures and thickness-dependent evolutions of these grids are still largely unknown. Here, by using orthorhombic [001]-oriented DyScO3 substrates we have directly observed large-scale screw dislocation grids in the DyScO3/BiFeO3 oxide heteroepitaxies exhibiting large shear strain. Pure screw dislocations with a[100] and a[01̅0] Burgers vectors were confirmed by multiscale transmission electron microscopy study. Our results directly confirm screw dislocation grids as a factor to tailor shear strains in epitaxial systems and suggest a practical platform for studying structures and induced responses corresponding to screw dislocations.

Real-Time Transformation of Flux-Closure Domains with Superhigh Thermal Stability.

Polar topologies have received extensive attention due to their exotic configurations and functionalities. Understanding their responsive behaviors to external stimuli, especially thermal excitation, is highly desirable to extend their applications to high temperature, which is still unclear. Here, combining in situ transmission electron microscopy and phase-field simulations, the thermal dynamics of the flux-closure domains were illuminated in PbTiO3/SrTiO3 multilayers. In-depth analyses suggested that the topological transition processes from a/c domains to flux-closure quadrants were influenced by the boundary conditions of PbTiO3 layers. The symmetrical boundary condition stabilized the flux-closure domains at higher temperature than in the asymmetrical case. Furthermore, the reversible thermal responsive behaviors of the flux-closure domains displayed superior thermal stability, which maintained robust up to 450 °C (near the Curie temperature). This work provides new insights into the dynamics of polar topologies under thermal excitation and facilitates their applications as nanoelectronics under extreme conditions.

Atomic-Scale Tunable Flexoelectric Couplings in Oxide Multiferroics.

Flexoelectricity is an effective tool in modulating the crystallographic structures and properties of oxides for multifunctional applications. However, engineering the nonuniform strain to obtain tunable flexoelectric behaviors at the atomic scale remains an ongoing challenge in conventional substrate-imposed ferroelectric films. Here, the regulatable flexoelectric behaviors are demonstrated at atomic scale in [110]-oriented BiFeO3 thin films, which are triggered by the strain-field coupling of high-density interfacial dislocations. Using aberration-corrected scanning transmission electron microscopy, the asymmetric polarization rotation around the single dislocation is revealed, which is induced by the gradient strain fields of the single dislocation. These strain fields are highly correlated to generate huge strain gradients between neighboring dislocations, and thereby, serial flexoelectric responses are engineered as a function of dislocation spacings in thicker BiFeO3 films. This work opens a pathway for the modulation of flexoelectric responses in ferroelectrics, which could be extended to other functional materials to create exotic phenomena.

Periodic Polarization Waves in a Strained, Highly Polar Ultrathin SrTiO3.

SrTiO3 is generally paraelectric with centrosymmetric structure exhibiting unique quantum fluctuation related ferroelectricity. Here we reveal highly polar and periodic polarization waves in SrTiO3 at room temperature, which is stabilized by periodic tensile strains in a sandwiched PbTiO3/SrTiO3/PbTiO3 structure. Scanning transmission electron microscopy reveals that periodic a/c domain structures in PbTiO3 layers exert unique periodic tensile strains in the ultrathin SrTiO3 layer and consequently make the highly polar and periodic states of SrTiO3. The as-received polar SrTiO3 layer features peak polar ion displacement of ∼0.01 nm and peak tetragonality of ∼1.07. These peak values are larger than previous results, which are comparable to that of bulk ferroelectric PbTiO3. Our results suggest that it is possible to integrate large and periodic strain state in oxide films with exotic properties, which in turn could be useful in optical applications and information addressing when used as memory unit.

Prevalence of age-related macular degeneration in Chinese populations worldwide: A systematic review and meta-analysis.

IMPORTANCE: Age-related macular degeneration (AMD) is a leading cause of irreversible blindness, but the magnitude of AMD among Chinese populations worldwide is still unknown. BACKGROUND: To investigate the prevalence of AMD in Chinese populations worldwide. DESIGN: Meta-analysis. PARTICIPANTS: Nine studies with 29 344 subjects in total. METHODS: All population-based studies on AMD prevalence in Chinese populations worldwide were identified and only studies using standardized AMD grading systems (Wisconsin Age-Related Maculopathy Grading System, Age-Related Eye Disease Study System of Classifying AMD, the International Classification and Grading System for AMD or the Clinical Classification of Age-Related Macular Degeneration) were included. We used meta-analysis to estimate the pooled prevalence and its 95% confidence interval (95% CI) of AMD, and to explore the racial differences and regional differences. MAIN OUTCOME MEASURES: Age-specific prevalence, gender-specific prevalence and pooled prevalence of early and late AMD among Chinese population worldwide. RESULTS: Altogether, 9 studies with 29 344 individuals were included and analysed. The crude pooled prevalence of early and late AMD among Chinese populations worldwide aged 50 years and above is 4.9% (95% CI: 3.1%-7.7%) and 0.7% (95% CI: 0.5%-1.1%), respectively. Corresponding crude prevalence among Caucasian populations are 10.1% (95% CI: 5.7%-17.2%) and 1.6% (95% CI: 1.0%-2.4%). There are statistically significant differences within age and gender subgroups. CONCLUSIONS AND RELEVANCE: Among persons aged 50+ years, both early AMD and late AMD in Chinese populations worldwide were less common compared with that reported from Caucasian populations. Considering the significant racial or ethnic differences in AMD prevalence between Chinese and Caucasian people, further studies are needed to explore the possible mechanism behind this discrepancy.

The burden, causes, and determinants of blindness and vision impairment in Asia: An analysis of the Global Burden of Disease Study.

Background: Asia accounts for more than half of the world's population and carries a substantial proportion of the global burden of blindness and vision impairment. Characterising this burden, as well as its causes and determinants, could help with devising targeted interventions for reducing the occurrence of blindness and visual impairment. Methods: Using the Global Burden of Disease Study 2019 database, we retrieved data on the number of disability-adjusted life years (DALYs); crude and age-standardised rates; and the prevalence (with 95% uncertainty intervals (95%UIs)) of blindness and vision loss due to six causes (age-related macular degeneration, cataracts, glaucoma, near-vision impairment, refractive error, and other vision loss) for Asian countries for the period between 1990 and 2019. We defined DALYs as the sum of the years lost due to disability and years of life lost, and calculated age-standardised figures for the number of DALYs and prevalence by adjusting for population size and age structure. We then evaluated the time trend of the disease burden and conducted subgroup analyses by gender, age, geographic locations, and socio-demographic index (SDI). Results: In 2019, the DALYs and prevalence of blindness and vision loss had risen by 90.1% and 116% compared with 1990, reaching 15.84 million DALYs (95% UI = 15.83, 15.85) and 506.71 million cases (95% UI = 506.68, 506.74). Meanwhile, the age-standardised rate of DALYs decreased from 1990 to 2019. Cataracts, refractive error, and near vision impairment were the three most common causes. South Asia had the heaviest regional disease burden (age-standardised rate of DALYs = 517 per 100 000 population; 95% UI = 512, 521). Moreover, the burden due to cataracts ranked high in most Asian populations. Being a woman; being older; and having a lower national SDI were factors associated with a greater vision loss burden. Conclusions: The burden due to vision loss remains high in Asian populations. Cataracts, refractive error, and near vision loss were the primary causes of blindness and vision loss. Greater investment in ocular disease prevention and care by countries with lower socioeconomic status is needed, as well as specific strategies targeting cataract management, women and the elderly.

Polar Bloch points in strained ferroelectric films.

Topological domain structures have drawn great attention as they have potential applications in future electronic devices. As an important concept linking the quantum and classical magnetism, a magnetic Bloch point, predicted in 1960s but not observed directly so far, is a singular point around which magnetization vectors orient to nearly all directions. Here we show polar Bloch points in tensile-strained ultrathin ferroelectric PbTiO3 films, which are alternatively visualized by phase-field simulations and aberration-corrected scanning transmission electron microscopic imaging. The phase-field simulations indicate local steady-state negative capacitance around the Bloch points. The observation of polar Bloch points and their emergent properties consequently implies novel applications in future integrated circuits and low power electronic devices.

Time trends and heterogeneity in the disease burden of visual impairment due to cataract, 1990-2019: A global analysis.

Objectives: This study aimed to estimate the disease burden of cataract and evaluate the contributions of risk factors to cataract-associated disability-adjusted life years (DALYs). Materials and methods: Prevalence and DALYs of visual impairment due to cataract were extracted from the Global Burden of Disease (GBD) study 2019 to explore time trends and annual changes. Regional and country-level socioeconomic indexes were obtained from open databases. The time trend of prevalence and DALYs was demonstrated. Stepwise multiple linear regression was used to evaluate associations between the age-standardized rate of DALYs of cataract and potential predictors. Results: Global Prevalence rate of visual impairment due to cataract rose by 58.45% to 1,253.9 per 100,000 population (95% CI: 1,103.3 to 1,417.7 per 100,000 population) in 2019 and the DALYs rate rose by 32.18% from 65.3 per 100,000 population (95% CI: 46.4 to 88.2 per 100,000 population) in 1990 to 86.3 per 100,000 population (95% CI: 61.5 to 116.4 per 100,000 population) in 2019. Stepwise multiple linear regression model showed that higher refractive error prevalence (ß = 0.036, 95% CI: 0.022, 0.050, P < 0.001), lower number of physicians per 10,000 population (ß = -0.959, 95% CI: -1.685, -0.233, P = 0.010), and lower level of HDI (ß = -134.93, 95% CI: -209.84, -60.02, P = 0.001) were associated with a higher disease burden of cataract. Conclusion: Substantial increases in the prevalence of visual impairment and DALYs of cataract were observed from 1990 to 2019. Successful global initiatives targeting improving cataract surgical rate and quality, especially in regions with lower socioeconomic status, is a prerequisite to combating this growing burden of cataract in the aging society.

Improving Effective Lens Position Prediction for Transscleral Fixation of Intraocular Lens Among Congenital Ectopia Lentis Patients.

PURPOSE: To introduce a method of predicting effective lens position (ELP) among congenital ectopia lentis (CEL) patients undergoing transscleral fixation of intraocular lens (IOL), and evaluate its effect on improving refractive outcome by utilizing the Sanders-Retzlaff-Kraff / theoretical (SRK/T) formula. DESIGN: Retrospective cross-sectional study. METHODS: A training set (93 eyes) and validation set (25 eyes) was included. Z value as the distance between the iris plane and a hypothetic postoperative IOL position was introduced in this study. The Z-modified ELP consisted of corneal height (Ch) and Z (ELP = Ch + Z), and Ch was calculated by keratometry (Km) and white-to-white (WTW). The value of Z was identified by linear regression formula with the involvement of axial length (AL), Km, WTW, age, and gender. The comparison of mean (MAE) and mediate absolute error (MedAE) among Z-modified SRK/T formula, SRK/T, Holladay I, and Hoffer Q formula was performed to evaluate the performance of Z-modified SRK/T formula. RESULTS: Z value was associated with AL, K, WTW, and age (Z = offset + 15.1093 × lg (AL) + 0.0953899 × Km - 0.3910268 × WTW + 0.0164197 × Age - 19.34804). The Z-modified ELP has good accuracy with no difference to back-calculated ELP. The accuracy of Z-modified SRK/T formula was better than other formulas (P < .001) as the MAE was 0.24 ± 0.19 diopter (D) and MedAE was 0.22 D (95% CI: 0.01-0.57 D). Sixty-four percent of eyes had a refractive error smaller than ±0.25 D, and none of the subjects had a prediction error greater than ±0.75 D. CONCLUSIONS: ELP of CEL can be accurately predicted by AL, Km, WTW, and age. Z-modified SRK/T formula improved on the current formula by improving predicting accuracy of ELP and may serve as a promising formula for CEL patients with transscleral fixation of IOL.

Time trends and heterogeneity in the disease burden of trachoma, 1990-2019: a global analysis.

PURPOSE: To evaluate the epidemiological trends and associated risk factors of disease burden due to trachoma. METHODS: Data for the country-specific disability-adjusted life year (DALY) number, rate and age-standardised rate of trachoma together with related data of other common eye diseases were acquired from the Global Burden of Disease Study 2019 database. The Socio-Demographic Index (SDI), Human Development Index (HDI), inequality-adjusted HDI and other related indices were obtained from published data or publicly available databases. Regression analyses were conducted to evaluate the associations between potential risk factors and the age-standardised DALY burden of trachoma. RESULTS: The global DALY burden due to trachoma decreased by 37% from 1990 to 2019 and decreased by 69.8% after adjusting for age and population growth, and, in available 1990-2019 data, had the greatest reduction in attributable DALYs of all common eye disease, with the others analysed being cataract, glaucoma, refractive disorders and age-related macular degeneration. Women had higher age-standardised DALY burden due to trachoma than men (p<0.001). The African region (p<0.001) had the heaviest burden among global regions. The age-standardised DALY rate was higher in countries with lower income (p<0.001) and lower SDI (p<0.001). Higher disease burden due to trachoma was associated with lower HDI (ß=-48.102, 95% CI -86.888 to -9.316, p=0.016), lower SDI (ß=-48.063, 95% CI -83.702 to -12.423, p<0.001) and lower expected years of schooling (ß=-2.352, 95% CI -3.756 to -0.948, p=0.002). CONCLUSIONS: The global disease burden due to trachoma decreased from 1990 to 2019 and it had the greatest reduction compared with other common eye diseases. Lower HDI, socioeconomic status and educational level were related to a higher national disease burden of trachoma. Our findings could provide necessary information for trachoma control and prevention.

Burden of near vision loss in China: findings from the Global Burden of Disease Study 2019.

PURPOSE: To investigate the burden of near vision loss (NVL) in China by year, age and gender from 1990 to 2019. METHODS: We used estimates from the Global Burden of Disease (GBD) 2019 study to report the prevalence and disability-adjusted life-years (DALYs) due to NVL in China. Estimates of crude counts and age-standardised rates per 100 000 population are accompanied by 95% uncertainty intervals (UIs). We summarised the age-specific and sex-specific patterns and trends regarding the burden of NVL in China, compared with seven neighbouring countries. RESULTS: From 1990 to 2019, the all-age number and rate for NVL prevalence and DALYs increased significantly in China (all p<0.001). The age-standardised rate decreased from 7538.1 (95% UI 6946.3 to 8075.1) to 7392.9 (95% UI 6855.8 to 7890.5) per 100 000 population for NVL prevalence (p=0.107), and from 74.9 (95% UI 69.6 to 79.9) to 73.8 (95% UI 70.6 to 80.1) per 100 000 population for DALYs (p=0.388). Women had higher NVL prevalence (t=170.1, p<0.001) and DALYs (t=192.5, p<0.001) than men. Higher disease burden of NVL was observed in the middle-aged and elderly population. The age-standardised prevalence and DALY rate attributable to NVL in China were lower than in India, North Korea, Pakistan (all p<0.001), but higher than Russia, South Korea, Singapore and Japan (all p<0.001). CONCLUSIONS: Despite a small decrease in age-standardised prevalence and DALYs due to NVL in China in the past two decades, the existing burden is still considerable and significantly higher compared with neighbouring developed countries. An approach that includes all stakeholders is needed to further reduce this burden.

Evaluation of functional vision and eye-related quality of life in children with congenital ectopia lentis: a prospective cross-sectional study.

OBJECTIVES: This study aims to evaluate the effect of congenital ectopia lentis (CEL) on functional vision and eye-related quality of life (ER-QOL) in children and their families using the Paediatric Eye Questionnaire (PedEyeQ). DESIGN: A questionnaire survey administered via in-person interviews of patients with CEL and their parents. PARTICIPANTS: 51 children with CEL and 53 visually normal controls accompanied by 1 parent completed the survey questionnaires for the study from March 2022 to September 2022. OUTCOME MEASURES: PedEyeQ domain scores. Functional vision and ER-QOL of children and their families were evaluated by calculating and comparing the Rasch domain scores of the PedEyeQ. RESULTS: PedEyeQ domain scores were significantly worse with CEL compared with controls (p<0.01 for each), with the exception of the Proxy Social domain among children aged 0-4 years (p=0.283). Child PedEyeQ greatest differences were in the functional vision domain (5-11 years, -20 points (95% CI -27 to -12)) and frustration/worry domain (12-17 years, -41 (95% CI -37 to -6)). Proxy PedEyeQ greatest differences were in the functional vision domain (0-4 years, -34 (95% CI -45 to -22)) and frustration/worry domain (5-11 years, -27 (95% CI -39 to -14); 12-17 years, -37(95% CI (-48 to -26))). Parent PedEyeQ greatest difference was in the 'worry about child's eye condition' (-57 (95% CI (-63 to -51))). CONCLUSIONS: In this study, children with CEL had reduced functional vision and ER-QOL compared with controls. Parents of children with CEL also experience reduced quality of life.

Room-Temperature Ferroelectricity of Paraelectric Oxides Tailored by Nano-Engineering.

Inducing clear ferroelectricity in the quantum paraelectric SrTiO3 is important for triggering methods to discover hidden phases in condensed matter physics. Several methods such as isotope substitution and freestanding membranes could introduce ferroelectricity in SrTiO3 toward nonvolatile memory applications. However, the stable transformation from quantum paraelectric SrTiO3 to ferroelectricity SrTiO3 at room temperature still remains challenging. Here, we used multiple nano-engineering in (SrTiO3)0.65/(CeO2)0.35 films to achieve an emergent room-temperature ferroelectricity. It is shown that the CeO2 nanocolumns impose large out-of-plane strains and induce Sr/O deficiency in the SrTiO3 matrix to form a clear tetragonal structure, which leads to an apparent room-temperature ferroelectric polarization up to 2.5 µC/cm2. In collaboration with density functional theory calculations, it is proposed that the compressive strains combined with elemental deficiency give rise to local redistribution of charge density and orbital order, which induce emergent tetragonality of the strained SrTiO3. Our work thus paves a pathway for architecting functional systems in perovskite oxides using a multiple nano-design.

Achieving High-Temperature Multiferroism by Atomic Architecture.

Materials with multiple order parameters, typically, in which ferroelectricity and magnetism are coupled, are illuminative for next-generation multifunctional electronics. However, searching for such single-phase multiferroics is challenging owing to antagonistic orbital occupancy and chemical bonding requirements for polarity and magnetism. Appropriate multiferroic candidates have been proposed, but their practical implementation is impeded by the low working temperature, weak coupling between ferroic orders, or antiparallel spin alignment in magnetic sublattices. Here, we report a family of single-phase multiferroic materials in which high-temperature magnetism and voltage-switchable ferroelectricity are coupled. Using pulsed laser deposition, we have fabricated single-crystalline thin films incorporating a uniformly percolated open-shell dn framework, which are composed of Fe cations with B-site occupancy and exhibit long-range spin ordering into the displacive ferroelectric PbTiO3 lattice, as demonstrated by atomically resolved chemical analysis. The tetragonal polar Pb(Ti1-x,Fex)O3 (PFT(x), x ≤ 0.10) family exhibits a switchable ferroelectric nature and magnetic interaction with a moderate coercive field of around 300 Oe at room temperature. Notably, the magnetic order even persists above 500 K, which is higher than already reported potential multiferroic candidates until now. Our strategy of merging a spin-ordered sublattice into inherent ferroelectrics via atomic occupancy engineering provides an available pathway for highly thermally stable multiferroic and spintronic applications.

Geological timescales' aging effects of lunar glasses.

Physical aging is a long-lasting research hot spot in the glass community, yet its long-term effects remain unclear because of the limited experimental time. In this study, we discover the extraordinary aging effects in five typical lunar glassy particles with diameters ranging from about 20 to 53 micrometers selected from Chang'e-5 lunar regolith. It is found that geological time scales' aging can lead to unusually huge modulus enhancements larger than 73.5% while much weaker effects on hardness (i.e., varies decoupling evolutions of Young's modulus and hardness during aging) in these lunar glassy samples. Such extraordinary aging effects are primarily attributed to the natural selected complex glassy compositions and structures, consistent with high entropy and minor element doping criteria, prevailing under the special lunar conditions and the extensive aging time for the lunar glasses. This study offers valuable insights for developing high-performance and stable glassy materials for radiation protection and advanced space explorations.

Disease Burden of Glaucoma in China: Findings from the Global Burden of Disease 2019 Study.

Purpose: To provide evidence for future strategies in preventing glaucomatous blindness by investigating the disease burden in terms of age, year, and gender from 1990 to 2019 in China. Methods: The prevalence and disability-adjusted life years (DALYs) of blindness and vision loss due to glaucoma in China were extracted from the Global Burden of Disease (GBD) 2019 study. Age-standardized data is presented in comparison to China's neighboring countries. Results: From 1990 to 2019, the prevalent cases and DALYs number with glaucomatous blindness and vision loss increased by 129.53% and 67.29%, respectively. Overall, higher age-standardized prevalence and DALYs rate were detected in males than in females between 1990 and 2019, and people aged 60 to 89 years suffered from a higher DALY number than other age groups in 2019. Among the neighboring countries, China ranked from fourth in 1990 (88.52, 95% uncertainty interval [UI]: 74.62 to 103.24, per 100,000 population) to third in 2019 (71.14, 95% UI: 59.34 to 84.42, per 100,000 population) in age-standardized prevalence while from fourth in 1990 (10.13, 95% UI: 6.68 to 14.46, per 100,000 population) to sixth in 2019 (5.98, 95% UI: 4.14 to 8.42, per 100,000 population) in age-standardized DALYs. Compared with other GBD regions, the largest decrease in age-standardized DALY rate due to glaucoma was found in China (-40.87%, 95% UI: -43.97% to -37.82%). A higher percentage decrease in age-standardized prevalence was also found in China (-19.66%, 95% UI: -22.44% to -17.09%). Conclusion: Substantial increases in the prevalence of visual impairment and DALYs number of glaucoma were observed from 1990 to 2019. Efforts targeting glaucoma prevention and treatment in China are urgently required, especially for the elderly population and men.

Time trends and associated factors of global burden due to drug use disorders in 204 countries and territories, 1990-2019.

BACKGROUND: Drug use disorders (DUDs) have been a public health crisis which strongly impacted community health and socio-economic development. However, there are few studies based on the latest global data to show changes in the disease burden due to DUDs, specifically investigating associations between the country-level socio-economic factors and the burden of DUDs. METHODS: Data of DUDs were extracted from the Global Burden of Disease Study 2019 database to explore the trends of the disease burden due to DUDs from 1990 to 2019. Univariate linear regression and stepwise multiple linear regression analysis were performed to analyze the correlations between burden due to DUDs and country-level socio-economic factors. RESULTS: Globally, the number of disability-adjusted life-years (DALYs) caused by DUDs approximately increased by 2.6% yearly from 1990 to 2019, though the age-standardized DALY rate has not changed significantly in the past 30 years. The age-standardized DALY rate of opioid use disorders showed an upward trend during the past 30 years and was highest among 5 types of DUDs in 2019. Inequality-adjusted human development index (ß = 15.9, 95% confidence interval [CI]: 12.9-18.9, P < 0.001) was identified as the key risk factor associated with square-root transformed age-standardized DALY rate of DUDs. CONCLUSIONS: Global burden due to DUDs has increased significantly over the past 30 years. More effective targeted public health policies should be formulated to manage the public health challenge of DUDs, especially in developed countries and territories.

Association Between Migraine and Dry Eye: A Systematic Review and Metaanalysis.

PURPOSE: The purpose of this study was to assess whether migraine might be associated with the increased risk of dry eye disease and to determine the strength of the association between migraine and dry eye disease. METHODS: We searched EMBASE, PubMed, Web of Science databases and China National Knowledge Infrastructure, WanFang, and VIP databases for studies that investigated the association between dry eye and migraine from inception to September 8, 2020. Relevant data were extracted by 2 investigators independently. Publication bias and heterogeneity were evaluated. Odds ratio (OR) and 95% confidence interval (CI) were computed by metaanalysis using random-effects models. RESULTS: Of the 565 studies identified, 7 studies met the inclusion criteria and were included in this metaanalysis. Patients with migraine had significantly higher morbidity of dry eye compared with the control group (OR = 1.55; 95% CI = 1.32-1.82; P < 0.001). Subgroup analysis showed that the association between dry eye and migraine was stronger in hospital-based studies (OR = 1.97, P = 0.036) than population-based studies (OR = 1.42, P < 0.001). In addition, differences in geographic location and diagnostic criteria have no effect on the results. CONCLUSIONS: There was a significant association between dry eye and migraine. Patients with migraine are more prone to suffer from dry eye than subjects without migraine, and the association strength varies among populations studied.

Characteristics of Anterior Segment in Congenital Ectopia Lentis: An SS-OCT Study.

Purpose: To investigate the characteristics of anterior chamber angle parameters in congenital ectopia lentis (CEL) patients and to evaluate the sensitivity and specificity of anterior segment parameters in distinguishing CEL from healthy controls. Setting. Zhongshan Ophthalmic Center, Guangzhou, China. Design: Cross-sectional study. Methods: 35 CEL patients and 35 age- and sex-matched healthy controls were recruited. Axial length (AL) and anterior segment parameters including anterior chamber width (ACW), angle open distance (AOD), angle recess area (ARA), trabecular-iris space area (TISA), and trabecular-iris angle (TIA) were measured. All the above parameters and the ratio index of angle parameters, which was defined as the angle parameter value of the narrower side to that of the contralateral side, were compared between CEL and controls. Receiver operating characteristic (ROC) curves were also plotted to evaluate the diagnostic performance of anterior chamber angle parameters in CEL patients. Results: All angle parameters of the contralateral side to the dislocated lens side were significantly smaller than those of the dislocated lens side in CEL (all P < 0.05). For the diagnostic performance of anterior chamber angle parameters, the ratio index of TIAr500 combined with TIAr750 had the best diagnostic performance for CEL screening (AUC = 0.798), and TIAr500 of 0.887 and TIAr750 of 0.917 were detected to be the optimal cut-off points, representing a sensitivity of 89.8% and specificity of 68.7%. Conclusion: The contralateral side to the dislocated lens side in the CEL had a narrower anterior chamber angle. TIAr500 combined with TIAr750 is the optimal combination strategy for ectopia lentis screening.