Fístula carótido-cavernosa con hipertensión ocular secundaria: reporte de caso / Carotid-cavernous fistula with secondary ocular hypertension. A case report

Presentación del caso. Paciente femenina de 62 años con una historia de diez meses de dolor ocular pulsátil, proptosis e inyección conjuntival en el ojo izquierdo; posteriormente presentó un edema palpebral superior izquierdo. Se evaluó con mejor agudeza visual corregida de 20/30 en dicho ojo y presión intraocular de 30 mmHg. Intervención terapéutica.Resonancia magnética nuclear de órbitas evidencia proptosis y dilatación de vena oftálmica superior izquierda, por lo que se diagnosticó como defecto del drenaje venoso e hipertensión ocular del ojo izquierdo. Inició tratamiento hipotensor tópico de ojo izquierdo; estudios de imagen angiotomografía de órbitas y ultrasonido doppler de ojo izquierdo, con énfasis en párpado superior, evidencian fístula carótido-cavernosa izquierda de alto gasto. Se realizó angiografía cerebral diagnóstica y terapéutica con embolización de fístula en arterias meníngea media y faríngea ascendente con ausencia de flujo por dichas ramas después de la intervención. Evolución clínica. Presentó una evaluación clínica favorable, conservando agudeza visual y presión intraocular dentro de valores normales en ojo izquierdo, con evidente disminución de congestión venosa epiescleral, edema de párpado superior y ausencia de proptosis izquierda. Ultrasonido doppler control de párpado superior izquierdo con disminución de flujo venoso a valores normales

Case presentation. 62 years old female with ten months history of ocular pain, proptosis, and conjunctival hyperemia in left eye, developing swollen upper eyelid. Best corrected visual acuity was 20/30 in her left eye, with and intraocular pressure of 30 mmHg. Treatment. Nuclear magnetic resonance of the orbits showed proptosis and dilated superior ophthalmic vein. Initial diagnosis. Abnormal venous drainage and ocular hypertension in the left eye. Topical hypotensive treatment of the left eye was initiated with ocular hypotensive eyedrops. Angiotomography of the orbit and left eye Doppler ultrasound, with upper eyelid emphasis, gave visualization of high flow carotid-cavernous fistula. Cerebral diagnostic and therapeutic angiography with embolization of the fistula in middle meningeal and ascending pharyngeal arteries showed no vascular flow after the procedure. Outcome. Positive clinical outcome, with corrected visual acuity conserved and normal eye pressure. Notable relief of ocular congestion and swollen upper eyelid with no proptosis in the left eye. Doppler ultrasound in the upper eyelid showed normal flow rate measurement.

Research Progress in the Clinicopathology of Ocular Accessory Lymphoma / 华中科技大学学报(医学版)

Ocular adnexal lymphoma is a common orbital malignant tumor.The incidence of ocular adnexal lymphoma is in-creasing rapidly each year,and the clinical manifestations and imaging characteristics of the disease are not specific.Therefore,the diagnosis of the disease relies on pathological tissue analysis.Accurate diagnosis of ocular adnexal lymphoma relies on mor-phology,immunohistochemistry,molecular and cytogenetics.With in-depth research on the disease,it has been found that the clinical prognosis of this tumor is characterized by high recurrence.This article mainly explains the correlation between high dis-ease recurrence rate and histopathological characteristics.

Evaluation of asymptomatic ocular surface disorders in hospitalized patients with primary pterygium before surgery / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To investigate the preoperative ocular symptoms and the characteristics of asymptomatic ocular surface abnormalities in hospitalized patients with primary pterygium.METHODS: Cross-sectional study. Hospitalized patients diagnosed with primary pterygium and scheduled to receive pterygium excision surgery at the Xiamen Eye Center of Xiamen University from August 2022 to October 2022 were enrolled. Ocular surface disease index questionnaire(OSDI), six examinations including non-invasive tear film break-up time, Schirmer I test, tear meniscus height, lid margin abnormality, meibomian gland dropout and tear film lipid layer thickness, and anterior segment optical coherence tomography(AS-OCT)were performed and statistically analyzed.RESULTS: A total of 178 cases(178 eyes), with a mean age of 54.39±10.75 years old, were recruited, including 75 males(42.1%)and 103 females(57.9%). The average values of ocular surface parameters in these patients included OSDI: 11.47±9.69, tear film break-up time: 7.10±3.86 s; tear meniscus height: 0.16±0.07 mm, Schirmer I test values: 14.39±7.29 mm/5 min, and pterygium thickness: 504.74±175.87 μm. Totally 161 eyes(90.4%)presented with abnormal lid margin, 44 eyes(24.7%)presented with meibomian gland dropout score ≥4, 52 eyes(29.2%)presented with low lipid layer thickness. In the 6 objective examinations, abnormalities in at least 4 of these tests were found in 85.4% of eyes. Pterygium morphology was classified into four grades: 10 eyes(5.6%)of grade Ⅰ, 93 eyes(52.2%)of grade Ⅱ, 60 eyes(33.7%)of grade Ⅲ, and 15 eyes(8.4%)of grade Ⅳ. In patients with a higher grade of pterygium, the tear film break-up time was lower, and the proportion of abnormal lid margin was also significantly higher(P<0.05). The patients were further divided into two subgroups, including 121 eyes(68.0%)with normal OSDI <13 in the normal group and 57 eyes(32.0%)with OSDI ≥13 in the abnormal group. No significant difference was found in the proportion of meibomian gland dysfunction between the two groups of patients(71.9% vs. 71.9%, P=0.872). In addition, there were differences in the number of abnormal objective examinations(4.11±0.85 vs. 4.91±0.99, P<0.001).CONCLUSIONS: Asymptomatic ocular surface abnormalities were present preoperatively in patients hospitalized for primary pterygium. A comparable high incidence of structural or functional meibomian gland dysfunction existed in pterygium patients with or without apparent ocular discomfort. More attention should be paid to the ocular surface abnormalities in those asymptomatic patients before primary pterygium surgery.

Transcriptional differential analysis of ocular surface ectoderm and surface ectoderm / 国际眼科杂志(Guoji Yanke Zazhi)

AIM:To identify transcriptional differences between the ocular surface ectoderm(OSE)and surface ectoderm(SE)using RNA-seq, and elucidate the OSE transcriptome landscape and the regulatory networks involved in its development.METHODS:OSE and SE cells were differentiated from human embryonic stem(hES)cells. Differentially expressed genes(DEGs)between OSE and SE were analyzed using RNA-seq. Based on the DEGs, we performed gene ontology(GO)analysis, Kyoto Encyclopedia of Genes and Genomes(KEGG)pathway enrichment analysis, and protein-protein interaction(PPI)network analysis. Transcription factors(TFs)and hub genes were screened. Subsequently, TF-gene and TF-miRNA regulatory networks were constructed using the NetworkAnalyst platform.RESULTS:A total of 4 182 DEGs were detected between OSE and SE cells, with 2 771 up-regulated and 1 411 down-regulated genes in OSE cells. GO-BP analysis revealed that up-regulated genes in OSE were enriched in the regulation of ion transmembrane transport, axon development, and modulation of chemical synaptic transmission. Down-regulated genes were primarily involved in nuclear division, chromosome segregation, and regulation of cell cycle phase transition. KEGG analysis indicated that up-regulated genes in OSE cells were enriched in signaling pathways such as cocaine addiction, axon guidance, and amphetamine addiction, while down-regulated genes were enriched in proteoglycans in cancer, ECM-receptor interaction, protein digestion and absorption, and cytokine-cytokine receptor interaction. Additionally, compared with SE, 204 TFs(including FOS, EGR1, POU5F1, SOX2, and PAX6)were up-regulated, and 80 TFs(including HAND2, HOXB6, HOXB5, HOXA5, and HOXB8)were down-regulated in OSE cells. Furthermore, we identified 6 up-regulated and 9 down-regulated hub genes in OSE cells, and constructed TF-gene and TF-miRNA regulatory networks based on these hub genes.CONCLUSIONS:The transcriptome characteristics of OSE and SE cells were elucidated through RNA-seq analysis. These findings may provide a novel insight for studies on the development and in vitro directed induction of OSE and corneal epithelial cells.

Correlation between myopia progression and visual performance in children / 国际眼科杂志(Guoji Yanke Zazhi)

The incidence of myopia among Chinese adolescents is progressively rising, indicating a distinct trend toward younger age onset.This paper aims to comprehensively review the impact of various visual performance on myopia and its progression, with a specific emphasis on accommodative function, convergence function, and ocular position. A meticulous exploration of accommodation function, encompassing accommodative amplitude, accommodative facility, accommodative response, positive relative accommodation, and negative relative accommodation, has been undertaken to elucidate its contributory role in myopia progression. Concurrently, an exhaustive analysis of convergence function has been conducted including esotropia and exotropia, convergence insufficiency and convergence excess, fusional function vergence, divergence insufficiency, and excess, providing a nuanced understanding of convergence's implications for myopia advancement. Furthermore, the influence of ocular position on myopia progression, along with other factors affecting perceptual ocular position and intermittent exotropia, is discussed. The primary objective of this article is to unveil the multifaceted visual performance influencing myopia and its progression, elucidating the paramount significance of accommodative function, convergence function, and ocular position in this context.

Research progress of Mendelian randomization in ocular diseases / 国际眼科杂志(Guoji Yanke Zazhi)

Etiological research is necessary for understanding the occurrence and epidemiological patterns of diseases, and is also a prerequisite for the diagnosis, prevention and treatment of clinical diseases. Mendelian randomization(MR), a method of research that combines genetics and epidemiology, has the advantage of exploring the causal relationship between exposure and disease genetically as well as avoiding confounding factors and reverse causation. Thus, it has been extensively utilized in the etiological study of diseases. This paper reviews the implementation of MR in the research of ocular diseases and provides ideas and approaches for the investigation of related mechanisms as well as the development of intervention strategies.

Analysis of ocular biometric parameters in Tibetan patients with age-related cataract / 国际眼科杂志(Guoji Yanke Zazhi)

AIM:To compare the differences of ocular biometric parameters of age-related cataract between Tibetan and Han ethnic groups, and to analyze the distribution characteristics of ocular biometric parameters in Tibetan cataract patients.METHODS:Retrospective cohort study. A total of 661 patients(1 030 eyes)with age-related cataract confirmed in the hospital between January 2019 and December 2020 were enrolled. The parameters of axial length, anterior chamber depth, keratometry, corneal astigmatism and astigmatic axis were measured by IOL Master 500 in 483 cases(739 eyes)of Tibetan age-related cataract patients and 178 cases(291 eyes)of Han patients.RESULTS:The axial length, anterior chamber depth and corneal astigmatism of the Tibetan patients with age-related cataract were 23.33(22.81, 23.86)mm, 3.04(2.79, 3.30)mm and 0.73(0.47, 1.07)D. The mean keratometry was 43.89±1.35 D. The results indicated that Tibetan cataract patients had shorter axial lengths and smaller keratometry compared to Han patients(all P<0.05). Age in Tibetan patients was negatively correlated with axial length and anterior chamber depth, and positively correlated with keratometry(all P<0.05). Tibetan male patients had longer axial lengths, deeper anterior chambers, and flatter corneas compared to female patients(all P<0.05).CONCLUSION:There were differences in ocular biometric parameters between age-related cataract patients of Tibetan and Han ethnicities. The distribution of ocular biometric parameters in Tibetan cataract patients varied across different age groups and gender groups.

Safety and efficacy of 0.01% hypochlorous acid before cataract phacoemulsification / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To evaluate the efficacy of 0.01% hypochlorous acid as a conjunctival sac disinfectant before cataract phacoemulsification and its impact on the ocular surface.METHODS: Randomized controlled clinical trial. A total of 285 patients who were scheduled for cataract phacoemulsification surgery were randomly divided into the hypochlorous acid group and the povidone iodine group. Before and after disinfection, conjunctival sac swabs were taken, and bacterial culture and colony-forming units(CFUs)testing were performed using blood agar and chocolate agar media, respectively. All patients were evaluated for ocular symptom scores and pain severity scores 2 h, 1 d, and 1 wk after disinfection, and underwent corneal fluorescein staining, eye redness index, tear meniscus height, and noninvasive breakup time(NIBUT)examination. The incidence of endophthalmitis after surgery was recorded.RESULTS: Conjunctival sac disinfection with 0.01% hypochlorous acid significantly reduced the rate of positive bacterial cultures and colony-forming ability of the conjunctival sac, with statistically significant differences compared with the pre-disinfection period(both P<0.01), and the disinfecting ability of hypochlorous acid was comparable to that of povidone-iodine(χ2=0.811, P=0.368). The scores of ocular symptoms and pain severity in the hypochlorous acid group were significantly lower than those in the povidone-iodine group(both P<0.01). The corneal fluorescein staining and eye redness index in the hypochlorous acid group were significantly lower than those in the povidone-iodine group(all P<0.01). No endophthalmitis occurred in either group of patients. CONCLUSION: As a conjunctival sac disinfectant, 0.01% hypochlorous acid is safe and effective, with minimal discomfort and damage to the ocular surface in patients.

Correlation between ocular surface status and blood lipids in patients with meibomian gland dysfunction during pregnancy / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To analyze the correlation between ocular surface status and serum lipids in patients with meibomian gland dysfunction(MGD)during pregnancy, and to provide new ideas for the management and treatment of MGD during pregnancy.METHODS: Totally 120 pregnant women(240 eyes)treated in our hospital from May 2021 to May 2022 were selected and they were divided into MGD group(60 cases, 120 eyes)and control group(60 cases, 120 eyes)according to the presence or absence of MGD. All subjects received the ocular surface disease index scores(OSDI)and underwent examinations of meibomian gland morphology and function, tear film and blood lipid.RESULTS: The scores of OSDI, the related indexes of meibomian gland, corneal fluorescein staining(FL)scores, total cholesterol(TC), triglyceride(TG)and low density lipoprotein-cholesterol(LDL-C)in the MGD group were significantly higher than those in the control group(P<0.05). The scores of fluorescein breakup time(FBUT), Schirmer Ⅰ test(SIt)and high-density lipoprotein cholesterol(HDL-C)in the MGD group were significantly lower than those in the control group(P<0.05). Correlation analysis showed that the scores of TG, TC, LDL-C were negatively correlated with the values of FBUT(rs =-0.702, -0.647, -0.710, all P<0.001).CONCLUSION: The level of blood lipids in pregnant patients with MGD is significantly increased, and the levels of TC, TG and LDL-C may be related to the stability of tear film.

Circumlimbal suture and laser burns:Comparison between two different chronic glaucoma models / 中南大学学报(医学版)

Objective:Glaucoma is a multifactorial optic neuropathy with a high rate of irreversible visual loss,and its pathogenesis is complex and still unclear.Elevated intraocular pressure(IOP)is well recognized as the sole modifiable risk factor for the development of glaucoma in the majority of cases.This study aims to compare 2 different methods of inducing chronic ocular hypertension by circumlimbal suture or by laser burns in degree and lasting time of the IOP,different status of the retina and retinal ganglion cells(RGCs),and changes of the microstructure of neurons. Methods:The chronic ocular hypertension models were induced by 2 different ways.One kind of the models was built by unilateral circumlimbal suture(10/0)implantation(suture group),another kind of model was built by laser burns at trabecular meshwork and episcleral veins(laser group).The untreated contralateral eye served as the control group.Changes in IOP were observed and regularly monitored in the 2 groups of rats.HE staining was applied to observe the retinal and optic nerve pathology.Transmission electron microscope(TEM)was used to observe the mitochondrial morphology.RGCs were specifically labeled with Brn3b antibody and counted.The expression of caspase-3 was detected by Western blotting to clarify the apoptosis of RGCs. Results:Compared with the control group,IOP were significantly increased in the suture group and the laser group(both P<0.05).The suture group induced a 1.5-fold elevation of IOP,and sustained for 8 weeks.The laser group induced a 2-fold elevation of IOP for 12 weeks.Both methods could cause RGCs loss(both P<0.05),which were verified by pathology and immune staining of Brn3b.The expressions of caspase-3 were also increased(both P<0.05).The mitochondrial morphology became more fragment,which changed from long shape to round and small one under TEM in 2 models.For comparison,the pathology changes of retinal structure in suture group were not obviously than those in the laser group. Conclusion:Circumlimbal suture can build an effective model of chronic elevated IOP and induce glaucomatous pathologic changes similar to those in the laser photocoagulation,but the pathologic changes are milder than those in laser photocoagulation.Compare with translimbal laser photocoagulation,equipment and skill demand for circumlimbal suture is less.

Correlation analysis of electronic screen use and myopia among primary and secondary school students in six provinces and cities of China / 中国学校卫生

Objective@#To study the correlation between electronic screen use and myopia among primary and secondary school students in six provinces and cities in China, in order to provide a scientific basis for comprehensive prevention and control of myopia.@*Methods@#From November 2020 to June 2022, a total of 16 557 primary and secondary school students from six provinces and cities in China (Beijing City, Liaoning Province, Zhejiang Province, Henan Province, Shaanxi Province, Chongqing City) were selected by stratified cluster random sampling and probability smampling methods, and a questionnaire prepared by Beijing Center for Disease Control and Prevention was used to investigate their electronic screen use. According to Screening Criteria for Myopia in Children and Adolescents, 0.5% mass concentration of compound topicamide eye drops was used to paralyze the ciliary muscle and undergo slit lamp optometry. Chisquare test was used to compare the differences between groups, and binary Logistic regression was used to analyze the association between electronic screen use and myopia.@*Results@#About 58.3% of primary and secondary school students used electronic screens for more than two hours a day on average, and 63.4% of primary and secondary school students used continuously electronic products for more than 15 minutes at a time for nonstudy purposes. After adjusting for confounding factors, parents unrestricted use of electronic screen time and electronic screen time ≥2 h/d were positively correlated with myopia (OR=1.27, 1.13, P<0.05). Gender stratified analysis showed that boys who used electronic screen time ≥2 h/d had a higher risk of myopia (OR=1.15, P<0.05). The results of grade stratification analysis showed that parents unrestricted electronic screen use time and electronic screen time ≥2 h/d were positively correlated with myopia in the lower grade of primary school students (OR=1.34, 1.18, P<0.05). Among the higher grade of primary school students, continuous use of electronic screens for nonstudy purposes for more than 15 minutes at one time was positively correlated with myopia (OR=1.18, P<0.05). There was a multiplicative interaction between total screen time and one continuous screen time (OR=1.04, P<0.05).@*Conclusions@#Primary and secondary students in six provinces and cities in China reports excessive electronic screen usage which is associated with myopia. Schools and parents should jointly limit the use of electronic screen among primary and secondary students to reduce the occurrence of myopia.

Effect of behavioral vision training on post-stroke ocular motility disorders / 中国康复理论与实践

ObjectiveTo explore the effect of behavioral vision training on post-stroke ocular motility disorders (PSOMD). MethodsFrom August to Octobor, 2023, a total of 21 PSOMD patients in Beijing Bo'ai Hospital were selected. They received behavioral vision training, including brain-based visual training and visual fusion training, for four weeks. Visual function was assessed with Snellen eye chart, strabismus prism and Titmus near stereopia. ResultsThe vision of both right and left eyes improved after training (Z right eye = -3.601, Z left eye = 3.012, P < 0.01), while the strabismus prism reduced significantly (t = 8.930, P < 0.001). But Titmus near stereopia showed no difference (P > 0.05). ConclusionBehavioral vision training could improve vision and strabismus after stroke.

Application of color doppler flow imaging in the diagnosis of ocular toxocariasis in children / 中华眼底病杂志

Objective:To summarize the characteristics of color doppler flow imaging (CDFI) of ocular toxocariasis (OT) in children.Methods:A retrospective clinical study. From July 2014 to June 2020, 61 OT patients with 61 eyes diagnosed through clinical and laboratory testing in the Department of Ophthalmology of Beijing Tongren Hospital of Capital Medical University were included in the study. There were 45 males with 45 eyes and 16 females with 16 eye (male: female=2.81:1). Age were (6.93±2.50) years. The right eye and left eye were 29 and 32 eyes, respectively. Both eyes of the patient underwent two-dimensional ultrasound and CDFI examination. Two dimensional ultrasound was used to estimate the axial length (AL) of the affected eyes and healthy eyes on the opposite side. Among them, 52 cases were measured for AL using optical biometry and/or A-mode ultrasound. Vitreoretinal surgery was performed within one week after ultrasound examination. Two-dimensional ultrasound was used to observe the morphology of vitreous opacity, its connection to the eyeball wall, and whether posterior vitreous detachment and retinal detachment have occurred. CDFI examination was used to observe the presence of blood flow signals on the pathological membrane. The detection rates of different forms of vitreous opacity and traction retinal detachment were calculated. The location of proliferative lesions in the eye was analyzed. Paired t-test was performed to compare the AL of the affected eye and the healthy eye on the opposite side. Perform Kappa consistency test on the location of proliferative lesions was used during CDFI examination and vitreoretinal surgery. Results:All affected eyes have varying degrees of vitreous opacity. Among them, 23 eyes (37.7%, 23/61) showed typical "Christmas tree" like turbidity; 27 eyes (44.3%, 27/61) had clustered and striped echoes; 9 eyes (14.8%, 9/61) had weak punctate and strip echoes. Two eyes (3.3%, 2/61) showed a large amount of dense punctate and strip-shaped echoes. There were 50 eyes (82.0%, 50/61) with traction retinal detachment, of which 46 eyes (92.0%, 46/50) had visible blood flow signals on the detached retina, and the remaining 4 eyes (8.0%, 4/50) had no blood flow signals. During CDFI and surgery, there were 5 (8.2%, 5/61) and 4 (6.6%, 4/61) eyes with visible proliferative lesions in the periphery, respectively; 18 (29.5%, 18/61) and 14 (23.0%, 14/61) eyes were distributed in the posterior pole, respectively; there were 38 (62.3%, 38/61) and 43 (70.5%, 43/61) eyes with both peripheral and posterior polar regions, respectively. The consistency between CDFI and surgery in detecting the location of proliferative lesions was good ( κ=0.832, 95% confidence interval 0.691-0.973, P<0.001). The two-dimensional ultrasound measurement results showed that the AL of the affected eye was shorter than that of the contralateral healthy eye in 46 cases (75.4%, 46/61). Among the 52 patients who underwent AL biometry, the AL of the affected eye was shorter than that of the contralateral healthy eye by (0.63±0.68) mm, and the difference was statistically significant ( t=-6.738, P<0.05). Conclusions:CDFI can clearly display various intraocular lesions (vitreous opacity and traction retinal detachment) and eyeball sizes in children with OT. Vitreous opacity is often manifested as "Christmas tree" like, clustered, strip-shaped.

Application and progress of cyclosporine A in ocular surface diseases / 国际眼科杂志(Guoji Yanke Zazhi)

Cyclosporine A, a cyclic polypeptide, exhibits potent immunosuppressive activity and exerts its effects through various mechanisms including immunosuppression, anti-inflammatory, inhibition of apoptosis, promotion of epithelial healing and goblet cell function recovery, enhancement of tear secretion, and close association with ocular surface disease repair. Owing to its significant efficacy, inhibition of disease recurrence and few side effects, the clinical application of cyclosporine A in the management of ocular surface diseases, including dry eye, corneal graft rejection following penetrating keratoplasty, vernal keratoconjunctivitis, noninfective keratitis and herpes simplex virus keratitis, has witnessed a substantial rise in recent years. Nevertheless, variations exist in the management of ocular surface inflammatory diseases when utilizing distinct concentrations and dosage forms of cyclosporine A. Therefore, the paper provides an overview of impacts of cyclosporine A on ocular surface diseases.

Research progress on pathology and pathogenesis of chronic ocular graft-versus-host disease / 国际眼科杂志(Guoji Yanke Zazhi)

Allogeneic hematopoietic stem cell transplantation(allo-HSCT)is a treatment for many malignant tumors of blood system and severe immunodeficiency, and chronic graft-versus-host disease(cGVHD)is one of the major complications after transplantation, which seriously affects the life quality of patients. The cGVHD can attack all the target tissues of the eye. The more common ones are lacrimal gland, eyelid, conjunctiva, cornea and limbus, meibomian gland, etc. The pathophysiological process is inflammation and fibrosis. Although many researchers at home and abroad have gradually begun to explore the disease and obtained many new findings, its pathology and pathogenesis are still not fully understood, and there is no unified and effective treatment. Clinically, the treatment of the disease is usually when symptoms have appeared. At this time, the target tissue is likely to have irreversible and permanent damage, resulting in a protracted and refractory situation. Therefore, this thesis mainly clarifies the research progress of the pathology and pathogenesis of ocular cGVHD in recent years, in order to provide new guidance for the treatment of the disease.

Research progress on ocular diseases associated with SARS-CoV-2 / 国际眼科杂志(Guoji Yanke Zazhi)

The corona virus disease 2019(COVID-19)in 2019 has shown a global pandemic status in a short time since its outbreak, and many variants of the severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)were highly infectious and pathogenic. SARS-CoV-2 may infect tissue cells through the mediation of angiotensin-converting enzyme-2(ACE2)and transmembrane serine protease 2(TMPRSS2), leading to different diseases. Clinically, respiratory, cardiovascular, and gastrointestinal systems diseases are relatively common; many patients also seek medical attention based on eye symptoms as their main complaint. Compared with severe systemic diseases, eye-related symptoms are easily overlooked. This article reviews the pathogenesis and cases of various eye diseases related to SARS-CoV-2, aiming to enhance clinicians' attention to SARS-CoV-2-related eye diseases, avoid delaying the disease and causing irreversible loss of vision, and provide new ideas for the prevention and treatment of eye diseases.

Research progress of SARS-CoV-2 vaccine-related ocular adverse events / 国际眼科杂志(Guoji Yanke Zazhi)

Since 2019, severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)infection has been widespread in the world, causing about 770 million infecting and 6.9 million deaths. Vaccines against SARS-CoV-2 infection have become the main way to prevent the severe SARS-CoV-2. The use of SARS-CoV-2 vaccine has substantial protection against the serious consequences of SARS-CoV-2 infection, but multiple systemic adverse reactions can occur after the use of SARS-CoV-2 vaccine. More and more studies have shown that SARS-CoV-2 vaccine caused lesions of ocular conjunctiva, cornea, sclera, uvea, retina and optic nerve tissue and resulted in damage to visual function. In this paper, the classification and characteristics of SARS-CoV-2 vaccines and related studies on ocular tissue lesions were reviewed, hoping to better understand the ocular adverse reactions of SARS-CoV-2 vaccine and provide some theoretical guidance for the prevention and treatment of ocular tissue damage caused by SARS-COV-2 vaccine.

Effect of early immunotherapy in preventing conversion of ocular myasthenia gravis to generalized myasthenia gravis / 西安交通大学学报(医学版)

【Objective】 To compare the risk of generalization in patients with ocular myasthenia gravis (OMG) receiving or not receiving immunosuppressive treatment. 【Methods】 The data of patients with OMG registered in Tangdu Hospital of Air Force Military Medical University from January 1, 2015 to May 1, 2019 were reviewed; the patients were divided into treatment group and control group according to whether they had received immunosuppressive treatment. The multivariate Cox proportional hazards regression model analysis was used to compare the risk of generalization between the two groups of patients within 2 years of onset. Sensitivity analysis was used to evaluate the duration of immunosuppressive treatment and the risk of generalization under different immunotherapy regimens. By using stratified analysis, the consistency of the main results across different levels of subgroup factors was evaluated. 【Results】 A total of 702 OMG patients were collected. Of them 367 patients (52.3%) were included in the treatment group, with an average onset age of (50.54±15.1) years, and 159 (43.3%) being female. Another 335 patients (47.7%) were included in the control group, with an average age of (49.1±14.6) years, and 159 ones (47.5%) were female. A total of 28 cases (7.7%) in the treatment group and 106 cases (31.6%) in the control group developed generalization during the observation period. After multivariate-adjusted Cox model analysis, patients who had received immunosuppressive treatment had a significantly lower risk of generalization compared with the control group (HR=0.24; 95% CI: 0.15-0.37; P<0.001). Sensitivity analysis found that the longer the duration of immunosuppression, the lower the risk of generalization (HR=0.88; 95% CI: 0.85-0.91; P<0.001). Stratified analysis showed that immunosuppressive therapy reduced the risk of generalization in different subgroups of patients. 【Conclusion】 Early immunosuppressive treatment can significantly reduce the risk of generalization in patients with OMG.

A comparative analysis of ocular surface parameters before and after N95 face mask use among healthcare workers

Objectives@#This study determined whether the use of an N95 face mask was associated with changes in ocular surface parameters and dry eye symptomatology among healthcare workers with no baseline dry eye disease. @*Methodology@#This was a prospective, analytical, quasi-experimental study. The ocular surface and dry eye symptomatology of 33 healthcare workers (n=66 eyes) were evaluated at baseline and 3 hours after use of 3M™ VFlex™ Particulate Respirator 9105 N95 mask (3M, Minnesota, USA). The following parameters were measured: ocular surface disease index (OSDI), tear break-up time (TBUT), tear break-up pattern (TBUP), non-invasive TBUT (NIKBUT), tear meniscus height (TMH), meibography, and bulbar conjunctival redness.@*Results@#Among all the parameters tested, only OSDI and bulbar redness showed significant changes when pre-N95 and post-N95 values were compared. Although each was interpreted as normal, the median OSDI score improved from 7 to 1 (p < 0.001). Median bulbar conjunctival redness score worsened from 0.9 to 1.1 (p < 0.001). @*Conclusion@#Among healthcare workers with no dry eye disease, the use of the 3M™ Vflex™ Particulate Respirator 9105 N95 mask was not associated with changes in TBUT, TBUP, NIKBUT, TMH, and meibogaphy. An improvement of dry eye symptoms was reported after VFlex™ mask use.

Clinical profile and outcomes of Ocular Dermoid Cysts at the Philippine General Hospital

Objective@#This study described the clinical profile and outcomes of patients with ocular dermoid cysts at a subspecialty Ophthalmology clinic of the Philippine General Hospital (PGH). @*Methods@#Medical records of 38 patients seen at the External Disease & Cornea Clinic from January 2012 to June 2023 were reviewed. Demographics, best-corrected visual acuity (BCVA), refraction, other associated malformations, and dermoid characteristics were collected. For those that underwent surgery, the procedures performed and histopathology reports were reviewed. Most recent refraction, BCVA, presence of amblyopia, recurrence, and complications were recorded. @*Results@#Mean age at presentation was 8.33 years old with equal male:female distribution (52% vs 48%). Thirtyfour (34) participants (89.5%) had unilateral dermoids and 4 participants (10.5%) had bilateral dermoids, for a total of 42 eyes. Thirty-five (35) or 83.3% of the dermoids were located at the inferotemporal quadrant of the cornea. There were 42.1% participants who had associated congenital anomalies, with dermolipoma and preauricular tags being the most common ocular and craniofacial findings, respectively. Twenty-seven (27) eyes (64.2%) underwent surgery and the most common procedure was excision with limbal conjunctival autograft (55.6%). In the 8 eyes that underwent simple excision, recurrence of the dermoid was seen in 1 patient and development of pseudopterygium in 5 patients. Dermoid was the histopathological diagnosis in 96.3% of the excised tissues. Twenty-four (24) patients (63.2%) presented with ambylopia with BCVA <20/30, and regardless of type of intervention done, only 7 participants (23.3%) had a visual acuity better than 20/30 during their latest consult.@*Conclusion@#Ocular dermoid is a common congential anomaly usually presenting as an isolated, unilateral mass at the inferotemporal limbal area. Aside from the obvious effect on the cosmetic appearance of the eye, a more pressing concern is the high incidence of amblyopia. Timely excision with limbal conjunctival autograft is highly recommended coupled with aggressive amblyopia therapy.