Comparison of three-dimensional heads-up system versus traditional microscopic system in medical education for vitreoretinal surgeries: a prospective study.

BACKGROUND: To compare the value and efficiency of the three-dimensional (3D) heads-up surgical system and traditional microscopic (TM) system in teaching and learning vitreoretinal surgeries. METHODS: Twenty ophthalmologists and scrub nurses were recruited as teachers, and 45 junior ophthalmology residents and trainee doctors, trainee nurses, and medical students were recruited as observers. Each teacher and observer were assigned to both a 3D-assisted and TM-assisted vitreoretinal surgery and then asked to complete satisfaction questionnaires for both surgical systems at the end of each surgery. RESULTS: The 3D heads-up surgical system was rated significantly higher in most of the subscales and overall satisfaction score by both teachers and observers (P < 0.05). However, ratings for instrument adjustment were significantly higher in the TM group compared to the 3D group for junior ophthalmology residents and trainee doctors (6.1 ± 1.7 vs. 8.8 ± 1.1, P < 0.001). CONCLUSIONS: The 3D heads-up surgical system has great didactical value in the medical education of vitreoretinal surgeries, but it is important to consider the specific needs of different learners when choosing between the two systems. TRIAL REGISTRATION: Not applicable.

Differences in aqueous humor protein profiles in patients with proliferative diabetic retinopathy before and after aflibercept treatment.

PURPOSE: To investigate the changes in aqueous humor (AH) protein profiles before and after intravitreal aflibercept (IVA) treatment in patients with proliferative diabetic retinopathy (PDR). METHODS: 5 PDR patients provided 10 samples of AH before and after IVA treatment (pre-group vs. post-group). Proteins were identified using liquid chromatography-tandem mass spectrometry. Then, bioinformatics was employed to investigate the functional significance of differentially expressed proteins (DEPs) and hub proteins. RESULTS: A total of 16 DEPs were identified, consisting of 8 downregulated proteins and 8 upregulated proteins. Bioinformatics analysis indicated that the most significantly enriched biological process was "blood coagulation, intrinsic pathway." The most significantly enriched signaling pathway was "complement and coagulation cascades." HBB, HPX, VEGFA, and CA1 were identified as hub proteins for IVA treatment. CONCLUSIONS: Together with the downregulation of the intravitreal vascular endothelial growth factor level, IVA may also change the AH protein composition in PDR patients, with DEPs involved in the blood coagulation, intrinsic pathway, complement, and coagulation cascades. IVA treatment may protect against PDR by regulating HBB, HPX, VEGFA, and CA1 expression.

The public-private partnerships in healthcare sector in China.

This manuscript is a narrative review on experience in the healthcare public-private partnerships (PPP) field project in China. The PPP model allows healthcare officials to share the risk of building new facilities with the private sector. The objective of this study is to evaluate and to review the PPP of healthcare sector in China, and to investigate the critical success factors and best practice of PPP. We adapted the PPP evaluation framework of the World Bank Independent Evaluation Group as our conceptual framework to summarize the literatures. The current study systematically reviewed the evolution and current status of public and private hospitals development in China, and to investigate factors related to the successful and less successful deployment and performance of PPP in the healthcare sector of China, and to develop best practice models of PPP among hospitals of China. We found that the PPP organizations providing finance and political risk coverage, thus enabling specific PPP transactions to reach financial closure-potentially setting demonstration effects. Such PPPs may then contribute to improving access to infrastructure and social services, which drives economic growth and other optimal outcomes.

Risking one's life to save one's livelihood: Precarious work, presenteeism, and worry about disease exposure during the COVID-19 pandemic.

The present study advances research on the negative consequences of precarious work experiences (PWE), which include perceptions of threats to one's job and financial security as well as a sense of powerlessness and inability to exercise rights in the workplace. Using the COVID-19 pandemic as a backdrop, we examine how PWE relate to sickness presenteeism and worry about work-related COVID-19 exposure. In a 12-week, four-wave study of workers working fully in-person, perceptions of powerlessness and job insecurity were associated with presenteeism (e.g., general presenteeism as well as attending work with known or possible COVID-19 infection) and concerns about disease exposure at work. Whereas powerlessness primarily operated at the between-person level of analysis, job insecurity's effects emerged at both levels of analysis. A sense of powerlessness at work also predicted sending children to school/daycare sick. In sum, the findings suggest that precarity related to being able to keep one's job and a sense of powerlessness at work contribute to concerns about the risk of COVID-19 exposure at work and, simultaneously, behaviors that may contribute to the health risks faced by others. This research provides added support to the argument that precarious work should be addressed in order to improve both worker well-being and public health. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Three-dimensional heads-up system assisted pars plana vitrectomy and subretinal recombinant tissue plasminogen activator injection for submacular hemorrhage.

BACKGROUND: To evaluate the outcomes of three-dimensional (3D) heads-up system assisted pars plana vitrectomy (PPV) and subretinal injection of recombinant tissue plasminogen activator (rt-PA) for submacular hemorrhage (SMH). METHODS: Medical records of SMH patients who underwent 3D heads-up system assisted-PPV and subretinal injection of rt-PA from June 2021 to January 2022 were reviewed. The main outcomes included best-corrected visual acuity (BCVA), SMH absorption, and perioperative complications. RESULTS: We finally included 18 SMH eyes, most of which happened secondary to polypoidal choroidal vasculopathy (PCV) (10, 55.56%), followed by retinal arterial microaneurysm (RAM) (5, 27.78%), traumatic retinopathy (2, 11.11%) and neovascular age-related macular degeneration (nAMD) (1, 5.56%). The greatest linear dimension (GLD) and height of SMH were 6538.17 ± 2533.11 µm and 937.36 ± 420.21 µm, respectively. After an average postoperative follow-up period of 131.06 ± 38.96 days, patients' BCVA improved significantly from 1.85 ± 0.62 to 1.14 ± 0.82 logMAR (P < 0.05). SMH was completely and partially absorbed in 9 (50.00%) and 6 (33.33%) eyes, with no occurrence of iatrogenic retinal break. However, 4 additional PPVs were performed to manage the postoperative SMH and/or vitreous hemorrhage (VH) recurrence (2, 11.11%) and retinal detachment (RD) occurrence (2, 11.11%). Preoperative BCVA was significantly correlated with postoperative BCVA in multiple linear regression analysis (P < 0.05), and hemorrhagic pigment epithelial detachment (PED) was significantly correlated with SMH and VH recurrence in univariate binary logistic regression analysis (P < 0.05). CONCLUSIONS: The 3D heads-up system assisted-PPV and subretinal injection of rt-PA were efficacious in eliminating SMH and improving visual prognosis with satisfactory safety profile, while caution should be taken for PCV patients with hemorrhagic PED and massive SMH.

Development of Diagnostic Recommendations for Vitreoretinal Lymphoma.

PURPOSE: To develop diagnostic recommendations for diffuse large B-cell vitreoretinal lymphoma (VRL) in Chinese patients. METHODS: Retrospective observational case series. Seventy-three eyes of 40 VRL patients and 8 control patients were analyzed. Eighteen patients from Beijing Tongren Hospital and 46 patients from literature were involved as validations. RESULTS: Diagnostic methods included (1) typical clinical manifestations; (2) vitreous cytology; (3) immunohistochemical examination of vitreous or choroid/retina; (4) aqueous humor or vitreous cytokine; (5) vitreous cell gene rearrangement; (6) vitreous flow cytometry. If patients meet (1)+(2)+(3), or if they meet (1), and two of (4), (5), (6) are positive, they can be diagnosed as VRL. The sensitivity and specificity values for accurate diagnosis were 0.975 and 1.00. One hundred percent eyes from Beijing Tongren Hospital and 92.7% eyes from literature can be diagnosed. CONCLUSION: We developed diagnostic recommendations for diffuse large B-cell VRL through vitreous cytology combined with multiple auxiliary examinations.

Differences in aqueous humor protein profiles in patients with proliferative diabetic retinopathy before and after conbercept treatment.

To investigate the changes in aqueous humor (AH) protein profiles before and after intravitreal conbercept (IVC) treatment in proliferative diabetic retinopathy (PDR) patients. Ten PDR patients provided 20 samples of AH before (pre group) and after (post group) IVC treatment. Liquid chromatography-tandem mass spectrometry was performed to identify proteins. Bioinformatics analysis was used to explore the functional relevance of differentially expressed proteins (DEPs) and hub proteins. Parallel reaction monitoring (PRM) method was used to verify the hub proteins in another 8 samples of AH before and after IVC treatment in 4 PDR patients. A total of 30 DEPs were identified, consisting of 14 downregulated proteins and 16 upregulated proteins. Bioinformatics analysis indicated that DEPs mostly involved in neutrophil degranulation, antioxidant activity, secretory granule lumen, cytoplasmic vesicle lumen, vesicle lumen, and fluid shear stress. HP, VEGFA, CTSD, and LYZ were identified as hub proteins, among which HP and CTSD were verified by PRM. In addition to decreasing the intravitreal vascular endothelial growth factor level, IVC may alter the AH protein profile in PDR patients, especially HP and CTSD, with the DEPs involved in neutrophil degranulation, antioxidant activity, secretory granule lumen, cytoplasmic vesicle lumen, vesicle lumen, and fluid shear stress. SIGNIFICANCE: Patients with proliferative diabetic retinopathy (PDR) regularly receive intravitreal conbercept treatment these days. The effect of this treatment has been determined by previous studies. However, the mechanism of IVC in PDR is not eventually determined. No studies have compared the aqueous humor (AH) protein profile before and after IVC treatment in the same patient. This is a topic deserving of further exploration. A proteomic method based on liquid chromatography-tandem mass spectrometry (LC-MS/MS) was utilized in this study to analyze and assess the AH samples to explore the mechanism underlying the effects of IVC treatment on PDR.

A novel surgical approach for fixation of a posterior chamber intraocular lens of Rayner 620 H with Gore-Tex suture.

PURPOSE: To report a novel surgical approach for the scleral fixation of the Rayner 620 H intraocular lens (IOL) with Gore-Tex suture and its outcomes at 6 months postoperatively. METHODS: 19 consecutive patients who underwent novel surgical approach for the scleral fixation of Rayner 620 H IOL with Gore-Tex suture at Peking Union Medical College Hospital between June 2020 and June 2021 were included. Data on best-corrected visual acuity (BCVA), spherical equivalent, total astigmatism/axis, short-term and long-term complications, and corresponding management with a follow-up of 6 months were collected. RESULTS: Nineteen patients (11 men and 8 women) with a mean age of 62.7 ± 10.6 years were included. The median BCVA improved significantly from 0.90 ± 0.90 (Snellen 20/160) preoperatively to 0.20 ± 0.30 (Snellen 20/32) at postoperative 6 months follow-up (P < 0.001). The stratification of the accuracy of refractive outcomes was 53% of patients within ± 0.5 D and 84% of patients within ± 1.0 D of the refractive target. Corneal edema (n = 3, 16%) and increased intraocular pressure (IOP) (n = 4, 11%) were short-term complications. Long-term complications included increased IOP (n = 1, 5%), and macular edema (n = 1, 5%). CONCLUSION: The novel surgical approach for scleral fixation of the Rayner 620 H IOL with Gore-Tex suture is a reasonable option for patients who need secondary IOL placement without adequate capsular support.

Early onset drusen and RPE dysfunction in a patient with NLRP3-AID.

Retinal pigment epithelium (RPE) dysfunction, manifested as drusen formation and RPE mottling, is a characteristic lesion of aging. The mechanism of RPE dysfunction remains unknown. Previous animal studies have proven that the activation of NLRP3 inflammasome in RPE leads to apoptosis and pyroptosis, which may play a very important role in the development of age-related macular degeneration (AMD). However, there is a lack of clinical evidence to support the above hypothesis. Herein, we report a 38-year-old Chinese Han woman who had NLRP3-associated autoinflammatory disease (NLRP3-AID) with widely scattered drusen at the posterior pole in both eyes. NLRP3-AID is a rare disease caused by mutations of the NLRP3 gene, leading to NLRP3 inflammasome activation. This report of early-onset drusen provides clinical evidence that the NLRP3 inflammasome might contribute to the occurrence of RPE dysfunction and is a potential cause of age-related macular degeneration (AMD).

Screening and Identification of Key Biomarkers in Metastatic Uveal Melanoma: Evidence from a Bioinformatic Analysis.

Purpose: To identify key biomarkers in the metastasis of uveal melanoma (UM). Methods: The microarray datasets GSE27831 and GSE22138 were downloaded from the Gene Expression Omnibus database. Differentially expressed genes (DEGs) were identified, and functional enrichment analyses were performed. A protein−protein interaction network was constructed, and four algorithms were performed to increase the reliability of hub genes. Biomarker analysis and metastasis-free survival analysis were performed to screen and verify prognostic hub genes. Results: A total of 138 DEGs were identified, consisting of 71 downregulated genes and 67 upregulated genes. Four genes (ROBO1, FMN1, FYN and FXR1) were selected as hub genes. Biomarker analysis and metastasis-free survival analysis showed that ROBO1, FMN1, FYN and FXR1 were factors affecting the metastasis and metastasis-free survival of UM (all p < 0.05). High expression of ROBO1 and low expression of FMN1 were associated with longer metastasis-free survival. Multivariable logistic regression and Cox analyses in GSE 27831 indicated that ROBO1 was an independent factor affecting metastasis and metastasis-free survival of UM (p = 0.010 and p = 0.009), while ROBO1 and FMN1 were independent factors affecting metastasis and metastasis-free survival of UM in GSE22138 (all p < 0.05). Conclusions: ROBO1, FMN1, FYN and FXR1 should be regarded as diagnostic biomarkers for the metastasis of UM, especially ROBO1 and FMN1. High expression of ROBO1 and low expression of FMN1 were associated with longer metastasis-free survival. This study may facilitate the understanding of the molecular mechanisms underlying the metastasis of UM.

Pursuing Diabetic Nephropathy through Aqueous Humor Proteomics Analysis.

In order to determine the possible aqueous humor (AH) proteins involved in diabetic nephropathy (DN) progression, we performed gel electrophoresis-liquid chromatography-tandem mass spectrometry protein profiling of AH samples from 5 patients with proliferative diabetic retinopathy (PDR) combined DN and 5 patients with PDR. Function enrichment analyses were carried out after the identification of differentially expressed proteins (DEPs). Protein-protein interaction networks were then built and the Search Tool for the Retrieval of Interacting Genes database and CytoNCA plugin in Cytoscape were utilized for module analysis. Ingenuity Pathway Analysis (IPA) was used to analyze disease and biological function, Tox function enrichment and upstream regulatory molecules/networks. Fifty-four DEPs were finally confirmed, whose enriched functions and pathways covered cell adhesion, extracellular exosome, complement activation, complement and coagulation cascades, etc. Nine hub genes were identified, including NCAM1, PLG, APOH, C3, PSAP, RBP4, CDH2, NUCB1, and GNS. IPA showed that C3 and PLG are involved in renal and urological system abnormalities. Conclusively, DEPs and hub proteins confirmed in this exploratory AH proteomic analysis may help us gain a deeper understanding of the molecular mechanisms involved in DN progression, providing novel candidate biomarkers for the early detection for diagnosis of DN.

Microbial spectrum and risk factors of endogenous endophthalmitis in a tertiary center of Northern China.

AIM: To study the clinical features, microbial spectrum, associated factors and prognosis of endogenous endophthalmitis (EE) in a group of Chinese patients. METHODS: The medical records from 32 eyes of 29 patients diagnosed with EE in Peking Union Medical College Hospital from January 2009 to October 2019 were reviewed. RESULTS: The initial visual acuity (VA) of 30 eyes in this study was worse than 20/400. Twenty-three eyes were diagnosed with fungal endophthalmitis and nine with bacterial endophthalmitis. The most common fungal and bacterial isolates were Candida and Klebsiella pneumoniae, respectively. Several rare fungi and bacteria species were also isolated from our patients, including Cryptococcus, Paecilomyces, Brucella, and Bacillus licheniformis. The leading risk factor for EE was diabetes. The most common extraocular infection locus was genitourinary tract. Vitrectomy was performed on twenty-nine eyes. Eight eyes achieved final VA of 20/400 or better. EE caused by Candida had a better prognosis. CONCLUSION: The visual outcome of EE is based on pathogens and prompt intervention. Early vitrectomy and antimicrobial treatment are beneficial for EE.

Comparison of Retinal Changes Following Silicone Oil and Perfluoropropane Gas Tamponade for Proliferative Diabetic Retinopathy Patients.

Purpose: To investigate the different tamponade effects of intravitreal silicone oil (SO) and perfluoropropane gas on the retinal structure and vasculature in proliferative diabetic retinopathy (PDR) patients. Methods: Thirty-eight eligible patients (47 eyes) with PDR requiring pars plana vitrectomy (PPV) were enrolled in the prospective observational study. Subjects were divided into two groups after PPV: SO group subjects underwent SO tamponade, whereas Gas group subjects underwent perfluoropropane gas tamponade. The primary outcomes of this study were longitudinal changes in retinal structure and vasculature between 10 and 90 days after the operation. Secondary outcomes were longitudinal changes in peripapillary retinal nerve fiber layer (pRNFL) thickness between 10 and 90 days after the operation in each sector. Results: Thirty-six eyes of 27 patients with a median age of 56.6 ± 9.8 years completed follow-up and were statistically analyzed. No significant difference in demographics or clinical characteristics was found between the two groups. Eyes in the SO group had a statistically significant decrease in pRNFL thickness at 90 days after PPV (p < 0.001), and there was a significant intergroup difference compared with the Gas group (p = 0.001), except for the temporal sector. Eyes in the Gas group had a statistically significant increase in parafoveal vessel density (VD) of the superficial vascular complex (SVC) at 90 days after PPV (p = 0.023), although there was no significant intergroup difference. The type of tamponade, changes in full retina thickness, and parafoveal SVC VD showed a significant correlation with changes in pRNFL thickness (all p < 0.05). Conclusion: SO tamponade resulted in a significantly greater decrease in pRNFL over 90 days than gas tamponade in patients with PDR. In addition, the change in the pRNFL was significantly correlated with changes in full retina thickness and SVC VD after the operation.

Characterization of Conjunctival Sac Microbiome from Patients with Allergic Conjunctivitis.

Conjunctival sac microbiome alterations have been reported to be closely associated with many ocular diseases. However, the characteristic of conjunctival sac microbiome in allergic conjunctivitis (AC) was scarcely described. In this study, we aimed to identify the differences of the conjunctival sac microbiome composition in AC patients compared with normal controls (NCs) using high-throughput 16S rDNA sequencing metagenomic analysis. The conjunctival sac microbiome samples from 28 AC patients and 39 NC patients were collected. The V3-V4 region of 16S rRNA gene high-throughput sequencing was performed on the illumina MiSeq platform. Alpha diversity, beta diversity and the relative abundance at the phylum and genus levels were analyzed using QIIME. Alpha diversity demonstrated by Chao1, Observed_species and PD_whole_tree indexes did not show significant difference between the AC and NC groups, while the Shannon index was higher in the AC group. Beta diversity showed divergent microbiome composition in different groups (p < 0.005). The top five abundant phyla were Firmicutes, Proteobacteria, Actinobacteriota, Bacteroidota and Cyanobacteria in both groups. The top five abundant genera were Bacillus, Staphylococcus, Corynebacterium, Acinetobacter and Ralstonia in the AC group and Acinetobacter, Staphylococcus, Bacillus, Clostridium_sensu_stricto_1, Corynebacterium and Geobacillus in the NC group. The Firmicutes/Bacteroidetes (F/B) ratio at the phylum level was similar between groups (p = 0.144). The Bacillus/Acinetobacter (B/A) ratio at the genus level was higher in the AC group (p = 0.021). The dysbiosis detected in this study might provide further evidence to investigate the mechanism and treatment methods for allergic conjunctivitis.

Proteomic changes of aqueous humor in proliferative diabetic retinopathy patients treated with different intravitreal anti-VEGF agents.

Anti-VEGF-based treatment have been regularly used in recent years in proliferative diabetic retinopathy (PDR) patients. However, some of these patients fail to respond effectively to anti-VEGF. Given that VEGF is not the sole factor influencing PDR pathogenesis and that different anti-VEGF pharmaceuticals are likely to differentially impact these underlying pathophysiological processes, we performed a prospective analysis of the protein profiles of the aqueous humor (AH) in PDR patients before and after treatment with three intravitreal anti-VEGF drugs (ranibizumab, aflibercept, and conbercept) to assess and compare the short-term impacts of these agents. Liquid chromatography-tandem mass spectrometry (LC-MS/MS)-based proteomic methods were used to evaluate the AH protein profiles of PDR patients using paired pre- and 7 days post-anti-VEGF treatment samples (ranibizumab [IVR]: n = 10; conbercept [IVC]: n = 10; aflibercept [IVA]: n = 5). Gene ontology (GO) annotation, KEGG pathway analyses, and protein-protein interaction (PPI) networks were then used to explore the functional relevance of proteins that were differentially expressed between groups. Here, a total of 874 proteins from 25 patients (50 AH samples) were identified in the three patient groups. Different and common clusters of regulated proteins for each group were identified. We identified RARRES1, ALDH3A1, and RBP4 as being specifically regulated following treatment with all three tested anti-VEGF agents. We further found that VEGFR1, VEGFR2, APOM, hornerin, and HSP90B1 were differentially expressed in different anti-VEGF agent groups. In summary, we discovered that ALDH3A1 was a previously unreported protein that was related to angiogenesis and was differentially expressed in the three anti-VEGF treatment groups, suggesting that it may be a new target for PDR therapy. The described proteomic changes in the AH of PDR patients treated with different anti-VEGF agents provide novel targets which may explain the heterogeneity of anti-VEGF treatment responses in these patients, providing a robust foundation for future studies of PDR pathogenesis.

PUMCH experience and strategy for the management of idiopathic macular hole: a retrospective cohort study.

PURPOSE: To introduce and evaluate a modified therapeutic strategy for idiopathic macular holes (IMH). METHODS: A retrospective review of patients with diagnosis of IMH from July 2016 to January 2020 at Peking Union Medical College Hospital. These patients were managed strictly according to our therapeutic strategy. Their comprehensive clinical data were collected and analyzed. RESULTS: 209 eyes suffering stage II to IV IMH were identified. For stage II IMH, the spontaneous closure rate was 8.9%, the initial success rate of intravitreal injections (IVI) of expansile gas and pars plana vitrectomy (PPV) + internal limiting membrane peeling (ILMP) + air tamponade was 84.2% and 100%, respectively. The initial success rate of PPV + ILMP + air tamponade for stage III and stage IV IMH was 89.8% and 86.4%, respectively. Following our intervention strategy, stage II IMH achieved a final IMH closure rate of 100%, stage III of 99% and stage IV of 97%. The final best corrected visual acuity was significantly improved (P < 0.05). Sitting position air-fluid (A-F) exchange alone successfully induced IMH closure in 7/19 eyes that did not achieve IMH closure by initial PPV. For three refractory cases that failed additional PPV + ILM stuffing, intraoperative OCT assisted PPV + sub-retinal BSS injection successfully induced the IMH closure. As the remaining three unclosed IMH cases were dry and stable, no more interventions were conducted. CONCLUSION: The general IMH closure rate based on our therapeutic strategy was satisfactory with a favorable prognosis. IVI expansile gas and sitting position A-F exchange were effective and highly cost-effective under certain circumstances.

[Endophthalmitis Caused by Mixed Infections in Silicone Oil-filled Eye:One Case Report].

The incidence of endophthalmitis after vitrectomy is extremely low,especially lower in silicone oil-filled eyes.Silicone oil exerts a toxic effect on the cell membranes of microorganisms and leads to the lack of nutrients.It is thus believed to inhibit the growth of bacteria and fungi.Endophthalmitis induced by mixed bacteria in silicone oil-filled eye has been rarely reported.We reviewed the clinical manifestations,diagnosis,and treatment of a patient with endophthalmitis caused by mixed infection of Morganella morganii and Staphylococcus epidermidis in the silicone oil-filled eye,aiming to improve the understanding and diagnosis of mixed infections.

The influence of delayed treatment due to COVID-19 on patients with neovascular age-related macular degeneration and polypoidal choroidal vasculopathy.

PURPOSE: To explore the impact of coronavirus disease 2019 (COVID-19) on the prognosis of patients with neovascular age-related macular degeneration (nAMD) and polypoidal choroidal vasculopathy (PCV), and share the experience in managing them during pandemics. METHOD: This is a retrospective study of nAMD and PCV patients treated at Peking Union Medical College Hospital from 31 December 2019 to 1 August 2020. Baseline demographic and clinical characteristics, best corrected visual acuity (BCVA), optical coherence tomography (OCT) features, duration of delayed treatment and number of anti-vascular endothelial growth factor (VEGF) injections were analyzed. RESULTS: A total of 130 nAMD patients (155 eyes) and 76 PCV patients (89 eyes) were identified. Compared to the conditions before COVID-19, the BCVA of delayed cases decreased significantly, and the proportion of patients presenting with sub-macular scar was significantly greater in the delayed treatment group (p < 0.05). The BCVA of non-delayed cases remained stable, with the percentage of patients with disease activity sub-retinal fluid and hemorrhage at the fovea decreasing significantly (p < 0.05). The stable cases who did not require anti-VEGF treatment had significantly worse baseline and final BCVA, these patients were likely to be chronic and 'burnt out' cases with significantly worse anatomical structures (p < 0.05). CONCLUSIONS: The delayed cases due to the pandemic suffered compromised visual function and a higher rate of sub-macular scar formation, while the visual function of non-delayed cases remained stable with favorable anatomical outcomes, suggesting the importance of regular follow-up for nAMD and PCV patients. Besides, effective measures of hospitals during pandemics are crucial to provide timely treatment for chronic disease.

Using machine learning to investigate the public's emotional responses to work from home during the COVID-19 pandemic.

According to event system theory (EST; Morgeson et al., Academy of Management Review, 40, 2015, 515-537), the coronavirus disease 2019 (COVID-19) pandemic and resultant stay-at-home orders are novel, critical, and disruptive events at the environmental level that substantially changed people's work, for example, where they work and how they interact with colleagues. Although many studies have examined events' impact on features or behaviors, few studies have examined how events impact aggregate emotions and how these effects may unfold over time. Applying a state-of-the-art deep learning technique (i.e., the fine-tuned Bidirectional Encoder Representations from Transformers [BERT] algorithm), the current study extracted the public's daily emotion associated with working from home (WFH) at the U.S. state level over four months (March 01, 2020-July 01, 2020) from 1.56 million tweets. We then applied discontinuous growth modeling (DGM) to investigate how COVID-19 and resultant stay-at-home orders changed the trajectories of the public's emotions associated with WFH. Our results indicated that stay-at-home orders demonstrated both immediate (i.e., intercept change) and longitudinal (i.e., slope change) effects on the public's emotion trajectories. Daily new COVID-19 case counts did not significantly change the emotion trajectories. We discuss theoretical implications for testing EST with the global pandemic and practical implications. We also make Python and R codes for fine-tuning BERT models and DGM analyses open source so that future researchers can adapt and apply the codes in their own studies. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Ring lymphoma: highly indicative ultrasound biomicroscopy findings of ciliary body lymphoma.

BACKGROUND: To describe the ultrasound biomicroscopy (UBM) findings of extremely rare ciliary body lymphoma. METHODS: This was a retrospective noncomparative case series study. Five patients (8 affected eyes) diagnosed with ciliary body lymphoma at Peking Union Medical College Hospital from 2008 to 2019 were included. The UBM findings, including the location, height, and acoustic features, were documented to assess the tumour characteristics. RESULTS: UBM in all 8 (100%) affected eyes revealed 360° ring-like, solid infiltration of the ciliary body with low and homogeneous internal reflectivity. The continuity of the tumours could be most vividly demonstrated by transverse sections. CONCLUSIONS: Ciliary body lymphoma tends to grow in a characteristic circumferential 360° pattern, and the name "ring lymphoma of the ciliary body" is proposed.