Volume ,2026 Issue 3

Intelligent Ophthalmology

• An intelligent segmentation method for leakage points in central serous chorioretinopathy based on fluorescein angiography images

  Jian-Guo Xu, Yong-Chi Liu, Fen Zhou, Jian-Xin Shen, Zhi-Peng Yan, Xin-Ya Hu, Wei-Hua Yang

  2026(3):421-433 ,DOI: 10.18240/ijo.2026.03.01

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  AIM: To construct an intelligent segmentation scheme for precise localization of central serous chorioretinopathy (CSC) leakage points, thereby enabling ophthalmologists to deliver accurate laser treatment without navigational laser equipment. METHODS: A dataset with dual labels (point-level and pixel-level) was first established based on fundus fluorescein angiography (FFA) images of CSC and subsequently divided into training (102 images), validation (40 images), and test (40 images) datasets. An intelligent segmentation method was then developed, based on the You Only Look Once version 8 Pose Estimation (YOLOv8-Pose) model and segment anything model (SAM), to segment CSC leakage points. Next, the YOLOv8-Pose model was trained for 200 epochs, and the best-performing model was selected to form the optimal combination with SAM. Additionally, the classic five types of U-Net series models [i.e., U-Net, recurrent residual U-Net (R2U-Net), attention U-Net (AttU-Net), recurrent residual attention U-Net (R2AttU-Net), and nested U-Net (UNet++)] were initialized with three random seeds and trained for 200 epochs, resulting in a total of 15 baseline models for comparison. Finally, based on the metrics including Dice similarity coefficient (DICE), intersection over union (IoU), precision, recall, precision-recall (PR) curve, and receiver operating characteristic (ROC) curve, the proposed method was compared with baseline models through quantitative and qualitative experiments for leakage point segmentation, thereby demonstrating its effectiveness. RESULTS: With the increase of training epochs, the mAP50-95, Recall, and precision of the YOLOv8-Pose model showed a significant increase and tended to stabilize, and it achieved a preliminary localization success rate of 90% (i.e., 36 images) for CSC leakage points in 40 test images. Using manually expert-annotated pixel-level labels as the ground truth, the proposed method achieved outcomes with a DICE of 57.13%, an IoU of 45.31%, a precision of 45.91%, a recall of 93.57%, an area under the PR curve (AUC-PR) of 0.78 and an area under the ROC curve (AUC-ROC) of 0.97, which enables more accurate segmentation of CSC leakage points. CONCLUSION: By combining the precise localization capability of the YOLOv8-Pose model with the robust and flexible segmentation ability of SAM, the proposed method not only demonstrates the effectiveness of the YOLOv8-Pose model in detecting keypoint coordinates of CSC leakage points from the perspective of application innovation but also establishes a novel approach for accurate segmentation of CSC leakage points through the “detect-then-segment” strategy, thereby providing a potential auxiliary means for the automatic and precise real-time localization of leakage points during traditional laser photocoagulation for CSC.

Basic Research

• Depression induces ocular surface inflammation and dry eye-like changes in mice

  Xiang Lin, Yu-Wen Liu, Jia-Ni Li, Wei-Jie Ouyang, Li-Ying Tang, Jie-Li Wu, Zhao-Lin Liu, Shi-Nan Wu, Jiao-Yue Hu, Zu-Guo Liu

  2026(3):434-442 ,DOI: 10.18240/ijo.2026.03.02

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  AIM: To investigate the impact of depression-like behavior on ocular surface homeostasis in a mouse model, with a focus on dry eye-like alterations. METHODS: Male C57BL/6J mice (10–12 weeks old) were randomly assigned to control or restraint stress (RS) groups. The RS group underwent three intermittent 24-hour restraint sessions to induce depressive-like behavior. Behavioral testing, tear secretion measurement, and corneal Oregon Green Dextran (OGD) staining were performed. Postmortem analyses included histological evaluation of lacrimal glands, goblet cell quantification using periodic acid-Schiff staining, and assessment of key inflammatory and apoptotic markers: interleukin (IL)-17, matrix metalloproteinases (MMP)-3, MMP-9, IL-13, interferon (IFN)-γ, and cleaved caspase-3 and -8. RESULTS: Repeated RS induced depression-like behavior and significant ocular surface changes. RS-treated mice showed increased corneal OGD uptake and upregulation of gene/protein expression of IL-17, MMP-3, and MMP-9 (P<0.05). Goblet cell density and IL-13 protein expression were reduced, while IFN-γ protein expression was elevated (P<0.05). Cleaved caspase-3 and -8 levels were significantly increased in both cornea and conjunctiva. Tear volume and lacrimal gland size were unchanged; however, mild inflammatory infiltration was observed in lacrimal glands. CONCLUSION: Repeated RS leads to ocular surface inflammation and dry eye-like pathology, including corneal barrier disruption, goblet cell loss, and epithelial apoptosis. These findings suggest that depression contributes to the pathogenesis of dry eye disease via immune-mediated mechanisms.

• Vaccinia-related kinase 1/snail family transcriptional repressor 1 regulates epithelial-mesenchymal transition and inflammation in proliferative vitreoretinopathy

  Ying Ying, Xin Liao

  2026(3):443-454 ,DOI: 10.18240/ijo.2026.03.03

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  AIM: To investigate whether vaccinia-related kinase 1 (VRK1) mediates transforming growth factor-beta2 (TGF-β2)-caused epithelial-mesenchymal transition (EMT) and inflammatory responses in retinal pigment epithelial (RPE) cells through regulating snail family transcriptional repressor 1 (SNAI1), and to validate its role in a proliferative vitreoretinopathy (PVR) mouse model. METHODS: Human RPE cell line ARPE-19 cells were treated with TGF-β2 to construct an EMT model. Western blot detected VRK1 level. The effects of VRK1 on SNAI1 expression and biological behavior of ARPE-19 cells were detected by immunofluorescence, ELISA, Transwell, and scratch assay, and the interaction between VRK1 and SNAI1 was confirmed through immunoprecipitation. A PVR mouse model was constructed, and the effects of VRK1 or/and SNAI1 on retinal damage were assessed by pathologic staining. Inflammatory factors and EMT-related proteins were assessed with ELISA and Western blot. RESULTS: VRK1 was upregulated in ARPE-19 cells after TGF-β2 treatment. Overexpression of VRK1 increased cell viability, promoted cell migration and EMT, and the levels of inflammatory factors. Silencing of VRK1 reversed the above indexes. There was a direct interaction between VRK1 and SNAI1, and overexpresssion SNAI1 weakened the impacts of silencing of VRK1. In PVR mice, silencing of VRK1 ameliorated retinal structural damage, decreased proinflammatory factor levels, and suppressed SNAI1 and mesenchymal marker expression. SNAI1 overexpression antagonized the protective effects of silencing VRK1 and exacerbated EMT and inflammatory responses. CONCLUSION: VRK1 plays a key role in retinal structural and inflammatory damage in PVR mice by regulating SNAI1 and mediating TGF-β2-caused EMT and inflammatory responses in RPE cells.

• Protective effects of zingerone on the retina in diabetic rats

  Bahadir Utlu, Betül Dertsiz Kozan, Serkan Yildirim

  2026(3):455-461 ,DOI: 10.18240/ijo.2026.03.04

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  AIM: To investigate the effects of zingerone (ZO) on the retina in diabetic rats. METHODS: A total of 70 rats were randomly selected and divided into seven groups [diabetic group (Dm+; n=10), diabetic+metformin group (Dm+Met; n=10), diabetic+ZO25 group (Dm+ZO25; n=10), diabetic+ZO50 group (Dm+ZO50; n=10), diabetic+metformin group+ZO 50 Group (Dm+Met+ZO50; n=10)]. Diabetes was induced by streptozotocin (STZ), and metformin and two different doses of ZO were administered via gavage. Retinal tissues were evaluated by histopathological and immunohistochemical analyses. RESULTS: In diabetic rats, severe retinal inflammation, tissue necrosis, and increased tumor necrosis factor-α (TNF-α) expression were observed. ZO administration reduced these effects in a dose-dependent manner. Protective effects of metformin alone were limited, and no synergistic benefit was observed in ZO+Met groups. Administration of 50 mg/kg ZO to non-diabetic rats caused no retinal toxicity. Additionally, elevated 8-OHdG and c-Jun N-terminal kinase (JNK) expressions in diabetic retinopathy models were significantly reduced by ZO treatment. CONCLUSION: ZO can markedly reduce the pathological effects of the retina in a diabetic rat model.

Clinical Research

• Outcomes of lacrimal sac hydrostatic pressure application in congenital nasolacrimal duct obstruction

  Ilanit Trifonov, Tal Koval, Ran Moshkovsky, Oriel Spierer

  2026(3):462-467 ,DOI: 10.18240/ijo.2026.03.05

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  AIM: To assess the success rate of lacrimal sac hydrostatic pressure application (HPA) maneuver, a conservative office procedure for treatment of congenital nasolacrimal duct obstruction (CNLDO). METHODS: The medical records of pediatric patients, 36mo old or younger, diagnosed with CNLDO between the years 2016-2022, were retrospectively reviewed. In all children, HPA was performed by a pediatric ophthalmologist. Success was defined as the resolution of epiphora and discharge within 48h of the intervention. RESULTS: A total of 281 eyes (194 patients) with CNLDO underwent HPA. Follow-up data were available for 261 eyes (179 patients, 50.3% male) and these patients were included in the analysis. The mean follow-up time was 11.6±13mo. Ninety-seven patients (54.2%) had unilateral nasolacrimal duct obstruction, while 82 patients (45.8%) had bilateral CNLDO. The mean age at the time of HPA was 5.8±5.9mo. Complete resolution of symptoms was achieved in 102 (39.1%) eyes. Patients 6mo old or younger at the time of HPA had a significantly higher success rate compared to patients older than 6mo (43.7% vs 30.9%, P=0.04). Younger age at the time of pressure application was associated with a higher resolution rate of CNLDO (OR 0.93, P=0.004). Sex assigned at birth, prematurity, laterality of the obstruction and type of symptoms (epiphora, discharge) were not correlated with success. A second HPA was performed in 46 eyes, with resolution of symptoms in 12 eyes (26.1%). CONCLUSION: Hydrostatic pressure applied on the lacrimal sac by an experienced ophthalmologist or an experienced pediatrician may be an effective treatment for CNLDO. We recommend HPA as an initial active conservative approach in all pediatric patients with CNLDO, especially those younger than 6mo.

• Intraocular lens tilt and decentration in congenital ectopia lentis: baseline characteristics and first-year report

  Hui-Wen Ye, Xin-Xin Liu, Zhen-Zhen Liu, Yi-Yuan Ma, Xin-Yu Zhang, Dan-Ying Zheng, Guang-Ming Jin

  2026(3):468-474 ,DOI: 10.18240/ijo.2026.03.06

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  AIM: To investigate the characteristics and associated factors of intraocular lens (IOL) tilt and decentration after transscleral suture-fixated IOL surgery in congenital ectopia lentis (CEL). METHODS: CEL patients undergoing transscleral suture-fixated IOL surgery were divided into two groups based on implanted IOL type (three-piece IOL or one-piece IOL). The IOL tilt and decentration at 3-month and 1-year postoperative were measured. Multivariate regression analyses were performed to identify the associated factors of IOL tilt and decentration as well as longitudinal changes. RESULTS: The 61 CEL patients (mean age 9.07±5.05y) in three-piece IOL (M/F: 14/7) group had a greater tilt than those with one-piece IOL (M/F: 28/12) group both at 3-month postoperative (horizontal: P=0.024; vertical: P=0.048) and 1-year postoperative (horizontal: P=0.011; vertical: P=0.001). Three-piece IOL group had a greater longitudinal change between 3-month postoperative to 1-year postoperative in IOL tilt (horizontal: P=0.028; vertical: P=0.026) and a greater longitudinal change in horizontal IOL decentration than one-piece IOL group (P<0.05). The longer axial length (AL) was associated with the longitudinal changes in IOL tilt (P=0.039), while the three-piece IOL was associated with the longitudinal changes in horizontal IOL decentration 1-year postoperatively (P=0.011). CONCLUSION: IOL tilt is greater in the three-piece IOL group than that in the one-piece IOL group 1-year postoperatively. The three-piece IOL is associated with greater longitudinal changes of IOL decentration, while longer AL is associated with longitudinal changes of IOL tilt. For CEL patients, more stable IOL type should be selected and patients with longer AL warrant closer monitoring.

• Comparison of three different instruments for vault measurements after implantable collamer lens implantation

  Bo-Liang Li, Ming-Rui Cheng, Wei-Teng Chang, Ya-Di Lei, Guang-Han Xu, Ming-Wei Li, Zhi-Wei Mao, Xun Chen, Xiao-Ying Wang

  2026(3):475-482 ,DOI: 10.18240/ijo.2026.03.07

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  AIM: To evaluate the differences and consistency of vault measurements obtained by Scheimpflug tomography (Pentacam), anterior segment optical coherence tomography (AS-OCT, CASIA II), and ultrasound biomicroscopy (UBM) following implantable collamer lens (ICL) V4c implantation. METHODS: Vault measurements were acquired using three modalities: Pentacam, CASIA II AS-OCT, and UBM. Repeated-measures analysis of variance was used to compare the vault values obtained by the three devices. The correlation and consistency of measurements among the three instruments were assessed using the Pearson correlation coefficient, intraclass correlation coefficient (ICC), and Bland-Altman plots. RESULTS: This retrospective study enrolled 210 myopic eyes of 210 patients (158 women and 52 men) who underwent ICL implantation: 108 eyes had a myopic ICL V4c implanted, and 102 eyes had a toric ICL V4c implanted. The mean vault values measured by Pentacam, CASIA II, and UBM were 452.64±204.20 μm, 538.57±203.54 μm, and 560.95±227.54 μm, respectively, with statistically significant differences among the three groups (P<0.05). Pearson correlation analysis showed strong positive correlations between vault values measured by different instruments (all P<0.001). ICC results indicated good consistency among the three measurement modalities (all P<0.001). Stratified analysis revealed that when the vault value was ≤250 μm, the correlation and consistency of measurements across the three instruments were lower than those in the medium and high vault subgroups. CONCLUSION: Vault values measured by Pentacam are lower than those obtained by CASIA II and UBM, with UBM yielding the highest mean vault values. Measurements from the three instruments are not interchangeable but can serve as mutual references due to their significant correlation and good overall consistency. Pentacam and CASIA II demonstrate the highest consistency in vault measurement. Notably, when the vault value is ≤250 μm, the consistency between Pentacam and the other two instruments decreases significantly.

• Minimally invasive four-point scleral refixation for dislocated 4-haptic IOL by horizontal mattress sutures and Hoffman pockets

  Zhao-Liang Zhang, Jia-Hui Shen, Jun-Yi Chen, Qin-Tuo Pan, Xu-Ting Hu, Zong-Duan Zhang

  2026(3):483-489 ,DOI: 10.18240/ijo.2026.03.08

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  AIM: To evaluate the clinical outcomes of a new minimally invasive technique using horizontal mattress sutures and Hoffman pockets for four-point refixation of dislocated four-haptic intraocular lenses (IOLs). METHODS: This retrospective consecutive case series included eyes with dislocated Akreos AO60 IOLs underwent scleral refixation using a horizontal mattress double-needle suture technique with intralamellar knot burial via Hoffman pockets. Clinical outcomes assessed included pre- and postoperative best-corrected visual acuity (BCVA), intraocular pressure (IOP), spherical equivalent (SE), suture duration, IOL centration, and perioperative complications. RESULTS: A total of 10 eyes from 10 patients (6 males) were included. The mean age at the time of IOL refixation was 53.10±13.07y (range: 28–68y). The mean interval between initial IOL implantation and dislocation was 8.44±3.54y. The mean postoperative follow-up duration was 11.45±10.30mo. Surgical time averaged 15.3±1.77min, with no intraoperative complications. The mean axial length was 27.16±4.35 mm, with high myopia (HM) as the leading comorbidity (4/10 eyes). Postoperative BCVA significantly improved compared to preoperative values (P=0.025). Postoperative SE was significantly improved compared with preoperative (P=0.01). All IOLs remained centered throughout follow-up. CONCLUSION: This minimally invasive four-point scleral fixation technique offers a safe and effective refixation strategy for dislocated four-haptic IOLs. The horizontal mattress suture configuration combined with Hoffman pockets facilitates durable centration, avoids conjunctival dissection, and could be adopted into routine surgical practice.

• Goniosynechialysis under a microscope alone and under direct gonioscopy for chronic angle-closure glaucoma patients coexisted with cataract

  Jie Du, Yao-Yao Li, De-Fu Chen, Jia-Qian Li, Qiang-Jie Huang, Shu-Qing Zhu, Wen-Qing Ye, Si Zhu, Shu-Xia Xu, Guo-Xing Li, Yuan-Bo Liang

  2026(3):490-497 ,DOI: 10.18240/ijo.2026.03.09

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  AIM: To compare the efficacy of goniosynechialysis (GSL) under a microscope alone (GM) and under direct gonioscopy (GG) for chronic angle-closure glaucoma (CACG) coexisted with cataract. METHODS: A prospective, single-center, and randomized controlled trial was conducted. Patients diagnosed as CACG and cataract were randomly allocated into either GM group or GG group. In GM group, the range of peripheral anterior synechiae (PAS) was confirmed through gonio-lens after phacoemulsification with intraocular lens implantation (PEI). PAS was separated only under a microscope. After separating the closed angle of 360° by this method, we used a surgical gonioscope to confirm the PAS range. If any remaining PAS was present, we would separate them with an iris repositor under the direct gonio-lens until angle of 360° was reopened. In GG group, PAS was separated under direct gonioscopy after PEI until angle of 360° was reopened. The range of residual PAS after GSLs was the primary outcome. Intraoperative complications (hyphema), intraocular pressure (IOP) and anti-glaucoma medication usage after operation were the secondary outcomes. RESULTS: Sixty eyes were included, each group comprising 30 eyes. The average age [GM group: 66.3±6.8y (12 males), GG group: 67.6±8.9y (7 males), P=0.550], the baseline IOP (GM group: 29.6±11.5 mm Hg, GG group: 32.4±12.2 mm Hg, P=0.366) and the average initial PAS extent (GM group: 8.9±2.6h, GG group: 9.4±2.5h, P=0.425) were similar in the two groups. In GM group, the PAS range reduced from 8.9±2.6h before operation to 7.2±2.9h after PEI and 3.3±2.2h after GSL. In GG group, the PAS range reduced from 9.4±2.5h before operation to 7.5±2.9h after PEI and 0.1±0.3h after GSL. The PAS after PEI was significantly reduced compared to the pre-operative PAS in both groups (all P<0.001). The extent of residual PAS after GSL in GM group was larger than that in GG group with significant statistical difference (P<0.001). Patients who underwent GSL without a gonioscope were more likely to develop hyphema than those who underwent GSL under direct gonioscopy. The difference of hyphema grade between the two groups was statistically significant (P=0.019). CONCLUSION: PEI alone can not open 360° of angle completely. PEI+GSL significantly reduced PAS range. But for patients with CACG, GSL under a microscope alone is more difficult to separate stable PAS completely and adequately than GSL under direct gonioscopy.

• Repeatability, reproducibility, and agreement regarding measurement of choroidal vascularity index between OCT and OCT angiography

  Mu-Han Zhong, Jia-Li Zhang, Ke-Xin Yu, Shu-Qi Fan, Xue Li, Hao Chen, Jin-Hua Bao, Ying-Ying Huang

  2026(3):498-508 ,DOI: 10.18240/ijo.2026.03.10

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  AIM: To explore the repeatability, reproducibility, and agreement in the measurement of the choroidal vascularity index (CVI) for different swept-source optical coherence tomography (OCT) devices and between OCT and OCT angiography (OCTA) images. METHODS: Two swept-source OCT imaging systems, VG200I and Topcon DRI OCT Triton, were used to capture OCT and OCTA images in triplicate. The first and third images were taken by one operator, and the second image was taken by another operator. The built-in software was used to calculate the CVI from the OCTA images (CVI-OCTA), and a custom-designed algorithm was used to calculate the CVI from the OCT images (CVI-OCT). Repeatability and reproducibility were assessed with the intraclass correlation coefficient (ICC), and agreement between devices and between OCT and OCTA were evaluated with Bland-Altman analysis. RESULTS: Sixty-eight eyes from 35 adults (17 females) were included in the analysis. The average age of the participants was 23.6±2.3y, with an average spherical equivalent refraction of -3.08±2.47 D and an average AL of 25.21±1.20 mm. Both OCT devices demonstrated high repeatability and reproducibility in measuring the CVI-OCTA (all ICCs>0.894 across five choroidal regions) and CVI-OCT (all ICCs>0.838). Furthermore, the between-device agreement in measuring the CVI-OCT was good [mean difference (MD) ranging from -2.32% to -3.07%], but that in measuring the CVI-OCTA was poor (MD, 1.48% to -7.43%). Additionally, the between-imaging agreement (CVI-OCTA versus CVI-OCT) was poor for both devices (Triton, MD, 6.05% to 12.68%; VG200I, MD, 6.67% to 12.09%). CONCLUSION: Both OCT devices and the two analytical methods demonstrate good stability. The inter-device consistency of CVI-OCT is good, while the inter-device consistency of CVI-OCTA and the consistency between the two analytical methods in the same device are both poor.

• Sex differences in retinal neurovascular changes in type 1 diabetes without retinopathy

  Yao Chen, Qian-Xin Li, Tong Zhang, Yao Tan, Rong-Han Wu, Ling Gao

  2026(3):509-516 ,DOI: 10.18240/ijo.2026.03.11

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  AIM: To investigate the sex-specific correlation between systemic factors and retinal neurovascular alterations in individuals with type 1 diabetes mellitus (T1DM) who do not exhibit signs of diabetic retinopathy (DR). METHODS: A cohort participant without DR diagnosed with T1DM, underwent comprehensive ophthalmologic evaluation, optical coherence tomography angiography retinal structural and microvascular density analysis, and systemic parameter assessment. Multiple linear regression analysis was used to investigate the impact of systemic parameters on retinal alterations in distinct gender groups. RESULTS: A total of 182 individuals were included, consisting of 85 males (mean age 23.28±12.75y) and 97 females (mean age 22.98±13.68y). Males exhibited significantly greater thickness in both the internal retinal layer and the entire retina compared to females (P<0.01), whereas females had higher densities of deep retinal vessels and choroidal capillaries (P<0.05). Additionally, glycemic control was found to have a notable influence on retinal thickness in males (P<0.05), while insulin function had a more pronounced impact on retinal structure in females (P<0.01). Furthermore, a significant correlation was observed between thyroid function markers and retinal parameters in both male and female (P<0.05). CONCLUSION: Sex differences in alterations in retinal structure and microcirculation are observed in individuals with T1DM prior to the development of clinical DR, with a noted association between these changes and systemic parameters.

• Assessment of pan-immune-inflammation value as a novel marker of proliferative diabetic retinopathy stage

  Ozlem Candan, Gözde Orman, Nurten Ünlü, Güner Uney

  2026(3):517-525 ,DOI: 10.18240/ijo.2026.03.12

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  AIM: To evaluate the predictive value of pan-immune-inflammation value (PIV) in the diagnosis of proliferative diabetic retinopathy (PDR) and its association with the stage of PDR. METHODS: This observational case-control study included participants who underwent routine complete blood count testing. Inflammation-related indices, including neutrophil-to-lymphocyte ratio, systemic immune-inflammation index (SII), and PIV, were derived and analyzed. Receiver operating characteristic curve (ROC) analysis was applied to assess the diagnostic performance of these indices in distinguishing patients with PDR, with sensitivity, specificity, area under ROC, and optimal threshold values calculated. In addition, binary logistic regression analysis was performed to evaluate the association between inflammatory indices and PDR stage. RESULTS: This study included 205 patients: 60 with diabetes without retinopathy (mean age: 61.81±10.76y), 80 with PDR (mean age: 61.63±10.03y) and 65 healthy controls (mean age: 59.52±5.88y). The PDR group had significantly higher white blood cell (WBC, P<0.001), monocyte (MONO, P=0.009) and neutrophil (NEU) counts (P<0.001). SII and PIV had the highest sensitivity and area under ROC for predicting patients with PDR (0.822, 0.846, respectively). The optimal cut-off values for discriminating patients with PDR were determined to be >527.12 and >299.08 for SII and PIV, respectively. The logistic regression analysis demonstrated that a decrease in lymphocyte (LYM) count and an increase in platelet count (PLT), glycated haemoglobin (HbA1c), SII, and PIV were all significantly associated with the development of high-risk PDR (all P<0.05). PIV was more stable than independent MONO, LYM, PLT and NEU levels in predicting both the diagnosis and stage of PDR. The optimal cut-off value for PIV to discriminate patients with high-risk PDR was found to be >345.87 area under ROC=0.871, with sensitivity of 0.827 and specificity of 0.812. CONCLUSION: PIV is a reliable, valuable, and inexpensive blood index that can be used for early detection and staging of PDR. PIV may therefore be essential to be used for the follow-up of diabetic patients.

• Factors influencing the treatment duration and visual prognosis of cytomegalovirus retinitis after allogeneic hematopoietic stem cell transplantation

  Shuo Wu, Yi-Hong Ding, Chuan Zhang, Jing Hou

  2026(3):526-531 ,DOI: 10.18240/ijo.2026.03.13

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  AIM: To explore the factors influencing the treatment duration and visual prognosis of cytomegalovirus (CMV) retinitis (CMVR) after allogeneic hematopoietic stem cell transplantation (allo-HSCT). METHODS: All participants received ganciclovir intravenous infusion or oral and intravitreal injection of ganciclovir (IVG) 3 mg twice a week for 4 consecutive times (induction phase). The affected eyes were divided into stop treatment group (Group A), continue treatment group (Group B), and relapse after treatment group (Group C) according to whether local therapy could be terminated at the end of the induction phase and whether CMVR recurred within 3mo after the termination of local therapy. RESULTS: The study included 31 participants (48 eyes) diagnosed with CMVR including 11 males and 20 females. The mean age was (28±8.2)y. There were 17 cases of binocular disease (34 eyes) and 14 cases of monocular disease (14 eyes). Visual acuity improved in 26 eyes (54.1%), remained unchanged in 9 eyes (18.8%), and decreased in 13 eyes (27.1%). The peak value of blood CMV in Group B was significantly higher than that in Group A (P=0.013). The number of eyes with anterior chamber inflammation in Group C was significantly lower than that in Groups A and B (P=0.015, P=0.016). The average number of interval days was higher in Group A than in Group B. For Group A, there was a strong positive correlation between the number of eyes with CMV positive blood (r=0.712, P=0.031) and visual acuity changes. For Group B, there was a moderately strong positive correlation between the days of blood CMV after transplantation (r=0.371, P=0.043) and the times of injections. For Group C, there was a strong positive correlation between the peak value of blood CMV (r=0.719, P=0.029) and the times of injection. CONCLUSION: Systemic use of antivirals combined with intravitreal injection of antivirals is effective for patients with CMVR after allo-HSCT surgery. Patients with shorter interval days, higher peak or more days of blood CMV need more injections. Patients with positive blood CMV at initial diagnosis have worse visual prognosis.

• Evaluation of retina and choroid via OCT in anti-DFS70/LEDGF positive healthy individuals

  Ata Baytaroğlu, Suzan Doğruya, I. Merve Uçar Baytaroğlu

  2026(3):532-538 ,DOI: 10.18240/ijo.2026.03.14

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  AIM: To investigate the association between anti-DFS70 antibody positivity and ocular parameters, specifically, the choroidal vascularity index (CVI) and other optical coherence tomography (OCT) metrics, in a healthy population. METHODS: This age- and sex-matched case-control study enrolled 84 healthy individuals with positive anti-DFS70 antibody findings and 84 healthy negative controls. All participants underwent detailed ophthalmological examinations, including biometry and OCT imaging. Anti-DFS70 positivity was determined by indirect immunofluorescence and scored semi-quantitatively (1+ to 3+). CVI was calculated from OCT images using a standardized protocol with Image J software. Statistical analyses, including Student’s t-test, Mann-Whitney U test, Spearman correlation, and logistic regression, were used to compare groups and identify predictive factors. RESULTS: The individuals who tested positive and negative for anti-DFS70 included in the study were matched for age (median age=47y) and sex (F:M=7:1). CVI was significantly lower in the anti-DFS70-positive group compared to the negative group. A higher anti-DFS70 antibody titer was significantly associated with decreased subfoveal and nasal choroidal thickness (P=0.016 and P=0.014, respectively). In univariate regression analysis, CVI was the only significant predictor of anti-DFS70 positivity [odds ratio (OR)=0.02, P=0.025]. Multivariate analysis revealed a positive correlation between macular thinning outside the subfoveal area and anti-DFS70 status (P<0.05). CONCLUSION: Our study demonstrates a novel association between anti-DFS70 antibody positivity and reduced choroidal vascularity in healthy individuals. These findings suggest that anti-DFS70 antibodies may be associated with subtle choroidal vascular changes detectable by OCT, even in asymptomatic individuals. Further longitudinal research is warranted to clarify the underlying mechanisms and long-term clinical significance of these ocular changes.

• Positive/negative binocular fusional C-optotypes and 2D planar C-optotypes on transient accommodation and stability in adult eyes: implications for myopia prevention and control

  Qing-Xia Fan, Jing Lin, Ling Xu, Wei He

  2026(3):539-548 ,DOI: 10.18240/ijo.2026.03.15

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  Abstract:

  AIM: To investigate the effects of binocular fusional C-optotypes (positive/negative) and 2D planar C-optotypes on the amplitude and stability of transient accommodation (TAC) in adults, and to provide a basis for non-contact myopia intervention. METHODS: This was a self-controlled study. Using red-blue 3D technology, four experimental stages were set up: Test A [fixating on the 1 m negative fusional C-optotypes, 8△ base-in (BI)], Test B (fixating on the 5 m planar C-optotypes), Test C (fixating on the 1 m planar C-optotypes), and Test D [fixating on the 1 m positive fusional C-optotypes, 20△ base-out (BO)]. A WAM-5500 open-field autorefractor was used to measure TAC and accommodative microfluctuations [evaluated via interquartile range (IQR) and median-based coefficient of variation (CVmed)]. Additionally, the convergence accommodation to convergence (CA/C) ratio was calculated, and a visual fatigue questionnaire was administered to assess participants’ subjective visual comfort. RESULTS: A total of 21 subjects (7 males, 14 females; aged 23-41y) with normal binocular visual function were enrolled. The results showed that the TAC increased gradually across the four stages, and these values were Test A (-0.35±0.26 D)0.05), but the fluctuation stability of Test D showed a significant difference between the first 20s and the second 20s (P=0.017). The CA/C ratio was significantly higher in Test D (0.05±0.02 D/△) than in Test A (0.03±0.02 D/△, P=0.007), indicating stronger accommodation-convergence linkage during positive fusional fixation. The visual fatigue scores of all stages were low (median 0-1), with Test D slightly higher than Test B and Test C (P<0.05). No linear correlation was found between TAC and age (all r<0.1, P>0.05). CONCLUSION: Negative fusional C-optotypes induce ciliary muscle relaxation to reduce TAC, while positive fusional C-optotypes enhance accommodation-convergence coordination to increase TAC. The red-blue 3D-based non-contact training mode exhibits good safety (median visual fatigue scores: 0-1 across all tests) and provides a novel dual-directional (relaxation-activation) strategy for myopia prevention and control.

• Comparison of binocular vision indices in Parkinson’s disease patients vs age-sex-matched healthy controls

  Reyhaneh Shariati-Moghaddam, Ali Shoeibi, Morad Amir Ahmad, Hadi Ostadimoghaddam, Hassan Hashemi, Akbar Derakhshan, Zahra Hemmatian, Abbasali Yekta, Mehdi Khabazkhoob

  2026(3):549-555 ,DOI: 10.18240/ijo.2026.03.16

  Abstract: (15) HTML (0) PDF (711.84 KKB)(16)

  Abstract:

  AIM: To evaluate the differences in near point of convergence (NPC), fusional vergence, saccadic eye movements, versional eye movements, and heterophoria between patients diagnosed with Parkinson’s disease (PD) and healthy subjects. METHODS: A cross-sectional comparative study was conducted, enrolling two cohorts: a PD group and a healthy control group. The PD group was recruited via non-random convenience sampling, while the control group was selected randomly from individuals without PD. All participants were screened according to predefined inclusion and exclusion criteria before undergoing a comprehensive optometric assessment, which included measurements of uncorrected visual acuity, corrected visual acuity, and objective and subjective refraction. Subsequently, binocular vision function evaluations were performed, covering NPC measurement, fusional vergence reserve assessment at both distance and near, saccadic eye movement testing, and versional eye movement and heterophoria assessment. RESULTS: A total of 42 PD patients and 41 healthy controls were included in the final analysis. The two groups were well-matched in terms of sex distribution [29 males (69.0%) in the PD group vs 29 males (70.7%) in the control group, P=0.867] and mean age (55.3±9.6y in the PD group vs 54.9±9.8y in the control group, P=0.866). The prevalence of abnormal versional eye movements was significantly higher in the PD group than in the control group (23.81%, 95%CI: 12.05%-39.45% vs 7.32%, 95%CI: 1.54%-19.92%; P=0.025). Near exophoria was more prevalent in PD patients (61.90%, 95%CI: 45.64%-76.43%) than in controls (17.07%, 95%CI: 7.15%-32.06%), with a significant difference [odds ratio (OR)=7.99; 95%CI: 2.83-21.99; P<0.001]. The mean NPC was significantly greater (more receded) in the PD group than in the control group (9.01±3.74 cm vs 7.20±2.15 cm; P=0.007). A statistically significant positive correlation was observed between PD severity and NPC values (Pearson’s correlation coefficient=0.309; P=0.046). Except for distance base-out break and distance base-out recovery values, all other fusional vergence parameters were significantly lower in the PD group than in the control group (P<0.05). The mean saccadic test score was significantly lower in PD patients than in controls (3.29±0.57 vs 3.78±0.42; P<0.001). Among all fusional vergence indices, near base-in blur yielded the highest area under the curve (AUC=0.877), with a sensitivity of 69% and specificity of 90%, followed by distance base-out blur (AUC=0.824, sensitivity=97.6%, specificity=66.7%), near base-out blur (AUC=0.814, sensitivity=76.2%, specificity=72.7%), near base-out break (AUC=0.749, sensitivity=78.6%, specificity=67.6%), and near base-out recovery (AUC=0.749, sensitivity=95.2%, specificity=50%). CONCLUSION: PD is associated with significant binocular vision function impairment, with receded NPC and reduced near fusional vergence reserves being the most prominent disorders. These findings highlight the potential value of binocular vision assessment as a non-invasive biomarker for the early detection and clinical monitoring of PD.

Investigation

• Prevalence of heterophoria, tropia, and near point of convergence abnormality in a high school student population in Erbil city center

  Morad Amir Ahmad

  2026(3):556-563 ,DOI: 10.18240/ijo.2026.03.17

  Abstract: (44) HTML (0) PDF (510.46 KKB)(25)

  Abstract:

  AIM: To determine the prevalence of tropia, phoria, and abnormality of near point of convergence (NPC), along with associated ocular symptoms, in high school students. METHODS: This cross-sectional study was conducted in Erbil, Iraq. The target population consisted of high school students selected through a multi-stage cluster sampling method. Comprehensive visual examinations were performed for all students, including measurement of uncorrected and corrected visual acuity, objective and subjective refraction, and distance and near cover tests. NPC was evaluated using a single 6/12 visual target mounted on a centrally positioned Gulden fixation stick. Ocular symptoms were investigated through interviews. RESULTS: Of the 996 selected students, 921 participated in the study. Of them, 543 (58.96%) were female, and their ages ranged from 13 to 22y. The prevalence of tropia was 3.58% [95% confidence interval (CI): 2.38%–4.78%], observed in 3.44% of males and 3.68% of females. Exotropia (1.95%, 95%CI: 1.06%–2.85%) was more common than esotropia (1.52%, 95%CI: 0.73%–2.31%). The 15.42% (95%CI: 13.09%–17.75%) of students had phoria. Exophoria (13.79%, 95%CI: 11.56%–16.02%) was significantly more prevalent than esophoria (1.63%, 95%CI: 0.81%–2.45%). The prevalence of NPC abnormality in the total study population was 24.97% (95%CI: 22.18%–27.77%). It was 26.72% (95%CI: 22.26%–31.18%) in males and 23.76% (95%CI: 20.18%–27.34%) in females (P=0.307). The most common symptom in phoria was headache (86.62%, 95%CI: 81.02%–92.22%), followed by tired or sore eyes (61.97%, 95%CI: 53.99%–69.96%). The most common symptoms in tropia were blurry vision (93.94%, 95%CI: 79.77%–99.26%) and difficulty concentrating (87.88%, 95%CI: 76.74%–99.01%). CONCLUSION: Among Erbil’s high school students, the prevalence of strabismus, particularly the exodeviation type, is relatively high, and a significant percentage of students have NPC abnormalities. Addressing and correcting these binocular vision problems, due to their associated visual symptoms, can lead to an improvement in students’ quality of life and academic performance.

Mendelian Randomization

• Causal effect of obesity on cataract and mediating roles of metabolites: a Mendelian randomization study

  Chen Li, Jiao-Man Wang, Wei-Hua Yang

  2026(3):564-574 ,DOI: 10.18240/ijo.2026.03.18

  Abstract: (3) HTML (0) PDF (1.72 MKB)(11)

  Abstract:

  AIM: To investigate the causal effect of obesity on cataract risk and explores the potential mediating roles of metabolites using Mendelian randomization (MR). METHODS: Summary-level data from large-scale genome-wide association studies to examine the relationship between obesity and cataract were utilized. Obesity-related traits, including body mass index (BMI), waist-to-hip ratio (WHR), and waist circumference (WC). A two-sample MR approach was employed to assess the causal effect of obesity on cataract risk, while potential mediators were identified from suitable genome-wide association studies (GWAS) datasets. Additionally, a metabolic pathway analysis was conducted. RESULTS: An increase of 1 standard deviation (SD) in BMI, WHR, and WC was associated with a significantly higher risk of cataract (BMI: odds ratio (OR) 1.0017, 95% confidence interval (CI): 1.0001–1.0032, P=0.0320; WHR: OR 1.0029, 95%CI: 1.0006–1.0051, P=0.0129; WC: OR 1.0020, 95%CI: 1.0001–1.0038, P=0.0390]. These associations remained robust after adjusting for confounding factors in multivariable MR analysis. Furthermore, a two-step MR analysis identified eight potential metabolic mediators, with one mediator showing a significant causal role in the relationship between obesity and cataract. CONCLUSION: This work highlights the importance of addressing obesity as a modifiable risk factor for cataracts, particularly through metabolic pathways.

• Causal relationships between 41 inflammatory cytokines and myopia: a Mendelian randomization study

  Xiao-Fei Wu, Lei Yu, Ying Zhang, Shuang Li, Rui Li, Lian-Yi Sun

  2026(3):575-581 ,DOI: 10.18240/ijo.2026.03.19

  Abstract: (7) HTML (0) PDF (1.46 MKB)(10)

  Abstract:

  AIM: To investigate the potential causal associations between 41 inflammatory cytokines and myopia using a two-sample Mendelian randomization (MR) approach. METHODS: Publicly available genome-wide association study (GWAS) datasets were utilized for this two-sample MR analysis. Inflammatory cytokine-related GWAS data were extracted from The University of Bristol’s Research Data Repository, and myopia-related GWAS data were obtained from the FinnGen project. Single nucleotide polymorphisms (SNPs) associated with inflammatory cytokines were systematically selected as instrumental variables (IVs) based on three rigorous criteria: relevance, independence, and exclusion of pleiotropy. Five MR methods were employed for causal inference: the inverse-variance weighted (IVW) method as the primary analysis, supplemented by MR-Egger regression, weighted median estimator, simple mode, and weighted mode approaches. Sensitivity analyses were performed to evaluate the robustness of the causal estimates. RESULTS: A total of 773 myopia-associated SNPs were identified. MR analysis revealed that higher levels of macrophage inflammatory protein 1-α (MIP-1α) were associated with a 17% reduced risk of myopia [odds ratio (OR)=0.83; 95% confidence interval (CI): 0.69-0.99; P<0.05]. In contrast, elevated levels of eotaxin (OR=1.26; 95%CI: 1.07-1.47; P<0.01), stromal cell-derived factor-1α (SDF-1α; OR=1.68; 95% CI: 1.08-2.62; P<0.05), and interleukin-2 receptor subunit alpha (IL-2Rα; OR=1.25; 95%CI: 1.01-1.53; P<0.05) were significantly associated with an increased risk of myopia. Sensitivity analyses confirmed the reliability of these results. CONCLUSION: This study provides evidence supporting a causal relationship between specific inflammatory cytokines and myopia. MIP-1α may act as a protective factor against myopia, while eotaxin, SDF-1α, and IL-2Rα are potential risk factors for myopia. These findings emphasize the critical role of inflammatory pathways in the pathogenesis of myopia, offering novel insights for the development of preventive and therapeutic strategies for myopia.

• Triglyceride-driven pathogenesis in thyroid-associated ophthalmopathy: a dual approach of clinical correlation and genetic causality

  Jia-Min Cao, Hai-Yan Chen, Feng Zhang, Wei Xiong

  2026(3):582-589 ,DOI: 10.18240/ijo.2026.03.20

  Abstract: (5) HTML (0) PDF (1.76 MKB)(10)

  Abstract:

  AIM: To clarify the clinical correlations and causal relationships between lipid metabolism and the progression of thyroid-associated ophthalmopathy (TAO). METHODS: This case-control study retrieved clinical data from 2018 to 2023. A total of 2591 patients were enrolled, including 197 patients with TAO (case group) and 2394 patients with hyperthyroidism without TAO (control group). Serum lipid parameters, including triglycerides, total cholesterol, high-density lipoprotein (HDL), low-density lipoprotein (LDL), and the HDL/total cholesterol ratio, as well as thyroid function markers, were compared between the two groups. Correlation analyses were performed to evaluate the associations between serum lipid levels and key ocular manifestations of TAO, including exophthalmos degree, clinical activity score, and disease severity. Furthermore, Mendelian randomization (MR) analysis was conducted using genome-wide association study (GWAS) datasets, with hyperthyroidism as the exposure variable and serum lipid parameters as the outcome variables, to infer the causal relationship between hyperthyroidism, lipid metabolism, and TAO progression. RESULTS: The TAO group consisted of 101 males and 96 females, while the hyperthyroidism group included 706 males and 1688 females. Compared with the control group, patients with TAO had significantly higher levels of triglycerides (1.83±1.21 vs 1.40±1.08 mmol/L, P<0.01), total cholesterol, LDL, and HDL. Correlation analysis showed that triglyceride levels were positively correlated with exophthalmos degree, whereas HDL levels were inversely correlated with exophthalmos degree. No significant associations were found between serum lipid levels and clinical activity score (P>0.1). MR analysis confirmed that hyperthyroidism exerted a causal effect in reducing serum triglycerides [inverse-variance weighting odds ratio (OR)=0.035, 95% confidence interval (CI): 0.01-0.12] and total cholesterol (OR=0.085, 95%CI: 0.02-0.34), with no evidence of horizontal pleiotropy (MR-PRESSO P>0.05). CONCLUSION: Elevated serum triglyceride levels are an independent risk factor for TAO severity, especially exophthalmos, and triglyceride metabolism is inversely regulated by thyroid function.

Bibliometric Research

• Bibliometric analysis of papers on inflammation in glaucoma from 2000 to 2025

  Wen-Li Chen, Xue Wu, Li-Xia Zhang

  2026(3):590-599 ,DOI: 10.18240/ijo.2026.03.21

  Abstract: (4) HTML (0) PDF (3.28 MKB)(9)

  Abstract:

  AIM: To perform a bibliometric analysis of publications focusing on inflammatory mechanisms in glaucoma, thereby comprehensively understanding the current research status and identifying potential frontier directions for future studies. METHODS: A systematic search was conducted in the Web of Science Core Collection (WoSCC) database to retrieve relevant literature published from January 1, 2000, to August 31, 2025 (data accessed on September 12, 2025). Multiple data visualization tools were employed to conduct in-depth analyses of the included publications, covering aspects such as publication quantity and quality, evolutionary trends of research hotspots, keyword co-occurrence networks, and collaborative patterns among countries/regions, institutions, and authors. RESULTS: A total of 3381 articles related to glaucoma inflammation were extracted from WoSCC. The analysis showed that the USA had the highest research output in this field (29.04%, n=982), followed by China (18.40%, n=622) and UK (6.01%, n=203). Based on citation frequency and burst intensity, the USA also ranked as the most influential country. Baudouin C and Sun X were identified as the most productive authors, while Journal of Glaucoma and Investigative Ophthalmology & Visual Science were the journals with the highest number of published relevant articles. Additionally, keyword analysis revealed that “neuroinflammation”, “retinal ganglion cells (RGCs)”, “pathophysiology”, and “traditional Chinese medicine” are emerging research hotspots in the field of immune-inflammatory responses in glaucoma. CONCLUSION: This study presents a comprehensive bibliometric overview of research on glaucoma-related inflammation, indicating that this field has received extensive scientific attention with a steady upward trend in research activity. Furthermore, it establishes a theoretical basis for the development of neuroinflammation-targeted therapeutic strategies for glaucoma and emphasizes the necessity of strengthening interdisciplinary collaboration to promote the clinical translation of research findings.

• A bibliometric and visualized analysis of choriocapillaris from 2013 to 2023

  Pu-Ying Wei, Xi-Zhe Wang, Jin-Ming Han

  2026(3):600-611 ,DOI: 10.18240/ijo.2026.03.22

  Abstract: (6) HTML (0) PDF (4.74 MKB)(8)

  Abstract:

  AIM: To assess the current research status and emerging trends of the choriocapillaris (CC) by bibliometric analysis. METHODS: Publications spanning from January 2013 to May 2023 were retrieved on June 27th, 2023, using the Web of Science Core Collection. Bibliometric and visualized analyses were performed employing the bibliometrix, CiteSpace and VOSviewer. RESULTS: A total of 1563 papers met the inclusion criteria, and a publication growth trend was observed. The United States was the leading country in the CC field. Retina and Investigative Ophthalmology & Visual Science stood out as highly impactful and prolific journals. Research topics in the CC field encompassed choroidal neovascularization, choroidal thickness, central serous chorioretinopathy, age-related macular degeneration, myopia, choroidal vascularity index, and diabetic retinopathy, based on the co-citation analysis. The keyword “high myopia” experienced a burst lasting until 2023. CONCLUSION: In the past decade, research in the field of CC has flourished due to recent advancements in choroidal imaging; with focus shifting towards elucidating its role in various diseases. This will provide novel insights into managing chorioretinal diseases and vision-preserving interventions.

Review Article

• Growth hormone-releasing hormone in retinal disorders and uveitis: an updated review

  Sha-Lin Yi, Yu-Qiang Huang

  2026(3):612-618 ,DOI: 10.18240/ijo.2026.03.23

  Abstract: (6) HTML (0) PDF (640.23 KKB)(12)

  Abstract:

  Growth hormone-releasing hormone (GHRH) is a hypothalamic releasing hormone that plays a crucial physiological role in regulating the synthesis and release of anterior pituitary hormones. In recent years, studies have found that GHRH possesses functions like anti-inflammation, promoting cell proliferation, and facilitating cell migration. It participates in regulating the development of uveitis and diabetic retinopathy. Additionally, it also has an impact on the development of retinal ganglion cells by modulating the inflammatory response and mediating the immune response. Given the important roles of GHRH in ophthalmic diseases, elucidating the molecular regulation of the GHRH-GHRH receptor (GHRHR) signal and the innovative development of intervention pathways that directly or indirectly target GHRH serve as strong evidence of how basic research guides innovation and translation. In this review, research reports on GHRH in ophthalmic diseases including retinal diseases and uveitis were summarized and analyzed.

• Viral mechanisms, tropism, and clinical relevance regarding the ophthalmic manifestations of SARS-CoV-2 infection

  Samuel González, Jhesua Arellano, Edwin Estefan Reza-Zaldivar, Salvador Mena-Munguía, Benito Minjarez, Yury Rodríguez-Yáñez

  2026(3):619-629 ,DOI: 10.18240/ijo.2026.03.24

  Abstract: (4) HTML (0) PDF (1.20 MKB)(18)

  Abstract:

  To explore the mechanisms underlying ocular infection by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), we conducted a comprehensive review of current literature, focusing on viral entry pathways, receptor expression in ocular tissues, and associated clinical manifestations. This review encompasses studies published within the last five years with a focus on original research and systematic reviews that provide molecular, histological, or clinical evidence. The findings show that SARS-CoV-2 can infect ocular tissues through multiple receptors beyond angiotensin-converting enzyme 2 (ACE2), including transmembrane serine protease 2 (TMPRSS2), CD147, alanyl aminopeptidase N (ANPEP), dipeptidyl peptidase 4 (DPP4), angiotensin II receptor type 2 (AGTR2), and polymeric immunoglobulin receptor (PIGR), which are expressed in retinal, conjunctival, corneal, limbal, and photoreceptor cells. The virus may also reach ocular structures via neurovascular invasion. Clinically, patients with coronavirus disease 2019 (COVID-19) may present with a broad spectrum of ophthalmic manifestations, including conjunctivitis, hyperreflective lesions in the inner retinal layers, flame-shaped hemorrhages, cotton-wool spots, retinal pallor, hard exudates, and various forms of maculopathy, such as paracentral acute middle maculopathy and acute macular neuroretinopathy (AMN). These signs reflect both direct viral damage and secondary effects of systemic inflammation and microvascular injury. Understanding the molecular and clinical spectrum of ocular involvement is essential for early diagnosis, appropriate ophthalmologic care, and the prevention of long-term visual sequelae in patients affected by COVID-19.

Letter to the Editor

• A novel CRB1 variant presenting as Leber congenital amaurosis-8 with angle-closure glaucoma in a Chinese family

  Gong Chen, Zhi-Ruo Wang, Cong Zhao, Hui-Hui Chen, Jing-Ming Shi

  2026(3):630-633 ,DOI: 10.18240/ijo.2026.03.25

  Abstract: (17) HTML (0) PDF (969.21 KKB)(12)

  Abstract:

• Unilateral solitary ciliary body mass: a case report and review of the literature

  Wen-Yuan Xie, Yuan Zhao, Pei-Fang Ren, Xiao-Yu Wang, Li-Ping Shen

  2026(3):634-636 ,DOI: 10.18240/ijo.2026.03.26

  Abstract: (12) HTML (0) PDF (1.18 MKB)(11)

  Abstract:

• Algorithm of automatic identification of diabetic retinopathy foci based on ultra-widefield scanning laser ophthalmoscopy

  Jie Wang, Su-Zhen Wang, Xiao-Lin Qin, Meng Chen, Heng-Ming Zhang, Xin Liu, Meng-Jun Xiang, Jian-Bin Hu, Hai-Yu Huang, Chang-Jun Lan

  Abstract:

  ● AIM: To propose an algorithm for automatic detection of diabetic retinopathy (DR) lesions based on ultra-widefield scanning laser ophthalmoscopy (SLO). ● METHODS: The algorithm utilized the FasterRCNN (Faster Regions with CNN features)+ResNet50 (Residua Network 50)+FPN (Feature Pyramid Networks) method for detecting hemorrhagic spots, cotton wool spots, exudates, and microaneurysms in DR ultra-widefield SLO. Subimage segmentation combined with a deeper residual network FasterRCNN+ResNet50 was employed for feature extraction to enhance intelligent learning rate. Feature fusion was carried out by the feature pyramid network FPN, which significantly improved lesion detection rates in SLO fundus images. ● RESULTS: By analyzing 1076 ultra-widefield SLO images provided by our hospital, with a resolution of 2600×2048 dpi, the accuracy rates for hemorrhagic spots, cotton wool spots, exudates, and microaneurysms were found to be 87.23%, 83.57%, 86.75%, and 54.94%, respectively. ● CONCLUSION: The proposed algorithm demonstrates intelligent detection of DR lesions in ultra-widefield SLO, providing significant advantages over traditional fundus color imaging intelligent diagnosis algorithms.

• The relationship of blood cell-associated inflammatory indices and diabetic retinopathy: a Meta-analysis and systematic review

  Wen-Juan Luo, Wen-Fang Zhang

  Abstract: (64685) HTML (992) PDF (1.51 MKB) (1558)

  Abstract:

  AIM: To explore the correlation between several blood cell-associated inflammatory indices including mean platelet volume (MPV), platelet distribution width (PDW), neutrophil to lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR), and the presence and severity of diabetic retinopathy (DR). METHODS: We searched for eligible studies from PubMed, EMBASE, Web of Science and CNKI up to December 13, 2017. Standardized mean difference (SMD) calculated with confidence interval (CI) of 95% was used to estimate the values of those indices. RESULTS: A total of 31 studies were included in the present Meta-analysis. As compared with type 2 diabetes mellitus (T2DM) patients without DR, the values of MPV, PDW, NLR, and PLR were higher in patients with DR (SMD=0.67; 95%CI: 0.36 to 0.98; SMD=0.51; 95%CI: 0.27 to 0.75; SMD=0.77; 95%CI: 0.49 to 1.05 and SMD=1.18; 95%CI: 0.07 to 2.28). Additionally, it was also observed that MPV was closely correlated with the severity of DR. CONCLUSION: MPV, PDW, NLR, and PLR could be recommended as diagnostic biomarkers for DR, and MPV could be applied to assess the severity of DR.

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• Surgical outcome of 21 patients with congenital upper eyelid coloboma

  Arshad Ali Lodhi, Sameen Afzal Junejo, Mahtab Alam Khanzada, Imran Akram Sahaf, Zahid Kamal Siddique

  Abstract: (60348) HTML (0) PDF (420.04 KKB) (2053)

  Abstract:

  AIM: To evaluate the surgical outcome of congenital upper eyelid coloboma repair. · METHODS: All patients underwent complete ophthalmic and general examination before going to surgery, and then examination under anesthesia was performed to assess the site and size of eyelid defect, conjunctival involvement. The status of cornea and ocular motility with forced duction test was also being noted. The surgical procedure was performed according to the size of defect. · RESULTS: Out of 21 cases of congenital upper eyelid coloboma, 18 occurred in isolation with upper eyelid medial defect, 13 were bilateral and 5 were unilateral. Others were associated with Goldenhar syndrome and CHARGE syndrome with bilateral upper lid medial defects. All patients were presented for surgical corrections during age of 2.5-4.0 years except one that presented at 25 years of age. Cosmetically surgical results were acceptable, except one that was already presented with opaque corneal. · CONCLUSION: In this study, overall surgical results were satisfactory except one that was presented late with compromised cornea.

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• Safety of intravitreal quinupristin/dalfopristin in an animal model

  Veronica E. Giordano, Sergio E. Hernandez-Da Mota, Tania N. Adabache-Guel, Armando Castillejos-Chevez, Sonia Corredor-Casas, Samantha M. Salinas-Longoria, Rafael Romero-Vera, Juan M. Jimenez-Sierra, Jose L. Guerrero-Naranjo, Virgilio Morales-Canton

  Abstract: (51087) HTML (939) PDF (594.71 KKB) (1484)

  Abstract:

  AIM: To determine whether different intravitreal doses of quinupristin/dalfopristin lead to electroretinographic or histological changes in the rabbit retina over one month period after injection. METHODS: Eighteen New Zealand white rabbits were divided into three treatment groups (groups 1 to 3) and different intravitreal doses of quinupristin/dalfopristin were tested in each group. The right eye was injected with the drug and the left eye received intravitreal injection of 5% dextrose water and served as control eye. The doses delivered to each group were 0.1 mg/0.1 mL, 1 mg/0.1 mL and 10 mg/0.1 mL. Simultaneous, bilateral, dark-adapted electroretinography and clinical images of both eyes were obtained in all groups before injection (baseline) and after 7, 14, 21 and 28d, followed by enucleation for histological examination. RESULTS: Subjects in the group 1 showed no signs of toxicity in the electroretinogram when compared with groups 2 and 3 (Kruskall-Wallis test, P=0.000). By day 7, no electrical response to light stimuli was recorded in the treated eyes in groups 2 and 3, consistent with severe damage due to retinal toxicity. Light microscopy revealed no significant histopathological changes in the group 1, while rabbits in groups 2 and 3 had signs of granulomatous inflammation in most cases. CONCLUSION: Intravitreal 0.1 mg/0.1 mL doses of quinupristin/dalfopristin do not lead to electroretinographic or histological signs of retinal toxicity compared with 1 mg/0.1 mL and 10 mg/0.1 mL in this rabbit model.

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• Ocular manifestation and their associated factors among HIV/AIDS patients receiving highly active antiretroviral therapy in Southern Ethiopia

  Anteneh Amsalu, Kindie Desta, Demiss Nigussie, Demoze Delelegne

  Abstract: (50622) HTML (967) PDF (338.44 KKB) (1479)

  Abstract:

  AIM: To assess the pattern of ocular manifestation and associated factors among human immunodeficiency virus (HIV) /acquired immunodeficiency syndrome (AIDS) patients on highly active antiretroviral therapy (HAART) at Hawassa University Referral Hospital, Southern Ethiopia. METHODS: A cross sectional study was conducted from January 2014 to April 2015. After obtaining informed written consent, 240 adult HIV/AIDS patients on HAART were randomly selected regardless of their ophthalmic symptoms, WHO status or CD4 count. Data were collected using structured questionnaires and ophthalmologic clinical examination. Data were entered and analyzed using SPSS version 20.0 software. RESULTS: The mean duration of HAART was 62.5mo. The prevalence of HIV related ocular manifestation was 14.2%. Seborrheic blepharitis (5%) was the most common ocular manifestation, followed by squamoid conjunctival growth (3.8%). The rate of ocular manifestation was significantly higher among study participants who had CD4+ count <200 cells/μL (AOR=3.83; 95%CI: 1.315-11.153), low duration of HAART (AOR=3.0; 95%CI: 1.305-6.891) and who had primary school education [odds ratio (OR) =2.8; 95%CI: 1.105-7.099]. Prevalence of visual impairment and blindness was 10.9% and 5.8%, respectively. CONCLUSION: HAART may be the reason for the decline in the prevalence of ocular manifestation in HIV/AIDS patients in the study area. Ophthalmologic screening of HIV/AIDS patients, especially those with CD4 counts of <200/μL cells and in the first five years of HAART follow-up is recommended to reduce visual impairment and/or blindness.

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• Research progress about the effect and prevention of blue light on eyes

  Zhi-Chun Zhao, Ying Zhou, Gang Tan, Juan Li

  Abstract: (14525) HTML (1044) PDF (290.71 KKB) (3765)

  Abstract:

  In recent years, people have become increasingly attentive to light pollution influences on their eyes. In the visible spectrum, short-wave blue light with wavelength between 415 nm and 455 nm is closely related to eye light damage. This high energy blue light passes through the cornea and lens to the retina causing diseases such as dry eye, cataract, age-related macular degeneration, even stimulating the brain, inhibiting melatonin secretion, and enhancing adrenocortical hormone production, which will destroy the hormonal balance and directly affect sleep quality. Therefore, the effect of Blu-rays on ocular is becoming an important concern for the future. We describe blue light’s effects on eye tissues, summarize the research on eye injury and its physical prevention and medical treatment.

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• Proteomic analysis of anti-angiogenic effects by conbercept in the mice with oxygen induced retinopathy

  Ji Jin, Lei Chen, Gao-Qin Liu, Pei-Rong Lu

  Abstract: (10596) HTML (0) PDF (2.76 MKB) (1445)

  Abstract:

  AIM: To analyze the retinal proteomes with and without conbercept treatments in mice with oxygen-induced retinopathy (OIR) and identify proteins involved in the molecular mechanisms mediated by conbercept. METHODS: OIR was induced in fifty-six C57BL/6J mouse pups and randomly divided into four groups. Group 1: Normal17 (n=7), mice without OIR and treated with normal air. Group 2: OIR12/EXP1 (n=14), mice received 75% oxygen from postnatal day (P) 7 to 12. Group 3: OIR17/Control (n=14), mice received 75% oxygen from P7 to P12 and then normal air to P17. Group 4: Lang17/EXP2 (n=21), mice received 75% oxygen from P7 to P12 with intravitreal injection of 1 μL conbercept at the concentration of 10 mg/mL at P12, and then normal air from P12 to P17. Liquid Chromatography-Mass Spectrometry (LC-MS)/MS data were reviewed to find proteins that were up-regulated after the conbercept treatment. Gene ontology (GO) analysis was performed of conbercept-mediated changes in proteins involved in single-organism processes, biological regulation, cellular processes, immune responses, metabolic processes, locomotion and multiple-organism processes. RESULTS: Conbercept induced a reversal of hypoxia-inducible factor 1 signaling pathway as revealed by the Kyoto Encyclopedia of Genes and Genomes (KEGG) analysis and also induced down-regulation of proteins involved in blood coagulation and fibrin clot formation as demonstrated by the Database for Annotation, Visualization and Integrated Discovery (DAVID) and the stimulation of interferon genes studies. These appear to be risk factors of retinal fibrosis. Additional conbercept-specific fibrosis risk factors were also identified and may serve as therapeutic targets for fibrosis. CONCLUSION: Our studies reveal that many novel proteins are differentially regulated by conbercept. The new insights may warrant a valuable resource for conbercept treatment.

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• Achromatopsia caused by novel missense mutations in the CNGA3 gene

  Xi-Teng Chen, Hui Huang, Yan-Hua Chen, Li-Jie Dong, Xiao-Rong Li, Xiao-Min Zhang

  Abstract: (9623) HTML (0) PDF (771.47 KKB) (1506)

  Abstract:

  AIM:To identify the genetic defects in a Chinese family with achromatopsia.METHODS:A 2.5-year-old boy, who displayed nystagmus, photophobia, and hyperopia since early infancy, was clinically evaluated. To further confirm and localize the causative mutations in this family, targeted region capture and next-generation sequencing of candidate genes, such as CNGA3, CNGB3, GNAT2, PDE6C, and PDE6H were performed using a custom-made capture array.RESULTS:Slit-lamp examination showed no specific findings in the anterior segments. The optic discs and maculae were normal on fundoscopy. The unaffected family members reported no ocular complaints. Clinical signs and symptoms were consistent with a clinical impression of autosomal recessive achromatopsia. The results of sequence analysis revealed two novel missense mutations in CNGA3, c.633T>A (p.D211E) and c.1006G>T (p.V336F), with an autosomal recessive mode of inheritance.CONCLUSION: Genetic analysis of a Chinese family confirmed the clinical diagnosis of achromatopsia. Two novel mutations were identified in CNGA3, which extended the mutation spectrum of this disorder.

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• Tests for malingering in ophthalmology

  Ali Ihsan Incesu

  Abstract: (9267) HTML (0) PDF (281.98 KKB) (2071)

  Abstract:

  Simulation can be defined as malingering, or sometimes functional visual loss (FVL). It manifests as either simulating an ophthalmic disease (positive simulation), or denial of ophthalmic disease (negative simulation). Conscious behavior and compensation or indemnity claims are prominent features of simulation. Since some authors suggest that this is a manifestation of underlying psychopathology, even conversion is included in this context. In today’s world, every ophthalmologist can face with simulation of ophthalmic disease or disorder. In case of simulation suspect, the physician’s responsibility is to prove the simulation considering the disease/disorder first, and simulation as an exclusion. In simulation examinations, the physician should be firm and smart to select appropriate test(s) to convince not only the subject, but also the judge in case of indemnity or compensation trials. Almost all ophthalmic sensory and motor functions including visual acuity, visual field, color vision and night vision can be the subject of simulation. Examiner must be skillful in selecting the most appropriate test. Apart from those in the literature, we included all kinds of simulation in ophthalmology. In addition, simulation examination techniques, such as, use of optical coherence tomography, frequency doubling perimetry (FDP), and modified polarization tests were also included. In this review, we made a thorough literature search, and added our experiences to give the readers up-to-date information on malingering or simulation in ophthalmology.

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• Therapeutic effects of mesenchymal stem cells administered at later phase of recurrent experimental autoimmune uveitis

  Ping-Ting Zhao, Ling-Jun Zhang, Hui Shao, Ling-Ling Bai, Bo Yu, Chang Su, Li-Jie Dong, Xun Liu, Xiao-Rong Li, Xiao-Min Zhang

  Abstract: (8880) HTML (0) PDF (2.01 MKB) (1499)

  Abstract:

  AIM: To test the therapeutic effects of delayed treatment of mesenchymal stem cells (MSCs) in recurrent experimental autoimmune uveitis (rEAU). METHODS: The efficacy of different regimens of MSC administration in rEAU were tested by evaluation of clinical and pathological intraocular inflammation, as well as retinal structural and functional integrity using optical coherence tomography (OCT) and electroretinogram (ERG). The retinal sections were also immunostained with antibodies to glial fibrillary acidic protein (GFAP) and rhodopsin (RHO). RESULTS: Delayed treatment of MSCs effectively alleviated the severity of intraocular inflammation with relative intact of outer retinal structure and function. Moreover, double therapies with longer interval led to an even better clinical evaluation, as well as a trend of decrease in relapse and amelioration of retinal function. MSC therapies also effectively reduced GFAP expression and increased RHO expression in the retina. CONCLUSION: MSC administration can effectively treat developed diseases of rEAU, and multiple therapies can provide additional therapeutic benefits.

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• Rapamycin ameliorates experimental autoimmune uveoretinitis by inhibiting Th1/Th2/Th17 cells and upregulating CD4+CD25+ Foxp3 regulatory T cells

  Li-Fei Yuan, Guang-Da Li, Xin-Jun Ren, Hong Nian, Xiao-Rong Li, Xiao-Min Zhang

  Abstract: (8154) HTML (0) PDF (871.51 KKB) (1449)

  Abstract:

  AIM:To determine the effects of rapamycin on experimental autoimmune uveoretinitis (EAU) and investigate of role of rapamycin on T cell subsets in the disease. METHODS:EAU was induced in rats using peptides 1169 to 1191 of the interphotoreceptor binding protein (IRBP). Rapamycin (0.2 mg/kg/d) was administrated by intraperitoneal injection for a consecutive 7d after immunization. Th1/Th2/Th17 cytokines, TGF-β1, and IL-6 produced by lymphocyteswere measured by ELISA, while Th17 cells and CD4+CD25+ regulatory T cells (Tregs) from rat spleen were detected by flow cytometry. RESULTS: Intraperitoneal treatment immediately after immunization dramatically ameliorated the clinical course of EAU. Clinical responses were associated with reduced retinal inflammatory cell infiltration and tissue destruction. Rapamycin induced suppression of Th1/Th2/Th17 cytokines, including IFN-γ, IL-2, IL-17, IL-4, and IL-10 release from T lymphocytes of EAU rats, in vitro. Rapamycin also significantly increased TGF-β1 production but had no effect on IL-6 productionof T lymphocytes from EAU rats in vitro. Furthermore, rapamycin decreased the ratio of Th17 cells/CD4+T cells and upregulated Tregs in EAU, as detected by flow cytometry. CONCLUSION: Rapamycin effectively interferes with T cell mediated autoimmune uveitis by inhibiting antigen-specific T cell functions and enhancing Tregs in EAU. Rapamycin is a promising new alternative as an adjunct corticosteroid-sparing agent for treating uveitis.

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• Superglue injuries of the eye

  Sagili Chandrasekhara Reddy

  Abstract: (8071) HTML (0) PDF (669.75 KKB) (2048)

  Abstract:

  AIM: To report various ocular lesions caused by accidental instillation of superglue.METHODS: Three cases of ocular injuries are described in children aged 6 years, 3 years and 8 months, following accidental instillation of superglue in the eye.RESULTS: In the first case there was sticking of eyelashes in the medial 1/3 of eyelids in both eyes. In the second case sticking of eye lashes was present in the lateral 1/3 of eyelids in the left eye. In the third case, superglue was present on the right cheek, above the right ear and sticking of eyelids in medial 1/3 in right eye. The eyelids were separated by pulling the lid margins with fingers in the first case and later on superglue was removed by trimming the eyelashes; and by direct trimming the eyelashes in second and third cases. There was no injury to other structures of anterior segment in the first two cases. However, removal of the superglue on the cornea resulted in corneal abrasion in the third case which healed with medical treatment and patching of the right eye.CONCLUSION: Accidental instillation of superglue is possible because of the appearance of the tube like eye ointment tube. Immediate medical aid will prevent ocular morbidity.

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• A near-vision chart for children aged 3-5 years old:new designs and clinical applications

  Yang-Qing Huang, He Huang, Rong-Zhi Huang

  Abstract: (7018) HTML (0) PDF (963.79 KKB) (1697)

  Abstract:

  AIM:To introduce a new near-vision chart for children aged 3-5 years old and its clinical applications.METHODS:The new near-vision chart which combined the Bailey-Lovie layout with a newly devised set of symmetry symbols was designed based on Weber-Fechner law. It consists of 15 rows of symmetry symbols, corresponding to a visual acuity range from 1.3 to 0.1 logMAR. The optotypes were red against a white background and were specially shaped four basic geometric symbols:circle, square, triangle，and cross, which matched the preschool children''s cognitive level. A regular geometric progression of the optotype sizes and distribution was employed to arrange in 15 lines. The progression rate of the optotype size between two lines was 1.2589 and two smaller groups of optotypes ranging from 0.7 to -0.1 logMAR were included for repetitive testing. A near visual acuity was recorded in logMAR or decimal, and the testing distance was 25 cm.RESULTS:This new near-vision chart with pediatric acuity test optotypes which consists of 4 different symbols (triangle, square, cross, and circle) met the national and international eye chart design guidelines. When performing the near visual acuity assessment in preschoolers (3-5 years old). It overcame an inability to recognize the letters of the alphabet and difficulties in designating the direction of black abstract symbols such as the tumbling ''E'' or Landolt ''C'', which the subjects were prone to lose interest in. Near vision may be recorded in different notations:decimal acuity and logMAR. These two notations can be easily converted each other in the new near-vision chart. The measurements of this new chart not only showed a significant correlation and a good consistency with the Chinese national standard logarithmic near-vision chart (r=0.932, P<0.01), but also indicated good test-retest reliability (89% of retest scores were within 0.1 logMAR units of the initial test score) and a high response rate.CONCLUSION:The results of this study support the validity and reliability of near visual acuity measurements using the new near-vision chart in children aged 3-5y over a wide range of visual acuities, and the new eye chart was especially suitable for the detection of amblyopia risk factors and low vision examination in children (3-5y of age). It can be applied in routine clinical practice.

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• Malingering or simulation in ophthalmology-visual acuity

  Ali Ihsan Incesu, Güng?r Sobac?

  Abstract: (6642) HTML (0) PDF (320.40 KKB) (1792)

  Abstract:

  Simulation can be defined as malingering, or sometimes functional visual loss (FVL). It manifests as either simulating an ophthalmic disease (positive simulation), or denial of ophthalmic disease (negative simulation). Conscious behavior and compensation or indemnity claims are prominent features of simulation. Since some authors suggest that this is a manifestation of underlying psychopathology, even conversion is included in this context. In today's world, every ophthalmologist can face with simulation of ophthalmic disease or disorder. In case of simulation suspect, the physician's responsibility is to prove the simulation considering the disease/disorder first, and simulation as an exclusion. In simulation examinations, the physician should be firm and smart to select appropriate test(s) to convince not only the subject, but also the judge in case of indemnity or compensation trials. Almost all ophthalmic sensory and motor functions including visual acuity, visual field, color vision and night vision can be the subject of simulation. Examiner must be skillful in selecting the most appropriate test. Apart from those in the literature, we included all kinds of simulation in ophthalmology. In addition, simulation examination techniques, such as, use of OCT (optical coherence tomography), frequency doubling perimetry (FDP), and modified polarization tests were also included. In this review, we made a thorough literature search, and added our experiences to give the readers up-to-date information on malingering or simulation in ophthalmology.

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• Prevalence of vitreous floaters in a community sample of smartphone users

  Blake F. Webb, Jadon R. Webb, Mary C. Schroeder, Carol S. North

  Abstract: (6518) HTML (0) PDF (202.26 KKB) (1881)

  Abstract:

  AIM: To estimate the prevalence and risk factors for vitreous floaters in the general population.METHODS: An electronic survey was administered through a smartphone app asking various demographic and health questions, including whether users experience floaters in their field of vision. Multivariate logistic regression analysis was used to determine risk factors.RESULTS:A total of 603 individuals completed the survey, with 76% reporting that they see floaters, and 33% reporting that floaters caused noticeable impairment in vision. Myopes were 3.5 times more likely (P=0.0004), and hyperopes 4.4 times more likely (P=0.0069) to report moderate to severe floaters compared to those with normal vision. Floater prevalence was not significantly affected by respondent age, race, gender, and eye color.CONCLUSION:Vitreous floaters were found to be a very common phenomenon in this non-clinical general population sample, and more likely to be impairing in myopes and hyperopes.

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• Comparison of fibrin glue and suture technique in pterygium surgery performed with limbal autograft

  Bora Yüksel, Sultan Kaya ünsal, Sevgi Onat

  Abstract: (6412) HTML (0) PDF (165.03 KKB) (1816)

  Abstract:

  AIM: To compare the efficiency and safety of fibrin glue to suture technique in pterygium surgery performed with limbal autograft. METHODS: A prospective randomised clinical trial was carried out in 58 eyes of 58 patients operated for primary nasal pterygium. Autologous conjunctival graft taken from the superotemporal limbus was used to cover the sclera after pterygium excision. In 29 eyes, the transplant was attached to the sclera with a fibrin tissue adhesive (Beriplast P) and in 29 eyes with 8-0 Virgin silk sutures. The Mann-Whitney U test was used for statistical analysis. Postoperative patient discomfort (pain, stinging, watering) and biomicroscopic findings (hyperemia, edema) were graded. Patients were followed up at least for six months. RESULTS: Subconjunctival hemorrhage occured under the graft in one patient in group 1. In seven cases of group 2, sutures were removed at the 15th day because of granulomatous tissue reaction. Patient symptoms were significantly less and biomicroscopic findings were better in group 1. Pterygium recurrence was seen in one case of group 1, and 2 cases of group 2. Average surgery cost was higher (P<0.05) and surgery time was shorter (P<0.05) in fibrin group. CONCLUSION: Using fibrin glue for graft fixation in pterygium surgery causes significantly less postoperative pain and shortens surgery time significantly.

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• Photobiomodulation for the treatment of retinal diseases: a review

  Ivayla I. Geneva

  Abstract: (6395) HTML (0) PDF (331.95 KKB) (2124)

  Abstract:

  Photobiomodulation (PBM), also known as low level laser therapy, has recently risen to the attention of the ophthalmology community as a promising new approach to treat a variety of retinal conditions including age-related macular degeneration, retinopathy of prematurity, diabetic retinopathy, Leber’s hereditary optic neuropathy, amblyopia, methanol-induced retinal damage, and possibly others. This review evaluates the existing research pertaining to PBM applications in the retina, with a focus on the mechanisms of action and clinical outcomes. All available literature until April 2015 was reviewed using PubMed and the following keywords: “photobiomodulation AND retina”, “low level light therapy AND retina”, “low level laser therapy AND retina”, and “FR/NIR therapy AND retina”. In addition, the relevant references listed within the papers identified through PubMed were incorporated. The literature supports the conclusion that the low-cost and non-invasive nature of PBM, coupled with the first promising clinical reports and the numerous preclinical-studies in animal models, make PBM well-poised to become an important player in the treatment of a wide range of retinal disorders. Nevertheless, large-scale clinical trials will be necessary to establish the PBM therapeutic ranges for the various retinal diseases, as well as to gain a deeper understanding of its mechanisms of action.

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• Cod liver oil: a potential protective supplement for human glaucoma

  Wen-Bin Huang, Qian Fan, Xiu-Lan Zhang

  Abstract: (6280) HTML (0) PDF (246.01 KKB) (1688)

  Abstract:

  Glaucoma is one of the leading causes of visual impairment and blindness. Improved knowledge of the pathogenesis of this disease has allowed the exploration of new therapeutic methods. In general, elevated intraocular pressure (IOP), oxidative stress, and vascular insufficiency are accepted as the major risk factors for the progression of glaucoma. Many natural compounds have been found beneficial for glaucoma. Nutritional therapies are now emerging as potentially effective in glaucomatous therapy. One nutritional supplement with potential therapeutic value is cod liver oil, a dietary supplement that contains vitamin A and omega-3 polyunsaturated fatty acids (PUFAs). Vitamin A is important for preserving normal vision and it is a well-known antioxidant that prevents the oxidative damage that contributes to the etiology and progression of glaucoma. Vitamin A is also a crucial factor for maintaining the integrity of conjunctival and corneal ocular surfaces, and preventing the impairment of ocular epithelium caused by topical antiglaucomatous drugs. Omega-3 fatty acids are beneficial for glaucoma patients as they decrease IOP, increase ocular blood flow, and improve optic neuroprotective function. In this article, we propose that cod liver oil, as a combination of vitamin A and omega-3 fatty acids, should be beneficial for the treatment of glaucoma. However, further studies are needed to explore the relationship between cod liver oil and glaucoma.

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• Epidemiology and molecular genetics of congenital cataracts

  Jun Yi, Jun Yun, Zhi-Kui Li, Chang-Tai Xu, Bo-Rong Pan

  Abstract: (6140) HTML (0) PDF (570.98 KKB) (2071)

  Abstract:

  · Congenital cataract is a crystallin severe blinding disease and genetic factors in disease development are important. Crystallin growth is under a combination of genes and their products in time and space to complete the coordination role of the guidance. Congenital cataract-related genes, included crystallin protein gene (CRYAA, CRYAB, CRYBA1/A3, CRYBA4, CRYBB1, CRYBB2, CRYBB3, CRYGC, CRYGD, CRYGS), gap junction channel protein gene (GJA1, GJA3, GJA8), membrane protein gene (GJA3, GJA8, MIP, LIM2), cytoskeletal protein gene (BF-SP2), transcription factor genes (HSF4, MAF, PITX3, PAX6), ferritin light chain gene (FTL), fibroblast growth factor (FGF) and so on. Currently, there are about 39 genetic loci isolated to which primary cataracts have been mapped, although the number is constantly increasing and depends to some extent on definition. We summarized the recent advances on epidemiology and genetic locations of congenital cataract in this review.

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• Aniridia rings implantation for treatment of congenital aniridia combined with cataract surgery: a case report

  Juan-Juan Li, Yun-Peng Li, Zhu-Lin Hu

  Abstract: (5905) HTML (0) PDF (87.46 KKB) (1782)

  Abstract:

  We describe the successful treatment in a patient with bilateral congenital aniridia and cataract by insertion of capsular tension rings and IOL.

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• Prevention of exposure keratopathy in intensive care unit

  Hua Shan, Du Min

  Abstract: (5877) HTML (0) PDF (107.88 KKB) (1730)

  Abstract:

  AIM: To compare the efficacy for preventing exposure keratopathy of three forms of eye care (artificial tear, moist chamber and polyethylene covers) for intensive care patients. METHODS: Eighty-four patients in Intensive Care Unit (ICU) were randomized to three treatment groups, including artificial tears group, moist chambers group and polyethylene film group. Patients of artificial tear group received two drops of carboxymethylcellulose drops to each eye every 2 hours. The moist chambers and the polyethylene were changed every 12 hours or as needed if they became unclean or torn. The corneal fluorescein stains were performed daily. RESULTS: No of 28 patients (0%) in the polyethylene group and one of the 27 patients (3.70%) in the moist chamber group had exposure keratopathy, compared to 8 of the 29 patients (27.59%) in the artificial tear group. There were statistical significance between the artificial tear group and the moist chamber group (P=0.02), and the artificial tear group and the polyethylene group (P =0.003). The time on eye care every day of the artificial tear group, the moist chamber group and the polyethylene group was 26.69±2.39 minutes, 35.33±2.63 minutes and 7.48±0.87 minutes, respectively. The eye care of the polyethylene group were statistically more time-save than that of the artificial tear group (P<0.001) and the moist chamber group (P<0.001). CONCLUSION: Polyethylene covers are more effective and more time-saving in reducing the incidence of corneal damage in intensive care patients

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