Analysis of the correlation between imaging features and disease severity in IgG4-related ophthalmic disease

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Objective: This study aims to investigate the correlation between the imaging characteristics of patients with IgG4-related ophthalmic disease (IgG4-ROD) and the serum immunoglobulin G4 (IgG4) levels, providing new insights for assessing the systemic severity of IgG4-related diseases. Methods We collected postoperative tissue samples from 29 patients with histopathologically confirmed IgG4-ROD at the Ophthalmology Department of Jilin University Second Hospital from August 2023 to September 2024. We retrospectively analyzed the correlation between patients' orbital imaging features and serum IgG4 levels, and explored the proportion of characteristic imaging changes including enlargement of the lacrimal gland, thickening of the trigeminal nerve branches, thickening of the extraocular muscles, inflammatory-like changes of the nasal mucous membranes, hypertrophy of the eyelid soft tissues, as well as hyperplasia of other intraorbital soft tissues in the imaging. A grading score for affected tissue structures was established to evaluate the correlation between characteristic imaging changes and serum IgG4 levels. Results Among the 29 patients diagnosed with IgG4-ROD, lacrimal gland involvement was observed in all patients (100%). Extraocular muscle involvement was present in 17 patients (58.62%). Five patients had involvement of the trigeminal nerve branches (including 4 with infraorbital nerve involvement and 3 with frontal nerve involvement, with 2 patients having simultaneous involvement of both nerves), accounting for 17.24% of the cases. Eyelid soft tissue hypertrophy was observed in 24 patients (82.76%), and nasal mucosal inflammatory responses were noted in 15 patients (51.72%). Additionally, two patients (6.90%) presented with other proliferative lesions within the orbit. The correlation analysis between the grading scores for imaging features and serum IgG4 levels demonstrated a significant positive correlation. Conclusion The extent of characteristic structural involvement observed in the imaging features of IgG4-related ophthalmic disease is significantly correlated with serum IgG4 levels. This correlation can assist in evaluating the systemic severity of IgG4-related diseases and provides clinical evidence supporting the need for comprehensive systemic evaluations, such as PET-CT, in patients whose initial presentation is IgG4-related ophthalmic disease.

Analysis of the correlation between imaging features and disease severity in IgG4-related ophthalmic disease

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Objective: This study aims to investigate the correlation between the imaging characteristics of patients with IgG4-related ophthalmic disease (IgG4-ROD) and the serum immunoglobulin G4 (IgG4) levels, providing new insights for assessing the systemic severity of IgG4-related diseases. Methods We collected postoperative tissue samples from 29 patients with histopathologically confirmed IgG4-ROD at the Ophthalmology Department of Jilin University Second Hospital from August 2023 to September 2024. We retrospectively analyzed the correlation between patients' orbital imaging features and serum IgG4 levels, and explored the proportion of characteristic imaging changes including enlargement of the lacrimal gland, thickening of the trigeminal nerve branches, thickening of the extraocular muscles, inflammatory-like changes of the nasal mucous membranes, hypertrophy of the eyelid soft tissues, as well as hyperplasia of other intraorbital soft tissues in the imaging. A grading score for affected tissue structures was established to evaluate the correlation between characteristic imaging changes and serum IgG4 levels. Results Among the 29 patients diagnosed with IgG4-ROD, lacrimal gland involvement was observed in all patients (100%). Extraocular muscle involvement was present in 17 patients (58.62%). Five patients had involvement of the trigeminal nerve branches (including 4 with infraorbital nerve involvement and 3 with frontal nerve involvement, with 2 patients having simultaneous involvement of both nerves), accounting for 17.24% of the cases. Eyelid soft tissue hypertrophy was observed in 24 patients (82.76%), and nasal mucosal inflammatory responses were noted in 15 patients (51.72%). Additionally, two patients (6.90%) presented with other proliferative lesions within the orbit. The correlation analysis between the grading scores for imaging features and serum IgG4 levels demonstrated a significant positive correlation. Conclusion The extent of characteristic structural involvement observed in the imaging features of IgG4-related ophthalmic disease is significantly correlated with serum IgG4 levels. This correlation can assist in evaluating the systemic severity of IgG4-related diseases and provides clinical evidence supporting the need for comprehensive systemic evaluations, such as PET-CT, in patients whose initial presentation is IgG4-related ophthalmic disease.

Application of Artificial Intelligence in the Diagnosis and Treatment of Lacrimal Disorders: Challenges and Opportunities

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Lacrimal disorders are a common ophthalmic disease characterized by a complex diagnosis and treatment process, involving intricate treatment methods and multiple clinical and image data. Previous studies have indicated that artificial intelligence (AI), particularly in the fields of machine learning and deep learning, has significant potential for application in the diagnosis and treatment of lacrimal disorders. However, the application of AI in this filed still faces numerous challenges, including the intricacies of multimodal data integration, constraints in model generalisation capabilities, the necessity for real-time predictions and adaptive adjustments, and the challenges associated with clinical validation. These issues require further research and resolution. This paper summarizes the current status and challenges of AI applications in the diagnosis and treatment of lacrimal disorders, explores emerging technologies and strategies, and proposes future development directions, with a special emphasis on the importance of integrating AI with emerging technologies. Through forward-looking analysis and discussion, this paper aims to provide valuable references for future research and clinical practice. We call for intensified research in these critical areas to promote the development and application of AI in the field of lacrimal disorder diagnosis and treatment.

IgG4-ROD Viewed through a Molecular Perspective: from Autoimmunity to Fibrosis

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Immunoglobulin G4-related ophthalmic disease (IgG4-ROD) is a systemic condition characterized by the infiltration of IgG4-positive plasma cells and elevated serum IgG4 levels. The ocular manifestations of this disease can involve the lacrimal gland, orbital fat, infraorbital nerves, extraocular muscles, and eyelids, often accompanied by inflammatory and fibrotic processes. At the molecular level, IgG4-ROD is associated with the interaction of various immune cells and cytokines, including Th1, Th2, Treg, and Tfh cells, as well as the cytokines IL-4, IL-13, and TGF-β. These molecules collectively contribute to the pathogenesis of IgG4-ROD by promoting B cell activation and IgG4 production, as well as facilitating the development of fibrosis. Diagnosis is primarily based on histopathological features, while treatment typically involves glucocorticoids and immunosuppressive agents aimed at controlling immune-mediated inflammation and fibrosis, alleviating symptoms, and preventing organ damage. As our understanding of the molecular pathogenesis of IgG4-ROD deepens, treatment strategies are expected to be continuously refined to offer patients more precise and effective therapeutic options. This article summarizes and elucidates the key molecules and signaling pathways implicated in the pathogenesis of IgG4-related eye diseases, and reviews the interplay between autoimmunity and fibrosis, as well as their transformations, from a molecular perspective.

IgG4-ROD Viewed through a Molecular Perspective: from Autoimmunity to Fibrosis

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Immunoglobulin G4-related ophthalmic disease (IgG4-ROD) is a systemic condition characterized by the infiltration of IgG4-positive plasma cells and elevated serum IgG4 levels. The ocular manifestations of this disease can involve the lacrimal gland, orbital fat, infraorbital nerves, extraocular muscles, and eyelids, often accompanied by inflammatory and fibrotic processes. At the molecular level, IgG4-ROD is associated with the interaction of various immune cells and cytokines, including Th1, Th2, Treg, and Tfh cells, as well as the cytokines IL-4, IL-13, and TGF-β. These molecules collectively contribute to the pathogenesis of IgG4-ROD by promoting B cell activation and IgG4 production, as well as facilitating the development of fibrosis. Diagnosis is primarily based on histopathological features, while treatment typically involves glucocorticoids and immunosuppressive agents aimed at controlling immune-mediated inflammation and fibrosis, alleviating symptoms, and preventing organ damage. As our understanding of the molecular pathogenesis of IgG4-ROD deepens, treatment strategies are expected to be continuously refined to offer patients more precise and effective therapeutic options. This article summarizes and elucidates the key molecules and signaling pathways implicated in the pathogenesis of IgG4-related eye diseases, and reviews the interplay between autoimmunity and fibrosis, as well as their transformations, from a molecular perspective.

IgG4-ROD Viewed through a Molecular Perspective: from Autoimmunity to Fibrosis

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Immunoglobulin G4-related ophthalmic disease (IgG4-ROD) is a systemic condition characterized by the infiltration of IgG4-positive plasma cells and elevated serum IgG4 levels. The ocular manifestations of this disease can involve the lacrimal gland, orbital fat, infraorbital nerves, extraocular muscles, and eyelids, often accompanied by inflammatory and fibrotic processes. At the molecular level, IgG4-ROD is associated with the interaction of various immune cells and cytokines, including Th1, Th2, Treg, and Tfh cells, as well as the cytokines IL-4, IL-13, and TGF-β. These molecules collectively contribute to the pathogenesis of IgG4-ROD by promoting B cell activation and IgG4 production, as well as facilitating the development of fibrosis. Diagnosis is primarily based on histopathological features, while treatment typically involves glucocorticoids and immunosuppressive agents aimed at controlling immune-mediated inflammation and fibrosis, alleviating symptoms, and preventing organ damage. As our understanding of the molecular pathogenesis of IgG4-ROD deepens, treatment strategies are expected to be continuously refined to offer patients more precise and effective therapeutic options. This article summarizes and elucidates the key molecules and signaling pathways implicated in the pathogenesis of IgG4-related eye diseases, and reviews the interplay between autoimmunity and fibrosis, as well as their transformations, from a molecular perspective.

IgG4-ROD Viewed through a Molecular Perspective: from Autoimmunity to Fibrosis

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Immunoglobulin G4-related ophthalmic disease (IgG4-ROD) is a systemic condition characterized by the infiltration of IgG4-positive plasma cells and elevated serum IgG4 levels. The ocular manifestations of this disease can involve the lacrimal gland, orbital fat, infraorbital nerves, extraocular muscles, and eyelids, often accompanied by inflammatory and fibrotic processes. At the molecular level, IgG4-ROD is associated with the interaction of various immune cells and cytokines, including Th1, Th2, Treg, and Tfh cells, as well as the cytokines IL-4, IL-13, and TGF-β. These molecules collectively contribute to the pathogenesis of IgG4-ROD by promoting B cell activation and IgG4 production, as well as facilitating the development of fibrosis. Diagnosis is primarily based on histopathological features, while treatment typically involves glucocorticoids and immunosuppressive agents aimed at controlling immune-mediated inflammation and fibrosis, alleviating symptoms, and preventing organ damage. As our understanding of the molecular pathogenesis of IgG4-ROD deepens, treatment strategies are expected to be continuously refined to offer patients more precise and effective therapeutic options. This article summarizes and elucidates the key molecules and signaling pathways implicated in the pathogenesis of IgG4-related eye diseases, and reviews the interplay between autoimmunity and fibrosis, as well as their transformations, from a molecular perspective.

Efficacy of Low-Level Red Light Therapy in Children and Adolescents with Low to Moderate Myopia

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Purpose: This study aimed to evaluate the therapeutic effects of Low-Level Red Light (LLRL) treatment on children and adolescents with low to moderate myopia. Methods: A total of 100 children and adolescents under the age of 15 with low to moderate myopia were included in the study. Only the right eye of each subject was analyzed. Participants were randomly assigned to a control group (Orthokeratology lens, Ortho-K) and a treatment group (Repeated Low Intensity Single Wavelength Red Light Therapy, RLRL). The treatment group received 650 nm low-intensity single-wavelength red light therapy combined with refractive correction, while the control group wore Ortho-K lenses only at night. All subjects maintained normal daily life and study habits during the study period, with assessments conducted at baseline and 1, 3, 6, and 12 months after treatment. Best-corrected visual acuity (BCVA), spherical equivalent refraction (SE), axial length (AL), and choroidal thickness (CT) were measured at each follow-up. Results: BCVA in the treatment group showed significant improvement at 6 and 12 months after the intervention compared to baseline (P < 0.05). The SE and AL in the treatment group increased significantly less at 6 and 12 months compared to both baseline and the control group (P < 0.05). Furthermore, the change in choroidal thickness in the treatment group was significantly greater at 6 and 12 months than at baseline and compared to the control group (P < 0.05). Conclusion: Low-Level Red Light therapy is a safe and effective method for improving vision, inhibiting the progression of myopia, and controlling axial length elongation in children and adolescents with low to moderate myopia.
Original Article

Application of Plan-Do-Check-Action cycle and fishbone diagram analysis in optimizing surgical procedures to improve satisfaction degree of doctor-nurse-patient

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Background: To study the application of management tools such as Plan-Do-Check-Action (PDCA) cycle and fishbone diagram in optimizing surgical procedures to improve the satisfaction of doctor-nurse-patient.

Methods: The fundus surgery nursing team of our hospital began to implement the PDCA cycle management mode to optimize the surgical procedure from July 2017, set up a project activity improvement team, unified the surgical labeling processing plan, and made the fundus surgery procedure, and established the preoperative health education for surgical patients, and standardized the training content of post-rotating doctors and interns.

Results: The satisfaction degree to surgical procedure after implementation of doctors and nurses was higher than that before implementation.

Conclusions: Using PDCA cycle and fishbone diagram analysis tools to manage the surgical procedure optimization can better integrate doctor-nurse medical care, improve the efficiency and accuracy of the surgical procedure delivery and operation, and optimize the satisfaction of the three parties of doctor-nurse-patient.

Original Article
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  • 眼科学报

    主管:中华人民共和国教育部
    主办:中山大学
    承办:中山大学中山眼科中心
    主编:林浩添
    主管:中华人民共和国教育部
    主办:中山大学
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  • Eye Science

    主管:中华人民共和国教育部
    主办:中山大学
    承办:中山大学中山眼科中心
    主编:林浩添
    主管:中华人民共和国教育部
    主办:中山大学
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