Objective: To analyze the clinical manifestations, imaging characteristics, and treatment methods of secondary glaucoma associated with congenital ectropion uveae (CEU). Methods: Observational case series and literature review. A retrospective analysis was conducted on the electronic medical records of patients diagnosed with secondary glaucoma due to CEU at the Zhongshan Ophthalmic Center, Sun Yat-sen University, China. Data collected included demographics, visual acuity, intraocular pressure (IOP), slit-lamp examination, gonioscopy, ultrasound biomicroscopy (UBM), and surgical treatment methods. Postoperative IOP were also collected. A literature review was conducted to summarize the clinical characteristics and treatment outcomes of secondary glaucoma due to CEU. Results: Two male patients with secondary glaucoma due to CEU were included, aged 24 and 11 years, respectively. Both patients had a chronic course of disease affecting the right eye, with no systemic abnormalities. The best-corrected visual acuity was hand motion/40 cm to 0.16, and the average IOP at presentation was 37 mmHg, with an average central anterior chamber depth of 3.45 mm. Clinical examination revealed clear corneas, pupils measuring approximately 5-5.5 mm with brisk light reflexes, and nearly 360° of brownish ectropion of the uveae. The lenses were clear, and fundus examination showed glaucomatous optic disc cupping with a normal retina. In the 24-year-old patient, gonioscopy revealed a wide-open angle with trabecular meshwork pigmentation, while UBM indicated slight posterior bowing of the iris and angle closure at the 7 o'clock position. In the 11-year-old patient, both gonioscopy and UBM showed complete angle closure. Corneal endothelial microscopy was normal in both patients. Both were diagnosed with secondary glaucoma due to CEU in the right eye, with elevated IOP that was uncontrolled by maximal medications. The 24-year-old underwent trabeculectomy with intraoperative use of antimetabolites, while the 11-year-old received a drainage valve implantation with antimetabolites. No significant intraoperative or postoperative complications were observed, and IOP was well controlled over a six-month follow-up period. Conclusions: CEU is characterized by ectropion of the uveae and is frequently associated with secondary glaucoma, which may present as open-angle or angle-closure (goniodysgenesis) glaucoma. The effectiveness of IOP-lowering medications is limited, often necessitating surgical intervention. Given that secondary glaucoma due to CEU predominantly affects children and young adults, the use of antimetabolites during glaucoma surgery can yield favorable treatment outcomes.

Objective: with the intention of effective prevention and treatment for retinal vein occlusion (RVO), this meta-analysis was performed systematically, evaluating the risk factors of RVO in East Asia. Methods: PubMed, Web of Science, Cochrane Library, CNKI, Wanfang and VIP databases were searched for studies that reported risk factors of RVO in East Asia, published from the establishment of the database to May 2024. To further filter the articles, NOS evaluation method was utilized to assess the quality of selected articles. After valid data were extracted, Meta-analysis was performed by Review Manager software. Results: a total of 21 literatures were included, including 27561 cases in the RVO group (Case group) and 514578 cases in the NRVO group (Control group). Results of meta-analysis showed that chronic kidney disease [odds ratio (OR)=4.14, 95% confidence interval (CI): (1.86%, 9.24%)], hypertension [OR=4.11, 95% CI: (3.09%, 5.48%)], hyperlipidemia [OR=3.45, 95%CI: (2.32%, 5.12%)], diabetes mellitus [OR=3.00, 95%CI: (1.88%, 4.80%)], homocysteine [OR=0.87, 95%CI: (0.59%, 1.15%)], have statistically significant differences between the RVO group and the NRVO group(P<0.05). Conclusion: the occurrence of RVO is closely related to its risk factors, such as chronic kidney disease, hypertension, hyperlipidemia, diabetes mellitus and high homocysteine. In the process of diagnosis and treatment of RVO, doctors should focus on the above risk factors to prevent the occurrence of the disease.

Pathological myopia (pathologicalmyopia, PM) secondary choroid neovascularization (CNV choroidalneovascularization) a high incidence in the world, especially in Asia the crowd. Macular CNV is a common cause of irreversible central vision loss, which seriously affects the quality of life of patients with high myopia. Traditional treatments for PM-CNV include thermal laser photocoagulation, photodynamic therapy with Vitipofen, and surgery. However, the long-term prognosis for these treatments is disappointing. Over the past decade, anti-angiogenic therapy with anti-vascular endothelial growth factor (anti-VEGF) drugs has become the standard treatment for myopic CNV. The anti-VEGF regimen was more effective than the traditional regimen in improving vision. In this paper, the pathogenesis of myopic CNV was initially discussed, the molecular structure and mechanism of action of existing anti-VEGF drugs were described, and the efficacy and safety of different anti-VEGF drugs in the treatment of PM-CNV were systematically compared. The current status and progress of diagnosis and treatment of PM-CNV were reviewed.

Purpose: Artificial intelligence (AI) significantly enhances the screening and diagnostic processes for retinopathy of prematurity (ROP). In this article, we focused on the application and performance of AI in detecting ROP and distinguishing plus disease in ROP. Methods: We searched PubMed, Embase, Medline, Web of Science, and Ovid for studies published from January 2018 to July 2024. Studies evaluating the diagnostic performance of AI with expert ophthalmologists' judgment as a reference standard were included. The risk of bias was assessed using the QUADAS-2 tool. Statistical analysis included data pooling, forest plot construction, heterogeneity testing, and meta-regression. Results: Fourteen of the 186 studies were included. The pooled sensitivity, specificity and the area under the curve (AUC) of the AI diagnosing ROP were 0.95 (95% CI 0.93-0.96), 0.97 (95% CI 0.94-0.98) and 0.97 (95% CI 0.95-0.98), respectively. The pooled sensitivity, specificity and the AUC of the AI distinguishing plus disease were 0.92 (95% CI 0.80-0.97), 0.95 (95% CI 0.91-0.97) and 0.98 (95% CI 0.96-0.99), respectively. Cochran’s Q test (p < 0.01) and Higgins I2 heterogeneity index revealed considerable heterogeneity. The country of study, number of centers, data source and the number of doctors were responsible for the heterogeneity. For ROP diagnosing, researches conducted in China using private data in single center with less than 3 doctors showed higher sensitivity and specificity. For plus disease distinguishing, researches in multiple centers with less than 3 doctors showed higher sensitivity. Conclusion: This study revealed the powerful role of AI in diagnosing ROP and distinguishing plus disease. However, significant heterogeneity was noted among all included studies, indicating challenges in the application of AI for ROP diagnosis in real-world settings. More studies are needed to address these disparities, aiming to fully harness AI's potential in augmenting medical care for ROP.

Purpose: To report on surgical outcomes of removing subfoveal nodules and to evaluate the histopathological findings of subfoveal nodules in pediatric patients with coats’ disease. Methods: This was a retrospective, interventional case series in which 6 pediatric patients had large (>1 disk diameter) subfoveal nodules. Vitrectomy and excision of subfoveal nodules with silicon oil tamponade were performed. Silicon oil was removed 3 months later. Results: This study was carried out in 6 patients with a mean follow-up of 9.2±1.5 months (range: 7-11 months), and the mean age was 5.2±2.4 years (range: 2-8 years). Preoperative visual acuity ranged from light perception (LP) to 20/250, and postoperative visual acuity ranged from LP to 20/200. Histopathology revealed nodules composed of proliferating fibrous tissue, hyaline degeneration with foamy histiocytes, focal myofibroblast hyperplasia, ossified tissue, and cholesterol fissures, with chronic cellular infiltration. No nodules regressed during the follow-up period. Conclusion: Certain eyes of pediatric patients with coats’ disease who underwent subfoveal nodule removal and no evidence of nodule regression may benefit from submacular surgery. Histopathological findings revealed that anti-proliferative and anti-fibrotic agents could be targets for treating coats disease.

Objective: To assess the prevalence and distribution of four blood-borne pathogens among ophthalmic patients at an eye hospital in Southern China. Methods: We conducted a retrospective analysis of data from outpatient and inpatient ophthalmic patients who underwent screening for hepatitis B surface antigen (HBsAg), hepatitis C virus antibody (anti-HCV), human immunodeficiency virus antibody (anti-HIV), and treponema pallidum antibody (anti-TP) at Zhongshan Ophthalmic Center of Sun Yat-sen University from January 2017 to December 2023. The positivity rates of these markers were recorded and analyzed. Results: A total of 253246 patients were included in the study, with positivity rates for HBsAg, anti-HCV, anti-TP, and anti-HIV at 9.00%, 0.45%, 0.13%, and 1.55%, respectively. Among these, 686 patients tested positive for two or more markers, with the highest co-positivity observed for HBsAg and anti-HCV (57.29%), followed by anti-HIV and anti-TP (15.74%). The positivity rate of HBsAg showed a yearly decline, while the rates for anti-HCV, anti-HIV, and anti-TP remained relatively stable from 2017 to 2023. Males had significantly higher positivity rates for HBsAg, anti-HCV, anti-TP, and anti-HIV compared to females (P < 0.001). Significant differences in positivity rates for these markers were also observed across different age groups and ophthalmic conditions (P < 0.001). HBsAg positivity was highest in patients with ocular trauma (11.54%), followed by those with vitreoretinal diseases (10.99%). Anti-HCV positivity was most prevalent among patients with optic neuropathies (0.62%), followed by those with ocular trauma (0.57%). Anti-TP positivity was highest in patients with optic neuropathies (2.60%), with glaucoma patients showing the second-highest rate (2.00%). Anti-HIV positivity was most frequent in uveitis patients (0.55%), followed by those with vitreoretinal diseases (0.30%). Conclusions: The distribution of HBsAg, anti-HCV, anti-TP, and anti-HIV positivity varies across different ophthalmic conditions. Screening for these preoperative infection markers in ophthalmic patients is crucial for assessing surgical risks, understanding potential etiologies, and implementing effective infection control measures

Retinitis pigmentosa (RP) is the most common hereditary retinal disease, with a high global incidence. The underlying pathological mechanisms involve degenerative changes in the optic nerve and progressive loss of the retina, primarily affecting rod photoreceptor cells and, subsequently, cone photoreceptor cells. The pathogenesis is complex, and there is currently no single effective treatment. Traditional Chinese Medicine (TCM) emphasizes a holistic approach and syndrome differentiation, showing certain advantages in treating and maintaining visual function and delaying disease progression. This article reviews recent literature on TCM treatments for retinitis pigmentosa, including a brief overview of the RP pathogenesis, herbal medicine, acupuncture, and combined acupuncture and herbal treatments, and discusses the limitations and prospects of TCM in treating RP.

Objective To observe the effect of orthokeratology combined with vision therapy and Clouclip(OCVTC)on myopia control in myopic children with dysfunctional accommodation. Methods The study involved ninety-nine patients who visited Optometric Center of Langfang Aier Eye Hospital from April 2022 to January 2023.They were divided into 3 groups: the OCVTC group(39 patients),the orthokeratology(Ortho-k)group(30 patients)and the single vision spectacle lense(SVL)group(30 patients).Subsequently, change in axial length(AL)and the refractive error were measured and compared among the three groups at pretreatment and 1-year post-treatment. Results There was significant difference between AL and the refractive error after 1 year of intervention(P < 0.05).With the OCVTC group exhibiting slightly smaller refractive error (without significant differences) as well as significantly lower axial growth than the ortho-k group (P < 0.05).The changes in refractive error and axial length in the two groups were significantly slower than those in the SVL group (P < 0.05). Moreover, when splitted by the mean initial accommodation sensitivity, faster growth in refractive error was observed in the group with lower than mean sensitivity compared with that with higher than mean sensitivity. Conclusions For children wearing ortho-k lenses, effects of visual therapy and Cloudclip on myopia control are significantly superior to that of ortho-k or SVL alone.Moreover, the lower the initial accommodation sensitivity, the faster the growth in refractive error .

Dominant optic atrophy (DOA) is an inherited optic neuropathy and more than 75% of DOA patients harbor pathogenic mutations in OPA1. We reported a 39-year-old female harboring c.2119G>T mutation of OPA1 and manifested progressive visual impairment after hydroxychloroquine (HCQ) therapy. The patient’s visual impairment remained stable for 10 years until she began to take HCQ 13 months ago. She complained about progressively decreased vision in both eyes. Bilateral pale temporal optic disc was similar with that of 11 years ago. Optical coherence tomography showed bilateral moderate retinal nerve fiber layer thinning other than the nasal quadrant and general thinning of the inner retina in the macular. Microcystic macular edema was noted in nasal macular in both eyes. Visual field testing showed paracentral scotoma and microperimetry showed decrease sensitivity in the macular in both eyes. After the patient stopped taking HCQ, her functional tests including visual acuity, field testing and microperimetry testing was stable compared with those of 2 years ago. However, progressive inner macular and RNFL thinning was shown by OCT. OPA1 c.2119 G>T found in this patient was a mutation that had been rarely reported in previous studies. The patient has been followed up for over 10 years and her visual acuity stayed stable for decades long until she took HCQ for 13 months. Her vision decline terminated after she stopped taking HCQ. Although HCQ toxicity is highly related to the duration and daily dose, HCQ may aggravate visual impairment in certain individuals harboring OPA1 mutation. Patients with DOA should avoid using neurotoxic HCQ and other medications that may interfere mitochondrial metabolism.

Objective: To investigate the effect of EZ Prep cleaning solution as an alternative to xylene for manual deparaffinization in the preparation of special staining slides. Methods: EZ Prep cleaning solution was utilized to replace xylene for deparaffinization in a retrospective study involving 100 paraffin-embedded specimens from the Clinical Pathology Department of Zhongshan Ophthalmic Center, Sun Yat-sen University. Routine sections were prepared and duplicated, with one set deparaffinized using traditional xylene and the other using EZ Prep cleaning solution. Subsequent special staining was performed following standardized laboratory protocols. Deparaffinization time and staining outcomes were compared. Results: Slides treated with EZ Prep cleaning solution for manual deparaffinization demonstrated staining quality comparable to those treated with xylene across various special stains, including Gram's, GMS, PAS, Masson, and Congo red staining. EZ Prep could replace xylene deparaffinized sections with the advantages of shorter deparaffinized time and environmental protection, which is worthy of promotion and application.