Purpose: To evaluate impression cytology test from the tarsal conjunctiva which includes standardized acquisition, impression transfer, and staining protocols from normal individuals in age groups ranging from 8 to 30 years. Method: Thirty healthy volunteers with no ocular surface symptoms or signs of allergic conjunctivitis underwent impression cytology of the upper tarsal conjunctiva in the right eye after informed consent. The impression cytology filter paper was imprinted on a glass slide using three different techniques to transfer the cells from the paper to the slide. Various standardization steps were evaluated to determine the best method to acquire and stain the cells. Modified Wright Giemsa stain was used to describe the cellular profile of the conjunctival epithelial cells. Results: The polyethersulfone membrane had the better acquisition of cells and did not dissolve when treated with methanol. The mean cellular grading on IC paper and for age groups 8-15, 16-25 and 26-30 was 0.85, 1.66 and 0.87, respectively. The mean grading acquired through slides in age groups 8-15, 16-25 and 26-30 were 2.14, 2.1, 2.87 respectively. Conclusion: We have described a novel method for acquiring, transferring and staining impressions from the tarsal conjunctiva.
Objective: To construct a prediction model for DR by combining systemic indexes and retinal blood flow information.\nMethods: A total of 567 patients with DM were enrolled and divided into non-DR group (380 cases) and DR group (187 cases). General data, routine ophthalmic examination and retinal blood flow (OCTA) datas were collected. The systemic risk factors and OCTA parameters closely related to the occurrence of DR were screened out by pairwise comparison and logistic regression analysis, and the nomogram prediction model was constructed and optimized.\nResults: The systemic risk factors for DR included diabetic macular edema, fasting blood glucose, glycosylated hemoglobin, age, duration of diabetes, and diabetic peripheral vascular disease, and OCTA parameters should pay attention to the vascular density of the retinal layer in the macula region of 3*3. According to its regression coefficient of β, the score weight of each risk factor was calculated proportionally to obtain a prediction model. The area under the ROC curve of this prediction model is 0.864, Brier = 0.130.\nConclusion: Diabetic macular edema, fasting blood glucose, glycosylated hemoglobin, age, diabetes mellitus, diabetic peripheral vascular disease, and macular 3*3 retinal inner layer vascular density are significantly correlated with the occurrence of DR. The risk prediction model established by this method has good clinical value for the prediction of DR.
Pseudoexfoliation syndrome (PXS) was defined by the abnormal deposition of fiber substances intraocularly and manifested as white or gray powdery pseudoexfoliation material (PXM) under slit lamp microscopy. Deposition of PXM in anterior chamber angle could cause pseudoexfoliation glaucoma (PXG). PXM that entered aqueous humor circulation could also enter bloodstream and result in vascular damage. PXM could enter ocular fundus vessels, especially microvascular and capillary vessels, causing the change in organizational structure and vessel density (VD). Since fundus pathology was usually irreversible and PXM in fundus vessels was very difficult to clear, early diagnosis of ocular fundus pathology in PXS was essential. Optical coherence tomography (OCT) and optical coherence tomography angiography (OCTA), which were based on optical coherence tomography technology, had the advantages of real-time, non-intrusive and high resolution, and were widely used in detection of fundus structural and vascular pathology. There were substantial studies regarding quantitative evaluation of PXS fundus pathology. This study was to review the description of PXS fundus pathology on OCT and OCTA.
Pterygium is a nonneoplastic degenerative tissue that grows subepithelially, and its pathogenesis is mainly related to ultraviolet exposure, however, the full mechanism of pterygium remains unclear. Recent studies have found that viral infection, oxidative stress, inflammatory mediators, tumor suppressor gene inactivation, DNA methylation, apoptosis and proliferative proteins, extracellular matrix regulators, epithelial-mesenchymal cell transformation and other factors are related to the pathogenesis, but the specific mechanism of each factor needs to be studied. In this article, the author reviews the current pathogenesis of pterygium. Exploring its different related factors and their roles in the pathogenesis of pterygium will help to provide new prevention and treatment strategies for clinical practice.
Diabetic retinopathy (DR) is a microvascular complication of diabetes mellitus, which is the primary cause of vision loss in people of working age. Diabetic macular edema (DME) can occur at any stage of DR, which is a thickening of the central retina caused by leakage of capillaries in the macular area, and is the main cause of vision loss in DR patients. DME can occur at any stage of DR, and it is a thickening of the retina in the center of the macula due to leakage of the macular capillaries, which is the main cause of vision loss in patients with DR. Nowadays, there are various treatments for DME, and the effect of anti-vascular endothelial growth factor (VEGF) as the first-line treatment is remarkable, but there are some patients who do not have any regression or recurrence after regular anti-VEGF treatment, and there are patients with no response or responding to anti-VEGF treatment. However, in some patients, edema does not subside or recurs after regular anti-VEGF treatment, and DME with no or poor response to anti-VEGF occurs. Currently, the treatment methods include conversion of anti-VEGF drugs, corticosteroids, lasers, surgeries, and combination therapies, and there is no clear guideline on the treatment of refractory DME. This article reviews articles related to the treatment of refractory DME at home and abroad and intends to provide references for the treatment options of refractory DME in the future.
Visual health is one of the important indicators of physical health of adolescents and children, including myopia, amblyopia, strabismus and other poor visual acuity problems, which have a wide and profound impact on the individual growth and development of adolescents and children, family life quality, social sustainable development and economic level, and is currently a major public health and social problem. Through combing research, summarizing the health promotion models and existing problems at home and abroad, leading the new era based on new ideas, starting a new journey with new missions, reconstructing the "family-school-medical-community-government" collaborative cooperation model based on the theory of health consciousness. Develop and innovate nested vision health management mode for adolescents and children and complete model construction. Combine existing resources, strengthen investment in related professional development, integrate professional training, value-leading and health awareness, effectively implement important directive spirit and phased goals of the Implementation Plan, effectively improve the vision level of adolescents and children, and promote the comprehensive development of vision health management mode. It will make up for the deficiency of the existing model, lay the theoretical and research foundation for promoting the vision health management model of adolescents and children nationwide, and at the same time, in order to accelerate the realization of Healthy China 2030, provide a larger scale and more systematic vision health care services, and further lead the high-quality development of the health level of the whole people.
Neurotrophic keratopathy is a disease related to degenerative changes in corneal nerves, resulting in impaired sensory and nutritive functions of corneal nerves. This leads to corneal epithelial defects, corneal ulcers, and corneal perforation. Currently, the main treatment modalities include pharmacotherapy, non-surgical interventions, and surgical treatment. However, drug therapy and non-surgical interventions often yield unsatisfactory results for severe neurotrophic keratopathy patients. Performing corneal transplantation in patients with unrecovered corneal sensation may result in persistent epithelial non-healing post-transplantation. Therefore, the restoration of corneal sensation is a crucial prerequisite for visual rehabilitation. Corneal neurotization emerges as an important and effective therapeutic approach for severe cases of neurotrophic keratopathy, aiming to restore corneal sensation and enhance corneal transparency. The procedure involves transplanting nerves from a donor with normal sensory function to the paralyzed sub-Tenon perilimbal space, allowing nerve endings to regenerate into the corneal stroma and restoring corneal sensory function. With continuous improvements in the technique of corneal neurotization, its favorable postoperative outcomes and advantages are becoming increasingly evident. This article, based on the team's experience in corneal nerve transplantation, elaborates on the treatment modalities for neurotrophic keratopathy and the application and prospects of various surgical techniques in corneal neurotization.
Rapamycin (mTOR) is a protein kinase primarily involved in the regulation of nutrient levels, growth, and metabolism in vivo. mTOR serves as a crucial target for cancer, aging, and other metabolic diseases while participating in various biological processes such as proliferation, transdifferentiation, and autophagy. However, there is a scarcity of reviews on the mTOR gene's role in eye diseases. Studies have confirmed that mTOR exhibits close associations with pterygium, age-related macular degeneration (AMD), glaucoma, cataract formation, diabetic retinopathy (DR), uveal melanoma, and other ocular conditions. Therefore, this paper provides a concise review of the role played by the mTOR gene along with its expression levels and signaling pathways within related eye diseases. The aim is to offer insights into their pathological mechanisms and potential treatments while paving the way for further research.
