Aims: To identify the characteristic retinal neurovascular changes in patients in different stages of nondiabetic chronic kidney disease (CKD) and to develop a model for the accurate diagnosis of nondiabetic CKD.
Methods: Peripapillary retinal nerve fiber layer (pRNFL) thickness and average macular ganglion cell-inner plexiform layer (GC-IPL) thickness of nondiabetic CKD patients and healthy controls (HC) were evaluated by spectral-domain optical coherence tomography (OCT). The vessel density (VD) and perfusion density (PD) of the macula were obtained from optical coherence tomography angiography (OCTA). The estimated glomerular filtration rate (eGFR) was obtained to access the kidney function of CKD patients. Multiple linear regression models were used to adjust for confounding factors in statistical analyzes. The diagnostic capabilities of the parameters were evaluated by logistic regression models.
Results: 131 nondiabetic CKD patients and 62 HC entered the study. eGFR was found significantly associated with parafoveal VD and PD (average PD: β = 0.000 4, P_adjusted < 0.001) in various sectors. Thinning of pRNFL (β = -6.725, P_adjusted < 0.001) and GC-IPL (β = -4.542, P_adjusted < 0.001), as well as decreased VD (β = -2.107, P_- adjusted < 0.001) and PD (β = -0.057, P_adjusted = 0.032 8) were found in CKD patients. Thinning of pRNFL and deteriorated perifoveal vasculature were found in early CKD, and the parafoveal and foveal VD significantly declined in advanced CKD. Logistic regression models were employed, and selected neurovascular parameters showed an AUC of 0.853 (95% Confidence Interval [CI]: 0.795 to 0.910) in distinguishing CKD patients from HC.
Conclusions: Distinctive retinal neurovascular characteristics could be observed in nondiabetic CKD patients of different severities. Our results suggest that retinal manifestations could be valuable in the screening, diagnosis, and follow-up evaluation of patients with CKD.

Aims: To identify the characteristic retinal neurovascular changes in patients in different stages of nondiabetic chronic kidney disease (CKD) and to develop a model for the accurate diagnosis of nondiabetic CKD.
Methods: Peripapillary retinal nerve fiber layer (pRNFL) thickness and average macular ganglion cell-inner plexiform layer (GC-IPL) thickness of nondiabetic CKD patients and healthy controls (HC) were evaluated by spectral-domain optical coherence tomography (OCT). The vessel density (VD) and perfusion density (PD) of the macula were obtained from optical coherence tomography angiography (OCTA). The estimated glomerular filtration rate (eGFR) was obtained to access the kidney function of CKD patients. Multiple linear regression models were used to adjust for confounding factors in statistical analyzes. The diagnostic capabilities of the parameters were evaluated by logistic regression models.
Results: 131 nondiabetic CKD patients and 62 HC entered the study. eGFR was found significantly associated with parafoveal VD and PD (average PD: β = 0.000 4, P_adjusted < 0.001) in various sectors. Thinning of pRNFL (β = -6.725, P_adjusted < 0.001) and GC-IPL (β = -4.542, P_adjusted < 0.001), as well as decreased VD (β = -2.107, P_adjusted < 0.001) and PD (β = -0.057, P_adjusted = 0.032 8) were found in CKD patients. Thinning of pRNFL and deteriorated perifoveal vasculature were found in early CKD, and the parafoveal and foveal VD significantly declined in advanced CKD. Logistic regression models were employed, and selected neurovascular parameters showed an AUC of 0.853 (95% Confidence Interval [CI]: 0.795 to 0.910) in distinguishing CKD patients from HC.
Conclusions: Distinctive retinal neurovascular characteristics could be observed in nondiabetic CKD patients of different severities. Our results suggest that retinal manifestations could be valuable in the screening, diagnosis, and follow-up evaluation of patients with CKD.

Objective: To investigate the lifestyle and myopia among primary school students in urban areas of Fujian with the context of myopia prevention and control measures, aiming to provide scientific evidence for identifying high-risk myopia population and formulating effective intervention strategies. 

Methods: A cross-sectional study was conducted from October to November 2023, enrolling 811 fourth-grade students from three primary schools in three cities across Fujian. Personal information and lifestyle-related pattern were collected using customized questionnaire. Participants underwent comprehensive ophthalmic assessments including distance visual acuity tests and refractive examinations. Logistic regression analysis was used to assess the impact of lifestyle on the onset of myopia.

Results: The prevalence of myopia among fourth-grade students in urban primary schools in Fujian was 46.4%. Only 25.8% students engaged in outdoor activities for more than 2 hours daily, while63.3% participated in outdoor activities during class breaks. Multivariate Logistic regression analysis revealed that outdoor activities during class breaks (OR= 0.646 [95% confidence interval(CI): 0.473-0.881], P = 0.006) and daily time spent outdoors (2-3 hours, OR=0.682 [95%CI：0.466-0.993], P=0.047; more than 3 hours, OR=0.403 [95%CI: 0.192-0.796], P = 0.01) were independent protective factors against myopia. Lifestyle significantly enhanced the predictive performance for myopia (P = 0.01). Additionally, parental myopia (one parent with myopia, OR=2.247 [95%CI: 1.612- 3.145], P < 0.001; both parents with myopia, OR=4.824 [95%CI: 3.262-7.204], P < 0.001) emerged as a key risk factor for myopia.

Conclusion: There is considerable scope for improving the lifestyle of primary school students in urban areas of Fujian. Lifestyle is strongly associated with myopia onset, highlighting the need for schools and families to actively encourage students to engage in more outdoor activities and take breaks outdoors to prevent and control myopia. Students with parents, especially both parents, having myopia should be considered as a key target group for myopia prevention efforts.

Objective: To investigate the lifestyle and myopia among primary school students in urban areas of Fujian with the context of myopia prevention and control measures, aiming to provide scientific evidence for identifying high-risk myopia population and formulating effective intervention strategies. 

Methods: A cross-sectional study was conducted from October to November 2023, enrolling 811 fourth-grade students from three primary schools in three cities across Fujian. Personal information and lifestyle-related pattern were collected using customized questionnaire. Participants underwent comprehensive ophthalmic assessments including distance visual acuity tests and refractive examinations. Logistic regression analysis was used to assess the impact of lifestyle on the onset of myopia.

Results: The prevalence of myopia among fourth-grade students in urban primary schools in Fujian was 46.4%. Only 25.8% students engaged in outdoor activities for more than 2 hours daily, while63.3% participated in outdoor activities during class breaks. Multivariate Logistic regression analysis revealed that outdoor activities during class breaks (OR= 0.646 [95% confidence interval(CI): 0.473-0.881], P = 0.006) and daily time spent outdoors (2-3 hours, OR=0.682 [95%CI：0.466-0.993], P=0.047; more than 3 hours, OR=0.403 [95%CI: 0.192-0.796], P = 0.01) were independent protective factors against myopia. Lifestyle significantly enhanced the predictive performance for myopia (P = 0.01). Additionally, parental myopia (one parent with myopia, OR=2.247 [95%CI: 1.612- 3.145], P < 0.001; both parents with myopia, OR=4.824 [95%CI: 3.262-7.204], P < 0.001) emerged as a key risk factor for myopia.

Conclusion: There is considerable scope for improving the lifestyle of primary school students in urban areas of Fujian. Lifestyle is strongly associated with myopia onset, highlighting the need for schools and families to actively encourage students to engage in more outdoor activities and take breaks outdoors to prevent and control myopia. Students with parents, especially both parents, having myopia should be considered as a key target group for myopia prevention efforts.

Blindness prevention has been an important national policy in China. Previous strategies, such as deploying experienced cataract surgeons to rural areas and assisting in building local ophthalmology centers, had successfully decreased the prevalence of visual impairment and blindness. However, new challenges arise with the aging population and the shift of the disease spectrum towards age-related eye diseases and myopia. With the constant technological boom, digital healthcare innovations in ophthalmology could immensely enhance screening and diagnosing capabilities. Artifcial intelligence (AI) and telemedicine have been proven valuable in clinical ophthalmology settings. Moreover, the integration of cutting-edge communication technology and AI in mobile clinics and remote surgeries is on the horizon, potentially revolutionizing blindness prevention and ophthalmic healthcare. The future of blindness prevention in China is poised to undergo signifcant transformation, driven by emerging challenges and new opportunities.

Blindness prevention has been an important national policy in China. Previous strategies, such as deploying experienced cataract surgeons to rural areas and assisting in building local ophthalmology centers, had successfully decreased the prevalence of visual impairment and blindness. However, new challenges arise with the aging population and the shift of the disease spectrum towards age-related eye diseases and myopia. With the constant technological boom, digital healthcare innovations in ophthalmology could immensely enhance screening and diagnosing capabilities. Artifcial intelligence (AI) and telemedicine have been proven valuable in clinical ophthalmology settings. Moreover, the integration of cutting-edge communication technology and AI in mobile clinics and remote surgeries is on the horizon, potentially revolutionizing blindness prevention and ophthalmic healthcare. The future of blindness prevention in China is poised to undergo signifcant transformation, driven by emerging challenges and new opportunities.