In this case reportit describes a novel technique using indocyanine green gel for the surgical excision of conjunctival lymphangiectasia (CL). CL was found on the nasal side of left eye in a 50-year-old male. Surgical excision of the entire cystic lesion with an intact cyst wall was completed with the assistance of an indocyanine green (ICG) gel. No sutures were used throughout the entire procedure. Subsequent post operative follow-up was uneventful. Herein, we report a novel technique used to facilitate the identifcation and complete removal of an intraocular cystic lesion ensuring an intact cyst wall.

In this case reportit describes a novel technique using indocyanine green gel for the surgical excision of conjunctival lymphangiectasia (CL). CL was found on the nasal side of left eye in a 50-year-old male. Surgical excision of the entire cystic lesion with an intact cyst wall was completed with the assistance of an indocyanine green (ICG) gel. No sutures were used throughout the entire procedure. Subsequent post operative follow-up was uneventful. Herein, we report a novel technique used to facilitate the identifcation and complete removal of an intraocular cystic lesion ensuring an intact cyst wall.

Objective: Fengqing County, situated in Yunnan Province, is a high-altitude regionknown for its ethnic diversity and a notably high prevalence of pterygium. As akey area for Sun Yat-sen University's poverty alleviation initiatives, this studyaims toinvestigate the unique characteristics of pterygiumin specific region. Methods: We analyzed data from hospitalized patients admitted to the Ophthalmology department of the People's Hospital of Fengqing in 2023. The data wereextracted from medical records through the hospital information system. The chi-square test was used for statistical comparison, and multivariate logistic regression analysiswas conduct to explorethefactors influencingthe onset ofpterygium.A significance level of P< 0.005 wasset. Results: In 2023,outof 1137 ophthalmic inpatients, 207 (18.2%) underwent pterygium surgery. There was asignificant female predominance, with a female-to-male ratio of6.67:1(P<0.001). However,nosignificantethnic variation was observed(P=0.57).The majority of patients were in the 46-55 age group (36.71%),and the recurrence rate was low at1.71%. Female gender,increasingage, diabetes mellitus, age-related cataract, and meibomian gland dysfunctionwere identified as independent risk factors for pterygium in this region. Conclusion:Fengqingislikelyto have intricate connections betweentheoccurrence andtreatment of perygium and its local geography, culture, and socio-economic conditions. Medical assistance programs should take these factors into account andprioritizethem in poverty alleviationinitiatives.

Objective: Fengqing County, situated in Yunnan Province, is a high-altitude regionknown for its ethnic diversity and a notably high prevalence of pterygium. As akey area for Sun Yat-sen University's poverty alleviation initiatives, this studyaims toinvestigate the unique characteristics of pterygiumin specific region. Methods: We analyzed data from hospitalized patients admitted to the Ophthalmology department of the People's Hospital of Fengqing in 2023. The data wereextracted from medical records through the hospital information system. The chi-square test was used for statistical comparison, and multivariate logistic regression analysiswas conduct to explorethefactors influencingthe onset ofpterygium.A significance level of P< 0.005 wasset. Results: In 2023,outof 1137 ophthalmic inpatients, 207 (18.2%) underwent pterygium surgery. There was asignificant female predominance, with a female-to-male ratio of6.67:1(P<0.001). However,nosignificantethnic variation was observed(P=0.57).The majority of patients were in the 46-55 age group (36.71%),and the recurrence rate was low at1.71%. Female gender,increasingage, diabetes mellitus, age-related cataract, and meibomian gland dysfunctionwere identified as independent risk factors for pterygium in this region. Conclusion:Fengqingislikelyto have intricate connections betweentheoccurrence andtreatment of perygium and its local geography, culture, and socio-economic conditions. Medical assistance programs should take these factors into account andprioritizethem in poverty alleviationinitiatives.

Purpose: Strabismus is associated with a higher prevalence of idiopathic thoracic scoliosis (ITS) in children. This study aims to investigate whether superior oblique palsy (SOP) poses a higher risk for developing ITS among children and adolescents. Methods: A cross-sectional study. The study group comprised 347 consecutive candidates for SOP surgery aged 4 to 18 years; Patients within the same age range with ocular trauma were enrolled as the control group. Preoperative chest plain radiographs were used to measure the Cobb angle. Demographic information and clinical data, including diopter, best corrected visual acuity, deviation degree, and binocular function, were analyzed. Results: A significantly higher prevalence of ITS was found in study group compared with control group (12.68% vs 4.18%，P < 0.001) . Additionally, the mean Cobb angle was lagger in SOP group than that in control group (5.02°±3.87° vs 3.84°±3.09°, P < 0.001). Males in SOP group showed a higher prevalence of ITS  (12.9% vs 2.87%, P = 0.007), but there was no significant difference in females between two groups (12.3% vs 7.69%, P = 0.295). Good near stereopsis acuity was  significantly associated with high prevalence of thoracic scoliosis (P < 0.001). Multivariate logistic regression analysis revealed that a large distant magnitude of deviation (>20 PD) and near stereoacuity were significantly associated with ITS. Conclusions: Patients with SOP have a significantly  higher risk of developing idiopathic thoracic scoliosis, especially those with good near stereoscopic and large distant magnitude of deviation. 

Purpose: Strabismus is associated with a higher prevalence of idiopathic thoracic scoliosis (ITS) in children. This study aims to investigate whether superior oblique palsy (SOP) poses a higher risk for developing ITS among children and adolescents. Methods: A cross-sectional study. The study group comprised 347 consecutive candidates for SOP surgery aged 4 to 18 years; Patients within the same age range with ocular trauma were enrolled as the control group. Preoperative chest plain radiographs were used to measure the Cobb angle. Demographic information and clinical data, including diopter, best corrected visual acuity, deviation degree, and binocular function, were analyzed. Results: A significantly higher prevalence of ITS was found in study group compared with control group (12.68% vs 4.18%，P < 0.001) . Additionally, the mean Cobb angle was lagger in SOP group than that in control group (5.02°±3.87° vs 3.84°±3.09°, P < 0.001). Males in SOP group showed a higher prevalence of ITS  (12.9% vs 2.87%, P = 0.007), but there was no significant difference in females between two groups (12.3% vs 7.69%, P = 0.295). Good near stereopsis acuity was  significantly associated with high prevalence of thoracic scoliosis (P < 0.001). Multivariate logistic regression analysis revealed that a large distant magnitude of deviation (>20 PD) and near stereoacuity were significantly associated with ITS. Conclusions: Patients with SOP have a significantly  higher risk of developing idiopathic thoracic scoliosis, especially those with good near stereoscopic and large distant magnitude of deviation. 

Purpose: To report a case of interface fluid syndrome following small incision lenticule extraction (SMILE) and subsequent CIRCLE enhancement. Case Presentation: A 30-year-old female experienced progressively worsening vision following refractive enhancement surgery. The patient had experienced a transient increase in intraocular pressure (IOP) after SMILE, normalized poststeroid cessation. Three months after the enhancement, her best-corrected visual acuity deteriorated from 20/20 in both eyes before the surgery to 20/300. IOP measured by non-contact tonometry was 25.3 mmHg in the right eye and 26.7 mmHg in the left eye, while the measurements off the flap using iCare were 55.3 mmHg and 47.8 mmHg, respectively. Examination revealed moderate corneal edema, interface fluid pockets, and haze, which were confirmed by anterior segment optical coherence tomography. Treatment involved the discontinuation of steroids and the introduction of hypotensive medication, leading to significant symptom relief. Conclusion: This case highlights the importance of cautious and conservative steroid use, particularly in steroid-responsive patients. When steroids are administered in cases potentially involving diffuse lamellar keratitis and haze, monitoring peripheral IOP is essential.

Purpose: To report a case of interface fluid syndrome following small incision lenticule extraction (SMILE) and subsequent CIRCLE enhancement. Case Presentation: A 30-year-old female experienced progressively worsening vision following refractive enhancement surgery. The patient had experienced a transient increase in intraocular pressure (IOP) after SMILE, normalized poststeroid cessation. Three months after the enhancement, her best-corrected visual acuity deteriorated from 20/20 in both eyes before the surgery to 20/300. IOP measured by non-contact tonometry was 25.3 mmHg in the right eye and 26.7 mmHg in the left eye, while the measurements off the flap using iCare were 55.3 mmHg and 47.8 mmHg, respectively. Examination revealed moderate corneal edema, interface fluid pockets, and haze, which were confirmed by anterior segment optical coherence tomography. Treatment involved the discontinuation of steroids and the introduction of hypotensive medication, leading to significant symptom relief. Conclusion: This case highlights the importance of cautious and conservative steroid use, particularly in steroid-responsive patients. When steroids are administered in cases potentially involving diffuse lamellar keratitis and haze, monitoring peripheral IOP is essential.

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.

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.

Autoimmune uveitis is one of the most common inflammatory eye diseases leading to blindness globally. Its etiology is primarily associated with autoimmune responses. Patients with this condition often exhibit complex and chronic disease courses, with a high propensity for recurrence. Current treatments mainly involve corticosteroids and immunosuppressive agents, which, despite their effectiveness, entail significant side effects that severely impact patients' vision and quality of life. There are still unresolved questions regarding the etiology and immunopathogenesis of autoimmune uveitis, and traditional high-throughput sequencing techniques fall short of adequately elucidatingits pathogenic mechanisms at the cellular level. With the continuous advancement of single-cell sequencing technology, an increasing number of studies are leveraging this approach to deeply investigate the pathogenesis of autoimmune uveitis, thereby offering new insights for identifying novel diagnostic and therapeutic targets. This paper reviews the latest applications of single-cell sequencing technology in exploring the pathogenesis of autoimmune uveitis. Through the utilization of this technology, researchers can gain a more comprehensive understanding of cellular-level changes in patients, providing robust support for the search for new therapeutic avenues. These studies offer new directions for the diagnosis and treatment of autoimmune uveitis and provide valuable information for the development of future therapeutic strategies and approaches.

Autoimmune uveitis is one of the most common inflammatory eye diseases leading to blindness globally. Its etiology is primarily associated with autoimmune responses. Patients with this condition often exhibit complex and chronic disease courses, with a high propensity for recurrence. Current treatments mainly involve corticosteroids and immunosuppressive agents, which, despite their effectiveness, entail significant side effects that severely impact patients' vision and quality of life. There are still unresolved questions regarding the etiology and immunopathogenesis of autoimmune uveitis, and traditional high-throughput sequencing techniques fall short of adequately elucidatingits pathogenic mechanisms at the cellular level. With the continuous advancement of single-cell sequencing technology, an increasing number of studies are leveraging this approach to deeply investigate the pathogenesis of autoimmune uveitis, thereby offering new insights for identifying novel diagnostic and therapeutic targets. This paper reviews the latest applications of single-cell sequencing technology in exploring the pathogenesis of autoimmune uveitis. Through the utilization of this technology, researchers can gain a more comprehensive understanding of cellular-level changes in patients, providing robust support for the search for new therapeutic avenues. These studies offer new directions for the diagnosis and treatment of autoimmune uveitis and provide valuable information for the development of future therapeutic strategies and approaches.

Congenital cataract (CC) is one of the most common causes of pediatric visual impairment. As our understanding of CC's etiology, clinical manifestations, and pathogenic genes deepens,various CC categorization systems based on diferent classifcation criteria have been proposed. Regrettably, the application of the CC category in clinical practice and scientifc research is limited. It is challenging to obtain preciseinformation that could guide the timely treatment decision-making for pediatric cataract patients or predict their prognosis from a specific CC classification. This review aims to discuss the statusquo of CC categorization systems and the potential directions for future research in this field, focusingon categorization principles and scientific application in clinical practice. Additionally, it aims to propose the potential directions for future research in this domain.

Congenital cataract (CC) is one of the most common causes of pediatric visual impairment. As our understanding of CC's etiology, clinical manifestations, and pathogenic genes deepens,various CC categorization systems based on diferent classifcation criteria have been proposed. Regrettably, the application of the CC category in clinical practice and scientifc research is limited. It is challenging to obtain preciseinformation that could guide the timely treatment decision-making for pediatric cataract patients or predict their prognosis from a specific CC classification. This review aims to discuss the statusquo of CC categorization systems and the potential directions for future research in this field, focusingon categorization principles and scientific application in clinical practice. Additionally, it aims to propose the potential directions for future research in this domain.

Bilateral diffuse uveal melanocytic proliferation (BDUMP) is a rare paraneoplastic ocular syndrome, often associated with significant vision loss and poor prognosis^[1].  BDUMP is typically linked to systemic malignancies, including ovarian, lung, pancreatic, and colorectal cancers^[1]. Here, we reported a case of BDUMP in a 59-year-old male patient who had been misdiagnosed with a nonfunctional adrenal adenoma. This man, with a history of diabetes mellitus and high blood pressure, complained of progressive visual loss in both eyes. He was diagnosed with BDUMP after undergoing comprehensive ophthalmic assessments at our eye center. After being referred to the urology department, he was initially diagnosed with a right nonfunctional adrenal adenoma because his renin-aldosterone levels and serum potassium levels were normal. However, three months later, the adrenal mass rapidly increased in size, and liver metastasis was confirmed. Despite normal tumor marker levels, a histopathological diagnosis ultimately confirmed adrenocortical carcinoma. This case underscores the importance of considering underlying malignancies in patients with BDUMP and highlights the necessity for early systemic evaluation, including imaging studies and multidisciplinary consultations. Timely diagnosis of underlying cancers may improve patient outcomes. It is worth noting that normal hormone levels and a tumor small-sized cannot be used as conclusive evidence that the tumor is a nonfunctional adrenal adenoma; patients with BDUMP should be closely followed up to identify the primary malignancy.

Bilateral diffuse uveal melanocytic proliferation (BDUMP) is a rare paraneoplastic ocular syndrome, often associated with significant vision loss and poor prognosis^[1].  BDUMP is typically linked to systemic malignancies, including ovarian, lung, pancreatic, and colorectal cancers^[1]. Here, we reported a case of BDUMP in a 59-year-old male patient who had been misdiagnosed with a nonfunctional adrenal adenoma. This man, with a history of diabetes mellitus and high blood pressure, complained of progressive visual loss in both eyes. He was diagnosed with BDUMP after undergoing comprehensive ophthalmic assessments at our eye center. After being referred to the urology department, he was initially diagnosed with a right nonfunctional adrenal adenoma because his renin-aldosterone levels and serum potassium levels were normal. However, three months later, the adrenal mass rapidly increased in size, and liver metastasis was confirmed. Despite normal tumor marker levels, a histopathological diagnosis ultimately confirmed adrenocortical carcinoma. This case underscores the importance of considering underlying malignancies in patients with BDUMP and highlights the necessity for early systemic evaluation, including imaging studies and multidisciplinary consultations. Timely diagnosis of underlying cancers may improve patient outcomes. It is worth noting that normal hormone levels and a tumor small-sized cannot be used as conclusive evidence that the tumor is a nonfunctional adrenal adenoma; patients with BDUMP should be closely followed up to identify the primary malignancy.

Objective: The study aimed to report the distinctive fundus appearance of bilateral asymmetric choroidal melanocytosis and reviewed the clinical and multimodal imaging characteristics to differentiate choroidal melanocytosis from malignant pigmented retinal lesions. Methods: An observational case report and literature review.  Results: A 60-year-old patient underwent comprehensive ophthalmologic examinations.Underfunduscopic examination, bilateral choroidal melanocytosis with asymmetry choroidal pigmentation change was observed. In the right eye, there was diffuse darker coloration extending from posterior pole to the mid-peripheral retina. In the left eye, flat patches of choroidal hyperpigmentation were present, involving superior and inferior hemisphere region, while other regions were depigmented. Spectral-domain optical coherence tomography revealed that the layers of retina and choroid were basically normal, with no elevation of the retinal pigment epithelium.Near infrared reflectance images provided a clearer view of mottled focal hyperpigmentation area, which corresponded to the choroidal hyperpigmentation. Conclusions: This case highlights the effectiveness of multimodal imaging in distinguishing choroidal melanocytosis from malignant entities. It emphasizes the crucial role of multimodal imaging in guiding clinical management to prevent vision-threatening complications and monitor potential malignant transformation.

Objective: The study aimed to report the distinctive fundus appearance of bilateral asymmetric choroidal melanocytosis and reviewed the clinical and multimodal imaging characteristics to differentiate choroidal melanocytosis from malignant pigmented retinal lesions. Methods: An observational case report and literature review.  Results: A 60-year-old patient underwent comprehensive ophthalmologic examinations.Underfunduscopic examination, bilateral choroidal melanocytosis with asymmetry choroidal pigmentation change was observed. In the right eye, there was diffuse darker coloration extending from posterior pole to the mid-peripheral retina. In the left eye, flat patches of choroidal hyperpigmentation were present, involving superior and inferior hemisphere region, while other regions were depigmented. Spectral-domain optical coherence tomography revealed that the layers of retina and choroid were basically normal, with no elevation of the retinal pigment epithelium.Near infrared reflectance images provided a clearer view of mottled focal hyperpigmentation area, which corresponded to the choroidal hyperpigmentation. Conclusions: This case highlights the effectiveness of multimodal imaging in distinguishing choroidal melanocytosis from malignant entities. It emphasizes the crucial role of multimodal imaging in guiding clinical management to prevent vision-threatening complications and monitor potential malignant transformation.

Objectives: To evaluate the performance of orthokeratology (ortho-k) lens reordering using software-designed system, so as to determine the feasibility of ortho-k lens reordering without discontinuing lens wear. Methods: This study is a retrospective analysis of data of ortho-k lens wearers who had a history of short-term discontinuation of lens wear. A total of 94 individuals aged over 8 years with spherical equivalent refraction ranging from -0.50 to -6.50 diopters were included. The corneal topography data at baseline (before ortho-k) and after lens wear discontinuation (cessation of ortho-k treatment) were imported separately into the lens-design software, along with corresponding refraction data. Subsequently, corneal and lens parameters were generated and compared. Intraclass correlation coefficients (ICC) were calculated, and Bland and Altman analyses were conducted. Results: All 94 children were involved in the retrospective analysis. Compared with baseline data, there was a high level of consistency between Rwo (without discontinuation) and Rwith (with discontinuation), with an ICC of 0.96 (P<0.001). Furthermore, the comparison of lens parameters generated by the Easyfit software between baseline and after short-term discontinuation showed a high degree of  consistency, with all of the ICC values exceeding 0.90. Similar results were obtained using the WAVE software, as both ICC values and Bland-Altman plots demonstrated a high level of consistency in lens parameters between two conditions (nearly all data points fell within the 95% LoAs ). Conclusions: It is feasible to directly reorder new ortho-k lenses using software fitting approaches. However, further investigations are ncessary to validate their practicability in a clinical setting.

Objectives: To evaluate the performance of orthokeratology (ortho-k) lens reordering using software-designed system, so as to determine the feasibility of ortho-k lens reordering without discontinuing lens wear. Methods: This study is a retrospective analysis of data of ortho-k lens wearers who had a history of short-term discontinuation of lens wear. A total of 94 individuals aged over 8 years with spherical equivalent refraction ranging from -0.50 to -6.50 diopters were included. The corneal topography data at baseline (before ortho-k) and after lens wear discontinuation (cessation of ortho-k treatment) were imported separately into the lens-design software, along with corresponding refraction data. Subsequently, corneal and lens parameters were generated and compared. Intraclass correlation coefficients (ICC) were calculated, and Bland and Altman analyses were conducted. Results: All 94 children were involved in the retrospective analysis. Compared with baseline data, there was a high level of consistency between Rwo (without discontinuation) and Rwith (with discontinuation), with an ICC of 0.96 (P<0.001). Furthermore, the comparison of lens parameters generated by the Easyfit software between baseline and after short-term discontinuation showed a high degree of  consistency, with all of the ICC values exceeding 0.90. Similar results were obtained using the WAVE software, as both ICC values and Bland-Altman plots demonstrated a high level of consistency in lens parameters between two conditions (nearly all data points fell within the 95% LoAs ). Conclusions: It is feasible to directly reorder new ortho-k lenses using software fitting approaches. However, further investigations are ncessary to validate their practicability in a clinical setting.