Corneal foreign body is one of common diseases in ophthalmic emergency. Improper handling can cause different degree of corneal injuries, even corneal infection, perforation and endophthalmitis. Therefore, it is essential to eliminate corneal foreign bodies safely and effectively. This article mainly summarizes the influence of the characteristics of the corneal foreign bodies, the first diagnosis time after injury, corneal co-infection and the methods of weeding out the corneal foreign bodies upon the clinical prognosis of corneal foreign body removal, aiming to provide useful reference for medical practitioners in removing corneal foreign bodies.
Objective: To assess the repeatability and reproducibility in measurements of retinal vessel diameter and tortuosity in diabetic patients using the Automated Retinal Image Analyzer (ARIA). Methods: A prospective diagnostic trial was performed; 2 skilled researchers performed a semi-automatic analysis of retinal vessels in digital color fundus photography (45° field of view centered on the optic disc) from 49 diabetic patients using ARIA software. Six largest arterioles and venules coursing through an area of 0.5–1.0 disc diameter surrounding the optic disc were selected. Then the retinal vessel parameters were calculated into the central retinal artery equivalent (CRAE), central retinal vein equivalent (CRVE), arteriole-to-venule ratio (AVR), mean retinal arteriolar tortuosity (MRAT) and mean retinal venular tortuosity (MRVT). To evaluate the repeatability of those values in 2 measurements by the same researcher and the reproducibility between different researchers. Bland-Altman analysis was employed to assess the agreement of the outcomes. Results: There was no significant difference in the CRAE, CRVE, and AVR values in the two-time measurements of researcher A (t= -0.089, -1.425 and 1.214, all P>0.05). It also showed a good repeatability and a highly positive correlation (ICC≥0.725, r≥0.721). There was no significant difference in those measurements between researcher A and B (t= -1.169, -0.050, 0.941, all P>0.05). It also showed a good reproducibility and a highly positive correlation (ICC≥0.750, r≥0.697). Results showed that there was no significant difference in the MRAT and MRVT values both in intraobserver and interobserver measurements (P≥0.05). Besides, Spearman’s nonparametric correlation analysis showed good repeatability and reproducibility (r≥0.571, r≥0.588, all P<0.01). Conclusion: ARIA software yields good repeatability and reproducibility in the measurements of retinal vessel diameter and tortuosity in diabetic patients.
The classic pathogeneses of allergic conjunctivitis include type I hypersensitivity and type IV hypersensitivity, in which mast cells, eosinophils and some active substances such as histamine play important role. However, sincethe therapeutic drugs have not achieved satisfactory efficacy in clinical practices, a significant number of patients fail to achieve a good quality of life. The pathogenesis of allergic conjunctivitis remains to be further studied.Current studies have identified a variety of inflammatory cells such as Th17 cell and cytokines such as IL-17, the mechanisms of neuromodulation, flora dysregulation mechanisms, and lipid mediators that may be involved in the pathogenesis of allergic conjunctivitis, which has significant clinical implications for the study of mechanisms of allergic conjunctivitis. In this article, we will review the recent research progress of the pathogenesis of allergic conjunctivitis in order to provide new ideas for the treatment of allergic conjunctivitis.
Meibomian gland dysfunction (MGD) is a chronic and diffuse disease of the eyelid gland. It is usually characterized by obstruction of the terminal duct of the eyelid gland or changes in the quantity/quality of the eyelid fat secreted. It can clinically cause dry eye symptoms such as abnormal tear film, corneal epithelial damage and eye irritation. The etiology of MGD is complex and affected by a variety of factors. Therefore, the study on the pathogenesis of MGD is of great importance to guide clinical work. This article introduces the animal research model of MGD, and reviews the cellular and molecular mechanisms related to MGD based on some basic research.
Objective: To investigate the relationship between gene-polymorphisms and proliferative diabetic retinopathy in patients who have type 2 diabetes mellitus (T2DM). Method: A total of 700 hospitalized T2DM patients were included in this study from January 2019 to September 2020. They were divided into two groups: the no-diabetic retinopathy (NDR) group (n=386) and the proliferative diabetic retinopathy (PDR) group (n=314). Basic clinical data were collected, and clinical indexes affecting diabetic retinopathy were analyzed. Two tag SNPs rs5370 in endothelin 1 (EDN1) and rs800292 in complement factor H (CFH) were examined using kompetitive allele-specific polymerase chain reaction (KASP) genotyping assays. Logistic regression was used to analyse the relationship between the polymorphisms of these two SNPs and PDR in a Guangxi Han population with T2DM. Results: Significant differences were found through the analysis of the systolic blood pressure—whether using insulin or not—and the glomerular filtration rate (GFR) between the two groups (Psystolic blood pressure=0.025, Pinsulin=0.001, PGFR=0.013) The TT genotype of rs5370 was determined to be associated with an increased risk of PDR (P=0.03, OR=2.973; adj.P=0.011, OR=2.718). The AA genotype of rs800292 was also determined to be associated with an increased risk of PDR (P=0.037, OR=1.949; adj.P=0.044, OR=2.058). Conclusion: Increased systolic blood pressure and decreased GFR may be associated with PDR in patients with T2DM. The rs5370 polymorphism of the EDN1 gene and the rs800292 polymorphism of the CFH gene are significantly associated with the risk of PDR in Guangxi’s Han population.
Objective: To understand the literature distribution characteristics of dry eye research in the world in the last 5 years, and to analyze the research trend and hotspots in this field. Methods: Based on the Web of Science Core Collection (WoSCC) database, a bibliometric analysis was conducted to evaluate the global research trends related to dry eye. Knowledge mappings were constructed by VOSviewer v.1.6.16 to visualize the publications, the distribution of countries, international collaborations, author productivity, source journals, and research hotspots in this fifield. In addition, CiteSpace IV was used to capture the keywords of outbreaks and to explore the rise and fall of hotspots. Research frontiers could be discovered by this analysis. Results: In total, 2 567 peer-reviewed articles were retrieved on dry eye research from 2016 to 2020. The United States ranked the highest among countries withthe most publications. The most productive institution was the Keio University. Kazuo Tsubota contributed the largest number of publications in this field, and MA Lemp was the most cited author. Ocular Surface was the most prolific journal in dry eye research. The top-cited references were mainly about the reports of the International Workshop on Meibomian Gland Dysfunction (MGD). The most cited literature was mainly dry eye series reports by TFOS Dry Eye Workshop II. Six categories were obtained by cluster analysis: 1) pathogenic mechanism and pathophysiology; 2) definition and classification; 3) epidemiological study; 4) treatment; 5) secondary dry eye; 6) diagnosis. Current research foreword is ocular pain, rebamipide, small incision lenticule extraction (SMILE) surgery, and tear film dynamics. Conclusion: Through the bibliometrics analysis of the international literature in the field of dry eye in the past five years, this study visualized the current research status, hotspots, and frontier in this field. Leading topics in dry eye research are eye pain, rebamipide, SMILE surgery, and tear dynamics.
Objective: To explore the effect of diversified education on improving the accuracy and satisfaction of eye medication in patients undergoing ophthalmic ambulatory surgery. Methods: A total of 200 practitioners of administering eye medication after undergoing ambulatory surgery in Zhongshan Ophthalmic Center, Sun Yat-sen University from October to December 2020 were investigated by convenience sampling, 100 practitioners admitted from October to November were included in the control group, and 100 practitioners were included in the experimental group. The control group adopted the traditional method of education, while the experimental group applied diversified education mode to carry out health education. The health education needs of the patients were investigated by the self-made health education needs questionnaire, and the effect of intervention wasevaluated by the eye medication implementation evaluation form and health education satisfaction questionnaire. Results: After the intervention, the correct rate of eye medication in experimental group (94%) was higher than the control group (35%) with a statistical difference (P<0.05). The satisfaction score about diversified education in experimental group was significantly higher than the control group with a statistical difference (P<0.05).Conclusion: Diversified education model can improve the accuracy of administering eye medication in patientsundergoing ophthalmic ambulatory surgery, and the satisfaction in patients and their families is significantly improved. It is worthy of clinical application.
Objective: To investigate off-label ophthalmic medications, and provide an effective and safe evidence-based reference for the rational use of ophthalmic drugs. Methods: On the basis of collecting the off-label drug use recorded in 21 Aier Eye Hospital Group which including ophthalmic central cities and provincial capital level hospitals, and spot checking the prescription and doctor’s order drug use, this article conducted full demonstration and evaluation of off-label drug use which referred to the off-label drug used consensus of Guangdong and Shandong, and other literature on the off-label drug use in ophthalmology. The paper conducted statistics, analysis and induction, and solicited the opinions of relevant ophthalmology clinical experts. Results: Sorting out the evidence of the guides,consensus, journal papers and other evidence-based medicine in ophthalmic medication, recommending 8 items of level 1, 29 items of level 2, and 24 items of level 3, we compiled the “Reference catalogue for the off-label drug use in ophthalmic hospital (2021 edition)” within the group which can providing reference for clinical use. There were 61 off-label drugs commonly used in ophthalmology, involving 32 drugs. Among them, 32 items (52.5%) were used by over administration route, 13 items (21.3%) were used by over indication, and 14 items (23.0%) were used by over indication and administration route. Antibacterial drugs were the most frequently used in the varieties and items of off-label drug use, accounting for 13 (40.6%) and 26 (42.6%) respectively. Conclusion: Ophthalmic off-label medications are common owing to the special route of administration. Such as intraocular injection or eye drop have played a good role in the treatment of some ocular infectious diseases. Standardizing the off-label drug use of ophthalmology is an effective measure to reducing medical risks.
Objective: To measure the adherence to ophthalmology follow-up and the related health belief of patients with diabetes in medical alliance, and analyze the influencing factors. Methods: Totally 334 community-dwelling patients with diabetes mellitus were recruited in a medical alliance in Guangzhou by convenient sampling method. They were investigated by the Chinese version of the Compliance with Annual Diabetic Eye Exams Survey (CADEES-C). Results: Dilated fundus examination within the last year were only reported by 24.3% of respondents. The mean score of the CADEES-C was 3.09±0.64, with the highest score in perceived benefit and threat dimensions and the lowest score in behavioral cue dimension. The factors that mainly influence the adherence to ophthalmology follow-up and their related health beliefs of patients with diabetes are types of diabetes, propensity to seek treatment, other complications of diabetes, knowledge of medical alliance and family pattern. Conclusion: The adherence to ophthalmology follow-up and the related health belief of patients with diabetes are at low level with the deficiency of behavioral cues. It is suggested that medical alliance should play a critical role to improve the status quo by developing more screening and referrals.
Keratoconus is a well-know disease in ophthalmology. This paper reports a case of keratopathy, female, 33 years old, had blurred vision without special inducement, and keratoconus was initially considered. However, after a series of examinations, diagnosis what kind of ocular disease the patient had in both eyes was not possible, and the patient had no regular specialist treatment, and the discomfort symptoms of both eyes disappeared after taking a full rest at home for 2 weeks, and the cornea was examined by Department of Optometry in Third People’s Hospital of Gansu Province returned to normal and corrected visual acuity was normal. The patient had a seizure in 2014, and after multiple hospital visits, the diagnosis could not be confirmed, after 2–3 weeks of rest, the symptoms disappeared. Therefore, after sorting out the special report of this visit, it is specially reported for the reference of all experts and colleagues to get a clear or direction of diagnosis and treatment, guide the diagnosis and treatment for patients who experience such similar situation in the future, and reduce the length of illness.
