Stargardt disease (STGD1, OMIM#248200) is the most common hereditary macular dystrophy, caused by mutations in the ABCA4 gene, and is an autosomal recessive inherited disorder. The disease typically manifests in late childhood or early adulthood, leading to progressive and irreversible visual impairment. Significant advances in understanding the clinical and molecular characteristics, as well as the underlying pathophysiology, have ultimately facilitated numerous human clinical trials of new therapies that have been completed, are ongoing, and are planned. This review focuses on the progress in gene therapy research for STGD1. The primary obstacle in STGD1 gene therapy is the lengthy sequence of the ABCA4 gene and the low efficiency of specific transduction of the ABCA4 gene into photoreceptor cells. The key to addressing this issue is to develop a vector with a large carrying capacity that can efficiently transduce the ABCA4 gene into photoreceptor cells. Current gene therapy strategies for STGD1 mainly include adeno-associated viral (AAV) vectors, lentiviral vectors, nanoparticles, optogenetics, and antisense oligonucleotides(AONs). With the deepening of research, it is hoped that effective gene therapy methods for STGD1 will be developed in the future, bringing new therapeutic hope to patients. This review provides valuable references and ideas for clinical applications and scientific research.
Glaucoma, a group of optic nerve degenerative diseases, is characterized by papillary atrophy, visual field defects, and decreased vision. It is also the leading cause of irreversible blindness worldwide, significantly reducing patients’ the quality of life of patients and posing considerable health economic burdens. However, the pathogenesis of glaucoma remains unclear, and promoting aqueous humor outflow to reduce intraocular pressure is the only treatment option available to slow disease progression. The main pathway for aqueous humor outflow is through the trabecular meshwork into Schlemm's canal and finally into the episcleral veins, highlighting the crucial role of the trabecular meshwork in regulating aqueous humor outflow and maintaining intraocular pressure balance. In recent years, there have been notable breakthroughs in in vivo and in vitro aqueous humor outflow measurement techniques and trabecular meshwork imaging technologies.Many studies suggest that the trabecular meshwork exhibits pressure-dependent rhythmic pulsation, playing a crucial role in the pulse-like outflow of aqueous humor. Unfortunately, in glaucoma, this pulsation weakens or even disappears as the disease progresses. This article focuses on the trabecular meshwork's pump theory and summarizes the latest research progress in aqueous humor outflow in glaucoma, exploring potential effective therapeutic strategies aimed at restoring trabecular meshwork function. This provides new insights for the clinical diagnosis and treatment of glaucoma.
Objective：To evaluate the clinical efficacy and safety of 25-gauge+（25G+）combined with 10K（10000）cuts per minute（cpm）minimally invasive vitrectomy (MIVS) in treating primary rhegmatogenous retinal detachment (RRD). Methods: An analysis was performed on 92 patients (92 eyes) diagnosed with RRD who received treatment at Fuzhou Southeast Eye Hospital(Jinshan New Hospital) from January 2023 to May 2024. The patients were categorized into two groups, A and B, each comprising 46 patients along with their corresponding eyes. Group A served as the intervention group receiving the combination of 25G+ with 10K cpm MIVS, while Group B acted as the control group undergoing treatment with 25G+ combined with 7.5K cpm MIVS. This study compared operation time, best corrected visual acuity (BCVA), intraocular pressure (IOP), macular central foveal thickness（CFT）, as well as intraoperative and postoperative complications between both groups. Results: Both groups successfully achieved retinal reattachment without significant differences in pure vitrectomy time (p>0.05); however, total operation time in Group A was shorter than that in Group B (p<0.05). At 7d，4、8wk postoperatively, BCVA improved significantly for both groups compared to preoperative values (P<0.01), with Group A demonstrating superior BCVA relative to Group B (p< 0.01). At 7d postoperatively, CFT in Group A was thicker than that observed in Group B，nonetheless, this difference did not reach statistical significance (p>0.05). Both groups exhibited elevated IOP postoperatively when contrasted against preoperative measurements，this difference being statistically significant in time but not between the two groups themselves (p>0.05). Mild discomfort persisted for both groups at 7d postoperatively without significant variance between the two groups (p>0.05). No serious complications arose during or after surgery in the two groups.Conclusion: 25G+ combined with 10K cpm MIVS is effective, safe and comfortable in the treatment of RRD, with high operation efficiency, rapid postoperative recovery and good patient feeling.
Ideological and political education plays a crucial role in cultivating excellent physicians who have ideals and beliefs, high moral character, solid knowledge and compassion. In teaching professional medical knowledge and skills, ophthalmology tutors should also integrate ideological and political elements in the training of medical students. According to the characteristics of ophthalmology, we describe the necessity of integrating ideological and political education into theoretical knowledge learning, clinical internships, and scientific research. In addition, we provide the methods of "how to integrate" to enhance the affinity and relevance of the ideological and political education. Of note, ideological and political education of ophthalmology is a systematic project, and that only by raising the awareness of all personnel, strengthening design of all course, and grasping the full implementation, can we achieve the goal of cultivating excellent physicians.
Dry eye disease (DED) and allergic conjunctivitis (AC) are two prevalent ocular disorders that often co-occur and share some similar clinical manifestations and biochemical characteristics, complicating diagnosis. Allergic reactions may trigger an inflammatory response in the eye, compromising the microenvironment of the ocular surface and the stability of the tear film, thereby exacerbating dry eye symptoms and affecting visual quality. When allergic conjunctivitis and dry eye occur together, they can significantly reduce a patient's quality of life and performance. A comprehensive therapeutic approach is needed to address the interaction of these two diseases.
Objective: To investigate the perioperative health education needs and its influencing factors of patients undergoing ophthalmic day surgery. Methods: A total of 156 patients undergoing day ophthalmic surgery in the operating room of a Grade A hospital in Henan Province were selected by convenience sampling method. General data questionnaire and perioperative health education demand questionnaire were used to investigate the patients undergoing day ophthalmic surgery. Independent sample t test, one-way analysis of variance, multiple linear regression and other statistical methods were used for statistical analysis. Result: Perioperative health education needs of patients undergoing daytime ophthalmological surgery were 86.79±1.81, among which preoperative self-preparation, postoperative common complications management and postoperative eye guidance had the highest scores (4.79±0.41, 4.96±0.19, 4.74±0.44), and intraoperative body positioning had the lowest scores. 3.47±0.50 points; In the selection of perioperative health education practitioners, 75% of the patients chose the ophthalmic specialist nurses in the operating room; in the selection of perioperative health education methods, 61.54% of the patients chose the comprehensive health education methods; in the time point of perioperative health education, 78.85% of the patients chose the segmented health education; In terms of influencing factors, education background, marital status, monthly family income and low vision were the influencing factors of perioperative health education demand. Conclusion: Patients with daytime ophthalmic surgery have a high demand for perioperative health education. It is necessary to strengthen the standardized training of ophthalmic nurses in the operating room and provide adequate perioperative health education guidance according to the health education needs of patients with daytime ophthalmic surgery, so as to improve the satisfaction and medical experience of patients with daytime ophthalmic surgery and reduce the occurrence of complications.
Intense pulsed light (IPL) is a broad-spectrum, non-coherent light with wavelengths ranging from 500 to 2000 nm, produced by high-output xenon flash lamps. Since its application value in the treatment of dry eye was first discovered at the beginning of the 20th century, it has gradually gained widespread attention from ophthalmologists. As an emerging optical therapy, IPL improves meibomian gland function through selective photothermal action, photobiomodulation, thermal radiation effects, anti-inflammatory properties, and antibacterial and acaricidal effects. It enhances the stability of the tear film, reduces inflammatory responses, restores the ocular surface microenvironment, and thus improves ocular symptoms and signs, achieving the goal of treating diseases. In recent years, with the continuous development and application of IPL technology, treatment has become non-invasive, safe, and effective. Its application range in ocular diseases has been continuously expanding. To date, there have been reports on the efficacy and safety of IPL in treating meibomian gland dysfunction (MGD) and related dry eye, Demodex blepharitis, chalazion, blepharokeratoconjunctivitis (BKC), and allergic conjunctivitis, among other ocular surface diseases. However, there are still relatively few studies on the use of IPL in treating ocular surface diseases, and more in-depth research is still needed. This article reviews the mechanisms of action, clinical applications, efficacy, and safety of IPL in the treatment of ocular surface diseases both domestically and internationally. It aims to provide a reference for the application of IPL in ocular diseases.
Peripheral ulcer keratitis (PUK) is a rare but serious ocular condition characterised by progressive crescentic peripheral corneal stromal thinning with associated epithelial defects, which may be associated with underlying local or systemic autoimmune diseases or in an idiopathic form (Mooren's ulcer). Clinically, patients with PUK often present with painful vision loss with PUK. It can be clinically differentiated from marginal keratitis and Terrien's marginal degeneration. Pharmacological treatment is aimed at reducing the local and systemic inflammatory response, and when corneal thinning or perforation occurs, surgical treatment may be indicated in the setting of systemic immunosuppression.
Peripheral ulcer keratitis (PUK) is a rare but serious ocular condition characterised by progressive crescentic peripheral corneal stromal thinning with associated epithelial defects, which may be associated with underlying local or systemic autoimmune diseases or in an idiopathic form (Mooren's ulcer). Clinically, patients with PUK often present with painful vision loss with PUK. It can be clinically differentiated from marginal keratitis and Terrien's marginal degeneration. Pharmacological treatment is aimed at reducing the local and systemic inflammatory response, and when corneal thinning or perforation occurs, surgical treatment may be indicated in the setting of systemic immunosuppression.
Peripheral ulcer keratitis (PUK) is a rare but serious ocular condition characterised by progressive crescentic peripheral corneal stromal thinning with associated epithelial defects, which may be associated with underlying local or systemic autoimmune diseases or in an idiopathic form (Mooren's ulcer). Clinically, patients with PUK often present with painful vision loss with PUK. It can be clinically differentiated from marginal keratitis and Terrien's marginal degeneration. Pharmacological treatment is aimed at reducing the local and systemic inflammatory response, and when corneal thinning or perforation occurs, surgical treatment may be indicated in the setting of systemic immunosuppression.
