Purpose:To explore the effects of digital therapeutics on amblyopic eye growth and identify population traits linked to rapid eye growth due to these treatments. Design: A retrospective cohort study.Methods: Data for this study were sourced from the Uniting Functions in Ophthalmology and Optometry database (UFOs) at Zhongshan Ophthalmic Center, Sun Yat-sen University. We employed the Cox proportional hazards model to explore the link between digital therapeutics for amblyopia and rapid eye growth. Subgroup analysis evaluated the sensitivity to rapid eye growth from digital therapeutics, with the results' robustness verified through sensitivity analysis. Results:The study included 1,394 children with amblyopia, with an average follow-up time of 237 days; 694 children (50%) experienced rapid eye growth events. Including 477 in the digital therapeutics group and 917 in the non-digital therapeutics group. After adjustments for demographics and clinical baselines, digital therapeutics were associated with a 64% increased risk of rapid eye growth (HR: 1.64; 95% CI: 1.40-1.94, P<0.001).Subgroup analysis showed significant risk increase in children aged 3-5 (HR: 1.77; 95% CI: 1.47-2.13, P<0.001) but not in ages 6-12 (HR: 1.33; 95% CI: 0.92-1.92, P=0.128), with consistent findings across genders (HR: 1.63 for both, P<0.001). Patients with better initial visual acuity were more vulnerable (HR: 1.96; 95% CI: 1.58-2.42), while those with moderate to poor acuity showed no increased risk (HR: 1.30; 95% CI: 0.95-1.80, P=0.103; HR: 1.19; 95% CI: 0.75-1.89, P=0.458).Children with an initial spherical equivalent ≤-6.0D did not exhibit increased risk (HR: 0.93; 95% CI: 0.48-1.79, P=0.818). However, those with >-6.0D had variable risks, with the -6.0D to -3.0D group showing a significant 2.14 times higher risk than the non-digital group (HR: 2.14; 95% CI: 1.07-4.30, P=0.032). Conclusions: Digital therapeutics is an independent risk factor for rapid eye growth in children with amblyopia. Children aged 3 to 5 or those with better initial BCVA or an amblyopic eye SE between -6.0D and -3.0D exhibit a higher risk of rapid eye growth following digital therapy.

Visual information is transmitted from the eye to the brain via the axons of retinal ganglion cells (RGCs), which travel a long distance through the optic nerve and connect with neurons in visual related nuclei. Like most mature neurons in the central nervous system (CNS), RGCs cannot regenerate their axons once damaged and quickly undergo cell death. Traditionally, extrinsic factors that cause neurodegeneration and regenerative failure in RGCs have been attributed to the extracellular environment, including glial or inflammatory cells. However, emerging evidence suggests that the survival and axon regeneration of RGCs are also affected by the intricate retinal circuitry. In particular, the activation of a multicellular signaling cascade involving changes in inhibitory interneurons, specifically amacrine cells (ACs), plays a significant role in determining the fate of RGCs. In this review, we summarize current knowledge on the involvement of extrinsic factors in regulating cell survival and axon regeneration following optic nerve injury.

Purpose: The aim of this study is to evaluate the safety and efficacy of the specific inhibitor of IL-6 for topical use, tocilizumab, in regulating corneal alkali burn repair.. Method: 15 corneal alkali burned mice were treated with topical application of tocilizumab (2.5mg/mL) 6 times a day for 14 days; 15 alkali burned mice received saline eye drops for 14 days. Check for corneal opacity and epithelial wound healing under a stereomicroscope. Evaluate the localization of IL-6, myofibroblasts (alpha SMA+cells), infiltration of immune cells (CD11b+cells), and goblet cells (PAS staining+cells) on corneal sections. Evaluate the area of corneal neovascularization (CD31 labeled) and neolymphatic vessels (LYVE1 labeled) on the whole-mount cornea. Measure the expression level of IL-6 on mouse cornea through qRT-PCR experiment. In addition, 6 normal mice were subjected to topical administration of tocilizumab eye drops (2.5mg/mL) to detect the corneal toxicity of tocilizumab. Result: After corneal alkali burn, the expression of IL-6 in the stroma increases. Topical use of tocilizumab to inhibit the expression level of IL-6 in the cornea can regulate corneal repair after burn reduction, and no significant corneal toxicity was observed. In addition, inhibiting IL-6 through tocilizumab can promote corneal epithelial healing, inhibit corneal neovascularization and lymphatic vessel formation, inhibit corneal epithelial metaplasia, and reduce immune cell infiltration in the cornea. Conclusion: Topical use of tocilizumab to inhibit IL-6 showed no significant corneal toxicity and can regulate the repair of corneal alkali burns.

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.

The choroid is the primary source of blood supply for the retina. As the largest and most important vascular system within the eye, the choroidal vasculature plays a crucial role in providing blood to the outer retina. This paper aims to elucidate the blood flow and anatomical foundation of the choroid in normal human eyes. Understanding these characteristics in a healthy state will aid in identifying pathological changes in the choroid, which is of significant value for the diagnosis and differential diagnosis of ocular diseases.

圆锥角膜（KC）是一种典型的扩张性眼病，以角膜扩张变薄并向前锥形突起为特征，严重时可致盲。KC三联征之一铁锈色Fleischer环，主要由上皮细胞基底膜周围的铁离子沉积组成。近年来，越来越多研究表明，铁稳态失衡可能与KC的发生和发展密切相关。KC患者泪液中铁相关蛋白的异常表达，提示铁稳态失衡可能是诱发KC的潜在致病机制。此外，角膜上皮细胞内铁稳态失衡导致细胞内铁离子异常积聚，进而引发活性氧和脂质过氧化物的大量生成，最终可能触发细胞铁死亡。从恢复铁稳态角度出发，螯合过量的铁离子和调控铁死亡过程关键靶点可能是未来KC潜在的治疗方法。目前关于铁稳态失衡导致KC发病的具体机制仍存在诸多谜团。随着相关研究的不断深入，有望通过改善角膜铁稳态失衡，为KC临床治疗带来新的思路和突破，也为KC患者提供更精准和个体化的治疗策略。

In recent years, the emissions of chemical industry waste have led to a severe imbalance in the ozone layer, with the penetration of ultraviolet B (UV-B) radiation through the depleted ozone layer becoming a primary inducer of ultraviolet eye disorders. UV-B exposure stimulates oxidative DNA damage and apoptosis in human corneal epithelial cells, leading to ocular conditions such as keratitis, conjunctivitis, cataracts, pterygium, and macular degeneration. Moreover, regions with high UV-B exposure, such as high altitudes, marine environments, and polar regions, heighten the risk of UV-induced ocular diseases among specific occupational groups. Therefore, this paper provides a comprehensive overview of the characteristics of UV-B-induced ocular diseases, the pathophysiological mechanisms of photochemical damage, and protective measures. It particularly summarizes natural active substances with ultraviolet protection effects, providing a basis for the prevention and drug development of ultraviolet eye diseases, which helps to reduce the risk of UV-induced eye disease among specialized workers.

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 = 0.0004, 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 = 0.0328) 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: 0.795 to 0.910) in distinguishing CKD patients from HC. Conclusion: 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.

Purpose: To develop a survival prediction model for primary conjunctival malignant tumor. Materials and methods: Detailed information of cases diagnosed with primary conjunctival malignant tumors from 2000 to 2019 were collected from SEER database, then the cases met the inclusion criteria were randomly assigned to the development group (1216 cases) or validation group (608 cases). Relevant risk factors affecting overall survival (OS) were identified using Cox proportional hazards regression analysis. A nomogram was constructed to predict the 1-year, 3-year, and 5-year survival rates. Concordance index (C index) were calculated to present the predictive power of the mode. Receiver operating characteristic curves (ROC curves) and calibration curves were plotted. The area under the curve (AUC) was measured. Decision curve analysis (DCA) was also applied. Results: The overall survival rate was 77.8%. There were statistically significant differences in the survival time distribution among groups based on age (P < 0.001), histology (P < 0.001), and stage (P = 0.01). According to the multivariate analysis, patients with lymphoma, younger age, and localized lesions had better survival outcomes. The C-index of the constructed model was 0.79. The AUC values for predicting 1-year, 3-year, and 5-year mortality were 0.824, 0.796, and 0.815 in the training group, and 0.750, 0.820, and 0.838 in the validation group, respectively. The DCA results showed a significant advantage of the model, while the calibration plots indicated that the predicted OS were in good agreement with the actual OS in both groups. Conclusions: A satisfying survival prediction model for malignant conjunctival tumor is presented in this study.

Objective To explore the impact of different quiescent times after ophthalmic surgery on the air quality of class III clean operating rooms, aiming to provide a scientific basis for improving surgical efficiency and ensuring patient safety. Methods Eight ophthalmic operating rooms meeting the class III clean standard were selected. After completing ophthalmic surgery, the operating rooms were cleaned and disinfected according to the standards for consecutive surgeries. Subsequently, the operating rooms were divided into three groups based on different quiescent times: 5 minutes, 10 minutes, and 15 minutes. A total of 216 petri dishes were sampled, with 72 petri dishes per group. After the quiescent period ended, the indoor air was sampled using the settling method and immediately sent to the laboratory for culture and analysis. Results The culture results showed that out of 72 petri dishes in the 5-minute quiescent group, 2 developed colonies, with a contamination rate of 5%; the 72 petri dishes in the 10-minute quiescent group did not develop any colonies, with a contamination rate of 0%; and 18 out of 72 petri dishes in the 15-minute quiescent group developed colonies, with a contamination rate of 25%. These data indicate that the contamination rate increases with the extension of the quiescent time. Conclusion Although the contamination rate in the 15-minute quiescent group increased, the contamination rate of all groups was within an acceptable range. The study results indicate that when performing consecutive ophthalmic surgeries in a class III clean operating room, the air quality of the operating room is not affected even if the quiescent time is reduced to 5 minutes after following the prescribed cleaning and disinfection requirements. This finding provides an important reference for optimizing the management of the operating room.