Background: To develop and assess usability of a smartphone-based visual acuity (VA) test with an automatic distance calibration (ADC) function, the iOS version of WHOeyes. Methods: The WHOeyes was an upgraded version with a distinct feature of ADC of an existing validated VA testing APP called V@home. Three groups of Chinese participants with different ages (≤20, 20-40, >40 years) were recruited for distance and near VA testing using both an Early Treatment Diabetic Retinopathy Study (ETDRS) chart and the WHOeyes. The ADC function would determine the testing distance. Infrared rangefinder was used to determine the testing distance for the ETDRS, and actual testing distance for the WHOeyes. A questionnaire-based interview was administered to assess satisfaction. Results: The actual testing distance determined by the WHOeyes ADC showed an overall good agreement with the desired testing distance in all three age groups (p > 0.50). Regarding the distance and near VA testing, the accuracy of WHOeyes was equivalent to ETDRS. The mean difference between the WHOeyes and ETDRS ranged from -0.084 to 0.012 logMAR, and the quadratic weighted kappa (QWK) values were greater than 0.75 across all groups. The test-retest reliability of WHOeyes was high for both near and distance VA, with a mean difference ranging from -0.040 to 0.004 logMAR and QWK all greater than 0.85. The questionnaire revealed an excellent user experience and acceptance of WHOeyes. Conclusions: WHOeyes could provide accurate measurement of the testing distance as well as the distance and near VA when compared to the gold standard ETDRS chart. Keywords: smartphone-based; visual acuity test; WHOeyes, V@home; ETDRS;
Glaucoma is characterized by the progressive degeneration and loss of retinal ganglion cells (RGCs) and their axons, making it one of the most common causes of vision loss. Although the exact underlying mechanisms remain unclear, it is well known that elevated intraocular pressure (IOP) is a major risk factor for the progression of glaucoma. Currently, the primary means of controlling glaucoma involves reducing IOP through medication and surgery. Tafluprost, due to its effective and long-term ability to lower IOP, minimal side effects, high patient compliance, and absence of significant systemic side effects, has become the first-line treatment for primary open-angle glaucoma and ocular hypertension. Recent studies suggest that Tafluprost may also have neuroprotective effects beyond its IOP-lowering effects. This article aims to review the pharmacological and potential neuroprotective effects of Tafluprost, providing a theoretical basis and research foundation for developing more effective drugs for glaucoma treatment. However, there is still a lack of sufficient clinical evidence to support the neuroprotective effects of Tafluprost, and further investigations are required to explore in this field to furnish critical theoretical backing for the development of drugs that target optic nerve protection and facilitate vision restoration through optic nerve regeneration.
Glucocorticoid (GC) are widely used in the treatment of ocular inflammation. However, glucocorticoid-induced glaucoma (GIG) is a common complication, and its pathogenesis has been extensively studied. This review summarizes the crucial role of zinc in GIG and its regulatory mechanisms, highlighting zinc's significant involvement in the pathogenesis of glaucoma. Zinc, the second most abundant transition metal in the human body, is essential for protein structure, enzyme catalysis, and cell signaling regulation. The effects of GC on zinc distribution vary across different tissues and cell types, affecting zinc uptake and release, which may contribute to the pathological processes of glaucoma. Zinc influences the degradation and remodeling of the trabecular meshwork extracellular matrix and the survival and axonal regeneration of retinal ganglion cells, playing complex roles in the pathogenesis of GIG. We discuss existing strategies for regulating zinc in vivo, including zinc supplementation and reduction strategies, providing potential therapeutic approaches. Future research should explore the mechanisms of zinc's role in glaucoma and its interaction with glucocorticoids, evaluate the safety and efficacy of zinc supplementation or chelation in glaucoma treatment, and develop novel zinc delivery and chelation systems. These efforts will help fully elucidate the role of zinc in glaucoma and its therapeutic potential, enabling more precise prevention and treatment strategies to improve patient outcomes.
Abstract AIM： To investigate the relationship between intraocular pressure (IOP) and central corneal thickness (CCT) and refractive error and its clinical significance. METHODS：In a retrospective study of large samples, 5713 patients and 11426 eyes underwent central corneal thickness, intraocular pressure, and refraction examinations. According to the central corneal thickness, it was divided into seven groups: 1 group 440-470um, 31 eyes; 2 group 471-500um, 743 eyes; 3 group of 501-530um, 3469 eyes; 4 group 531-560um, 4402 eyes; 5 group 561-590um, 2233 eyes; 6 group of 591-620um, 508 eyes; 7 group 621-650um, 40 eyes. According to the diopter, they were divided into five groups: 1 group with low hyperopia (+3.00 to 0D), 54 eyes; 2 group with low myopia (0< diopter < -3.00D), 2162 eyes; 3 group with moderate myopia (-3.00≤ diopter < -6.00D), 6771 eyes; 4 group of high myopia (-6.00≤ diopter < -9.00D), 2120 eyes; 5 group of ultra-high myopia (-9.00≤ diopter < -12.00D), 101 eyes. The corresponding intraocular pressure values were calculated respectively, and the obtained data were analyzed by variance analysis, Pearson linear correlation analysis and linear regression equation analysis. RESULTS：The central corneal thickness was 442 to 650 (541.27±28.46) um, the equivalent spherical degree was +2.50 to -11.87 (-4.40±1.76) D, and the intraocular pressure was 8.3 to 25.0 (16.09±2.52) mmHg. The results of correlation analysis showed a moderate positive correlation between corneal thickness and intraocular pressure (r=0.456, P<0.001). The regression equation was Y=-5.79 +0.04X (the central corneal thickness was X, the intraocular pressure was Y), the coefficient determination of the regression model was R2=0.208, and the regression model was statistically significant (F=2998.42, P<0.001）.The mean intraocular pressure of the seven groups were (12.04±2.03) mmHg in group 1, (14.15±2.10) mmHg in group 2, (15.09±2.26) mmHg in group 3, (16.28±2.29) mmHg in group 4, (17.35±2.25) mmHg in group 5, (18.51±2.38) mmHg in group 6, and (19.90±2.93) mmHg in group 7. The analysis of variance was statistically significant (F=454.09, P<0.001). The results of correlation analysis showed a low negative correlation between refraction and intraocular pressure (r= -0.092, P<0.001). The mean intraocular pressure (IOP) of the five groups were (15.19±2.84) mmHg in group 1, (15.77±2.55) mmHg in group 2, (16.10±2.52) mmHg in group 3, (16.39±2.39) mmHg in group 4, and (16.39±2.41) mmHg in group 5. The analysis of variance was statistically significant between groups (F=18.841, P<0.001). CONCLUSION： IOP increased with the increase of CCT and showed a moderate positive correlation, and a low negative correlation with diopter. The IOP increased by about 1mmHg for every 30um increase in central cornea thickness, and by about 0.1mmHg for every 1D increase in myopia degree.
Objective: To systematically analyze the related studies on intervention schemes for patients with visual field defects after stroke and identify, summarize, and summarize the specific content, outcome indicators, and intervention effects to provide reference for clinical practice and future research in this field. Methods: According to the method of scoping review, the systematic search was conducted in 9 databases, including CNKI, CQVIP, Wanfang Database, China Biomedical Literature Database, PubMed, Web of Science, Embase, CINAHL, and the Cochrane Library. The search time limit was from the establishment of the database to April 10, 2024. The included literature was screened, summarized, and analyzed. Results: A total of 12 articles were finally included, summarizing the intervention methods and outcome indicators for patients with visual field defects after stroke. The intervention methods include alternative intervention, compensatory intervention, and rehabilitative intervention. The outcome indicators include daily living activities, daily living extended activities, reading performance, and visual field examination. Conclusion: The current intervention schemes for patients with visual field defects after stroke are diverse in content, with low evidence quality and inconsistent outcome indicators. Further high-quality research is needed to explore the best training plan and standardize the outcome indicators. In the future, continuous improvement and optimization of rehabilitation strategies should be carried out to establish the best multidisciplinary structure and formulate scientific, systematic, and individualized plans.
Objective: To systematically analyze the related studies on intervention schemes for patients with visual field defects after stroke and identify, summarize, and summarize the specific content, outcome indicators, and intervention effects to provide reference for clinical practice and future research in this field. Methods: According to the method of scoping review, the systematic search was conducted in 9 databases, including CNKI, CQVIP, Wanfang Database, China Biomedical Literature Database, PubMed, Web of Science, Embase, CINAHL, and the Cochrane Library. The search time limit was from the establishment of the database to April 10, 2024. The included literature was screened, summarized, and analyzed. Results: A total of 12 articles were finally included, summarizing the intervention methods and outcome indicators for patients with visual field defects after stroke. The intervention methods include alternative intervention, compensatory intervention, and rehabilitative intervention. The outcome indicators include daily living activities, daily living extended activities, reading performance, and visual field examination. Conclusion: The current intervention schemes for patients with visual field defects after stroke are diverse in content, with low evidence quality and inconsistent outcome indicators. Further high-quality research is needed to explore the best training plan and standardize the outcome indicators. In the future, continuous improvement and optimization of rehabilitation strategies should be carried out to establish the best multidisciplinary structure and formulate scientific, systematic, and individualized plans.
Meibomian gland dysfunction (MGD) is a chronic and diffuse meibomian gland disease, however， traditional treatment methods cannot achieve satisfactory results. Intense pulsed light (IPL) is an emerging treatment for MGD, with a complex mechanism of action. IPL may treat meibomian gland dysfunction by promoting meibum secretion, ablation of abnormal dilation of eyelid margin capillaries, eradication of Demodex, and anti-inflammatory mechanisms; However, the antibacterial effect and photobiomodulation of Intense pulsed light are not fully understood. This article provides a review of the mechanism of IPL treatment for MGD, in order to understand its possible mechanisms and explore the effectiveness of treatment.
We present the case of a 45-year-old female patient who initially presented with fever and headache, testing positive for COVID-19 antigen at that time. One week later, she experienced a sudden bilateral decrease in visual acuity, accompanied by visual field defects, headache, and pain upon eye movement. The patient denied any significant medical history and autoimmune diseases. All four demyelinating antibodies associated with optic neuritis were negative. The patient exhibited highly congested edema of the optic discs, and enhanced orbital MRI indicated bilateral optic nerve enhancement, suggesting possible bilateral optic neuritis. This raises the question of whether this is an incidental optic neuritis during the COVID-19 period or a bilateral acute optic neuritis related to COVID-19 infection. In this article, we will discuss and elaborate on the potential mechanisms by which COVID-19 infection could lead to optic neuritis, aiming to shed light on this matter
post-transplant lymphoproliferative disease (PTLD) is a spectrum of lymphocyte or plasma cell proliferation caused by immunosuppression after solid organ , allogeneic hematopoietic stem cell or bone marrow transplantation, ranging from benign lymphoproliferation to malignant,with incidence from 1% to 17% after single organ transplantation. Intraocular PTLD is very rare, with more than 20 cases reported in the literature.It occured from 3 months to 10 years after transplantation,even after withdrawal of immunosuppressants.About half of the cases involved both eyes.The symptoms included eye pain,red eyes, floaters,blurring of vision, and so on, with about one-third cases asymptomatic. The most common signs were iris nodules,anterior chamber cells, and mutton-fat keratic precipitates. A few of the cases manifested vitreous opacity, subretinal mass, swelling of the optic papilla, granulomatous uveitis and so on.PTLD could involve the eye alone without systemic manifestations.Histologically PTLD was classified into four categories (World Health Organization,2017): Non-destructive PTLD , Polymorphic PTLD , Monomorphic PTLD , and Classic Hodgkin lymphoma PTLD.Before 2000, the mortality for PTLD was as high as 86%. With the introduction of close monitoring and prompt treatment, the prognosis of PTLD has been significantly improved, but the mortality is still as high as 25% to 60%.We should be fully aware of the early manifestations of this disease to early diagnose, timely treat, and improve its prognosis.
