Abstract Objective To investigate the clinical features of congenital optic disc dysplasia and review the literature. Methods A case of atypical congenital optic disc dysplasia was retrospectively analyzed. Besides, the etiology, fundus manifestations and morbidity of the disease were also analyzed and discussed. Results The optic disc was pale with unclear boundary in the patient's left eye. The cup-to-disk ratio was about 0.3. There was large retinal atrophy around the optic disc. The blood vessels were slender with abnormal shape. The structure of macular was unclear and fovea reflection can not be seen. The vitreous body was slightly cloudy and the left eye wall was indented below the optic nerve. Conclusion Congenital dysplasia of the optic disc is rare and the pathogenesis is not fully elucidated. It was often misdiagnosed as simple amblyopia, strabismus or ametropia. Correct identification and timely treatment of these diseases are crucial to improve the prognosis.

Purpose: To evaluate the application of SIt, phenol red thread, and SMTube in the diagnosis of dry eye, and to analyze the consistency and correlation of these methods in evaluating tear volume. [13] Methods: This study selected 30 dry eye patients (60 eyes) treated from October to December 2023. All underwent SIt, phenol red thread, and SMTube examinations, and the correlation and consistency of the measurement results were analyzed. Inclusion criteria: (1) voluntarily signed the informed consent form, age between 18 and 50 years old; (2) dry eye diagnosis criteria: based on the "Chinese Dry Eye Expert Consensus: Examination and Diagnosis (2020)" with an Ocular Surface Disease Index (OSDI) score ≥13. [13]. Exclusion of patients with any history of corneal or ocular surgery, Stevens Johnsons syndrome, Sj?gren's syndrome, or immune-related or other systemic diseases or risk factors. [18]. The study was reviewed and approved by the Ethics Committee of Kunming Aier Eye Hospital [No.2023(01)], and all included patients were informed of the purpose of the experiment according to the "Helsinki Declaration" and signed the informed consent form. [13-14]. Results: The correlation between the phenol red thread and SMTube was very strong, with an R-squared value of the fitting line as high as 0.77; the R-squared value for the SIt and SMTube fitting line was 0.25, showing some correlation; the R-squared value for the SIt and phenol red thread fitting line was 0.34, also showing some correlation. The measurement results of SMTube and phenol red thread were relatively consistent, and the results of the two measurement methods showed a moderate degree of correlation with the results of the tear paper test (correlation coefficient <0.7), indicating some consistency. Conclusion: The measurement results of SMTube and phenol red thread are relatively consistent, and the results of the two measurement methods show a moderate degree of correlation with the results of the tear paper test (correlation coefficient <0.7), indicating some consistency. SMTube and phenol red thread can be used interchangeably with SIt in tear detection, with a quick and comfortable examination process, and can replace the routine SIt in clinical examination.

Objective: To investigate the current situation of critical thinking abilities of master’s degree postgraduates in ophthalmology and to identify the factors affecting the critical thinking abilities. Methods: Using the Critical Thinking Disposition Inventory-Chinese Version (CTDI-CV), a questionnaire survey was conducted among 81 master’s degree postgraduates in ophthalmology. Results: The average total score of the CTDI-CV for the 81 master’s degree postgraduates in ophthalmology was 294.79±29.18, indicating a general possession of positive critical thinking abilities, yet scores in “Truth Seeking” and “Systematicity” were relatively low. There are differences in critical thinking abilities among master’s degree postgraduates in ophthalmology of various grades and degree categories. Multivariate linear regression indicates that degree categories is correlated with the critical thinking abilities of ophthalmology graduate students. Conclusion: The master’s degree postgraduates in ophthalmology generally exhibit positive traits of critical thinking, yet there is room for improvement in specific areas. Postgraduate education should adopt targeted measures to cultivate the critical thinking abilities of postgraduates.

Purpose: To explore the effect of EVFW(episcleral venous fluid wave) on the IOP(intraocular pressure) after cataract surgery. Design: Retrospective study Object of study: 43 cases (50 eyes) cataract patients from Chengdu First People’s Hospital ophthalmology during January 2023 to July 2023. Research method: 25 eyes whose anterior chamber angle were irrigated during cataract surgery are classified as experimental group, and the other 25 eyes whose anterior chamber angle were not irrigated during cataract surgery are classified as control group. All surgeries were operated by Liuzhi Zeng archiater. The degree and position of EVFW were recorded during catarcat surgery. And the IOP changes of 1 day, 1 week, 1 month and 3 months after cataract surgery were observed. Result: There was no difference between the preoperative IOP of experimental group(17.72±2.189mmHg) and control group(17.04±1.670mmHg); There was no difference in age between the experimental group(69.52±9.417) and control group(71.28±7.871); There was no difference of statistics in IOP changes of 1 day, 1 week and 1 month between the experimental group and control group. The IOP of third month after surgery(14.56±2.755mmHg) reduced obviously compared with the preoperative IOP(17.72±2.189mmHg) in experimental group (P<0.05), and so did the control group in which the postoperative IOP(15.28±1.487mmHg) was obviously lower than the preoperative IOP(17.04±1.670mmHg) (P<0.05). There was no difference of statistics in Introcular pressure drops between the experimental group (-3.16±3.460mmHg) and control group(-1.76±1.855mmHg) in the third month after surgery. There was no correlation between the EVFW quadrants and the Introcular pressure drops in the third month after surgery (P>0.05). Conclusion: Phacoemulsification can reduce forword IOP. Addition irrigation of anterior chamber angle and EVFW in normal human eyes can’t reduce more IOP.

Objective: To investigate the situation of day surgery in an eye hospital in Tianjin, and to provide the focus and basis for further promotion of day surgery, so as to promote day surgery in other medical institutions in China. Methods: The data of patients undergoing day surgery in an eye hospital from January 2018 to January 2023 were retrospectively analyzed. The clinical data such as the number of day surgeries completed, disease categories, surgical methods, the proportion of day surgeries to elective surgeries, the rate of day surgery withdrawal and the causes were statistically analyzed. SPSS 22.0 statistical software was used to establish a database for analysis. Results: In the past 5 years, 65949 patients underwent daytime ophthalmic surgery, including 35474 patients > 60 years old, accounting for 53.79%. The male/female ratio was 0.44:1 (20207:45742). The number of daytime operations showed an increasing trend year by year. The top five types of daytime operations were crystal phacoemulsification + intraocular lens implantation (72.08%), vitreous injection (19.55%), strabismus correction (5.27%), pterygium excision + corneal epithelial transplantation (1.28%) and silicone oil extraction (0.61%). The department with the largest number of day surgery units is the cataract department. The proportion of day operation in elective surgery increased yearly, and the average length of stay of elective surgery patients decreased year by year. The total number of day surgery patients was 67025, and the total number of withdrawal cases was 1076, the withdrawal rate was 1.61%, among which the proportion of patients who did not check in to the hospital according to the agreement was the highest (33.09%). Conclusion: With the maturity of day surgery, patients are more willing to choose day surgery. Among the 65949 day operation patients, patients aged 60 and above accounted for the largest proportion, and more women than men. Among the types of diseases in day surgery, lens disease was the first, senile cataract was the main one, choroidal and retinal diseases were the second, and retinal detachment and diabetic retinopathy were the main ones. The withdrawal rate of day surgery patients can be effectively reduced by telephone visit and SMS push one day before surgery. Compared with the traditional hospitalization mode, the implementation of day surgery can effectively reduce the average hospitalization days of patients, significantly improve the utilization rate and turnover rate of beds, shorten the waiting time and hospitalization days of patients, help optimize the allocation of hospital resources, improve the medical experience and satisfaction of patients, enable more patients to obtain high-quality medical services, and solve the contradiction between supply and demand, which is worthy of great promotion.

Background/Aims: This study describes vascular abnormalities in X-linked retinoschisis (XLRS) using fundus fluorescein angiography (FFA) and ultra-widefield swept-source optical coherence tomography angiography (UWF SS-OCTA) to better understand the disease's vascular features and impact. Methods: A retrospective cross-sectional study was conducted on 26 XLRS patients (46 eyes), with assessments including best-corrected visual acuity, slit-lamp examination, fundus photography, FFA, and UWF SS-OCTA. FFA abnormalities were classified into two categories: those associated with peripheral schisis (e.g., dendritic capillary dilation/leakage) and those associated with the optic disc (e.g., peripapillary choroidal neovascularization (PPCNV), situs inversus of optic disc). Results: The mean age of patients was 11.3±6.5 years. Macular schisis appeared in 97.8% of eyes, peripheral schisis in 89.1%, and bullous schisis in 67.39%. Major vascular changes identified by FFA included dendritic capillary dilation/leakage (91.3%), internal residual vessel leakage (78.3%), and capillary dropout/ischemia (71.7%). Minor changes included zonal retinal pigment epithelium (RPE) proliferation (6.5%), bridging vessels (4.4%), and capillary sheathing (4.4%). PPCNV was noted in 10.9% and situs inversus of optic disc in 13.0% of eyes. Additionally, situs inversus of optic disc and zonal RPE proliferation were novel findings. Major FFA changes correlated with broader bullous schisis (P=0.045) (P＜0.001) (P =0.003). No significant correlation was found between gene mutation type and FFA abnormalities(P=1.000) (P=0.539). Conclusions: This study highlighted the significant prevalence (95.7%) of vascular abnormalities in XLRS and emphasized the importance of combining FFA with UWF SS-OCTA for comprehensive evaluation, enhancing the understanding of XLRS pathophysiology and aiding in targeted treatment approaches.

Objective: To observe the safety and efficacy of endoscopic-assisted lacrimal duct probing in neonates with acute dacryocystitis. Methods: A retrospective study was conducted on 103 cases (148 eyes) of neonates with acute dacryocystitis treated from December 2016 to December 2022. Among them, 58 cases (76 eyes) in the observation group were treated with lacrimal duct probing surgery assisted by nasal endoscopy; 45 cases (72 eyes) in the control group were treated with conventional conservative treatment. Analyze the treatment time, cure rate, and complications of the two groups. Results: The average treatment time in the observation group was 2.67 ± 0.28days, while the average treatment time in the control group was 8.69± 0.63 days. The treatment time in both groups was statistically significant (P <0.05), with a cure rate of 98.68% in the observation group and 22.22% in the control group. The cure rates in both groups were statistically significant (P <0.05), and the incidence of complications in the observation group was less than that in the control group. Conclusion: Nasal endoscopic assisted dacryocystitis probing surgery for the treatment of neonates with acute dacryocystitis has a higher success rate and safety compared to,so it is worthy of promotion.

Objective: To explore the application value of intravitreal injection of ganciclovir and low-dose triamcinolone acetonide in acute retinal necrosis syndrome and evaluate their clinical efficacy. Method: Retrospective case series study. A total of 26 patients (27 eyes) diagnosed with acute retinal necrosis syndrome in our hospital from February 2019 to December 2023 were included in the study. The observation group (12 eyes) and the control group (15 eyes) were treated with systemic acyclovir or ganciclovir intravenous infusion. Both the observation group and the control group received 3mg of ganciclovir multiple times. The observation group received 1mg of triamcinolone acetonide after 3-5 injections of ganciclovir, while the control group received 3mg of ganciclovir intravitreal injection alone. Postoperative patients were followed up for 3 months, and the treatment effect was evaluated by observing the best corrected visual acuity (log MAR), anterior posterior segment condition, changes in intraocular inflammatory factors, and viral titers before and after treatment in both groups of patients. Results: At the last follow-up of the two groups of patients, there was a significant improvement in visual acuity in the observation group, while there was no significant improvement in the control group; Both groups of patients showed improvements in vitreous opacity and fundus manifestations, with a significant reduction in intraocular inflammation. The observation group showed a more significant reduction in inflammation; There were 24 cases of VZV infection and 2 cases of HSV infection in two groups of patients. The final virus titers in both groups were significantly lower than before treatment, and there was no significant difference in the final virus detection titers between the two groups. Conclusion: In the treatment of acute retinal necrosis, systemic antiviral drugs combined with intravitreal injection of antiviral drugs and low-dose triamcinolone acetonide can effectively improve patients' vision, control inflammatory reactions and virus replication, reduce the occurrence of retinal detachment, and have good clinical treatment effects.

With the rapid development of artificial intelligence (AI) technology, its application in the field of healthcare is bringing revolutionary changes. Cataracts, as one of the most common reversible visual impairments worldwide, still face many practical issues in terms of limited medical resources, low diagnostic accuracy, and low referral efficiency. Therefore, it is crucial to utilize AI technology's powerful computational analysis and intelligent decision-making capabilities to optimize traditional medical practices and safeguard people's visual health.This article investigates the applications of AI technology on a new model of hierarchic diagnosis and treatment for cataracts, including automatic analysis and recognition of cataract images, remote healthcare, and referral support. These applications can bring significant benefits and important impacts to cataract patients, society, and governments. They can help improve the efficiency of cataract diagnosis and treatment, alleviate the imbalance of medical resources, optimize the allocation and management of healthcare resources, and promote societal health progress.However, the practical application of AI technology also faces risks and challenges. It is important to fully prioritize and protect patients' data privacy and security by establishing strict regulatory and oversight mechanisms. Additionally, continuous efforts should be made to enhance technological innovation and comprehensively evaluate the robustness, fairness, and interpretability of AI algorithms to further improve the accuracy and trustworthiness of AI systems.

Abstract Objective The promoter of cyp4v2 was obtained to achieve target gene efficient expression in all layers of the retina, in preparation for BCD gene therapy. Methods The gene sequence of cyp4v2 was retrieved from NCBI. Primers were designed according to the retrieved sequence, and the genomic DNA of ARPE19 cells was used as a template, promoters of different lengths were obtained by PCR. Different lengths promoters were constructed containing luciferase, and the enzyme digestion confirmed that the inserted fragments were consistent with the target fragments. The activity of the promoter was detected by a dual fluorescence system to obtain the core promoter of interest. Different enhancer elements were added to further increase the activity without changing its expression pattern. Results The core promoter sequence was cloned by truncating or missing the promoter of different lengths, and the core promoter was systematically optimized to enhance the expression level, so that the cyp4v2 gene delivered by AAV had the same expression pattern as the endogenous gene while being highly expressed, and the performance is better than that of constitutive promoters such as CMV. Conclusion The promoter sequence of cyp4v2 was successfully cloned. It can better realize the expression of cyp4v2 and reduce the side effects caused by ectopic expression of cyp4v2, to prepare for the gene therapy of BCD.