AIM： To explore the clinical treatment of peripheral necrotizing keratitis after femtosecond laser-assisted??in situ?keratomileusis (FS-LASIK). METHODS：Retrospective case-control study. A total of 18,448 cases of FS-LASIK were collected in our hospital from 2022-06/2023-05. 22 cases and 39 eyes of patients with peripheral necrotizing keratitis were observed. The scope of peripheral corneal necrosis were examined under a slit lamp microscope and treated accordingly. And 30 cases of patients who were operated on the same day were randomly selected as the control group. Observe the changes in naked eye visual acuity, diopters and intraocular pressure between the two groups after cure. RESULTS：Among the 18,448 cases, 22 patients and 39 eyes with peripheral necrotizing keratitis were found, with an incidence rate of 1.2‰, including 4 males and 18 females, aged 31 ± 5.0 years old. Topical tobramycin and dexamethasone eye drops were administered once an hour and in descending order every other day. The patient's pain, foreign body sensation, and tearing symptoms were significantly relieved. Most of the peripheral corneal necrosis lesions improved in 1 week, and gradually healed to form interlaminar clouds in 2 weeks. After treatment, the naked eye visual acuity, intraocular pressure, and diopters of the PNK group showed no significant changes compared with those of the control group. No glucocorticoid-induced intraocular hypertension occurred. CONCLUSION：Topical tobramycin and dexamethasone eye drops have a good therapeutic effect on peripheral necrotizing keratitis. The necrotic area forms scars after healing. The PNK case in this article is limited to the periphery and has no significant impact on naked eye vision, intraocular pressure, and diopters. KEYWORDS：Femtosecond laser-assisted??in situ?keratomileusis; Peripheral necrotizing keratitis; Diffuse lamellar keratitis; Postoperative complications; Glucocorticoids
Leukemia is a kind of myeloproliferative malignant clonal disease, its first symptoms are diverse, but with vision for first symptoms rare [1], with fever, fatigue, liver and spleen galomegaly for first symptoms, through this paper reported 1 case with vision for for chronic granular leukemia cases, for future clinical work experience, in order to improve the early diagnosis, avoid misdiagnosis, diagnosis.
Abstract: Objective To retrieve and analyze the clinical trials of Chinese medicine against dry eye disease(Dry eye disease，DED) included in the China Clinical Trial Registry (ChiCTR), and to understand their distribution characteristics and development trends. Methods A computerized search was performed on the clinical trials related to the prevention and treatment of dry eye in TCM included in ChiCTR from the establishment of the database to January 27, 2024, data were extracted and entered into Excel 365 for de-emphasis, and the included data were statistically analysed using the SPSS 26.0 software, and the corresponding charts were plotted to summarize the characteristics of the clinical trials. Results A total of 29 clinical trials were included, of which 24 were pre-registered. The registered research projects involved 8 provincial administrative regions and 21 clinical trial organizations in Shanghai, Beijing, Guangdong, Hunan, Zhejiang, Fujian, Shenzhen, and Hubei provinces, among which the Shanghai Institute of Acupuncture and Meridian Research (7 projects, 24.14%) registered the largest number of projects. The sources of funding were mainly 13 local finance (43.33%), self-funding (26.67%), university research funding (10.00%), pharmaceutical company funding (10.00%), hospital funding (6.67%), and national financial support (3.33%). The types of studies were mostly intervention studies (24, 87.76%), and the study design was most frequently randomized parallel controlled studies (25, 86.20%). Interventions included acupuncture, classic Chinese herbal formulas/hospital-made formulas, and proprietary Chinese medicines, and outcome indicators included primary, secondary, side effect, and additional indicators. Conclusion The rise in the number of clinically registered trials of Chinese medicine against dry eye in China tends to stabilize, the distribution of registration areas is not balanced, and the filling of clinical trial data is incomplete and not standardized, and the follow-up should strengthen the training of investigators about clinical trial registration and improve the awareness of clinical trial registration among investigators.
Abstract Aim: The objective of this study was to investigate the prognosis of massive vitreous hemorrhage (VH) secondary to polypoidal choroidal vasculopathy (PCV) after vitrectomy. Methods: Forty-nine eyes in 48 patients with PCV and breakthrough VH who underwent 23-gauge pars plana vitrectomy between January 2015 and December 2020 were enrolled. The main outcome parameters were best-corrected visual acuity, postoperative adverse events, and reoperation. Results: The average follow-up time was 20.0±15.82 months. The average preoperative best-corrected visual acuity (BCVA) was 2.12±0.65 logarithm of the minimum angle of resolution (logMAR), the BCVA at six months was 1.65±0.64 logMAR, and the six-month follow-up BCVA was 1.67±0.76 logMAR. Compared to the average preoperative BCVA, the six-months and last follow-up BCVA after vitrectomy improved (P<0.05). Postoperative complications were observed in 10 eyes (20.4%), including recurrent retinal detachment, recurrent vitreous hemorrhage, macular hole, hyphema and lens dislocation. Fourteen eyes (28.6%) underwent cataract surgery procedure an average of 10.16±5.14 months after vitrectomy. BCVA one week and three months after cataract surgery improved compared to BCVA before cataract surgery (P<0.05). Conclusions: Although the prognosis of vitrectomy varies greatly, cataract surgery could be considered to improve BCVA if polypoidal lesions are inactive six months after vitrectomy. Keywords: polypoidal choroidal vasculopathy; vitreous hemorrhage; vitrectomy; visual acuity
Objective: To understand the situation of non proliferative diabetic retinopathy (NPDR) in Kashi by optical coherence tomography angiography (OCTA). Method: 32 patients with NPDR who visited our hospital from August 2022 to April 2023 were included in the study, and 50 patients were included in the normal control group. Obtain two sets of OCTA data, including the Superficial Retinal Vascular Plexus (SVP), Deep Retinal Vascular Plexus (DVP), and Foveal Avascular Zone (FAZ) areas, and compare the differences in different indicators between the two groups. Results: 11 men (34.375%) in the NPDR group, with an average age of 58 ± 9.89 years, an average number of years with diabetes of 13.39 ± 7.2, an average glycosylated hemoglobin value of 9.48 ± 2.28 mmol/L, and the best corrected visual acuity (BCVA) (decimal visual acuity) of 0.54 ± 0.3. There were 50 cases in the normal control group and 21 cases (42%) in males. The best corrected visual acuity (BCVA) was 0.97 ± 0.12. The SVP blood flow density (%) in the NPDR group was (21.65 ± 5.38), while the normal control group was (26.36 ± 6.23). The DVP blood flow density (%) in the NPDR group was (19.12 ± 4.3), while the normal control group was (27.51 ± 2.95). The FAZ area (mm2) in the NPDR group was (0.51 ± 0.15), while the normal control group was (0.41 ± 0.14). Compared with the normal control group, the SVP blood flow density and DVP blood flow density in the NPDR group were significantly reduced, while the FAZ area was significantly increased, And it has statistical significance (P=0.001, P<0.001, P=0.003, respectively). Glycated hemoglobin (HbA1c) was negatively correlated with SVP blood flow density (%) and DVP blood flow density (%) (Pearson correlation coefficients were -0.381, P=0.032 and -0.583, P<0.001), while glycated hemoglobin (HbA1c) was not significantly correlated with FAZ area (Pearson correlation coefficient was -0.203, P=0.301). Conclusion: The blood flow density and FAZ area of non proliferative diabetes retinopathy patients in Kashgar have changed on OCTA, which is of great significance for early detection and treatment of the disease.
Objective: To understand the situation of non proliferative diabetic retinopathy (NPDR) in Kashi by optical coherence tomography angiography (OCTA). Method: 32 patients with NPDR who visited our hospital from August 2022 to April 2023 were included in the study, and 50 patients were included in the normal control group. Obtain two sets of OCTA data, including the Superficial Retinal Vascular Plexus (SVP), Deep Retinal Vascular Plexus (DVP), and Foveal Avascular Zone (FAZ) areas, and compare the differences in different indicators between the two groups. Results: 11 men (34.375%) in the NPDR group, with an average age of 58 ± 9.89 years, an average number of years with diabetes of 13.39 ± 7.2, an average glycosylated hemoglobin value of 9.48 ± 2.28 mmol/L, and the best corrected visual acuity (BCVA) (decimal visual acuity) of 0.54 ± 0.3. There were 50 cases in the normal control group and 21 cases (42%) in males. The best corrected visual acuity (BCVA) was 0.97 ± 0.12. The SVP blood flow density (%) in the NPDR group was (21.65 ± 5.38), while the normal control group was (26.36 ± 6.23). The DVP blood flow density (%) in the NPDR group was (19.12 ± 4.3), while the normal control group was (27.51 ± 2.95). The FAZ area (mm2) in the NPDR group was (0.51 ± 0.15), while the normal control group was (0.41 ± 0.14). Compared with the normal control group, the SVP blood flow density and DVP blood flow density in the NPDR group were significantly reduced, while the FAZ area was significantly increased, And it has statistical significance (P=0.001, P<0.001, P=0.003, respectively). Glycated hemoglobin (HbA1c) was negatively correlated with SVP blood flow density (%) and DVP blood flow density (%) (Pearson correlation coefficients were -0.381, P=0.032 and -0.583, P<0.001), while glycated hemoglobin (HbA1c) was not significantly correlated with FAZ area (Pearson correlation coefficient was -0.203, P=0.301). Conclusion: The blood flow density and FAZ area of non proliferative diabetes retinopathy patients in Kashgar have changed on OCTA, which is of great significance for early detection and treatment of the disease.
Objective: To investigate the effects of a compound Lycium barbarum fumigation formulation administered through ultrasonic nebulization on corneal status and tear film quality in a rat model of evaporative dry eye, providing experimental evidence for the clinical use of the compound Lycium barbarum fumigation formulation. Methods: Forty clean-grade male Sprague-Dawley rats were randomly divided into four groups: control group, model group, sodium hyaluronate eye drops group, and traditional Chinese medicine (TCM) nebulization group. Except for the control group, the remaining three groups were induced to develop the evaporative dry eye model using a mechanical method of blocking the meibomian glands. After successful modeling, the model group received no treatment, the sodium hyaluronate eye drops group received sodium hyaluronate eye drops three times daily (1 drop each time), and the TCM nebulization group received the compound Lycium barbarum fumigation formulation via nebulization twice daily for 20 minutes each time. Tear film break-up time (BUT), corneal injury score, tear pH value, and other indicators were observed before intervention, after 2 days, 1 week, and 2 weeks of intervention. Results: Tear film break-up time: After 2 days of TCM nebulization, the tear film break-up time was significantly prolonged in the TCM nebulization group and the sodium hyaluronate eye drops group compared to the model group (P<0.01). After 1 and 2 weeks, the tear film break-up time in the TCM nebulization group further increased compared to the model group and the sodium hyaluronate eye drops group (P<0.01). The effect of TCM nebulization treatment was most significant after 2 days, with BUT approaching the level of the control group. Corneal injury score: After 2 days of TCM nebulization, the corneal injury score significantly decreased, while there was no significant change in the sodium hyaluronate eye drops group. After 1 and 2 weeks, both the TCM nebulization group and the sodium hyaluronate eye drops group showed a significant reduction in corneal injury score (P<0.01), with the TCM nebulization group demonstrating a more significant improvement. Tear pH value: After 2 days of TCM nebulization, there was a significant decrease in tear pH value, while there was no significant change in the sodium hyaluronate eye drops group. After 1 and 2 weeks, the tear pH value continued to decrease in the TCM nebulization group, while there was no significant change in the sodium hyaluronate eye drops group. The effect of TCM nebulization treatment was most significant after 2 weeks, with a more significant decrease in tear pH value. Conclusion: TCM nebulization treatment with the compound Lycium barbarum fumigation formulation shows significant effects in alleviating ocular surface dysfunction, improving corneal injury scores, and reducing tear pH values, which are more significant compared to the sodium hyaluronate eye drops group.
Background Research innovations on disease screening, diagnosis, and management in ophthalmology have been boosted by deep learning (DL) in the last decade. To assess historical research trends and current advances, we conducted an artificial intelligence (AI)–human hybrid analysis of publications on DL in ophthalmology. Methods All DL-related articles in ophthalmology published between 2012 and 2022 from Web of Science were included. 500 high-impact articles annotated with key research information were used to fine-tune an LLM for reviewing medical literature and extracting information. After verifying the LLM's accuracy in extracting diseases and imaging modalities, we analyzed trend of DL in ophthalmology using 2535 articles. Results Researchers using LLM were 70% (p = 0.0001) faster than those who did not, while achieving comparable accuracy (97% versus 98%, p = 0.7681). The field has grown 116% annually, paralleling trends of the broader DL domain. The publications focused heavily on diabetic retinopathy (p = 0.0003), glaucoma (p = 0.0011), and age-related macular diseases (p = 0.0001) using retinal fundus photographs (FP, p = 0.0015) and optical coherence tomography (OCT, p = 0.0001). DL studies utilizing multimodal images have been growing, with FP and OCT combined being the most frequent. Furthermore, 43 publicly available ocular image datasets were summarized. Conclusion This study has characterized the landscape of publications on DL in ophthalmology, by identifying the trends and breakthroughs among research topics and the fast-growing areas. This study provides an efficient framework for combined AI–human analysis to comprehensively assess the current status and future trends in the field.
The vigorous development of digital ophthalmology technology has penetrated into all fields of ophthalmology and brought about major changes. This paper summarizes the research and development of leading-edge technology in ophthalmology, focusing on the breakthroughs and achievements of various technologies, focusing on the domestic but also looking at the world, and elucidating the status quo and achievements of global advanced ophthalmology technologies in recent years. For example, artificial intelligence can be applied to the accurate monitoring of many diseases, the efficient evaluation of high-incidence diseases, and the technical support of telemedicine, etc., which improves the accuracy and efficiency of screening, diagnosis, treatment and other links, reduces the burden of doctors, and shows great application potential; Other technologies such as digital imaging technology have also made leaps and bounds in surgical navigation and imaging diagnosis. 3D modeling and new machine learning technologies have contributed to surgical design and improved surgical success, providing more efficient and convenient services to patients with eye diseases around the world. In addition, digital ophthalmology technology also shows a diversified development trend, and multi-disciplinary communication, cross-use, collision of different sparks. Although many cutting-edge ophthalmic technologies are still in the initial stage of development, there is still a certain distance from the implementation of high coverage, and there are still many uncertainties in the accuracy and interpretability of algorithms, medical ethics, public acceptance, medical disputes, clinical technical challenges and other issues. But there is no doubt that with the increasing improvement of medical level, the above technology will be continuously improved and popularized.
