眼底影像专栏

一站式玻璃体腔注药中心成立前后效果评价

The evaluation of the effects before and after the establishment of a one-stop intravitreal injection center

:252-260
 
目的:探讨一站式玻璃体腔注药中心成立前后不同管理模式下的成效,分析其对患者就医时间和就医体验的影响。方法:采用回顾性临床研究。选择2023年1月—2024年3月在汕头大学·香港中文大学联 合汕头国际眼科中心接受玻璃体腔注药的2955例患者纳入研究。将2023年1月—2023年8月玻璃体腔注 药中心成立前接受玻璃体腔注药的1399例患者作为对照组;2023年9月—2024年3月玻璃体腔注药中心成立后接受玻璃体腔注药的1556例患者作为观察组。对照组采用常规日间手术流程,观察组成立一 站式玻璃体腔注药中心,优化诊疗和护理服务流程。通过使用问卷调查比较两组患者就医期间从预约手术、手术当天到术后复查各节点的等待时间、健康教育知晓率、患者满意度及不良事件发生率的差异。结果:问卷调查结果显示,对照组、观察组患者间预约等待手术时间分别为(3.93±2.98) d、 (1.34±2.38) d,手术时间分别为(2.53±2.11) min、(1.93±1.82) min,在院时间分别为(313.62±184.96) min、(85.43±34.14) min,术后复查耗时分别为(45.92±48.44) min、(25.82±16.21) min,差异均有统计学意义(P<0.001);患者的总体健康教育知晓率成立前后分别为(95.50%、98.70%),差异有统计学意义 (χ2 =16.09,P<0.001);患者满意度调查结果显示,各项就医体验选项“非常满意”的占比成立后比 成立前明显提高。结论:一站式玻璃体腔注药中心护理模式简化了就医流程,极大地减少了患者就医期 间从预约手术、手术当天到术后复查各节点的等待时间、可显著提升工作效率,明显改善患者整体就 医体验。

To explore the application effects of different nursing models before and after the establishment of a one-stop intravitreal injection center, and to analyze their impact on patient's medical time and experience. Methods: A retrospective clinical study was conducted. From January 2023 to March 2024, 2955 patients who received anti-VEGF drug treatment at the Shantou International Eye Center, a joint initiative of Shantou University and the Chinese University of Hong Kong, were included in the study. The 1399 patients who received anti-VEGF drug treatment before the establishment of the intravitreal injection center from January 2023 to August 2023 were set as the control group; the 1556 patients who received anti-VEGF drug treatment after the establishment of the intravitreal injection center from September 2023 to March 2024 were set as the observation group. The control group followed the routine day surgery process, while the observation group established a one-stop intravitreal injection center to optimize the diagnosis, treatment, and nursing service process. A questionnaire survey was used to compare the differences in waiting time at various points from appointment to surgery, on the day of surgery, and postoperative review, health education awareness rate, patient satisfaction, and adverse event rate between the two groups. Results: The questionnaire survey showed that the waiting time for surgery between the control group and the observation group was (3.93±2.98) d, (1.34±2.38) d, respectively, the surgery time was (2.53±2.11) min, (1.93±1.82) mi, the in-hospital time was (313.62±184.96 min, 85.43±34.14) min, and the postoperative review time was (45.92±48.44) min, (25.82±16.21) min, with all differences being statistically significant (P <0.001); the overall health education awareness rate before and after the establishment was (95.50%, 98.70%), with a significant difference (P <0.001, χ2=16.09); the patient satisfaction survey showed that the proportion of "very satisfied" in various medical experience options was significantly higher after the establishment than before. Conclusions: The one-stop intravitreal injection center nursing model has simplified the medical process, greatly reducing the waiting time at various points from appointment to surgery, on the day of surgery, and postoperative review, significantly improving work efficiency, and significantly improving the overall medical experience of patients.

眼底影像专栏

非感染性葡萄膜炎继发脉络膜新生血管的多模式影像特征

Multimodal imaging features of choroidal neovascularization secondary to non-infectious uveitis

:241-251
 
目的:评估炎非感染性葡萄膜炎继发炎性脉络膜新生血管(inflammatory choroidal neovascularization, iCNV)的临床特征及眼底多模式影像表现。方法:采用回顾性观察性研究,采用眼底荧光素血管造影(fundus fluorescein angiography, FFA)、吲哚菁绿血管造影(Indocyanine green angiography, ICGA)、谱域相干光断层扫描(spectral domain optical coherence tomography, SD-OCT)联合光学相干断层扫描血管成像(optical coherence tomography angiography, OCTA)等多种眼底影像学方法,对纳入患者的眼底进行检查,分析非感染性iCNV的面积、分型、位置及形态等影像学特征与临床特征的关系。结果:研究共纳入39例患者,对48只患眼中的51处iCNV病灶进行了评估。纳入患者年龄为(35.28±13.62)岁。其中3例患眼出现多灶性CNV。SD-OCT显示92.16%(47/51)的iCNV为2型CNV,17.65%(9/51)的iCNV出现海绵征,13.72%(7/51)的iCNV伴有局灶脉络膜凹陷。ICGA造影期间,74.50%的iCNV病灶(38/51)伴有弱荧光病灶,25.49%的病例(13/51)显示脉络膜高通透性表现。OCTA enface图像显示iCNV形态多样,包括焦点状(15例,29.41%)、盘状/海扇状(16例,31.37%)、枯树状(9例,17.65%)、星状(9例,17.65%)及弥漫网状(2例,3.92%)。其中,枯树状及星状iCNV提示iCNV为非活动性(P<0.01)。结论:非感染性iCNV与炎性病灶关系密切,在SD-OCT,ICGA上皆具特征性的影像表现。OCTA能直观地观察到iCNV的形态。这些多模式影像特征为临床医生提供了对于非感染性iCNV重要的鉴别诊断依据,有助于制定有效的诊疗方案。
Objective: To evaluate the clinical characteristics and multimodal imaging features of non-infectious inflammatory choroidal neovascularization (iCNV). Methods: In this study retrospective, observational study, multimodal imaging examinations, including fluorescein angiography (FFA), indocyanine green angiography (ICGA), spectral-domain optical coherence tomography (SD-OCT), and optical coherence tomography angiography (OCTA), were used to observe the morphology of non-infectious iCNV in patients diagnosed with uveitis. The area of iCNV, CNV types, CNV morphology and other imaging characteristics were further analyzed. Results: A total of 39 patients were included, with 48 affected eyes and 51 iCNV were identified. The average age of the included patients was 35.28±13.62 years. Among the affected eyes, 3 presented with multifocal CNV, and 92.16% of iCNV were classified as type 2 CNV. iCNV exhibited diverse morphologies, including focal-like pattern (15 cases, 29.41%),sea-fan pattern(16 cases, 31.37%), dead-tree pattern CNV(9 cases, 17.65%), stellar pattern (9 cases, 17.65%), and diffuse reticular (2 cases, 3.92%). Notably, tree-like and stellar pattern iCNV showed a significant correlation with non-active CNV (P < 0.01). Conclusions: Non-infectious iCNV is closely related to inflammatory lesions, exhibiting characteristic imaging features on SD-OCT and ICGA. OCTA allows for direct observation of the morphology of iCNV. These multimodal imaging characteristics provide important diagnostic criteria for clinicians, aiding in the formulation of effective treatment plans.
团体标准解读

《睑板腺按摩操作流程》团体标准解读

Interpretation of the group standard for operation procedure of meibomian gland massage

:236-240
 
睑板腺功能障碍可导致眼表微环境失衡,眼部不适及视功能障碍,深刻影响着患者的视觉生活质量。
睑板腺按摩作为一种通过机械挤压睑板腺疏通睑板腺开口,排出异常睑酯的治疗手段,目前已被广泛应用于临床干眼患者,成为睑板腺功能障碍最常见的物理治疗方法。但由于睑板腺按摩的操作手法多样,不同医疗机构所积累的操作经验也不尽相同,导致在治疗过程中存在较多潜在风险,若操作不当,可造成眼部感染、眼睑红肿、结膜水肿出血,甚至角膜损伤。因此,制定标准化的操作流程,规范睑板腺按摩治疗非常重要。然而,目前尚缺乏全面、系统化且规范化的睑板腺按摩操作的临床实践指导。鉴于此,中山大学中山眼科中心联合全国19所医疗机构进行反复修订,于2023年12月17日在全国团体标准信息平台发布《睑板腺按摩操作流程》的团体标准。文章对该团体标准进行深度解读,以更好指导临床工作。
Meibomian gland dysfunction (MGD) can lead to an imbalance in the ocular surface microenvironment, eye discomfortable, and visual impairment, thereby profoundly affecting the visual quality of life of patients. Meibomian gland massage is now widely used in clinical patients, serving as the most prevalent physical therapy for MGD. The mechanism of meibomian gland massage is to open the meibomian gland opening by squeezing the meibomian gland and expel abnormal eyelid esters. However, due to the diverse techniques used in meibomian gland massage and the varying levels of operational experience accumulated by different medical institutions, there are many potential risks in treatment process. If medical staff operate improperly, it can cause eye infections, eyelid redness and swelling, conjunctival edema and bleeding, and even corneal damage. Therefore, it is crucial to establish the standardized procedure of meibomian gland massage therapy. Yet, there is currently lack of comprehensive, systematic, and standardized clinical practice guidance. Thus, the Zhongshan Ophthalmic Center, Sun Yat-sen University, in collaboration with 19 medical institutions across the country, has released the group standard for Operation Procedure of Meibomian Gland Massage on the National Group Standard Information Platform on December 17, 2023. This article aims to provide an in-depth interpretation of the group standard to guide clinical work better.
团体标准解读

《强脉冲光治疗睑板腺功能障碍操作流程》团体标准解读

Operation procedure of intense pulsed light for meibomian gland dysfunction

:231-235
 
睑板腺功能障碍(meibomian gland dysfunction, MGD)是一种慢性弥漫性睑板腺疾病,可引起眼红、眼干、异物感等眼部不适,影响患者的眼健康及生活质量。强脉冲光(intense pulsed light, IPL)作为一种新兴有效的物理治疗方法,目前已广泛应用于治疗MGD及其他常见的眼表疾病,如蠕形螨性睑缘炎、睑缘炎相关角结膜病变、复发性睑板腺囊肿等。在IPL临床应用中,规范的操作是保障治疗有效性与安全性的关键。为更好指导和规范临床眼科医护人员的IPL治疗操作,由中山大学中山眼科中心牵头,联合全国19所医疗机构,经过多次修订,于2023年12月17日在全国团体标准信息平台发布了《强脉冲光治疗睑板腺功能障碍操作流程》的团体标准。文章旨在对该团体标准进行深度解读,详细阐述操作中的重点、难点与操作细节,以更好地指导临床工作。
Meibomian gland dysfunction is a chronic diffuse meibomian gland disease that can cause eye discomfort such as redness, dryness, and foreign body sensation in patients, and influence their eye health and quality of life. Intense pulsed light (IPL), as an effective physical therapy for meibomian gland dysfunction, is being used to treat meibomian gland dysfunction and related diseases widely, such as demodex blepharitis, keratoconjunctivitis, recurrent meibomian gland cysts and so on.. In the clinical application of IPL, standardized procedures are key to ensuring the effectiveness and safety of treatment. In order to better guide and standardize the IPL treatment operation of clinical ophthalmic medical workers, led by the Zhongshan Ophthalmic Center, Sun Yat-sen University, and joined with 19 medical institutions across the country, after multiple revisions, the group standard " Operation Procedure of Intense Pulsed Light for Meibomian Gland Dysfunction" was released on the National Group Standard Information Platform on December 17, 2023. This article aims to provide an in-depth interpretation of the group's standards, detailing the key points, difficulties, and operational details of specific operations, in order to better guide clinical work.
团体标准

广东省玻璃体腔注药操作及质量控制规范

Standard operating procedure and quality control Standards for Intravitreal Injection in Guangdong Province

:223-230
 
玻璃体腔注药是年龄相关性黄斑变性、糖尿病视网膜病变、视网膜静脉阻塞等常见慢性眼底病的主要治疗方式,凭借其治疗量大、操作流程化、实施简便,已成为眼科临床常规诊疗项目。基于《“十四五”全国眼健康规划(2021-2025年)》要求,秉承以患者为中心的服务理念,在确保医疗安全的基础上,优化治疗流程,提升患者接受玻璃体腔注药治疗的就诊体验和治疗效果。同时,广东省将有望承接越来越多港澳的眼病患者,需要建立融合粤港澳大湾区的广东省注药标准。因此,在广东省医学会的领导下,由中山大学中山眼科中心联合广东省内其他21所医疗机构共同起草,通过函审、专家论证会等形式,共邀广东省内35名权威专家进行多轮会审,在参考国内外玻璃体腔注药标准的基础上,结合粤港澳大湾区眼科现状,共同讨论最终确定了本标准。本团体标准系统地描述了玻璃体腔注药的基本要求、适应证与禁忌证,制定了全新的玻璃体腔注药标准操作流程及其质量控制标准,并且介绍了并发症或不适的预防及处理,为广东省各级具有资质的医疗机构所开展的玻璃体腔注药的临床应用以及质量评估提供指导。
Intravitreal injection represents the primary method of drug administration for a range of common chronic endophthalmic diseases, including age-related macular degeneration, diabetic retinopathy and retinal vein occlusion. Recognized for its high clinical efficacy, procedural standardization, and operational accessibility, this has become a routine clinical practice in ophthalmology. In alignment with the "National Eye Health Plan during the 14th Five-Year Plan period (2021–2025)" and the patient-centered service philosophy, this approach optimizes treatment processes and enhances patient experience and therapeutic outcomes while ensuring medical safety. Furthermore, Guangdong Province is poised to become a pivotal hub for ophthalmic care within the Guangdong-Hong Kong-Macao Greater Bay Area, anticipating a growing influx of patients from Hong Kong and Macao. This necessitates the development of a unified intravitreal injection standard tailored to regional healthcare integration. Under the auspices of the Guangdong Medical Association, a consortium led by Zhongshan Ophthalmic Center, Sun Yat-sen University, and 21 collaborating medical institutions across Guangdong, formulated this standard. Through iterative reviews involving correspondencebased evaluations and multidisciplinary expert consultations, 35 distinguished specialists refined the standard, synthesizing global best practices with insights into the Greater Bay Area’s unique ophthalmological landscape. This group standard systematically outlines the basic requirements, indications and contraindications of intravitreal injection, establishes a new standard operating procedure for intravitreal injection and quality control standards for this procedure. In addition, we have introduced guidance for the clinical application of this technique and quality assessment, as well as for the prevention and management of complications or adverse reactions.

Causes and factors associated with vision impairment in the elderly population in Mangxin town, Kashgar region, Xinjiang, China

Causes and factors associated with vision impairment in the elderly population in Mangxin town, Kashgar region, Xinjiang, China

:-
 

Purpose: This study aimed to investigate the prevalence, causes, and influencing factors of vision impairment in the elderly population aged 60 years and above in Mangxin Town, Kashgar region, Xinjiang, China. Located in a region characterized by intense ultraviolet radiation and arid climatic conditions, Mangxin Town presents unique environmental challenges that may exacerbate ocular health issues. Despite the global emphasis on addressing vision impairment among aging populations, there remains a paucity of updated and region-specific data in Xinjiang, necessitating this comprehensive assessment to inform targeted interventions. Methods: A cross-sectional study was conducted from May to June 2024, involving 1,311 elderly participants (76.76% participation rate) out of a total eligible population of 1,708 individuals aged ≥60 years. Participants underwent detailed ocular examinations, including assessments of uncorrected visual acuity (UVA) and best-corrected visual acuity (BCVA) using standard logarithmic charts, slit-lamp biomicroscopy, optical coherence tomography (OCT, Topcon DRI OCT Triton), fundus photography, and intraocular pressure measurement (Canon TX-20 Tonometer). A multidisciplinary team of 10 ophthalmologists and 2 local village doctors, trained rigorously in standardized protocols, ensured consistent data collection. Demographic, lifestyle, and medical history data were collected via questionnaires. Statistical analyses, performed using Stata 16, included multivariate logistic regression to identify risk factors, with significance defined as P < 0.05. Results: The overall prevalence of vision impairment was 13.21% (95% CI: 11.37–15.04), with low vision at 11.76% (95% CI: 10.01–13.50) and blindness at 1.45% (95% CI: 0.80–2.10). Cataract emerged as the leading cause, responsible for 68.20% of cases, followed by glaucoma (5.80%), optic atrophy (5.20%), and age-related macular degeneration (2.90%). Vision impairment prevalence escalated significantly with age: 7.74% in the 60–69 age group, 17.79% in 70–79, and 33.72% in those ≥80. Males exhibited higher prevalence than females (15.84% vs. 10.45%, P = 0.004). Multivariate analysis revealed age ≥80 years (OR = 6.43, 95% CI: 3.79–10.90), male sex (OR = 0.53, 95% CI: 0.34–0.83), and daily exercise (OR = 0.44, 95% CI: 0.20–0.95) as significant factors. History of eye disease showed a non-significant trend toward increased risk (OR = 1.49, P = 0.107). Education level, income, and smoking status showed no significant associations. Conclusion: This study underscores cataract as the predominant cause of vision impairment in Mangxin Town’s elderly population, with age and sex as critical determinants. The findings align with global patterns but highlight region-specific challenges, such as environmental factors contributing to cataract prevalence. Public health strategies should prioritize improving access to cataract surgery, enhancing grassroots ophthalmic infrastructure, and integrating portable screening technologies for early detection of fundus diseases. Additionally, promoting health education on UV protection and lifestyle modifications, such as regular exercise, may mitigate risks. Future research should expand to broader regions in Xinjiang, employ advanced diagnostic tools for complex conditions like glaucoma, and explore longitudinal trends to refine intervention strategies. These efforts are vital to reducing preventable blindness and improving quality of life for aging populations in underserved areas.

Purpose: This study aimed to investigate the prevalence, causes, and influencing factors of vision impairment in the elderly population aged 60 years and above in Mangxin Town, Kashgar region, Xinjiang, China. Located in a region characterized by intense ultraviolet radiation and arid climatic conditions, Mangxin Town presents unique environmental challenges that may exacerbate ocular health issues. Despite the global emphasis on addressing vision impairment among aging populations, there remains a paucity of updated and region-specific data in Xinjiang, necessitating this comprehensive assessment to inform targeted interventions. Methods: A cross-sectional study was conducted from May to June 2024, involving 1,311 elderly participants (76.76% participation rate) out of a total eligible population of 1,708 individuals aged ≥60 years. Participants underwent detailed ocular examinations, including assessments of uncorrected visual acuity (UVA) and best-corrected visual acuity (BCVA) using standard logarithmic charts, slit-lamp biomicroscopy, optical coherence tomography (OCT, Topcon DRI OCT Triton), fundus photography, and intraocular pressure measurement (Canon TX-20 Tonometer). A multidisciplinary team of 10 ophthalmologists and 2 local village doctors, trained rigorously in standardized protocols, ensured consistent data collection. Demographic, lifestyle, and medical history data were collected via questionnaires. Statistical analyses, performed using Stata 16, included multivariate logistic regression to identify risk factors, with significance defined as P < 0.05. Results: The overall prevalence of vision impairment was 13.21% (95% CI: 11.37–15.04), with low vision at 11.76% (95% CI: 10.01–13.50) and blindness at 1.45% (95% CI: 0.80–2.10). Cataract emerged as the leading cause, responsible for 68.20% of cases, followed by glaucoma (5.80%), optic atrophy (5.20%), and age-related macular degeneration (2.90%). Vision impairment prevalence escalated significantly with age: 7.74% in the 60–69 age group, 17.79% in 70–79, and 33.72% in those ≥80. Males exhibited higher prevalence than females (15.84% vs. 10.45%, P = 0.004). Multivariate analysis revealed age ≥80 years (OR = 6.43, 95% CI: 3.79–10.90), male sex (OR = 0.53, 95% CI: 0.34–0.83), and daily exercise (OR = 0.44, 95% CI: 0.20–0.95) as significant factors. History of eye disease showed a non-significant trend toward increased risk (OR = 1.49, P = 0.107). Education level, income, and smoking status showed no significant associations. Conclusion: This study underscores cataract as the predominant cause of vision impairment in Mangxin Town’s elderly population, with age and sex as critical determinants. The findings align with global patterns but highlight region-specific challenges, such as environmental factors contributing to cataract prevalence. Public health strategies should prioritize improving access to cataract surgery, enhancing grassroots ophthalmic infrastructure, and integrating portable screening technologies for early detection of fundus diseases. Additionally, promoting health education on UV protection and lifestyle modifications, such as regular exercise, may mitigate risks. Future research should expand to broader regions in Xinjiang, employ advanced diagnostic tools for complex conditions like glaucoma, and explore longitudinal trends to refine intervention strategies. These efforts are vital to reducing preventable blindness and improving quality of life for aging populations in underserved areas.
Original Article

Advances in understanding conjunctival goblet cell traits and regenerative processes

Advances in understanding conjunctival goblet cell traits and regenerative processes

:1-8
 

Conjunctival goblet cells are of great significance to the ocular surface. By secreting mucinsparticularly MUC5ACthey play a pivotal role in stabilizing the tear film, safeguarding the cornea from environmental insults, and preserving overall ocular homeostasis. Over the past decade, remarkable progress has been made in understanding the distinctive biological characteristics and regenerative potential of these specialized cells, opening novel avenues for treating various ocular surface disorders, ranging from dry eye syndrome and allergic conjunctivitis to more severe conditions such as Stevens-Johnson syndrome.

This review comprehensively examines the morphology, function, and regulation of conjunctival goblet cells. Advanced imaging modalities, such as transmission electron microscopy, have provided in-depth insights into their ultrastructure. Densely packed mucin granules and a specialized secretory apparatus have been uncovered, highlighting the cells’ proficiency in producing and releasing MUC5AC. These structural characterizations have significantly enhanced our understanding of how goblet cells contribute to maintaining a stable and protective mucosal barrier, which is crucial for ocular surface integrity.

The review further delves into the intricate signaling networks governing the differentiation and regeneration of these cells. Key pathways, including Notch, Wnt/β-catenin, and TGF-β, have emerged as essential regulators of cell fate decisions, ensuring that goblet cells maintain their specialized functions. Critical transcription factors, such as Klf4, Klf5, and SPDEF, have been identified as indispensable for driving the differentiation process and sustaining the mature phenotype of goblet cells. Additionally, the modulatory effects of inflammatory mediatorssuch as IL-6, IL-13, and TNF-αand growth factors, such as EGF and FGF, are explored. These molecular insights offer a robust framework for understanding the pathophysiological mechanisms underlying ocular surface diseases, wherein the dysregulation of these processes often results in diminished goblet cell numbers and impaired tear film stability.

Innovative methodological approaches have provided a strong impetus to this field. The development of three-dimensional (3D) in vitro culture systems that replicate the native conjunctival microenvironment has enabled more physiologically relevant investigations of goblet cell biology. Moreover, the integration of stem cell technologiesincluding the use of induced pluripotent stem cells (iPSCs) and bone marrow-derived mesenchymal stem cells (BM-MSCs)has made it possible to generate goblet cell-like epithelia, thereby presenting promising strategies for tissue engineering and regenerative therapies. The application of artificial intelligence in optimizing drug screening and biomaterial scaffold design represents an exciting frontier that may accelerate the translation of these findings into effective clinical interventions.

In conclusion, this review underscores the central role of conjunctival goblet cells in preserving ocular surface health and illuminates the transformative potential of emerging regenerative approaches. Continued research focused on deciphering the intricate molecular mechanisms governing goblet cell function and regeneration is essential for developing innovative, targeted therapies that can significantly improve the management of ocular surface diseases and enhance patient quality of life.

Conjunctival goblet cells are of great significance to the ocular surface. By secreting mucinsparticularly MUC5ACthey play a pivotal role in stabilizing the tear film, safeguarding the cornea from environmental insults, and preserving overall ocular homeostasis. Over the past decade, remarkable progress has been made in understanding the distinctive biological characteristics and regenerative potential of these specialized cells, opening novel avenues for treating various ocular surface disorders, ranging from dry eye syndrome and allergic conjunctivitis to more severe conditions such as Stevens-Johnson syndrome.

This review comprehensively examines the morphology, function, and regulation of conjunctival goblet cells. Advanced imaging modalities, such as transmission electron microscopy, have provided in-depth insights into their ultrastructure. Densely packed mucin granules and a specialized secretory apparatus have been uncovered, highlighting the cells’ proficiency in producing and releasing MUC5AC. These structural characterizations have significantly enhanced our understanding of how goblet cells contribute to maintaining a stable and protective mucosal barrier, which is crucial for ocular surface integrity.

The review further delves into the intricate signaling networks governing the differentiation and regeneration of these cells. Key pathways, including Notch, Wnt/β-catenin, and TGF-β, have emerged as essential regulators of cell fate decisions, ensuring that goblet cells maintain their specialized functions. Critical transcription factors, such as Klf4, Klf5, and SPDEF, have been identified as indispensable for driving the differentiation process and sustaining the mature phenotype of goblet cells. Additionally, the modulatory effects of inflammatory mediatorssuch as IL-6, IL-13, and TNF-αand growth factors, such as EGF and FGF, are explored. These molecular insights offer a robust framework for understanding the pathophysiological mechanisms underlying ocular surface diseases, wherein the dysregulation of these processes often results in diminished goblet cell numbers and impaired tear film stability.

Innovative methodological approaches have provided a strong impetus to this field. The development of three-dimensional (3D) in vitro culture systems that replicate the native conjunctival microenvironment has enabled more physiologically relevant investigations of goblet cell biology. Moreover, the integration of stem cell technologiesincluding the use of induced pluripotent stem cells (iPSCs) and bone marrow-derived mesenchymal stem cells (BM-MSCs)has made it possible to generate goblet cell-like epithelia, thereby presenting promising strategies for tissue engineering and regenerative therapies. The application of artificial intelligence in optimizing drug screening and biomaterial scaffold design represents an exciting frontier that may accelerate the translation of these findings into effective clinical interventions.

In conclusion, this review underscores the central role of conjunctival goblet cells in preserving ocular surface health and illuminates the transformative potential of emerging regenerative approaches. Continued research focused on deciphering the intricate molecular mechanisms governing goblet cell function and regeneration is essential for developing innovative, targeted therapies that can significantly improve the management of ocular surface diseases and enhance patient quality of life.

Original Article

Prevalence of idiopathic thoracic scoliosis in children and adolescents with superior oblique palsy: a cross‑sectional study

Prevalence of idiopathic thoracic scoliosis in children and adolescents with superior oblique palsy: a cross‑sectional study

:1-8
 

Purpose: Strabismus is associated with a higher prevalence of idiopathic thoracic scoliosis (ITS) in children. This study aims to investigate whether superior oblique palsy (SOP) poses a higher risk for developing ITS among children and adolescents.

Methods: A cross-sectional study. The study group comprised 347 consecutive candidates for SOP surgery aged 4 to 18 yearsPatients within the same age range with ocular trauma were enrolled as the control group. Preoperative chest plain radiographs were used to measure the Cobb angle. Demographic information and clinical data, including diopter, best corrected visual acuity, deviation degree, and binocular functionwere analyzed.

Results: A significantly higher prevalence of ITS was found in study group compared with control group (12.68% vs 4.18%p< 0.001) . Additionally, the mean Cobb angle was lagrger in SOP group than that in control group (5.02°±3.87° vs 3.84°±3.09°, < 0.001). Males in SOP group showed a higher prevalence of ITS  (12.9% vs 2.87%, p = 0.007), but there was no significant difference in females between two groups (12.3% vs 7.69%, p = 0.295). Good near stereopsis acuity was  significantly associated with high prevalence of thoracic scoliosis (p<0.001). Multivariate logistic regression analysis revealed that a large distant magnitude of deviation (>20PD) and near stereoacuity were significantly associated with ITS.

Conclusions: Patients with SOP have a significantly  higher risk of developing idiopathic thoracic scoliosis, especially those with good near stereoscopic and large distant magnitude of deviation. 


Purpose: Strabismus is associated with a higher prevalence of idiopathic thoracic scoliosis (ITS) in children. This study aims to investigate whether superior oblique palsy (SOP) poses a higher risk for developing ITS among children and adolescents.

Methods: A cross-sectional study. The study group comprised 347 consecutive candidates for SOP surgery aged 4 to 18 yearsPatients within the same age range with ocular trauma were enrolled as the control group. Preoperative chest plain radiographs were used to measure the Cobb angle. Demographic information and clinical data, including diopter, best corrected visual acuity, deviation degree, and binocular functionwere analyzed.

Results: A significantly higher prevalence of ITS was found in study group compared with control group (12.68% vs 4.18%p< 0.001) . Additionally, the mean Cobb angle was lagrger in SOP group than that in control group (5.02°±3.87° vs 3.84°±3.09°, < 0.001). Males in SOP group showed a higher prevalence of ITS  (12.9% vs 2.87%, p = 0.007), but there was no significant difference in females between two groups (12.3% vs 7.69%, p = 0.295). Good near stereopsis acuity was  significantly associated with high prevalence of thoracic scoliosis (p<0.001). Multivariate logistic regression analysis revealed that a large distant magnitude of deviation (>20PD) and near stereoacuity were significantly associated with ITS.

Conclusions: Patients with SOP have a significantly  higher risk of developing idiopathic thoracic scoliosis, especially those with good near stereoscopic and large distant magnitude of deviation. 

Review Article

Role of omics approaches in the study of pediatric cataract

Role of omics approaches in the study of pediatric cataract

:1-7
 

Pediatric cataract, a leading cause of blindness in children globally, imposing a significant financial burden on both families and society. The extensive phenotypic heterogeneity of this condition means that the underlying mechanisms remain poorly understood, limiting the development of precise and effective treatments. The advent of omics technologies has provided potent tools for unraveling the pathogenesis of pediatric cataract. By mapping expression profiles across various molecular levels, these omics approaches enhance our understanding of the diseases etiological mechanisms, aid in the identification of novel biomarkers and key pathways, and offer researchers new insights for the innovative strategies in disease diagnosis and targeted therapies. In this review, we summarize the application of omics approaches in clinical and basic research on pediatric cataract over the past decade, encompassing genomics, transcriptomics, proteomics, and metabolomics. Furthermore, we discuss the current challenges and future prospects of omics analyses in pediatric cataract studies.

Pediatric cataract, a leading cause of blindness in children globally, imposing a significant financial burden on both families and society. The extensive phenotypic heterogeneity of this condition means that the underlying mechanisms remain poorly understood, limiting the development of precise and effective treatments. The advent of omics technologies has provided potent tools for unraveling the pathogenesis of pediatric cataract. By mapping expression profiles across various molecular levels, these omics approaches enhance our understanding of the disease’s etiological mechanisms, aid in the identification of novel biomarkers and key pathways, and offer researchers new insights for the innovative strategies in disease diagnosis and targeted therapies. In this review, we summarize the application of omics approaches in clinical and basic research on pediatric cataract over the past decade, encompassing genomics, transcriptomics, proteomics, and metabolomics. Furthermore, we discuss the current challenges and future prospects of omics analyses in pediatric cataract studies.
Original Article

Stressful factors experienced by patients while waiting vitreo-retinal day surgery: a qualitative study

Stressful factors experienced by patients while waiting vitreo-retinal day surgery: a qualitative study

:1-8
 

Purpose: The day surgery mode has significantly reduced preoperative waiting time for patients. However, this mode also led to brief and sometimes abrupt interactions between patients with vision loss and nursing staff during the preoperative visits. Additionally, patients may experience negative emotions. The aim of this study was to describe the preoperative experiences and identify related stressful factors among patients waiting vitreo-retinal day surgery. Methods: This study was guided by an interpretive approach. Semi-structured, face-to-face, in-depth interviews were conducted with patients from August 2021 to October 2024. Inductive content analysis and research software were used to analyze the data. Results: Twenty-seven patients agreed to participate the interviews. Their ages ranged from 19 to 70 years old. The waiting time before hospitalization varied from 7 to 90 days. Three main categories emerged from patients’ complaints: day surgery procedures, concerns about eye conditions and supports. Conclusions: The findings underscore the importance of preoperative care services. It is suggested that providing accurate preoperative information and effective support can significantly enhance the quality of preoperative care service.


Purpose: The day surgery mode has significantly reduced preoperative waiting time for patients. However, this mode also led to brief and sometimes abrupt interactions between patients with vision loss and nursing staff during the preoperative visitsAdditionally, patients may experience negative emotions. The aim of this study was to describe the preoperative experiences and identify related stressful factors among patients waiting vitreo-retinal day surgery. Methods: This study was guided by an interpretive approach. Semi-structured, face-to-face, in-depth interviews were conducted with patients from August 2021 to October 2024. Inductive content analysis and research software were used to analyze the data. Results: Twenty-seven patients agreed to participate the interviews. Their ages ranged from 19 to 70 yearold. The waiting time before hospitalization varied from 7 to 90 days. Three main categories emerged from patients’ complaints: day surgery procedures, concerns about eye conditions and supports. Conclusions: The findings underscore the importance of preoperative care services. It is suggested that providing accurate preoperative information and effective support can significantly enhance the quality of preoperative care service.
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  • 眼科学报

    主管:中华人民共和国教育部
    主办:中山大学
    承办:中山大学中山眼科中心
    主编:林浩添
    主管:中华人民共和国教育部
    主办:中山大学
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  • Eye Science

    主管:中华人民共和国教育部
    主办:中山大学
    承办:中山大学中山眼科中心
    主编:林浩添
    主管:中华人民共和国教育部
    主办:中山大学
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