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Table of Content

    22 June 2026, Volume 50 Issue 3
    Application of gene editing technology in ocular diseases research
    Chen Zhiyu, Wang Sheng, Zhang Linyi, Wang Weiwei, Xiong Siwei
    2026, 50(3):  161-171.  doi:10.3760/cma.j.cn115500-20251031-26301
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    Gene editing refers to the process of modifying specific targets in an organism’s genome using gene-editing technologies, with the third-generation editing tools represented by clustered regularly interspaced short palindromic repeats/CRISPR-associated protein 9 (CRISPR/Cas9) currently being the primary approach. In Leber congenital amaurosis type 10, EDIT-101 yielded anatomical and functional improvements in a subset of patients. For autosomal dominant retinitis pigmentosa (RP), therapeutic strategies have evolved toward more precise prime editing; similarly, X-linked RP has shown favorable outcomes in murine models, alongside the establishment of optimized dog animal models. In Stargardt disease, efficient editing of photoreceptors and retinal pigment epithelial cells has been achieved in non-human primates. Regarding age-related macular degeneration (AMD), the HG202 therapy for neovascular AMD has entered clinical trials, with early data indicating favorable therapeutic efficacy; meanwhile, dry AMD studies have successfully targeted complement factor genes in cellular models. In glaucoma, editing genes associated with aqueous humor production effectively lowered intraocular pressure in mouse models and conferred protection to retinal ganglion cells. Furthermore, clinical investigations into herpes simplex keratitis and transforming growth factor beta induced corneal dystrophy have confirmed the safety profile and robust antiviral effects of gene editing interventions. Nevertheless, significant challenges remain, including limitations in delivery system efficiency and capacity, precision and off-target risks, and unknown long-term side effects.
    Basic research and preclinical studies on ocular organoids
    Xiang Zihan, Teng Xu
    2026, 50(3):  172-178.  doi:10.3760/cma.j.cn115500-20251031-26302
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    Organoids, as three\|dimensional in vitro multicellular micro\|models that recapitulate the complex structure and physiological functions of native organs, have become essential tools in life sciences and translational medicine. Ocular organoids, by reconstructing three\|dimensional human ocular tissues in vitro, provide a critical platform for investigating the mechanisms of ocular diseases, drug screening, and regenerative medicine. In recent years, ocular organoid technology has successfully replicated the developmental processes and complex structures of various ocular tissues, such as the retina and cornea, thereby advancing both fundamental research and clinical translation. This article systematically summarizes the technical advances in this field, including culture protocols for multiple cell sources, innovative induction strategies, and emerging engineering\|medical integration approaches for optimization. It further reviews the clinical applications prospects of eye organoids in disease modeling, drug development, and regenerative medicine. In addition, the challenges currently faced in the field—such as heterogeneity control, complex structural recapitulation, and large\|scale production—as well as future directions are discussed, providing a reference for further progress and innovation in this area.
    Application of functional defocused frame glasses in myopia prevention and control
    Zheng Xiaohui, Shi Huilin, Li Yingshan, Li Cairui
    2026, 50(3):  179-183.  doi:10.3760/cma.j.cn115500-20251112-26303
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    With advances in optical design and optometric techniques, the functions of spectacle lenses have evolved from merely correcting refractive errors to partially preventing and slowing the onset and progression of myopia. Iteratively upgraded functional defocus spectacle lenses restrain excessive axial elongation and retard myopic progression based on the principle of peripheral retinal defocus, thereby exerting definite myopia-control efficacy. Such lenses feature safe and comfortable wear with high compliance. Four major mainstream categories are currently available: defocus incorporated multiple segments, highly aspherical lenslets technology, cylindrical annular refractive element and diffusion optics technology, which have become crucial interventions for myopia control in children and adolescents.
    Application of diffusion optics technology based on contrast theory in myopia prevention and control 
    Xing Xiaoying, Zhang Dan, Du Junhui
    2026, 50(3):  184-190.  doi:10.3760/cma.j.cn115500-20250929-26304
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    Contrast is defined as the ratio of the light intensity of a target to that of its background. The contrast theory posits that contrast signals are a critical regulator of ocular axial growth, and excessive high-contrast visual signals can trigger the onset of myopia. High-contrast signals can abnormally activate the retinal ON/OFF pathways, which in turn causes dysfunction of the dopaminergic system, resulting in choroidal thinning and reduced choroidal blood flow, and ultimately leading to hypoxic scleral remodeling — the fundamental pathophysiological change driving the onset and progression of myopia.In recent years, diffusion optics technology (DOT) based on the contrast theory has been proposed. DOT lenses developed with this technology can reduce high-contrast signals impinging on the retina solely through their micro-scattering structures, thereby slowing axial elongation and controlling myopia progression, with a favorable safety profile and excellent tolerance of visual function. However, existing studies are mainly limited to short-term evaluations, and the long-term efficacy and rebound effect of the lenses remain to be further verified.
    The application of medications in myopia prevention and control
    Lu Qiuye, Ou Shangkun
    2026, 50(3):  191-195.  doi:10. 3760/cma.j.cn115500-20251029-26305
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    Myopia management has evolved from traditional physical correction to early pharmacological intervention. In particular, low-concentration (e.g., 0.01%) atropine, a non-selective muscarinic receptor antagonist, has been extensively investigated and widely applied in myopia prevention and control. In addition, endogenous hormones such as insulin/insulin-like growth factor-1 and estrogen are involved in the regulation of scleral extracellular matrix remodeling, while the dopamine/melatonin circadian rhythm modulates retinal dopamine levels, both of which jointly participate in the onset and progression of myopia. This review elaborates on the mechanism of action, key clinical evidence, as well as existing consensus and controversies of the above-mentioned various pharmacological agents for myopia control, aiming to provide evidence-based references for clinical pharmacological treatment strategies of myopia.
    Comparison of different platform  for refractive corneal lenticule extraction
    Wang Shen , Jiang Yang, Li Ying
    2026, 50(3):  196-201.  doi:10.3760/cma.j.cn115500-20251014-26306
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    Keratorefractive lenticule extraction/refractive corneal lenticule extraction (KLEx/RCLE) is a type of laser corneal refractive surgery. In recent years, it has evolved from being represented solely by small incision lenticule extraction (SMILE) using a single femtosecond laser platform to a multi-platform approach, including the KLEx systems—SMILE (VisuMax 500), SMILE Pro (VISUMAX 800), SmartSight (SCHWIND ATOS), CLEAR (FEMTO LDV Z8), and SILK (ELITA). This review compares the similarities and differences among these five systems in terms of device design, surgical procedures, correction range, clinical outcomes, and complications. It aims to provide a reference for clinicians when selecting a KLEx system, while also identifying current gaps in evidence and future research directions. 
    Advances in Toric intraocular lens
    Wen Keyi, Wan Xiuhua
    2026, 50(3):  201-209.  doi:10.3760/cma.j.cn115500-20251209-26307
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    Toric intraocular lens (Toric IOL) implantation offers advantages such as a wide range of astigmatism correction, high precision, no need for corneal incisions, and long-term stability of postoperative effect, making it the preferred option for treating cataracts with significant preoperative corneal astigmatism. Recent years have witnessed numerous advances in Toric IOL design and clinical application. In terms of haptic design, new configurations including modified C-loop, modified L-loop, square-frosted loop, plate-loop, and double-loop designs have emerged. Regarding materials, acrylic has largely replaced polymethylmethacrylate and silicone; cutting-edge research focuses on hydrophobic treatment of hydrophilic acrylic or introduction of bioactive coatings. For functional design, novel technologies such as aspheric, multifocal, extended depth of focus, and light-adjustable designs have been developed. Clinically, Toric IOL implantation has achieved satisfactory refractive outcomes in patients with irregular astigmatism featuring central regular components, capsular bag defects, non-progressive keratoconus, stable post-penetrating keratoplasty status, and Fuchs endothelial corneal dystrophy without corneal edema. Deeper understanding of posterior corneal astigmatism, along with instruments enabling direct measurement of posterior corneal curvature and astigmatism (e.g., IOLMaster 700, Pentacam) and newer formulas (e.g., Barrett, EVO, Hoffer QST, Kane), has significantly improved Toric IOL power calculation accuracy. Innovations in transscleral suture fixation have enabled astigmatic correction using Toric IOLs in patients lacking capsular support. Preoperative axis marking and postoperative rotational measurement techniques are transitioning from manual to digital and big data-driven approaches.
    Ocular risks associated with vaginal delivery in highly myopic pregnant women
    Lin Fankai, Wu Zhenggen
    2026, 50(3):  210-215.  doi:10.3760/cma.j.cn115500-20251214-26308
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    Ocular safety and delivery mode selection in highly myopic pregnant women have become important clinical issues. High myopia is characterized by pathological eyeball elongation, which mainly causes three types of fundus complications: lacquer cracks, retinoschisis, and choroidal neovascularization (CNV). Hormonal changes during pregnancy and intraocular pressure fluctuations induced by the Valsalva maneuver during delivery further increase the risk of retinal detachment and subretinal hemorrhage. Prenatal risk assessment can be conducted using fundus laser scanning, OCT/OCTA, and other imaging modalities. Based on these assessments, clinical decisions can be stratified as follows: vaginal delivery is relatively safe for women without active CNV and with well-controlled retinal breaks. Cesarean section is recommended for those with active macular CNV. Prophylactic laser photocoagulation can be administered when clinically indicated. This article reviews the ocular pathological alterations, delivery-related risks, prenatal assessment, and delivery decision-making strategies in highly myopic pregnant women to provide evidence for clinical management.
    Imaging biomarkers for predicting anti-VEGF response in nAMD based on OCT and OCTA
    Tu Jiaojiao, Jin Yu
    2026, 50(3):  216-223.  doi:10.3760/cma.j.cn115500-20260119-26309
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    Neovascular age-related macular degeneration (nAMD) is a leading cause of vision loss in the elderly population. Although anti-vascular endothelial growth factor (anti-VEGF) therapy has become the first-line treatment for nAMD, patient responses vary considerably. This article systematically reviews the value of OCT and OCTA imaging biomarkers in predicting anti-VEGF treatment response in nAMD. The presence of intraretinal fluid (IRF), subretinal hyperreflective material (SHRM), pigment epithelial detachment (PED), outer retinal tubulation (ORT), larger macular neovascularization (MNV) area, higher fractal dimension (FD), and higher lacunarity are associated with poor treatment response and worse visual prognosis, whereas the presence of baseline subretinal fluid (SRF) is associated with favorable visual outcomes. In addition, qualitative morphological features of MNV, including vascular loops and peripheral anastomotic arches, help assess lesion activity and predict treatment resistance. Identification of these biomarkers and their predictive value may facilitate early recognition of hyporesponders or non-responders, enable adjustment of treatment regimens, and prevent further vision loss.
    The application of biomechanical biomarkers in the diagnosis of ocular diseases
    Song Ankang, Cao Huazheng, Chen Wei
    2026, 50(3):  224-229.  doi:10.3760/cma.j.cn115500-20251113-26310
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    With in-depth research on ocular biomechanics, the mechanical properties of ocular tissues such as the cornea, Bruch's membrane-choriocapillaris complex, retina, and lamina cribrosa have emerged as novel biomarkers for the early diagnosis of various ophthalmic diseases. The corneal stress-strain index(SSI), corneal hysteresis,(CH) and corneal resistance factor(CRF) can serve as early predictive indicators for myopia; the second version of the SSI (SSIv2) holds unique value in the subclinical diagnosis of keratoconus(KC); the "stiffening" caused by lipid deposition and calcification of the Bruch's membrane-choriocapillaris complex is a key biomechanical event in the initiation of age-related macular degeneration(AMD); increased retinal stiffness may occur earlier than the clinical signs of diabetic retinopathy(DR); and trabecular meshwork stiffening as well as changes in lamina cribrosa thickness(LCT) are closely associated with the development of glaucomatous optic neuropathy. This review systematically summarizes the research progress of biomechanics in the early diagnosis of myopia, KC, AMD, DR, and glaucomatous optic neuropathy, aiming to provide new theoretical foundations and technical approaches for the early diagnosis and intervention of ocular diseases.
    Advances in the pathogenesis and treatment of adenoid cystic carcinoma of the lacrimal gland
    Zhang Xinran, Dong Weili
    2026, 50(3):  230-236.  doi:10.3760/cma.j.cn115500-20251228-26311
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    Adenoid cystic carcinoma of the lacrimal gland (LGACC) is one of the most common malignant epithelial tumors in the lacrimal gland region, characterized by aggressive local invasion, a high tendency for local recurrence, and a propensity for distant metastasis. Its occurrence and progression are closely associated with various molecular abnormalities, including dysregulation of normal signaling pathways caused by myeloblastosis (MYB)-related gene fusion and rearrangement, aberrant activation of the Notch signaling pathway that promotes tumor invasion, and increased molecular heterogeneity resulting from mutations in other oncogenes and related signaling pathways. Currently, surgical resection combined with postoperative adjuvant radiotherapy remains the mainstay of treatment for LGACC, and neoadjuvant intra-arterial chemotherapy may help improve local control and survival outcomes. With continuing advances in molecular biology and genomics, targeted therapies directed at key molecular abnormalities in LGACC have emerged as a promising research direction. 
    Deeply cherishing the memory of professor Zhang Shiyuan, a distinguished ophthalmologist
    Liang Jianyi, Zhang Jingxue, Li Jianjun, Wang Shuang, Liang Qingfeng, Hou Shengping, Jin Zibing, Wang Ningli
    2026, 50(3):  237-240.  doi:10.3760/cma.j.cn115500-20260525-26312
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    Professor Zhang Shiyuan(1929-2026), the fourth director of the Beijing Institute of Ophthalmology, passed away on May 24, 2026, at the age of 97. This article briefly reviews his medical career and major contributions to the field of ophthalmology in China.