Table of Content

22 April 2024, Volume 48 Issue 2

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The causes and surgical methods of intraocular lens exchange

Yue Peilin, Wang Zhenyu, Yang Yiquan, Song Xudong

2024, 48(2):  81-86.  doi:10.3760/ cma.j.issn.1673-5803.2024.02.001

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Following cataract surgery, factors related to the intraocular lens (IOL) may cause symptoms such as failure to improve or even a decrease in visual acuity, glare, and increased astigmatism, which necessitate secondary or multiple surgeries including IOL exchange. The common causes of IOL exchange surgery include dislocation and subluxation, refractive error of the IOL, and neuroadaptation failure of multifocal IOL. Surgical methods include removing the original IOL, implanting the new IOL in situ, or using various suture fixation techniques. However, it is more important to avoid the occurrence of IOL exchange surgery by achieving stable operation, appropriate size of capsulorhexis, accurate preoperative biological measurements, suitable formula for calculating refractive power during the perioperative period of cataract patients. (Int Rev Ophthalmol, 2024, 48:  81-86)

The impact of regulatory factors on the TGF-β pathway on posterior capsule opacification 

Xu Su, Zhang Yuhang, Si Wei, Zhang Fengyan

2024, 48(2):  87-92.  doi:10.3760/ cma.j.issn.1673-5803.2024.02.002

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Posterior capsule opacification (PCO) is the primary cause of compromised visual acuity in patients following cataract surgery, with an incidence ranging from 30% to 50% in adults and up to 100% in children. The pathogenic mechanism of  PCO is complex. The TGF-β pathway influences the epithelial-mesenchymal transition and migration of lens epithelial cells. The expression of certain ribonucleic acids, autophagy or apoptosis can exert influence on PCO formation, thereby leading to the identification of potential therapeutic agents for its prevention.  (Int Rev Ophthalmol, 2024, 48:  87-92)

Imaging biomarkers of pathological myopia in the optic disc

Lu Zixing, Yan Shenshen, Tian Bei

2024, 48(2):  93-98.  doi:10.3760/ cma.j.issn.1673-5803.2024.02.003

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Vision impairment caused by pathologic myopia (PM) is a global public health concern. Changes in the morphological characteristics of the optic disc region can serve as an early warning for the onset and progression of PM. Alterations such as optic disc tilting, peripapillary atrophy of the retina and choroid, and parapapillary choroidal cavitations are associated with the development of posterior staphyloma. Pathologic changes in the optic disc in PM often coexist with PM-related macular degeneration, with the progression and expansion of atrophic areas around the optic disc and the peripapillary choroid indicating the development of myopic maculopathy. Insufficient blood flow in the optic disc area and its surroundings may be a reason for the morphological and functional changes in PM. Timely and accurate identification of such characteristic imaging biomarkers is crucial for the prevention, control, and treatment of PM. (Int Rev Ophthalmol, 2024, 48: 93-98)

Application of artificial intelligence in strabismus and pediatric ophthalmology

Wang Zijian, Gan Xiaolin, Zhang Lu, Guo Changmei

2024, 48(2):  99-103.  doi:10.3760/ cma.j.issn.1673-5803.2024.02.004

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Artificial intelligence technology is developing rapidly in the field of strabismus and pediatric ophthalmology. It shows high accuracy in the selection of screening strabismus, the timing of auxiliary intermittent exotropia surgery, and the design of auxiliary surgery volume. It can also be used to assess the severity of retinopathy of prematurity, assist the diagnosis and whole-course management of congenital cataract, predict the prognosis of myopia prevention and control, and screen amblyopia early to achieve intervention  early.  In addition, it can be applied to the diagnosis and classification of retinoblastoma. (Int Rev Ophthalmol, 2024, 48: 99-103)

Advances in the prevention and treatment of perioperative dry eye disease with cyclosporine

Han Yilin, Zhang Fengyan

2024, 48(2):  103-108.  doi:10.3760/ cma.j.issn.1673-5803.2024.02.005

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Dry eye disease (DED) is a multifactorial and prevalent disease associated with ocular surface inflammation and impaired lubrication. In recent years, numerous studies have demonstrated that perioperative pharmacological use, surgical trauma, individual factors, and postoperative inflammatory responses are associated with postoperative DED. Cyclosporine selectively regulates T cells, protecting goblet cells and conjunctival epithelial cells while promoting tear secretion. As a result, it effectively alleviates dry eye symptoms in patients, improving the precision of surgeries and patient satisfaction. Currently, cyclosporine is widely used in the clinical treatment of perioperative dry eye, achieving favorable outcomes.  (Int Rev Ophthalmol, 2024, 48: 103-108)

Research progress in predicting postoperative visual acuity of idiopathic macular hole

Lin Yanjun, Chen Qianyin, Zhang Jinglin

2024, 48(2):  109-116.  doi:10.3760/ cma.j.issn.1673-5803.2024.02.006

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Idiopathic macular hole (IMH) can often be successfully anatomically closed through a  pars plana vitrectomy combined with internal limiting membrane peeling. However，  the restoration of visual function mainly depends on macular function. The visual acuity is the most commonly used indicator to evaluating macular function and is influenced by multiple factors. The shorter the duration of preoperative symptoms, the better the best-corrected visual acuity, the smaller the tear size, the more complete the outer structure of retinal and the state of retinal blood vessels, the better the postoperative visual improvement. In recent years, artificial intelligence has also been gradually used to predict postoperative visual acuity of IMH, the models trained on preoperative imaging data and relevant clinical features by automatic recognition provide the basis for clinical decision-making and understanding postoperative recovery of patients. (Int Rev Ophthalmol, 2024, 48: 109-116)

Research progress of galactose lectin 3 in diabetes retinopathy

Feng Zhaochen, Zhou Ziyi, Sun Xiaojia, Dou Guorui

2024, 48(2):  116-122.  doi:10.3760/ cma.j.issn.1673-5803.2024.02.007

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In the pathological changes of diabetic retinopathy (DR), chronic inflammation, vascular regeneration and leakage, and immune cell activation play important roles. Galectin-3 (Gal-3) is the only chimeric member of the galectin family, proven to be associated with disease inflammation, cell adhesion, and chemotaxis. Gal-3 regulates the phenotype, phagocytic ability, and chemotaxis of immune cells such as microglia and macrophages in the retina, modulating the progression of inflammation in DR. It can also act on vascular endothelial cells, retinal pigment epithelial cells, and pericytes, affecting the blood-retinal barrier. Furthermore, Gal-3 has been confirmed as a disease marker and therapeutic target, serving as an important prognostic evaluation indicator. Currently, Gal-3 has demonstrated safety and efficacy as a therapeutic target in various systemic inflammatory and vascular diseases, and the use of Gal-3 inhibitors has provided a therapeutic approach, especially in alleviating pathological neovascularization in diabetic retinopathy. Research on Gal-3 is of great significance for understanding the pathogenesis of DR and exploring new treatment approaches. (Int Rev Ophthalmol, 2024, 48: 116-122)

The relationship between inwardly rectifying potassium channels and retinopathy

2024, 48(2):  123-128.  doi:10.3760/ cma.j.issn.1673-5803.2024.02.008

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Inwardly rectifying potassium (Kir) channels, a subclass within the potassium channel family, are extensively distributed in a variety of tissue cells and play a vital role in maintaining bodily homeostasis. Recent research indicates their presence in the retinal pigment epithelium, neurons, glial cells, and vascular cells. These channels are instrumental in preserving retinal osmotic balance, combating neurotoxic and oxidative stress, and facilitating visual processing. Kir channels have been implicated in the progression of several retinal diseases, including diabetic retinopathy, hereditary KCNJ13-related retinal disorders, and glaucoma. (Int Rev Ophthalmol, 2024, 48: 123-128)

Research progress of laser-induced chorioretinal venous anastomosis  in the treatment of non-ischemic central retinal vein occlusion

2024, 48(2):  129-132.  doi:10.3760/ cma.j.issn.1673-5803.2024.02.009

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Non-ischemic central retinal vein occlusion (CRVO) can cause macular edema and impairment of  central vision. Intravitreal anti-VEGF therapy helps to reduce macular edema in CRVO, it does not work in venous stasis and elevated retinal central venous pressure (RCVP) caused by retinal venous return distrubance. Laser-induced chorioretinal venous anastomosis (L-CRVA) is helpful for transchoroidal drainage of retinal venous blood to reduce RCVP and relieve retinal venous stasis. With the development of laser, the success rate of anastomosis formation  has been improved and complications have been reduced. The combination of L-CRVA and anti-VEGF may permanently cure non-ischemic CRVO and help to reduce the burden of patients.  (Int Rev Ophthalmol, 2024, 48: 129-132)

Roles of astrocytes activation in the mechanism and treatment of optic nerve injury in glaucoma

2024, 48(2):  133-138.  doi:10.3760/ cma.j.issn.1673-5803.2024.02.010

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Glaucoma is a progressive optic neuropathy characterized by the loss of retinal ganglion cells and degenerative changes in the optic nerve, with multiple mechanisms involved in its pathogenesis that are not yet well understood. Astrocytes are one of the main cell types that make up the retina and optic disc, and during fluctuations in intraocular pressure and retinal tissue injury, astrocytes become activated and participate in the response by releasing various immune regulatory factors or chemotactic factors with neuroprotective or neurotoxic effects. Recent studies have shown that astrocytes play an important role in glaucoma optic neuropathy, and regulating the reactivity of astrocytes may provide potential therapeutic targets for the prevention and treatment of glaucoma. (Int Rev Ophthalmol, 2024, 48:  133-138)

The role of insulin-like growth factor 1 receptor in thyroid associated ophthalmopathy

Lv Panpan, Hao Rui

2024, 48(2):  139-144.  doi:10.3760/ cma.j.issn.1673-5803.2024.02.011

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The pathogenic mechanisms of thyroid-associated ophthalmopathy (TAO) have not been fully elucidated. Overexpression of  insulin-like growth factor 1 receptor (IGF-1R) plays a certain promoting role in the pathogenesis of TAO, and the use of its inhibitor, teprotumumab, can exert an inhibitory effect on the clinical manifestations and progression of TAO. Elevated levels of immunoglobulin G and beta-blocking protein in the serum of TAO patients can regulate the expression or function of IGF-1R, promoting the clinical manifestations and progression of TAO. In 2020, teprotumumab became the first drug approved by the U.S. FDA for the treatment of TAO, and the implementation of targeted anti-IGF-1R therapy and related clinical trials have laid the foundation for studying the role of IGF-1R in the pathogenesis of TAO and targeted therapy for TAO.  (Int Rev Ophthalmol, 2024, 48: 139-144)


Application of bioceramics in the treatment of eye diseases

Mai Tangqin, Tang Shangzhang, Xiong Ke

2024, 48(2):  145-150.  doi:10.3760/ cma.j.issn.1673-5803.2024.02.012

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Compared with metal, polymer and other biomaterials, bioceramic materials have good biocompatibility and physicochemical stability, and are mainly used to repair biological hard tissues such as bones and teeth. At present, it shows good histocompatibility and physicochemical stability in fields of ophthalmology. Bioactive glass is used to make the skirt of artificial cornea, and hydroxyapatite is often used in orbital repair. In addition, hydroxyapatite and β-tricalcium phosphate (β-TCP) are also commonly used in orbital fracture repair and defect repair. Alumina and composite materials can be used to make artificial eyes to increase their stability.  (Int Rev Ophthalmol, 2024, 48: 145-150)

The relationship between exosomes and intraocular malignant tumor metastasis

2024, 48(2):  151-155.  doi:10.3760/ cma.j.issn.1673-5803.2024.02.013

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Exosome, a kind of small vesicle enclosed by a phospholipid bilayer, is secreted by cells. Exosomes carry many biological molecules, such as protein, DNA, mRNA, miRNA, lipid, which are mediators of intercellular communication. Exosomes play an important role in many tumor pathological processes such as invasion and metastasis, chemical resistance, angiogenesis, and immune escape. Recent studies have found that exosomes exist in the serum, vitreous body, tumor tissue and tumor cell lines cultured in vitro of patients with uveal melanoma (UM) and retinoblastoma (RB), and are involved in the metastasis and malignancy of these two tumors.  (Int Rev Ophthalmol, 2024, 48:  151-155)

Clinical manifestations of ocular involving neurofibromatosis 

Feng Yun, Li Ting, Chen Ling, Zhang Shasha, Hong Xia, Lin Ping, Mao Zhen

2024, 48(2):  156-封三.  doi:10.3760/ cma.j.issn.1673-5803.2024.02.014

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Neurofibromatosis (NF) is a neurocutaneous syndrome characterized by the development of tumors of the central or peripheral nervous system including the brain, spinal cord, eyes, skin and bones. When the eyes are involved by NF, the clinical manifestations are varied, which can affect not only the eyelids and orbits, but also the intraocular structures such as the lens, uvea, and retina. It can cause varying degrees of damage to the patient’s appearance and visual function, leading to eyelid ptosis, facial deformities, decreased vision, and visual field defects, seriously affecting the patient's visual quality and quality of life.  (Int Rev Ophthalmol, 2024, 48: 156-Cover III)