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    22 June 2025, Volume 49 Issue 3
    Oculomechanics medicine
    He Yuan, Du Huan, Ge Ping, Jia Yuanbo, Xu Feng, Sun Xinghuai
    2025, 49(3):  161-170.  doi:10. 3760/cma.j.cn115500-20250331-25301
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    With the development of interdisciplinary integration between medicine and engineering, the role of mechanical factors in the pathogenesis, progression, diagnosis, and treatment of ophthalmic diseases has become increasingly prominent, emerging as a focal point in both basic and clinical research.Oculomechanics medicine focuses on the application of mechanical factors in understanding disease mechanisms and developing therapeutic interventions in ophthalmology. Centered on establishing direct correlations between biomechanical parameters of ocular tissues and clinical management, this field organically integrates four key components: ocular biomechanics, ocular mechanobiology, ocular mechanodiagnostics, and ocular mechanotherapeutics. Specifically, ocular biomechanics investigates the mechanical responses arising from biological changes in ocular tissues, while ocular mechanobiology explores biological alterations induced by mechanical forces. Ocular mechanodiagnostics leverages mechanical characteristics to develop novel diagnostic tools for enhanced precision in early disease detection, whereas ocular mechanotherapeutics focuses on formulating personalized treatment strategies through mechanical interventions in ocular tissues.

    Factors influencing corneal biomechanics
    Gong Yuwei, Qin Yu, Zheng Yajie, Yang Haoming, Li Lei, Xiao Ruohan, Liang Gang
    2025, 49(3):  170-176.  doi:10. 3760/cma.j.cn115500-20241216-25302
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    Corneal biomechanics are fundamental properties that determine the morphological stability and optical function of the cornea. Factors affecting corneal biomechanics include physiological factors (e.g., age, intraocular pressure, refractive status, hormonal levels), behavioral factors (e.g., contact lens wear, use of eye drops, eye rubbing, smoking), ocular and systemic diseases (e.g., keratoconus, glaucoma, diabetes mellitus, dry eye disease, keratoconjunctivitis, thyroid-associated ophthalmopathy), as well as surgical interventions and trauma. These factors collectively regulate corneal properties such as stiffness, deformability, and energy dissipation.

    Relationship between the size of optical zone of orthokeratology lens and myopia control
    Yu Xingmeng, Liu Fang
    2025, 49(3):  177-181.  doi:10. 3760/cma.j.cn115500-20241113-25303
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    Orthokeratology (Ortho-K) lenses have been widely used for myopia correction and control in children and adolescents due to their ability to provide clear uncorrected visual acuity and effective myopia suppression. Small optical zone Ortho-K lenses refer to designs with an optical zone diameter smaller than 6.0 mm, typically featuring specifications such as 5.0 mm or 5.5 mm optical zones. Compared to conventional Ortho-K lenses with larger optical zones, small optical zone lenses induce a smaller central treatment zone and a steeper mid-peripheral defocus ring. This design generates more pronounced peripheral retinal myopic defocus and higher-order aberrations, thereby enhancing myopia control efficacy. However, such optical characteristics may lead to reduced objective visual quality parameters, such as the modulation transfer function (MTF).

    Study of the pathogenesis and etiology of peripheral ulcerative keratitis
    Li Qi, Li Zhaorui, Wu Qingmei, Xie Cuijuan, Li Yunqiu
    2025, 49(3):  182-188.  doi:10. 3760/cma.j.cn115500-20241213-25304
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    Peripheral ulcerative keratitis (PUK) is an acute destructive disease of the corneal periphery, typically presenting as a crescent-shaped lesion accompanied by corneal epithelial defects, stromal thinning, and inflammatory cell infiltration. The disease is associated with various systemic and local infectious and non-infectious factors, including rheumatoid arthritis, pathogenic microorganism infections (such as bacteria, fungi, viruses), ocular surgery, and ocular trauma. The exact pathogenesis of PUK remains unclear; however, due to the unique anatomical structure of the corneal limbus, high-molecular-weight substances such as immune complexes may preferentially deposit in this region. Through the combined action of T cells, B cells, the complement system, and matrix metalloproteinases, these deposits trigger corneal epithelial destruction and stromal melting, ultimately leading to the development of peripheral ulcerative keratitis.

    Research progress of corneal collagen crosslinking in the treatment of keratoconus 
    Wang Xiaoxuan, Sun Fangfang , Liu Xiaopeng, Luo Junxiang, Lei Yulin
    2025, 49(3):  189-197.  doi:10. 3760/cma.j.cn115500-20241115-25305
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    Keratoconus(KC) is a common congenital, progressive, non-inflammatory degenerative corneal disorder. Corneal collagen cross-linking can increase corneal stiffness and control disease progression. Enhanced riboflavin penetration is achieved through iontophoresis and penetration enhancers; improved oxygen supply for better cross-linking efficacy is facilitated by pulsed light, oxygen delivery devices, and graphitic carbon nitride quantum dot-based oxygen self-supply platforms; riboflavin formulations using hydroxypropyl methylcellulose as a carrier prevent intraoperative corneal thinning; Rose Bengal-green light illumination combined with chemical cross-linking agents reduces biotoxicity; customized ultraviolet collagen cross-linking targeting specific weakened corneal areas maintains keratoconus stability; and epithelial-sparing riboflavin cross-linking protocols overcome the corneal epithelium barrier against large/hydrophilic drug molecules while avoiding complications associated with epithelial debridement.

    Ferroptosis and its role in the pathogenesis of diabetic retinopathy
    Ouyang Qianqian, Zeng Feng
    2025, 49(3):  197-202.  doi:10. 3760/cma.j.cn115500-20241118-25306
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    Ferroptosis is a form of iron-dependent, lipid peroxidation-driven cell death. Under conditions of iron overload, glutathione peroxidase becomes inactivated, leading to the accumulation of intracellular lipid peroxides. This triggers severe damage to mitochondria and cell membranes, ultimately resulting in cell death. Diabetic retinopathy (DR) arises from interactions among apoptosis, endothelial hyperplasia, and neuronal apoptosis. Ferroptosis can influence DR pathogenesis through multiple pathways, including iron metabolism dysregulation, abnormal amino acid metabolism, and mitochondrial damage caused by the accumulation of lipid peroxide radicals. Targeted regulation of ferroptosis pathways offers a novel direction for the treatment of DR.

    The role of miR-199a-3p in the pathogenesis and progression of retinopathy
    Chen Yang, Huang Xionggao, Linghu Minli
    2025, 49(3):  203-207.  doi:10. 3760/cma.j.cn115500-20241118-25307
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    MicroRNA-199a-3p (miR-199a-3p), a member of the miRNA family, serves as a critical regulator of gene expression and plays essential roles in cellular processes such as growth, apoptosis, invasion, migration, and metastasis. MiR-199a-3p is also present in human ocular tissues, including the aqueous humor, vitreous body, conjunctival epithelial cells, and cornea, where it exerts significant regulatory effects on the development and progression of retinal diseases. By modulating signaling pathways and interacting with specific target genes, miR-199a-3p induces upregulation or downregulation of their expression in retinal pathologies. This mechanism underscores its pivotal role in retinopathies such as diabetic retinopathy, age-related macular degeneration, and proliferative vitreoretinopathy.

    Effects of obstructive sleep apnea on ocular fundus structure and retinal microcirculation in children
    Ye Mai, Lin Haishuang, Zhang Chaoyue, Lei Yanyun, Zheng Haihua
    2025, 49(3):  208-212.  doi:10. 3760/cma.j.cn115500-20241204-25308
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    Obstructive sleep apnea (OSA) is a chronic sleep-related breathing disorder,which can lead to a series of local and systemic complications. The effects of OSA on fundus structure and retinal microcirculation in children include increased intraocular pressure, thinner choroidal thickness, and decreased retinal microvascular density.After adenotonsillectomy, the intraocular pressure of children with OSA decreased and the thickness of retinal nerve fiber layer increased compared with that before surgery.

    Risk factors and clinical characteristics of rhegmatogenous retinal detachment after ICL implantation in high myopia
    Pan Liduo, Deng Jian, Li Yonghao
    2025, 49(3):  213-217.  doi:10. 3760/cma.j.cn115500-20250106-25309
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    Posterior chamber phakic implantable collamer lens (ICL) implantation has become the primary refractive surgery option for patients with high myopia. However, with the increasing number of procedures performed, postoperative complications-particularly the potential risk of rhegmatogenous retinal detachment (RRD)-have also risen. Current evidence shows that the 10-year incidence rate of RRD following ICL implantation in highly myopic eyes is 1.71%, demonstrating no significant difference compared to the 1.25% incidence in unoperated highly myopic eyes. The pathogenesis of RRD after ICL implantation may be associated with vitreoretinal alterations in high myopia, surgery-related factors (such as residual viscoelastic agents and intraocular inflammation), and the synergistic effects of both. RRD occurring within the first 6 months postoperatively is generally attributed to surgical factors, whereas cases emerging after longer intervals are more likely associated with the natural progression of high myopia. Furthermore, when RRD does occur following ICL implantation, timely surgical intervention can successfully reattach the retina and preserve visual acuity, with the ICL typically remaining in situ as explantation is usually unnecessary.

    Research progress of extended depth-of-focus intraocular lens
    Zhang Jingwen, Xu Su, Han Yilin, Wang Zibo, Zhang Fengyan
    2025, 49(3):  218-223.  doi:10. 3760/cma.j.cn115500-20241224-25310
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    Multifocal, trifocal, and extended depth-of-focus (EDOF) intraocular lens (IOL) address patients' needs for multi-distance vision through distinct optical designs. EDOF IOL create an elongated focal point to enhance the depth of focus, achieving continuous vision range that meets intermediate and distance vision demands while reducing optical disturbances such as glare and halos, albeit with slightly compromised near vision. Multifocal EDOF IOL, which integrate multifocal and EDOF technologies, are primarily categorized into multifocal refractive EDOF IOL, multifocal diffractive IOL, and hybrid refractive-diffractive multifocal EDOF IOL based on their optical designs. These IOL enable multi-distance vision while minimizing optical interference, maintaining higher visual quality and contrast sensitivity, thereby offering cataract patients more personalized IOL options. However, neuroadaptation remains a significant challenge for multifocal EDOF IOL, necessitating further research into its mechanisms and solutions in the future.

    Mechanism of glucocorticoid-induced cataracts 
    Jian Yufeng, Zhang Jingshang, Wan Xiuhua
    2025, 49(3):  224-229.  doi:10. 3760/cma.j.cn115500-20241127-25311
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    The mechanisms underlying glucocorticoid-induced cataract formation are complex. Glucocorticoids can exacerbate oxidative stress by impairing antioxidant capacity, leading to lens degeneration. Additionally, they upregulate epithelial-mesenchymal transition (EMT), contributing to lens fibrosis, while reducing the expression of the structural protein vimentin, thereby diminishing lens stability and transparency. Glucocorticoids also mediate cataract development through mechanisms such as disrupting ion channel transport, inactivating Na-K-ATPase, regulating apoptosis, and inducing abnormalities in cellular molecules. Therapeutic interventions, including the use of drugs like methotrexate, and reducing glucocorticoid dosage may help lower the incidence of glucocorticoid-induced cataracts.

    Application of multi-omics technology in the pathogenesis, diagnosis and treatment of IgG4-related ophthalmic disease
    Liu Rui, Ma Jianmin
    2025, 49(3):  229-234.  doi:10. 3760/cma.j.cn115500-20241202-25312
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    IgG4-related ophthalmic disease (IgG4-ROD), a manifestation of IgG4-related disease in ocular tissues, has emerged as a key focus in the study of inflammatory orbital lesions in recent years. IgG4-ROD primarily affects the lacrimal glands and may involve multiple sites such as extraocular muscles, orbital fat, and conjunctiva. It often co-occurs with other systemic conditions, yet its complex pathogenesis remains incompletely understood, particularly regarding fibrosis and potential mechanisms of malignant transformation, which require further investigation. Current advances in multi-omics technologies—including genomics, transcriptomics, metabolomics, and radiomics—have provided critical insights into the disease mechanisms, diagnostic differentiation, and therapeutic strategies for IgG4-ROD. The integration of multi-omics approaches offers novel research perspectives and technical pathways to achieve precision diagnosis and treatment.

    Evaluation of quality of life questionnaire for low vision patients
    Zhao Weiqi, Liu Bo, Hong Yuchen, Yang Xiaohui
    2025, 49(3):  235-240.  doi:10. 3760/cma.j.cn115500-20250516-25313
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    Low vision severely impacts patients' visual quality and overall quality of life (QoL).QoL questionnaires are widely used to evaluate the effects of visual impairment on daily living. These questionnaires are categorized into vision-related quality of life (VRQoL) scales and health-related quality of life (HRQoL) scales. Common general-purpose scales include the National Eye Institute Visual Function Questionnaire (NEI-VFQ), Low Vision Quality of Life Questionnaire (LVQoL), Visual Function Index (VF-14),Short Form Health Survey Questionnaire(SF-36), and EuroQol 5-Dimension Questionnaire (EQ-5D). Specialized scales such as the Children’s Visual Function Questionnaire (CVFQ) are also available for pediatric and adolescent populations. In clinical practice, combining VRQoL and HRQoL assessments provides a more comprehensive evaluation of low-vision patients’ QoL and the effectiveness of rehabilitation interventions.