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    Fluid misdirection syndrome during cataract surgery
    Zuo Jiamu, Wan Xiuhua
    International Review of Ophthalmology    2024, 48 (1): 25-28.   DOI: 10.3760/ cma.j.issn.1673-5803.2024.01.005
    Abstract1509)            Save
    Fluid misdirection syndrome during cataract surgery is a rare and serious complication, characterized by an immediate increase in intraocular pressure, iris anterior movement and shallow anterior chamber, excluding iris hyphema. The pathological mechanism involves the accumulation of fluid between the posterior chamber and the anterior hyaloid membrane. Its risk factors include high intraocular pressure and thinning of the lens capsule. To prevent fluid misdirection syndrome, adequate assessment and meticulous operation during surgery are important. Currently, pars-plana fluid aspiration is the primary treatment method for this condition. (Int Rev Ophthalmol, 2024, 48: 25-28)
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    Transscleral cyclophotocoagulation with micropulse laser for refractory glaucoma
    Tao De, Zhang Tiemin, Su Yufang, Yang Yajun
    International Review of Ophthalmology    2024, 48 (1): 15-19.   DOI: 10.3760/ cma.j.issn.1673-5803.2024.01.003
    Abstract763)            Save
    This article summarizes 8 foreign research articles on the treatment of refractory glaucoma with transscleral cyclophotocoagulation with micropulse laser (MP-TSCPC). There were a total of 453 eyes with refractory glaucoma, including more than 33 eyes with pseudoexfoliative glaucoma, 43 eyes with chronic angle-closure glaucoma, more than 58 eyes with neovascular glaucoma, and more than 264 eyes with primary open-angle glaucoma. Most patients had previously undergone incisional glaucoma surgery or had a history of failed glaucoma surgery. Laser power was from 1.6 to 2 W. The duration of treatment lasts between 100 to 360 seconds, and the total energy used was within range of 62 to 225 J.  Follow-up time was from 2 to 18 months, and the success rate was from 33.3% to 73.7%. The preoperative highest intraocular pressure (IOP) was (39.1±13.84) mmHg, and the postoperative lowest IOP was (11.1±4.4) mmHg. The maximum number of anti-glaucoma eyedrops used preoperatively was 4, while postoperatively it was reduced to a minimum of 1.5 eyedrops. Most postoperative complications were anterior chamber inflammatory reactions, with 2 cases of eyeball atrophy and 15 cases of hypotony being the most severe complications. The studies showed that MP-TSCPC can effectively reduce IOP in refractory glaucoma and is a new treatment modality for refractory glaucoma. (Int Rev Ophthalmol, 2024, 48:  15-19)
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    Morphological changes of the Schlemm canal in glaucoma patients
    Zhao Mian, Ye Wenqing, Liang Yuanbo
    International Review of Ophthalmology    2025, 49 (1): 1-7.   DOI: 10.3760/cma.j.cn115500-20241115-01001
    Abstract746)      PDF(pc) (805KB)(277)       Save
    Schlemm canal is a circular tubular structure surrounding the trabecular meshwork around the limbus, which has a different morphological changes ( diameter and area ) in different states and different quadrants. For example, the study showed that the diameter and area of Schlemm canal decreased significantly with age, and the nasal side of Schlemm canal area was greater than the temporal side in normal adults. However, the diameter and area of Schlemm canal in high myopia were significantly larger than that of the normal control group, and the area of Schlemm canal in glaucoma patients was significantly smaller than that of normal subjects. As an important part of the aqueous drainage channel, the measurement of Schlemm canal morphological parameters has been paid great attention by researchers. The measurement methods have been developed from light microscope and electron microscope to ultrasound biological microscopy and optical coherence tomography. Previous studies have reported that the parameters of Schlemm canal in glaucoma patients was significantly smaller than that of normal subjects, as well as glaucoma treatment, such as medication, laser and surgical, can alter the microstructure of the Schlemm canal. (Int Rev Ophthalmol, 2025, 49:  1-7)
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    Mechanism of low-intensity red light therapy in regulating axial elongation
    Wang Yumo, Sun Hongyan, Lin Hongzhan, Yang Mingming
    International Review of Ophthalmology    2024, 48 (6): 426-432.  
    Abstract650)            Save
    Myopia has become an urgent problem in global public health. Low-intensity red light therapy has been shown to be effective in delaying axial elongation in a non-invasive manner, but its mechanism remains unclear. Low-intensity red light therapy is based on the principle that specific molecules absorb photons and respond to light signals, resulting in changes in the electronic excited state of molecules, temporarily changing their structure and function, and achieving highly specific and targeted biological regulation. The regulation of axial length involves a complex cascade of reactions that begins in the retina and affects the sclera. Light exposure is closely related to axial elongation. Previous studies have indicated that the visual stimulation elicited by low-intensity red light is received by retinal neurons and generates signals, which are transduced through the retinal pigment epithelium and choroid to the sclera, leading to the release of neurotransmitters, alterations in choroidal blood flow, and scleral remodeling. This review explores the relationship between low-intensity red light therapy and axial regulation, investigating the mechanisms by which low-intensity red light slows down axial growth. (Int Rev Ophthalmol, 2024, 48:  426-432)
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    Application of capsular tension ring in cataract surgery
    Chen Dongjun, Wan Xiuhua
    International Review of Ophthalmology    2023, 47 (4): 315-321.   DOI: 10.3760/ cma.j.issn.1673-5803.2023.04.005
    Abstract589)            Save
    When there are anomalies in the zonules,the safety of cataract surgery is significantly compromised,leading to increased risks of vitreous prolapse,capsular rupture,residual lens cortex,and dislocation of the intraocular lens(IOL). The use of capsular tension rings(CTRs)and related intraocular devices allow ophthalmologists to maintain the stability of the capsular bag easily during complex cataract surgeries,enhancing the controllability of anterior segment procedures and reducing or alleviating intraoperative and postoperative complications. Moreover, they improves the prognosis of zonular anomalies related conditions. With continuous advancements in design and materials,the indications for capsular tension rings are expanding gradually. Especially for highly myopic patients,CTRs can effectively stabilize the position of the IOL,provide additional support to the relaxed zonules,inhibit migration and proliferation of residual lens epithelial cells,and improve patients' visual quality while reducing the incidence of retinal detachment post-surgery. (Int Rev Ophthalmol, 2023, 47: 315-321)
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    Anti-VEGF drugs for fundus neovascular diseases
    Hou Huimin, Chang Xueke, Jin Yujia, Song Zongming
    International Review of Ophthalmology    2024, 48 (6): 464-470.   DOI: 10.3760/ cma.j.issn.1673-5803.2024.06.013
    Abstract568)            Save
    Retinal neovascularization is a type of ophthalmic disease that involves abnormal proliferation of retinal and choroidal blood vessels. Vascular endothelial growth factor (VEGF) plays a key role in the pathogenesis of fundus neovascular diseases. Anti-VEGF drugs (such as pegatinib, bevacizumab, ranibizumab, busizumab, aflibercept, conbercept, fariximab, etc) can reduce vascular leakage, promote the absorption of effusion and accelerate the regression of neovascularization. Neovascular diseases in the fundus are related to multiple factors, and targeting multiple channels simultaneously may produce better prognosis. With the development of new drug delivery methods, sustained-release drugs, and novel drugs targeting more pathways, anti VEGF drugs provide a more efficient and safe option for the treatment of retinal neovascularization. Innovative drugs include gene therapy drugs ADVM-022 and RGX-314, local eye drops such as pazopanib, squalylamine, regorafenib, oral tyrosine kinase inhibitor CM082, and monoclonal antibody drug loaded implants , all of which have certain prospects.(Int Rev Ophthalmol, 2024, 48:  464-470)
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    Mechanism and safety of controlling myopia with repeated low-level red light
    Li Haobin, Ge Jinling
    International Review of Ophthalmology    2024, 48 (3): 229-234.   DOI: 10.3760/ cma.j.issn.1673-5803.2024.03.013
    Abstract537)            Save
    The research results of repeated low-level red light (RLRL) irradiation assisted treatment of myopia in children and adolescents show that RLRL irradiation can slow down the growth of myopia in children and adolescents. The possible mechanism is to increase choroid thickness, promote retinal dopamine secretion, inhibit melatonin secretion, promote cell repair, and inhibit cell apoptosis. The safety of RLRL has also been widely controversial in clinical practice, as the retina of children and adolescents is not yet fully developed. Long term repeated exposure to low-level red light may induce radiation-induced cataracts, degeneration of retinal tertiary neurons and pigment epithelial cells, and macular light damage.
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    Pathogenesis and potential drug  of cataract
    Ma Lin, Huang Lintao, Shi Hang, Wang Wanhe, Wu Li'an
    International Review of Ophthalmology    2025, 49 (1): 25-31.   DOI: 10.3760/cma.j.cn115500-20240722-01005
    Abstract534)            Save
    The pathogenesis of cataracts is linked to multiple factors, with oxidative stress, excessive quinone substances, aldose reductase activity, and lens protein aggregation being the main mechanisms. Recently, many drugs and compounds have been identified through basic and animal studies as having potential anti-cataract effects. These include polyphenolic compounds extracted from plants, Ginkgo biloba leaves, ginger, and drugs like pirenoxine eye drops for excessive quinone substances. Aldose reductase inhibitors such as diosgenin and L-lysine and anti-lens protein aggregation agents like lanosterol and 25-hydroxycholesterol also show promise, indicating a shift towards molecular approaches in anti-cataract therapy. Despite the therapeutic potential seen in research, limitations such as the extrapolation of animal study results and individual variability currently hinder their clinical application. With further research, these drugs may be used in clinical settings in the future. (Int Rev Ophthalmol, 2025, 49:  25-31)
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    Hyperglycemia induces diabetic retinopathy through oxidative stress
    Ding Yuwan, Huang Hong, Xu Jing
    International Review of Ophthalmology    2023, 47 (5): 424-429.   DOI: 10.3760/ cma.j.issn.1673-5803.2023.05.007
    Abstract525)            Save
    Diabetic retinopathy (DR) is a retinal microvascular complication that arises with the prolongation of the disease in diabetic patients. Its main pathological changes include retinal inflammation, increased vascular permeability, and abnormal retinal surface angiogenesis. Multiple mechanisms are involved in the development of DR, and oxidative stress is an important mechanism in its development, which includes the polyol pathway, advanced glycation end products (AGEs) pathway, the hexosamine pathway (HBP), the protein kinase C (PKC) pathway, and the angiotensin II (ANG II) pathway. The initiation of oxidative stress triggers an intracellular cascade reaction that generates excessive reactive oxygen species. Excessive reactive oxygen species lead to protein modification, inflammatory response, apoptosis, dysregulation of autophagy, impaired mitochondrial function, interfering with a variety of signaling pathways and affecting a variety of biological processes, which result in the onset and progression of DR. Further study of these interactions is important for understanding the pathogenesis of DR and finding relevant therapeutic strategies.
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    Research progress and clinical application of lens organoids
    Xiong Yingyue, Chen Xiaona, Wei Jia, Gao Yali
    International Review of Ophthalmology    2024, 48 (6): 401-406.   DOI: 10.3760/ cma.j.issn.1673-5803.2024.06.001
    Abstract513)      PDF(pc) (805KB)(205)       Save
    The pathogenesis of cataract is relatively complex, lack of effective drug treatment, and postoperative visual quality cannot be restored to normal state. With the application of stem cell technology in ophthalmology, researchers have used stem cells from various sources to successfully induce the formation of humanoid lenses in vitro and reproduce the microscopic three-dimensional structure of some of their unique functions. These lens organoids are used to build disease models in vitro, study the mechanisms and inductions of related diseases, screen drugs and even regenerate alternative treatments. It provides more possibilities for preventing and treating cataracts. This paper reviews the research progress of lens organoids, introduces the breakthrough research methods, summarizes their clinical applications in mechanism research, drug screening and regenerative replacement therapy, and puts forward personal prospects in the direction of related research and cultivation and the construction of 3D lens or whole eye structure in cooperation with multi-bioengineering. (Int Rev Ophthalmol, 2024, 48:  401-406)
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    Application of posterior scleral reinforcement surgery in the treatment of high myopia
    Wu Jiale, Xiong Zhaohui, Xu Yincong, Sun Miaomiao, Gao Jie
    International Review of Ophthalmology    2023, 47 (6): 517-523.   DOI: 10.3760/cma.j.issn.1673-5803.2023.06.008
    Abstract486)            Save
    The most obvious feature of pathological myopia is the gradual increase of the eye axis and the appearance of posterior staphyloma. Posterior scleral reinforcement surgery is currently an effective surgical method for delaying or preventing axial elongation in the treatment of pathological myopia. It mainly uses reinforcement materials to cause inflammatory reactions, neovascularization, and collagen fiber proliferation in the sclera to strengthen the weak posterior sclera and prevent further increase in axial length. This surgical method has been improved on the basis of strip method, patch method, and injection method, and currently, single strip reinforcement method is still the main method. Posterior scleral reinforcement materials are mainly divided into two categories: biological and non-biological, each with its own advantages and disadvantages. Currently, artificial pericardial patches and allogeneic sclera are the main types. Although posterior scleral reinforcement surgery has significant advantages in controlling the development of high myopia, imaging examination suggests that the shape and location of staphyloma in the sclera are diverse, making it difficult for this surgery to conform to the surgical mechanism, leading to controversy over the postoperative efficacy. (Int Rev Ophthalmol, 2023, 47:  517-523)
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    The relationship between dome-shaped macula and refractive state and common complications
    Wang Gechun, , Yuan Fei
    International Review of Ophthalmology    2023, 47 (4): 339-344.   DOI: 10.3760/ cma.j.issn.1673-5803.2023.04.009
    Abstract470)            Save
    Dome-shaped macula (DSM) shows an inward bulge of the retina and choroid in the macula area on optical coherence tomography. The exact pathogenesis of DSM remains unclear, but it is primarily associated with adaptive compensation due to localized sclera thickening. DSM exists in patients with myopia, emmetropia or hypermetropia,  and is more frequently observed in patients with high ametropia. The prevalence rate is about 10%~20% among high myopia people. Common complications of DSM include  serous retinal detachment, choroidal neovascularization, retinoschisis, macular hole and macular epiretinal membrane, etc. Currently, it needs to be further confirmed that whether DSM is a concomitant or a causal relationship with the occurrence of complications. For asymptomatic DSM, regular follow-up observation is recommended. If complications occur and significantly impair visual function, methods such as anti-vascular endothelial growth factor, photocoagulation, photodynamic therapy or manual therapy can be used. (Int Rev Ophthalmol, 2023, 47: 339-344)
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    Advances in surgical treatment of  cataract with high myopia
    Liu Jianying, Li Jing, Wan Xiuhua
    International Review of Ophthalmology    2023, 47 (6): 524-530.   DOI: 10.3760/cma.j.issn.1673-5803.2023.06.009
    Abstract469)            Save
     Cataract surgery with high myopia is complex cataract surgery, which is difficult and risky, and is more prone to intraoperative and postoperative complications such as posterior capsule rupture and retinal detachment. Femtosecond laser-assisted cataract surgery have further improved the surgical accuracy, safety, and efficacy. Pathological changes in the anatomical structure and intraocular microenvironment of high myopic eyes affect the accuracy of the intraocular lens (IOL) calculation formula and the stability of the IOL. The fifth-generation Barrett Universal II formula has proven to be more accurate in patients with high myopia, and the vertically placed one-piece plate-haptic IOL is more stable in the capsular bag and suitable for cataract patients with high myopia.  (Int Rev Ophthalmol, 2023, 47:  524-530)
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    Advances in the study of retinal peripheral defocusing theory
    Wu Xiaomei, Li Shuangle
    International Review of Ophthalmology    2024, 48 (1): 51-55.   DOI: 10.3760/ cma.j.issn.1673-5803.2024.01.010
    Abstract462)            Save
    The theory of peripheral retinal defocus is currently the mainstream theory for myopia prevention and control. Based on the retinal peripheral defocus technology, there are orthokeratology, defocus soft lenses, defocus frame glasses, etc., all of which are in the process of lowering retinal defocus to control the growth of myopia, and they have achieved a better effect for myopia prevention and control. Based on the theory of retinal peripheral defocus, our independently developed multispectral refractive topography (MRT) can quantify the retinal hyperopic defocus, and this breakthrough technology once again verifies that retinal peripheral defocus is the focus of myopia prevention and control. In this article, we review the application and progress of retinal peripheral defocus. (Int Rev Ophthalmol, 2024, 48:  51-55)

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    Progress on prediction of vault after ICL implantation
    Zhu Qiujian, Yuan You, Song E
    International Review of Ophthalmology    2023, 47 (5): 456-461.   DOI: 10.3760/ cma.j.issn.1673-5803.2023.05.012
    Abstract458)            Save
    Vault is an important index to evaluate the safety of implantable collamer lens(ICL) implantation, and is also the focus of this surgical research. The choice of ICL size is the most important controllable factor for postoperativevault. The most traditional ICL size selection method is selected by white-to-white diameterand anterior chamber depth, but the accuracy of this method is not satisfactory. Therefore, researchers have tried to predict the postoperative arch height and ICL size through ultrasound biomicroscopy(UBM), anterior segment OCT and even artificial intelligence, and achieved certain results. This article attempts to compare and analyze various vaulting prediction and ICL size selection methods, and expounds the characteristics, effects and evolution history of various methods.
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    Research progress of stem cell exosomes in treatment of glaucoma
    Lv Jiayan, Fu Qiang, Man Xuejing
    International Review of Ophthalmology    2024, 48 (3): 177-183.   DOI: 10.3760/ cma.j.issn.1673-5803.2024.03.004
    Abstract453)            Save
    Glaucoma is a group of diseases characterized by characteristic optic atrophy. Its pathological manifestations are the damage and apoptosis of retinal ganglion cells. Stem cell exosomes are extracellular microvesicles released by stem cells, which not only retain the function of stem cells in promoting the regeneration and repair of damaged retinal ganglion cells, but also mitigatethe side effects of stem cells, and therefore have become a substitute for stem cells. In addition, stem cell exosomes can also induce the proliferation of trabecular meshwork cells and promote aqueous humor outflow; and it can be used as a drug carrier of anti-scarring drug aptamer S58 in anti-glaucoma surgery, delaying the degradation of S58 and significantly enhancing the duration of its anti-scarring effect. Based on the biological characteristics and functions of exosomes. The research progress of exosomes in glaucoma treatment puts forward that exosomes secreted by stem cells have broad application prospects in glaucoma treatment.
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    Idiopathic macular epiretinal membrane and its OCT and OCTA imaging features
    Wang Gechun, Yuan Fei
    International Review of Ophthalmology    2023, 47 (5): 429-435.   DOI: 10.3760/ cma.j.issn.1673-5803.2023.05.008
    Abstract447)            Save
    Macular epiretinal membrane is a non-vascular fibroblast membrane located on the retinal inner surface in the macular area. Idiopathic macular epiretinal membrane (iERM) accounts for about 80%. Currently, optical coherence tomography (OCT) is the preferred diagnostic method for identifying iERM. OCT technology enables the early detection of the thickened and enhanced layer in the macular region associated with iERM. The information provided by OCT, such as the staging of the condition, central macular thickness, and integrity of the ellipsoid zone, plays a significant role in follow-up, determining the optimal timing for surgery and predicting prognosis. Optical coherence tomography angiography (OCTA) combines the technology of OCT and vascular imaging. In patients with iERM, OCTA images exhibit differences compared to those of normal eyes due to the traction caused by the epiretinal membrane on the retinal vasculature. Therefore, key parameters obtained through OCTA, such as the FAZ (foveal avascular zone) area, degree of vascular distortion, and vascular density, provide valuable insights for evaluating the prognosis of patients. The application of OCT and OCTA aids in more accurate diagnosis and management of patients with macular epiretinal membrane.
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    Animal models and induction methods of myopia
    Ma Yao, You Yuxia
    International Review of Ophthalmology    2023, 47 (6): 503-507.   DOI: 10.3760/ cma.j.issn.1673-5803.2023.06.005
    Abstract447)            Save
    Many kinds of myopia animal models are commonly used, including guinea pigs, mice, chickens, tree shrews, etc. The traditional form deprivation method is still the most widely used method for myopia modeling, and the modeling is relatively stable after multiple methods of improvement. However, due to the limited occurrence of form deprivation in humans, the application of experimental results to humans still requires caution. With the development of laser surgery, optical defocusing has provided new modeling methods, which are similar to the naturally occurring myopia in humans. However, the current application scope is still limited. The frequency flash stimulation method can induce moderate to low myopia, but the induction range for myopia diopter is still limited. Different animals have different feeding conditions, induction methods, inducible myopia, and model stability. Currently, there is a lack of recognized and high-quality animal model production standards. (Int Rev Ophthalmol, 2023, 47: 503-507)
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    Research status of optic disc structure in peripapillary hyper-reflective ovoid mass-like structures 
    Meng Jiaxin, Liu Xia, Zhao Ying
    International Review of Ophthalmology    2023, 47 (6): 488-493.   DOI: 10.3760/cma.j.issn.1673-5803.2023.06.002
    Abstract446)      PDF(pc) (1152KB)(1481)       Save
    Peripapillary hyper-reflective ovoid mass-like structures (PHOMS) are a novel finding observed through enhanced-depth imaging optical coherence tomography (EDI-OCT), appearing as annular or partially annular complexes containing vascular structures surrounding the optic disc on EDI-OCT images. PHOMS frequently coexist with tilted optic disc, optic disc drusen, demyelinating optic neuritis, Leber hereditary optic neuropathy, ischemic optic neuropathy, idiopathic intracranial hypertension, pseudopapilledema and other diseases related to axoplasmic flow stasis. However their pathophysiology and significance remain unclear. (Int Rev Ophthalmol, 2023, 47:  488-493)
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    Modifying hemodynamic abnormalities in the treatment of normal tension glaucoma
    Wang Yiyan, Qing Guoping
    International Review of Ophthalmology    2023, 47 (4): 302-307.   DOI: 10.3760/ cma.j.issn.1673-5803.2023.04.003
    Abstract433)      PDF(pc) (744KB)(1192)       Save
    正常眼压性青光眼(normal tension glaucoma,NTG)作为一种特殊类型的青光眼,患者的眼压在正常范围内波动但仍出现进行性视网膜神经节细胞损伤及青光眼性视野缺损。大量研究证实非眼压因素在NTG的发病过程中起重要作用,其中血流流变异常受到了较多的关注。局部眼血流不足、系统性低血压、血管功能调控异常等血流动力学异常会导致NTG患者视乳头灌注压和血供不足从而加重NTG。因此,治疗NTG患者的异常血流状态可能成为降眼压治疗之外的、针对病因的重要治疗方法。(国际眼科纵览,2023, 47:302-307)
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    Pathological changes in the anterior capsule of diabetic cataract
    Xie Yi, Guan Huaijin, Ji Min
    International Review of Ophthalmology    2023, 47 (4): 322-327.   DOI: 10.3760/ cma.j.issn.1673-5803.2023.04.006
    Abstract425)            Save
    Diabetic cataract is one of the ocular complications caused or aggravated by diabetes mellitus (DM), its pathogenesis has not been elaborated completely. The lens capsule is an acellular, transparent, smooth basement membrane which acts as a barrier secreted by the lens epithelial cells. In hyperglycaemic states, the permeability of lens capsule membrane is altered and a series of pathological changes occur including: histological abnormalities such as fibrosis of anterior lens capsule, loss of intercellular junctions and gaps between epithelial cells and capsule membrane, ultrastructural abnormalities such as epithelial complex structure, gap laxity, finger-like protrusions and lamellar separation, as well as abnormal expression of basement membrane-related molecules. The balance of internal homeostasis of the lens will then accelerate the development of cataracts. Progress of researches on diabetic anterior lens capsule changes help to rethink the mechanism of diabetic cataract from a different perspective and provide a pathological basis for diagnosis and prevention. (Int Rev Ophthalmol, 2023, 47: 322-327)
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    Mechanisms of photoreceptor death in retinal degenerative diseases
    Li Yihui, Jin Zibing
    International Review of Ophthalmology    2023, 47 (5): 406-412.   DOI: 10.3760/ cma.j.issn.1673-5803.2023.05.004
    Abstract416)            Save
    Retinal degenerative diseases, characterized by progressive loss of photoreceptors, cause irreversible damage to vision. In the past, apoptosis and necrosis were considered to be the main mechanisms of photoreceptor death. Recently, pyrodeath, autophagy, PARP-1-dependent cell death and iron death have been confirmed to be related to photoreceptor death. Specially, autophagy has a dual effect on photoreceptor cells. Inhibition of these signaling pathways can reduce the photoreceptor death in retinal degenerative diseases. With the further of the understanding of cell death, the diagnosis and treatment of retinal degenerative diseases will be updated and improved.
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    Application of optical coherence tomography angiography on assessment of microcirculation changes in glaucoma
    Zhang Yihan, Zhang Fengyan
    International Review of Ophthalmology    2023, 47 (4): 296-301.   DOI: 10.3760/ cma.j.issn.1673-5803.2023.04.002
    Abstract411)      PDF(pc) (748KB)(1835)       Save
    Optical coherence tomography angiography (OCTA) is a novel, non-invasive ophthalmic examination technique that provides high-resolution images of microvascular. OCTA can quantitatively analyze optic disc, retinal and choroidal blood perfusion of patients with glaucoma and assess their microvascular changes. Patients with different types of glaucoma may have decreased vessel density of the optic disc, peripapillary, macular retina, choroid and abnormal indexes related to foveal avascular zone, whose changes are related to the degree of visual field defect, the thickness of the nerve fiber layer, and the thickness of the ganglion cell complex.  (Int Rev Ophthalmol, 2023, 47: 296-301)
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    Effect of optic disc size on thickness of retinal nerve fiber layer and ganglion cell complex
    Li Caixia, Li Shuning
    International Review of Ophthalmology    2023, 47 (4): 308-314.   DOI: 10.3760/ cma.j.issn.1673-5803.2023.04.004
    Abstract405)            Save
    Examination of retinal nerve fiber layer (RNFL) and ganglion cell complex (GCC) have been widely used for the screening and diagnosis of early glaucoma, but the thicknesses of RNFL and GCC are affected by race, age, sex, ocular factors and systemic diseases. Optic disc size is one of the important influencing factors for measuring the thickness of RNFL and GCC in patients with different optic disc sizes using optical coherence tomography (OCT). The measurement of RNFL in the normal scanning mode of OCT is influenced by the size of optic disc, and the RNFL in large optic disc is thicker. Therefore, proportional scanning mode is more suitable for RNFL measurement of different types of optic disc. However, it is still controversial whether patients with larger optic disc have greater GCC thickness measurements than those with small optic disc, which needs further study to verify. (Int Rev Ophthalmol, 2023, 47: 308-314)
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    The relationship between exercise and intraocular pressure, ocular blood flow perfusion, and optic nerve protection#br#
    Lin Jingjing, Liang Yuanbo, Nie Li
    International Review of Ophthalmology    2024, 48 (1): 8-14.   DOI: 10.3760/ cma.j.issn.1673-5803.2024.01.002
    Abstract404)      PDF(pc) (985KB)(752)       Save
    Exercise therapy, as an auxiliary treatment for glaucoma, recently has attracted broad attention. Previous clinical studies have confirmed that exercise can reduce intraocular pressure and improve ocular perfusion in healthy people and glaucoma patients. In addition, animal experiments have shown that exercise also has a certain protective effect on the optic nerve. This article reviewed the research on the relationship between exercise and intraocular pressure, ocular perfusion, and neuroprotection, as well as the related mechanisms, to further promote the application of exercise therapy in clinical practice. (Int Rev Ophthalmol, 2024, 48: 8-14)
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    Research progress of PANoptosis in the mechanism and treatment of glaucoma
    Ye Dan, Xu Yue, Huang Jingjing
    International Review of Ophthalmology    2023, 47 (6): 542-547.   DOI: 10.3760/cma.j.issn.1673-5803.2023.06.012
    Abstract403)            Save
    Glaucoma is a group of irreversible blinding ophthalmopathies characterized by progressive loss of retinal ganglion cells (RGC) and axonal damage. The specific damage mechanism has not been clarified. PANoptosis is an inflammatory cell death pathway, including apoptosis, necroptosis and pyroptosis. There are three activation pathways of cell death and molecular crosstalk in the retina of glaucoma patients and experimental animal models of glaucoma, which are closely related to the occurrence and development of glaucomatous RGC death. Targeted intervention with PANoptotic related molecules can inhibit retinal damage and RGC loss in glaucoma. (Int Rev Ophthalmol, 2023, 47:  542-547)
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    Relationship between high myopia and primary open angle glaucoma
    Lin Leying, Lin Peijie, Lai Mingying
    International Review of Ophthalmology    2024, 48 (3): 172-176.   DOI: 10.3760/ cma.j.issn.1673-5803.2024.03.003
    Abstract402)            Save
    Primary open-angle glaucoma is a chronic and progressive optic neuropathy with characteristic morphological changes of optic disc and retinal nerve fiber layer, and without other eye diseases or congenital abnormalities, which will eventually lead to irreversible blindness. High myopia is an independent risk factor for primary open angle glaucoma, but it is accompanied by changes in eyeball morphology and optic disc structure, which brings difficulties to early clinical diagnosis and treatment. At present, a large number of studies show that the risk of primary open angle glaucoma in patients with high myopia is higher than that in patients with non-high myopia. This paper summarizes the relationship between high myopia and primary open angle glaucoma from the aspects of epidemiology, intraocular pressure, axial length, visual field, optic disc and retinal nerve fiber layer.
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    The influence factors of  rotational stability of Toric introcular lens
    Tian Gengqi, Zhang Fengyan
    International Review of Ophthalmology    2024, 48 (1): 35-40.   DOI: 10.3760/ cma.j.issn.1673-5803.2024.01.007
    Abstract398)            Save
    The Toric introcular lens (IOL) is the main way to solve larger corneal astigmatism in cataract patients, and its rotational stability is one of the main factors determining its postoperative corrective effect. The axial rotation of Toric IOLs is affected by various factors such as preoperative marking, intraoperative alignment, self-rotation, capsular bag fibrosis, and surgical methods. Only by fully understanding the effect factors and targeting the individual characteristics of the patient can we better minimize the occurrence of postoperative rotation. (Int Rev Ophthalmol, 2024, 48: 35-40)

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    The role of NETs in the pathogenesis of diabetic retinopathy
    Feng Qianhong, Yuan Fei
    International Review of Ophthalmology    2023, 47 (4): 350-353.   DOI: 10.3760/ cma.j.issn.1673-5803.2023.04.011
    Abstract392)            Save
    Neutrophil extracellular traps(NETs) are network structures composed of nuclear DNA and/or mitochondrial DNA and various proteins released by neutrophils after receiving external stimulation. NETs play an important role in clearing pathogens, inflammation, autoimmunity, etc. Recent years, increasing evidence suggests that NETs are involved in the development of diabetic retinopathy (DR). The hyperglycemic and low-grade inflammatory environment in T2DM can induce NETs in the retina. DR itself also can increase the adhesion of neutrophils in retinal vessels and induce NETs. In addition, some studies have demonstrated that NETs can induce the regression of retinal pathological neovascularization. The study of NETs provides new strategies and directions for the prevention and research of DR. (Int Rev Ophthalmol, 2023, 47: 350-353)
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    Advance of immediately sequential bilateral cataract surgery in COVID-19 era
    Ren Yuecong, Yan Hong
    International Review of Ophthalmology    2023, 47 (4): 333-338.   DOI: 10.3760/ cma.j.issn.1673-5803.2023.04.008
    Abstract389)            Save
    Immediate sequential bilateral cataract surgery(ISBCS) is performed on both eyes on the same day but as separate procedures which was first reported in 1952. The COVID-19 pandemic has sparked a greater interest in ophthalmologist perceptions of ISBCS in recent years because of the cost savings and convenience. Especially in countries where there is a long waiting list for second eye cataract surgery. Despite the advantages of rapid restoration of binocular vision and reduction of epidemic exposure in specific contexts, further clinical research on ISBCS is needed on the long-term safety including bilateral endophthalmitis, refractive surprise, corneal decompensation, and bilateral macular edema. (Int Rev Ophthalmol, 2023, 47: 333-338)
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    Development history of ocular prosthesis and status of three-dimensional printing ocular prosthesis
    Niu Linghan, Li Dongmei
    International Review of Ophthalmology    2024, 48 (3): 161-165.   DOI: 10.3760/ cma.j.issn.1673-5803.2024.03.001
    Abstract385)      PDF(pc) (1269KB)(312)       Save
    Starting with the glass prosthetics from 18th century, ocular prosthesis has been continuously improved in terms of materials and craftsmanship, in order to provide better appearance and wearing experience for patients. With the development of technology, the combination of three-dimensional printing (3D printing) with computer-aided design (CAD), material manufacturing and other technologies has brought new ideas to the entire process of ocular prosthesis design and production. In terms of iris localization and color determination, 3D printed ocular prosthesis has a more accurate appearance. By combining CAD technology and eye socket scanning technology, 3D printed prostheses can provide a more accurate appearance. Compared with traditional prostheses, it shortens the customization time and reduces labor investment.
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    Applications of intraoperative optical coherence tomography in ophthalmic surgery
    Zhang Xiruo, Qu Shen, Bi Yanlong
    International Review of Ophthalmology    2023, 47 (4): 289-295.   DOI: 10.3760/ cma.j.issn.1673-5803.2023.04.001
    Abstract383)      PDF(pc) (1644KB)(1415)       Save
    Optical coherence tomography ( OCT ) is gradually becoming widely used in the field of ophthalmology because of its ability to provide high-resolution tissue images that are real-time, noninvasive and can be examined in vivo. This article summarizes the application scenarios of intraoperative OCT (iOCT) in a wide range of anterior and posterior segment surgeries, including corneal surgery, cataract surgery, glaucoma surgery and vitreoretinal surgery. iOCT facilitates a profound understanding of intraoperative tissue anatomy, localization, and dynamic changes. It aids surgeons in making informed decisions during surgery, thereby enhancing surgical safety and precision, and fostering the progression of minimally invasive ophthalmic procedures. However, limitations such as expensive equipment, challenges in tracking scanning, and limited imaging field of view restrict its further development and wider application. (Int Rev Ophthalmol, 2023, 47: 289-295)
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    Mini-scleral contact lenses for ocular surface diseases
    Yang Xinyu, Chen Luxia
    International Review of Ophthalmology    2024, 48 (1): 20-24.   DOI: 10.3760/ cma.j.issn.1673-5803.2024.01.004
    Abstract383)            Save
    Scleral contact lens (SCL) is a large-diameter, rigid, breathable contact lens. It is not contact with the cornea and is completely supported by the sclera. In recent years, SCL can form a tear reservoir between the posterior surface of the lens and the anterior surface of the cornea, neutralize optical aberrations to provide clear and stable vision for patients with corneal irregularities, due to the continuous improvement of its safety in clinical application, SCL has become a widely accepted new treatment method and can also effectively treat a variety of ocular surface diseases. In order to make the wearing of the lenses more convenient and comfortable, the SCL has been continuously updated in material and design, resulting in the emergence of mini SCL, which not only retain the advantages of SCL, have better application advantages in clinical applications, but also are easier to wear and have a wider range of applications. Mini-SCL can be used to treat primary or secondary irregular corneas, also can effectively treat dry eye caused by a variety of ocular surface diseases. In addition, Mini-SCL can also be combined with drugs to increase the efficacy of the drug. This article briefly describes the application, adverse reactions and related research progress of mini-SCL in ocular surface diseases, in order to provide reference for clinical treatment. (Int Rev Ophthalmol, 2024, 48: 20-24)
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    Correlation between hypertensive retinopathy and other important target organs injury
    Zhao Runze, Sun Xiaojia, Lian Kun, Chang Tianfang, Dou Guorui
    International Review of Ophthalmology    2023, 47 (5): 418-423.   DOI: 10.3760/ cma.j.issn.1673-5803.2023.05.006
    Abstract382)            Save
    With the aging of China's population, the incidence of hypertension is increasing year by year. Retinal blood vessels have similar anatomical structure and functional characteristics with cerebrocardiovascular structure and renal blood vessels, meanwhile small retinal arteriopathy in hypertensive patients may precede the clinical symptoms of other important target organs damaged by hypertension, and retinal microcirculatory changes are expected to be a predictor of systemic pathologic changes in hypertensive patients. Although the correlation between hypertensive retinopathy and damage to the major target organs of hypertension has been confirmed, the examination and diagnostic criteria used in various studies are different, making replicability and clinical dissemination difficult. In recent years, the clinical application of artificial intelligence diagnosis model established by multi-modal hypertension retinopathy big data under fundus photography and optical coherence tomography (flow angiography) may solve this problem.
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    The role of retinal microglia in blinding eye diseases 
    Li Wanqian, Hou Shengping
    International Review of Ophthalmology    2023, 47 (6): 498-503.   DOI: 10.3760/cma.j.issn.1673-5803.2023.06.004
    Abstract382)            Save
    Microglia are retinal resident immune cells, which are particularly critical for maintaining the dynamic balance of the retinal microenvironment. Microglia have diverse functions, strong plasticity, and activated microglia can play a dual role in protecting tissue and exacerbating damage in response to external stimuli. There is growing evidence that retinal microglia are involved in the development of a variety of blinding eye diseases, such as uveitis, age-related macular degeneration (AMD) and diabetic retinopathy (DR).  (Int Rev Ophthalmol, 2023, 47:  498-503)
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    The causes and surgical methods of intraocular lens exchange
    Yue Peilin, Wang Zhenyu, Yang Yiquan, Song Xudong
    International Review of Ophthalmology    2024, 48 (2): 81-86.   DOI: 10.3760/ cma.j.issn.1673-5803.2024.02.001
    Abstract379)      PDF(pc) (732KB)(698)       Save
    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)
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    Recent progress in diagnosis, treatment and research of geographic atrophy
    Liao Xingming, Yang Yuting, Ma Hongjie
    International Review of Ophthalmology    2024, 48 (5): 333-340.   DOI: 10.3760/ cma.j.issn.1673-5803.2024.05.003
    Abstract379)            Save
    Geographic atrophy (GA) is an advanced form of age-related macular degeneration, characterized by progressive and irreversible loss of photoreceptors, retinal pigment epithelium, and choriocapillaris. Ophthalmic imaging technologies, such as color fundus photography, fundus autofluorescence, and optical coherence tomography, are crucial tools for diagnosing and assessing disease progression in GA. Monitoring visual function is essential in the disease surveillance of GA, and a single visual function test may not fully reflect the patient's true visual experience. A comprehensive assessment should combine best corrected visual acuity, low luminance visual acuity, and microperimetry to provide a more complete evaluation. Currently, there is no effective treatment for GA, but emerging therapies such as complement inhibitors and gene therapy show promising prospects. (Int Rev Ophthalmol, 2024, 48:  333-340)
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    Rotational stability  of Toric IOL and its influencing factors
    Hong Yang, Zhao Chunmei, Liu Xiangyun
    International Review of Ophthalmology    2023, 47 (4): 328-332.   DOI: 10.3760/ cma.j.issn.1673-5803.2023.04.007
    Abstract375)            Save
    Toric IOL implantation is a way to correct cataract with astigmatism. The degree of rotation is positively correlated with the increase of astigmatism and defocus aberration. The rotation of the IOL will lead to different degrees of astigmatism and defocus aberration. Long axial length, irregular capsulorhexis, severe fibrosis of the anterior capsule membrane, poor adhesion of IOL materials, and postoperative vigorous activity are all risk factors for Toric IOL rotation. (Int Rev Ophthalmol, 2023, 47: 328-332)
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    Research progress on the application of premium intraocular lenses in glaucoma patients
    Wu Renyi, , , Zheng Tan
    International Review of Ophthalmology    2024, 48 (1): 1-7.   DOI: 10.3760/ cma.j.issn.1673-5803.2024.01.001
    Abstract375)      PDF(pc) (812KB)(899)       Save
    Due to the increasing demand for vision and spectacle independence among patients, as well as technological advancements, premium intraocular lenses (IOLs), including presbyopia correction IOLs and astigmatism correction IOLs, are increasingly being adopted in clinical practice. Existing studies have shown that some glaucoma patients implanted with premium IOLs have a high rate of spectacle independence, excellent visual acuity, and comparable contrast sensitivity to healthy subjects, with high postoperative patient satisfaction. However, there is currently a lack of sufficient evidence to support the safety ofpremium IOL implantation in patients with advanced glaucoma. When combining cataract extraction surgery with certain glaucoma surgeries, premium IOLs should be carefully selected, as there may be other intraoperative and postoperative factors that affect the visual quality after surgery. Premium IOL often has better results in suspected glaucoma patients, patients with high intraocular pressure, and glaucoma patients with good early disease control. The selection of IOL should be comprehensively considered based on the patient's expected refractive outcome, glaucoma subtypes, the type and severity of glaucoma visual field defects, and the type of glaucoma surgery. (Int Rev Ophthalmol, 2024, 48: 1-7)

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    Portable visual field testing systems for screening and diagnosis of glaucoma
    Shen Xiaoyuan, Chen Zidong, Yu Minbin
    International Review of Ophthalmology    2024, 48 (4): 241-247.   DOI: 10.3760/cma.j.issn.1673-5803.2024.04.001
    Abstract375)      PDF(pc) (1136KB)(434)       Save
    Visual field testing plays a crucial role in the diagnosis and treatment of glaucoma. Currently, there are various portable visual field testing devices based on personal computers, tablet computers, virtual reality technology, and smartphones that can be used to monitor the visual function of glaucoma patients. For example, the Moorfields Motion Displacement Test (MMDT) based on personal computers and the Melbourne Rapid Fields (MRF) test on tablet computers have initially demonstrated feasibility in community and home settings, while the imo system based on virtual reality technology and the GearVision system based on smartphones have shown practicality. These visual field testing methods are portable, low-cost, relatively accurate, and highly accessible. They provide effective supplementary monitoring tools for glaucoma diagnosis and treatment, and meet the demands of telemedicine. However, there are still issues such as inconsistent screen parameters, resolution limitations, and the need for standardized testing environments that need to be addressed.(Int Rev Ophthalmol, 2024, 48:   241-247)

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