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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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    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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    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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    Application progress of custom artificial iris
    Nie Zetong, Hu Bojie
    International Review of Ophthalmology    2023, 47 (6): 481-487.   DOI: 10.3760/cma.j.issn.1673-5803.2023.06.001
    Abstract340)      PDF(pc) (1595KB)(1380)       Save
    Iris defects often cause severe glare, photophobia, decreased contrast sensitivity, decreased best corrected visual acuity and cosmetic problems. There are various ways of iris reconstruction, recent studies have found that implantation of a custom artificial iris can safely and effectively treat congenital and acquired iris defects. Custom artificial iris has achieved good results in stability, visual function, and aesthetics, making it a novel and effective treatment option. (Int Rev Ophthalmol, 2023, 47:  481-487)
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    International Review of Ophthalmology    2023, 47 (4): 384-384.   DOI: 10.3760/cma.j.issn.1673-5803.2023.04.017
    Abstract179)            Save
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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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    Application of intense pulsed light combined with meibomian gland expression in the treatment of dry eye
    Tian Lu, Chen Luxia
    International Review of Ophthalmology    2023, 47 (4): 373-377.   DOI: 10.3760/ cma.j.issn.1673-5803.2023.04.015
    Abstract328)            Save
    Intense pulsed light (IPL) is a relatively new treatment for meibomian gland dysfunction (MGD) causing lipid deficiency dry eye.  IPL combined with meibomian gland expression (MGX) is not only effective in treating MGD and other lipid deficiency dry eye, but also prevents the recurrence of blepharitis-associated keratoconjunctivitis (BKC), and is a promising treatment option for aqueous tear deficiency dry eye, surgical and lifestyle-related dry eyes. The combination of multiple approaches may have an important role in refractory dry eyes.(Int Rev Ophthalmol, 2023, 47: 373-377)
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    Ocular surface damage of thyroid-associated ophthalmopathy
    Lin Xiaoxuan, Li Jinying
    International Review of Ophthalmology    2023, 47 (4): 354-359.   DOI: 10.3760/ cma.j.issn.1673-5803.2023.04.012
    Abstract301)            Save
    Thyroid-associated ophthalmopathy associated with autoimmunity is a disease of inflammatory infiltration of periorbital and intraorbital ocular tissue caused by multi-factor disorders, but the pathogenesis has not been elucidated. The ocular damage caused by TAO has a wide range of involvement, and the ocular surface damage has a significant impact on visual function. The enlargement of palpebral fissure, the lesion of meibomian gland, the dysfunction of meibomian gland and the decrease of lipid layer of tear film caused by TAO lead to excessive evaporation of tear and the change of high osmotic pressure of tear, which induces or aggravates ocular surface inflammation. The abnormal expression of inflammatory factors in tears and the pathological changes of main and accessory lacrimal glands, and the decrease of water layer led to the further increase of tear osmotic pressure. The vicious circle of inflammation causes the damage of keratoconjunctival barrier, the decrease of corneal nerve fiber density and the decrease of corneal sensitivity. The changes of corneal biomechanical properties and the decrease of deformability in patients with TAO affected the measurement of intraocular pressure. TAO is also accompanied by orbital tissue hyperplasia and expansion, and the orbital pressure increases in patients, which lead to the disturbance of blood circulation. The nutritional supply of the ocular surface is impaired, and the normal physiological function of the ocular surface including the secretion of mucin by conjunctival goblet cells is affected. Ocular surface damage caused by TAO causes a series of serious eye discomfort and facial damage, which threatens the physical and mental health of patients. (Int Rev Ophthalmol, 2023, 47: 354-359)
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    Progress in diagnosis and treatment of optic nerve sheath meningiomas
    Ren Tingting, Ma Jianmin
    International Review of Ophthalmology    2023, 47 (4): 378-383.   DOI: 10.3760/ cma.j.issn.1673-5803.2023.04.016
    Abstract337)            Save
    Optic nerve sheath meningioma (ONSM) is a rare and slow-growing benign tumor that arises from arachnoid epithelial cells. ONSM primarily affects middle-aged women, and its clinical manifestations are mainly painless-progressive vision loss. Diagnosis is largely based on the combination of clinical and imaging findings. The typical CT/MRI findings are tubular or fusiform thickening of the optic nerve, followed by a ” double-track sign” after enhanced scan, which also may be accompanied by calcification. Treatment includes observation, radiotherapy and surgery, among which radiotherapy is the first choice for the treatment of ONSM. At present, there are many radiotherapy methods for ONSM, including spatially fractionated radiation therapy (SFRT), intensity modulated radiation therapy (IMRT), stereotactic radiosurgery (SRS), proton beam radiotherapy (PBT), 3-dimensional conformal radiation therapy (3D-CRT), etc. Surgical treatment can cause vision loss in patients and is usually not be used, but new surgical approaches have been proposed in the literature to prevent tumor extension to the contralateral side. Drug therapy has yielded vision improvement in some cases and is expected to be a potential treatment for ONSM. The mortality of ONSM is almost zero, but the visual prognosis is generally poor.(Int Rev Ophthalmol, 2023, 47: 378-383)
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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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    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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    Ocular surface complications in patients with AIDS
    Gu Jie, Zhuang Xun, Zhu Rongrong
    International Review of Ophthalmology    2023, 47 (5): 466-470.   DOI: 10.3760/cma.j.issn.1673-5803.2023.05.014
    Abstract236)            Save
    Acquired immune deficiency syndrome (AIDS) involve multiple organs and systems. It is prone to missed and misdiagnosed because of diversification and the lack of typical symptoms in eyes. The patients with AIDS are more likely to develop ocular surface diseases, such as ocular surface squamous neoplasia, vernal keratoconjunctivitis, keratitis, dry eyes and so on. They can affect visual function and even cause blindness if not treated in time.
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    International Review of Ophthalmology    2023, 47 (5): 391-391.  
    Abstract360)            Save
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    Progress on blue-light filtering IOL
    Guo Zhaoxing, Wan Xiuhua
    International Review of Ophthalmology    2023, 47 (5): 462-465.   DOI: 10.3760/ cma.j.issn.1673-5803.2023.05.013
    Abstract311)            Save
    Blue-light filtering introcular lens (IOLs) can effectively filter out some of the short wavelength blue light and are expected to provide protection to the fundus. Research confirms that blue light-filtering IOLs do not significantly affect postoperative color vision, sleep quality, or contrast sensitivity. Several long-term cohort studies have provided new evidence-based medical evidence for retinal protection, but some studies still suggest that blue light-filtering IOLs do not have significant advantages over clear IOLs.
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    Role of human herpesvirus and human papillomavirus in the pathogenesis of pterygium
    Zhou Shuowen, Xu Yesheng, Zheng Libin, Yao Yufeng
    International Review of Ophthalmology    2023, 47 (5): 471-474.   DOI: 10.3760/cma.j.issn.1673-5803.2023.05.015
    Abstract281)            Save
    Primary pterygium is a triangular fibrovascular lesion originating from the conjunctiva that often breaks through the limbus and extends to the cornea. The pathogenesis of primary pterygium has yet to be fully elucidated, but ultraviolet light, wind and dust, viral infection, and other factors may be involved in it. Pathogenetic researches indicate that human herpesvirus(HHV) and human papillomavirus(HPV) are detected in pterygium tissue, but the prevalence varies greatly, suggesting that the virus infection may only act as one of the factors in pterygium pathogenesis or recurrence. If the involvement of the virus is confirmed in pterygium pathogenesis, antiviral medications or vaccination may become a new research direction for pterygium therapy.
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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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    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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    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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    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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    Application of stent materials for lacrimal duct intubation surgery
    Xu Enpei, Li Guanghui
    International Review of Ophthalmology    2023, 47 (4): 367-372.   DOI: 10.3760/ cma.j.issn.1673-5803.2023.04.014
    Abstract295)            Save
    With the continuous advancement in artificial lacrimal duct improvements and tissue transplantation, significant progress has been made in the clinical treatment of lacrimal duct obstruction. However, complications such as postoperative scar obstruction or inflammatory reactions have not been completely resolved. Previous studies mainly focused on optimizing artificial lacrimal duct improvements, but it is currently difficult to achieve better clinical outcomes through surgical modifications. With the development of molecular biology and tissue engineering techniques, new scaffold materials are continuously being developed, providing a broad prospect for the treatment of lacrimal duct obstruction. Silicone-based materials, widely used in clinical tear duct intubation, still need improvement in terms of tissue compatibility compared to polypropylene and polymer materials. The development of new biodegradable materials indicates a new research direction for tear duct intubation materials. In addition, the combination of autologous and allogeneic materials provides a new developmental direction for tear duct bypass reconstruction surgery without the need for internal support.(Int Rev Ophthalmol, 2023, 47: 367-372)
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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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    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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    Application of peripheral blood inflammatory markers in diabetic retinopathy
    Sun Huixin, Zhou Xiyuan
    International Review of Ophthalmology    2023, 47 (4): 345-349.   DOI: 10.3760/ cma.j.issn.1673-5803.2023.04.010
    Abstract349)            Save
    Diabetic retinopathy (DR) is one of the common microvascular complications of diabetes. Previous studies have highlighted the association of chronic inflammation and DR. Neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), monocyte-to-lymphocyte ratio (MLR) and systemic immune-inflammation index (SII) have been proven to be potential inflammatory markers in diabetes mellitus and DR. All the makers above are derived from blood routine test, which is economical, practical, convenient and quick, and have a good application prospect. However, due to the influence of systemic conditions, drug use and other factors, it is currently not widely used in the clinic. Strengthening the monitoring of these makers is helpful for the diagnosis and prognosis of DR. (Int Rev Ophthalmol, 2023, 47: 345-349)
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    Morphological changes of vitreoretinal interface in myopic individuals
    Wu Suming, Zhang Zhengwei
    International Review of Ophthalmology    2023, 47 (6): 512-516.   DOI: 10.3760/ cma.j.issn.1673-5803.2023.06.007
    Abstract352)            Save
    Pathological myopia is the main cause of visual impairment in myopic individuals, and its complications are closely related to the vitreoretinal interface. Optical coherence tomography (OCT) can observe its morphological changes, mainly including the posterior precortical vitreous pocket, posterior vitreous detachment, residual vitreous cortex, traction, and anterior retinal membrane. These changes play an important role in the occurrence and development of pathological myopia.(Int Rev Ophthalmol, 2023, 47:  512-516)
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    Advances in the application of lens capsule grafting
    Guo Zhaoqiong, Yu Fangliang
    International Review of Ophthalmology    2023, 47 (6): 530-535.   DOI: 10.3760/cma.j.issn.1673-5803.2023.06.010
    Abstract337)            Save
    As a scraffold for good cell growth, the lens capsule is elastic, malleable, transparent, and available in cataract surgery, and is a simple and widely derived autologous material, which can be used as a graft in anti-glaucoma, treatment of refractory macular hole and corneal ulcer surgery. In trabeculectomy combined with cataract extraction and intraocular lens implantation, the autologous anterior capsule liner is padded under the scleral flap, which can not only play a good role in mechanical barrier, but also inhibit the occurrence of neovascularization and prevent the formation of cicatricial filter vesicles. Lens capsular flap transplantation promotes the proliferation and migration of Müller cells during macular hole surgical repair, thereby promoting macular hole healing; In vitro experiments, the lens capsule promotes corneal epithelial cell growth, adhesion and replacement of the Descemet's layer, maintaining corneal transparency. It may provide a new method for treating corneal ulcers.(Int Rev Ophthalmol, 2023, 47:  530-535)
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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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    Clinical application progress of antibacterial photodynamic therapy in ocular infectious diseases
    Li Mengxi, Zhang Zhen, Zhang Yue, Li Li
    International Review of Ophthalmology    2023, 47 (6): 548-552.   DOI: 10.3760/cma.j.issn.1673-5803.2023.06.013
    Abstract307)            Save
    Antibacterial photodynamic therapy (aPDT) is a new treatment method, which uses radiation within a specific electromagnetic spectrum as a light source to activate photosensitizers enriched in the lesion and generate reactive oxygen radicals (ROS), and finally kill pathogenic microorganisms. Compared with traditional anti-infection therapy, aPDT shows the advantage of lower cytotoxicity, extremely low drug resistance and accurate localization. Because of the excellent optical properties of eyeballs, aPDT is especially suitable for the treatment of eye infections such as bacterial keratoconjunctivitis, viral keratitis, fungal keratitis, acanthamoeba keratitis and various infectious endophthalmitis.(Int Rev Ophthalmol, 2023, 47:  548-552)
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    Application of optical coherence tomography angiography in postoperative follow-up of rheogenic retinal detachment
    Ye Hongli, Jiao Kangwei, Xiao Libo, Bao Zheng Yilin, Huang Yue
    International Review of Ophthalmology    2023, 47 (6): 493-497.   DOI: 10.3760/cma.j.issn.1673-5803.2023.06.003
    Abstract321)            Save
    Rhegmatogenous retinal detachment (RRD) is mainly treated by surgery, and anatomical reattachment can be achieved in most patients after surgery, but the visual improvement is often not obvious. Optical coherence tomography angiography (OCTA) can observe the area of foveal avascular zone in the fovea of macular, the vessels density of retinochoroid in macular area and the capillary density around optic disc. Dynamic follow-up of postoperative choroidal and optic disc microvascular changes has important guiding value for the analysis and prediction of visual function in patients with RRD. (Int Rev Ophthalmol, 2023, 47:  493-497)
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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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    Relationship between cerebrospinal fluid dynamics and pathophysiological mechanisms of optic nerve damage diseases
    Fu Yingdi, Xie Yuan, Wang Ningli
    International Review of Ophthalmology    2023, 47 (5): 392-399.   DOI: 10.3760/ cma.j.issn.1673-5803.2023.05.002
    Abstract359)            Save
    In recent years, it has been proposed that the impairment of cerebrospinal fluid (CSF)dynamics is the common pathophysiological mechanism causing diseases associated with optic nerve impairment. Further study of CSF dynamics, especially optic nerve subarachnoid space (ONSAS) cerebrospinal fluid dynamics, may contribute to the understanding of conditions such as idiopathic intracranial hypertension, spaceflight-associated neuro-ophthalmic syndrome, normal-tension glaucoma and other diseases that cause optic nerve damage and visual impairment, and provide more ideas for their prevention and treatment.The CSF may not flow into ONSAS because of the degree of optic canal stenosis, intraocular pressure and the variation of anatomic structure. The change of ONSAS cerebrospinal fluid pressure is the main factor that cause optic disc edema and atrophy. The changes of pressure and inflammation stimulate the proliferation of meningeal epithelial cells in ONSAS and make the space of lumen become smaller, it leads to the occurrence of optic nerve sheath compartment syndrome, which damages the CSF dynamics and further leads to optic nerve injury. At present, there is no gold standard for evaluating CSF pressure in ONSAS and means to monitor CSF dynamics in real time. The change of CSF pressure in ONSAS can only be roughly judged by the change of optic nerve sheath diameter or intracranial pressure.
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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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    Advances in the treatment of fungal keratitis
    Lee Yan, Zhou Qing
    International Review of Ophthalmology    2023, 47 (4): 360-366.   DOI: 10.3760/ cma.j.issn.1673-5803.2023.04.013
    Abstract334)            Save
    The current difficulties in the diagnosis and treatment of Fungal keratitis (FK) are not easily detected in early diagnosis of the disease, the biotoxicity of antifungal drugs and the low bioavailability of the drugs in the eye, etc. With more research on FK treatment in recent years, new drugs and drug carrier formulations have been proposed and their efficacy has been verified in animal models of FK infection. Regarding surgical treatment, corneal transplantation, and photodynamic therapy are the more commonly used treatment modalities, while the newly proposed low-temperature plasma surgical system is more advantageous in the control of infection and safety in the treatment of FK. (Int Rev Ophthalmol, 2023, 47: 360-366)
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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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    The risk factors and prevention of postoperative strabismus infection
    Zhang Feie, Cai Yan
    International Review of Ophthalmology    2023, 47 (6): 564-569.   DOI: 10.3760/cma.j.issn.1673-5803.2023.06.016
    Abstract299)            Save
    Infection after strabismus surgery is a rare complication, but it affects postoperative recovery and surgical outcomes. Post-strabismus infection often manifests as keratoconjunctivitis, subconjunctival abscess, Tenon's capsule abscess, orbital cellulitis, periorbital abscess or endophthalmitis. The type, depth and location of the infection determine the treatment. Superficial infections recover well with topical antibiotic treatment; abscesses require incision and drainage as well as systemic antibiotics; infections involving deeper tissues require systemic treatment; and severe endophthalmitis can lead to vision loss or even blindness, requiring vitreous cavity injection antibiotics or vitrectomy.(Int Rev Ophthalmol, 2023, 47:  564-569)
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    Role of platelets in retinopathy of prematurity
    Kong Jiayi, Li Manhong, Zhang Zifeng, Wang Yusheng
    International Review of Ophthalmology    2023, 47 (5): 413-417.   DOI: 10.3760/ cma.j.issn.1673-5803.2023.05.005
    Abstract291)            Save
    Retinopathy of prematurity (ROP) has already become the leading cause of blindness in children worldwide, while neovascularization is the significant pathological cause of ROP occurrence and development. Except for participating in coagulation and hemostasis, wound healing, inflammation and tumor metastasis, platelets, the cellular debris produced by mature macrophages, play an important role in angiogenesis through regulating angiogenesis related factors and cells. Researchers have shown that the role and variation of platelets in ROP may provide new ideas for early screening and treatment with platelets infusion.
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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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    Influence of high altitude on dry eye
    Yang Qi, Cai Yan
    International Review of Ophthalmology    2023, 47 (6): 553-557.   DOI: 10.3760/cma.j.issn.1673-5803.2023.06.014
    Abstract296)            Save
    The high altitude, low humidity, hypoxia, and strong ultraviolet rays in the plateau environment are risk factors for inducing dry eye. The combination of low pressure and humidity increases the rate of tear evaporation and decreases tear film stability. Additionally, the strong winds and sand cause inflammatory changes on the ocular surface while hypoxia can lead to corneal oedema. Moreover, ultraviolet rays destabilize the tear film and increase the evaporation of tears. All these environmental factors prevalent in highland areas can cause dry eye by either damaging the tear film or raising the rate of tear evaporation. (Int Rev Ophthalmol, 2023, 47:  553-557)
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    Dry eye after small incision femtosecond laser lenticule extraction in different degrees of myopia
    Reyila·Ainiwaer, Ding Lin
    International Review of Ophthalmology    2023, 47 (6): 508-512.   DOI: 10.3760/cma.j.issn.1673-5803.2023.06.006
    Abstract335)            Save
    Dry eyes is one of the most common complications after laser vision correction. Although small incision lenticule extraction (SMILE) has the lowest incidence of dry eye compared with other refractive procedures. The prevalence of dry eye in patients with different degrees of myopia after SMILE is different, and the related influencing factors may also be different. The higher the degree of myopia, the more denervation caused by SMILE surgery leads to the increased release of substance P (SP) and calcitonin gene-related peptide (CGRP) from corneal sensory nerve fibers, the increased occurrence of neurogenic inflammation and the severer dry eye symptoms. Dry eye related examinations such as corneal staining, Schirmer test, tear film break-up time, tear osmolality, corneal sensitivity and ocular surface disease index score were more abnormal. (Int Rev Ophthalmol, 2023, 47:  508-512)
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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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    Associated factors of myopic shift after surgery for congenital cataract children
    Du Qiuxuan, Yuan Jing, Su Wenjie, Huang Yusen
    International Review of Ophthalmology    2023, 47 (5): 452-455.   DOI: 10.3760/ cma.j.issn.1673-5803.2023.05.011
    Abstract315)            Save
    It is a common clinical scientific problem that myopic shift after congenital cataract surgery in children. The influencing factors are being explored. Among which, the younger the patient when cataract extraction with intraocular lens (IOL) implantation is performed, the greater the myopic shift. Moreover, patients can be treated with IOL implantation or optical correction after cataract extraction, achieving similar axial growth in a long-term follow-up period.The visual axis opacity and glaucoma after surgery can both increase the myopic shift. Clarify the best time point for IOL implantation, accurately calculate the IOL power, reasonable planning of follow-up time, has important clinical significance to improve the long-term visual quality of patients and reduce excessive myopic shift.
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