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Table of Content

    22 August 2022, Volume 46 Issue 4
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    Neural adaptation in patients with implanted multifocal 
    Wang Juexue, Wan Xiuhua
    2022, 46(4):  289-296.  doi:10.3760/ cma.j.issn.1673-5803.2022.04.001
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    Halo and other visual problems can worsen patient’s visual quality after the implantation of multifocus intraocular lens (mIOL), which is related to the neural adaptation of the brain. Studies have found that there are individual differences in neural adaptation, and younger patients are more prone to have neural adaptation. Neural adaptation is related to retinal image processing and the corresponding cerebral cortex activity. To achieve stable neural adaptation needs at least 6 months. Video games, computer cognitive training or computer visual training can improve the neural adaptation of patients after multifocus IOL implantation.  (Int Rev Ophthalmol, 2022, 46:  289-296)
    Epidemiology and pathogenesis of glucocorticoid-induced cataract
    Li Chenshuang, Yan Hong
    2022, 46(4):  296-303.  doi:10.3760/cma.j.issn.1673-5803.2022.04.002
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    The long-term use of systemic glucocorticoid as well as topical sustained-release preparations would result in glucocorticoid induced cataract (GIC), increasing the risk of both cortical and nuclear cataracts and making the onset of cataracts earlier than those of healthy people. The risk of cataracts is different according to different administration methods, doses, dosage forms and the disparate systemic diseases. For example, intravitreal injection of long-acting sustained-release glucocorticoids is about 3 to 5 times the risk of cataracts compared with oral administration. The risk of cataracts was 1.03 times higher for every additional 1 g of prednisone-equivalent cumulative oral hormone. The risk of cataracts was 2.4 times higher in patients taking the third-generation glucocorticoid Difloxacin than in patients taking prednisone. The pathogenesis of GIC has not been thoroughly elucidated, and the current research mainly focuses on glucocorticoid receptor-mediated changes in protein structure and function, abnormal cell differentiation caused by growth factors, excessive activation of apoptosis, changes in the structure and function of crystallins and oxidative stress. (Int Rev Ophthalmol, 2022, 46:  296-303)

    The pathogenesis of keratoconus
    Ma Chunxia, Wang Yingwei, Zhou Jian
    2022, 46(4):  304-309.  doi:10.3760/cma.j.issn.1673-5803.2022.04.003
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    Keratoconus is a disease characterized by corneal dilatation, thinning of central corneal stroma and conical protrusion. The pathogenesis is still unclear. The existing research on genetic genes mainly focuses on genome-wide association analysis, linkage analysis, candidate gene analysis and mitochondrial genome, and the enzymology research mainly focuses on lyases and inhibitory components. In addition, apoptosis, inflammatory reaction and chronic corneal injury (eye rubbing, wearing of corneal contact lenses, ultraviolet) are also related to the pathogenesis of keratoconus. (Int Rev Ophthalmol, 2022, 46:  304-309)

    Corneal opacity assessment method and its application in corneal diseases
    Dilinuer·Tuxunjiang, Ding Lin
    2022, 46(4):  310-317.  doi:10.3760/cma.j.issn.1673-5803.2022.04.004
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    Corneal opacity can be caused by various causes including trauma, infection, edema and  dystrophy. The traditional method for subjective observing corneal opacity is slit lamp microscopy. In recent years, some new methods have been tried, such as spectrophotometry, scatterometer, Scheimpflug tomography system, coherent light tomography, laser scanning confocal microscopy, and so on. However, no standard quantify method for corneal opacity has been widely adopted. (Int Rev Ophthalmol, 2022, 46:  310-317)
    Mechanism and clinical application of tacrolimus in treatment of dry eye disease
    Zhang Zijie, Jia Zhe, Zhao Shaozhen
    2022, 46(4):  318-323.  doi:10.3760/cma.j.issn.1673-5803.2022.04.005
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    Dry eye disease (DED) is widely believed that immune-related inflammation plays an important role in its pathogenesis. Tacrolimus (FK506) has a certain therapeutic effect on ocular inflammation in dry eye by inhibiting calcineurin or MAPK pathway in T lymphocytes, NF-κB pathway in ocular surface cells, and apoptosis of ocular surface cells. Currently, studies on the topical use of tacrolimus in the treatment of dry eye have focused on dry eye with systemic immune diseases, including chronic graft-versus-host disease, Sjgren's syndrome, cicatoid pemphigoid, Steven-Johnson syndrome, etc.(Int Rev Ophthalmol, 2022, 46:  318-323)

    Research on the changes of ocular surface microorganisms in meibomian gland dysfunction patients
    Bao Zhengyilin Zhang Wenjia Huang Yue Hu Zhulin
    2022, 46(4):  324-327.  doi:10.3760/ cma.j.issn.1673-5803.2022.04.006
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    Meibomian gland dysfunction (MGD) is closely related to ocular surface microorganisms. The changes in the species and quantity of ocular surface microorganisms are the inducement or aggravating factors of MGD. There are many potential pathogenic strains on the ocular surface in MGD patients, such as coagulate negative staphylococcus, propionibacterium acnes, and corynebacterium and so on. The strong immune escape and toxicity of ocular surface microorganisms affect the immune response of MGD patients. In addition, the microorganisms on the eye surface have lipase and protease activities, which affect the secretion and anti-inflammatory response of eyelid fat in meibomian gland, and aggravate the condition of MGD patients.(Int Rev Ophthalmol, 2022, 46:  324-327)
    Role of inflammatory cytokines in the pathogenesis of diabetes retinopathy
    Liu Shuang
    2022, 46(4):  327-332.  doi:10.3760/cma.j.issn.1673-5803.2022.04.007
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    Vascular endothelial growth factor, interleukin-1, interleukin-8, tumor necrosis factor and other inflammatory cytokines play an important role in the occurrence and development of diabetes retinopathy (DR), which can induce the activation and migration of leukocytes, leading to capillary obstruction, retinal hypoxia and endothelial cell damage. Then the blood retinal barrier ruptured, and edema, hemorrhage, exudation and microaneurysm formed in the retina. Under the stimulation of persistent inflammatory reaction and cytokines, local pathological neovascularization occurs in the retina, which aggravates the progression of DR. Inflammatory factors in vitreous and aqueous humor are related to the progression of DR. In immune pathology, the inflammatory process induces a series of complex molecular and cellular signaling, which changes the physiological response of the affected eye tissues, thereby generating an inflammatory phenotype. These inflammatory biomarkers can evaluate the inflammatory process, and reliable and easily available inflammatory biomarkers will provide valuable information for the development of new DR biomarkers and their treatments. (Int Rev Ophthalmol, 2022, 46:  327-332)

    Closing macular holes without gastamponade#br#
    Zhang Yingjie, Zhu Dongqing
    2022, 46(4):  333-335.  doi:10.3760/cma.j.issn.1673-5803.2022.04.008
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    To avoid the possible complications and postoperative prone position of gas tamponade after macular hole (MH) surgery, several recent studies have reported that gas tamponade can be avoided by different methods, including only conventional vitrectomy and internal limiting membrane (ILM) peeling or combined with macular plug, autologous blood clot covering and temporal ILM flap. Although the number of patients included in these studies was small, and the size and type of MH were different, high MH closure rate was achieved. (Int Rev Ophthalmol, 2022, 46:  333-335)
    Application of adalimumab in non-infectious uveitis
    Peng Yu, Qiu Xinwen, Ye Bo, Chen Jiansu
    2022, 46(4):  336-340.  doi:10.3760/cma.j.issn.1673-5803.2022.04.009
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    Non-infectious uveitis (NIU) is a group of immune-mediated diseases with complex etiology and difficult treatment. Tumor necrosis factor-α (TNF-α) is the key pro-inflammatory factor in NIU. Adalimumab is a fully humanized monoclonal antibody targeting TNF-α, specifically binding to TNF-α and therefore blocking its induced downstream processes. Application of adalimumab in NIU including uveitis caused by Behcet's disease, Vogt-Koyanagi-Harada syndrome, ankylosing spondylitis-related uveitis, and children's uveitis can effectively reduce inflammation, the dosage of glucocorticoid, and the recurrence rate. Its safety has also been initially confirmed. Adalimumab is a suitable option for second-line treatment of NIU and shows great potential in the treatment of NIU. (Int Rev Ophthalmol, 2022, 46:  336-340)
    Related molecular mechanisms of oxidative stress in retinitis pigmentosa
    Chen Peipei, Liu Xi, Ding Xuemeng, Guan Huaijin
    2022, 46(4):  341-346.  doi:10.3760/ cma.j.issn.1673-5803.2022.04.010
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    Retinitis pigmentosa (RP) is an inherited retinal disease. Non-genetic biological factors such as inflammation, autophagy and oxidative stress also play important roles in its pathogenesis and progression. Oxidative DNA damage is a key regulator of microglia activation and photoreceptor degeneration in RP and is also a mutation of endogenous antioxidant pathways including DNA repair, protection from oxidative stress, and genes associated with antioxidant defense (MUTYH, CERKL and GLO1 genes) activation. Exposure to oxidative stress alters the expression of microRNA and long noncoding RNA. Furthermore, upregulation of the P2X7 receptor causes macrophages and microglia to release pro-inflammatory cytokines and reactive oxygen species, leading to neuroinflammation and neurodegeneration in RP. Multi-pathway analysis suggests that oxidative microglia activation may trigger a vicious cycle of neuroinflammation and degeneration, suggesting that microglia may be a key therapeutic target for oxidative stress in RP.(Int Rev Ophthalmol, 2022, 46:  341-346)
    Advances on research of retinal oxygen metabolism in myopia
    Che Danyang, Miao Peng, Zhou Jibo
    2022, 46(4):  346-350.  doi:10.3760/cma.j.issn.1673-5803.2022.04.011
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    Recently, the researches on retinal oxygen metabolism in myopia mainly focuses on retinal oxygen saturation and retinal blood flow. The studies of retinal oxygen saturation have now been limited to measurement of oxygen saturation in the large retinal vessels. Most studies have found retinal vessel diameter was reduced in myopic eyes. Retinal blood flow in myopic eyes decreased, foveal and peripapillary capillary density decreased, and foveal avascular area increased. There was a positive correlation between blood oxygen saturation and axial length in myopic children and adolescents. However, arterial and venous oxygen saturation difference in highly myopic adults was less than in emmetropia adults. (Int Rev Ophthalmol, 2022, 46:  346-350)
    Research progress of fundus lesions in hypertensive disorder complicating pregnancy
    Wei Dan, Su Jiumei, Gao Jun
    2022, 46(4):  351-355.  doi:10.3760/cma.j.issn.1673-5803.2022.04.012
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    Hypertensive disorder complicating pregnancy (HDCP) is a common serious complication in obstetrics. Systemic small vessel spasm, vessel endothelial injury and ischemia are the basic pathophysiological changes, which in turn cause retinal ischemia, hypoxia, increased vascular permeability, and HDCP fundus lesions (retinal edema, hemorrhage, and retinal detachment, etc.). HDCP fundus lesions are divided into arterial spasm stage, arteriosclerosis stage and retinopathy stage. In addition to the fundus photographs, OCT can detect changes in retinal thickness and other structure, such as multiple superficial retinal detachment, high-reflection bright spots on the outside of the retina, Elschnig spots, and the thickness changes of the choroid etc. Fundus lesions in HDCP patients and the influencing factors related to the severity of fundus lesions include blood pressure, serum albumin, proteinuria and uric acid. In HDCP patients with fundus lesions, the incidence of low birth weight infants (<2.5 kg) is increased, but its effect on retinopathy of prematurity remains inconclusive.(Int Rev Ophthalmol, 2022, 46:  351-355)
    Ocular manifestations after antiretroviral therapy in AIDS patients
    Kang Yonghua, Zhuang Xun, Zhu Rongrong
    2022, 46(4):  356-360.  doi:10.3760/ cma.j.issn.1673-5803.2022.04.013
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    Antiretroviral therapy (ART) is the main method of treatment of human immunodeficiency virus (HIV) infection. With the widely application of the ART drugs, the survival time of AIDS patients is prolonged, and the reports of ocular side effects associated with ART drugs are gradually increased. Patients may have visual impairment, mainly manifestedas immune recovery uveitis, retinal and optic nerve damage, cataract, etc. (Int Rev Ophthalmol, 2022, 46:  356-360)
    The role and mechanism of human immunodeficiency virus infection on the progression of age-related macular degeneration
    Zhou Yamei, Zeng Jia, Liu Xiaojuan
    2022, 46(4):  361-366.  doi:10.3760/cma.j.issn.1673-5803.2022.04.014
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    Human immunodeficiency virus (HIV) is the causative agent of acquired immunodeficiency syndrome (AIDS). Epidemiological surveys have shown that the prevalence of age-related macular degeneration (AMD) in HIV infected people is higher than that in non HIV infected people. HIV down-regulates tight junction proteins in retinal pigment epithelium (RPE) cells, disrupting the blood-retinal barrier (BRB), and induce oxidative stress and inflammation in RPE cells through glycoprotein 120 (gp120) on the envelope surface and transactivator of transcription (Tat), resulting in the loss of photoreceptors, consequently promoting AMD progression. (Int Rev Ophthalmol, 2022, 46:  361-366)

    Advances in genetic researches of concomitant strabismus
    Wang Yachen, Fu Tao
    2022, 46(4):  366-369.  doi:10.3760/ cma.j.issn.1673-5803.2022.04.015
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    The etiology and pathogenesis of concomitant strabismus is complex. Some patients have a clear family history, indicating that genetic factors play an important role in the pathogenesis of concomitant strabismus. Concomitant strabismus is generally considered as a kind of disease with complex genetic pattern and high genetic heterogeneity. Esotropia and exotropia show different genetic pattern and heritability in different studies. In recent years, genetic studies revealed the role of 7q31.2 and 4q28.3 locus, variation of gene like ARIX, and NPLOC4-TSPAN10-PDE6G gene cluster in the pathogenesis of concomitant strabismus. Future studies need larger sample size, more pedigrees study, and more specific gene mutations. (Int Rev Ophthalmol, 2022, 46: 366-369)
    Visual impairment and visual rehabilitation after stroke
    Wang Xue, Wu Jun, Zhou Jinqiong
    2022, 46(4):  370-377.  doi:10.3760/cma.j.issn.1673-5803.2022.04.016
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    Visual impairment is the common complication of stroke, which can be manifested in three aspects: visual sensory impairment, visual dyskinesia and visual perception impairment. Visual impairment can significantly affect the visual perception and quality of life of patients, and hinder the overall rehabilitation process of the whole body. Visual sensory impairment includes visual acuity decline and visual field defects. The needs of visual function can be met through glasses and visual aids instruments. The rehabilitation means of visual field defects include alternative treatment, compensatory training and restorative treatment. Visual dyskinesia include strabismus and eye movement disorders, and their treatment include eye movement training, prism, covering, medicine and strabismus correction surgery. Visual neglect is the most common form of visual perception disorder, and its treatment include acupuncture and various modern rehabilitation methods. The effective treatment and rehabilitation of visual impairment provide good visual conditions for the whole-body rehabilitation of stroke patients. (Int Rev Ophthalmol, 2022, 46:  370-377)
    Advances on orbital solitary fibrous tumor
    Yan Haihan, Ma Jianmin
    2022, 46(4):  378-384.  doi:10.3760/cma.j.issn.1673-5803.2022.04.017
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    Orbital solitary fibrous tumor (SFT) is a rare tumor originating from perivascular multipotent mesenchyme and can occur in various parts of the orbit. Mass involving in the orbit and proptosis are the most common manifestations. The age of onset is 40-50 at most and there is no difference in incidence between men and women. A small percentage of orbital SFT patients may experience tumor recurrence and metastasis. The clinical and imaging findings of orbital SFT are mostly non-specific. The histopathological morphologic changes of orbital SFT are extensive and there are many subtypes. Immunohistochemical staining has high specificity. Surgical resection is the main treatment for orbital SFT, and close follow-up is very important. (Int Rev Ophthalmol, 2022, 46:  378-384)

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