Table of Content

22 August 2024, Volume 48 Issue 4

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Portable visual field testing systems for screening and diagnosis of glaucoma

Shen Xiaoyuan, Chen Zidong, Yu Minbin

2024, 48(4):  241-247.  doi:10.3760/cma.j.issn.1673-5803.2024.04.001

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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)





Application prospects of microRNAs in glaucoma research

Wu Renyi, Gao Ruxin

2024, 48(4):  248-254.  doi:10.3760/cma.j.issn.1673-5803.2024.04.002

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miRNAs are small non-coding RNA molecules that participate in the pathophysiological mechanisms of glaucoma. miRNA has the potential to serve as a biomarker for early detection and diagnosis of glaucoma. The study of miRNA in glaucoma helps to elucidate the molecular pathways and mechanisms of glaucoma, promote the development of personalized medicine for glaucoma, and can be applied to the treatment of glaucoma and non-invasive disease monitoring. Although miRNA research in glaucoma has good application prospects, there are also challenges and limitations, such as lack of standardized protocols for sample collection, storage, and DNA extraction, poor tissue specificity and accessibility of samples, and poor reproducibility in different populations. By addressing these limitations, not only can we enhance our understanding of the role of miRNA in glaucoma, but also pave the way for personalized medical methods. (Int Rev Ophthalmol, 2024, 48:  248-254)





Application of anti-scarring therapy in glaucoma filtration surgery

Liu Yuning, Zhao Chunmei, Liu Xiangyun, Mu Qirui, Zhao Le

2024, 48(4):  254-260.  doi:10.3760/cma.j.issn.1673-5803.2024.04.003

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Scarring around the filtering bleb after glaucoma filtering surgery (GFS) is a major cause of surgical failure. The antimetabolic drug mitomycin-C (MMC) is the first-line treatment for scarring in GFS, but its cytotoxicity can lead to serious complications. Newer anti-scarring approaches include improved surgical techniques (e.g. creation of conjunctival flaps of varying depth), use of physical barriers to the filtration pathway (e.g. biodegradable collagen matrix implants, biodegradable collagen matrix implants, sodium hyaluronate, amniotic membranes, corneal stromal lenses and perfluoropropane gas), and anti-scarring drugs (glucocorticosteroids and non-steroidal anti-inflammatory drugs in addition to MMC, 5-fluorouracil and transforming growth factor-beta-regulating drugs, and the Chinese herbal medicines Dan Huayu Tang, glaucoma and granules, etc.), eye massage, β-radiation therapy, and so on.(Int Rev Ophthalmol, 2024, 48:   254-260)





The influence of different haptic designs of intraocular lenses on their axial position

Zhang Xin, Zhang Yue, Xu Yanhui, Chen Zhimin

2024, 48(4):  261-266.  doi:10.3760/cma.j.issn.1673-5803.2024.04.004

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The position of the intraocular lens(IOL) after cataract surgery is not fixed, and most of it will undergo linear motion after surgery, and then it is relatively stable. The axial position of the IOL is affected by many factors, including the anatomical structure of the eyeball, the surgical method, the design of the IOL, the lens capsular bag, etc. As the supporting element of the IOL, the design of the IOL loop plays a key role in the stability of the axial position of the IOL, including the material of the loop, the thickness and width of the loop, the relationship between the optical part and the loop, the number of loops, the type of loop, the angle of the loop and the diameter of the loop. (Int Rev Ophthalmol, 2024, 48:   261-266)





Research progress  on  anti-VEGF drugs and glucocorticaid drugs for the treatment of retinal vein  occlusion-associated macular edema

Huang Ju, Li Shiyi, Zhang Ao, Wang Kang, Xie Yingbin

2024, 48(4):  267-272.  doi:10.3760/cma.j.issn.1673-5803.2024.04.005

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Currently, the main therapeutic strategies for retinal vein occlusion-associated macular edema macular edema (RVO-ME) encompass intravitreal injections of anti-vascular endothelial growth factor (VEGF) agents and corticosteroids. The clinical efficacy of dexamethasone intravitreal implant (Ozurdex) for the treatment of RVO-ME in improving visual acuity and reducing central macular thickness (CMT) is superior to that of anti-VEGF drugs at 1 month, and there is no statistically significant difference in clinical efficacy between the two drug types within 3 months post-injection, while Ozurdex needs to be re-injected within 6 months post-injection to maintainits favorable efficacy. When the two types of drugs are combined, either in a spaced or simultaneous injection regimen, they have similar or even better efficacy than monotherapy while reducing the frequency of injections. Meanwhile, intravitreal injections of these two types of drug can cause ocular complications such as high intraocular pressure, concurrent cataracts, endophthalmitis, retinal tears, vitreous hemorrhage, and corneal damage. (Int Rev Ophthalmol, 2024, 48:  267-272)





The morphological alterations of Bruch's membrane in myopic eyes

Lu Yuhan, Chen Wei

2024, 48(4):  272-277.  doi:10.3760/cma.j.issn.1673-5803.2024.04.006

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The evolution of myopia is intricately linked to the progressive elongation of the ocular axis. Throughout this process, there is a notable thinning of the choroid and sclera, yet their volumes remain remarkably stable. Intriguingly, the thickness of Bruch's membrane (BM) appears to be decoupled from variations in the axial length of the eye. Given that the spatial separation between the ora serrata and the posterior pole escalates in tandem with axial elongation, this phenomenon suggests a concomitant expansion of the BM surface area. Consequently, the observed independence of BM thickness from changes in axial length provides compelling evidence for a compensatory increase in BM volume as the ocular axis extends. In highly myopia, a robust correlation has been observed between increased axial length and the incidence of BM openings, BM defects, and peripapillary atrophy. These findings indicate that the morphological modifications of BM within myopia may significantly contribute to the pathophysiological mechanisms governing axial elongation, hinting at novel therapeutic targets for myopia management.(Int Rev Ophthalmol, 2024, 48:  272-277)





The correlation between helicobacter pylori infection and eye diseases

Miao Hui, Yang Yiquan, Lv Aiguo, Fan Sujie

2024, 48(4):  278-283.  doi:10.3760/cma.j.issn.1673-5803.2024.04.007

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Helicobacter pylori is a gram-negative bacterium with flagella. In addition to causing gastrointestinal infections, it is also associated with other systemic diseases such as autoimmune diseases, cardiovascular and cerebrovascular diseases, endocrine system diseases, etc. In recent years, increasing studies have found that helicobacter pylori infection also has adverse effects on some eye diseases, such as blepharitis, glaucoma, and central serous chorioretinopathy. Helicobacter pylori can participate in the occurrence and development of the related eye diseases through mechanisms such as stimulating the release of inflammatory mediators, the production of antibodies and effector T cells, and molecular mimicry. Eradicating helicobacter pylori may help treat the aforementioned eye diseases.(Int Rev Ophthalmol, 2024, 48:  278-283)





The effectiveness and safety of multifocal soft corneal contact lenses in controlling myopia in adolescents

Wu Ziyan, Yan Zhipeng

2024, 48(4):  283-289.  doi:10.3760/cma.j.issn.1673-5803.2024.04.008

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Multifocal soft contact lenses (MFSCL) is an effective methods of preventing and controlling myopia in adolescents. The concentric ring design and progressive peripheral design of MFSCL have been proven to have good effects for myopia control. Compared to single-vision spectacles and single-vision soft contact lenses, MFSCL has obvious advantages, providing clear long-distance vision, slowing down axial elongation, and delaying myopia progression. However, due to direct attachment to the surface of the eye, it may cause instability of the tear film, conjunctivitis, and chronic damage to various layers of corneal cells caused by hypoxia. Therefore, standardized fitting, nursing, and regular follow-up monitoring are necessary.  (Int Rev Ophthalmol, 2024, 48:  283-289)





The effect of laser corneal refractive surgery on corneal and tear neuromediators

Shao Yuhao, Li Min, Zou Jun

2024, 48(4):  290-297.  doi:10.3760/cma.j.issn.1673-5803.2024.04.009

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Corneal neuromediators, which are released by corneal nerves and their interactions with target cells, play a crucial role in maintaining normal corneal physiological functions and facilitating the repair process of the cornea. Laser corneal refractive surgery, involving the ablation of the cornea, not only results in corneal tissue damage but also leads to changes in the expression levels of corneal and tear neuromediators postoperatively. Specifically, the expression levels of substance P (SP) and vasoactive intestinal peptide (VIP) in tears are elevated compared to preoperative values, while the changes in the expression levels of calcitonin gene-related peptide (CGRP) in tears and nerve growth factor (NGF) in both the cornea and tears have shown inconsistent results in current research. Additionally, the expression levels of corneal and tear neuromediators are significantly affected by the type of laser corneal refractive surgery and are closely associated with the postoperative recovery of corneal nerve and ocular surface function. (Int Rev Ophthalmol, 2024, 48:  290-297)





Impact of strabismus surgery on ocular hemodynamics

Zhong Huifen, Huang Longxiang, Zheng Weidong

2024, 48(4):  298-304.  doi:10.3760/cma.j.issn.1673-5803.2024.04.010

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Strabismus surgery may trigger hemodynamic changes in the anterior and posterior segments of the eye, further affecting postoperative ocular health and visual function. However, different strabismus surgeries involve different types of muscles, surgical methods, and surgical incisions that have different effects on ocular hemodynamics and duration. Strabismus surgery may cause impaired anterior segment blood flow and increased or decreased retinal and choroid blood flow. The risk of anterior segment ischemia can be reduced by using imaging methods such as iris angiography, color Doppler imaging, and optical coherence tomography angiography (OCTA) to assess the risk factors before strabismus surgery, and selecting an appropriate surgical plan. At the same time, high-precision imaging methods can be used to monitor and evaluate the changes of iris, retina and choroidal blood flow after surgery, which is helpful for the early detection and treatment of ischemia-related complications. (Int Rev Ophthalmol, 2024, 48:  298-304)





Advances in the diagnosis and treatment of enophthalmos due to burst orbital fracture

Qi Han, Liu Jinling

2024, 48(4):  305-310.  doi:10.3760/cma.j.issn.1673-5803.2024.04.011

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Orbital fracture is a common type of ocular trauma, and the main clinical manifestations include endophthalmos, binocular diplopia, limited eye rotation, and sensory deficits in the infraorbital innervation area, and so on, with endophthalmos being one of the most common and cosmetically compromising complications. The mechanism causing endophthalmos is mainly related to the imbalance between the volume of orbital contents and orbital bony volume. The traditional surgical technique for orbital fracture repair is usually performed by the clinician after analyzing the CT scanning image data of the orbit according to his experience, which is very subjective and requires the surgeon to make repeated attempts to achieve the best repair results, but it is generally difficult to achieve accurate repair. The choice of implant is also very important to the outcome of the procedure, and the results of resorbable material restorations are widely recognized. At present, three-dimensional printing technology is widely used in the clinic, using three-dimensional printing preform technology to personalize the implant material for fracture patients, and orbital fracture revision surgery can improve the endophthalmos more obviously.(Int Rev Ophthalmol, 2024, 48:  305-310)





Relationship between depression and dry eye

Ma Yueni, Yang Ruibo

2024, 48(4):  310-315.  doi:10.3760/cma.j.issn.1673-5803.2024.04.012

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Depression and dry eye are both major social and public health problems that endanger the physiological and psychological health of patients, and they are mutually causative, forming a vicious circle. Inflammation and autonomic dysfunction may be the co-morbid mechanisms of depression and dry eye. Depression-associated dry eye is a chronic pain associated with depression, or dry eye itself is a somatised symptom in depressed patients. Antidepressants can exacerbate or even induce dry eyes. A series of ocular surface irritation symptoms brought about by dry eyes can also cause bad mood in patients. (Int Rev Ophthalmol, 2024, 48:   310-315)





Tear biomarkers for ocular and systemic diseases

Wang Yue, Xie Xiaodong

2024, 48(4):  316-320.  doi:10.3760/cma.j.issn.1673-5803.2024.04.013

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Tear fluid contains a large number of proteins, cytokines and other substances involved in regulating the function and metabolism of a variety of cells in the eye, thus reflecting the individual pathophysiological state. With the improvement of micro-sample analysis technology, tear fluid has become an ideal source for the detection of potential biomarkers of diseases due to its easy accessibility, convenient storage and stable nature. Glaucoma, keratitis, thyroid-related eye diseases, and even some systemic diseases (Alzheimer's disease, diabetes mellitus, tumors) are associated with changes in potential biomarkers in tear fluid, and their detection may provide some clinical reference value for the prevention and early diagnosis of these diseases.(Int Rev Ophthalmol, 2024, 48:  316-320)