Table of Content

25 July 2026, Volume 35 Issue 4

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ADC therapy-related ocular surface toxicity: an emerging challenge in precision cancer therapy

Deng Yingping, Tang Jing

2026, 35(4):  257-258.  doi:10.13281/i.cnki.issn.1004-4469.2026.04.001

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Antibody-drug conjugates (ADCs) have propelled cancer therapy into the era of precision medicine; however, their ocular surface toxicity, as a prototypical manifestation of the "on-target, off-tumor" paradox, has emerged as a critical bottleneck constraining clinical benefit. The underlying mechanisms involve pathological processes including target antigen cross-expression, payload bystander effects, and tear film homeostasis disruption, with predominant clinical manifestations of corneal epithelial microcyst-like changes, punctate keratitis, and tear film dysfunction. The management paradigm is shifting from passive intervention to mechanism-driven proactive prevention, emphasizing baseline evaluation, dynamic monitoring, and integrated multidisciplinary management. Heterogeneity in toxicity profiles across distinct ADC agents provides crucial clues for structural optimization of drugs and individualized stratified management of patients. Deepening mechanistic research and establishing radiomics-based early warning systems represent the future direction toward achieving a balance between antitumor efficacy and ocular surface safety.





Analysis of the characteristics of drug-related ocular adverse reactions in antibody-drug conjugate cancer therapy

Gao Fei, Wu Yuhan, Jiang Yang, Li Ying, Chen Di, Zhao Chan

2026, 35(4):  259-263.  doi:10.13281/i.cnki.issn.1004-4469.2026.04.002

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Objective To explore the clinical characteristics of drug-related ocular adverse reactions caused by antibody-drug conjugates (ADC) in tumor treatment. Design Retrospective case series. Participants  7 patients (14 eyes) with ocular adverse reactions to ADC who were treated at the Chinese Academy of Medical Sciences Peking Union Medical College Hospital from March 2024 to December 2024. Methods Clinical patients who received ADC-based tumor treatment and had ocular adverse reactions were included. Comprehensive ophthalmic examinations were conducted, and the types and grades of drug-related ocular adverse reactions were recorded and analyzed. Main Outcome Measures Incidence of symptoms, incidence of signs, incidence of visual acuity decline, and incidence of different lesion grades. Results There were 6 male patients and 1 female patient, with an average age of 55.6±3.2 years. All patients had bilateral involvement. The related adverse reaction symptoms included: eye redness (85.8%), foreign body sensation (57.1%), blurred vision (57.1%), tearing (42.9%), and eye itching (14.3%); The related adverse reaction signs included: ocular congestion (85.8%), conjunctival edema (71.4%), increased secretions (57.1%), eyelid-scleral adhesion (42.9%), pseudomembrane (42.9%), follicular hyperplasia (42.9%), rough corneal epithelium (42.9%), corneal epithelial defect (28.6%), corneal opacity (14.3%), and corneal neovascularization (14.3%); During the lesion process, the most severe situation of visual acuity decline was: visual acuity decline of 1 line (42.9%), visual acuity decline of 2 lines (21.4%), visual acuity decline of 3 lines (14.3%), and visual acuity decline of 5 lines or more (21.4%); The proportion of grade 2, grade 3, and grade 4 drug-related ocular adverse reactions was 42.9%, 28.6%, and 28.6%, respectively. After anti-inflammatory and symptomatic treatment, the ocular lesion conditions of all patients were ultimately stabilized. Conclusions The use of ADC for tumor treatment has the potential risk of causing severe ocular adverse reactions. It is necessary to pay sufficient attention, conduct close follow-up, and actively treat.





Disproportionality analysis of ocular adverse events of antineoplastic drugs based on the FAERS database

Zhang Wentao, Yang Qi, Liu Yuna

2026, 35(4):  264-269.  doi:10.13281/i.cnki.issn.1004-4469.2026.04.003

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Objective To systematically analyze the clinical characteristics of ocular adverse events (OAE) associated with anti-cancer agents based on data from the FDA adverse event reporting system (FAERS), and to clarify the differences among different drug classes in terms of affected sites, risk intensity, and temporal patterns of OAE, so as to provide evidence for clinical risk-stratified monitoring. Design Retrospective study. Participants Data reports from the FAERS database spanning 89 quarters, from the first quarter of 2004 to the first quarter of 2026. Methods After applying FDA-standard deduplication strategies, keyword stem matching, all OAE-related reports in the FAERS database were included. Disproportionality analyses, including reporting odds ratios and information components, were performed on the signal intensities of system organ classes (i.e., affected sites/organs) and preferred terms (i.e., signs/symptoms of OAE manifestations) for various anti-cancer agents, to quantitatively assess the intensity and severity of OAE associated with each drug class. Descriptive analysis was conducted on the time to onset (TTO) of OAE associated with anti-cancer agents. Main Outcome Measures Signal intensity of system organ classes and preferred terms, reporting rates, distribution of vision-threatening OAE, and TTO. Results Antibody drug conjugates (ADC) were associated with a higher overall risk of OAE, being the most prominent at both the single agent and preferred term levels, and exhibited marked payload subtype heterogeneity; ADC with the monomethyl auristatin F (MMAF) payload demonstrated the most extensive corneal toxicity. Subgroup analysis of tyrosine kinase inhibitors (TKI) revealed that the fibroblast growth factor receptor (FGFR) inhibitor subclass carried the highest risk of ocular toxicity, suggesting that the overall ocular risk of TKI is primarily driven by the FGFR-targeting subclass. At the preferred term level, the strongest signal was belantamab associated keratopathy (information component value=12.49). Time to onset (TTO) varied across anti-cancer drug classes: the median TTO for ADC was relatively long (228 days), suggesting that long term safety monitoring is warranted in clinical practice. Conclusion OAE associated with anti-cancer agents exhibit distinct class-specific characteristics. ADC demonstrated particularly prominent ocular toxicity signals and showed clear payload-dependent differences, with MMAF-containing ADC being characterized by a high risk of corneal disorders. TTO analysis suggested that ocular safety monitoring for ADC should be extended long time.





Observation on the short term efficacy of laser enhanced anti-VEGF precise permeation therapy for neovascular age-related macular degeneration

Wang Yiwei, Zhai Yujia, Jiang Yuqi, Huang Houbin

2026, 35(4):  278-284.  doi:10.13281/i.cnki.issn.1004-4469.2026.04.007

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 Objective To investigate the short-term (6-month) safety and efficacy of laser enhanced anti-VEGF precise permeation (LEAP) therapy based on indocyanine green angiography localization in patients with neovascular age-related macular degeneration (nAMD). Design A prospective, non-randomized controlled study. Participants A total of 112 patients (122 eyes) with nAMD who received intravitreal injection of anti-vascular endothelial growth factor (anti-VEGF) drugs at the First Medical Center and the Third Medical Center of Chinese PLA General Hospital from September 2023 to March 2026. Methods According to patients' voluntary treatment willingness, the subjects were divided into LEAP treatment group and simple anti-VEGF intravitreal injection group. The number of treatments and efficacy indicators at the 6-month follow-up were observed and compared between the two groups, and the differences in treatment burden and efficacy of the two regimens were evaluated. Main Outcome Measures Number of treatments at the 6-month endpoint, best corrected visual acuity (BCVA), central macular thickness (CMT), height of subretinal fluid (SRF), and height of pigment epithelial detachment (PED). Results Before enrollment in the study, the mean number of intravitreal injections in the LEAP treatment group was (5.77±3.73). At the 6-month short-term endpoint, the LEAP group achieved lesion stability with a mean treatment count of only (0.48±0.91) times, which was significantly lower than (2.79±1.03) times in the intravitreal injection alone group (z=-8.568, P＜0.001).There were no significant between-group differences in efficacy indicators including best corrected visual acuity (P=0.058), central macular thickness (P=0.663), subretinal fluid height (P=0.082), and pigment epithelial detachment height (P=0.242). All intragroup efficacy parameters were significantly improved compared with baseline (all P<0.05). No adverse events related to LEAP treatment were observed during the study period. Conclusion LEAP therapy serves as a novel strategy to remarkably reduce the treatment frequency for nAMD, with non-inferior efficacy and safety compared with conventional simple anti-VEGF intravitreal injection therapy.





Clinical and multimodal imaging characteristics of focal scleral nodules

Yan Yanni, Shi Xuehui, Wei Wenbin

2026, 35(4):  285-289.  doi:10.13281/i.cnki.issn.1004-4469.2026.04.008

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Objective To investigate the clinical features and multimodal fundus imaging characteristics of focal scleral nodules (FSN). Design Retrospective case series. Participants Six patients (6 eyes) diagnosed with FSN at Beijing Tongren Hospital between January 2023 and July 2025 were included. Methods All patients underwent comprehensive ophthalmic examinations, including best-corrected visual acuity, intraocular pressure, slit-lamp biomicroscopy, indirect ophthalmoscopy, color fundus photography, OCT, OCT angiography (OCTA), FFA, ICGA, and B-scan ultrasonography. Main Outcome Measures Fundus findings and imaging characteristics on OCT, OCTA, FFA, ICGA, and ultrasonography. Results Six patients (6 eyes) with FSN were included, all of whom were female. The best-corrected visual acuity in the affected eyes ranged from 0.8 to 1.0. All lesions presented as solitary, yellow-white, well-demarcated elevated nodules, 4-eye lesions located in the posterior pole. OCT demonstrated that all lesions were confined within the sclera, appearing as well-defined dome-shaped structures without definite choroidal involvement. The overlying choroid was progressively thinned due to upward compression by the scleral nodule, with the thinning most pronounced at the lesion margins. OCTA revealed choroidal flow voids within the lesion area. On FFA, the lesions showed hypo- or slight hyperfluorescence in the early phase with late staining, whereas ICGA demonstrated persistent hypofluorescence throughout all phases. Long-term follow-up was available in five cases. One lesion showed marked enlargement (from 3.29 mm×2.53 mm×0.88 mm to 7.83 mm×6.34 mm×2.07 mm) over 32 months and continued to progress despite photodynamic therapy, while the remaining lesions remained stable. Conclusions FSN is characterized by a solitary, well-defind yellow-white elevated subretinal nodule located posterior to the ocular equator. The characteristic OCT features of FSN consists of a roundish lesion localized within the sclera, accompanied by compressive thinning of the choroid and retina overlying the lesion. Most FSN lesions remain stable for a long time.





Association between Chinese visceral adiposity index and retinal vein occlusion: the Kailuan Eye Study

Shi Xuhan, Wang Qian, Yang Jingyan, Yan Yanni, Wei Wenbin

2026, 35(4):  290-297.  doi:10.13281/i.cnki.issn.1004-4469.2026.04.009

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Objective To investigate the association between the Chinese Visceral Adiposity Index (CVAI) and retinal vein occlusion (RVO). Design Cross-sectional study. Participants A total of 8,499 participants (16,998 eyes) from the Kailuan Eye Study with determinable RVO status and non-missing CVAI data were included. Among them, 111 participants (114 eyes) had RVO, and 8,388 participants (16,776 eyes) had no RVO. Only data from the right eye were analyzed. Methods Baseline characteristics were compared between participants with and without RVO. Multivariable logistic regression was used to assess the association between CVAI and RVO. Additional subgroup analyses were performed by age and sex. Restricted cubic spline (RCS) Logistic regression was further applied to examine the dose-response relationship between CVAI and the risk of RVO. Main Outcome Measures CVAI and RVO. Results Compared with participants without RVO, those with RVO were older, more likely to be male, and had higher prevalences of diabetes and hypertension. They also had higher systolic blood pressure, diastolic blood pressure, body mass index, waist circumference, fasting blood glucose, creatinine, urea, waist-to-hip ratio, and CVAI levels (all P<0.05). In multivariable logistic regression analysis, CVAI remained significantly associated with RVO after adjustment for diabetes, history of hypertension, and creatinine level [odds ratio (OR)= 1.371, 95% CI, 1.143-1.643, Wald χ2=11.619, P=0.001]. Subgroup analyses showed that the association between CVAI and RVO appeared more pronounced in men and in participants aged ≥60 years; however, neither the age interaction nor the sex interaction was statistically significant (Wald χ2=1.079, P for interaction=0.299 and Wald χ2=1.196, P for interaction=0.658, respectively). RCS Logistic regression analysis demonstrated a significant overall association between CVAI and the risk of RVO (likelihood ratio χ2=12.099, P for overall association=0.007), whereas no significant nonlinearity was detected (likelihood ratio χ2=1.447, P for nonlinearity=0.485). Conclusion Higher CVAI was independently associated with RVO. No significant nonlinear relationship was observed between CVAI and RVO risk, and the dose-response pattern was more consistent with an approximately linear positive association. These findings suggest that CVAI may help identify visceral adiposity dysfunction and metabolic-vascular risk burden in patients with RVO or individuals at high risk, and may provide supplementary information for systemic risk factor screening and comprehensive management.





A study on the relative inner nuclear layer thickness as an imaging biomarker for diabetic retinopathy

Gu Xinming, Chen Xiaosi, Wu Hanyu, Zhang Xinyuan

2026, 35(4):  298-303.  doi:10.13281/i.cnki.issn.1004-4469.2026.04.010

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Objective To investigate the relationship between the relative inner nuclear layer (rINL) and the development and progression of diabetic retinopathy (DR). Design Nested case-control study. Participants The study included 95 patients (95 eyes) with type 2 diabetes mellitus (T2DM) who visited Beijing Tongren Hospital, Capital Medical University, from 2019 to 2022. Among them, 31 patients (31 eyes) had no DR (DM group), 34 patients (34 eyes) had non-proliferative DR (NPDR), and 30 patients (30 eyes) had proliferative DR (PDR). Additionally, 35 age- and gender-matched healthy subjects (35 eyes) were enrolled as controls. Methods General clinical data, including gender, age, and duration of T2DM, were collected. Fasting blood samples were obtained for biochemical analysis, including glycated hemoglobin (HbA1c), fasting blood glucose (FBG), total cholesterol, triglycerides, low-density lipoprotein cholesterol, and high-density lipoprotein cholesterol (HDL-C). All participants underwent comprehensive ophthalmic examinations, including visual acuity, intraocular pressure, fundus photography, and swept-source optical coherence tomography (SS-OCT). Retinal images obtained via SS-OCT were segmented into separate zones. Full retinal thickness and INL thickness were measured for each zone, and the rINL (defined as INL thickness divided by total retinal thickness, multiplied by 100%) was calculated and subsequently analyzed. Main Outcome Measures rINI, NLL thickness, full retinal thickness, blood lipid metabolism indicators. Results Compared with the control group, the rINL was significantly lower in the PDR group (P=0.005). Furthermore, the outer ring rINL was significantly lower in the DM, NPDR, and PDR groups compared to the control group (P<0.001). Spearman correlation analysis revealed a significant negative correlation between the outer ring rINL and T2DM duration, HbA1c, and FBG levels (P<0.01). Univariate logistic regression analysis showed that a greater outer ring rINL was a protective factor against DR development (OR=0.578, 95% CI: 0.447~0.748, P<0.001). Multivariate ordered logistic regression analysis further confirmed that both outer ring rINL (OR=0.739, 95% CI: 0.558~0.978, P=0.034) and HDL-C (OR=0.054, 95% CI: 0.013~0.222, P<0.001) were independent protective factors against the development and progression of DR. Conclusion The outer ring rINL is an independent protective factor for the development and progression of DR, serves as a promissing novel imaging biomarker for DR diagnosis and management, and is associated with systemic lipid metabolism.





Assessing the feasibility of artificial intelligence for severity grading in fuchs endothelial corneal dystrophy

Liu Enshuo, Qu Jinghao, Xiao Gege, Peng Rongmei, Hong Jing

2026, 35(4):  304-313.  doi:10.13281/i.cnki.issn.1004-4469.2026.04.011

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 Objective  To investigate the feasibility and clinical value of applying artificial intelligence for severity grading of Fuchs endothelial corneal dystrophy (FECD). Design Cross-sectional study. Participants  245 patients with FECD who visited the Ophthalmology Clinic of Peking University Third Hospital between January 2022 and June 2025. Method A total of 605 confocal microscopy images from FECD patients were collected and screened. The boundaries of guttae were manually annotated to establish the gold standard. A U-Net++ neural network combined with a watershed algorithm as post-processing was developed and tested. Nine neural networks, including U-Net, were constructed as control models. Main Outcome Measures The segmentation accuracy was evaluated using accuracy, sensitivity, specificity, Intersection over Union (IoU), Dice coefficient, and modified Hausdorff distance (MHD). The accuracy of the guttae parameters (area ratio, density, and average size) output by the model was also assessed. Results Among 605 confocal microscope images of 245  patients, the U-Net++ model achieved a Dice coefficient of 0.7676, IoU of 0.6229, accuracy of 0.9670, sensitivity of 0.7923, specificity of 0.9799, MHD of 33.99 px, and AUC of 0.9758. The mean relative errors for guttae area ratio, density, and average size were 0.453, 0.280, and 0.222, respectively. Overall, these results outperformed multiple control models. Conclusions The deep learning model on confocal microscope images can effectively detect lesion regions in FECD and output multiple guttae parameters for automated severity grading, contributing to the advancement of precise diagnosis and management of FECD.

Study on the effectiveness and short-term safety of scleral lens treatment for keratoconus 

Liu Jing, Zhang Zhaocheng, Ye Furong, Zhao Xuemei, Zhang Yukun, Wu Binge, Jie Ying, Tian Lei

2026, 35(4):  314-319.  doi:10.13281/i.cnki.issn.1004-4469.2026.04.012

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Objective To evaluate the effectiveness and short-term safety of scleral lenses in treating  keratoconus. Design Retrospective case series study. Participants Twenty-two patients (34 eyes) with keratoconus fitted with scleral lenses at the Beijing Tongren Hospital, Capital Medical University, including 12 patients (17 eyes) who completed one-month follow-up. Methods All patients underwent a standardized fitting process for scleral lenses. BCVA, spherical equivalent (SE), non-contact intraocular pressure (IOP), and tear film thickness under the lens (central, limbal, and peripheral regions) were measured before lens insertion, immediately after insertion, 60-90 minutes post-insertion, and at one month follow-up (the average daily wearing time was 3.3±1.7 hours). Anterior segment optical coherence tomography angiography (OCTA) was used to quantitatively analyze the average blood flow density percentages within 5 mm×5 mm, 7 mm×7 mm, and 9 mm×9 mm grid areas centered on the superior, inferior, nasal, and temporal quadrants of the lens landing zone, both before lens insertion and 60-90 minutes post-insertion. Main Outcome Measures BCVA, SE, IOP, tear film thickness, and average blood flow density percentage. Results Immediately after lens insertion, BCVA improved significantly from baseline spectacle correction 0.38±0.33 logMAR to 0.08±0.12 logMAR (P<0.0001). At 60-90 minutes post-insertion, BCVA was 0.07±0.12 logMAR, which showed no significant difference from the immediate post-insertion values (P=0.2054). At one-month follow-up, BCVA remained stable at 0.07±0.09 logMAR, showing significant improvement over baseline spectacle correction (0.46±0.31 logMAR) (P<0.0001), and no significant change compared to values at 60-90 minutes post-insertion (0.06±0.09 logMAR) (P=0.9847). Tear film thickness at 60-90 minutes post-insertion was significantly reduced across all regions compared to immediately after insertion (horizontal center: 224.1±56.9 μm; vertical center: 218.6±50.7 μm; superior edge: 133.9±49.1 μm; inferior edge: 300.3±90.2 μm; nasal edge: 212.8±86.0 μm; temporal edge: 228.0±71.8 μm) (all P<0.05), and remained within ideal ranges. At one-month follow-up, tear film thickness in all regions continued to be significantly reduced compared to immediately after lens insertion (all P<0.0001). Compared to values at 60-90 minutes post-insertion, only the temporal region showed a statistically significant difference (P=0.0097), other regions showed no significant changes (all P>0.05), and all mean values remained within safe limits. OCTA showed no statistically significant differences in the average blood flow density percentages across grid areas at 60-90 minutes post-insertion (5 mm×5 mm area: 61.17%±7.50%; 7 mm×7 mm area: 57.91%±6.38%; 9 mm×9 mm area: 55.50%±5.50%) compared to before lens insertion uncorrected eyes (61.82%±6.34%, 58.48%±5.75%, 56.71%±5.51%, respectively) (all P>0.05). Conclusion Scleral lenses can significantly improve BCVA in patients with keratoconus, maintain stable visual acuity during one-month follow-up, keep tear film thickness within a safe range, and do not cause notable reductions in anterior segment blood flow density, demonstrating good short-term safety.





Analysis of  alternative splicing of CIZ1 in serum of patients with allergic conjunctivitis and its correlation with clinical indicators

Bao Jiayu, Hao Yiran, Wen Ya, Wu Binge, Tian Lei, Jie Ying

2026, 35(4):  320-325.  doi:10.13281/i.cnki.issn.1004-4469.2026.04.013

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Objective Analyse the expression changes of the CDKN1A-interacting zinc finger protein 1 gene (CIZ1) in the serum of patients with allergic conjunctivitis, clarify its alternative splicing patterns, and explore its correlation with clinical indicators. Design Case-control study. Participants Thirty-two patients with active allergic conjunctivitis were recruited from the Ophthalmology Department of Inner Mongolia Baotou Second Affiliated Hospital from July 2020 to December 2020, along with 32 age- and gender-matched healthy volunteers. Methods The transcriptome of serum RNA from healthy volunteers and patients with allergic conjunctivitis was sequenced. Alternative splicing events were identified and quantified using rMATS. The mRNA levels of CIZ1 in clinical samples were quantified by real-time fluorescence quantitative PCR (qPCR), and serum total immunoglobulin E (IgE) levels were measured by ELISA. Human conjunctival epithelial cells (HConEpiCs) were cultured in vitro, and treated with IL-4 and IL-13 for 24 hours, and transfected with CIZ1 siRNA to knockdown its expression. The expression changes of CIZ1, occludin, and claudin-1 were detected by qPCR and Western blot. Main Outcome Measures CIZ1 alternative splicing patterns, serum CIZ1 mRNA levels, serum IgE levels, total ocular symptom score (TOSS) values, and tight junction protein expression levels at the cellular level. Results There were 262 differentially expressed long non-coding RNAs and 1425 differentially expressed mRNAs. A total of 128 genes had significant differential splicing events. CIZ1 exhibited mutually exclusive exons (MXE) alternative splicing events. The total serum CIZ1 mRNA level in patients with allergic conjunctivitis during the acute phase was significantly higher than that in the healthy control group (P<0.0001). Correlation analysis revealed significant positive correlations between serum CIZ1 levels and both total IgE (r=0.7907, P<0.0001) and TOSS scores (r=0.6955, P<0.0001). The serum total mRNA level of patients with TOSS score > 5 was significantly higher than that of patients with TOSS score ≤5 (P<0.001). In vitro experiments showed that IL-4 and IL-13 treatment significantly upregulated CIZ1 expression in HConEpiCs cells and concomitantly downregulated occludin and claudin-1 expression; furthermore, CIZ1 knock down reversed the downregulation of tight junction proteins induced by IL-4 and IL-13. Conclusion In the serum of patients with allergic conjunctivitis, CIZ1 undergoes aberrant MXE alternative splicing. Its expression is significantly upregulated in patient serum and correlates positively with disease severity. CIZ1 may disrupt ocular surface epithelial barrier function by downregulating tight junction proteins.

Clinical characteristics and prognostic analysis of patients with NMOSD-ON and MOGAD-ON

Xu Dengfeng, Wang Yingying, Yu Yasai, Yuan Qin, Liu Jianliang

2026, 35(4):  326-330.  doi:10.13281/i.cnki.issn.1004-4469.2026.04.014

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 Objective To compare and analyze the clinical characteristics and treatment efficacy between patients with neuromyelitis optica spectrum disorders associated optic neuritis (NMOSD-ON) and myelin oligodendrocyte glycoprotein antibody disease associated optic neuritis (MOGAD-ON). Design Retrospective case series. Participants Forty patients （53 eyes） diagnosed with NMOSD-ON and MOGAD-ON at the Ophthalmology Center of Affiliated Hospital of Shandong Second Medical University from December 2021 to December 2024. Methods Patients were divided into NMOSD-ON group (18 patients, 22 eyes) and MOGAD-ON group (22 patients, 31 eyes) based on serum antibody results. The two groups were compared in terms of demographic characteristics, clinical manifestations (including visual acuity, ocular pain, optic disc edema), peripapillary retinal nerve fiber layer (RNFL) thickness, cranial/orbital magnetic resonance imaging (MRI) findings, treatment outcomes, and recurrence. Main Outcome Measures Demographic characteristics, clinical manifestations, best corrected visual acuity (BCVA) before and after treatment, RNFL thickness, treatment response rate, and recurrence rate. Results The proportion of females in the NMOSD-ON group was significantly higher than that in the MOGAD-ON group (88.9% vs. 50.0%, P=0.009). The age at first onset in the NMOSD-ON group was significantly older than that in the MOGAD-ON group (55.00±14.41 years vs. 24.05±16.40 years, P<0.001). The incidence of optic disc edema was significantly higher in the MOGAD-ON group than in the NMOSD-ON group (74.2% vs. 13.7%, P<0.001). The proportion of eyes with pretreatment BCVA≤0.1 was 81.8% in the NMOSD-ON group and 54.8% in the MOGAD-ON group (P=0.041). At initial presentation, both superior and temporal RNFL thicknesses in the NMOSD-ON group were lower than those in the MOGAD-ON group (both P<0.05). At the early follow-up visit (1-3 months after treatment), the rate of visual improvement (including both complete recovery and partial improvement) in the NMOSD-ON group was 36.3%, significantly inferior to the 90.4% observed in the MOGAD-ON group (P<0.001). The 1-year recurrence rates were 44.4% and 36.4% for the NMOSD-ON and MOGAD-ON groups, respectively, with no significant difference (P=0.604). Conclusions NMOSD-ON predominantly affects middle-aged and elderly individuals, with a female predominance. It presents with more severe initial visual impairment, more pronounced RNFL thinning, and poorer visual recovery after standard high-dose corticosteroid pulse therapy compared to MOGAD-ON. MOGAD-ON is more common in young people and children, has a higher incidence of optic disc edema, but shows a better response to corticosteroid therapy.

Clinical characteristics of shallow anterior chamber after cataract extraction combined with angle surgery for primary angle-closure glaucoma

Pei Xueting, Yu Xiaowei, Zhang Shuo, He Linhui, Fan Zhigang

2026, 35(4):  331-336.  doi:10.13281/i.cnki.issn.1004-4469.2026.04.015

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 Objective To explore the causes and clinical features of shallow anterior chamber after phacoemulsification combined with intraocular lens (IOL) implantation and gonio-surgery in primary angle-closure glaucoma (PACG) patients. Design Retrospective case series. Participants A consecutive series of 329 PACG patients (376 eyes) who underwent phacoemulsification combined with IOL implantation and gonioto-surgery at the Glaucoma Department of Beijing Tongren Hospital from July 1, 2023, to December 31, 2024, were included.  Methods The clinical data of the patients were reviewed. Using univariate Logistic regression analysis to evaluate the risk (OR value) of predicting the occurrence of shallow anterior chamber after surgery based on various parameters. Main Outcome Measures The clinical features, biometric parameters, OR value. Results  Among the 329 patients (376 eyes), 14 patients (17 eyes) developed early postoperative shallow anterior chamber. The age range of the shallow anterior chamber group was wide, from 39 to 83 years old. Preoperative uncorrected visual acuity, maximum intraocular pressure and visual field defect severity showed no statistically significant differences between two groups (P>0.05). Compared with the other PACG patients, the shallow anterior chamber group had a shorter axial length [(21.49±1.19) mm vs (22.40±0.71) mm, P=0.000], a shorter white-to-white distance [(11.19±0.31) mm vs (11.42±0.36) mm, P=0.005], a thinner lens thickness [(4.78±0.48) mm vs (5.02±0.32) mm, P=0.012], and a more anteriorly positioned scleral spur [(2.70±0.41) mm vs (2.88±0.17) mm, P=0.010], with statistically significant differences. For every 1.0 mm decrease in axial length, every 0.1 mm decrease in white-to-white distance, and every 0.1 mm decrease in scleral spur depth, the risk of postoperative shallow anterior chamber increased by 2.50 times (OR=0.423, 95%CI: 0.236-0.757), 5.78 times (OR=0.173, 95%CI: 0.038-0.797) and 9.26 times (OR=0.108, 95%CI: 0.012-0.951), respectively. Conclusions  The incidence of shallow anterior chamber after phacoemulsification combined with goniosurgery in patients with PACG is relatively low, which is mainly attributed to elevated vitreous cavity pressure arising from the pathophysiological mechanisms of atypical malignant glaucoma. Risk factors for this complication include short axial length, short white-to-white distance, and anteriorly positioned scleral spur. Among these, an anteriorly located scleral spur depth serves as the most sensitive predictive marker for postoperative shallow anterior chamber.





Preliminary observation on the effects of instantaneous biomechanical forces on retinal ganglion cell numbers in mice

Xing Xinhui, Zhu Wei

2026, 35(4):  337-343.  doi:10.13281/i.cnki.issn.1004-4469.2026.04.016

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Objective  Investigate the effects of instantaneous biomechanical forces on retinal ganglion cells (RGCs). Design  Experimental research. Participants 35 C57BL/6J mice. Methods Eight-week-old C57BL/6J mice were randomly assigned to groups (control group, 10-day eye rubbing group, 20-day eye rubbing group, 30-day eye rubbing group). Erythromycin eye ointment was applied to the left eye of the mice three times daily at 4-hour intervals to induce the mice to rub their eyes with both forepaws, mimicking the transient biomechanical forces generated during human eye rubbing. The frequency of eye rubbing was continuously monitored using video recording. After 10, 20, and 30 days of eye rubbing, the retinas were isolated, and immunofluorescence staining was performed to label RGCs, followed by quantitative analysis of the changes in RGC numbers in the peripheral, intermediate, and central regions of the retina. Main Outcome Measures The number of RGCs. Results One hour after applying erythromycin eye ointment, the frequency of mice rubbing their left eyes increased by 6.23 times compared to the control (P<0.0001), and the frequency of rubbing their right eyes increased by 3.39 times compared to the control (P<0.01). In the peripheral retinal region, after 20 days of eye rubbing, the number of RGCs in the left eye decreased by 8.3% compared to the control (P<0.01), while the number of RGCs in the right eye showed no significant change (P>0.05); after 30 days of eye rubbing, the number of RGCs in the left eye decreased by 11.7% compared to the control (P<0.001), and the number of RGCs in the right eye decreased by 9.7% compared to the control (P<0.01). In the mid-peripheral retinal region, after 30 days of eye rubbing, the number of RGCs in the left eye decreased by 6.9% compared to the control (P<0.05), while the number of RGCs in the right eye showed a decrease compared to the control, but without statistical significance (P>0.05). In the central retinal region, the number of RGCs in both the left and right eyes showed no significant change at any time point. At the same time point, there was no obvious difference in the number of RGCs between the left and right eyes in the same retinal region. Conclusions Long-term eye rubbing leads to a reduction in the number of RGCs in mice, with damage showing a time-accumulated effect; compared to the central and intermediate regions, RGCs in the peripheral region exhibit higher susceptibility to instantaneous biomechanical fluctuations; low-frequency eye rubbing does not show a significant difference in RGC damage compared to high-frequency eye rubbing.

The application effect of scenario-based health education based on virtual reality technology in patients undergoing cataract day surgery

Ma Xiaowei, Wang Ke, Wang Runnan, Wan Weining, Liu Xuejiao, Liu Shuxian

2026, 35(4):  344-348.  doi:10.13281/i.cnki.issn.1004-4469.2026.04.017

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 Objective To explore the application effect of scenario-based health education based on virtual reality technology in patients undergoing cataract day surgery. Design A non-synchronous controlled trial. Participants 100 patients undergoing cataract day surgery at Beijing Tongren Hospital. Method Patients admitted from July to October 2024 were assigned to the control group (50 cases), and patients admitted from November 2024 to February 2025 were assigned to the intervention group (50 cases). The control group received routine preoperative health education, while the intervention group received scenario-based health education based on virtual reality technology of phacoemulsification cataract surgery in addition to the routine education. Main Outcome Measures Self-rating anxiety scale (SAS) scores, perioperative health knowledge cognition scores, and intraoperative cooperation scores before and after health education. Results After the implementation of health education, the intervention group had an SAS score of 35.38±5.82, significantly lower than the control group score of 41.34±4.64 (P<0.001). After the implementation of health education, the intervention group had a health knowledge cognition score of 90.42±5.37, significantly higher than the control group score of 72.64±9.72 (P<0.001). The proportion of scores with good surgical cooperation in the intervention group after the implementation of health education (86% ) was significantly higher than that of the control group (52%) (P<0.001). Conclusion Scenario-based health education based on virtual reality technology of phacoemulsification cataract surgery can reduce patients' preoperative anxiety, improve perioperative health knowledge cognition in cataract day surgery patients, and enhance surgical cooperation.