Microbiome as an endocrine organ and its relationship with eye diseases:Effective factors and new targeted approaches

Microbiome is an endocrine organ that refers to both the complicated biological system of microbial species that colonize our bodies and their genomes and surroundings.Recent studies confirm the connection between the microbiome and eye diseases,which are involved in the pathogenesis of eye diseases,including age-related macular disorders,diabetic retinopathy,glaucoma,retinitis pigmentosa,dry eye,and uveitis.The aim of this review is to investigate the microbiome in relation to eye health.First,a brief introduction of the characteristics of the gut microorganisms terms of composition and work,the role of dysbiosis,the gut microbiome and the eye microbiome in the progression of eye illnesses are highlighted,then the relationship among the microbiome and the function of the immune system and eye diseases,the role of inflammation and aging and the immune system,It has been reviewed and finally,the control and treatment goals of microbiome and eye diseases,the role of food factors and supplements,biotherapy and antibiotics in relation to microbiome and eye health have been reviewed.

Pattern of Eye Diseases among Tea Workers

Background: Bangladesh’s tea industry is essential to the country’s economic expansion. Since tea workers in Bangladesh are marginalized within our community, they have limited access to comprehensive eye care services. Productivity and well-being are cornerstones of comprehensive health care strategy. Ocular disorders are influenced by life expectancy, sociodemographic status, and the epidemiological transition. In this context, the state of ocular health and the many eye illnesses remain to be significantly addressed. Purpose: To evaluate the pattern of eye diseases among tea workers in a tea estate of Bangladesh. Methods: This cross-sectional observational study was carried out in Halda Valley Tea Estate, Nazirhat, Fatickchari, Chattogram, Bangladesh, under the supervision of the Department of Community Ophthalmology, BSMMU, following ethical clearance and approval by the IRB board of BSMMU. With informed written consent and approval from the authority of the tea estate, a total of 110 tea workers were recruited. Socio-demographic characteristics, ocular findings, and patterns of eye diseases were determined and recorded. Results: The mean age of the study participants was 39.60 ± 11.63 years. The maximum (58.1%) study participants were 31 - 50 years old, female (64.5%), illiterate (82.7%), and tribal (71.8%) indigenes. Eye diseases were found in 94.5% of workers. Presbyopia (28.2%), cataracts (27.3%), and refractive error (26.4%) were the most common. Tea workers with eye diseases were significantly older than those who did not have any eye diseases (40.20 ± 11.57 vs. 29.17 ± 7.31 years, p Conclusion: A significant number of tea workers had eye diseases, of which presbyopia, cataracts, and refractive error were the most common.

Mendelian randomization analysis:the causal relationship between statins and eye diseases

Background:The specific role of statins in the field of ophthalmology is not clear.Statins have the advantages of pleiotropic,relatively safety and low cost,and are a promising choice for the prevention and management of eye diseases.Nevertheless,there is a divergence of findings regarding the correlation between statin treatment and ocular conditions.Hence,our intention is to investigate the impact of statins on eye conditions through the utilization of Mendelian randomization(MR).Methods:The UK Biobank provided data on five statins,while the FinnGen database provided data on six eye diseases,including age-related macular degeneration,glaucoma,diabetic retinopathy,senile cataract,drug-induced cataract,and other cataracts.Causality exploration involved the utilization of various methods including inverse variance weighted(IVW),weighted median,weighted multivariate(weighted mode),and MR-Egger regression.To assess the reliability of the findings,funnel analysis,MR-Egger regression,leave-one-out method,and Cochran’s Q test were employed.Additionally,reverse MR analysis was performed to evaluate the potential for reverse causality between statin use and eye diseases.Results:Based on IVW analysis,there were three pairs of positive results with significant(P<0.05)causal relationship,including atorvastatin and drug-induced cataract(odds ratio(OR)=1.65E-05,95%confidence interval(CI):2.24E-09–0.12;P_(IVW)=0.02),rosuvastatin and drug-induced cataract(OR=2.77E-18,95%CI:7.53E-35–0.1;P_(IVW)=0.04)and fluvastatin with senile cataract(OR=0.5,95%CI:0.25–0.99;P_(IVW)=0.05).No significant causal relationship was observed between other types of statins and eye diseases.Sensitivity analysis found that the results were robust.Reverse MR analysis indicated no evidence of reverse causality between statin use and the examined eye diseases.Conclusion:Our study finally verified the strong causal relationship between three drugs and two diseases(atorvastatin and rosuvastatin and drug cataract,fluvastatin and senile cataract).This study confirms that statins may reduce the risk of certain eye diseases and provides new insights into the prevention and treatment of eye diseases.Furthermore,the lack of reverse causality reinforces the reliability of these associations.

Prevalence and risk factors for eye diseases, blindness, and low vision in Lhasa, Tibet

AIM: To determine the prevalence and risk factors for eye diseases, blindness, and low vision in Tibet, and to assist the development of eye disease prevention and treatment schemes.METHODS: We carried out a survey of eye diseases among a population living at high altitude. A total of 1 115 Tibetan permanent residents aged 40 years or older from the towns and villages of Qushui County, Lhasa Prefecture, Tibet Autonomous Region, participated in this study. All participants completed a detailed questio-nnaire, and underwent presenting and pinhole visual acuity tests,and a comprehensive ophthalmic examination.RESULTS: There were 187 blind eyes (8.43%), 231 eyes with low vision (10.41% ). The leading cause of visual impairment was cataract of 55.0% (101/187) blindness and of 50.2% (116/231) low vision, followed by fundus lesions of 22.9% blindness and 23.8% low vision, while only a low prevalence of glaucoma of 9.6% blindness and 1.7% low vision was observed. The analysis of 2 219 eyes showed that the most common external eye disease was pterygium (27.2%) in Tibet.CONCLUSION: The high prevalence of blindness and low vision in the Tibetan population at high altitude is a serious public health issue. There is a need to establish and maintain an appropriate effective eye care program in Tibet.

Therapeutic effect of Keap1-Nrf2-ARE pathway-related drugs on age-related eye diseases through anti-oxidative stress

Age-related eye diseases,including cataract,glaucoma,diabetic retinopathy(DR),and age-related macular degeneration(AMD),are the leading causes of vision loss in the world.Several studies have shown that the occurrence and development of these diseases have an important relationship with oxidative stress in the eye.The Keap1-Nrf2-ARE pathway is a classical pathway that resists oxidative stress and inflammation in the body.This pathway is also active in the development of age-related eye diseases.A variety of drugs have been shown to treat agerelated eye diseases through the Keap1-Nrf2-ARE(Kelch-like ECH-Associating protein 1-nuclear factor erythroid 2 related factor 2-antioxidant response element)pathway.This review describes the role of oxidative stress in the development of age-related eye diseases,the function and regulation of the Keap1-Nrf2-ARE pathway,and the therapeutic effects of drugs associated with this pathway on age-related eye diseases.

Potential therapeutic applications of mesenchymal stem cells for the treatment of eye diseases

Stem cell-based treatments have been extensively explored in the last few decades to develop therapeutic strategies aimed at providing effective alternatives for those human pathologies in which surgical or pharmacological therapies produce limited effects.Among stem cells of different sources,mesenchymal stem cells(MSCs)offer several advantages,such as the absence of ethical concerns,easy harvesting,low immunogenicity and reduced tumorigenesis risks.Other than a multipotent differentiation ability,MSCs can release extracellular vesicles conveying proteins,mRNA and microRNA.Thanks to these properties,new therapeutic approaches have been designed for the treatment of various pathologies,including ocular diseases.In this review,the use of different MSCs and different administration strategies are described for the treatment of diabetic retinopathy,glaucoma,and retinitis pigmentosa.In a large number of investigations,positive results have been obtained by in vitro experiments and by MSC administration in animal models.Most authors agree that beneficial effects are likely related to MSC paracrine activity.Based on these considerations,many clinical trials have already been carried out.Overall,although some adverse effects have been described,promising outcomes are reported.It can be assumed that in the near future,safer and more effective protocols will be developed for more numerous clinical applications to improve the quality of life of patients affected by eye diseases.

Chlorinated Polyfluoroalkyl Ether Sulfonic Acids(Cl-PFESAs)Are Associated with Eye Diseases in Humans and Eye Toxicity in Zebrafish

Evidence from animal experiments has shown that chlorinated polyfluoroalkyl ether sulfonic acids(Cl-PFESAs)can induce vision dysfunction in zebrafish.However,environmental epidemiological evidence supporting this hypothesis remains limited.In our case−control study,samples collected from 270 individuals(135 controls and 135 cases)from the Isomers of C8 Health Project data were analyzed for Cl-PFESAs.We also repeated our analysis on zebrafish to support our findings in humans and to decipher the mechanism underlying Cl-PFESA eye toxicity.The serum levels of per-and polyfluoroalkyl substances(PFASs)and alternatives were significantly higher in the cases than in the controls.Higher serum Cl-PFESA levels were associated with greater odds of eye diseases,and the trend showed a statistically significant dose-dependent relationship.The Shapley additive explanations(SHAP)value indicated that 8:2 Cl-PFESA was the dominant eye disease risk factor among the 13 studied PFASs.In zebrafish experiments,Cl-PFESAs induced eye toxicity in adult zebrafish by oxidative damage and cell apoptosis.Compared to the control group,there was significantly reduced thicknesses of the inner plexiform layer(IPL),outer plexiform layer(OPL),and retinal tissue in the zebrafish exposed to Cl-PFESAs.Our study provides human clinical and animal experimental data,showing that exposure to PFASs increases the odds of the development of eye toxicity.

The essential role of N6-methyladenosine RNA methylation in complex eye diseases

There are many complex eye diseases which are the leading causes of blindness,however,the pathogenesis of the complex eye diseases is not fully understood,especially the underlying molecular mechanisms of N6-methyladenosine(m6A)RNA methylation in the eye diseases have not been extensive clarified.Our review summarizes the latest advances in the studies of m6A modification in the pathogenesis of the complex eye diseases,including cornea disease,cataract,diabetic retinopathy,age-related macular degeneration,proliferative vitreoretinopathy,Graves’disease,uveal melanoma,retinoblastoma,and traumatic optic neuropathy.We further discuss the possibility of developing m6A modification signatures as biomarkers for the diagnosis of the eye diseases,as well as potential therapeutic approaches.

Dual‑Atom Nanozyme Eye Drops Attenuate Inflammation and Break the Vicious Cycle in Dry Eye Disease

Dry eye disease(DED)is a major ocular pathology worldwide,causing serious ocular discomfort and even visual impairment.The incidence of DED is gradually increasing with the highfrequency use of electronic products.Although inflammation is core cause of the DED vicious cycle,reactive oxygen species(ROS)play a pivotal role in the vicious cycle by regulating inflammation from upstream.Therefore,current therapies merely targeting inflammation show the failure of DED treatment.Here,a novel dual-atom nanozymes(DAN)-based eye drops are developed.The antioxidative DAN is successfully prepared by embedding Fe and Mn bimetallic single-atoms in N-doped carbon material and modifying it with a hydrophilic polymer.The in vitro and in vivo results demonstrate the DAN is endowed with superior biological activity in scavenging excessive ROS,inhibiting NLRP3 inflammasome activation,decreasing proinflammatory cytokines expression,and suppressing cell apoptosis.Consequently,the DAN effectively alleviate ocular inflammation,promote corneal epithelial repair,recover goblet cell density and tear secretion,thus breaking the DED vicious cycle.Our findings open an avenue to make the DAN as an intervention form to DED and ROSmediated inflammatory diseases.

Global trends in diabetic eye disease research from 2012 to 2021

Diabetic eye disease refers to a group of eye complications that occur in diabetic patients and include diabetic retinopathy, diabetic macular edema, diabetic cataracts, and diabetic glaucoma. However, the global epidemiology of these conditions has not been well characterized. In this study, we collected information on diabetic eye disease-related research grants from seven representative countries––the United States, China, Japan, the United Kingdom, Spain, Germany, and France––by searching for all global diabetic eye disease journal articles in the Web of Science and Pub Med databases, all global registered clinical trials in the Clinical Trials database, and new drugs approved by the United States, China, Japan, and EU agencies from 2012 to 2021. During this time period, diabetic retinopathy accounted for the vast majority(89.53%) of the 2288 government research grants that were funded to investigate diabetic eye disease, followed by diabetic macular edema(9.27%). The United States granted the most research funding for diabetic eye disease out of the seven countries assessed. The research objectives of grants focusing on diabetic retinopathy and diabetic macular edema differed by country. Additionally, the United States was dominant in terms of research output, publishing 17.53% of global papers about diabetic eye disease and receiving 22.58% of total citations. The United States and the United Kingdom led international collaborations in research into diabetic eye disease. Of the 415 clinical trials that we identified, diabetic macular edema was the major disease that was targeted for drug development(58.19%). Approximately half of the trials(49.13%) pertained to angiogenesis. However, few drugs were approved for ophthalmic(40 out of 1830;2.19%) and diabetic eye disease(3 out of 1830;0.02%) applications. Our findings show that basic and translational research related to diabetic eye disease in the past decade has not been highly active, and has yielded few new treatment methods and newly approved drugs.

Evaluation of dry eye disease symptomatology and mental health status among patients with different COVID-19 statuses

AIM:To evaluate dry eye disease(DED)symptomatology and mental health status in different COVID-19 patients.METHODS:A cross-sectional observational design was used.Totally 123 eligible adults(46.34%of men,age range,18-59y)with COVID-19 included in the study from August to November,2022.Ocular Surface Disease Index(OSDI),Five-item Dry Eye Questionnaire(DEQ-5),Hospital Anxiety and Depression Scale(HADS),and Pittsburgh Sleep Quality Index(PSQI)were used in this study.RESULTS:OSDI scores were 6.82(1.25,15.91)in asymptomatic carriers,7.35(2.50,18.38)in mild cases,and 16.67(4.43,28.04)in recurrent cases,with 30.00%,35.56%,and 57.89%,respectively evaluated as having DED symptoms(χ2=7.049,P=0.029).DEQ-5 score varied from 2.00(0,6.00)in asymptomatic carriers,3.00(0,8.00)in mild cases,and 8.00(5.00,10.00)in recurrent cases,with 27.50%,33.33%,and 55.26%,respectively assessed as having DED symptoms(χ2=8.532,P=0.014).The prevalence of clinical anxiety(50.00%)and depression(47.37%)symptoms were also significantly higher in patients with recurrent infection(χ2=24.541,P<0.001;χ2=30.871,P<0.001).Recurrent infection was a risk factor for high OSDI scores[odds ratio,2.562;95%confidence interval(CI),1.631-7.979;P=0.033]and DEQ-5 scores(odds ratio,3.353;95%CI,1.038-8.834;P=0.043),whereas having a fixed occupation was a protective factor for OSDI scores(odds ratio,0.088;95%CI,0.022-0.360;P=0.001)and DEQ-5 scores(odds ratio,0.126;95%CI,0.039-0.405;P=0.001).CONCLUSION:Patients with recurrent COVID-19 have more severe symptoms of DED,anxiety,and depression.

Dry eye disease in systemic lupus erythematosus: a cross sectional study

AIM:To explore ocular surface manifestations of dry eye disease(DED)and its influencing factors in systemic lupus erythematosus(SLE)patients.METHODS:Ophthalmological examinations were conducted in SLE patients(n=43)and controls(n=41),including Ocular Surface Disease Index(OSDI),objective scatter index(OSI),tear meniscus height(TMH),lipid layer thickness(LLT),non-invasive Keratograph tear breakup time(NIKBUT),corneal fluorescein score(CFS),Schirmer I test.DED was diagnosed according to the Tear Film and Ocular Surface Society Dry Eye Workshop II Criteria.SLE patients were further divided into DED group and non-DED group,the disease activity,clinical manifestations and laboratory investigations were compared between the two groups.The disease activity was evaluated by Systemic Lupus Erythematosus Disease Activity Index 2000(SLEDAI-2K).Receiver operative characteristic(ROC)curve and multiplefactor binary logistic regression were performed.RESULTS:SLE patients showed higher OSDI[9.1(2.8-15.9)vs 6.3(2.2-7.5),P=0.035],higher OSI[1.67(1.09-2.60)vs 0.96(0.87-1.60),P=0.001],higher CFS[1(0-2)vs 0(0-1),P=0.001],lower LLT[65(42-100)vs 100(79.5-100),P=0.010],and lower NIKBUT[8.03(4.02-9.73)vs 9.67(5.26-12.71),P=0.030]than controls.The 32.6%of SLE patients had DED,which was higher than 12.2%of healthy controls.DED group showed higher SLEDAI-2K score[9.7±6.1 vs 5.4±3.4,P=0.025],higher anti-cardiolipin antibody(ACL)[8.7(3.5-13.2)vs 3.6(2.0-6.9),P=0.035],and higher proportion of patients with cutaneous eruption[42.9%vs 6.9%,P=0.015]than non-DED group.According to multiple-factor binary logistic regression analysis,the SLEDAI-2K score(OR=1.194,P=0.041)and cutaneous eruption(OR=7.094,P=0.045)could be consider as risk factors for DED in SLE patients.The ROC curve of the combined factors including age,disease duration,SLEDAI-2K score,ACL,and cutaneous eruption was analyzed,with a sensitivity of 0.786,a specificity of 0.793,and an area under curve of 0.820.CONCLUSION:Ocular surface affection is frequent in SLE patients,and patients with high disease activity and cutaneous eruption show increased risk of DED.

Effect of the traditional Chinese medicine fumigation combined with the meibomian gland squeezer for treatment of dry eye associated with meibomian gland dysfunction

Background:To observe the effect of traditional Chinese medicine fumigation combined with the meibomian gland squeezer for the treatment of dry eye associated with meibomian gland dysfunction(MGD).Methods:This is a randomized,controlled,non-masked,single-center study.Seventy-four cases(74 eyes)of dry eye associated with MGD were randomly divided into two groups.Thirty-seven patients were chosen as the treatment group was treated by the traditional Chinese medicine fumigation 3 times a week combined with the meibomian gland squeezer once a week for one month.The other 37 cases were sorted as the control group and only treated with the meibomian gland squeezer once a week for one month.Both groups received the primary treatment for 1 month,including Tobradex eye ointment once a day and 0.1%sodium hyaluronate eye drops 4-6 times daily.Patients were evaluated at baseline and 2-week and 1-month visits for the ocular symptom scores,international ocular surface disease index(OSDI),fluorescein tear break-up time(TBUT),corneal fluorescein staining test(CFS),Schirmer I test,meibum quality and meibum expressibility.Results:Sixty-seven patients were followed in the study,and the mean age was 57(±12.6)years.Thirty-three patients(11 males)in the treatment group and 34 patients(8 males)in the control group were followed in the study,and the mean age of the two groups was 45.36±15.02 years and 43.68±13.43 years,respectively.Before treatment,there was no significant difference between the two groups in gender,age,ocular symptom scores,OSDI,TBUT,CFS,Schirmer I test,meibum quality,and meibum expressibility(P>0.05).Compared with baseline,the 2 groups had different degrees of improvement in the ocular symptom scores,OSDI,TBUT,CFS,meibum quality,and meibum expressibility at the 2-week and 1-month visits(P<0.05),and the treatment group showed a more significant improvement in the ocular symptom scores,OSDI,TBUT,CFS,meibum quality and meibum expressibility compared with the control group(P<0.05).In addition,no serious adverse events were observed in each group.Conclusions:The traditional Chinese medicine fumigation combined with the meibomian gland squeezer may be safe,effective,and helpful for the treatment of dry eye associated with MGD.

Knowledge, Attitude, and Practices Regarding Diabetic Eye Disease among General Population in Medina City, Saudi Arabia

Background: Diabetic eye disease is known as a group of eye problems that diabetic patients may develop as a complication of diabetes and can lead to blindness. They may include Diabetic retinopathy (DR), Cataracts, and Glaucoma. Objectives: This study aims to assess the knowledge, attitude, and practices (KAP) around diabetic eye disease in the general population including patients with DM and non-diabetic people in Medina City, Saudi Arabia. Methods: This is a cross-sectional study involving 385 participants via a self-administered online Questionnaire started in January 2023 in Medina, Saudi Arabia. Results: In total, 339 participants with ages ranged from 18 to more than 60 years with a mean age of 26.8 ± 12.6 years old completed the questionnaire. The majority were females (74.6%), singles (67.8%), and had a university level of education (54.6%). Most of the study participants were found to have poor knowledge levels (67%) in comparison to 33% who had an overall good knowledge of diabetic eye diseases. Knowledge level was found to be higher among old-aged participants and those with a family history of DM (P = 0.001, P = 0.049) respectively. Regarding participants’ attitudes and practices, the study showed good attitudes toward eye care practice for diabetics with half of the participants (50%) reporting self-awareness as a reason that made them undergo the first eye screening. Conclusion: Participants in the present study have poor knowledge and awareness level of diabetic eye disease. Furthermore, positive attitudes and perceptions have been revealed by the participants toward the practice of providing eye care for diabetics. .

Bilateral Retinal Nerve Fiber Layer Loss and Recovery with Teprotumumab in Thyroid Eye Disease

Background: Thyroid Eye Disease (TED) is known to alter tissues of the orbital cavity, including the optic nerve. However, its effect on measured global Retinal Nerve Fiber Layer (gRNFL) is not well elucidated. This case evaluates the effect of teprotumumab on gRNFL in a patient with moderate TED. Observations: A 60-year-old female with controlled ocular hypertension and moderate TED received 8 standard IV teprotumumab infusions. Comprehensive ocular evaluations were performed pre-, during-, and post-treatment. Bilateral gRNFL thickness decreased (10 m OD;12 m OS) at 4 months post-treatment start, persisting at 8 months, but recovered at 20 months. Conclusions and Importance: Teprotumumab treatment in patients with TED led to a transient bilateral decrease in gRNFL thickness, which was restored to baseline levels with no adverse events reported. Monitoring gRNFL changes in teprotumumab-treated patients is crucial as gRNFL thinning indicates retinal ganglion cell damage. Teprotumumabs ability to dampen the IGF-IR inflammatory cascade may have reduced retinal inflammation, leading to recovery.

Mechanisms of electrical stimulation in eye diseases:A narrative review

Background:In the last two decades,electrical stimulation(ES)has been tested in patients with various eye diseases and shows great treatment potential in retinitis pigmentosa and optic neuropathy.However,the clinical application of ES in ophthalmology is currently limited.On the one hand,optimization and standardization of ES protocols is still an unmet need.On the other hand,poor understanding of the underlying mechanisms has hindered clinical exploitation.Main Text:Numerous experimental studies have been conducted to identify the treatment potential of ES in eye diseases and to explore the related cellular and molecular mechanisms.In this review,we summarized the in vitro and in vivo evidence related to cellular and tissue response to ES in eye diseases.We highlighted several pathways that may be utilized by ES to impose its effects on the diseased retina.Conclusions:Therapeutic effect of ES in retinal degenerative diseases might through preventing neuronal apoptosis,promoting neuronal regeneration,increasing neurotrophic factors production in Müller cells,inhibiting microglial activation,enhancing retinal blood flow,and modulating brain plasticity.Future studies are suggested to analyse changes in specific retinal cells for optimizing the treatment parameters and choosing the best fit ES delivery method in target diseases.

Rabbit models of dry eye disease: comparative analysis

AIM:To report ocular changes in rabbits after the implementation of three different induction methods to create dry eye(DE)conditions and provides evidence of DErelated disease evolution.METHODS:Experimental methods were divided into 3 models.The first model used involved triple injection of complete Freund’s adjuvant,50µL each,also called the meibomian gland dysfunction(MGD)model.In the second model,DE conditions were created by the resection of nictitating membranes(NM),Harderian glands(HG),and main lacrimal glands(LG),also called the LGR model.The third model involved the topical administration of benzalkonium chloride(BAK)0.1%solution.The Schirmer test,ocular surface staining with fluorescein,and tear breakup time tests were implemented before and after excision.After euthanasia,the ocular tissues were dissected.Cornea,conjunctiva,and meibomian glands were treated with periodic acid–Schiff(PAS)staining and haematoxylin–eosin staining.RESULTS:The MGD model triggered inflammation of meibomian glands.It detected changes in the lipid layer of the tear film.The bilateral resection of NM,HG,and LG reduced the watering layer of the tear film.The topical administration of BAK of 0.1%solution impacted the mucosal layer of the tear film.CONCLUSION:Different changes are observed with different DE syndrome models.The composition of the tear film differ depending on which part of the eye is targeted.More studies need to be done to confirm whether an increased thickness of the cornea has any impact on the DE disease.

Optimizing Fully Convolutional Encoder-Decoder Network for Segmentation of Diabetic Eye Disease

In the emerging field of image segmentation,Fully Convolutional Networks(FCNs)have recently become prominent.However,their effectiveness is intimately linked with the correct selection and fine-tuning of hyperparameters,which can often be a cumbersome manual task.The main aim of this study is to propose a more efficient,less labour-intensive approach to hyperparameter optimization in FCNs for segmenting fundus images.To this end,our research introduces a hyperparameter-optimized Fully Convolutional Encoder-Decoder Network(FCEDN).The optimization is handled by a novel Genetic Grey Wolf Optimization(G-GWO)algorithm.This algorithm employs the Genetic Algorithm(GA)to generate a diverse set of initial positions.It leverages Grey Wolf Optimization(GWO)to fine-tune these positions within the discrete search space.Testing on the Indian Diabetic Retinopathy Image Dataset(IDRiD),Diabetic Retinopathy,Hypertension,Age-related macular degeneration and Glacuoma ImageS(DR-HAGIS),and Ocular Disease Intelligent Recognition(ODIR)datasets showed that the G-GWO method outperformed four other variants of GWO,GA,and PSO-based hyperparameter optimization techniques.The proposed model achieved impressive segmentation results,with accuracy rates of 98.5%for IDRiD,98.7%for DR-HAGIS,and 98.4%,98.8%,and 98.5%for different sub-datasets within ODIR.These results suggest that the proposed hyperparameter-optimized FCEDN model,driven by the G-GWO algorithm,is more efficient than recent deep-learning models for image segmentation tasks.It thereby presents the potential for increased automation and accuracy in the segmentation of fundus images,mitigating the need for extensive manual hyperparameter adjustments.

Spatial Correlation Module for Classification of Multi-Label Ocular Diseases Using Color Fundus Images

To prevent irreversible damage to one’s eyesight,ocular diseases(ODs)need to be recognized and treated immediately.Color fundus imaging(CFI)is a screening technology that is both effective and economical.According to CFIs,the early stages of the disease are characterized by a paucity of observable symptoms,which necessitates the prompt creation of automated and robust diagnostic algorithms.The traditional research focuses on image-level diagnostics that attend to the left and right eyes in isolation without making use of pertinent correlation data between the two sets of eyes.In addition,they usually only target one or a few different kinds of eye diseases at the same time.In this study,we design a patient-level multi-label OD(PLML_ODs)classification model that is based on a spatial correlation network(SCNet).This model takes into consideration the relevance of patient-level diagnosis combining bilateral eyes and multi-label ODs classification.PLML_ODs is made up of three parts:a backbone convolutional neural network(CNN)for feature extraction i.e.,DenseNet-169,a SCNet for feature correlation,and a classifier for the development of classification scores.The DenseNet-169 is responsible for retrieving two separate sets of attributes,one from each of the left and right CFI.After then,the SCNet will record the correlations between the two feature sets on a pixel-by-pixel basis.After the attributes have been analyzed,they are integrated to provide a representation at the patient level.Throughout the whole process of ODs categorization,the patient-level representation will be used.The efficacy of the PLML_ODs is examined using a soft margin loss on a dataset that is readily accessible to the public,and the results reveal that the classification performance is significantly improved when compared to several baseline approaches.

Role of lymphotoxin alpha as a new molecular biomarker in revolutionizing tear diagnostic testing for dry eye disease

Dry eye disease(DED),primarily classified as multifactorial ocular surface disorder,afflicts tens of millions of individuals worldwide,adversely impacting their quality of life.Extensive research has been conducted on tear film analysis over the past decades,offering a range of tests to evaluate its volume,health,and integrity.Yet,early diagnosis and effective treatment for DED continue to pose significant challenges in clinical settings.Nevertheless,by recognizing key phenomena in DED such as ocular surface inflammation,hyperosmolarity,and tear film instability,this article provides a comprehensive overview of both traditional and recently developed methods for diagnosing and monitoring DED.The information serves as a valuable resource not only for clinical diagnosis but also for further research into DED.