Clinical Observation of Recombinant Bovine Basic Fibroblast Growth Factor Eye Gel Combined with Tobramycin Dexamethasone Eye Drops in the Treatment of Dry Eye Syndrome in Patients after Cataract Surgery

Objective:To evaluate the therapeutic effect of recombinant bovine basic fibroblast growth factor(rbFGF)eye gel combined with tobramycin-dexamethasone(TOB-Dex)eye drops on dry eye syndrome(DES)after cataract surgery.Methods:86 patients with DES after cataract surgery,admitted from November 2021 to November 2023,were randomly divided into groups.The observation group included 43 patients treated with rbFGF eye gel combined with TOB-Dex eye drops.The reference group included 43 patients treated with TOB-Dex eye drops alone.Multiple indicators,including total effective rate and clinical symptom scores,were compared between the two groups.Results:The total effective rate in the observation group was higher than in the reference group(P<0.05).Before treatment,there were no differences in clinical symptom scores,serum factors,or disease severity scores between the two groups(P>0.05).Three weeks after treatment,the observation group had lower clinical symptom scores,serum factors,and disease severity scores compared to the reference group(P<0.05).The adverse reaction rate in the observation group was lower than in the reference group(P<0.05).Conclusion:rbFGF eye gel combined with TOB-Dex eye drops can improve the clinical efficacy for patients with DES after cataract surgery,alleviate disease symptoms,reduce inflammatory responses,and have fewer adverse reactions.

Efficacy of recombinant human epidermal growth factor plus sodium hyaluronate eye drops in diabetic dry eye post-cataract surgery

BACKGROUND Dry eye syndrome(DES)after diabetic cataract surgery can seriously affect the patient’s quality of life.Therefore,effective alleviation of symptoms in patients with this disease has important clinical significance.AIM To explore the clinical effect of recombinant human epidermal growth factor(rhEGF)plus sodium hyaluronate(SH)eye drops on DES after cataract surgery in patients with diabetes.METHODS We retrospectively evaluated 82 patients with diabetes who experienced DES after cataract surgery at Tianjin Beichen Hospital,Affiliated Hospital of Nankai University between April 2021 and April 2023.They were classified into an observation group(42 cases,rhEGF+SH eye drops)and a control group(40 cases,SH eye drops alone),depending on the different treatment schemes.The therapeutic efficacy,dry eye symptom score,tear film breakup time(TFBUT),basic tear secretion score[assessed using Schirmer I test(SIt)],corneal fluorescein staining(FL)score,tear inflammatory markers,adverse reactions during treat-ment,and treatment satisfaction were compared between the two groups.RESULTS Therapeutic efficacy was higher in the observation group compared with the control group.Both groups showed improved TFBUT and dry eye,as well as improved SIt and FL scores after treatment,with a more pronounced improvement in the observation group.Although no marked differences in adverse reactions were observed between the two groups,treatment satisfaction was higher in the observation group.CONCLUSION rhEGF+SH eye drops rendered clinical benefits to patients by effectively ameliorating dry eye and visual impairment with favorable efficacy,fewer adverse reactions,and high safety levels.Thus,this treatment should be promoted in clinical practice.

Prevalence and Factors Associated with Dry Eyes Syndrome in Glaucomatous Patients on Anti-Glaucoma Eye Drops Followed up at the Garoua Regional Hospital-Northern Cameroon

Background: Dry eye and glaucoma are two common pathologies in the elderly, and are very often associated. This association suggests a link between them and between their treatments. Our purpose for this study is to determine the prevalence of dry eye in our glaucoma patients treated with eye drops and deduce the factors associated with it. Patients and Methods: We conducted a cross-sectional, analytical study from October 2022 to September 2023 in the ophthalmology department of Garoua Regional Hospital in glaucoma patients aged over 15 years able to answer the Ocular Surface Disease Index (OSDI) questionnaires and treated with antiglaucoma eye drops for more than 3 months. These patients underwent a complete ophthalmological examination and a tear film break-up time test. Results: A total of 73 patients (146 eyes) were examined. The average age of the patients was 47.2 ± 16.5 years, with a male predominance of 54.8%. The prevalence of dry eye syndrome in our patients according to the OSDI score was 56.2% (95% CI) (44.8;67.6). The prevalence of dry eye syndrome on clinical examination of the BUT in the right eye was 83.7% (95% CI) (75.1;92.1) and 79.4% (70.2;88.7) in the left eye. The duration of antiglaucoma treatment was the factor associated with dry eye syndrome (p < 0.05) in glaucoma patients in our setting. Conclusion: Dry Eye Syndrome is common in glaucoma patients on drops in our setting. Treatment duration of more than 1 year seems to be associated with dry eyes.

Psychometric validation of the Chinese version of the dry eye-related quality-of-life score questionnaire

AIM:To psychometrically validate the Chinese version of the dry eye-related quality-of-life score questionnaire(DEQSCHN)among Chinese patients with dry eye.METHODS:This study involved 231 participants,including 191 with dry eye disease(DED)comprising the dry eye disease group,and 40 healthy participants forming the control group.Participants were required to complete the DEQS-CHN,and Chinese dry eye questionnaire and undergo clinical tests including the fluorescein breakup time(FBUT),corneal fluorescein staining(CFS),and Schirmer I test.To assess the internal consistency and retest reliability,Cronbach’sαand the intraclass correlation coefficient(ICC)were employed.Content validity was assessed by item-level content validity index(ICV)and an average scale-level content validity index(S-CVI/Ave).Construct validity was assessed by confirmatory factor analysis.The concurrent validity was assessed by calculating correlations between DEQS-CHN and Chinese dry eye questionnaire.Discriminative validity was evaluated through nonparametric tests,with receiver operating characteristic(ROC)curve serving as conclusive indicators of the questionnaire’s distinguishing capability.RESULTS:The Cronbach’sαcoefficients for frequency and degree of ocular symptoms,impact on daily life,and summary score were 0.736,0.704,0.811,0.818,0.861,and 0.860,respectively,and the ICC were 0.611,0.677,0.715,0.769,0.711,and 0.779,respectively.All I-CVI scores ranged from 0.833 to 1.000,with an S-CVI/Ave of 0.956.Confirmatory factor analysis results exhibited a wellfitting model consistent with the original questionnaire[χ^(2)/df=2.653,incremental fit index(IFI)=0.924,comparative fit index(CFI)=0.924,Tucker-Lewis index(TLI)=0.909,and root mean square error of approximation(RMSEA)=0.065].There was a moderate positive correlation between the DEQS-CHN and the Chinese dry eye questionnaire(r^(2)=0.588).The dry eye group demonstrated significantly higher scores compared to the control group,and the area under the curve(AUC)value was 0.8092.CONCLUSION:The DEQS-CHN has been demonstrated as a valid and reliable instrument for assessing the impact of dry eye disease on the quality of life among Chinese individuals with DED.

Different concentrations of hyaluronic acid eye drops for dry eye syndrome: a systematic review and Meta-analysis

AIM:To compare high or low concentration of hyaluronic acid eye drops(HY)for dry eye syndromes(DES).METHODS:Randomized controlled trials(RCTs)comparing various concentrations of HY were searched in PubMed,Embase,Web of Science,Cochrane,SinoMed,CNKI,Wanfang Database,CQVIP,and Chinese journals databases between inception and July 2023.Pooled standardized mean differences(SMD)or weighted mean difference(WMD)with 95%confidence intervals(CI)from RCTs evaluating Schirmer’s I test(SIT),corneal fluorescein staining score(CFS),tear breakup time(TBUT),DES score(DESS),and Ocular Surface Disease Index(OSDI)were calculated.Sensitivity analysis,Egger’s test and Meta-regression analysis were performed for all indicators.RESULTS:We conducted a Meta-analysis of 10 RCTs that met the inclusion criteria,involving 1796 cases.High-concentrations group significantly improved the outcome of CFS according to random effects modelling(SMD,-3.37;95%CI,-5.25 to-1.48;P=0.0005).The rest of the results were not statistically significant,including indicators such as SIT,TBUT,DESS and OSDI.CONCLUSION:For dry eyes with positive corneal staining,a high concentration of HY is recommended,whereas in other cases,a high concentration of HY does not offer a more pronounced advantage over a low concentration of HY in the treatment of dry eyes.

Analyze interleukin-1β,interleukin-6,and tumor necrosis factor-αlevels in dry eye and the therapeutic effect of cyclosporine A

BACKGROUND Dry eye is a common eye disease.Artificial tears supplements are widely used for the treatment of dry eyes.However,multiple adverse effects have been observed in patients receiving long-term treatment with artificial tears,which may affect the therapeutic effect.AIM To analyze the characteristics of interleukin-1β(IL-1β),interleukin-6(IL-6),and tumor necrosis factor-alpha(TNF-α)levels in patients with dry eye and the therapeutic effect of artificial tears combined with cyclosporine A.METHODS A total of 124 dry eye patients treated at The First People’s Hospital of Xining from April 2020 to April 2022 were selected as the observation group,while 20 healthy individuals served as the control group during the same period.Levels of inflammatory markers,including IL-1β,IL-6,and TNF-α,were analyzed.The observation group was further divided into a study group and a control group,each consisting of 62 patients.The control group received artificial tears,whereas the study group received a combination of artificial tears and cyclosporine A.Inflammatory markers,Schirmer’s test(SIT),tear break-up time(TBUT),corneal fluorescein staining(CFS),National Eye Institute Visual Function Questionnaire-25(NEI-VFQ-25)scores,and adverse events(AEs)were compared between the two groups.RESULTS The observation group exhibited significantly elevated serum levels of IL-1β,IL-6,and TNF-αin comparison to the healthy group.Following treatment,the study group demonstrated substantial reductions in IL-1β,IL-6,and TNF-αlevels relative to the control group.Moreover,after treatment,the study group experienced a marked decrease in CFS scores and significant increases in both SIT and BUT levels when compared to the control group.Additionally,significant improvements were observed in the primary symptom of dry eye and secondary symptoms such as photophobia,foreign body sensation,fatigue,red eye,and burning sensation within the study group.Furthermore,post-treatment NEI-VFQ-25 scores across all dimensions exhibited significant enhancements in the study group compared to the control group(P<0.05).It is noteworthy that significant AEs were reported in both groups throughout the treatment period.CONCLUSION Cyclosporine A combined with artificial tears is effective in treating dry eye,yielding enhanced outcomes by improving SIT and TBUT levels,reducing CFS scores,and ameliorating vision-related quality of life.

Influencing factors of self-management ability among dry eye patients in west China

AIM:To investigate the current situation and influencing factors of self-management ability in dry eye patients in west China.METHODS:A total of 265 patients clinically diagnosed with dry eye received a convenience survey questionnaire at West China Hospital of Sichuan University.All participants completed the rating scale of health self-management skill for adults(AHSMSRS),Huaxi Emotional-Distress Index(HEI),e-health literacy scale(e-HEALS)and Brief Illness Perception Questionnaire(Brief-IPQ).A generalized linear model was employed to establish a multivariate linear model with demographic data,psychological state,e-HEALS,and illness perception as independent variables and health selfmanagement skill score as the dependent variable.RESULTS:The mean score for health self-management skill was 165.58±15.79.Multivariate analysis revealed that advanced age,better illness perception and improved psychological state were associated with better health selfmanagement ability among dry eye patients.Furthermore,the health self-management ability of patients with a disease duration less than 1y was found to be higher compared to those with a disease duration exceeding 1y.CONCLUSION:The health self-management ability of dry eye patients in west China is relatively high.Age,duration of disease,illness perception and psychological state are the influencing factors on the health selfmanagement ability of dry eye patients.

Effectiveness of intravitreal ranibizumab for diabetic macular edema in vitrectomized versus non-vitrectomized eyes:a Meta-analysis

AIM:To evaluate the effectiveness and safety of intravitreal ranibizumab(IVR)for diabetic macular edema(DME)in vitrectomized versus non-vitrectomized eyes.METHODS:The PubMed,EMBASE,Web of Science,Cochrane,EBSCO were comprehensively searched for studies comparing vitrectomized and non-vitrectomized eyes with DME.Clinical outcomes of best-corrected visual acuity(BCVA),central macular thickness(CMT),the mean number of intravitreal injection and adverse events were extracted and analyzed.RESULTS:Six studies involving 641 eyes were included.Final visual gain significantly improved and CMT significantly reduced in vitrectomized eyes at 6mo and 12mo visits(P<0.05).Although the mean reduction in CMT among non-vitrectomized eyes was significantly greater than in vitrectomized eyes at the 6mo[mean difference(MD)=53.57,95%confidence interval(CI):28.03 to 78.72,P<0.0001]and 12mo(MD=49.65,95%CI:19.58 to 79.72,P=0.01),no significant difference was detected in improvement in BCVA at either 6mo(MD=0.05,95%CI:-0.02 to 0.13,P=0.14)or 12mo(MD=0.03,95%CI:-0.04 to 0.09,P=0.43).Injection number of ranibizumab in non-vitrectomized eyes was significantly less than that in vitrectomized eyes during 6-month period(MD=0.60,95%CI:0.16 to 1.04,P=0.008),while there was no statistically significant difference between the two groups during 12mo of follow-up.CONCLUSION:Evidence from current study suggests that IVR was useful for both vitrectomized group and nonvitrectomized group with DME.Although less reduction in macular thickness is found in vitrectomized group,visual improvement between two groups is similar.

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.

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.

Influencing factors of ocular pain in dry eye disease patients at high altitude

AIM:To quantify the severity and frequency of ocular pain in Tibetan plateau patients with dry eye,and to evaluate the related factors affecting ocular pain.METHODS:A retrospective study included 160 cases of dry eye disease(DED)patients who were treated from July 2022 to June 2023.Age,gender,occupation,illness course,anxiety,plateau duration,plateau protection,ocular surface disease index scale(OSDI),break-up time(BUT),Schirmer I test(SIT),conjunctivitis,history of ophthalmic medication,autoimmune disease,the workload of daily near vision range,smoking and overnight stay were obtained via comprehensive ophthalmic assessment,and their duration was followed up.Logistic regression analysis was used to determine the related factors affecting ocular pain.RESULTS:Totally 77.5%(124/160)of DED patients had ocular pain,of which the severity of ocular pain was mild,moderate,and severe in 30.0%,36.3%,and 11.3%of patients,respectively.Frequency of ocular pain was reported occasional,half the time,frequent,and persistent pain in 19.4%,36.9%,16.9%,and 4.4%.OSDI score was 19.67±5.70(13 to 36),and the level of pain was lowly correlated with OSDI(rs=0.316,P<0.001).Logistic regression showed that in plateau DED patients,increased anxiety led to increased severity and frequency of ocular pain[odds ratio(OR)=3.662,5.613,2.387,and 4.870;all P<0.05],professional eye protection and improvement of daily sleep quantity decreased pain(OR=0.307,0.572,0.418,and 0.789;all P<0.05),while smoking and general protection of plateau did not affect the severity and frequency of ocular pain(all P>0.05).CONCLUSION:Ocular pain is a common complaint in high-altitude DED patients during the pandemic.Anxiety,eye protection,and adequate sleep during the epidemic period are significantly associated with the severity and frequency of ocular pain in patients with plateau DED,while symptoms of DED have relatively little influence on them.

Dry eye rate and its relationship with disease stage in patients with primary hypertension:a cross-sectional study in Vietnam

AIM:To determine the dry eye(DE)rate and its relationship with disease stage in patients with primary hypertension.METHODS:A cross-sectional study included 432 patients with primary hypertension(with an equal number of patients in each group:144 in stage Ⅰ,Ⅱ,and Ⅲ hypertension)and 144 healthy subjects as a control group.The Ocular Surface Disease Index(OSDI)and Schirmer Ⅰ test without anesthetics were conducted on all 576 subjects.Subjects with OSDI scores<13 and Schirmer Ⅰ values equal to or under 10 mm were diagnosed with DE.RESULTS:The ratio of DE in hypertension patients was higher than in the control group(41.7%versus 18.8%;P<0.001).The proportion of patients with DE increased gradually according to the hypertension stage:27.1% in stage Ⅰ,40.3% in stage Ⅱ,and 57.6% in stage Ⅲ,P<0.001.Age,duration of hypertension,plasma urea,creatinine,and high-sensitivity C-reactive protein(CRP-hs)levels in hypertension patients with DE were higher than those without DE,P<0.001.Advanced age,a long duration of hypertension,diabetes mellitus,elevated plasma creatinine,and CRP-hs levels were independent factors associated with DE in primary hypertension patients,P<0.001.CONCLUSION:DE is a common disorder associated with advanced age,a long duration of hypertension,diabetes mellitus,elevated plasma CRP-hs,and creatinine levels in patients with primary hypertension.

Assessment of tear film parameters post-treatment with commercial eyelid cleaning wipes:a pilot study

AIM:To investigate the short-term effects of commercially available eyelid-cleaning wipes on film parameters.METHODS:This study enrolled 48 healthy participants aged 20-35y(both males and females).Clinical assessment included the Ocular Surface Disease Index(OSDI)questionnaire,non-invasive tear break-up time(NITBUT),tear meniscus height(TMH),and lipid layer pattern(LLP).Based on these initial results,participants were categorized as either non-dry eye or dry eye.Participants in each group were randomly allocated to either Blephaclean■or Systane■treatments.Changes in NITBUT,TMH,and LLP levels before and after lid wipe treatment were assessed.RESULTS:The dry eye group exhibited significantly higher OSDI scores and lower NITBUT and TMH levels than in the non-dry eye group(P<0.001).Following the application of eyelid wipes(Systane■wipes),dry eye subjects experienced a significant improvement in NITBUT levels(P=0.0014)compared to the non-dry eye individuals.Although the remaining participants showed a marginal increase in TMH and NITBUT levels,these changes did not achieve statistical significance(P>0.05).Similarly,the LLP levels were significantly improved with Systane■(P<0.001)post-treatment compared to individuals in the non-dry eye group.However,the dry eye subjects showed higher posttreatment LLP levels than the untreated group(P<0.02).CONCLUSION:The short-term effects of Systane®eyelid wipes on tear film parameters suggest their effectiveness in dry eye disease.Nonetheless,further exploration of their long-term impact is essential to justify their cost effectiveness and efficacy in treating both aqueous deficiency and evaporative dryness.

Intraocular pressure before and after capsulorhexis using two viscoelastic substances and two surgical approaches in enucleated porcine eyes

AIM:To investigate the influence of ophthalmic viscoelastic devices(OVDs)and different surgical approaches on the intraocular pressure(IOP)before and after creation of the curvilinear circular capsulorhexis(CCC)as a measure for anterior chamber stability during this maneuver.METHODS:Prospective experimental WetLab study carried out on enucleated porcine eyes.IOP was measured before and after CCC with the iCare Rebound tonometer(iCare ic200;iCare Finland Oy,Vantaa,Finland).The OVDs used were a cohesive one[Z-Hyalin,Carl Zeiss Meditec AG,Germany;hyaluronic acid(HA)]and a dispersive[Z-Celcoat,Carl Zeiss Meditec AG,Germany;hydroxy propylmethylcellulosis(HPMC)].The CCC was created using Utrata forceps or 23 g microforceps in different combinations with the OVDs.RESULTS:Using the Utrata forceps the IOP dropped from 63.65±6.44 to 11.25±3.63 mm Hg during the CCC.The use of different OVDs made no difference.Using the 23 g microforceps the IOP dropped from 65.35±8.15 to 36.55±6.09 mm Hg.The difference between IOP drop using either Utrata forceps or 23 g microforceps was highly significant regardless of the OVD used.CONCLUSION:Using the sideport for the creation of the capsulorhexis leads to a lesser drop in IOP during this maneuver compared to the main incision in enucleated porcine eyes.The use of different OVD has no significant influence on IOP drop.

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.

Endophthalmitis in silicone oil-filled eye: A case report

BACKGROUND Endophthalmitis occurring in silicone oil-filled eyes is a very rare occurrence,with reported incidence rates ranging between 0.07%and 0.039%.Traditional methods of management of infectious endophthalmitis include the removal of silicone oil,washout of the vitreous cavity,administration of intravitreal antibiotics,and reinjection of silicone oil.CASE SUMMARY Herein,we report the case of a 39-year-old man with unilateral endophthalmitis after pars plana vitrectomy and silicone oil tamponade.Intravitreal injections of full-dose antibiotics and anterior chamber washout were used to treat the patient.No signs of retinal toxicity were observed during the follow-up period.CONCLUSION Intravitreal full-dose antibiotic injections and anterior chamber washout are promising alternatives to traditional therapies for endophthalmitis in silicone oilfilled eyes.

Targeting Nrf2 signaling in dry eye

Dry eye,the most common ocular surface disease,can cause ocular surface tissue damage and discomfort symptoms and seriously affect people’s quality of life.The etiology of dry eye is diverse,and its pathogenesis is complex.The oxidative stress reaction is considered to be among the important factors in the pathogenesis of dry eye.Therefore,activating the antioxidant system has a potential therapeutic effect on dry eye.Nuclear factor erythroid 2-related factor 2(Nrf2)signaling pathway is considered the most important antioxidant pathway in the body.The activation of the Nrf2 signaling pathway and its interaction with other pathways are important mechanisms to prevent the occurrence and development of dry eye.This review describes the structure and function of Nrf2,summarizes the changes in the oxidative stress response in dry eye,focuses on the potential mechanism of the Nrf2 signaling pathway in the treatment of dry eye,and,finally,summarizes the drugs that activate the Nrf2 signaling pathway in the treatment of dry eye.

Retinal nerve fiber layer defects and chronic kidney disease:the Kailuan Eye Study

AIM:To investigate whether retinal nerve fiber layer defects(RNFLDs)is a potential risk factor for chronic kidney disease(CKD)in Chinese adults.METHODS:The Kailuan Eye Study was a populationbased study that included 14440 participants.All participants underwent detailed assessments,RNFLDs were diagnosed using color fundus photographs.RESULTS:Overall,12507 participants[8533 males(68.23%)]had complete systemic examination data and at least one evaluable fundus photograph.RNFLDs were found in 621 participants[5.0%;95%confidence interval(CI):4.6%-5.34%],and 70 cases of multiple RNFLDs were found(11.27%).After adjusting multiple factors,RNFLDs was significantly associated with CKD severity,the ORs of CKD stage 3,stage 4 and stage 5 were 1.698,4.167,and 9.512,respectively.Multiple RNFLDs were also associated with CKD severity after adjusting multiple factors,the ORs of CKD stage 3 and stage 5 were 4.465 and 11.833 respectively.Furthermore,2294 participants had CKD(18.34%,95%CI:17.68%-18.99%).After adjusting for other factors,CKD presence was significantly correlated with the presence of RNFLDs.CONCLUSION:The strongest risk factors for RNFLDs are CKD and hypertension.Conversely,RNFLDs can be an ocular feature in patients with CKD.Fundoscopy can help detect systemic diseases,and assessment for RNFLDs should be considered in CKD patients.

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.

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.