The enlightenment of artificial intelligence large-scale model on the research of intelligent eye diagnosis in traditional Chinese medicine

Eye diagnosis is a method for inspecting systemic diseases and syndromes by observing the eyes.With the development of intelligent diagnosis in traditional Chinese medicine(TCM);artificial intelligence(AI)can improve the accuracy and efficiency of eye diagnosis.However;the research on intelligent eye diagnosis still faces many challenges;including the lack of standardized and precisely labeled data;multi-modal information analysis;and artificial in-telligence models for syndrome differentiation.The widespread application of AI models in medicine provides new insights and opportunities for the research of eye diagnosis intelli-gence.This study elaborates on the three key technologies of AI models in the intelligent ap-plication of TCM eye diagnosis;and explores the implications for the research of eye diagno-sis intelligence.First;a database concerning eye diagnosis was established based on self-su-pervised learning so as to solve the issues related to the lack of standardized and precisely la-beled data.Next;the cross-modal understanding and generation of deep neural network models to address the problem of lacking multi-modal information analysis.Last;the build-ing of data-driven models for eye diagnosis to tackle the issue of the absence of syndrome dif-ferentiation models.In summary;research on intelligent eye diagnosis has great potential to be applied the surge of AI model applications.

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.

Comparison of Artisan iris-claw intraocular lens implantation and posterior chamber intraocular lens sulcus fixation for aphakic eyes

AIM:To compare the efficacy and complications of Artisan iris-claw intraocular lens(IOL)implantation and posterior chamber IOL sulcus fixation for the treatment of aphakic eyes without capsular support after vitrectomy.METHODS:A prospective study of 45 cases was conducted.Forty-five eyes without sufficient lens capsule support following pars plana vitrectomy(PPV)combined lens extraction were divided into two groups.Group A:25 eyes received Artisan iris-claw IOL implantation.Group B:20 eyes received posterior chamber IOL sulcus fixation.The corrected distance visual acuity(CDVA)and intraocular pressure(IOP),corneal endothelial cell loss rate,surgical time and complications were compared between the two groups.Pigment changes of trabecular meshwork and anterior chamber depths were measured at each time point in Artisan group.RESULTS:The mean surgical time of Artisan group was significantly shorter(P【0.05).No statistically significant difference in endothelial cell loss rate was noted between two groups at any time point(P】0.05).CDVA of Artian group was better than that of the sulcus fixation group 1d after surgery(P【0.05)and there was no statistically significant difference 1 and 3mo after surgery(P】0.05).Mean IOP showed no significant differences between groups before and after surgery.The postoperative complications of Artisan group were anterior uveitis,iris depigmentation,pupillary distortion and spontaneous lens dislocation.The complications of sulcus fixation group include choroidal detachment,intraocular haemorrhage,tilt of IOL optic part and retinal detachment.CONCLUSION:Secondary Artisan IOL implantation canbe performed less invasively and in a shorter surgical time period with earlier visual recovery after surgery compared to transscleral suturing fixation of an IOL.This technique is an effective and safe procedure.It is a promising option for the treatment of aphakic eyes without capsular support after vitrectomy.

Fabrication of Waterproof Artificial Compound Eyes with Variable Field of View Based on the Bioinspiration from Natural Hierarchical Micro–Nanostructures

Planar and curved microlens arrays(MLAs)are the key components of miniaturized microoptical systems.In order to meet the requirements for advanced and multipurpose applications in microoptical field,a simple manufacturing method is urgently required for fabricating MLAs with unique properties,such as waterproofness and variable field-of-view(FOV)imaging.Such properties are beneficial for the production of advanced artificial compound eyes for the significant applications in complex microcavity environments with high humidity,for instance,miniature medical endoscopy.However,the simple and effective fabrication of advanced artificial compound eyes still presents significant challenges.In this paper,bioinspired by the natural superhydrophobic surface of lotus leaf,we propose a novel method for the fabrication of waterproof artificial compound eyes.Electrohydrodynamic jet printing was used to fabricate hierarchical MLAs and nanolens arrays(NLAs)on polydimethylsiloxane film.The flexible film of MLAs hybridized with NLAs exhibited excellent superhydrophobic property with a water contact angle of 158°.The MLAs film was deformed using a microfluidics chip to create artificial compound eyes with variable FOV,which ranged from 0°to 160°.

Anti-detection technology of cat eye target based on decentered field lens

Optoelectronic imaging equipment is easy to expose to active laser detection devices because of ＂cat eye＂ effect. In this paper, we propose a new structure of optical system to reduce the retroreflector effect of a cat eye target. Decentered field lens structure is adopted in the design without sacrificing imaging quality and clear aperture. An imaging system with±30° field of view is taken for example. The detailed design and simulation results are presented. The results indicate that this kind of optical system can reduce the retroreflection signal substantially and maintain acceptable imaging performance.

Severe prelenticular membrane formation on the surface of a hydrophilic acrylic intraocular lens after cataract surgery in an eye with an Ahmed valve implant

【正】Dear Sir,Iam Yong-Sun Ahn,from the Department of Ophthalmology of St.Vincent Hospital of Suwon,Kyungki-do,South Korea.Cataracts are a common problem in eyes with a glaucoma drainage device(GDD),because tube shunt surgery increases the incidence and progression of cataracts[1].An Ahmed valve,the most commonly inserted GDD,is composed of a silicone tube connected to a flat plate sewn to the sclera,and aqueous humor flows from the

Clinical Comparison and Analysis of Decoction of Traditional Chinese Medicine Combined with Ear Acupoint Application and Simple Artificial Tears in the Treatment of Dry Eye Syndrome

OBJECTIVE: To study the clinical comparison and analysis of decoction of Traditional Chinese Medicine(TCM) combined with ear acupoint application and simple artificial tears in the treatment of dry eye syndrome. METHODS:A total of 62 patients(124 eyes) with dry eye syndrome treated in the Department of Ophthalmology of The 4th People's Hospital of Shenyang from July 2017 to March 2018 were selected and equally divided into 2 groups according to the admission order. The observation group received the combination therapy of TCM decoction and ear acupoint application, while the control group was given the simple artificial tears. The symptom score after 2 weeks, 4 weeks, and 8 weeks as well as the indicators including break-up time(BUT), Schirmer I test(SIT) and fluorescein(FL) were recorded and compared between groups. RESULTS: The symptom scores had no difference before treatment(P > 0.05), and were better in the observation group than those in the control group after treatment(P < 0.05). At 2 weeks, 4 weeks, and 8 weeks after the treatment, the amelioration level of BUT, SIT, and FL indicators in the observation group was better than that of the control group(P < 0.05). CONCLUSION: Compared with the artificial tears treatment method, the TCM decoction combined with ear acupoint application can significantly ameliorate the tear film stability, tear secretion, and reduce ocular surface damage for dry eye patients.

Mechanism of PEDF promoting the proliferation of lens epithelial cells in human eyes

Objective:To investigate the regulation effect of pigment epithelium-derived factor(PEDF) on the growth of human lens endothelial cells(LECs) and related mechanisms in mm and in vim.Methods:In the part of in vivo study,82 eyes of 82 patients with age-related cataract were included to collect the central lens anterior capsule(diameter at 5.0 to 5.5 mm) with the informed consent of surgery for patients.The selected specimens were divided into the LECs low density group and high density group with 20 specimens for each group based on hematoxylin and eosin staining results.The relative expression level of PEDF mRNA in LECs was detected by reverse transcription PCR.In the part of in vitro study,LEC line(HLEB3) was cultured and 50 ng/mL PEDF was added in media for 72 h in PEDF culture group,while normally cultured cells were used as the control group.The percentage of LECs at G_0and S phases and apoptotic rate of cells were assayed by using flow cytometry with annexin V-FTTC/7-AAD double staining method.Intracellular expression of vascular endothelial growth factor(VEGF) mRNA was detected by real-time fluorescence quantitative PCR.Results:The central anterior subcapsular LECs density and relative expression level of PEDF mRNA were lower than those of high density group.There were no significant differences between two groups(P=0.168).The apoptotic rate in the PEDF culture group was significantly reduced in comparison with the control group(P<0.001).In addition,the expression level of VEGF mRNA was lower in the PEDF culture group compared with the control group(P<0.001).Conclusions:In human eyes,PEDF may function as cytotropic factor to promote survival of LECs through anti-apoptosis and reducing-expression of VEGF.Decrease of PEDF content in LECs probably modulates the pathophysiological process of lens cells and further cataractogenesis.

Our experience with smartphone and spherical lens for the eye fundus examination during humanitarian project in Africa

To present the experience of eye fundus photo documentation by using the plus 20 diopters spherical Volk lens and a smartphone with 4.2 Mpix camera and LED flash within the screening project of eye disorders in countries where the standard ophthalmology equipment is not available. Totally 241 patients underwent ophthalmology screening examination. The documentation of the eye fundus included patients with Burkitt lymphoma, Kala Azar, malnutrition with unknown etiology, tuberculosis, HIV positive patients, Usher syndrome and hypertension. This technique as an alternative way of screening will become a standard within examination of patients with eye disorders in outfield regions of developing countries.

STUDY OF ARTIFICIAL EYES HAVING HIGH STRENGTH AND LOW DENSITY

The artificial eyes having high strength, low density and naturalmovement, which are made from hydroxyapatite and bioactive glass havebeen utilized ef- fectively in clinic. The technology of compoundinghydrox- yapatite, melting bioactive glass and making he artificaleyes are stated in this paper. In animal test, the bioactivity andbiocompatibility of the material making the artificial eyes areexamined by histological observation, SEM XRD and electronic probe.At the same time, application of the artificial eyes in clinic arealso introduced.

Artificial intelligence,machine learning and deep learning for eye care specialists

Artificial intelligence(AI)methods have become a focus of intense interest within the eye care community.This parallels a wider interest in AI,which has started impacting many facets of society.However,understanding across the community has not kept pace with technical developments.What is AI,and how does it relate to other terms like machine learning or deep learning?How is AI currently used within eye care,and how might it be used in the future?This review paper provides an overview of these concepts for eye care specialists.We explain core concepts in AI,describe how these methods have been applied in ophthalmology,and consider future directions and challenges.We walk through the steps needed to develop an AI system for eye disease,and discuss the challenges in validating and deploying such technology.We argue that among medical fields,ophthalmology may be uniquely positioned to benefit from the thoughtful deployment of AI to improve patient care.

Review of eye diagnosis in traditional Chinese medicine:Modernization and future prospects

This article reviews the basic theories, methods, and clinical applications of eye diagnosis in traditional Chinese medicine(TCM). It introduces cutting-edge methods and applications and explains that the modernization of TCM eye diagnosis includes “equipment-assisted diagnosis” and “artificial intelligencebased diagnosis”. The article also notes that while there are many recent studies of the static attributes of eyes in modern TCM eye diagnosis, modern application research on the dynamic attributes of eyes in TCM diagnosis theory is relatively rare. We propose, therefore, that introducing advanced eye-movement detection technology into TCM clinical diagnosis could help to further modernize TCM eye diagnosis.

Randomized controlled trial on the efficacy and safety of autologous serum eye drops in dry eye syndrome

BACKGROUND Autologous serum eye drops(ASEDs),a novel treatment derived from blood serum,have emerged as a groundbreaking solution for managing dry eye syndrome(DES).These drops have shown significant promise in relieving the distressing symptoms of DES.This study aimed to evaluate the safety and effectiveness of ASEDs compared to traditional treatments,which often prove inadequate or result in unwanted side effects,particularly in individuals with moderate-to-severe DES.AIM To evaluate whether ASEDs are safer and more effective than conventional artificial tears in the treatment of moderate-to-severe DES.METHODS This multi-centered randomized controlled trial included 240 patients with moderate-to-severe DES from three ophthalmology clinics in China.They were randomly assigned to receive either ASEDs or artificial tears for 12 wk.The primary outcome was the change in the ocular surface disease index(OSDI)score,with secondary outcomes including tear break-up time(TBUT),Schirmer I test,corneal fluorescein staining(CFS),and conjunctival impression cytology(CIC).Statistics analysis was performed using an analysis of covariance with adjustments made for baseline values.RESULTS Our findings revealed that both ASEDs and artificial tears significantly improved the OSDI score,TBUT,Schirmer I test,CFS,and CIC from baseline to week 12.The ASEDs group showed significantly greater improvement in all these measures than the artificial tears group(all P values<0.05).The average difference in the OSDI score between the two cohorts was-10.3(95%confidence interval:-13.6 to-7.0),indicating a substantial improvement in the ASEDs group.The occurrence of adverse events was comparable between cohorts,with no reports of severe adverse events.CONCLUSION ASEDs are more effective and safer than artificial tears for mitigating symptoms of moderate-to-severe DES.ASEDs could be an alternative/supplementary therapy for patients with DES less responsive to traditional treatments.

Crosslinked hyaluronic acid with liposomes and crocin for management symptoms of dry eye disease caused by moderate meibomian gland dysfunction

AIM:To study the effect of uncrosslinked and crosslinked hyaluronic acid combined with other artificial tear components in patients with dry eye caused by moderate meibomian gland dysfunction.METHODS:Prospective,single-blind,contralateral eye study.Fifty eyes(25 patients)were analyzed.Eye selection for each tear type was random,and the eye drop formulations,0.4%uncrosslinked hyaluronic acid and 0.2%galactoxyloglucan(tear A)and 0.15%crosslinked hyaluronic acid,crocin,and liposomes(tear B)were used.The determined dosing schedule was three times a day for six weeks,and the study participants underwent a clinical examination before and 45 d after lubricant treatment.The Schirmer test,tear breakup time(TBUT)test,and Ocular Surface Disease Index(OSDI)questionnaire were applied before and after instillation period with both types of artificial tears.RESULTS:On the Schirmer test,a significant improvement was obtained with both tear A(P<0.01)and tear B(P<0.01).On the TBUT test,a significant improvement was obtained with tear A(P<0.01)and tear B(P<0.01).The OSDI score significantly decreased after instillation period with both artificial tear types(P<0.01).CONCLUSION:Uncrosslinked hyaluronic acid combined with other components,such as tamarind seed polysaccharide,and crosslinked hyaluronic acid combined with liposomes and crocin are effective for management symptoms of dry eye 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.

Selective laser trabeculoplasty in pseudophakic and phakic eyes:a prospective study

AIM：To compare the efficacy of selective laser trabeculoplasty（SLT） in replacing medical therapy in pseudophakic and phakic eyes.METHODS：Subgroup of a prospective randomized clinical trial including patients with primary open angle glaucoma or ocular hypertension controlled with medication.Of 38 pseudophakic eyes were matched with 38 phakic eyes.SLT was offered as a way to decrease medication while maintaining the same low eye pressure.SLT was performed over 360°,at 3ns,spotsize 400 μm,100 spots.Data [intraocular pressure（IOP）,number of medications needed] were measured at 1h,1wk,1,3,6 and 12 mo.An independent-samples t-test was performed to compare baseline characteristics of the phakic and the pseudophakic group and differences in evolution of mean IOP and number of used medications.Chi-squared analysis was performed to investigate proportions of fast,slow and non-responders.RESULTS：The mean IOP measurement was 13.00± 2.88 mm Hg in the phakic group（38 eyes） and 13.51±3.06 mm Hg in the pseudophakic group（38 eyes）（P〉0.05）.This changed little after SLT and IOP lowering effect was comparable between the two groups.Main aim however was to lower the amount of medication needed.In the phakic group medication lowered from 1.29±0.62 at baseline,to 0.15±0.46 after 12mo;a reduction of 88.37%.In the pseudophakic group,used medication changed from 1.71±1.04,to 0.41±0.61;a 76.02% reduction.The differences were not statistically significant at any time point（P〉0.05）.IOP lowering occurred slightly faster in thepseudophakic group（50% of patients after one week） than in the phakic group（68% of patients after more than 4wk）.The difference was not significant（P〉0.05）.CONCLUSION：IOP lowering effect of SLT is comparable between phakic and pseudophakic eyes.

Bioinspired lenses from cats' eyes

It is well known that cats have fascinating eyes with various colors,such as green,blue,and brown.In addition,they possess strong night vision ability,which can distinguish things clearly even in a poor light environment.These drive us to reveal the secrets behind them.In fact,cats’ eyes can be considered as special lenses(which we would like to mimic by using a Luneburg lens).We make an analysis of the role of photonic crystals behind the lens and demonstrate that the integration of photonic crystals into Luneburg lens can be regarded as a retroreflector and greatly improve the light focusing intensity of the lens in a broad band of frequencies.This wonderful bioinspired phenomenon is expected to design more interesting and serviceable devices by combining photonic crystals with transformation optics.

Simple and High-Efficiency Preparation Method of Biometric 3D Artificial Compound Eyes for Wide-Field Imaging

Three-dimensional(3D)artificial compound eyes(ACEs)are helpful for wide field-o-fview imaging and sensing system applications.However,existing batch preparation methods are technically challenging.A bio-inspired,simple,and high-efficiency batch preparation method is proposed,which involves bonding a sticky microlens array(MLA)polydimethylsiloxane(PDMS)film to an elastic PDMS hemisphere under pressure,followed by abrupt pressure removal.Characterizations from a scanning electron microscope and laser scanning confocal microscope show that 3D ACEs prepared using the proposed method have high numbers of uniformly distributed ommatidia with a high-quality finish.Furthermore,optical imaging investigations demonstrate that the proposed preparation method can achieve clear,distortionfree imaging with a wide field-of-view(up to 140.2°).

Hydrogel-based contact lens achieve prolonged,local drug delivery to the eye

With the support by the National Natural Science Foundation of China,the research group led by Prof.Jiang Gangbiao(蒋刚彪)at the Department of Pharmaceutical Engineering,College of Materials and Energy,South China Agricultural University,in collaboration with the research group led by Prof.Yuan

AI-Based Advanced Approaches and Dry Eye Disease Detection Based on Multi-Source Evidence:Cases,Applications,Issues,and Future Directions

This study explores the potential of Artificial Intelligence(AI)in early screening and prognosis of Dry Eye Disease(DED),aiming to enhance the accuracy of therapeutic approaches for eye-care practitioners.Despite the promising opportunities,challenges such as diverse diagnostic evidence,complex etiology,and interdisciplinary knowledge integration impede the interpretability,reliability,and applicability of AI-based DED detection methods.The research conducts a comprehensive review of datasets,diagnostic evidence,and standards,as well as advanced algorithms in AI-based DED detection over the past five years.The DED diagnostic methods are categorized into three groups based on their relationship with AI techniques:(1)those with ground truth and/or comparable standards,(2)potential AI-based methods with significant advantages,and(3)supplementary methods for AI-based DED detection.The study proposes suggested DED detection standards,the combination of multiple diagnostic evidence,and future research directions to guide further investigations.Ultimately,the research contributes to the advancement of ophthalmic disease detection by providing insights into knowledge foundations,advanced methods,challenges,and potential future perspectives,emphasizing the significant role of AI in both academic and practical aspects of ophthalmology.