Background diseases and the number of previous intravitreal aflibercept injections on immediate intraocular pressure increase and vitreous reflux rate in phakic eyes

●AIM:To evaluate the effect of background diseases and number of previous intravitreal aflibercept injections(IVAIs)on immediate intraocular pressure(IOP)increase and vitreous reflux(VR)rate and to evaluate the correlation of both age and axial length with immediate IOP increase and VR rate.●METHODS:This study included 105 patients with cystoid macular edema secondary to retinal vein occlusion,35 patients with diabetic macular edema,69 patients with neovascular age-related macular degeneration(nAMD),and 12 patients with myopic choroidal neovascularization,which underwent first-time IVAI.The correlation of immediate IOP increase and VR rates with the four background diseases was investigated.Moreover,the correlation of age with immediate IOP increase and VR rate as well as correlation of axial length with immediate IOP increase and VR rate were evaluated.Further,54 patients with nAMD were treated with IVAI>10 times(multiple IVAIs).Moreover,the correlation of immediate IOP increase and VR rates with first-time and multiple IVAIs in nAMD was determined.●RESULTS:The immediate IOP increase(P=0.16)and VR rates(P=0.50)were almost similar among the four background diseases.The immediate postinjection IOP and age,VR rate and age,immediate postinjection IOP and axial length,or VR rate and axial length were not correlated in the four background diseases.The immediate IOP increase(P=0.66)and VR rates(P=0.28)did not significantly differ between first-time and multiple IVAIs in nAMD.●CONCLUSION:Background diseases and number of previous IVAIs have no effect on immediate IOP increase and VR rate.Further,age and axial length have no correlation on immediate IOP increase and VR rate.

Macular hole closure following anti-vascular endothelial growth factor injection in an eye with myopic choroidal neovascularization

Dear Editor,I am Cheolmin Yun,from the Department of Ophthalmology,Korea University College of Medicine.I write to present a case report of a female patient with a myopic patient suffering from atrophic choroidal neovascularization（CNV）and a full thickness macular hole（FTMH）,who was treated with an intravitreal anti-vascular endothelial growth factor （VEGF） injection without vitrectomy.

Retinal injury following intravitreal injection of a dexamethasone implant in a vitrectomized eye

Lee SM, Jung JW, Park SW, Lee JE, Byon IS. Retinal injury following intravitreal injection of a dexamethasone implant in a vitrectomized eye. Int J Ophthalmo12017; 10（6）： 1019-1020

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.

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.

Numerical Simulation of Asphaltene Precipitation and Deposition during Natural Gas and CO_(2) Injection

Asphaltene deposition is a significant problem during gas injection processes,as it can block the porous medium,the wellbore,and the involved facilities,significantly impacting reservoir productivity and ultimate oil recovery.Only a few studies have investigated the numerical modeling of this potential effect in porous media.This study focuses on asphaltene deposition due to natural gas and CO_(2) injection.Predictions of the effect of gas injection on asphaltene deposition behavior have been made using a 3D numerical simulation model.The results indicate that the injection of natural gas exacerbates asphaltene deposition,leading to a significant reduction in permeability near the injection well and throughout the reservoir.This reduction in permeability strongly affects the ability of gas toflow through the reservoir,resulting in an improvement of the displacement front.The displacement effi-ciency of the injection gas process increases by up to 1.40%when gas is injected at 5500 psi,compared to the scenario where the asphaltene model is not considered.CO_(2) injection leads to a miscible process with crude oil,extracting light and intermediate components,which intensifies asphaltene precipitation and increases the viscosity of the remaining crude oil,ultimately reducing the recovery rate.

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.

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.

A Study of Pharmacist-Patient Communication: Examining Optimal Distance and Angle Using an Eye-Tracking System

This study focuses on seating arrangement and interpersonal distance as important aspects of nonverbal communication and aims to elucidate the optimal distance and angle between pharmacist and patient through an analysis based on the subjective evaluation of the patient and the objective evaluation of eye movements. Seven female simulated patients and one male and one female pharmacist cooperated as patients and pharmacists, respectively. The medication teaching scenes were set up with three pharmacist placements (face-to-face at 50 cm and 70 cm, 90-degree at 70 cm) and three hospital rooms (0-degree, 45-degree, 90-degree). Pupil diameter, blink rate, saccades, and fixation rate of the patient at each of these locations were measured using a Tobii Pro Glass 2. The patient’s subjective evaluation at each placement was also investigated using the conversation scale, which assesses the optimal distance for conversation. The results for the pharmacy setting revealed that pupils were significantly more mydriatic at the 50 cm point than at the other points. The results for the hospital room setting showed the greatest mydriasis at the 0-degree point. The result of the 50 cm point for the pharmacy setting and the 0-degree point for the hospital room setting was similar to that of the subjective evaluation. When the likelihood of saccades occurrence in the hospital room setting was compared, saccades were found to be most likely to occur when medication instructions were given to patients at the 0-degree point. We believe that using pupil diameter for interpersonal distance, and saccades for angle will enable more accurate determinations of the optimal distance and angle between pharmacist and patient. The results of the present study suggest that the 70 cm face-to-face point in the pharmacy and the 45-degree point in the ward may be suitable for medication instruction.

Shenqi Fuzheng injection alleviates chemotherapy-induced cachexia by restoring glucocorticoid signaling in hypothalamus

Chemotherapy-induced cachexia(CIC)is a debilitating condition characterized by weight loss,muscle atrophy,and anorexia[1].While peripheral mechanisms of cachexia have been extensively studied,the involvement of the central nervous system(CNS)in CIC is often overlooked.Chemotherapeutic drugs cause stress responses and inflammation,which may impact the hypothalamus and disrupt systemic energy and neuroendocrine functions.Understanding hypothalamic roles in regulating these processes can provide insights into CIC's mechanisms and aid in developing novel therapies.

Associations between thyroid function and autoimmunity indicators and in vitro fertilization/intracytoplasmic sperm injection outcomes in euthyroid PCOS women

To the Editor:Polycystic ovary syndrome(PCOS),characterized by oligo-anovulation,hyperandrogenism,and polycystic ovaries,is the most common endocrinopathy affecting 5-15%of women of reproductive age.[1,2]It can result in a wide range of endocrine and metabolic disorders,including anovulatory infertility,insulin resistance,impaired glucose tolerance,diabetes,obesity,dyslipidemia,and cardiovascular disease,which can occur in different combinations and with different intensities.

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.

Treatment of SMA type 1 infants using a single-dose AAV9-mediated gene therapy via intrathecal injection of GC101:An open-label,single-arm study

Spinal muscular atrophy(SMA),a neurodegenerative disorder caused by mutations in survival motor neuron 1(SMN1)resulting in reduced expression of the survival motor neuron(SMN)protein,is inherited in an autosomal recessive manner.SMA type 1 is the most frequent subtype of SMA characterized by onset before 6 months of life,inability to achieve independent sitting,and rapidly progressive respiratory and bulbar deterioration,causing a mortality of>90%before 2 years of age.[1]Currently,there have been two lifelong splice-modifying therapies(nusinersen and risdiplam),and a single-dose gene replacement therapy via intravenous onasemnogene abeparvovec for SMA type 1 patients.

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.

Does HSP27 injection induce glaucoma damage in mice?

In a further aging society,excellent eyesight is an integral part of overall well-being and quality of life.Preserving good vision is crucial to maintaining mobility,independence,and mental health.There can be several reasons for visual impairment in elderly people,these include age-related macular degeneration,the leading cause of vision loss among older adults,cataract,glaucoma,diabetic retinopathy,retinal detachment,and others.

Tofacitinib combined with local low-dose ixekizumab injection benefits those with peripheral psoriatic arthritis

Dear Editor,Treating psoriatic arthritis(PsA)is always difficult.Systemic treatments can be administered either orally or through intramuscular and intra-articular injection,including conventional synthetics,biologics and targeted synthetic disease-modifying antirheumatic drugs[1].The alternatives,topical external therapies,are not effective on joint lesions due to drug permeability issues.Drugs injected into the articular cavity are also unsuitable for small peripheral joint lesions,the most common manifestations of PsA.The limited treatment options for PsA present a challenge.

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.

Distribution of pathogenic bacteria and antimicrobial sensitivity of eye infections in Suzhou

AIM:To investigate the types of bacteria in patients with eye infections in Suzhou and their drug resistance to commonly used antibacterial drugs.METHODS:The clinical data of 155 patients were retrospectively collected in this study,and the pathogenic bacteria species and drug resistance of each pathogenic bacteria were analyzed.RESULTS:Among the 155 patients(age from 12 to 87 years old,with an average age of 57,99 males and 56 females)with eye infections(160 eyes:74 in the left eye,76 in the right eye and 5 in both eyes,all of which were exogenous),71(45.81%)strains were gram-positive bacteria,23(14.84%)strains were gram-negative bacteria and 61(39.35%)strains were fungi.Gram-positive bacteria were highly resistant to penicillin and erythromycin(78.87%and 46.48%respectively),but least resistant to vancomycin at 0.Gram-negative bacteria were highly resistant to cefoxitin and compound sulfamethoxazole(100%and 95.65%respectively),but least resistant to meropenem at 0.Comparison of the resistance of gram-positive and gram-negative bacteria to some drugs revealed statistically significant differences(P<0.05)in the resistance of both to cefoxitin,cotrimoxazole,levofloxacin,cefuroxime,ceftriaxone and ceftazidime,and both had higher rates of resistance to gram-negative bacteria than to gram-positive bacteria.The distribution of bacterial infection strains showed that Staphylococcus epidermidis was the most common strain in the conjunctiva,cornea,aqueous humor or vitreous body and other eye parts.Besides,Fusarium and Pseudomonas aeruginosa were also among the most common strains of conjunctival and corneal infections.CONCLUSION:Gram-positive bacteria are the dominant bacteria in eye infections,followed by gram-negative bacteria and fungi.Considering the resistance of gramnegative bacteria to multiple drugs,monitoring of bacteria should be strengthened in eye bacterial infections for effective prevention and control to reduce complications caused by eye infections.