Role of short-wavelength filtering lenses in delaying myopia progression and amelioration of asthenopia in juveniles

AIM： To evaluate the positive effects of blue-violet light filtering lenses in delaying myopia and relieving asthenopia in juveniles. METHODS： Sixty ametropia juveniles （aged range, 11-15y） were randomized into two groups： the test group （30 children, 60 eyes）, wearing blue-violet light filtering lenses; and the control group （30 children, 60 eyes）, wearing ordinary aspherical lenses. Baseline refractive power of the affected eyes and axial length of the two groups was recorded. After 1-year, the patients underwent contrast sensitivity （glare and non-glare under bright and dark conditions）, accommodation-related testing, asthenopia questionnaire assessment, and adverse reaction questionnaire assessment. RESULTS： After ly of wearing the filtering lenses, changes in refractive power and axial length were not significantly different between the two groups （P〉0.05）. Under bright conditions, the contrast sensitivities at low and medium- frequency grating （vision angles of 6.3, 4.0, and 2.5） with glare in the test group were significantly higher than in the control group （P〈0.05）, while the contrast sensitivity at low-frequency grating （vision angles of 6.3 and 4.0） in the absence of glare in the test group was higher than in the control group （P〈0.05）. Under glare and non-glare dark conditions, the contrast sensitivities of various frequencies in the test group did not show significant differences compared with those in the control group （P〉0.05）. In the test group, the amplitude of accommodation, accommodative lag, and accommodative sensitivity of patients wearing glasses for 6 and 12mo were significantly elevated （P〈0.05）, while the asthenopia gratings were significantly decreased （P〈0.05）. Nevertheless, in the control group,the amplitude of accommodation, accommodative lag, and accommodative sensitivity after 12mo were not significantly altered compared with baseline （P〉0.05）, and the asthenopia grating was not significantly decreased （P〉0.05）. In addition, after wearing glasses for 6 to 12mo, the asthenopia grating of patients in the test group decreased significantly compared with the control group （P〈0.05）. At 12mo, the constituent ratio of adverse reactions did not show significant difference between the two groups （P〉0.05）. CONCLUSION： A l-year follow-up reveal that compare with ordinary glasses, short-wavelength filtering lenses （blue/ violet-light filters） increase the low- and medium-frequency contrast sensitivity under bright conditions and improved accommodation. They effectively relieved asthenopia without severe adverse reactions, suggesting potential for clinical application. However, no significant advantages in terms of refractive power or axial length progression were found compared with ordinary aspheric lenses.

Low color temperature artificial lighting can slow myopia development: Long-term study using juvenile monkeys

The incidence of myopia has increased rapidly in recent decades, suggesting that environmental factors, such as light,may be an important cause. Correlated color temperature(CCT) is a commonly used index to quantify the spectral composition of light. Here, we used 32 juvenile monkeys(16 females and 16 males) and selected four kinds of light with typical but different CCTs to study the relationship between CCT and ocular axial elongation.

Clinical Observation on the Prevention and Treatment of Juvenile Mild Myopia with Traditional Chinese Medicine Comprehensive Therapy

Objective:To observe the clinical effect of traditional Chinese medicine on the prevention and treatment ofjuvenile mild myopia.Methods:One hundred and twenty cases of juvenile mild myopia were randomly divided into six groups,with 20 cases in each group:western medicine group,ultrasonic group,acupuncture group,auricular point group,traditional Chinese oral decoction group,and traditional Chinese medicine comprehensive therapy group.The therapeutic effects of the treatment administered to the six groups were compared.Result:In the post-treatment and follow-up stages,the visual acuity of the traditional Chinese medicine comprehensive therapy group significantly improved along with reduced diopter compared to the other groups(p<0.05).However,the axial length of the six groups had no significant change compared with that before treatment(p>0.05).There were no adverse reactions in any of the patients.Conclusion:In the treatment of juvenile mild myopia,traditional Chinese medicine comprehensive therapy has good therapeutic effect without any adverse reactions;thus,it is worthy of clinical promotion.

OBSERVATION ON THERAPEUTIC EFFECTS OF EAR-ACUPOINT-PRESSURE TREATMENT ON 102 CASES OF JUVENILE MYOPIA

Ear-Acupoint-Pressure therapy has beenadopted to treat myopia in juvenile and youthpatients in our clinic since 1987 and satisfactorytherapeutic results have been obtained. It issummarized as follows:CLINICAL DATAAmong the 102 patients observed, 43 caseswere male, 59 cases female; 53 cases were be-tween 6 and 12 years; 38 cases were between 13and 19 years; 11 cases were between 20 and

Clinical Observation on Juvenile Macular Hole without Trauma and Hypermyopia

Purpose: To investigate the clinical characteristics of juvenile macular hole without trauma and hypermyopia, and research the mechanism of macular hole.Methods: Sixty-seven patients less than 40 years of age were studied retrospectively from June 1998 to March 2003. Five cases (7 eyes) aged from 22 to 38 years were reported and the clinical characteristics that had macular hole without trauma or hypermyopia were summed up.Results: There was 1 male and 4 females with visual acuity from 0.08 to 0.8. The images of optical coherence tomography (OCT) showed full thickness macular hole in 5 patients (7 eyes), and the diameters were from 87 to 1043 μm. Among them, 2 cases were combined with retina pigmentosa; 1 case with binocular Coat's disease; 1 case had bilateral macular hole combined with Eagles' disease; 1 case was combined with 2-2.5PD old retinochoroidal lesion under middle-peripheral fundus, and 1.5 PD retinal pigment epithelium (RPE) defect on the optical disk.Conclusion: The juvenile macular hole without trauma and hypermyopia combined the different retina vascular damages and the RPE defects.

Retardation of myopia by atropine regimes

Myopia is a huge health problem due to its high frequency,vision losses and public health cost.According to the World Health Organization,at least 2.2 billion people have vision impairment.Although myopia can be controlled at its early and middle stages,unfortunately,no cure can be achieved so far.Among the methods to control myopia,atropine,a muscarinic receptor antagonist,is the oldest but still the most effective for retardation of myopia progression.Despite such a fact,standard protocols have not been established for clinicians to use atropine for treatment of myopia.In this article,a concise and up to date summary of myopia epidemiology and pathogenesis and summarized therapeutic effects and side effects,possible mechanisms and application methods of atropine were provided in hope for clinical doctors to effectively control this problematic disease.At present,the protocol is recommend:use higher dose(1%)of atropine intermittently to effectively slowdown myopia progression in schoolchildren for 2y,and to significantly reduce side effects of atropine by decrease of atropine frequency for 1y and inhibit myopic rebound by withdrawal of topical atropine gradually for 1y.Application of a lower dose(0.05%)atropine regime should also be considered due to its effectiveness and application at regular basis.

A review of mechanism of action of outdoor exposure in preventing myopia incidence and progression

Various studies have suggested several environmental,pharmacological,medical,and optical interventions and some are in use but their efficacy in myopia control may be transient,and the cellular,molecular,and biochemical mechanisms involved unclear.Daylight exposure is currently regarded as an effective and enduring strategy in the control of myopia development and progression.However,the mechanism behind the effect of outdoor exposure and its association with genetic predisposition and other relatively more significant environmental factors on myopia is still a conundrum.This review focuses on survey-based and intervention-based studies carried out to propose a mechanism that accounts for myopia development and important for its control.

The optimal atropine concentration for myopia control in Chinese children: a systematic review and network Metaanalysis

AIM:To figure out whether various atropine dosages may slow the progression of myopia in Chinese kids and teenagers and to determine the optimal atropine concentration for effectively slowing the progression of myopia.METHODS:A systematic search was conducted across the Cochrane Library,PubMed,Web of Science,EMBASE,CNKI,CBM,VIP,and Wanfang database,encompassing literature on slowing progression of myopia with varying atropine concentrations from database inception to January 17,2024.Data extraction and quality assessment were performed,and a network Meta-analysis was executed using Stata version 14.0 Software.Results were visually represented through graphs.RESULTS:Fourteen papers comprising 2475 cases were included;five different concentrations of atropine solution were used.The network Meta-analysis,along with the surface under the cumulative ranking curve(SUCRA),showed that 1%atropine(100%)>0.05%atropine(74.9%)>0.025%atropine(51.6%)>0.02%atropine(47.9%)>0.01%atropine(25.6%)>control in refraction change and 1%atropine(98.7%)>0.05%atropine(70.4%)>0.02%atropine(61.4%)>0.025%atropine(42%)>0.01%atropine(27.4%)>control in axial length(AL)change.CONCLUSION:In Chinese children and teenagers,the five various concentrations of atropine can reduce the progression of myopia.Although the network Meta-analysis showed that 1%atropine is the best one for controlling refraction and AL change,there is a high incidence of adverse effects with the use of 1%atropine.Therefore,we suggest that 0.05%atropine is optimal for Chinese children to slow myopia progression.

One-year results for myopia control of orthokeratology with different back optic zone diameters: a randomized trial using a novel multispectral-based topographer

AIM:To present the 1-year results of a prospective cohort study investigating the efficacy,potential mechanism,and safety of orthokeratology(ortho-k)with different back optic zone diameters(BOZD)for myopia control in children.METHODS:This randomized clinical study was performed between Dec.2020 and Dec.2021.Participants were randomly assigned to three groups wearing ortho-k:5 mm BOZD(5-MM group),5.5 mm BOZD(5.5-MM group),and 6 mm BOZD(6-MM group).The 1-year data were recorded,including axial length,relative peripheral refraction(RPR,measured by multispectral refractive topography,MRT),and visual quality.The contrast sensitivity(CS)was evaluated by CSV-1000 instrument with spatial frequencies of 3,6,12,and 18 cycles/degree(c/d);the corneal higher-order aberrations(HOAs)were measured by iTrace aberration analyzer.The one-way ANOVA was performed to assess the differences between the three groups.The correlation between the change in AL and RPR was calculated by Pearson’s correlation coefficient.RESULTS:The 1-year results of 20,21,and 21 subjects in the 5-MM,5.5-MM,and 6-MM groups,respectively,were presented.There were no statistical differences in baseline age,sex,or ocular parameters between the three groups(all P>0.05).At the 1-year visit,the 5-MM group had lower axial elongation than the 6-MM group(0.07±0.09 vs 0.18±0.11 mm,P=0.001).The 5-MM group had more myopic total RPR(TRPR,P=0.014),with RPR in the 15°–30°(RPR 15–30,P=0.015),30°–45°(RPR 30–45,P=0.011),temporal(RPR-T,P=0.008),and nasal area(RPR-N,P<0.001)than the 6-MM group.RPR 15–30 in the 5.5-MM group was more myopic than that in the 6-MM group(P=0.002),and RPR-N in the 5-MM group was more myopic than that in the 5.5-MM group(P<0.001).There were positive correlations between the axial elongation and the change in TRPR(r=0.756,P<0.001),RPR 15–30(r=0.364,P=0.004),RPR 30–45(r=0.306,P=0.016),and RPR-N(r=0.253,P=0.047).The CS decreased at 3 c/d(P<0.001),and the corneal HOAs increased in the 5-MM group(P=0.030).CONCLUSION:Ortho-k with 5 mm BOZD can control myopia progression more effectively.The mechanism may be associated with greater myopic shifts in RPR.

Efficacy and safety of traditional Chinese medicine external interventions in juvenile myopia: A systematic review and meta-analysis

Background:Myopia is a common refractive error that is increasingly prevalent amongst young individuals.Preventing and controlling myopia is crucial due to its association with several complications such as myopic macular degeneration,glaucoma,and retinal detachment.Objective:The aim of this study is to systematically evaluate the efficacy of external Chinese medicine therapies in the treatment of adolescent myopia.Methods:We performed a systematic search of the Chinese National Knowledge Infrastructure(CNKI),PubMed,the Cochrane Library,Science Direct,WanFang,the Weipu Database(VIP),China Biology Medicine(CMB),Web of Science(WOS),Medline,Clinical Trials,the Chinese Science Citation Database(CSCD),and the Bailian Yun Library databases from January 2012 to December 2022 to identify the randomized control trials(RCTs)that compared traditional Chinese medicine(TCM)external therapies with conventional therapies for the treatment of juvenile myopia.Two independent reviewers conducted the screening process,data extraction,and quality assessment.A meta-analysis was then conducted.Results:A total of 1735 relevant articles were retrieved.We included 38 RCTs involving 3680 patients and 7250 eyes that used TCM external therapies for the intervention of juvenile myopia.The results of the metaanalysis showed that the efficacy of TCM external therapies in preventing and controlling myopia was statistically significant compared with conventional therapies[odds ratio(OR)=3.72,95%CI(2.87,4.83),P<0.01],and a funnel plot showed the basic symmetry.The meta-analysis results showed that compared with conventional therapies,TCM external therapies had statistically significant effects on the spherical equivalent[weighted mean difference(WMD)=0.22,95%CI(0.16,0.27),P<0.01],visual acuity[WMD=0.09,95%CI(0.07,0.12),P<0.01],and axial length[standardized mean difference(SMD)=0.19,95%CI(0.07,0.31),P<0.01].Conclusion:Results showed that TCM external therapies can be an effective intervention in preventing and controlling adolescent myopia.However,more large-scale,multicenter,double-blind,and long-term RCTs are needed to validate these results.

Effects of different orthokeratology lens designs on slowing axial length elongation in children with myopia

AIM:To elucidate whether differences exist in the impact on retarding the elongation of axial length(AL)among children with myopia when utilizing orthokeratology(ortho-k)lenses employing the corneal refractive therapy(CRT)design versus those employing the vision shaping treatment(VST)design.METHODS:This retrospective clinical trial aimed to collect and analyze AL data from individuals who wore ortho-k lenses for three years.A total of 654 subjects were enrolled and prescribed one of the three specific brands of ortho-k lenses:CRT,Euclid,and Mouldway.The study’s primary focus was to compare the rates of AL elongation and myopic progression across these three brands of ortho-k lenses.RESULTS:In the 3-year follow-up,the AL elongation exhibited variations of 0.73±0.36 mm in the CRT lens group,0.59±0.37 mm in the Euclid lens group,and 0.63±0.38 mm in the Mouldway lens group.A noteworthy disparity emerged between the CRT and Mouldway groups(P<0.01),as well as between the CRT and Euclid groups(P<0.001).Additionally,it was observed that 32.1%of participants who wore CRT lenses experienced a decelerated progression of myopia,in contrast to 47.2%in the Euclid group and 44.4%in the Mouldway group.Statistical analyses revealed a statistically significant distinction between the CRT and Euclid groups(P<0.01),and similarly,the CRT group demonstrated a statistically significant difference when compared to the Mouldway group(P<0.05).CONCLUSION:Ortho-k lenses represent a pragmatic strategy for mitigating the advancement of myopia.In contradistinction to ortho-k lenses utilizing the CRT design,those employing the VST design exhibited a more favorable impact regarding retarding AL elongation.

Bibliometric analysis of hotspots and trends of global myopia research

AIM:To gain insights into the global research hotspots and trends of myopia.METHODS:Articles were downloaded from January 1,2013 to December 31,2022 from the Science Core Database website and were mainly statistically analyzed by bibliometrics software.RESULTS:A total of 444 institutions in 87 countries published 4124 articles.Between 2013 and 2022,China had the highest number of publications(n=1865)and the highest H-index(61).Sun Yat-sen University had the highest number of publications(n=229)and the highest H-index(33).Ophthalmology is the main category in related journals.Citations from 2020 to 2022 highlight keywords of options and reference,child health(pediatrics),myopic traction mechanism,public health,and machine learning,which represent research frontiers.CONCLUSION:Myopia has become a hot research field.China and Chinese institutions have the strongest academic influence in the field from 2013 to 2022.The main driver of myopic research is still medical or ophthalmologists.This study highlights the importance of public health in addressing the global rise in myopia,especially its impact on children’s health.At present,a unified theoretical system is still needed.Accurate surgical and therapeutic solutions must be proposed for people with different characteristics to manage and intervene refractive errors.In addition,the benefits of artificial intelligence(AI)models are also reflected in disease monitoring and prediction.

Age-specific distribution of oculometric parameters and myopia in children aged 8-12y

AIM:To describe the distribution of ocular biometrics and to evaluate its associations with refractive error and to assess the contribution from ocular parameters to refractive error among Chinese myopic children.METHODS:This cross-sectional study evaluated subjects aged 8-12y.Keratometry,ocular biometry,and cycloplegic autorefraction were performed on each subject.Spherical equivalent refraction(SER)and ocular biometrics were assessed as a function of age and gender.The Pearson correlation analysis between SER and ocular biometrics was carried out.Multiple linear regression was performed to analyze the association between SER and ocular parameters.RESULTS:A total of 689 out of 735 participants(321 boys,48.1%)were analyzed,with a mean SER of-2.98±1.47 diopter(D).Axial length(AL),anterior chamber depth(ACD),corneal radius of curvature(CR),horizontal visible iris diameter(HVID),central corneal thickness(CCT)and lens power(LP)showed normal distribution.The AL,AL/CR ratio,ACD and CR increased from 8 to 12y of age,while SER and LP decreased,HVID and CCT remained stable.There was no difference in gender.SER decreased by 0.929 D for every 1 mm increase in AL and decreased by 1.144 D for every 0.1 increase in AL/CR ratio.The Pearson correlation coefficient between SER and AL was-0.538(P<0.01)and-0.747(P<0.01)between SER and AL/CR ratio.For the SER variance,AL explained 29.0%,AL/CR ratio explained 55.7%,while AL,CR,ACD and LP explained 99.3%after adjusting for age and gender.CONCLUSION:The AL,CR,ACD and LP are the most important determinants of myopic refractive error during myopia progression.

Ocular surface in patients with different degrees of myopia

AIM:To investigate the clinical features of the ocular surface in patients with different degrees of myopia.METHODS:A cross-sectional study was conducted involving 122 participants with myopia in Beijing Tongren Hospital from February to June,2023.After completing the Ocular Surface Disease Index(OSDI)score scale,measurements were taken for refraction,biometric parameters and ocular surface parameters.The prevalence,severity and related parameters of the dry eye among different groups based on axial length(AL)were compared.Correlation analysis was performed between ocular surface parameters and refraction/biometric measurement parameters.RESULTS:Statistically significant differences were observed in refractive error,corneal thickness,anterior chamber depth,and subfoveal choroidal thickness among the groups(all P<0.05).With the increase in AL,the incidence and severity of dry eye increased significantly(P<0.05).Moreover,the tear film break-up time(BUT)shortened(P<0.05),and the corneal fluorescein staining(CFS)points increased significantly(P<0.05).OSDI scores were positively correlated with AL and spherical equivalent(SE;both P<0.05);BUT was negatively correlated with AL,SE,and corneal astigmatism(AST;all P<0.05);Schirmer I test(SIT)results were negatively correlated with AL and SE(both P<0.05).CONCLUSION:AL elongation is a risk factor for dry eye onset in myopic participants.The longer the AL,the more severe the dry eye is,with the increased CFS spots and tear film instability.Additionally,SE and AST exhibit negative correlations with dry eye symptom scores and ocular surface parameters.

Covering corneal stromal lenticule for macular hole in pathological myopia

AIM:To evaluate the clinical effect of a new surgery technique(covering corneal stromal lenticule,CSL)for macular hole(MH)in pathological myopia.METHODS:This was a prospective non-randomized series case study.Fourteen eyes of 14 patients whose axial length were more than 29 mm and suffered from MH and macular hole retinal detachment(MHRD)were included in this study.All cases were treated with 25-gauge pars plana vitrectomy(PPV)with internal limiting membrane(ILM)peeling,covering CSL and C_(3)F_(8) gas tamponade.These cases were followed for 6mo,and the best-corrected visual acuity(BCVA),healing status of MH,the reattached rate of retinal detachment(RD),and reoperation rate were analyzed.RESULTS:All cases were successfully performed the surgery and the postoperative follow-up was completed.After surgery,MHs were healed in all 14 eyes(100%,14/14)after assessed by optical coherence tomography.The reattachment of retina was achieved in all 6 eyes(100%,6/6)with MHRD.BCVA was improved in 12 eyes(85.71%,12/14),and had no significant change in 2 eyes(14.29%,2/14).The overall mean BCVA was improved from 1.80±0.77 to 0.82±0.46 logMAR(F=10.46,P<0.01).No serious complications occurred in all cases.CONCLUSION:The new surgery technique(covering CSL)has high reattached rate of RD and high healing rate of MH in pathological myopia in the preliminary study.And it can effectively improve the visual function of patients.This new technique offers meaningful new ideas for treating refractory MH in pathological myopia.

Effect of artificial natural light on the development of myopia among primary school-age children in China:a three-year longitudinal study

AIM:To assess the efficacy of artificial natural light in preventing incident myopia in primary school-age children.METHODS:This is a prospective,randomized control,intervention study.A total of 1840 students from 39 classes in 4 primary schools in Foshan participated in this study.The whole randomization method was adopted to include classes as a group according to 1:1 randomized control.Classrooms in the control group were illuminated by usual light,and classrooms in the intervention group were illuminated by artificial natural light.All students received uncorrected visual acuity and best-corrected visual acuity measurement,non-cycloplegic autorefraction,ocular biometric examination,slit lamp and strabismus examination.Three-year follow-up,the students underwent same procedures.Myopia was defined as spherical equivalent refraction≤-0.50 D and uncorrected visual acuity<20/20.RESULTS:There were 894 students in the control group and 946 students in the intervention group with a mean±SD age of 7.50±0.53y.The three-year cumulative incidence rate of myopia was 26.4%(207 incident cases among 784 eligible participants at baseline)in the control group and 21.2%(164 incident cases among 774 eligible participants at baseline)in the intervention group[difference of 5.2%(95%CI,3.7%to 10.1%);P=0.035].There was also a significant difference in the three-year change in spherical equivalent refraction for the control group(-0.81 D)compared with the intervention group[-0.63 D;difference of 0.18 D(95%CI,0.08 to 0.28 D);P<0.001].Elongation of axial length was significantly different between in the control group(0.77 mm)and the intervention group[0.72 mm;difference of 0.05 mm(95%CI,0.01 to 0.09 mm);P=0.003].CONCLUSION:Artificial natural light in the classroom of primary schools can result in reducing incidence rate of myopia during a period of three years.

Multi-class classification of pathological myopia based on fundus photography

Pathological myopia(PM)is a severe ocular disease leading to blindness.As a traditional noninvasive diagnostic method,fundus color photography(FCP)is widely used in detecting PM due to its highfidelity and precision.However,manual examination of fundus photographs for PM is time-consuming and prone to high error rates.Existing automated detection technologies have yet to study the detailed classification in diagnosing different stages of PM lesions.In this paper,we proposed an intelligent system which utilized Resnet101 technology to multi-categorically diagnose PM by classifying FCPs with different stages of lesions.The system subdivided different stages of PM into eight subcategories,aiming to enhance the precision and efficiency of the diagnostic process.It achieved an average accuracy rate of 98.86%in detection of PM,with an area under the curve(AUC)of 98.96%.For the eight subcategories of PM,the detection accuracy reached 99.63%,with an AUC of 99.98%.Compared with other widely used multi-class models such as VGG16,Vision Transformer(VIT),EfficientNet,this system demonstrates higher accuracy and AUC.This artificial intelligence system is designed to be easily integrated into existing clinical diagnostic tools,providing an efficient solution for large-scale PM screening.

Effectivity and safety of trifocal intraocular lenses and capsular tension rings implantation for cataract patients with axial high myopia

●AIM:To assess effectivity and safety of trifocal intraocular lenses(IOLs)and capsular tension rings in treating cataract patients with axial high myopia.●METHODS:A prospective nonrandomized controlled clinical trial was conducted.Totally 98 eyes(74 patients)who underwent femtosecond laser-assisted cataract surgery(FLACS)with trifocal IOLs were enrolled in the study and followed up for 2y after surgery:46 eyes(33 patients)with capsular tension ring implantation in the long axial lengths(AL)group(26<AL<29 mm)and 52 eyes(41 patients)in the normal AL group(22<AL<24.5 mm).Postoperative outcomes about effectivity and safety,including the subjective and objective visual quality,and postoperative complications were assessed.●RESULTS:Uncorrected distance visual acuity at 5 m and uncorrected intermediate visual acuity at 60 and 80 cm in the long AL group were significantly worse than those in the normal AL group at 3mo postoperatively(P<0.05).The differences in reading speed,spectacle independence and potential visual complaints between the two groups were not statistically significant(P>0.05).The dysfunctional lens index and total modulation transfer function(MTF)average height were similar between the two groups.The postoperative internal coma aberrations in the axial high myopia eyes were significantly higher than that in the normal AL group(P<0.05).The total satisfaction score in the long AL group(91.32±2.76)was slightly higher than that in the normal AL group(90.36±3.47),but there was no difference(P=0.136).A statistically negative correlation was found between corrected distance visual acuity(CDVA)and dysfunctional lens index(r=-0.382,P=0.009),and between CDVA and the total MTF average height(r=-0.374,P=0.01).But there was no significant correlation between CDVA and total satisfaction score(r=0.059,P=0.696).Postoperative complications mainly presented as posterior capsular opacity(PCO),retinal detachment and cystoid macular edema.There was no difference in the incidence of fundus disease(6.5%vs 3.8%,P=0.663)or PCO(17.4%vs 7.7%,P=0.217)between the two groups at two years.●CONCLUSION:The utilization of trifocal IOL and capsular tension ring implantation is beneficial for cataract patients with axial high myopia undergoing FLACS.This approach not only ensures excellent subjective feelings and objective visual quality,but also does not increase the incidence of postoperative complications.

Early changes in corneal densitometry after FS-LASIK combined with accelerated corneal cross-linking for correction of high myopia

AIM:To observe the effects of femtosecond laserassisted excimer laser in situ keratomileusis combined with accelerated corneal cross-linking(FS-LASIK Xtra)on corneal densitometry after correcting for high myopia.METHODS:In this prospectively study,130 patients underwent FS-LASIK or FS-LASIK Xtra for high myopia.Their right eyes were selected for inclusion in the study,of which 65 cases of 65 eyes in the FS-LASIK group,65 patients with 65 eyes in the FS-LASIK Xtra group.Patients were evaluated for corneal densitometry at 1,3,and 6mo postoperatively using Pentacam Scheimpflug imaging.RESULTS:Preoperative differences in corneal densitometry between the FS-LASIK and FS-LASIK Xtra groups in different ranges were not statistically significant(P>0.05).Layer-by-layer analysis revealed statistically significant differences in the anterior(120μm),central,and total layer corneal densitometry between the FS-LASIK and FS-LASIK Xtra groups at 1 and 3mo postoperatively(all P<0.05),the FS-LASIK Xtra group is higher than that of the FS-LASIK group.Analysis of different diameter ranges showed statistically significant differences between the FS-LASIK group and the FS-LASIK Xtra group at 1mo postoperatively in the ranges of 0–2,2–6,and 6–10 mm(both P<0.05);At 3mo postoperatively,the FS-LASIK Xtra group is higher than that of the FS-LASIK group in the ranges of 0–2 and 2–6 mm(P<0.05).At 6mo postoperatively,there were no statistically significant differences in corneal densitometry between the FS-LASIK group and the FS-LASIK Xtra group in different diameter ranges(all P>0.05).CONCLUSION:There is an increase in internal corneal densitometry during the early postoperative period after FS-LASIK Xtra for correction of high myopia.However,the densitometry values decreased to the level of conventional FS-LASIK at 6mo after surgery,with the most significant changes observed in the superficial central zone.

Systemic juvenile idiopathic arthritis–associated lung disease: A retrospective cohort study

BACKGROUND Lung damage in systemic juvenile arthritis(sJIA)is one of the contemporary topics in pediatric rheumatology.Several previous studies showed the severe course and fatal outcomes in some patients.The information about interstitial lung disease(ILD)in the sJIA is scarce and limited to a total of 100 cases.AIM To describe the features of sJIA patients with ILD in detail.METHODS In the present retrospective cohort study,information about 5 patients less than 18-years-old with sJIA and ILD were included.The diagnosis of sJIA was made according to the current 2004 and new provisional International League of Associations for Rheumatology criteria 2019.ILD was diagnosed with chest computed tomography with the exclusion of other possible reasons for concurrent lung involvement.Macrophage activation syndrome(MAS)was diagnosed with HLH-2004 and 2016 EULAR/ACR/PRINTO Classification Criteria and hScores were calculated during the lung involvement.RESULTS The onset age of sJIA ranged from 1 year to 10 years.The time interval before ILD ranged from 1 mo to 3 years.The disease course was characterized by the prevalence of the systemic features above articular involvement,intensive rash(100%),persistent and very active MAS(hScore range:194-220)with transaminitis(100%),and respiratory symptoms(100%).Only 3 patients(60%)developed a clubbing phenomenon.All patients(100%)had pleural effusion and 4 patients(80%)had pericardial effusion at the disease onset.Two patients(40%)developed pulmonary arterial hypertension.Infusion-related reactions to tocilizumab were observed in 3(60%)of the patients.One patient with trisomy 21 had a fatal disease course.Half of the remaining patients had sJIA remission and 2 patients had improvement.Lung disease improved in 3 patients(75%),but 1 of them had initial deterioration of lung involvement.One patient who has not achieved the sJIA remission had the progressed course of ILD.No cases of hyper-eosinophilia were noted.Four patients(80%)received canakinumab and one(20%)tocilizumab at the last follow-up visit.CONCLUSION ILD is a severe life-threatening complication of sJIA that may affect children of different ages with different time intervals since the disease onset.Extensive rash,serositis(especially pleuritis),full-blown MAS with transaminitis,lymphopenia,trisomy 21,eosinophilia,and biologic infusion reaction are the main predictors of ILD.The following studies are needed to find the predictors,pathogenesis,and treatment options,for preventing and treating the ILD in sJIA patients.