ANovel Light Weight CNN Framework Integrated with Marine Predator Optimization for the Assessment of Tear Film-Lipid Layer Patterns

Tear film,the outermost layer of the eye,is a complex and dynamic structure responsible for tear production.The tear film lipid layer is a vital component of the tear film that provides a smooth optical surface for the cornea and wetting the ocular surface.Dry eye syndrome(DES)is a symptomatic disease caused by reduced tear production,poor tear quality,or excessive evaporation.Its diagnosis is a difficult task due to its multifactorial etiology.Out of several clinical tests available,the evaluation of the interference patterns of the tear film lipid layer forms a potential tool for DES diagnosis.An instrument known as Tearscope Plus allows the rapid assessment of the lipid layer.A grading scale composed of five categories is used to classify lipid layer patterns.The reported work proposes the design of an automatic system employing light weight convolutional neural networks(CNN)and nature inspired optimization techniques to assess the tear film lipid layer patterns by interpreting the images acquired with the Tearscope Plus.The designed framework achieves promising results compared with the existing state-of-the-art techniques.

Changes of tear film lipid layer thickness by 3% diquafosol ophthalmic solutions in patients with dry eye syndrome

AIM: To evaluate the quantitatively changes in lipid layer thickness(LLT) when 3% diquafosol eye drop is used for dry eye patients using the tear film interferometer. METHODS: A total 124 participants(32 males, 92 females;mean age, 28.9 y) diagnosed with dry eye disease(DED) received topical instillation of 4 ophthalmic solutions in one eye: diquafosol, normal saline, 0.1% sodium hyaluronate and 0.3% gatifloxacin, in a masked manner. LLT was measured using an interferometer at baseline and 20 min after the instillation of each ophthalmic solutions.RESULTS: Changes of LLT after instillation(nm, mean± standard error) were as follows: 12.6±2.0 for diquafosol(P<0.001), 1.2±2.2 for normal saline(P=0.301), 1.5±2.0 for hyaluronate(P=0.495), and 0.5±3.2 for gatifloxacin(P=0.884).CONCLUSION: Topical instillation of diquafosol increases tear film LLT in DED patients. Diquafosol 3% eye drop might be effective treatment option of evaporative DED with meibomian gland dysfunction.

Low concentration of sodium hyaluronate temporarily elevates the tear film lipid layer thickness in dry eye patients with lipid deficiency

AIM： To investigate the effects of different concentrations of artificial tears on lipid layer thickness （LLT） and blink rate （BR） in dry eye patients. METHODS： This study included 106 eyes of 58 patients with dry eye. The lipid deficiency type was defined as the LLT baseline 〈75 nm. The LLT and BR were measured at baseline and 1, 5 and 15min after the instillation of 0.1% or 0.3% sodium hyaluronate （SH） eye drops by using the LipiView ocular surface interferometer. RESULTS： In the lipid deficiency group, the LLT increased from baseline at 1rain post instillation. The LLT after the instillation of 0.1% SH was significantly higher than that after the instillation of 0.3% SH （P〈0.001）. The LLT returned to baseline at 15min post instillation of 0.1% SH and at 5min post instillation of 0.3% SH. In the non-lipid deficiency group, the LLT decreased from baseline at lmin and returned to baseline at 5rain for both treatments. The BRs were not significantly different at different time points for both treatments. CONCLUSION： SH eye drops induce a short-term increase in LLT of patients with lipid deficiency. A low concentration of artificial tears have a stronger effect than a high concentration of artificial tears on the increase in LLT. in comparison, SH eye drops induce a transient and slight decrease in LLT of patients without lipid deficiency. A low concentration of artificial tears might be better for patients with lipid deficiency.

Association between tear film break up time and blink interval in visual display terminal users

AIM：To investigate the association between tear film break up time（TBUT）and blinking interval in visual display terminal（VDT）users.METHODS：Nine hundred and thirty VDT users underwent dry eye testing,and functional visual acuity（FVA）test.The blinking interval during FVA was compared with TBUT.Subjects with longer blinking interval than TBUT were considered as unstable tear film.Logistic regression analysis revealed the risk factors for unstable tear group.RESULTS：Among 930 workers,858 subjects（92.3%）participated in this study.Almost 80% of the subjects were categorized into the unstable tear group.Unstable tear group has significantly lower Schirmer values and TBUT（17.5±11.6 vs 21.1±11.5 mm,3.7±2.6 vs 5.7±2.7s,both P〈0.001）.There were no significant differences in epithelial staining or severity of symptoms.Logistic regression showed that over 40y was a risk for being unstable tear group[odds ratio（OR）=1.53;95%confidence interval（CI）=1.06-2.20].Contact lens use was protective factor for being in the unstable tear group（OR=0.37;95%CI=0.26-0.53）.CONCLUSION：Subjects with shorter TBUT than blinking interval are prevalent among VDT users.Subjects over the age of 40 shows an increased risk for unstable tear film.

Clinical analysis of tear film after lamellar keratoplasty

AIM: To study the tear film stability after lamellar keratoplasty METHODS: Five female and eight male patients with lamellar keratoconus, aged from 18 to 32, were involved. After lamellar keratoplasty, Schirmer I test (S I t), tear break-up time (BUT) test, fluorescein staining test were used to judge the effect of the surgery at different time point. RESULTS: The S 1 t were greatly increased in 7 clays post operation (11.86+/-2.28 -25.14+/-1.97, 19.86+/-1.61) (P<0.05), there is no significant difference between 2nd month, 3rd month post-operative and pre-operation(11.86+/- 2.28 - 14.57+/-1.48, 8.14+/-0.86) (P >0.05). The mean break-up time decreased in 7 days post operation (5.00+/-1.31 -2.71+/- 0.18, 2.57+/- 0.20, 2.71+/- 0.36, 2.43+/- 0.20) (P <0.05). The mean scores of fluorescence increased post-operatively (0.14+/- 0.14 - 8.00+/- 0.00, 8.00+/- 0.00, 8.00+/- 0.00, 7.57+/- 0.20) (P<0.01). CONCLUSION: Lamellar keratoplaty influence the tear film stability, artificial tears and improving corneal epithelium cured medicine should be used after surgery.

Comparison of the effects of first and second generation silicone hydrogel contact lens wear on tear film osmolarity

AIM:To compare the effects of first and second generation silicone hydrogel(SiH) contact lens wear on tear film osmolarity.METHODS:The healthy subjects who have never used contact lenses before were enrolled in the study.Tear film osmolarity values of 16 eyes(group 1) who wore first generation SiH contact lenses were compared with those of 18 eyes(group 2) who wore second generation SiH contact lenses after three months follow-up.RESULTS:Beforecontactlenswear,tearfilmosmolarity of groups 1 and 2 were 305.02±49.08 milliosmole(mOsm) and 284.66±30.18mOsm,respectively.After three months of contact lens wear,osmolarity values were found 317.74±60.23mOsm in group 1 and 298.40±37.77mOsm in group 2.Although osmolarity values for both groups of SiH contact lens wear after three months periods were slightly higher than before the contact lens wear,the difference was not statistically significant. CONCLUSION:Contact lens wear may cause evaporation from the tear film and can increase tear film osmolarity leading to symptoms of dry eye disease.In the current study,there is a tendency to increase tear film osmolarity for both groups of SiH contact lens wear,but the difference is not statistically significant.

Measurement of central corneal thickness and precorneal tear film thickness of rabbits using the Scheimpflug system

AIMTo measure central corneal thickness (CCT) and pre-corneal tear film thickness using the Galilei dual-Scheimpflug analyzer (GSA) in New Zealand white rabbits.

Topographic tear film trend and new parameters for noninvasive break up time test

AIM:To evaluate the quantitative and qualitative results of the noninvasive tear film break-up time(NI-BUT)test and investigate the predictive ability of the new NIBUT parameter in discriminating between normal Ocular Surface Disease Index(OSDI;scores≤12)and abnormal OSDI(scores≥13).METHODS:A total of 341 eyes of 341 volunteers who applied for routine eye outpatient control were included in the prospective study.All participants'noninvasive first tear film break-up time(NIF-BUT),noninvasive average tear film break-up time(NIAvg-BUT)and average value of the first three break-up time(A3F-BUT)were analyzed.A3F-BUT,the new NI-BUT parameter,is calculated by adding the NIF-BUT value to the 2^(nd )break-up time value that has a difference of at most 1 second from the NIF-BUT value and to the 3^(rd) break-up time and then dividing the respective sum by 3.Receiver operating characteristic(ROC)curve and forward logistic regression analyses were performed to determine the parameter that had the best predictive ability between the OSDI groups.RESULTS:The NI-BUT values of 255 eyes of 255 volunteers included in the study were analyzed statistically.The mean NIF-BUT,NIAvg-BUT,and A3F-BUT values were calculated as 5.3±3.0,8±3.1,and 5.8±3.0 seconds,respectively.All three parameters were found to be significantly lower in the abnormal OSDI group(P=0.014,0.034,and 0.011,respectively).The area under the curve(AUC)of the A3F-BUT to predict abnormal OSDI was AUC=0.625(0.529-0.720),P=0.011 and NIF-BUT was AUC=0.599(0.502-0.696),P=0.043.The A3F-BUT parameter and NIF-BUT parameters were found to be significantly efficient in discriminating abnormal OSDI.CONCLUSION:The new parameter for the NI-BUT test has more predictive ability in the discrimination of OSDI groups.

Ocular surface and tear film changes after eyelid surgery

Eyelid surgery is widely and extensively used in facial plastic and reconstructive surgeries.There are many categories of eyelid surgeries,the most common of which include blepharoplasty,ptosis surgery,and eyelid reconstruction.In many cases,these procedures are combined,and there are many different techniques for each type of operation.Upper eyelid blepharoplasty usually includes the excision of skin,preseptal orbicularis oculi muscle,and orbital fat.Common methods of lower eyelid blepharoplasty are the skin-muscle flap,the skin flap,and the transconjunctival.Ptosis surgery is mainly divided into three types:transcutaneous,transconjunctival,and sling surgery.Surgeons often used the Hughes or Cutler-Beard Bridge Flaps in eyelid reconstruction.Different types and methods of surgery have their own advantages and disadvantages,and postoperative complications may occur.Therefore,postoperative complications of eyelid surgeries,such as dry eye symptoms,should be taken into serious consideration.Relevant literature involving these complaints can be found in PubMed by searching the terms“dry eye”,“eyelid”,“surgery”,and other related keywords.Moreover,various ocular surface and tear film alterations may be detected using the Ocular Surface Disease Index(OSDI),tear film breakup time,Schirmer test,fluorescein staining,and lissamine green staining after various eyelid surgeries.As dry eye disease is prevalent in the general population,it is more urgent to figure out what we can learn from these complaints.Further exploration in this field may help surgeons to choose a better surgical method and give an accurate evaluation of the postoperative effect.

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

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

Changes in Tear-Film Status and Ocular Surface Disease Index Score Following Prolonged Use of Face Mask

Background: Dry eye is characterized by tear film instability, decreased tear volume and a high Ocular Surface Disease Index (OSDI) score. Face masks have been linked to dry eye complaints in recent studies. Purpose: To evaluate the changes in tear-film status and Ocular Surface Disease Index (OSDI) score following prolonged use of face mask. Design: Cross-sectional study. Method: Patients between 18 to 70 years using masks regularly for at least 2 hours/day for at least 5 days/week from different eye-care centres in Dhaka were included. All subjects were divided into 4 groups. Mask use lasted approximately 2 hours/day in Group 1, 4 hours/day in Group 2, 6 hours/day in Group 3 and 8 hours or more/day in Group 4. Evaluation of symptoms, tear- film stability and tear volume was done by Ocular Surface Disease Index (OSDI) scores, Tear-film Break-Up Time (TBUT) and Schirmer-1 test. Average of right & left eye’s Tear-film Break Up time (TBUT) and Schirmer-1 value were noted. Results: Total 100 patients were enrolled (n = 100). The TBUT (p < 0.001) and Schirmer-1 measurement (p = 0.01) were significantly lesser and Ocular Surface Disease Index (OSDI) score were significantly higher in patients using face-masks for longer time (p < 0.001). Conclusion: Patients who wore masks for prolonged time had tear film instability, reduced tear volume and higher Ocular Surface Disease Index (OSDI) score.

Research on Tearing Property of Reinforced Plastic Film with Bi-axial Warp Knitted Fabric Skeleton

The specification of laid-in and warp yams,thedensity of fabric and the specification of groundyam are of great importance when the bi-axialwarp knitted fabric being knitted.In this paper,the tearing property of the reinforced plastic filmwith bi-axial warp knitted fabric skeleton istested and analyzed.The resuits show thatamong the three factors,the specification of laid-in and warp yam has the greatest influence onthe tearing strength of the reinforced plastic film,while the rest of them has secondary and lesseffect respectively,and there is exponential re-lation between the tearing strength of the rein-forced plastic film and the number of yams in thedirection of force.

润眼明目方熏蒸联合玻璃酸钠滴眼液治疗睑板腺功能障碍致干眼症临床研究

目的:观察润眼明目方熏蒸联合玻璃酸钠滴眼液(HYCOSAN)治疗睑板腺功能障碍(MGD)致干眼症患者的临床疗效。方法:选取MGD致干眼症患者112例,随机分为对照组和治疗组各56例。对照组采用HYCOSAN治疗,治疗组在对照组基础上联合润眼明目方熏蒸治疗。治疗4周后,比较2组临床疗效,以及2组治疗前后泪膜破裂时间(BUT)、角膜荧光素染色评分(FLS)、中医证候评分。结果:治疗后,治疗组总有效率为89.29%,对照组为75.00%,2组比较,差异有统计学意义(P<0.05)。治疗后,2组BUT均较治疗前增加(P<0.05),FLS均较治疗前降低(P<0.05);且治疗组BUT长于对照组(P<0.05),FLS低于对照组(P<0.05)。治疗后,2组眼干涩、畏光、腰膝酸软、头晕耳鸣、夜寐多梦等中医证候评分均较治疗前降低(P<0.05),且治疗组各项评分均低于对照组(P<0.05)。结论:润眼明目方熏蒸联合HYCOSAN治疗睑板腺功能障碍致干眼症,能够有效缓解患者中医证候,提高临床总有效率,改善患者睑板腺功能。

两种改良手术治疗上脸内翻倒睫对脸板腺功能的影响

目的探讨两种改良手术治疗上睑内翻倒睫对睑板腺功能的影响。方法选取2019年6月~2022年6月于我院确诊为上睑内翻倒睫的80例患者作为研究对象,采用随机数字表法分组,对照组(40例)采用睑板楔形切除术(Hotz)治疗,研究组(40例)采用带蒂眼轮匝肌桥状瓣转移术治疗,比较两组患者的眼表疾病指数(OSDI)及泪膜破裂时间(BUT)、睑板腺功能情况评分、并发症发生率。结果治疗后,两组OSDI评分均下降,且研究组低于对照组,两组BUT均提高,且研究组高于对照组(P<0.05)。治疗后,两组睑板腺功能评分均上升,研究组在术后1周、1个月、2个月均高于对照组(P<0.05)。研究组术后并发症发生率为5.00%,显著低于对照组的20.00%(P<0.05)。结论带蒂眼轮匝肌桥状瓣转移术治疗上睑内翻倒睫的效果优于Hotz术式治疗效果,可提升患者的眼表功能,改善睑板腺功能,安全性高,并发症发生少,有利于改善患者的眼部健康。

X线片测量肱骨大结节角与肩袖撕裂的相关性研究

目的 探讨X线片测量肱骨大结节角(GTA)与肩袖撕裂的相关性,为肩袖撕裂的预防、早期诊断和治疗提供依据和指导。方法 回顾性分析2020年1月至2023年12月医院收治的138例因肩部疼痛不适行肩部X线检查患者的病历资料。根据临床诊断结果将发生肩袖撕裂的患者纳入试验组(64例),未发生肩袖撕裂的患者纳入对照组(74例)。比较两组GTA的差异;考察GTA预测肩袖撕裂的临界值和预测能力;评价2名放射科医师测量结果的一致性和相关性。结果 试验组GTA大于对照组,差异有统计学意义(P<0.05)。区分试验组与对照组患者的GTA最佳临界值为≥70°,受试者工作特征(ROC)曲线下面积为0.826,灵敏度和特异度分别为0.88和0.81。2名放射科医师测量GTA结果的组内相关系数(ICC)为0.677,Pearson’s相关性系数r=0.547。结论 采用X线片测量GTA对肩袖撕裂具有较好的预测价值和较高的测量一致性,可为肩袖撕裂的预防、早期诊断和治疗提供依据和指导。

中药熏蒸对肝肾阴虚型干眼症的疗效研究

目的探讨干眼症(肝肾阴虚型)患者采用中药熏蒸治疗的临床价值。方法以随机样本抽样法,于2019年3月—2021年1月首都医科大学附属北京潞河医院中医科和眼科收治的肝肾阴虚型干眼症患者中,抽取60例,随机分为对照组、观察组,各30例。对照组:人工泪液;观察组:中药熏蒸。对比两组眼表疾病指数量表(ocular surface disease index,OSDI)评分、治疗效果、中医证候积分、泪膜稳定性、不良反应。结果治疗前,两组的OSDI评分比较,差异无统计学意(P>0.05);治疗后,同组较治疗前、组间OSDI评分对比,P<0.05;两组治疗效果比较,P>0.05;治疗前,两组各项中医证候评分对比,差异无统计学意义(P>0.05);治疗后,两组患者自觉眼睛干涩不爽和不耐久视症状较治疗前、组间各评分对比,P<0.05,白睛赤脉、口干鼻燥、咽干、便秘症状两组治疗前后、组间各评分对比,差异无统计学意义(P>0.05);治疗前,两组的SIT、FL对比,差异无统计学意义(P>0.05);治疗后,同组较治疗前、组间各指标对比,差异有统计学意义(P<0.05);两组患者均未发生不良反应。结论对肝肾阴虚型干眼症用中药熏蒸治疗,可改善患者视功能、眼表功能,效果显著。

波前像差引导的LASIK与SMILE手术对屈光不正患者视觉质量及泪膜稳定的影响

目的 探究波前像差引导的准分子激光原位角膜磨镶术(WF-LASIK)与飞秒激光小切口角膜基质透镜取出术(SMILE)手术对屈光不正患者视觉质量及泪膜稳定的影响。方法 选取2020年1月-2023年1月我院诊治的屈光不正患者60例(120只眼)作为研究对象。根据手术方式不同分为WF-LASIK组(30例,60只眼)与SMILE组(30例,60只眼),比较2组裸眼视力、屈光度、视觉质量、泪膜稳定及并发症。结果 经重复测量方差分析:两组裸眼视力、球镜、柱镜、等效球镜的时间效应有统计学意义(P<0.05),且WF-LASIK组术后1、3mo裸眼视力高于SMILE组(P<0.05);两组球差、水平彗差、垂直彗差、总高阶像差、泪膜破裂时间、泪液分泌试验的时间效应、组间效应及交互效应均有统计学意义(P<0.05),且WF-LASIK组术后1、3mo球差大于SMILE组(P<0.05),水平彗差、垂直彗差、泪膜破裂时间、泪液分泌试验低于SMILE组(P<0.05)。两组并发症总发生率比较无统计学意义(P>0.05)。结论 屈光不正患者通过WF-LASIK与SMILE手术均能获得良好视力效果,其中WF-LASIK手术在视觉质量方面具有较明显优势,SMILE手术在泪膜稳定性方面具有明显优势。

Role of tensile forces in hot tearing formation of cast Al-Si alloy

The instrumented applied rod casting apparatus （ARCA） was developed to investigate the effects of tensile forces in the hot tearing formation of cast AI-Si alloys. The obtained data of tensile forces/temperature was used to identify hot tearing initiation and propagation and the fracture surface of samples was also investigated. The result shows that the applied tensile forces have a complex effect on load onset for the hot tearing initiation and propagation. During the casting solidification, the tensile forces are gradually increased with the increase of solid fraction. Under the action of tensile forces, there will appear hot tearing and crack propagation on the surface of the sample. When the tensile forces exceed the inherent strength of alloys, there will be fractures on the sample. As for the A356 alloy, the critical fracture stress is about 0.1 MPa. The hot tearing surface morphology shows that the remaining intergranular bridge and liquid films are thick enough to allow the formation of dendrite-tip bumps on the fracture surface.

光学相干断层扫描在角膜塑形镜验配中的应用

目的:通过光学相干断层扫描(OCT)测量角膜塑形镜下泪液间隙厚度,探讨泪液间隙厚度与角膜塑形镜配适度之间的关系,为角膜塑形镜的验配提供一种更直观、量化的临床评估手段。方法:收集2023-01/12在我院验配角膜塑形镜的近视患者。在进行配镜之前,对所有患者都实施了全面的眼科诊断,涵盖了视力检测、裂隙灯检查、非接触眼压测量、眼底检查、双眼眼位检查、测量角膜直径、角膜地形图检查、泪膜破裂时间评估以及综合验光检查等项目。根据个人的检查结果选择试戴片的参数,待患者戴镜适应后进行荧光素染色配适度评估。将被检眼分为镜片过松组、镜片适配组、镜片过紧组。使用OCT测量三组被检眼泪液间隙厚度,评估三组数据之间差异性。结果:本研究共纳入近视患者49例77眼。验配前测得平均球镜度为-3.10±1.25 D,平均柱镜度为-0.43(-0.75,0)D,平均水平子午线角膜曲率(HK)为42.48±0.81 D,平均垂直子午线角膜曲率(VK)为42.98(42.25,43.50)D。镜片适配组21例34眼(13例双眼,8例单眼)、镜片过松组14例22眼(8例双眼,6例单眼)、镜片过紧组14例21眼(7例双眼,7例单眼)。三组受检者的主要基础资料比较无差异(均P>0.05)。使用OCT测量得出,镜片适配组、镜片过松组、镜片过紧组泪液间隙厚度分别为231.18(219.0,243.0)、220.41(214.0,224.3)、249.00(241.5,258.0)μm,三组厚度数值比较有差异(P<0.05)。结论:OCT技术提供了一种安全可靠的测量泪液间隙厚度的方法,它可以帮助评估角膜塑形镜的适配情况,为角膜塑形镜的验配评估提供了一种无创的、更直观和定量的评估手段。

视觉感知训练配合0.05%环孢素A治疗对中度干眼症患者眼表及泪膜的影响

目的探讨视觉感知训练配合0.05%环孢素A治疗对中度干眼症患者眼表及泪膜的影响。方法选取2021年2月—2023年2月首都医科大学附属北京朝阳医院收治的118例中度干眼症患者,采用随机数字表法分为对照组与观察组,各59例。对照组给予0.05%环孢素A治疗,观察组给予视觉感知训练配合0.05%环孢素A治疗。比较两组患者的干眼症状评分、眼表疾病指数量表(OSDI)、简式抑郁-焦虑-压力量表(DASS-21)、角膜荧光素染色(FL)评分、泪河高度、视觉质量分析系统(OQAS-Ⅱ)、泪膜破裂时间(BUT)、泪液分泌试验(SⅠt)。结果观察组与对照组治疗前、治疗1周、治疗1个月、治疗3个月干眼症状评分比较,采用重复测量设计的方差分析,结果:①不同时间点的干眼症状评分比较,差异有统计学意义(F=12.133,P=0.000);②观察组与对照组干眼症状评分比较,差异有统计学意义(F=316.129,P=0.000),观察组与对照组相比干眼症状评分较低,效果较好;③观察组与对照组的干眼症状评分变化趋势比较,差异有统计学意义(F=10.158,P=0.000)。观察组治疗前后OSDI评分、DASS-21评分的差值高于对照组(P<0.05);观察组治疗前后FL、泪河高度的差值高于对照组(P<0.05);观察组治疗前后调制传递函数(MTF)截止频率、斯特列尔比、泪膜散射指数(TF-OSI)的差值均高于对照组(P<0.05);观察组治疗前后BUT、SⅠt的差值均高于对照组(P<0.05)。结论视觉感知训练配合0.05%环孢素A治疗对中度干眼症患者具有显著疗效,能够有效提高患者的干眼症状、眼表健康和视觉质量,是一种有效且安全的治疗方法。