Anyang Eye Hospital

Limited PSA testing following JKN implementation resulted in an increase in median PSA levels and a shift toward more advanced disease, suggesting an inability to detect prostate cancer at an early stage. These findings underscore the urgent need for targeted policy adjustments to enhance early detection, particularly in primary care settings.

This study investigated the distinctive features and management outcomes of combined exfoliation syndrome and angle-closure glaucoma (XFS-PACG) through a prospective, multicenter observational cohort study including 350 patients (118 XFS, 127 PACG, 105 combined XFS-PACG). Combined pathology demonstrated unique characteristics including bimodal diurnal IOP fluctuations, asymmetric angle closure correlating with exfoliation material distribution, and accelerated zonular weakness with progressive anterior lens displacement. Disease progression was significantly more aggressive in combined cases (visual field deterioration − 2.9 ± 0.8 dB/year versus − 1.7 ± 0.6 and − 1.4 ± 0.5 dB/year in XFS and PACG respectively). Therapeutic response evaluation revealed that prostaglandin-alpha2agonist combinations were most effective pharmacologically in combined cases, while traditional laser peripheral iridotomy achieved limited sustained control (38.1%). Early phacoemulsification with minimally invasive glaucoma surgery demonstrated superior surgical outcomes (72.4% complete success) compared to filtering procedures (53.3%). These findings support an individualized treatment approach for combined XFS-PACG, with early intervention and condition-specific protocols to optimize outcomes in this challenging clinical entity.

The iridocorneal endothelial (ICE) syndrome is a rare but irreversibly blinding eye disease, whose etiology remains unknown and speculative. Characterization of its genomic and epigenomic landscape will benefit the development of etiology-based therapies. In this study, we recruited a cohort of 99 patients with ICE syndrome. Whole-genome sequencing was performed on 51 ICE patients and genome-wide DNA methylation profiling on 48 ICE patients. We then performed the mutational burden testing on genes and noncoding regulatory regions in the ICE cohort compared with control subjects (including 9197 East Asians from the gnomAD database and 350 normal Chinese from our in-house cohort). Copy number variance analysis was also performed. Hypomethylated and differentially methylated regions in ICE patients versus normal controls (45 normal Chinese from our in-house cohort) were explored. We identified RP1L1 (27/51, 53%) which emerged with a higher coding-altering mutational burden in the ICE syndrome cohort, whose mutations were mainly on chr8:10467637. We identified 41 regions exhibiting significant copy number variance. Specifically, regions at chr19:15783859-15791329 and chr3:75786061-75790887 showcased copy number loss in 39 and 19 out of 51 ICE patients, respectively. We also identified that 2717 differentially methylated regions and hypomethylation regions were predominantly found in ICE syndrome compared with normal samples (in 91.9% of 2717 differentially methylated regions). We also found 45 recurrent hypomethylation regions (identified in >10% ICE samples tested) that were differentially methylated (differential methylation < −0.1) between ICE syndrome and normal Chinese. Our study offers the first comprehensive genomic and epigenomic landscape of ICE syndrome, which will enhance the understanding of its etiology.

Background: Ocular hypertension (OHT) can lead to corneal transplant failure, yet no predictive model exists for OHT after femtosecond laser-assisted penetrating keratoplasty (Fs-PKP). This study aimed to develop and validate a predictive nomogram for OHT in Chinese patients undergoing Fs-PKP. Methods: A retrospective cohort study at Nanjing First Hospital included 238 patients who underwent Fs-PKP and were followed up for two years. OHT was defined as postoperative intraocular pressure exceeding 21 mmHg or an increase of more than 10 mmHg from baseline. Twenty-three variables related to recipient, donor, and surgical factors were evaluated. Key predictors were identified using the least absolute shrinkage and selection operator (LASSO) method and multivariate Cox regression, leading to nomogram development and validation via 500 bootstrap resamples. Results: The final nomogram included four independent predictors: prior PKP history, history of viral ocular disease, history of ocular trauma, and intraoperative plan. The model demonstrated good discrimination with a concordance index (C-index) of 0.705 (95% CI: 0.646-0.764), consistent after Bootstrap resampling (C-index: 0.705, 95% CI: 0.648-0.747). Time-dependent receiver operating characteristic analysis at 6, 12, and 24 months showed areas under the curve ranging from 0.677 to 0.756. Calibration curves indicated strong agreement between predicted and observed outcomes. Decision curve analysis demonstrated clinical usefulness across risk thresholds of 20%-70%. High-risk patients identified by the nomogram had significantly higher OHT rates than low-risk patients (P < 0.001). Conclusions: The nomogram accurately predicts OHT risk following Fs-PKP in Chinese patients, aiding clinical decision-making by preoperatively identifying high-risk individuals.

Elevated blood glucose levels may disrupt tear film and meibomian gland function, contributing to dry eye disease (DED) and meibomian gland dysfunction (MGD). This study aimed to explore the relationship between hyperglycemia and DED parameters. A cross-sectional study at Chifeng Chaoju Eye Hospital (June-August 2024) included 56 participants with DED symptoms. Tear meniscus height (TMH), non-invasive tear film breakup time (FNIBUT, ANIBUT), bulbar redness, and meibomian gland atrophy (U-LAMG, L-LAMG) were assessed using a non-invasive ocular surface analyzer. Fasting blood glucose levels stratified patients into high (≥7 mmol/l) and normal (<7 mmol/l) groups, and their association with DED parameters was analyzed. Among 56 patients (mean age 52.5 ± 18.0 years), those with elevated glucose levels (n=28) had more severe DED symptoms (OSDI, p = 0.046), lower TMH, FNIBUT, ANIBUT, and higher bulbar redness scores (all p < 0.05). In contrast, lower glucose levels were associated with greater U-LAMG and L-LAMG atrophy (p < 0.05). Glucose positively correlated with intraocular pressure (IOP), redness, U-LAMG, and L-LAMG but negatively correlated with TMH, FNIBUT, and ANIBUT (all p < 0.05). Hyperglycemia is linked to impaired tear film stability, meibomian gland function, and DED symptoms. Ocular surface disorders in individuals with diabetes may be prevented by effective glycemic control.

Purpose: To assess the combined therapeutic effects of topical rebamipide 2% and hyaluronic acid 0.15% in managing dry eye symptoms following cataract surgery.Methods: Patients who underwent cataract surgery (phacoemulsification with intraocular lens insertion) were assessed for dry eye one week following the procedure. Dry eye patients were randomly assigned to two groups: a treatment group receiving rebamipide 2% and hyaluronic acid 0.15% eye drops, and a control group who did not receive these treatments. Various dry eye tests, including Schirmer’s test, tear break up time (TBUT), ocular surface staining, tear film osmolarity, tear lipid layer thickness, and the ocular surface disease index, were conducted at one and two months after surgery.Results: Significant improvements in TBUT (1 month: &lt;i&gt;p&lt;/i&gt; &lt; 0.001; 2 months: &lt;i&gt;p&lt;/i&gt; &lt; 0.001) and ocular surface staining scores (1 month: &lt;i&gt;p&lt;/i&gt; = 0.001; 2 months: &lt;i&gt;p&lt;/i&gt; &lt; 0.001) were observed in the treatment group at both one and two months after surgery compared to baseline. During the follow-up period, the treatment group consistently showed significantly longer TBUT (&lt;i&gt;p&lt;/i&gt; &lt; 0.001 at both intervals) and lower ocular surface staining scores (1 month: &lt;i&gt;p&lt;/i&gt; = 0.007; 2 months: &lt;i&gt;p&lt;/i&gt; &lt; 0.001) when compared to the control group.Conclusions: The combined application of rebamipide and hyaluronic acid eye drops following cataract surgery effectively improved TBUT and ocular surface staining scores.

ABSTRACTObjectiveTo explore the causal relationship between cystatin C levels and different stages of diabetic retinopathy through Mendelian randomization (MR).MethodsThe MRC Integrative Epidemiology Unit provided the Genome‐wide association studies (GWAS) data related to cystatin C (exposure). GWAS data for outcomes [DR, proliferative diabetic retinopathy (PDR), severe non‐proliferative background diabetic retinopathy (SNPBDR)] were sourced from the FinnGen. Adopted Inverse Variance Weighting (IVW), MR‐Egger regression MR‐PRESSO, Weighted Median, Constrained Maximum Likelihood and Model Averaging (cML‐MA), Weighted model, Radial MR, and MR‐Lasso to estimate the causal relationship between cystatin C and diabetic retinopathy. We conducted multivariable MR analysis to evaluate the independent causal effects of cystatin C levels on diabetic retinopathy.ResultsBased on the IVW method, we observed a causal relationship between cystatin C and diabetic retinopathy [odds ratio (OR)random effect = 1.137, 95% confidence interval (CI): 1.035–1.250]/PDR (ORrandom effect = 1.123, 95%CI: 1.004–1.255)/SNPBDR (ORfixed effect = 2.002, 95%CI: 1.343–2.986). Consistent findings were obtained through the cML‐MA method. Cochran's Q test suggested the presence of heterogeneity between the cystatin C level and instrumental variables in relation to diabetic retinopathy and proliferative diabetic retinopathy, respectively. After adjusting for outliers using MR‐PRESSO and Radial MR, it was observed that the statistical significance of the association between cystatin C level and diabetic retinopathy persists. Reverse MR analysis indicated that genetically related SNPBDR may influence the cystatin C level. In multivariable MR analysis, there were indications suggesting a causal relationship of cystatin C with the risk of DR/PDR/SNPBDR adjusting for confounders.ConclusionsThis study utilizes Mendelian randomization analyses to establish a causal relationship between cystatin C and diabetic retinopathy, and reveals the impact of cystatin C on the risk of diabetic retinopathy, thus providing new evidence for clinical intervention of diabetic retinopathy.

Aim of this study was to explore the optimal training interval and times of microperimetric biofeedback training (MBFT) in maculopathies. Twenty-nine patients with maculopathies were divided into two groups: daily training (Group A) or alternate daily training (Group B). Both groups underwent 15 MBFT sessions. We compared the BCVA, reading speed, and fixation stability at baseline, after 5, 10, 15 sessions. After 15 sessions of MBFT, all visual parameters in both groups improved. There was a significant increase in BCVA after 5 sessions in both groups (P=0.016, and P<0.001 respectively), but Group A showed further improvement after 10 sessions (P<0.001). Regarding reading speed, Group A showed significant improvement from baseline after 15 sessions(P=0.020), Group B improved significantly after 5 sessions (P=0.047) and continued to improve after 10 sessions (P=0.030). Additionally, P1 and LgBCEA of Group A significantly improved after 10 sessions (P=0.001, and P=0.001 respectively), while Group B significantly improved after 5 sessions (P=0.002, and P<0.001 respectively). There was no significant difference in visual outcomes between the two groups (P>0.05) except LgBCEA (P=0.046) after 15 sessions. We concluded that the both MBFT frequencies are effective at improving vision and quality of life in patients with maculopathies. The alternate daily training group showed less time-dependent of improvement in all parameters and a greater benefit in fixation stability. Ten sessions are the optimal number of treatment sessions for alternate daily training.