Shandong Eye Hospital

BACKGROUND Toxocariasis has a wide geographic distribution, with high prevalence in tropical and subtropical regions. Ocular larva migrans is one of the most common manifestations in China and classically presents with peripheral granuloma, posterior granuloma, and chronic endophthalmitis. This report describes an atypical case of ocular toxocariasis in an adolescent male patient, initially misdiagnosed as chronic rhegmatogenous retinal detachment. CASE REPORT A 17-year-old male patient presented to our hospital with a 4-month history of progressive vision loss in his right eye, initially misdiagnosed as chronic rhegmatogenous retinal detachment, at a nearby facility. Scanning laser ophthalmoscopy identified a tractional retinal detachment accompanied by a granulomatous tubercle above the temporal peripheral retina in his right eye. The diagnosis of ocular toxocariasis was established by aqueous humor analysis, which revealed markedly elevated intraocular anti-Toxocara IgG levels and a significantly increased Goldmann-Witmer coefficient. The patient subsequently underwent scleral buckling, and 532 nm retinal laser photocoagulation 1 day after scleral buckling, resulting in successful anatomical reattachment. However, he developed retinal granulomatous lesions and vitritis 5 months following the surgery. Oral prednisone and albendazole effectively controlled intraocular inflammation and prevented further granulomatous progression. CONCLUSIONS Ocular toxocariasis may present with nonspecific findings, and serology and the Goldmann-Witmer coefficient are crucial for diagnosis. Scleral buckling is recommended for proliferative retinal changes, with adjunctive systemic therapy and long-term follow-up to prevent recurrence and preserve vision.

To compare the efficacy and safety of 0.50% and 0.75% pilocarpine ophthalmic solutions for treating presbyopia. In this prospective study, 22 presbyopic subjects (44 eyes) were assigned to use 0.50% or 0.75% pilocarpine bilaterally, once daily for 2 weeks. Primary outcomes included distance-corrected intermediate visual acuity (DCIVA) at 66 cm and distance-corrected near visual acuity (DCNVA) at 40 cm under photopic and mesopic conditions, pupil size, refractive error, intraocular pressure (IOP) and patient-reported adverse events. Assessments were conducted at baseline, day 1 (after 1 and 6 h) and week 2 (after 1 h). No serious adverse events occurred. Neither formulation affected IOP or refractive error significantly. Pupil constriction was greater in the 0.75% group than the 0.50% group (2.8 ± 1.1 vs. 2.0 ± 0.8 mm, p = 0.02). After 2 weeks, the gain in photopic DCNVA was 0.18 logMAR for both concentrations (p = 0.70). The respective gain in visual acuity measures for the 0.75% and 0.50% groups was: mesopic DCNVA, 0.14 and 0.19 logMAR (p = 0.25); photopic DCIVA, 0.14 and 0.09 logMAR (p = 0.02); mesopic DCIVA, 0.12 and 0.10 logMAR (p = 0.18). Both 0.50% and 0.75% pilocarpine improved visual performance in presbyopia significantly, suggesting it is a promising treatment option. Chinese Clinical Trial Registry (ChiCTR), 2023/3/2, No.ChiCTR2300068971.

PurposeTo compare the effects of topical versus peribulbar anesthesia on the early rotational stability of toric intraocular lenses (Toric IOLs).Patients and MethodsIn this prospective cohort study, 240 eyes undergoing phacoemulsification with Toric IOL implantation at Qingdao Eye Hospital were analyzed. Preoperative ocular parameters were recorded. Postoperative outcomes at 1 day, 1 week, and 1 month included Toric IOL rotation, uncorrected distance visual acuity (UDVA), residual astigmatism, intraocular pressure, and the rate of IOL repositioning. Binary logistic regression identified factors associated with repositioning.ResultsBaseline characteristics were similar between groups. On day 1, mean IOL rotation was significantly lower in the peribulbar group (3.61 ± 2.53°) than in the topical group (4.65 ± 5.40°, P=0.003), and UDVA was better (P=0.046). At 1 week, rotation remained smaller in the peribulbar group (P=0.040). By 1 month, no significant differences were found in rotation, UDVA, or residual astigmatism. Repositioning occurred in 1/112 (0.9%) peribulbar and 8/116 (6.9%) topical cases (P=0.034). Logistic regression confirmed anesthesia type as an independent factor for repositioning (P=0.045).ConclusionPeribulbar anesthesia enhances early postoperative rotational stability of Toric IOLs and reduces the need for repositioning.

PurposeThe pathological effects of pre-mRNA processing factor 8 (PRPF8) mutations on the retinal pigment epithelium (RPE) are not fully understood. We aimed to identify disease-specific cellular and molecular phenotypes in PRPF8 retinitis pigmentosa (RP) patient–derived induced pluripotent stem cell (iPSC)-RPE and to test whether adenine base editing (ABE), which corrects the PRPF8 mutation in iPSCs, can reverse abnormal RPE phenotypes.MethodsWe obtained patient-derived iPSCs with the heterozygous PRPF8 (c.5792C>T) mutation and created an induced mutation iPSC line by introducing the same mutation into wild-type iPSCs using CRISPR/Cas9. These cells were differentiated into RPE cells. We measured PRPF8 expression, barrier integrity, and apicobasal polarity. Electron microscopy examined apical microvilli and pigment granules. RNA sequencing quantified splicing events and affected pathways. ABE corrected the PRPF8 mutation in patient iPSCs, and the corrected clones were re-differentiated into RPE cells for evaluation.ResultsPRPF8-mutant RPE cells exhibited decreased PRPF8 mRNA and protein levels, weakened barrier function, and disrupted cell polarity. Ultrastructural analysis showed loss of apical microvilli and pigment granules. Transcriptomic analysis identified abnormal splicing events, with enrichment in cilium assembly and melanosome pathways. ABE correction restored PRPF8 expression, normalized barrier integrity, apicobasal polarity, and rescued the defects in apical microvilli and pigment granules.ConclusionsPRPF8 mutations in patient-derived iPSC RPE cause functional and ultrastructural defects driven by splicing abnormalities. ABE correction of the PRPF8 mutation in iPSCs can restore PRPF8 expression and alleviate cellular and molecular defects in RPE and highlights the therapeutic potential of precise gene editing correction strategies for RP.

Purpose To explore the influence of myopia during different spectacle correction status on binocular vision function. Methods A total of 1446 myopic patients (2892 eyes) with different glasses‐wearing states, with a mean age of 22.38 ± 4.74 years, were randomly selected from the Corneal Refractive Department of Jinan Mingshui Eye Hospital between September 2023 and December 2024. Based on the difference between the mean self‐worn spectacle spherical equivalent (SE) and postcycloplegic refraction SE, the patients were classified into three groups: the spectacle overcorrection group: 178 cases (356 eyes); the spectacle full‐correction group: 594 cases (1188 eyes); and the spectacle undercorrection group: 674 cases (1348 eyes). All patients underwent routine ophthalmic examinations and accommodative functions (accommodative amplitude [AMP], negative relative accommodation [NRA], positive relative accommodation [PRA], monocular accommodative facility [MAF], binocular accommodative facility [BAF], accommodative response [BCC]), and convergence functions (near‐horizontal phoria [NLP] and far‐horizontal phoria [DLP]). Accommodative convergence/accommodation (AC/A) ratio and near point of convergence (NPC) were detected, and all data were analyzed. Results The comparisons of postcycloplegic refraction spherical power and SE, spectacle and postcycloplegic refraction cylindrical power among the three groups revealed statistically significant differences (all p < 0.05). Comparisons of PRA and BAF values among the three groups unveiled statistically significant differences ( p < 0.05). Statistically significant differences were also observed in comparisons of NLP values ( p < 0.05). Accommodative dysfunction accounted for 52.98% of cases. Accommodative infacility (452 patients) emerged as the most prevalent subtype. Convergence dysfunction constituted 19.98% of abnormalities, with convergence insufficiency demonstrating the highest prevalence (200 patients). The comparison of different diagnostic types of visual function among the three patient groups unveiled statistically significant differences ( p < 0.05). DLP/NLP and spectacle sphere, spectacle SE, refraction sphere and refraction SE ( r = 0.062–0.081, p < 0.05); AC/A and spectacle sphere, spectacle SE, refraction sphere, and refraction cylinder and refraction SE ( r = 0.052 to 0.064, p < 0.05). PRA and spectacle sphere, spectacle SE ( r = 0.052, 0.054, p < 0.05). MAF/BAF positively correlated with refraction cylinder ( r = 0.07 to 0.099, p < 0.01). NRA and PRA were positively correlated with spectacle SE discrepancy ( r = 0.072, 0.129, p < 0.01). BAF and MAF were inversely correlated with spectacle SE discrepancy ( r = −0.067, −0.053, p < 0.05). AMP and multiple refractive parameters: spectacle sphere, spectacle SE, refraction sphere, and refraction SE ( r = −0.080–−0.093, p < 0.01). Conclusion The accuracy of spectacle correction influences accommodative and convergence functions in myopic patients. Precise prescriptions can improve visual quality and comfort.