最新刊期
      2021 年 第 1 期

        Review

      • 2021(1): 1-25. DOI: https://doi.org/10.1016/j.aopr.2021.100001
        摘要：The harmful effect of aerial fine particulate matter（PM2.5）has been a serious public health issue and has attracted worldwide attention, especially in developing countries. Numerous previous clinical and experimental studies have demonstrated that PM2.5 has a clear pathogenic effect on diseases related to the respiratory and cardiovascular systems. Recent researches have pointed out that PM2.5 plays a pivotal role in the occurrence and progression of ocular surface diseases. PM2.5 exposure has a pathogenic effect on ocular surface diseases such as dry eye, meibomian gland dysfunction, conjunctivitis, and blepharitis. The underlying mechanism involves inflammation, immune mechanisms, oxidative stress, autophagy, cell migration and epigenetics. This review aims to summarize the current research progress on the pathogenic mechanism of PM2.5-related ocular surface diseases.  
          
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        发布时间：2023-11-15
      • 2021, 1(1): 100002. DOI: 10.1016/j.aopr.2021.100002
          
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        发布时间：2023-11-15
      • 2021, 1(1): 100004. DOI: 10.1016/j.aopr.2021.100004
        摘要：

        Purpose

        To evaluate the postoperative effect of the lateral tarsal strip (LTS) procedure in treating lower eyelid involutional ectropion.

        Methods

        A retrospective study was performed on 85 eyelids in 67 patients with involutional ectropion who underwent LTS procedure. Pre- and postoperative lower eyelid laxity and ocular symptoms as well as perioperative complications were evaluated. Snap back test was performed to evaluate the elasticity of lateral canthal tendon loosening and, a lower lid distraction test was performed to evaluate the degree of severity before surgery. Ocular surface diseases were evaluated by the Ocular Surface Disease Index (OSDI), and symptoms including conjunctivitis, corneal ulcer, dry eye syndrome, and ocular pain were recorded. All patients were evaluated within one week and during the follow-up period of 4.2 ​± ​8.3 months. Furthermore, we reviewed the studies that also investigated the surgical effect of the LTS procedure in the literature from 1979 to 2019.

        Results

        The success rate was 95%. Only four eyelids required a second surgical intervention. Seventy-three (86%) eyelids had an excellent position after surgery, 9 (11%) only little improvement, and three had no improvement. No significant difference was found in the postoperative effects between different degrees of ectropion (p ​> ​0.05). No statistical correlation was found between surgical improvements and the ectropion severity (P ​> ​0.05). Fifty-two out of 85 eyes had no discomfort after the surgery. Mild complications included epiphora in 13 eyes (three cases caused by lacrimal punctum eversion), ocular pain in 12 eyes, wound hemorrhage in 12 eyes, and edema in 9 eyelids immediately after surgery, in which 91.2% (n ​= ​21) disappeared within one week and did not need any further treatment.

        Conclusions

        The lateral tarsal strip procedure can provide an aesthetically pleasing result for correcting the mild to moderate lower eyelid ectropion while maintaining decent eyelid function.  
          
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        发布时间：2023-11-15
      • 2021, 1(1): 100006. DOI: 10.1016/j.aopr.2021.100006
        摘要：

        Purpose

        Effect of intravenous sedation on patients’ visual experience and vital signs during cataract surgery under topical anesthesia: a randomized controlled trial.

        Design

        Prospective, double masked, randomized controlled trial.

        Methods

        150 eyes of 150 patients undergoing phacoemulsification and IOL implantation under topical anesthesia were randomized to receive either intravenous midazolam (0.015 ​mg/kg) or normal saline. The patients’ experience was evaluated using a questionnaire. Vital signs including blood pressure and heart rate were measured before, during and after surgery. Mean arterial pressure (MAP) was calculated.

        Results

        Both groups were comparable except that fewer patients in the control group were pseudophakic in the fellow eye (25.3% vs. 41.3%). More patients in the control group perceived hand movements (p ​< ​0.01), surgeon/medical staff (p ​= ​0.04) and sudden increase in vision during surgery (p ​< ​0.01) compared to midazolam group. More control group patients experienced fear (p ​< ​0.001), pain (p ​= ​0.06) and unpleasant surgical experience (20.3% vs. 1.3%, p ​< ​0.001). They also experienced greater fluctuation in MAP (16.9 ​± ​7.9 vs.7.2 ​± ​5.3, p ​< ​0.001) and this was accentuated in hypertensives. After adjusting for age, gender, hypertension status and other eye lens status, multivariable logistic regression analysis revealed that subjects in the control arm (OR ​= ​11.7, 95% [CI] ​= ​1.3–108, p ​= ​0.03), had a longer duration of surgery, experienced pain and more likely to report unpleasant experience. Adjusting for similar covariates, multivariable linear regression analysis showed that control group patients (β ​= ​8.5 ​mmHg, 95% CI ​= ​6.2–10.8, p ​= ​0.03) had hypertension, experienced fear during surgery and greater fluctuations in the MAP.

        Conclusions

        A sedative dose of intravenous midazolam during phacoemulsification under topical anesthesia significantly reduces patients’ visual experience, fear and fluctuations in MAP and improves overall surgical experience.  
          
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        发布时间：2023-11-15
      • 2021, 1(1): 100007. DOI: 10.1016/j.aopr.2021.100007
        摘要：

        Background

        To evaluate the feature of different retinal layer segmentation in neuromyelitis optica spectrum disorders (NMOSD) with spectral-domain optical coherence tomography (SD-OCT) and to compare it with that in multiple sclerosis (MS), healthy controls (HC), and idiopathic optic neuritis (ION).

        Methods

        We retrieved four electronic databases, including Pubmed, Embase, Cochrane Library, and Web of Science from inception to September 1st, 2021. A meta-analysis was performed to compare different retinal layer segmentation thicknesses between patients with or without a history of optic neuritis (ON) in NMOSD and the control group, including patients with MS, HC, and ION.

        Results

        Forty-two studies were included and the interval between the last ON onset and examination was greater than 3 months. Compared with that in HC eyes, the loss of retinal nerve fiber layer (RNFL) and macular ganglion cell and inner plexiform layer (GC-IPL) was serious in NMOSD eye especially after ON. Moreover, compared with that in ION eyes or MS-related-ON eyes, the injury to the peripapillary retinal nerve fiber layer (pRNFL) was severe in NMOSD-related-ON eyes. In addition, the correlation coefficient between pRNFL and prognostic visual acuity was 0.43. However, the one-arm study revealed the inner nuclear layer (INL) was thickened in NMOSD-related-ON eyes compared with HC eyes.

        Conclusions

        Inclusion of the RNFL and macular GC-IPL is recommended for monitoring disease progression and attention should be paid to changes in the INL.  
          
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        发布时间：2023-11-15
      • 2021, 1(1): 100008. DOI: 10.1016/j.aopr.2021.100008
        摘要：

        Background

        Cataract is the world's leading eye disease that causes blindness. The prevalence of cataract aged 40 years and older is approximately 11.8%–18.8%. Currently, surgery is the only way to treat cataracts.

        Main Text

        From early intracapsular cataract extraction to extracapsular cataract extraction, to current phacoemulsification cataract surgery, the incision ranges from 12 to 3 ​mm, and sometimes to even 1.8 ​mm or less, and the revolution in cataract surgery is ongoing. Cataract surgery has transformed from vision recovery to refractive surgery, leading to the era of refractive cataract surgery, and premium intraocular lenses (IOLs) such as toric IOLs, multifocal IOLs, and extended depth-of-focus IOLs are being increasingly used to meet the individual needs of patients. With its advantages of providing better visual acuity and causing fewer complications, phacoemulsification is currently the mainstream cataract surgery technique worldwide. However, patient expectations for the safety and accuracy of the operation are continually increasing. Femtosecond laser-assisted cataract surgery (FLACS) has entered the public's field of vision. FLACS is a combination of new laser technology and artificial intelligence to replace fine manual clear corneal incision, capsulorhexis, and nuclear pre-fragmentation, providing new alternative technologies for patients and ophthalmologists. As FLACS matures, it is being increasingly applied in complex cases; however, some think it is not cost-effective. Although more than 26 million cataract surgeries are performed each year, there is still a gap in the prevalence of cataracts, especially in developing countries. Although cataract surgery is a nearly ideal procedure and complications are manageable, both patients and doctors dream of using drugs to cure cataracts. Is surgery really the only way to treat cataracts in the future? It has been verified by animal experiments that lanosterol therapy in rabbits and dogs could make cataract severity alleviated and lens transparency partially recovered. Although there is still much to learn about cataract reversal, this groundbreaking work provided a new strategy for the prevention and treatment of cataracts.

        Conclusions

        Although cataract surgery is nearly ideal, it is still insufficient, we expect the prospects for cataract drugs to be bright.  
          
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        发布时间：2023-11-15
      • 2021, 1(1): 100005. DOI: 10.1016/j.aopr.2021.100005
        摘要：

        Background

        Keratoconus (KC) is the most common ectatic corneal disease, characterized by significantly localized thinning of the corneal stroma. Genetic, environmental, hormonal, and metabolic factors contribute to the pathogenesis of KC. Additionally, multiple comorbidities, such as diabetes mellitus, may affect the risk of KC.

        Main Text

        Patients with diabetes mellitus (DM) have been reported to have lower risk of developing KC by way of increased endogenous collagen crosslinking in response to chronic hyperglycemia. However, this remains a debated topic as other studies have suggested either a positive association or no association between DM and KC. To gain further insight into the underlying genetic components of these two diseases, we reviewed candidate genes associated with KC and central corneal thickness in the literature. We then explored how these genes may be regulated similarly or differentially under hyperglycemic conditions and the role they play in the systemic complications associated with DM.

        Conclusions

        Our comprehensive review of potential genetic factors underlying KC and DM provides a direction for future studies to further determine the genetic etiology of KC and how it is influenced by systemic diseases such as diabetes.  
          
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        发布时间：2023-11-15
      • 2021, 1(1): 100001. DOI: 10.1016/j.aopr.2021.100001
        摘要：

        Background

        The harmful effect of aerial fine particulate matter（PM2.5）has been a serious public health issue and has attracted worldwide attention, especially in developing countries.

        Main Text

        Numerous previous clinical and experimental studies have demonstrated that PM2.5 has a clear pathogenic effect on diseases related to the respiratory and cardiovascular systems. Recent researches have pointed out that PM2.5 plays a pivotal role in the occurrence and progression of ocular surface diseases. The current studies have shown that PM2.5 may promote the appearance of conjunctivitis, keratitis, blepharitis, dry eye, meibomian gland dysfunction（MGD） and other ocular surface diseases through regulating a series of mechanisms such as inflammation, immune reaction, oxidative stress, autophagy, cell migration, and epigenetics.

        Conclusions

        This review aims to summarize the current research progress on the pathogenic mechanism of PM2.5-related ocular surface diseases.  
          
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        发布时间：2023-11-15
      • 2021, 1(1): 100003. DOI: 10.1016/j.aopr.2021.100003
          
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        发布时间：2023-11-15
      • 2021, 1(1): 100009. DOI: 10.1016/j.aopr.2021.100009
          
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        发布时间：2023-11-15
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