The objective of this study is to analyze both the clinical and imaging characteristics of Nocardia keratitis using the in vivo confocal microscopy (IVCM) technique. A retrospective case series review of cases was undertaken. In Beijing Tongren Hospital's Department of Ophthalmology at Capital Medical University, 16 consecutive patients (16 eyes) were documented between 2018 and 2022, who all presented with Nocardia keratitis, and their medical records were collected. Eleven men and five women made up the group. The study's enrollment criteria necessitated the presence of the typical clinical symptoms of Nocardia keratitis and at least one positive diagnostic test, namely a corneal scraping or microbial culture, confirming Nocardia infection. Patient records, clinical examinations, and microbiological findings were comprehensively analyzed, scrutinizing risk factors, diagnostic delays, symptom presentation, diagnostic strategies, bacterial strain isolation, recovery durations, and visual acuity improvements both before and after the treatment process. This study employed slit-lamp microscopy, in vivo confocal microscopy (IVCM), scraping cytology, microbial culturing, and mass spectrometry identification as its methodological approaches. A study of 16 cases of Nocardia keratitis identified a strong correlation between plant or foreign body injuries, contact lens use, and surgical procedures as risk factors, with 5, 4, and 2 cases, respectively, associated with these exposures. Typically, a diagnosis took 208,118 days, with the fastest diagnosis being completed in 8 days and the slowest taking 60 days. In seven patients, the best corrected visual acuity measured below 0.05; in another seven, it fell between 0.05 and 0.3; and finally, two patients exhibited a visual acuity of 0.3 or greater. Characterized by superficial gray-white infiltrations in a distinctive wreath pattern on the cornea, the typical symptoms included corneal ulcers overlaid with dry, gray-white necrotic tissue; in advanced cases, corneal ulcer perforation occurred. Of the 16 cases studied, Nocardia corneal infection was diagnosed in 12 cases via scraping cytology, 9 cases by mass spectrometry, and 8 cases with both diagnostic methods. The corneal subepithelial and superficial stromal layer showed, via IVCM, filamentous hyphae that were elongated, beaded, branched, and fine to moderately reflective in appearance. bioinspired microfibrils Inflammatory cells, round and hyper-reflective, were also observed infiltrating the hyphae. Fourteen cases were managed through pharmacological intervention, and two cases via corneal transplantation. Following a minimum of six months of observation for all patients, the mean healing time was 375,252 days, and there were no instances of recurrence. The early stages of Nocardia keratitis are marked by dense, round, or wreath-like infiltrations. Subsequently, gray-white, dry, necrotic secretion and the formation of hypopyon become prominent features on corneal ulcer surfaces in the intermediate and advanced stages. The IVCM images exhibit a corneal lesion, a hallmark of which are fine, branched, or beaded, moderately reflective filamentous structures.
Employing domestic and InflammaDry point-of-care kits, a comparison of tear matrix metalloproteinase 9 (MMP-9) assays will be conducted, evaluating the suitability of the domestic kit in establishing a diagnostic strategy for dry eye. A cross-sectional study design was employed. The cross-sectional study, conducted continuously from June 2022 through July 2022, involved 30 dry eye patients and 30 age- and sex-matched healthy volunteers. The investigation of tear MMP-9 levels involved the application of both domestic and InflammaDry kits. Positive rates served as the basis for qualitative analysis, and quantitative analysis used the gray ratios of bands (the gray value of detection bands in comparison to the gray value of control bands). The correlations among MMP-9 levels, age, ocular surface disease index, fluorescence tear break-up time, tear meniscus height, Schirmer's test score, corneal fluorescein staining score, and meibomian gland dropout were evaluated. Statistical analysis encompassed the use of the Mann-Whitney U test, the paired Chi-square test, the Kappa statistic, and Spearman's correlation coefficient. In the control group, there were 14 males and 16 females, a total of 30 eyes, and their ages averaged 39,371,955 years. GDC-0919 11 men and 19 women (30 eyes) within the dry eye group exhibited moderate to severe dry eye, with ages falling within the 46 to 87 years range. Analysis of tear fluid MMP-9 rates showed a marked difference between dry eye patients (InflammaDry 8667%; domestic kit 7000%) and controls (InflammaDry 1667%, P<0.05). This disparity was further underscored by the excellent agreement between the two kits used (Kappa=0.53, P<0.0001). The Spearman correlation coefficient demonstrated a positive correlation between the corneal fluorescein staining score and gray ratios measured from both kits (InflammaDry = 0.48, P < 0.005; domestic kit = 0.52, P = 0.003). Analyzing the point-of-care assay for tear MMP-9, the domestic and InflammaDry kits show consistent results, with the domestic kit exhibiting decreased sensitivity but increased specificity.
The study seeks to analyze the efficiency and security of collar-button keratoprosthesis (c-bKPro) implantation for corneal blindness in challenging transplant cases within China. A case series was the chosen method for this study. The Eye Hospital of Shandong First Medical University, the Ophthalmology Division of Chinese PLA General Hospital, the Zhongshan Ophthalmic Center, Eye & ENT Hospital of Fudan University's Ophthalmology Department, and the Eye Hospital of Wenzhou Medical University collectively enrolled high-risk corneal blind patients who planned c-bKPro implantation from July 2019 to January 2020 in a prospective and consistent manner. The success of blindness cures and surgical interventions was ascertained through the lens of visual acuity (VA)005. To assess the surgical procedure's safety, the complications and keratoprosthesis retention rate were documented. The study cohort, consisting of 37 subjects (eyes), encompassed 32 males and 5 females, with ages spanning from 27 to 72 years. Following c-bKPro implantation, the observed indicators included corneal graft failure (21 eyes, 568%), chemical injury (8 eyes, 216%), thermal burn (5 eyes, 135%), unexplained corneal opacity (2 eyes, 54%), and corneal perforation (1 eye, 27%). At the three-month point after their surgeries, two trial participants chose to withdraw. Following a six-month observation period, thirty-five patients were monitored, in addition to thirty-one patients who were monitored for a period of twelve months. At six months, the VA was 0.005 in 83.8% of eyes, and at twelve months, it was 0.005 in 81.8% of eyes. Six out of eleven eyes concurrently diagnosed with glaucoma achieved a visual acuity measurement of 0.05. By the one-year point, the c-bKPro retention rate achieved a complete 100% rate. Surgical complications identified in this study included: retroprosthetic membrane formation (5 eyes, 161%), persistent corneal epithelial defects (5 eyes, 161%), macular edema (4 eyes, 129%), new-onset glaucoma (4 eyes, 125%, including one eye withdrawn from the study after 3 months), sterile corneal melting (2 eyes, 65%), sterile vitritis (1 eye, 32%), and infectious keratitis (1 eye, 32%). Implantation of C-bKPro devices is demonstrably a safe and effective approach to addressing corneal blindness in high-risk transplantation cases within China. Dendritic pathology Substantial visual enhancement was possible, coupled with a remarkably low rate of complications following the operation.
Among common clinical ocular surface diseases, Meibomian gland dysfunction (MGD) is frequently observed. Basic and clinical research in the field of MGD has demonstrably progressed in recent years, resulting in the ongoing use of innovative diagnostic and therapeutic techniques within clinical practice. Chinese ophthalmologists' understanding of MGD will be enhanced, and standardized diagnostic and therapeutic approaches to MGD will be established by the Chinese branch of the Asia Dry Eye Society and affiliated academic groups through a discussion of MGD's definition and categorization, informed by recent domestic and international research and clinical experiences, producing a consensus opinion to guide clinicians.
Cornea-related abnormalities, termed drug-induced keratopathy, are triggered by the utilization of particular drugs, predominantly in ophthalmic formulations. Drug preservatives, or the medications themselves, could be the causative agents behind these modifications. The disease is marked by a range of observable clinical features, but the lack of specific diagnostic standards can unfortunately result in misdiagnosis and inappropriate medical intervention. To overcome these obstacles, the Ophthalmology Branch's Cornea Group of the Chinese Medical Association convened prominent experts to scrutinize key strategies in diagnosing and treating drug-induced keratopathy. A cohesive viewpoint has been crafted, to strategize the tackling and management of this malady.
The groundbreaking application of artificial intelligence (AI) in ophthalmology has spurred revolutionary progress in diagnosing and treating eye diseases, resulting in a novel AI-driven diagnostic approach rich with imaging technologies. While clinical ophthalmology applications advance, AI research faces hurdles like inconsistent datasets and novel algorithm designs, insufficient integration of cross-modal information, and the difficulty of clinically interpreting the results. Recognizing the expanding need for AI in ophthalmic research, the creation of standardized data protocols, along with accessible platforms for sharing ophthalmic data, the advancement of crucial algorithms, and the development of understandable clinical models for disease screening, diagnosis, and prediction are essential. Likewise, the profound integration of advanced technologies, such as 5G, virtual reality, and surgical robots, will mark a crucial step in the development of ophthalmic intelligent medicine.