Light plays a crucial role in the proper development of human eyesand vision. In this sense. an inevitable tendency of modern development is the evolution of artificial light that, in turn, modulates the human environment. Current advancementsin artificial light technology are also one of the environmental factors that contribute to eye-relatedproblems. A major concern of artificial intelligence lighting in the future will be how to direct the technological progress of lighting to enhance eye health. Integratingvarious research studies and views on visual and optical science, the author puts forward an idea that the future of artificial intelligence lighting should be "from the sun, towards vision health". By providing an optimized spectral distribution,simulating natural light periodic changes, and developing programmable switches of spectral and intensity control, we are adjusting the man-made light to be close to sunlight, but yet more than the sunlight.
Objective: To develop a Rasch-based item bank for the assessment of Cataract-specific patient-reported outcomes (PROs) that can be evaluated precisely, comprehensively and dynamically. Methods: In this cross-sectional study, patients diagnosed with cataract in the Eye Hospital of Wenzhou Medical University were enrolled. Cataract patients answered an item pool of cataract PROs that was established by following the guidelines of the intemational PRO development process. Rasch analysis was used to test the category probability curve (CPC), measure precision, infit/outfit MNSQ, unidimensionality, targeting and differential item functioning (DIF). The items were refined until reliable characteristics were developed for the item bank. A Pearson correlation analysis was used to test each dimension for its correlation with visual acuity.Results: A total of 296 patients (130 males) were recruited for this study. Of those, 60.1% were illiterate with a median age of 70 years, an interquartile range of 63 t0 77 years, and a preoperative binocular visual acuity (LogMAR) range from 0.0 t0 3.0 (median 0.6). The conceptual framework of the item bank consisted of three domains. The Rasch analysis led to the following item banks: "Vision-related activity limitation" (23 items), "Visual symptoms" (14 items) and "Emotional well-being" (11 items). A11 items had four response options. The vision-related activity limitation domain had a category threshold order of -1.84, 0.04, 1.79,a person separation reliability/person separation index (PSR/PSD of 0.93/3.59. an eigenvalue of principal component analysis of 2.61, and targeting of -0.81 none of the items had a DIF. This domain had a moderate correlation with better visual acuity (r-0.619, P<O.OI) and binocular visual acuity (r-0.622, P<O.OI). The vision symptoms domain had a category threshold order of -1.83. -0.18, 2.00, a PSR/PSI of 0.88/2.68, an eigenvalue of principal components analysis of 2.53, and targeting of -1.35. Two items showing a DIF of ocular comorbidities. This domain had a moderate correlation with better visual acuity (r-0.482, P<O.OI)and binocular visual acuity (,-0.492, P<O.OI). The emotional well-being domain had a category threshold order of 2.83, 0.03, 2.80, a PSR/PSI of 0.88/2.68, an eigenvalue of principal components analysis of 2.79,targeting of 0.34. None of the items had a DIF. This domain showed moderate correlation with better visual acuity (r-0.425, P<O.01) and binocular visual acuity (F=0.426, P<O.01). A11 items were trimmed to meet the goodness of fit statistic criteria of 0.50-1.50. Conclusions: This study, which is based on the Rasch analysis,developed a cataract item bank that covers all three common concern domains of cataract patients. It is a comprehensive assessment denoting the PROs of cataract patients and is easy to understand and administer.It not only shows perfect psychometric properties but is also appropriate f'or measuring PROs in Chinese cataract patients.
Objective: To survey the Chinese ophthalmologists' understanding of clinical research types and provide evidence in clinical and scientific research knowledge. Methods: In this cross-sectional investigation,we designed and developed a survey about different types of clinical research in ophthalmology. Correct answers were worth one point each, and incorrect answers were worth no points. The correct answers were summed to get the total score. The educational background, professional qualifications, ranked distribution of hospitals of the surveyed ophthalmologists, size of the city, and attributes of the hospitals were stratified. The total score differences were compared and analyzed by Kruskal-Wallis H rank sum test. Multivariate logistic regression analysis was used to compare the relationship between total score and associated factors. Results :A total of 233 questionnaires were distributed, and 197 were completed. The effective return rate was 84.5%. The average age of the respondents was 38.8土8.6 years, including 99 males (50.2%) and 98 females (49.8%). The doctors scored higher than undergraduates (F=2.50, P<O.OOI), and residents scored higher than deputy chief physicians (F=3.17, P<O.O01). Ophthamologists practicing in Beijing, Shanghai, and Guangzhou (BSG) and in provinces and prefectures scored higher than those practicing in the countryside (P<0.05). Multivariate logistic regression was used to analyze the relationship between the total score and other factors. For the total score, there were significant differences between BSG [OR=7.52 (2.27-24.96),P<0.001], provinces [OR=3.48 (1.21-10.02), P=0.02], and prefectures [OR=3.18 (1.19-8.48), P=0.02] and the countryside. The other factors were not statistically significant. Conclusions: Highly educated students,residents, and doctors in big cities have higher perceptions of the types of clinical research. This suggests that the training of ophthalmologists should be strengthened and should start with medical students.
Objective: To evaluate the efficacy of drug treatment and iontophoretic collagen crosslinking alone and in combination in the treatment for acanthamoeba keratitis in rabbits. Methods: Rabbit corneas were scraped with circular blades and 0.1 ml acanthamoeba suspension was injected into the central corneal stroma. The injection caused a-3.O-mm diameter white edematous area. A soft corneal contact lens was then applied. Forty-eight hours after acanthamoeba were injected into the comeal stroma, the rabbits were randomly divided into four groups: Group A, untreated (n=10). Group B, treated 7 times/day with eyedrops containing 0.02% chlorhexidine combined with 2% metronidazole (n=10). Group C, stromal crosslinking with 0.1% riboflavin penetration by 5 min of iontophoresis, followed with 370 nm ultraviolet irradiation(10 mW/cm2, 9-mm aperture diameter, 9 min, total energy 5.4 J) (n=10). Group D, drug+crosslinked treatment (n=10). The right eye was selected as the experimental eye, and the left eye was the control eye.After treatment for 90 days, slit-lamp microscopy, confocal microscopy, and corneal histopathology were performed. Confocal microscopy was used to select the images with lesion depths of 100, 200, and 300 lim.The density of the acanthamoeba in each image was measured by Image J software. The experimental data were analyzed by Kruskal-Wallis H tests and 2x2 analysis of variance analysis. Results: After treatment for 90 days, the number of comeal lesions was significantly different in four groups (X2=19.73 8, P<O.O01). The classification of corneal lesions in the Groups B and C was significantly lower than that in the Group A, and the difference was statistically signmcant (P<0.05). The large reduction in the number of corneal lesions in Group D showed that the drug treatment and crosslinking acted synergistically to control the infection.Confocal microscopy measurements of the acanthamoeba density were significantly lower in the Groups B, C and D compared with the Group A (P<0.05). The combination of drug and crosslinking treatment synergistically lowered the density of the parasites. Histopathological sections stained by hematoxylin and eosin confirmed the reduced density of acanthamoeba in the three treated groups compared to the Group A (P<0.05). The combination of drug and crosslinking treatment synergistically lowered the density of the parasites. Conclusions: Iontophoretic comeal collagen crosslinking of acanthamoeba keratitis in rabbit eyes is effective. The combination of drug therapy and crosslinking is superior to local drug therapy alone or simple crosslinking alone.
Objective: To evaluate changes in multifocal electroretinogram (mfERG) and optical coherence tomography(OCT) before and after surgery in patients with thegmatogenous retinal detachment (RRD) involving the macular area. Methods: This was a retrospective study in which 52 eyes (52 patients) with RRD involving the macular area (RRD group) were compared with the fellow healthy eyes (normal control group). All patients in the RRD group underwent scleral buckling surgery. Before each surgery, the eyes were examined by mfERG and OCT. At one week and at l. 3, and 6 months after surgery, the eyes were examined again. Using Pearson product moment correlation analysis and repeated measurement methods were used to analyze the datas. Results: A11 RRD eyes successfully underwent the surgery successfully. The thickness of the macular fovea of the RRD group before surgery, 534士44 Um, was significantly greater than for the normal control group(户17.127, P<0.05). At one week and at l, 3. and 6 months after surgery, the foveal retinal thickness decreased significantly (P<O.01). The Nl and Pl wave amplitude densities at ring l of the RRD eyes were significantly less than in the control eyes (tN l =17.372, tPl=23.943, P<0.05) as was the delay in the peak latency (tNl=5.291, tPl=7.306, P<0.05). At one week and at l, 3, and 6 months after surgery, the N1 and Plwave amplitude densities at ring l were higher than before the surgery (P<O.01). The delay in the peak latency was not significantly changed compared to the preoperative values. At l, 3, and 6 months after the surgery, the best corrected visual acuity was negatively correlated with macular center thickness(r=-0.801, -0.695, -0.643, P<0.05, at each follow up). The ring l Nl and Pl wave amplitude densities were positively correlated with the macular center thickness (rx11=0.702, 0.695, 0.632, rpl=0.811, 0.713, 0.648, P<0.05, at each follow up), but the peak latency was not correlated with the macular center thickness.Conclusions: The morphology and function in the macular area of patients with RRD can be objectively and comprehensively measured by OCT and mfERG applications. With mfERG and OCT. the success after retinal detachment surgery can be assessed.
Fuchs endothelial comeal dystrophy (FECD) is one of the most common indicators for comeal transplantation caused by accidents. Previously, FECD was not common in our country, but now an mcreasing number of FECD patients are diagnosed in concurrence with the development of ophthalmology. As a result, the pathogenesis of FECD has gradually gained more attention. The pathogenesis of FECD is highly complex;it is the result of the interaction between genetic and environmental factors. In this paper, we focus on the genetic basis of FECD. Studying the genetic basis can foster a better understanding of the pathogenesis of FECD and lay a foundation for finding a non-surgical treatment for it.
