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Chinese Journal of Optometry Ophthalmology and Visual science
 
2023 Vol.25 Issue.7
Published 2023-07-25

Orignal Article
Case Report
Editorial
Review
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2023 Vol. 25 (7): 0- [Abstract] ( 107 ) [HTML 1KB] [ PDF 507KB] ( 4725 )
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2023 Vol. 25 (7): 0- [Abstract] ( 112 ) [HTML 1KB] [ PDF 47036KB] ( 7196 )
Editorial
481 Proper Understanding of Cytokines Detection in Diagnosis and Therapy of Eye Diseases
Jian Li1, Yong Tao2, Xinzhu Hou1,et al
Cytokines, which known as a "language between cells", are involved in the development of various eye diseases. The detection of cytokines plays an increasingly important role in the study of the molecular mechanism of eye disease pathogenesis, the construction of clinical guidelines and expert consensus, and the development of novel targeted therapies. With the aim of accurate and personalized medicine in ophthalmology, this article presents the application and signifcance of cytokine detection in the diagnosis and therapy of various eye diseases, as well as the advances in several molecular targeted therapies.

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2023 Vol. 25 (7): 481-485 [Abstract] ( 109 ) [HTML 1KB] [ PDF 907KB] ( 5028 )
Orignal Article
486 Analysis of the Effcacy ofAnti-VEGF Drugs in the Treatment for BRVO-ME and Changes of Infammatory Factors in HumanAqueous Humor
Yifan Xu, Ruifeng Wang, Zheng Fu, et al
Objective: To analyze the changes of inflammatory cytokines in human aqueous humor during the medication treatment with fusion protein anti-vascular endothelial growth factor (anti-VEGF) drugs for branch retinal vein occlusion-macnlar edema (BRVO-ME). Methods: In this prospective study, Forty patients (40 eyes) with BRVO-ME who attended the Second People's Hospital of Zhengzhou from January 2018 to April 2019 were randomly selected and divided into 20 patients (20 eyes) in the Conbercepe group and 20 patients (20 eyes) in the Aflibercepe group. Three initial monthly intravitreal anti-VEGF drugs injections followed by rejection if needed was performed. The patients' best corrected visual acuity (BCVA) and centrel retinal thickness (CRT) measued by optical coherence tomography were recorded. Before each injection, a sample of the patient's aqueous humor was extracted and the indexes of VEGF, placental growth factor (PIGF), monocyte chemotactic protein-1 (MCP-1), and interleukin-6 (IL-6) were measured. In case of normally distributed data, a t-test was conducted to compare 2 groups, and χ2test was used to compare counting data. Results: After therapy, patients' BCVA and CRT signifcantly improved compared to the prior injection (P<0.05). There was no signifcant difference in the number of injections, BCVAand CRT between the two groups (P>0.05). VEGF, PIGF, and IL-6 levels in aqueous humor were signifcantly lower in both groups compared to initial levels in the following treatment (P<0.05). In the frst and second months of treatment, neither group of patients' MCP-1 factor concentration in aqueous humor substantially changed from baseline (P>0.05), however, in the third month of treatment, it decreased compared to baseline (P<0.05). There were no discernible differences between the two groups (P<0.05). Conclusions: Both conbercept and afibercept can improve the visual acuity of BRVO-ME patients, reduce macular edema, and signifcantly inhibit the angiogenic factors and infammatory factors of aqueous humor in patients with BRVO-ME. There was no signifcant difference in the clinical effcacy and inhibitory effect on aqueous humor cytokines between the two fusion protein based anti-VEGF drugs in the treatment of BRVO-ME.

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2023 Vol. 25 (7): 486-491 [Abstract] ( 115 ) [HTML 1KB] [ PDF 789KB] ( 4978 )
492 ClinicalFeatureofOcular and Detection of Different Laboratory Samples from HIV Infector with Ocular Syphilis
Wenjun Kong1, Lianyong Xie1, Kuifang Du1, et al
Objective: To explore the methods of clinicalfeatureofocular and detection of different samples in laboratory from patients from human immunodefciency virus (HIV) -infected patients with ocular syphilis. Methods: This was a case series study. From January 2022 to September 2022, using random sampling method, 8 patients (11 eyes) with HIV and ocular syphilis who were frst diagnosed in the Ophthalmology Department and Infection Center Department of Beijing You'an Hospital were recruited, and had not received any treatment for syphilis before the visit. All patients have received highly active antiretroviral therapy (HAART). The standard logarithmic visual acuity chart, non-contact tonometer, slit lamp, ultra-wide angle fundus photography and optical cohrence tomography (OCT) were used to observe the best corrected vision, intraocular pressure, anterior segment and fundus of the patient. Blood, cerebrospinal fuid and aqueous humor were extracted by blood extraction, lumbar puncture and paracentesis of anterior chamber. Syphilis infection in the blood, cerebrospinal fluid and aqueous humor of the patients were detected by rapid plasma regain (RPR) and Treponema pallidum particle agglutination (TPPA). According to the treatment principle of neurosyphilis, 8 cases of ocular syphilis were treated with penicillin by intravenous drip. Follow up for 3-6 months. Results: All 8 patients were HIV-infected, including 6 males and 2 females. Ten eyes of 11 patients were syphilitic optic neuroretinitis, and 1 eyes were syphilis-related anterior uveitis. The number of CD4+T lymphocytes count in peripheral blood of patients was average 147 (67, 318) cell/μL. The HIV viral load was average 1 295 (0, 4 801) copies/mL. Eight patients showed positive TPPAand RPR in blood, TPPAin cerebrospinal fuids were positive in 8 cases, and RPR in cerebrospinal fuids were positive in 7 cases. The TPPA in aqueous humor of 11 eyes were positive, and the RPR in aqueous humor of 10 eyes were positive. After regular treatment of penicillin, the best corrected vision of 8 patients were signifcantly improved. Conclusions: The detection of TPPAand RPR in blood, cerebrospinal fuid and aqueous humor are important laboratory test methods for the diagnosis of HIV infected patients with ocular syphilis. The detection of TPPAand RPR in aqueous humor is helpful for the diagnosis of HIV infected patients with ocular syphilis who are frst diagnosed in ophthalmology.

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2023 Vol. 25 (7): 492-498 [Abstract] ( 103 ) [HTML 1KB] [ PDF 4216KB] ( 5369 )
499 Contributions of Sleep Deprivation to the Development of Lens-Induced Myopia and Retinal Dopamine Metabolism in Guinea Pigs
Xueli Yang, Yao Chen, Yuxin Guan, et al
Objective: To investigate the effects of sleep deprivation (SD) on the development of lens-induced myopia (LIM) and the dopamine (DA) metabolism in guinea pigs. Methods: This was an animal experimental study. A total of 30 three-week-old guinea pigs supplied were randomly divided into two groups: LIM group and LIM+SD group, raised either in a normal sleep environment or subjected to sleep deprivation for 20 hours every day. Refraction, corneal curvature radius, and ocular axial components were measured. The content of DAand 3, 4-dihydroxyphenylacetic acid (DOPAC) in the retina was assessed by the high-performance liquid chromatography electrochemical method, and the DOPAC/DA ratio was calculated. The expression of retinal tyrosine hydroxylase (TH) protein was evaluated by immunohistochemical staining and Western blot. Paired t-test was used to compare the refraction and DAturnover between the left and right eyes of guinea pigs. Independent sample t-test was used for comparison between the LIM group and the LIM+SD group. The refractive error and axial length of the guinea pig eyes in the defocus eyes underwent a correlation analysis with DA content by using Pearson correlation analysis. Results: Normal refractive development was not affected by SD in guinea pigs. However, SD signifcantly deepened myopia and prolonged the ocular axis of defocus eyes (t=5.63, P<0.001; t=-3.87, P=0.001). The content of retinal DAand DOPAC in all defocus eyes was lower than that in their control eyes (LIM group: t=-8.64, P<0.001; t=-13.03, P<0.001; LIM+SD group: t=-11.72, P<0.001; t=-16.32, P<0.001). Compared with LIM group, the defocus eyes of LIM+SD group had lower DAand DOPAC obviously (t=5.35, P<0.001; t=3.80, P=0.002), while the DOPAC/DA ratio increased and the difference was statistically signifcant (t=-3.60, P=0.003). The content of retinal DAin defocus eyes was correlated with refractive error (r=0.93, P<0.001) and eye axis length (r=-0.77, P=0.001). Retinal immunohistochemical staining showed that TH positive cells were mainly distributed in the nerve fber layer, ganglion cell layer, inner plexiform layer, and inner nuclear layer, and had a minor portion in outer plexiform layer. The expression of TH protein in defocus eyes was reduced compared with control eyes. Western blot showed that the expression of TH protein in defocus eyes was signifcantly lower than control eyes (LIM group: t=-40.25, P<0.001; LIM+SD group: t=-17.64, P<0.001). But the retinal TH protein expression had no significant difference in the defocus eyes between the LIM and LIM+SD groups (P>0.05). Conclusions: SD had no signifcant effects on normal refractive development. However, in a lens-induced environment, SD promotes the development of LIM in guinea pigs probably by accelerating DAcatabolism without affecting DAanabolism.

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2023 Vol. 25 (7): 499-505 [Abstract] ( 127 ) [HTML 1KB] [ PDF 4227KB] ( 5378 )
506 Comparison of the Efficacy of Peripheral Myopic Defocus Design and Orthokeratology Lenses to ControlAxial Elongation in Children with Myopia
Li Wei1, Ming Wang2, Shiao Yu1,et al
Objective: To compare the effectiveness of peripheral myopic defocus design spectacle lenses (PMDSL) and orthokeratology (OK) lenses in controlling axial elongation in children with myopia. Methods: In this retrospective study, we continuously enrolled children aged 6 to 14 with myopia ranging from -6.00 to -1.00 D, who were ftted with PMDSL lenses (149 cases) or OK lenses (152 cases) at the First Affliated Hospital of Zhengzhou University between June 2020 and June 2021. They were then followed up for a period of 12 months. Subsequently, the children were divided into four subgroups based on their age (6 to 10 years old, including 10 years old; 10 to 14 years old) and median myopia (-3.00 to -1.00 D, including -3.00 D; -6.00 to -3.00 D). The t-test and multiple linear regression analysis were used to compare the axial elongation between PMDSL and OK lenses groups, as well as among the four subgroups. Results: After 12 months, the axial elongation was 0.23±0.16 mm in the PMDSL group and 0.17±0.19 mm in the OK lenses group (t=2.86, P=0.007). The multiple linear regression analysis revealed that the axial elongation in the PMDSL group was 0.04 mm more than that in the OK lenses group (β=0.04, P=0.019). In the subgroups of children aged 6 to 10 years, the axial elongation was 0.26±0.16 mm in the PMDSL group and 0.19±0.21 mm in the OK lenses group (t=2.78, P=0.009). Among children with myopia ranging from -6.00 to -3.00 D, the axial elongation in the PMDSL group was 0.21±0.13 mm, while it was 0.13±0.18 mm in the OK lenses group (t=2.92, P=0.006). The multiple linear regression analysis further demonstrated that the axial elongation in the PMDSL group was 0.05 mm (β=0.05, P=0.041) and 0.07 mm (β=0.07, P=0.039) more than that in the OK lenses group in the corresponding subgroups mentioned above. However, there was no signifcant difference between the two subgroups of children aged 10 to 14 years and those with myopia ranging from -3.00 to -1.00 D (all P>0.05). Conclusion: OK lenses were found to be more effective than PMDSL in controlling axial elongation over a one-year treatment period, especially in children with relatively younger ages and higher degrees of myopia.

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2023 Vol. 25 (7): 506-511 [Abstract] ( 114 ) [HTML 1KB] [ PDF 830KB] ( 5241 )
512 The Effect of Treatment on Macular Microvasculature in Children with AnisometropicAmblyopia
Min Tang, Liying Luo, Yang Fu
Objective: To analyze the alternations of macular microcirculation in children with anisometropic amblyopia before and after treatment. Methods: This was a prospective study held from January 2019 to December 2020. Totally 42 children aged from 6 to 12 years old with anisometropic amblyopia were enrolled from the ophthalmology clinic of Shanghai General Hospital, and 27 children with non-amblyopia in the same age group were enrolled as a normal control group. Children with amblyopia received treatment and follow-up for at least 6 months. Optical coherence tomography angiography (OCTA) was used to analyze the macular vessel density of superficial capillary plexus (SCP) and deep capillary plexus (DCP), foveal avascular zone (FAZ), and macular thickness of both eyes before and after treatment. Data were corrected by eye axis length using Littman formula. Analysis of variance was used to compare the differences between amblyopic eyes, fellow eyes, and normal control group. And paired t-test was used to compare the differences before and after treatment for amblyopic eyes and fellow eyes. The alternations of visual acuity (LogMAR value) were analyzed in relation to the alternations of SCP, DCP, and FAZ. Results: At baseline, the vessel densities of whole image SCP, foveal SCP, whole image DCP and foveal DCP in amblyopic eyes were significantly smaller than those in fellow eyes and normal control group (all P<0.05), FAZ in amblyopic eyes were significantly greater than those in fellow eyes and the normal control group (F=53.57, P<0.001), while the differences between fellow eyes and the normal control group were not signifcant (P>0.05). After treatment, the vessel densities of whole image SCP and parafoveal SCP in amblyopic eyes were signifcantly higher than those at baseline (t=3.75, P=0.001; t=2.62, P=0.012), Whole image DCP in amblyopic eyes were significantly higher than those at baseline (t=2.63, P=0.012). But there was no significant difference between whole image SCP and whole image DCP in amblyopic eyes with fellow eyes and normal control group (P>0.05). FAZ in amblyopic eyes were signifcantly reduced from those at baseline (t=-2.33, P=0.025), but they were still significantly larger than those in fellow eyes and normal control group (F=32.38, P<0.001). Macular thickness did not show sighifcant difference between eyes irrespective treatment (P>0.05). After treatment, the best corrected visual acuity (LogMAR) of amblyopic eyes increased from 0.46±0.34 at baseline to 0.17±0.17 after treatment (t=4.91, P<0.001). There was no signifcant correlation between the alternations of visual acuity in amblyopic eyes with the alternations of whole image SCP, whole image DCP, and FAZ (all P>0.05). Conclusions: The vessel density of macular SCP and DCP in anisometropic amblyopia eyes are lower than those in normal eyes, while FAZ is greater. After amblyopia treatment, SCP, DCP and FAZ tend to approach to normal levels to a certain extent. There is no signifcant correlation between the alternations of visual acuity in amblyopic eyes with the alternations of SCP, DCP, and FAZ.

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2023 Vol. 25 (7): 512-517 [Abstract] ( 110 ) [HTML 1KB] [ PDF 4330KB] ( 5322 )
518 Comparison of Rotation Stability of Phakic Implantable Collamer Lens with Different Implantation Orientations
Shuaifei Li1, Changtao You1, Lingling Xu1,et al
Objective: To compare the rotation stability of horizontal, oblique, vertical implantable collamer lens (ICL) implantation and horizontal Toric ICL (TICL) implantation at 1 month and 1 year after operation. Methods: This was a retrospective clinical study. One hundred and eighty-four eyes of 92 consecutive patients with refractive errors who underwent ICL (V4c) implantation in the refractive surgery department of Zhengzhou Aier Eye Hospital from January 2020 to June 2021 were collected, composed of 59 eyes in horizontal ICL group, 33 eyes in oblique ICL group, 36 eyes in vertical ICL group, and 56 eyes in horizontal TICL group according to the axial orientation of the lens on the frst day after the operation.Uncorrected visual acuity, intraocular pressure, vault, and lens axial direction were recorded at 1 day, 1 month, and 1 year after operation, and the effectiveness index, lens rotation angle, and lens rotation direction were further calculated. Analysis of variance of repeated measures was used for the data analysis. Kruskal-Wallis test was used to compare lens rotation angles among groups. Pearson Chi-square test was used to compare lens rotation direction among groups. Spearman rank correlation analysis and multiple linear regression analysis were used to explore the correlation of age, gender, and other indicators with the lens rotation angle at 1 year after operation. Results: There were no signifcant differences in the effectiveness index, intraocular pressure, vault, and endothelial cell density among horizontal ICL group, oblique ICL group, vertical ICL group, and horizontal TICL group at 1 month and 1 year after operation (all P>0.05). There were no signifcant differences in lens rotation angles among the four groups at 1 month and 1 year after operation (H=6.36, P=0.095; H=4.82, P=0.185). There were no signifcant differences in lens rotation direction among the four groups at 1 month and 1 year after operation (χ2=4.44, P=0.617; χ2=6.03, P=0.420). There had no correlations of age, gender, and other indicators with lens rotation angle at 1 year after operation (all P>0.05). Conclusion: Horizontal ICL, oblique, vertical implantation, and horizontal TICL implantation can achieve relatively consistent postoperative outcomes and rotational stability at 1 month and 1 year after operation.

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2023 Vol. 25 (7): 518-523 [Abstract] ( 155 ) [HTML 1KB] [ PDF 791KB] ( 5042 )
524 Clinical Observation of Central Retinal Artery Occlusions in the Young and Middle-AgedAdults
GuangweiYu, Xin Chen, Ting Wang, et al
Objective: To determine the clinical features, therapeutic effects, and risk factors of central retinal artery occlusions (CRAO) in young and middle-aged adults. Methods: This was a retrospective study conducted at Jinan Mingshui Eye Hospital from November 2019 to January 2022. Clinical data of 17 (17 eyes) young and middle-aged adults (≤50 years) with CRAO were collected, including general data, medical history, clinical examination results, therapeutic effects, and risk factors. Results: The mean age of the subjects was 43.3±7.0 years (ranging 30-50 years), with 12 males and 5 females.All patients presented with acute vision loss 3 hours to 3 days, and the average blood pressure at the time of visit was 153.24±25.49 / 95.59±15.19 mmHg (1 mmHg=0.133 kPa). Eight eyes had serious visual impairments, including 1 eye with light perception, 5 eyes with hand moving, and 2 eyes with fnger counting. The visual acuity of 5 eyes was worse than 0.1, while 4 eyes were better than 0.15. All patients underwent fundus photography and OCT examination, and 8 patients had Fundus fuorescene angiography examination.All patients had non-arteritic CRAO, including 11 complete CRAO, 5 incomplete CRAO, and 1 case of CRAO with cilioretinal artery sparing. After treatments (follow-up: 5 days to 1 month), visual acuity improved in 10 eyes, 6 eyes had no obvious changes, and 1 eye had worse visual acuity. Blood pressure was elevated in 13 patient (76.5%). Conclusions: Hypertension is the most common system risk factor in the young and middle-aged adults with CRAO. Most patients suffered from serious visual impairments, and the outcomes of visual function were better in incomplete CRAO patients than in complete CRAO patients.

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2023 Vol. 25 (7): 524-529 [Abstract] ( 130 ) [HTML 1KB] [ PDF 10194KB] ( 5683 )
530 The Role of Intraoperative Optical Coherence Tomography in Guiding Vitreoretinal Surgery
Rong Cheng1, Chuan Yu2, Yuqian Wang1, et al
Objective: To evaluate the clinical role of intraoperative optical coherence tomography (iOCT) in guiding vitreoretinal surgeries. Methods: A retrospective series of case study. From February 2021 to December 2021, total 82 patients (82 eyes) who underwent vitreoretinal surgery due to macular hole, epimacular membrane, vitreous hemorrhage and other diseases in Wuhan Eyegood Ophthalmic Hospital were included in this study. All eyes were operated by the same surgeon for 25G vitrectomy, with iOCT scanning recording the preoperative, intraoperative and postoperative changes of retinal structure in the macular area. Analyze the consistency between the operator's observations under the microscope and the scanning images presented by iOCT. Results: Forty-two males and 40 females were included in this study, with ages ranging from 35 to 78 (63.0±7.0). Twenty-fve eyes (30%) were preoperatively diagnosed with epimacular membrane, 16 eyes (20%) with macular hole, 13 eyes (16%) with macular foveoschisis, 25 eyes (30%) with vitreous hemorrhage, and 3 eyes (4%) with vitreomacular traction syndrome. For cases with macular surgery, dynamical changes were observed during the whole operation. The etiologies of vitreous hemorrhage included proliferative diabetic retinopathy (12 eyes), retinal vein occlusion (7 eyes), retinal hole (3 eyes), retinal arterial macro aneurysm (2 eyes), and polypoid choroidal vasculopathy (1 eye). Nineteen cases showed structural abnormalities in the macular area on iOCT scanning, including macular edema (10 eyes), epimacular membrane (5 eyes), macular edema with epimacular membrane (2 eyes), and macular atrophy (2 eyes). Total 69 eyes (84%) showed consistent results between the operator's observation under the microscope and the iOCT image, and other 13 eyes (16%) showed inconsistency. Eventually 11 eyes (13%) were received the changed treatment strategy based on iOCT scanning results, including 4 eyes with macular hole, 3 eyes with epimacular membrane, and 4 eyes with vitreous hemorrhage. Conclusions:iOCT provides a clearly real-time dynamic observation of the intraoperative retina, especially the fine structure of the macular area, which can promptly guide the surgeon to choose a more suitable surgical method.

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2023 Vol. 25 (7): 530-535 [Abstract] ( 127 ) [HTML 1KB] [ PDF 17939KB] ( 6323 )
Case Report
536  
 

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2023 Vol. 25 (7): 536-538 [Abstract] ( 112 ) [HTML 1KB] [ PDF 15921KB] ( 6174 )
539  
 

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2023 Vol. 25 (7): 539-540 [Abstract] ( 117 ) [HTML 1KB] [ PDF 795KB] ( 4970 )
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2023 Vol. 25 (7): 541-543 [Abstract] ( 100 ) [HTML 1KB] [ PDF 9113KB] ( 5626 )
Review
544 Advances of Biotherapy for Treating Intraocular Malignant Tumor
Yuxin Li1, Wei Wei2, Yong Tao1, et al
Intraocular malignant tumors, which are serious blinding diseases and can even be life-threatening, mostly occur in the retina and uvea. With the rapid development of biotechnology, biotherapy for intraocular malignant tumors has evolved to include immunotherapy, small molecule targeted therapy, gene therapy and oncolytic virus therapy. This review summarized the recent advances, current problems, and future perspectives in the fundamental and clinical research of biotherapy for treating retinoblastoma and uveal melanoma, the most common primary intraocular malignancies in children and adults.

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2023 Vol. 25 (7): 544-549 [Abstract] ( 108 ) [HTML 1KB] [ PDF 782KB] ( 5003 )
550 Application of Single-Cell RNASequencing in Diabetic Retinopathy
Dongling Niu1, Yanchun Zhang2, Hongli Liu1
Diabetic retinopathy (DR) is the leading cause of blindness in the working population, and the pathogenesis is intricate and yet to be elucidated. Single-cell RNA-seq (scRNA-seq) provides a powerful tool to explore the pathogenesis of DR at single-cell resolution through in-depth analysis of cellular heterogeneity, functional changes and interactions. This article presents a review of the emerging scRNA-seq technology and its applications in DR, including studies of revealing the cell types and gene expression characteristics, deciphering the pathogenesis, and exploring new therapeutic targets and biomarkers of DR.

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2023 Vol. 25 (7): 550-554 [Abstract] ( 128 ) [HTML 1KB] [ PDF 755KB] ( 5137 )
555 Study of the Clinical Application of Next-Generation Sequencing in HIV Ocular Complications
Luoziyi Wang, Jing Jiang, Zhiliang Wang
Metagenomic next-generation sequencing (mNGS), which enables unbiased analysis of the total microbial and host genes in patients, is increasingly applied to diagnose rare, complex, and severe infections. Moreover, mNGS has broad application prospects in pathogen subtype classification, drug resistance, virulence analysis. Ocular opportunistic infection by immunodeficiency in human immunodeficiency virus (HIV) patients can severely damage the structure and function of eye tissues which is a major cause of visual impairment and blindness in these patients. The pathogenic microorganisms include bacteria, viruses, fungi, spirochetes, and parasites. The ocular opportunistic infections in HIV patients are challenging to diagnose because of the variable clinical symptoms and even mixed infections, meanwhile traditional pathogen detection methods are restricted to apply due to the limited volume of the eyeball and low cell count of intraocular fuids for sampling, and poor specifcity. Compared to traditional detections, metagenomic next-generation sequencing can accurately identify all pathogens causing eye infections in HIV patients with small samples and provide analysis of pathogen virulence and drug resistance. This review will categorize the application of mNGS technology in unbiased microbial detection and analysis of concurrent opportunistic eye infections in HIV patients.

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2023 Vol. 25 (7): 555-559 [Abstract] ( 107 ) [HTML 1KB] [ PDF 684KB] ( 4893 )
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