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  • Open Access Icon
  • Research Article
  • Cite Count Icon 1
  • 10.18240/ijo.2026.03.16
Comparison of binocular vision indices in Parkinson's disease patients vs age-sex-matched healthy controls.
  • Mar 18, 2026
  • International journal of ophthalmology
  • Reyhaneh Shariati-Moghaddam + 8 more

To evaluate the differences in near point of convergence (NPC), fusional vergence, saccadic eye movements, versional eye movements, and heterophoria between patients diagnosed with Parkinson's disease (PD) and healthy subjects. A cross-sectional comparative study was conducted, enrolling two cohorts: a PD group and a healthy control group. The PD group was recruited via non-random convenience sampling, while the control group was selected randomly from individuals without PD. All participants were screened according to predefined inclusion and exclusion criteria before undergoing a comprehensive optometric assessment, which included measurements of uncorrected visual acuity, corrected visual acuity, and objective and subjective refraction. Subsequently, binocular vision function evaluations were performed, covering NPC measurement, fusional vergence reserve assessment at both distance and near, saccadic eye movement testing, and versional eye movement and heterophoria assessment. A total of 42 PD patients and 41 healthy controls were included in the final analysis. The two groups were well-matched in terms of sex distribution [29 males (69.0%) in the PD group vs 29 males (70.7%) in the control group, P=0.867] and mean age (55.3±9.6y in the PD group vs 54.9±9.8y in the control group, P=0.866). The prevalence of abnormal versional eye movements was significantly higher in the PD group than in the control group (23.81%, 95%CI: 12.05%-39.45% vs 7.32%, 95%CI: 1.54%-19.92%; P=0.025). Near exophoria was more prevalent in PD patients (61.90%, 95%CI: 45.64%-76.43%) than in controls (17.07%, 95%CI: 7.15%-32.06%), with a significant difference [odds ratio (OR)=7.99; 95%CI: 2.83-21.99; P<0.001]. The mean NPC was significantly greater (more receded) in the PD group than in the control group (9.01±3.74 cm vs 7.20±2.15 cm; P=0.007). A statistically significant positive correlation was observed between PD severity and NPC values (Pearson's correlation coefficient=0.309; P=0.046). Except for distance base-out break and distance base-out recovery values, all other fusional vergence parameters were significantly lower in the PD group than in the control group (P<0.05). The mean saccadic test score was significantly lower in PD patients than in controls (3.29±0.57 vs 3.78±0.42; P<0.001). Among all fusional vergence indices, near base-in blur yielded the highest area under the curve (AUC=0.877), with a sensitivity of 69% and specificity of 90%, followed by distance base-out blur (AUC=0.824, sensitivity=97.6%, specificity=66.7%), near base-out blur (AUC=0.814, sensitivity=76.2%, specificity=72.7%), near base-out break (AUC=0.749, sensitivity=78.6%, specificity=67.6%), and near base-out recovery (AUC=0.749, sensitivity=95.2%, specificity=50%). PD is associated with significant binocular vision function impairment, with receded NPC and reduced near fusional vergence reserves being the most prominent disorders. These findings highlight the potential value of binocular vision assessment as a non-invasive biomarker for the early detection and clinical monitoring of PD.

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  • Research Article
  • 10.18240/ijo.2026.03.06
Intraocular lens tilt and decentration in congenital ectopia lentis: baseline characteristics and first-year report.
  • Mar 18, 2026
  • International journal of ophthalmology
  • Hui-Wen Ye + 6 more

To investigate the characteristics and associated factors of intraocular lens (IOL) tilt and decentration after transscleral suture-fixated IOL surgery in congenital ectopia lentis (CEL). CEL patients undergoing transscleral suture-fixated IOL surgery were divided into two groups based on implanted IOL type (three-piece IOL or one-piece IOL). The IOL tilt and decentration at 3-month and 1-year postoperative were measured. Multivariate regression analyses were performed to identify the associated factors of IOL tilt and decentration as well as longitudinal changes. The 61 CEL patients (mean age 9.07±5.05y) in three-piece IOL (M/F: 14/7) group had a greater tilt than those with one-piece IOL (M/F: 28/12) group both at 3-month postoperative (horizontal: P=0.024; vertical: P=0.048) and 1-year postoperative (horizontal: P=0.011; vertical: P=0.001). Three-piece IOL group had a greater longitudinal change between 3-month postoperative to 1-year postoperative in IOL tilt (horizontal: P=0.028; vertical: P=0.026) and a greater longitudinal change in horizontal IOL decentration than one-piece IOL group (P<0.05). The longer axial length (AL) was associated with the longitudinal changes in IOL tilt (P=0.039), while the three-piece IOL was associated with the longitudinal changes in horizontal IOL decentration 1-year postoperatively (P=0.011). IOL tilt is greater in the three-piece IOL group than that in the one-piece IOL group 1-year postoperatively. The three-piece IOL is associated with greater longitudinal changes of IOL decentration, while longer AL is associated with longitudinal changes of IOL tilt. For CEL patients, more stable IOL type should be selected and patients with longer AL warrant closer monitoring.

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  • Research Article
  • 10.18240/ijo.2026.03.10
Repeatability, reproducibility, and agreement regarding measurement of choroidal vascularity index between OCT and OCT angiography.
  • Mar 18, 2026
  • International journal of ophthalmology
  • Mu-Han Zhong + 7 more

To explore the repeatability, reproducibility, and agreement in the measurement of the choroidal vascularity index (CVI) for different swept-source optical coherence tomography (OCT) devices and between OCT and OCT angiography (OCTA) images. Two swept-source OCT imaging systems, VG200I and Topcon DRI OCT Triton, were used to capture OCT and OCTA images in triplicate. The first and third images were taken by one operator, and the second image was taken by another operator. The built-in software was used to calculate the CVI from the OCTA images (CVI-OCTA), and a custom-designed algorithm was used to calculate the CVI from the OCT images (CVI-OCT). Repeatability and reproducibility were assessed with the intraclass correlation coefficient (ICC), and agreement between devices and between OCT and OCTA were evaluated with Bland-Altman analysis. Sixty-eight eyes from 35 adults (17 females) were included in the analysis. The average age of the participants was 23.6±2.3y, with an average spherical equivalent refraction of -3.08±2.47 D and an average AL of 25.21±1.20 mm. Both OCT devices demonstrated high repeatability and reproducibility in measuring the CVI-OCTA (all ICCs>0.894 across five choroidal regions) and CVI-OCT (all ICCs>0.838). Furthermore, the between-device agreement in measuring the CVI-OCT was good [mean difference (MD) ranging from -2.32% to -3.07%], but that in measuring the CVI-OCTA was poor (MD, 1.48% to -7.43%). Additionally, the between-imaging agreement (CVI-OCTA versus CVI-OCT) was poor for both devices (Triton, MD, 6.05% to 12.68%; VG200I, MD, 6.67% to 12.09%). Both OCT devices and the two analytical methods demonstrate good stability. The inter-device consistency of CVI-OCT is good, while the inter-device consistency of CVI-OCTA and the consistency between the two analytical methods in the same device are both poor.

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  • Research Article
  • 10.18240/ijo.2026.03.13
Factors influencing the treatment duration and visual prognosis of cytomegalovirus retinitis after allogeneic hematopoietic stem cell transplantation.
  • Mar 18, 2026
  • International journal of ophthalmology
  • Shuo Wu + 3 more

To explore the factors influencing the treatment duration and visual prognosis of cytomegalovirus (CMV) retinitis (CMVR) after allogeneic hematopoietic stem cell transplantation (allo-HSCT). All participants received ganciclovir intravenous infusion or oral and intravitreal injection of ganciclovir (IVG) 3 mg twice a week for 4 consecutive times (induction phase). The affected eyes were divided into stop treatment group (Group A), continue treatment group (Group B), and relapse after treatment group (Group C) according to whether local therapy could be terminated at the end of the induction phase and whether CMVR recurred within 3mo after the termination of local therapy. The study included 31 participants (48 eyes) diagnosed with CMVR including 11 males and 20 females. The mean age was (28±8.2)y. There were 17 cases of binocular disease (34 eyes) and 14 cases of monocular disease (14 eyes). Visual acuity improved in 26 eyes (54.1%), remained unchanged in 9 eyes (18.8%), and decreased in 13 eyes (27.1%). The peak value of blood CMV in Group B was significantly higher than that in Group A (P=0.013). The number of eyes with anterior chamber inflammation in Group C was significantly lower than that in Groups A and B (P=0.015, P=0.016). The average number of interval days was higher in Group A than in Group B. For Group A, there was a strong positive correlation between the number of eyes with CMV positive blood (r=0.712, P=0.031) and visual acuity changes. For Group B, there was a moderately strong positive correlation between the days of blood CMV after transplantation (r=0.371, P=0.043) and the times of injections. For Group C, there was a strong positive correlation between the peak value of blood CMV (r=0.719, P=0.029) and the times of injection. Systemic use of antivirals combined with intravitreal injection of antivirals is effective for patients with CMVR after allo-HSCT surgery. Patients with shorter interval days, higher peak or more days of blood CMV need more injections. Patients with positive blood CMV at initial diagnosis have worse visual prognosis.

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  • Research Article
  • 10.18240/ijo.2026.03.19
Causal relationships between 41 inflammatory cytokines and myopia: a Mendelian randomization study.
  • Mar 18, 2026
  • International journal of ophthalmology
  • Xiao-Fei Wu + 5 more

To investigate the potential causal associations between 41 inflammatory cytokines and myopia using a two-sample Mendelian randomization (MR) approach. Publicly available genome-wide association study (GWAS) datasets were utilized for this two-sample MR analysis. Inflammatory cytokine-related GWAS data were extracted from The University of Bristol's Research Data Repository, and myopia-related GWAS data were obtained from the FinnGen project. Single nucleotide polymorphisms (SNPs) associated with inflammatory cytokines were systematically selected as instrumental variables (IVs) based on three rigorous criteria: relevance, independence, and exclusion of pleiotropy. Five MR methods were employed for causal inference: the inverse-variance weighted (IVW) method as the primary analysis, supplemented by MR-Egger regression, weighted median estimator, simple mode, and weighted mode approaches. Sensitivity analyses were performed to evaluate the robustness of the causal estimates. A total of 773 myopia-associated SNPs were identified. MR analysis revealed that higher levels of macrophage inflammatory protein 1-α (MIP-1α) were associated with a 17% reduced risk of myopia [odds ratio (OR)=0.83; 95% confidence interval (CI): 0.69-0.99; P<0.05]. In contrast, elevated levels of eotaxin (OR=1.26; 95%CI: 1.07-1.47; P<0.01), stromal cell-derived factor-1α (SDF-1α; OR=1.68; 95% CI: 1.08-2.62; P<0.05), and interleukin-2 receptor subunit alpha (IL-2Rα; OR=1.25; 95%CI: 1.01-1.53; P<0.05) were significantly associated with an increased risk of myopia. Sensitivity analyses confirmed the reliability of these results. This study provides evidence supporting a causal relationship between specific inflammatory cytokines and myopia. MIP-1α may act as a protective factor against myopia, while eotaxin, SDF-1α, and IL-2Rα are potential risk factors for myopia. These findings emphasize the critical role of inflammatory pathways in the pathogenesis of myopia, offering novel insights for the development of preventive and therapeutic strategies for myopia.

  • Open Access Icon
  • Research Article
  • 10.18240/ijo.2026.03.02
Depression induces ocular surface inflammation and dry eye-like changes in mice.
  • Mar 18, 2026
  • International journal of ophthalmology
  • Xiang Lin + 9 more

To investigate the impact of depression-like behavior on ocular surface homeostasis in a mouse model, with a focus on dry eye-like alterations. Male C57BL/6J mice (10-12 weeks old) were randomly assigned to control or restraint stress (RS) groups. The RS group underwent three intermittent 24-hour restraint sessions to induce depressive-like behavior. Behavioral testing, tear secretion measurement, and corneal Oregon Green Dextran (OGD) staining were performed. Postmortem analyses included histological evaluation of lacrimal glands, goblet cell quantification using periodic acid-Schiff staining, and assessment of key inflammatory and apoptotic markers: interleukin (IL)-17, matrix metalloproteinases (MMP)-3, MMP-9, IL-13, interferon (IFN)-γ, and cleaved caspase-3 and -8. Repeated RS induced depression-like behavior and significant ocular surface changes. RS-treated mice showed increased corneal OGD uptake and upregulation of gene/protein expression of IL-17, MMP-3, and MMP-9 (P<0.05). Goblet cell density and IL-13 protein expression were reduced, while IFN-γ protein expression was elevated (P<0.05). Cleaved caspase-3 and -8 levels were significantly increased in both cornea and conjunctiva. Tear volume and lacrimal gland size were unchanged; however, mild inflammatory infiltration was observed in lacrimal glands. Repeated RS leads to ocular surface inflammation and dry eye-like pathology, including corneal barrier disruption, goblet cell loss, and epithelial apoptosis. These findings suggest that depression contributes to the pathogenesis of dry eye disease via immune-mediated mechanisms.

  • Open Access Icon
  • Research Article
  • 10.18240/ijo.2026.03.07
Comparison of three different instruments for vault measurements after implantable collamer lens implantation.
  • Mar 18, 2026
  • International journal of ophthalmology
  • Bo-Liang Li + 8 more

To evaluate the differences and consistency of vault measurements obtained by Scheimpflug tomography (Pentacam), anterior segment optical coherence tomography (AS-OCT, CASIA II), and ultrasound biomicroscopy (UBM) following implantable collamer lens (ICL) V4c implantation. Vault measurements were acquired using three modalities: Pentacam, CASIA II AS-OCT, and UBM. Repeated-measures analysis of variance was used to compare the vault values obtained by the three devices. The correlation and consistency of measurements among the three instruments were assessed using the Pearson correlation coefficient, intraclass correlation coefficient (ICC), and Bland-Altman plots. This retrospective study enrolled 210 myopic eyes of 210 patients (158 women and 52 men) who underwent ICL implantation: 108 eyes had a myopic ICL V4c implanted, and 102 eyes had a toric ICL V4c implanted. The mean vault values measured by Pentacam, CASIA II, and UBM were 452.64±204.20 µm, 538.57±203.54 µm, and 560.95±227.54 µm, respectively, with statistically significant differences among the three groups (P<0.05). Pearson correlation analysis showed strong positive correlations between vault values measured by different instruments (all P<0.001). ICC results indicated good consistency among the three measurement modalities (all P<0.001). Stratified analysis revealed that when the vault value was ≤250 µm, the correlation and consistency of measurements across the three instruments were lower than those in the medium and high vault subgroups. Vault values measured by Pentacam are lower than those obtained by CASIA II and UBM, with UBM yielding the highest mean vault values. Measurements from the three instruments are not interchangeable but can serve as mutual references due to their significant correlation and good overall consistency. Pentacam and CASIA II demonstrate the highest consistency in vault measurement. Notably, when the vault value is ≤250 µm, the consistency between Pentacam and the other two instruments decreases significantly.

  • Open Access Icon
  • Research Article
  • 10.18240/ijo.2026.03.09
Goniosynechialysis under a microscope alone and under direct gonioscopy for chronic angle-closure glaucoma patients coexisted with cataract.
  • Mar 18, 2026
  • International journal of ophthalmology
  • Jie Du + 10 more

To compare the efficacy of goniosynechialysis (GSL) under a microscope alone (GM) and under direct gonioscopy (GG) for chronic angle-closure glaucoma (CACG) coexisted with cataract. A prospective, single-center, and randomized controlled trial was conducted. Patients diagnosed as CACG and cataract were randomly allocated into either GM group or GG group. In GM group, the range of peripheral anterior synechiae (PAS) was confirmed through gonio-lens after phacoemulsification with intraocular lens implantation (PEI). PAS was separated only under a microscope. After separating the closed angle of 360° by this method, we used a surgical gonioscope to confirm the PAS range. If any remaining PAS was present, we would separate them with an iris repositor under the direct gonio-lens until angle of 360° was reopened. In GG group, PAS was separated under direct gonioscopy after PEI until angle of 360° was reopened. The range of residual PAS after GSLs was the primary outcome. Intraoperative complications (hyphema), intraocular pressure (IOP) and anti-glaucoma medication usage after operation were the secondary outcomes. Sixty eyes were included, each group comprising 30 eyes. The average age [GM group: 66.3±6.8y (12 males), GG group: 67.6±8.9y (7 males), P=0.550], the baseline IOP (GM group: 29.6±11.5 mm Hg, GG group: 32.4±12.2 mm Hg, P=0.366) and the average initial PAS extent (GM group: 8.9±2.6h, GG group: 9.4±2.5h, P=0.425) were similar in the two groups. In GM group, the PAS range reduced from 8.9±2.6h before operation to 7.2±2.9h after PEI and 3.3±2.2h after GSL. In GG group, the PAS range reduced from 9.4±2.5h before operation to 7.5±2.9h after PEI and 0.1±0.3h after GSL. The PAS after PEI was significantly reduced compared to the pre-operative PAS in both groups (all P<0.001). The extent of residual PAS after GSL in GM group was larger than that in GG group with significant statistical difference (P<0.001). Patients who underwent GSL without a gonioscope were more likely to develop hyphema than those who underwent GSL under direct gonioscopy. The difference of hyphema grade between the two groups was statistically significant (P=0.019). PEI alone can not open 360° of angle completely. PEI+GSL significantly reduced PAS range. But for patients with CACG, GSL under a microscope alone is more difficult to separate stable PAS completely and adequately than GSL under direct gonioscopy.

  • Open Access Icon
  • Research Article
  • 10.18240/ijo.2026.03.18
Causal effect of obesity on cataract and mediating roles of metabolites: a Mendelian randomization study.
  • Mar 18, 2026
  • International journal of ophthalmology
  • Chen Li + 2 more

To investigate the causal effect of obesity on cataract risk and explores the potential mediating roles of metabolites using Mendelian randomization (MR). Summary-level data from large-scale genome-wide association studies to examine the relationship between obesity and cataract were utilized. Obesity-related traits, including body mass index (BMI), waist-to-hip ratio (WHR), and waist circumference (WC). A two-sample MR approach was employed to assess the causal effect of obesity on cataract risk, while potential mediators were identified from suitable genome-wide association studies (GWAS) datasets. Additionally, a metabolic pathway analysis was conducted. An increase of 1 standard deviation (SD) in BMI, WHR, and WC was associated with a significantly higher risk of cataract (BMI: odds ratio (OR) 1.0017, 95% confidence interval (CI): 1.0001-1.0032, P=0.0320; WHR: OR 1.0029, 95%CI: 1.0006-1.0051, P=0.0129; WC: OR 1.0020, 95%CI: 1.0001-1.0038, P=0.0390]. These associations remained robust after adjusting for confounding factors in multivariable MR analysis. Furthermore, a two-step MR analysis identified eight potential metabolic mediators, with one mediator showing a significant causal role in the relationship between obesity and cataract. This work highlights the importance of addressing obesity as a modifiable risk factor for cataracts, particularly through metabolic pathways.

  • Open Access Icon
  • Research Article
  • 10.18240/ijo.2026.03.22
A bibliometric and visualized analysis of choriocapillaris from 2013 to 2023.
  • Mar 18, 2026
  • International journal of ophthalmology
  • Pu-Ying Wei + 2 more

To assess the current research status and emerging trends of the choriocapillaris (CC) by bibliometric analysis. Publications spanning from January 2013 to May 2023 were retrieved on June 27th, 2023, using the Web of Science Core Collection. Bibliometric and visualized analyses were performed employing the bibliometrix, CiteSpace and VOSviewer. A total of 1563 papers met the inclusion criteria, and a publication growth trend was observed. The United States was the leading country in the CC field. Retina and Investigative Ophthalmology & Visual Science stood out as highly impactful and prolific journals. Research topics in the CC field encompassed choroidal neovascularization, choroidal thickness, central serous chorioretinopathy, age-related macular degeneration, myopia, choroidal vascularity index, and diabetic retinopathy, based on the co-citation analysis. The keyword "high myopia" experienced a burst lasting until 2023. In the past decade, research in the field of CC has flourished due to recent advancements in choroidal imaging; with focus shifting towards elucidating its role in various diseases. This will provide novel insights into managing chorioretinal diseases and vision-preserving interventions.