To assess the success rate of lacrimal sac hydrostatic pressure application (HPA) maneuver, a conservative office procedure for treatment of congenital nasolacrimal duct obstruction (CNLDO). The medical records of pediatric patients, 36mo old or younger, diagnosed with CNLDO between the years 2016-2022, were retrospectively reviewed. In all children, HPA was performed by a pediatric ophthalmologist. Success was defined as the resolution of epiphora and discharge within 48h of the intervention. A total of 281 eyes (194 patients) with CNLDO underwent HPA. Follow-up data were available for 261 eyes (179 patients, 50.3% male) and these patients were included in the analysis. The mean follow-up time was 11.6±13mo. Ninety-seven patients (54.2%) had unilateral nasolacrimal duct obstruction, while 82 patients (45.8%) had bilateral CNLDO. The mean age at the time of HPA was 5.8±5.9mo. Complete resolution of symptoms was achieved in 102 (39.1%) eyes. Patients 6mo old or younger at the time of HPA had a significantly higher success rate compared to patients older than 6mo (43.7% vs 30.9%, P=0.04). Younger age at the time of pressure application was associated with a higher resolution rate of CNLDO (OR 0.93, P=0.004). Sex assigned at birth, prematurity, laterality of the obstruction and type of symptoms (epiphora, discharge) were not correlated with success. A second HPA was performed in 46 eyes, with resolution of symptoms in 12 eyes (26.1%). Hydrostatic pressure applied on the lacrimal sac by an experienced ophthalmologist or an experienced pediatrician may be an effective treatment for CNLDO. We recommend HPA as an initial active conservative approach in all pediatric patients with CNLDO, especially those younger than 6mo.

To investigate the effects of zingerone (ZO) on the retina in diabetic rats. A total of 70 rats were randomly selected and divided into seven groups [diabetic group (Dm+; n=10), diabetic+metformin group (Dm+Met; n=10), diabetic+ZO25 group (Dm+ZO25; n=10), diabetic+ZO50 group (Dm+ZO50; n=10), diabetic+metformin group+ZO 50 Group (Dm+Met+ZO50; n=10)]. Diabetes was induced by streptozotocin (STZ), and metformin and two different doses of ZO were administered via gavage. Retinal tissues were evaluated by histopathological and immunohistochemical analyses. In diabetic rats, severe retinal inflammation, tissue necrosis, and increased tumor necrosis factor-α (TNF-α) expression were observed. ZO administration reduced these effects in a dose-dependent manner. Protective effects of metformin alone were limited, and no synergistic benefit was observed in ZO+Met groups. Administration of 50 mg/kg ZO to non-diabetic rats caused no retinal toxicity. Additionally, elevated 8-OHdG and c-Jun N-terminal kinase (JNK) expressions in diabetic retinopathy models were significantly reduced by ZO treatment. ZO can markedly reduce the pathological effects of the retina in a diabetic rat model.

To investigate the association between anti-DFS70 antibody positivity and ocular parameters, specifically, the choroidal vascularity index (CVI) and other optical coherence tomography (OCT) metrics, in a healthy population. This age- and sex-matched case-control study enrolled 84 healthy individuals with positive anti-DFS70 antibody findings and 84 healthy negative controls. All participants underwent detailed ophthalmological examinations, including biometry and OCT imaging. Anti-DFS70 positivity was determined by indirect immunofluorescence and scored semi-quantitatively (1+ to 3+). CVI was calculated from OCT images using a standardized protocol with Image J software. Statistical analyses, including Student's t-test, Mann-Whitney U test, Spearman correlation, and logistic regression, were used to compare groups and identify predictive factors. The individuals who tested positive and negative for anti-DFS70 included in the study were matched for age (median age=47y) and sex (F:M=7:1). CVI was significantly lower in the anti-DFS70-positive group compared to the negative group. A higher anti-DFS70 antibody titer was significantly associated with decreased subfoveal and nasal choroidal thickness (P=0.016 and P=0.014, respectively). In univariate regression analysis, CVI was the only significant predictor of anti-DFS70 positivity [odds ratio (OR)=0.02, P=0.025]. Multivariate analysis revealed a positive correlation between macular thinning outside the subfoveal area and anti-DFS70 status (P<0.05). Our study demonstrates a novel association between anti-DFS70 antibody positivity and reduced choroidal vascularity in healthy individuals. These findings suggest that anti-DFS70 antibodies may be associated with subtle choroidal vascular changes detectable by OCT, even in asymptomatic individuals. Further longitudinal research is warranted to clarify the underlying mechanisms and long-term clinical significance of these ocular changes.

To investigate the sex-specific correlation between systemic factors and retinal neurovascular alterations in individuals with type 1 diabetes mellitus (T1DM) who do not exhibit signs of diabetic retinopathy (DR). A cohort participant without DR diagnosed with T1DM, underwent comprehensive ophthalmologic evaluation, optical coherence tomography angiography retinal structural and microvascular density analysis, and systemic parameter assessment. Multiple linear regression analysis was used to investigate the impact of systemic parameters on retinal alterations in distinct gender groups. A total of 182 individuals were included, consisting of 85 males (mean age 23.28±12.75y) and 97 females (mean age 22.98±13.68y). Males exhibited significantly greater thickness in both the internal retinal layer and the entire retina compared to females (P<0.01), whereas females had higher densities of deep retinal vessels and choroidal capillaries (P<0.05). Additionally, glycemic control was found to have a notable influence on retinal thickness in males (P<0.05), while insulin function had a more pronounced impact on retinal structure in females (P<0.01). Furthermore, a significant correlation was observed between thyroid function markers and retinal parameters in both male and female (P<0.05). Sex differences in alterations in retinal structure and microcirculation are observed in individuals with T1DM prior to the development of clinical DR, with a noted association between these changes and systemic parameters.

To investigate the effects of binocular fusional C-optotypes (positive/negative) and 2D planar C-optotypes on the amplitude and stability of transient accommodation (TAC) in adults, and to provide a basis for non-contact myopia intervention. This was a self-controlled study. Using red-blue 3D technology, four experimental stages were set up: Test A [fixating on the 1 m negative fusional C-optotypes, 8△ base-in (BI)], Test B (fixating on the 5 m planar C-optotypes), Test C (fixating on the 1 m planar C-optotypes), and Test D [fixating on the 1 m positive fusional C-optotypes, 20△ base-out (BO)]. A WAM-5500 open-field autorefractor was used to measure TAC and accommodative microfluctuations [evaluated via interquartile range (IQR) and median-based coefficient of variation (CVmed)]. Additionally, the convergence accommodation to convergence (CA/C) ratio was calculated, and a visual fatigue questionnaire was administered to assess participants' subjective visual comfort. A total of 21 subjects (7 males, 14 females; aged 23-41y) with normal binocular visual function were enrolled. The results showed that the TAC increased gradually across the four stages, and these values were Test A (-0.35±0.26 D)<Test B (-0.46±0.24 D)<Test C (-0.77±0.32 D) <Test D (-1.38±0.31 D). There were significant overall differences (F=56.136, P<0.001). Compared with Test C, Test A reduced TAC by 0.42 D (P<0.05), while Test D increased it by 0.61 D (P<0.001). There was no significant intergroup difference in accommodative fluctuation amplitude (all P>0.05), but the fluctuation stability of Test D showed a significant difference between the first 20s and the second 20s (P=0.017). The CA/C ratio was significantly higher in Test D (0.05±0.02 D/△) than in Test A (0.03±0.02 D/△, P=0.007), indicating stronger accommodation-convergence linkage during positive fusional fixation. The visual fatigue scores of all stages were low (median 0-1), with Test D slightly higher than Test B and Test C (P<0.05). No linear correlation was found between TAC and age (all r<0.1, P>0.05). Negative fusional C-optotypes induce ciliary muscle relaxation to reduce TAC, while positive fusional C-optotypes enhance accommodation-convergence coordination to increase TAC. The red-blue 3D-based non-contact training mode exhibits good safety (median visual fatigue scores: 0-1 across all tests) and provides a novel dual-directional (relaxation-activation) strategy for myopia prevention and control.

To compare the visual outcomes between bilateral implantation of Tecnis ZXR00 extended depth-of-focus (EDOF) intraocular lenses (IOLs) and mixed implantation of Tecnis ZXR00 (EDOF) with Tecnis ZMB00 (bifocal) IOLs. This postoperative cross-sectional study enrolled patients who underwent phacoemulsification combined with IOL implantation. Patients were divided into two groups: the bilateral ZXR00 group (ZXR00-only group) and the mixed IOL group (ZXR00+ZMB00 group). Primary outcome measures included uncorrected and corrected distance visual acuity (UDVA, CDVA), uncorrected and distance-corrected near visual acuity (UNVA, DCNVA), uncorrected and distance-corrected intermediate visual acuity (UIVA, DCIVA), and defocus curves. Secondary outcome measures were visual quality, spectacle independence, patient satisfaction, photic phenomena, and stereopsis. A total of 47 patients (94 eyes) were included, with 26 patients (11 males, 15 females) in the ZXR00-only group (mean age: 62.73±7.24y) and 21 patients (7 males, 14 females) in the mixed group (mean age: 65.71±9.16y). There was no statistically significant difference in age between the two groups (P=0.218). The mixed group showed significantly better binocular DCNVA compared to the ZXR00-only group (P=0.002). Defocus curve analysis revealed that the mixed group exhibited superior performance at -2.5 to -4.0 D but inferior performance at -0.5 and -1.5 D. Near stereoacuity was significantly poorer in the mixed group (Randot: 5.589±0.744 vs 6.240±0.394 ln arcsec; Contour: 4.966±0.973 vs 5.740±0.833 ln arcsec; both P<0.01). Both groups achieved high levels of spectacle independence and patient satisfaction, with no significant differences in photic phenomena or questionnaire scores. Mixed implantation of EDOF and bifocal IOLs improve near visual acuity but may compromise near stereopsis. This approach provides a viable option for patients prioritizing near vision; however, caution is recommended for individuals requiring fine stereoscopic vision for daily or professional tasks.

To characterize the distribution of persistent fetal vasculature (PFV) subtypes and to evaluate corneal astigmatism (CA) in children with unilateral PFV. The medical records of patients diagnosed with PFV between January 2014 and August 2021 were retrospectively reviewed. Corneal keratometry parameters were measured using IOLMaster or a handheld keratometer. Differences in CA between the affected and fellow eyes were analyzed in 52 unilateral PFV patients with available examination data. Totally 133 patients diagnosed with PFV were retrospectively reviewed. The male-to-female ratio was 73/60. Median age at surgery was 38.03mo (interquartile range 58.27mo). Among the PFV patients, 32 (24.06%) had anterior PFV, 2 (1.50%) had posterior PFV, and 99 (74.44%) had combined anterior-posterior PFV. Mild combined PFV was the most common subtype. In unilateral PFV cases, the mean CA in the affected eye was 2.29±1.11 D, and 59.62% (31 eyes) had CA≥2.0 D. The mean CA in the affected eyes was significantly higher than in the fellow eyes (1.37±0.77 D; P<0.001). Among PFV-affected eyes with CA≥2.0 D, the steepest corneal meridian was vertically oriented in 30 cases (96.77%), while only 1 case (3.23%) had the steepest meridian oriented horizontally. In children with unilateral PFV, CA is significantly higher in the affected eyes than in the fellow eyes, and the steepest corneal meridian was predominantly oriented vertically.