To compare the intravitreal brolucizumab and bevacizumab injections for chronic central serous chorioretinopathy (cCSC). Patients with cCSC were classified into bevacizumab and brolucizumab group. The proportion of complete resolution of subretinal fluid (SRF), best-corrected visual acuity (BCVA), central macular thickness (CMT), and subfoveal choroidal thickness (SFCT) were compared between the two groups. A total of 40 eyes from 40 patients with aged 34-59y were enrolled in the study. Twenty eyes in bevacizumab group (17 males) and 20 eyes (18 males) in brolucizumab group. Comparing the proportion of complete resolution of SRF, the brolucizumab group was statistically significantly higher than the bevacizumab group (P<0.05). In 1mo, CMT was significantly reduced in the brolucizumab group compared to the bevacizumab group (265±69 vs 319±70 µm; P=0.021). However, there was no significant difference in CMT between the two groups at 2 and 3mo (P>0.05). Brolucizumab is anatomically and functionally superior to bevacizumab in the treatment of patients with cCSC.

To evaluate the clinical features, diagnosis, treatment, and outcome of peripheral exudative hemorrhagic chorioretinopathy (PEHCR), a variant of polypoidal choroidal vasculopathy (PCV), in a case series of Chinese patients. This study was retrospectively conducted from September 2018 to March 2025. Clinical examinations included color fundus photography, B-scan ultrasonography, fluorescein angiography (FA), indocyanine green angiography (ICGA), swept-source optical coherence tomography (SS-OCT), and optical coherence tomography angiography (OCTA), and two active or inactive subgroups and misdiagnosed cases were analyzed. Totally 19 patients (21 eyes) with a mean age of 54.3±9.4 (range, 36-68)y were included, with a majority of women (n=13, 68.4%). The mean follow-up period was 13±1.4 (range: 1-57)mo. Decreased visual acuity was the most frequent initial manifestation (17 eyes, 84.2%), and lesions were mainly distributed in the inferotemporal or temporal quadrant (14 eyes, 66.7%), with choroidal polyps and branching neovascular networks revealed by OCTA and ICGA. Nine patients had been previously misdiagnosed with choroidal melanoma, and 6 of them had massive vitreous hemorrhage (VH). PEHCR manifested along a spectrum ranging from active or inactive subretinal hemorrhagic forms to chronic fibrotic or atrophic forms. One patient experienced natural regression. Ten eyes received a mean of 4.7±1.1 (range: 3-7) intravitreal anti-vascular endothelial growth factor (VEGF) injections, two eyes underwent vitrectomy, and six eyes were treated with vitrectomy combined with anti-VEGF therapy. Best-corrected visual acuity (logMAR) in treated eyes (18 eyes) improved to 0.31±0.25 from the baseline of 1.50 ± 0.75 (P<0.001). PEHCR is a variant of PCV. Chinese patients with PEHCR have a relatively younger age of onset. Anti-VEGF injections and/or vitrectomy are treatment options for lesion regression or dense VH to gain better visual outcomes.

To investigate the long-term outcomes in acute primary angle closure (APAC) patients treated with lens extraction (LE) surgery and to identify risk factors for glaucomatous optic neuropathy (GON). In this longitudinal observational study, detailed medical histories of APAC patients and comprehensive ophthalmic examinations at final follow-up were collected. Logistic regression analysis was performed to identify predictors of blindness. Univariate and multivariate linear regression analyses were conducted to determine risk factors associated with visual outcomes. This study included 39 affected eyes of 31 subjects (26 females) with an average age of 74.1±8.0y. At 6.7±4.2y after APAC attack, 2 (5.7%) eyes had best-corrected visual acuity (VA) worse than 3/60. Advanced glaucomatous visual field loss was observed in 15 (39.5%) affected eyes and 5 (25.0%) fellow eyes. Nine affected eyes (23.7%) had GON, and 11 (28.9%) were blind. Six (15.4%) affected eyes and 2 (9.1%) fellow eyes had suspicious progression. A significantly higher blindness rate in factory workers compared to office workers. Logistic regression identified that worse VA at attack (OR 10.568, 95%CI 1.288-86.695; P=0.028) and worse early postoperative VA (OR 13.214, 95%CI 1.157-150.881; P=0.038) were risk factors for blindness. Multivariate regression showed that longer duration of elevated intraocular pressure (P=0.004) and worse early postoperative VA (P=0.009) were associated with worse visual outcomes. Despite LE surgery, some APAC patients experience continued visual function deterioration. Lifelong monitoring is necessary. Target pressure and progression rates should be re-evaluated during follow-up.

To determine whether paeonol (Pae), a naturally occurring phenolic compound, can serve as an effective pharmacological inhibitor of posterior capsular opacification (PCO). A rat model of cataract surgery-induced PCO was established, and Pae was administered via anterior chamber injection to evaluate its preventive effect on capsular opacification and fibrotic remodeling. Histological and immunohistochemical analyses were performed to assess epithelial-mesenchymal transition (EMT)-related changes in lens epithelial cells (LECs). Ex vivo lens capsule cultures were employed to examine the expression of Vimentin and Zonula Occludens-1 (ZO-1) by immunofluorescence and immunohistochemistry. In the human LEC line SRA01/04, EMT marker expression at both mRNA and protein levels was analyzed following transforming growth factor beta 2 (TGF-β2) stimulation, with Pae treatment. Western blotting and immunofluorescence were used to investigate the effect of Pae on TGF-β/Smad signaling and AMP-activated protein kinase (AMPK) activation. Molecular docking was performed to predict Pae-AMPK binding, and rescue experiments with AMPK inhibition were conducted to validate the mechanistic pathway. Pae significantly reduced capsular opacification and fibrotic remodeling in the rat PCO model compared with controls. In LECs, Pae markedly suppressed TGF-β2-induced EMT, evidenced by decreased expression of mesenchymal markers, such as Vimentin, Fibronectin, Collagen 1A1, α-SMA and preserved epithelial junctional protein ZO-1. Mechanistically, Pae was predicted to directly interact with the catalytic pocket of AMPK, which was experimentally confirmed by enhanced AMPK phosphorylation and nuclear translocation (P<0.05). This activation disrupted canonical TGF-β/Smad signaling, leading to suppression of EMT. Rescue experiments using AMPK inhibition abrogated the anti-EMT effect of Pae, further validating the AMPK-dependent mechanism. Pae exerts a potent inhibitory effect on PCO formation by blocking EMT of LECs through direct activation of AMPK and subsequent disruption of TGF-β/Smad signaling.

To evaluate the agreement of axial length (AL), anterior chamber parameters, and total cornea power obtained by swept-source optical coherence tomography (SS-OCT)-based and Scheimpflug-based optical biometers in myopic children. AL, steep keratometry (K), flat K, posterior corneal keratometry (PK), total keratometry (TK), anterior chamber depth (ACD), horizontal corneal diameter (CD), and central corneal thickness (CCT) were obtained using IOL Master 700 and Pentacam AXL. The agreement between the devices was evaluated using intraclass correlation coefficients (ICC), Bland-Altman plots, and astigmatism vector analysis. Totally 175 myopic children (48.5% male) with a mean age of 10.29±2.14y were enrolled. The ICC and Bland-Altman plots indicated a satisfactory agreement for AL, ACD, and CCT. The mean difference in CD of -0.31±0.30 mm was considered clinically significant (>0.2 mm). Additionally, measurements of K and TK obtained from the IOL Master 700 showed good agreement. Nevertheless, there were clinically significant differences observed in PK, simulated keratometry (simK), total cornea power, and astigmatism (at least 10% of the cases with a difference of >10 degrees in meridian) between the two devices. The study findings demonstrate a significant difference in K, PK, astigmatism, and CD, indicating that the two optical biometers cannot be considered interchangeable. Therefore, it is recommended to utilize one kind device for follow-up examinations in myopic children.

To build a functional generalized estimating equation (GEE) model to detect glaucomatous visual field progression and compare the performance of the proposed method with that of commonly employed algorithms. Totally 716 eyes of 716 patients with primary open angle glaucoma (POAG) with at least 5 reliable 24-2 test results and 2y of follow-up were selected. The functional GEE model was used to detect perimetric progression in the training dataset (501 eyes). In the testing dataset (215 eyes), progression was evaluated the functional GEE model, mean deviation (MD) and visual field index (VFI) rates of change, Advanced Glaucoma Intervention Study (AGIS) and Collaborative Initial Glaucoma Treatment Study (CIGTS) scores, and pointwise linear regression (PLR). The proposed method showed the highest proportion of eyes detected as progression (54.4%), followed by the VFI rate (34.4%), PLR (23.3%), and MD rate (21.4%). The CIGTS and AGIS scores had a lower proportion of eyes detected as progression (7.9% and 5.1%, respectively). The time to detection of progression was significantly shorter for the proposed method than that of other algorithms (adjusted P≤0.019). The VFI rate displayed moderate pairwise agreement with the proposed method (k=0.47). The functional GEE model shows the highest proportion of eyes detected as perimetric progression and the shortest time to detect perimetric progression in patients with POAG.

To investigate the effects of different light intensities and various mydriatic and miotic drugs on pupil accommodation in guinea pigs. Forty-two-week-old guinea pigs were randomly divided into four groups to assess pupillary responses under varying light intensities (100, 250, 500 lx) and pharmacological interventions (1% atropine, 1% cyclopentolate, 1% tropicamide, or 2% pilocarpine). Baseline pupil size and eccentricity were recorded using a non-contact Python-based imaging system integrating edge detection and pixel-to-distance conversion. Direct illumination effects were measured at sequential time points, followed by drug administration and longitudinal tracking of pupillary changes. The protocol was repeated at 12wk of age for developmental comparisons. Post-experiment, enucleated eyes were analyzed to evaluate in vitro vs in vivo differences. Significant age-dependent differences in pupil dynamics were observed. Both 2- and 12-week-old guinea pigs exhibited marked pupil constriction under direct illumination (P<0.001), with decreased eccentricity post-constriction (P<0.001). Indirect illumination caused inconsistent pupil size changes (2-week: P=0.68; 12-week: P=0.49). Pharmacologically, atropine, cyclopentolate, and tropicamide induced pupil dilation (P<0.001), whereas pilocarpine caused constriction (P<0.001). All drug groups showed reduced eccentricity (P<0.001). In vivo/in vitro comparisons revealed significant structural differences. This study investigates pupillary responses in developing guinea pigs, revealing a direct pupillary light reflex (PLR) with light intensity-dependent responses, while indirect PLR was undetectable. The differential effects of muscarinic modulators on pupillary responses underscore the critical role of cholinergic signaling in ocular accommodation, with age-related variations in sensitivity. Additionally, a novel non-contact measurement methodology achieved a precision of 0.01 mm for pupillary quantification, enhancing accuracy in ocular studies.

To investigate the genetic basis of Weill-Marchesani syndrome (WMS) in a Chinese family and clarify the pathogenic mechanism of novel ADAMTS17 mutations. Comprehensive clinical assessments and genetic analyses were performed on a Chinese family with two affected siblings. Whole-exome sequencing (WES) was conducted for the proband and other family members. Bioinformatics tools were used to evaluate the conservation, predicted pathogenicity, and structural effects of the identified ADAMTS17 variants. In addition, protein structure modeling was applied to assess the functional impacts of the mutations. The proband (a 32-year-old male) and his elder sister (42y) presented typical clinical features of WMS, including short stature, brachydactyly, high myopia, ectopia lentis, and secondary glaucoma. WES identified a novel compound heterozygous mutation in ADAMTS17: a splicing mutation (c.451-2A>G) inherited from the father and a missense mutation (c.1043G>A; p.C348Y) inherited from the mother. The splicing mutation disrupted normal mRNA splicing and processing, leading to premature translation termination. The missense mutation, which is located in the metalloprotease catalytic domain, was predicted to abolish a critical disulfide bond, thereby impairing protein stability. Both mutations exhibited high evolutionary conservation and were predicted to be pathogenic by multiple bioinformatics algorithms. A novel compound heterozygous mutation in ADAMTS17 is identified in this WMS-affected Chinese family, and its pathogenicity is verified via bioinformatics analysis and protein structural modeling. These findings are expected to facilitate the genetic diagnosis of WMS and deepen the understanding of its molecular pathogenesis.

To investigate the clinical characteristics and treatment outcomes, including visual function and overall survival (OS) of patients with ocular adnexal diffuse large B-cell lymphoma (OA-DLBCL). This retrospective cohort study enrolled 29 patients diagnosed with OA-DLBCL based on histopathological biopsy between 2006 and 2023. Patients were stratified into two subgroups: primary OA-DLBCL (no prior history of lymphoma) and secondary OA-DLBCL (history of DLBCL at non-ocular adnexal sites). OS was defined as the time interval from OA-DLBCL diagnosis to death from any cause. Survival analysis was performed using the Kaplan-Meier method, and prognostic factors affecting OS were identified using multivariate Cox proportional hazards regression with a stepwise selection approach. The cohort included 24 patients with primary OA-DLBCL (13 males, 11 females; mean age: 61.36±18.29y) and 5 patients with secondary OA-DLBCL (2 males, 3 females; mean age: 50.94±18.17y). Among the primary OA-DLBCL subgroup, 12 patients (50%) presented with advanced disease (Ann Arbor stage IIIE-IV), and 16 patients (66%) were classified as T4 disease according to the tumor-node-metastasis (TNM) staging system. The mean final visual acuity was 1.72±1.10 in the primary group and 0.90±1.18 in the secondary group. The 5-year OS rate for the entire cohort was 27.7%. Multivariate analysis identified five factors significantly associated with poor survival outcomes: epiphora [adjusted hazard ratio (aHR), 36.95], atherosclerotic cardiovascular disease (aHR, 10.08), human immunodeficiency virus (HIV) infection (aHR, 12.47), M1 stage (aHR, 6.99), and secondary OA-DLBCL (aHR, 6.03; all P<0.05). The median OS was 1.68y for primary OA-DLBCL and 1.12y for secondary OA-DLBCL. A substantial proportion of patients with primary OA-DLBCL present with advanced-stage disease at diagnosis. Epiphora, atherosclerotic cardiovascular disease, HIV infection, M1 stage, and secondary OA-DLBCL are independent prognostic factors for poor survival outcomes. These findings emphasize the urgent need for optimized therapeutic strategies and early screening protocols to improve the management of OA-DLBCL, particularly in developing countries.

To evaluate the clinical characteristics and risk factors associated with visual prognosis in patients with open globe injuries (OGIs) treated at Vietnam National Eye Hospital. A prospective observational study included patients with OGIs treated between June 2023 and June 2024. Data on demographics, injury features, and clinical findings were extracted from medical records. Poor visual outcome was defined as final best-corrected visual acuity (BCVA) worse than 20/400 or no light perception. Multivariable logistic regression was performed to identify independent risk factors. Among 509 patients (636 eyes), the mean age was 35.13y (range 20-51y), and 67.6% were male. After treatment, the proportion of eyes achieving ≥20/40 increased from 12.6% to 42.1%, while no light perception decreased from 29.1% to 9.4%. Independent predictors of poor visual outcomes included delayed admission [>4h, odds ratio (OR)=3.33, 95% confidence intervals (CI): 1.76-6.33, P<0.001], Zone III injury (OR=5.90, 95%CI: 2.85-12.24, P<0.001), wound length >10 mm (OR=2.59, 95%CI: 1.60-4.18, P<0.001), relative afferent pupillary defect (RAPD, OR=1.65, 95%CI: 1.03-2.64, P=0.039), endophthalmitis (OR=1.75, 95%CI: 1.01-3.03, P=0.047), retinal detachment (OR=3.32, 95%CI: 2.02-5.45, P<0.001), and eyelid lacerations (OR=1.94, 95%CI: 1.13-3.33, P=0.016) associated with OGIs. Vitreous hemorrhage (OR=0.44, 95%CI: 0.22-0.89, P=0.023) was associated with better outcomes, and female gender appeared protective. Poor visual outcomes remain common after OGIs, despite improve visual acuity in many cases. Several clinical and injury-related factors are strongly associated with prognosis. Early recognition of these predictors can support risk stratification and improve trauma care in similar settings.