eye diseases

眼部疾病
  • 文章类型: Journal Article
    目的:光学相干断层扫描(OCT)和OCT血管造影(OCTA)在眼科疾病的诊断中有着广泛的应用。本研究旨在提供眼科OCT和OCT血管造影的全面文献计量分析。
    方法:我们从WebofScienceCoreCollection检索了2003年至2022年有关眼科OCT和OCTA的出版物,并使用文献计量工具对分布进行了分析和可视化,趋势,和热点。
    结果:总计,选择了来自106个国家/地区的48,160名作者撰写的20,817篇文章。出版物数量大幅增加。在过去的二十年里,美国是生产力最高的国家,获得最高的引用。最富有成效的期刊是调查性眼科和视觉科学,并且获得了最多的引用。Moorfields眼科医院是生产力最高的机构。BandelloF发表的论文最多,而SpaideRF是最高被引作者。太空射频,2011年,AMJ眼科是被引用最多的文献。\"OCT\",“青光眼”和“OCTA”是过去二十年来的三个热点。“血管密度”和“深度学习”将成为未来的研究热点。
    结论:过去二十年来对关键词的眼科OCT和OCTA研究的文献计量分析,作者,引文,热点和趋势将为全球研究人员提供未来研究与合作的宝贵信息。
    OBJECTIVE: Optical coherence tomography (OCT) and OCT angiography (OCTA) are widely used in the diagnosis of ophthalmic diseases. This study aims to provide a comprehensive bibliometric analysis of ophthalmologic OCT and OCT angiography.
    METHODS: We retrieved publications on ophthalmic OCT and OCTA from 2003 to 2022 from the Web of Science Core Collection and used bibliometric tools to analyze and visualize the distribution, trend, and hotspots.
    RESULTS: In total, 20,817 articles written by 48,160 authors from 106 countries were selected. The number of publications has significantly increased. In the last two decades, the USA was the most productive country and received the highest citations. The most productive journal was Investigative Ophthalmology and Visual Science and received the highest number of citations. Moorfields Eye Hospital was the most productive institution. Bandello F published the most papers, while Spaide RF was the highest cited author. SPAIDE RF, 2011, AM J Ophthalmology was the most cited document. \"OCT\", \"glaucoma\" and \"OCTA\" were three hotspots in the last two decades. \"Vessel density\" and \"deep learning\" would be research hotspots in the future.
    CONCLUSIONS: The bibliometric analysis of ophthalmic OCT and OCTA research over the past two decades on keywords, authors, citations, hotspots and trends will provide global researchers with valuable information for future research and cooperation.
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  • 文章类型: Journal Article
    目的:克鲁松综合征是一种由10号染色体FGFR2基因突变引起的先天性遗传性疾病。它通常以常染色体显性遗传,是最常见的颅骨融合综合征之一。本文重点介绍克鲁松综合征的眼科相关方面,以帮助诊断和制定个性化治疗方案。
    方法:通过使用布尔运算符AND和OR对PubMed电子数据库进行组合系统搜索,选择以下关键字:\"Crouzon\",“颅骨融合症”,\"eye\",\"oculus\",“眼”,“眼科”,“眼科”,“眼科”,\"地球仪\",\"轨道\",“眼球突出”,\"驱魔\",“角膜病变”,“视觉”等。在对这些文章进行初步筛选后,重复文献被排除。
    结果:选择了47篇文章。本文介绍了眼部表现,克鲁松综合征可能的发病机制及治疗进展。
    结论:克鲁宗综合征的眼部异常发生率很高,比如浅轨道,眼球突出,超端粒,暴露性角膜病变,斜视,视神经病变,屈光不正,青光眼,等。这些眼部异常的发病机制与眼眶畸形有关。目前,大多数治疗方法都旨在弥补异常的解剖结构。
    OBJECTIVE: Crouzon syndrome is a congenital genetic disease caused by mutations of the FGFR2 gene on chromosome 10. It is usually inherited in an autosomal dominant pattern and is one of the most common types of craniosynostosis syndromes. This article focuses on the ophthalmology-related aspects of Crouzon syndrome in order to help diagnose and develop personalized treatment plans.
    METHODS: A combined systematic search of PubMed electronic database by using Boolean operators AND and OR was conducted, choosing the following keywords: \"Crouzon\", \"craniosynostosis\", \" eye \", \" oculus \", \" ocular \", \" ophthalmic \", \" ophthalmologic \", \" ophthalmology \", \" globe \", \" orbit \", \" exophthalmos \", \" exorbitism \", \" keratopathy \", \" visual \" etc. After the initial screening of these articles, repetitive literatures were excluded.
    RESULTS: 47 articles were selected. This article introduces the ocular manifestations, possible pathogenesis and treatment progress in Crouzon syndrome.
    CONCLUSIONS: The incidence of ocular abnormalities in Crouzon syndrome is very high, such as shallow orbits, exophthalmos, hypertelorism, exposure keratopathy, strabismus, optic neuropathy, ametropia, glaucoma, etc. The pathogenesis of these ocular abnormalities is related to orbital deformities. Most of the treatments are aimed at compensating the abnormal anatomic structure at present.
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  • 文章类型: Journal Article
    细胞外囊泡(EV)是可由大多数细胞分泌的各种尺寸的纳米级膜囊泡。电动汽车包含各种各样的货物,包括RNA,脂质,蛋白质,和其他具有细胞间通讯功能的分子,免疫调节,以及生理和病理过程的调节。眼睛里的生物流体,包括眼泪,房水,和玻璃体幽默,是基于EV诊断眼部疾病的重要来源。因为分子货物可能反映了其亲本细胞的生物学特性,这些生物流体中的电动汽车,以及在血液中,已被认为是有希望的候选生物标志物用于眼部疾病的早期诊断。此外,EV也已被用作许多眼部病症中的治疗剂和靶向药物递送纳米载体,因为它们在本质上具有低免疫原性和优异的生物相容性。在这次审查中,我们概述了基于EV的眼部疾病诊断和治疗研究领域的最新进展。我们总结了应用于眼部疾病的电动汽车的起源,评估了从眼部生物流体样品中分离EV的不同方法,强调了电动汽车作为药物输送系统的生物工程策略,介绍了眼病诊断和治疗的最新应用,并在目前的临床试验中展示了它们的潜力。最后,我们简要讨论了基于EV的眼部疾病研究面临的挑战,以及未来更好地关注EV临床转化研究的一些值得关注的问题.
    Extracellular vesicles (EVs) are nanoscale membrane vesicles of various sizes that can be secreted by most cells. EVs contain a diverse array of cargo, including RNAs, lipids, proteins, and other molecules with functions of intercellular communication, immune modulation, and regulation of physiological and pathological processes. The biofluids in the eye, including tears, aqueous humor, and vitreous humor, are important sources for EV-based diagnosis of ocular disease. Because the molecular cargos may reflect the biology of their parental cells, EVs in these biofluids, as well as in the blood, have been recognized as promising candidates as biomarkers for early diagnosis of ocular disease. Moreover, EVs have also been used as therapeutics and targeted drug delivery nanocarriers in many ocular disorders because of their low immunogenicity and superior biocompatibility in nature. In this review, we provide an overview of the recent advances in the field of EV-based studies on the diagnosis and therapeutics of ocular disease. We summarized the origins of EVs applied in ocular disease, assessed different methods for EV isolation from ocular biofluid samples, highlighted bioengineering strategies of EVs as drug delivery systems, introduced the latest applications in the diagnosis and treatment of ocular disease, and presented their potential in the current clinical trials. Finally, we briefly discussed the challenges of EV-based studies in ocular disease and some issues of concern for better focusing on clinical translational studies of EVs in the future.
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  • 文章类型: Journal Article
    目的:早期发现小儿眼病是一个世界性的问题。传统的筛查程序取决于医院和眼科医生,这是昂贵和耗时的。使用人工智能(AI)从移动照片中评估儿童的眼部状况可以方便地及早识别家庭环境中的眼部疾病。
    目标:开发一种识别近视的AI模型,斜视,和使用手机照片的眼睑。
    方法:这项横断面研究于2022年10月1日至2023年9月30日在上海市第九人民医院眼科进行,包括被诊断为近视的儿童,斜视,或上睑下垂。
    方法:开发了一种基于深度学习的模型来识别近视,斜视,和上眼睑。使用灵敏度评估模型的性能,特异性,准确度,曲线下面积(AUC),阳性预测值(PPV),负预测值(NPV),正似然比(P-LR),负似然比(N-LR),和F1得分。GradCAM++用于视觉和分析评估每个区域对模型的影响。进行性别亚组分析和年龄亚组分析以验证模型的普适性。
    结果:从476名患者(225名女性[47.27%];299名[62.82%],年龄在6至12岁之间)获得的1419张图像被用于构建模型。其中,946张单目图像用于识别近视和上睑下垂,473张双目图像用于识别斜视。该模型在检测近视方面表现出良好的敏感性(0.84[95%CI,0.82-0.87]),斜视(0.73[95%CI,0.70-0.77]),和下垂(0.85[95%CI,0.82-0.87])。在性别亚组分析期间,该模型在识别女性和男性儿童的眼部疾病方面表现出可比的性能。不同年龄亚组在识别眼部疾病方面存在差异。
    结论:在这项横断面研究中,AI模型在准确识别近视方面表现出强大的性能,斜视,和只使用智能手机图像的眼睑。这些结果表明,这种模型可以方便地在家中以方便的方式早期发现儿科眼部疾病。
    OBJECTIVE: Identifying pediatric eye diseases at an early stage is a worldwide issue. Traditional screening procedures depend on hospitals and ophthalmologists, which are expensive and time-consuming. Using artificial intelligence (AI) to assess children\'s eye conditions from mobile photographs could facilitate convenient and early identification of eye disorders in a home setting.
    OBJECTIVE: To develop an AI model to identify myopia, strabismus, and ptosis using mobile photographs.
    METHODS: This cross-sectional study was conducted at the Department of Ophthalmology of Shanghai Ninth People\'s Hospital from October 1, 2022, to September 30, 2023, and included children who were diagnosed with myopia, strabismus, or ptosis.
    METHODS: A deep learning-based model was developed to identify myopia, strabismus, and ptosis. The performance of the model was assessed using sensitivity, specificity, accuracy, the area under the curve (AUC), positive predictive values (PPV), negative predictive values (NPV), positive likelihood ratios (P-LR), negative likelihood ratios (N-LR), and the F1-score. GradCAM++ was utilized to visually and analytically assess the impact of each region on the model. A sex subgroup analysis and an age subgroup analysis were performed to validate the model\'s generalizability.
    RESULTS: A total of 1419 images obtained from 476 patients (225 female [47.27%]; 299 [62.82%] aged between 6 and 12 years) were used to build the model. Among them, 946 monocular images were used to identify myopia and ptosis, and 473 binocular images were used to identify strabismus. The model demonstrated good sensitivity in detecting myopia (0.84 [95% CI, 0.82-0.87]), strabismus (0.73 [95% CI, 0.70-0.77]), and ptosis (0.85 [95% CI, 0.82-0.87]). The model showed comparable performance in identifying eye disorders in both female and male children during sex subgroup analysis. There were differences in identifying eye disorders among different age subgroups.
    CONCLUSIONS: In this cross-sectional study, the AI model demonstrated strong performance in accurately identifying myopia, strabismus, and ptosis using only smartphone images. These results suggest that such a model could facilitate the early detection of pediatric eye diseases in a convenient manner at home.
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  • 文章类型: Journal Article
    碳量子点(CQDs),一种新兴的纳米材料,由于其独特的物理特性,在眼科应用中获得了关注,化学,和生物学特征。例如,它们固有的荧光能力为眼科疾病诊断提供了传统荧光染料的新颖和有前途的替代品。此外,由于优异的生物相容性和最小的细胞毒性,CQD非常适合于治疗应用。此外,功能化的CQDs可以有效地将药物递送到眼球的后部以抑制新生血管形成。这篇综述详细介绍了CQDs在眼科疾病管理中的应用,包括各种视网膜疾病,和眼部感染。虽然仍处于眼科的初始阶段,CQDs在诊断和治疗眼部疾病方面的巨大潜力是显而易见的.
    Carbon quantum dots (CQDs), an emerging nanomaterial, are gaining attention in ophthalmological applications due to their distinctive physical, chemical, and biological characteristics. For example, their inherent fluorescent capabilities offer a novel and promising alternative to conventional fluorescent dyes for ocular disease diagnostics. Furthermore, because of the excellent biocompatibility and minimal cytotoxicity, CQDs are well-suited for therapeutic applications. In addition, functionalized CQDs can effectively deliver drugs to the posterior part of the eyeball to inhibit neovascularization. This review details the use of CQDs in the management of ophthalmic diseases, including various retinal diseases, and ocular infections. While still in its initial phases within ophthalmology, the significant potential of CQDs for diagnosing and treating eye conditions is evident.
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  • 文章类型: Journal Article
    免疫肽毒性低,低免疫原性和靶向性,在药物输送和组装方面具有广阔的应用前景,在应用策略和药物组合方面是多种多样的。免疫肽对于调节眼部免疫稳态尤为重要,因为眼睛是免疫特权器官。免疫肽在适应性免疫和先天免疫中具有优势,通过调节T细胞治疗眼部免疫相关疾病,B细胞,免疫检查点,和细胞因子。本文综述了免疫肽在先天免疫和适应性免疫中的应用策略。包括自身免疫,感染,疫苗策略,和肿瘤。此外,它侧重于免疫肽介导眼部免疫(自身免疫性疾病,炎性风暴,和肿瘤)。此外,它回顾了免疫肽的应用策略和免疫肽在眼睛中的治疗潜力。我们期望免疫肽在治疗眼部疾病中得到重视,并为眼部疾病免疫肽的研究提供方向。
    Immunopeptides have low toxicity, low immunogenicity and targeting, and broad application prospects in drug delivery and assembly, which are diverse in application strategies and drug combinations. Immunopeptides are particularly important for regulating ocular immune homeostasis, as the eye is an immune-privileged organ. Immunopeptides have advantages in adaptive immunity and innate immunity, treating eye immune-related diseases by regulating T cells, B cells, immune checkpoints, and cytokines. This article summarizes the application strategies of immunopeptides in innate immunity and adaptive immunity, including autoimmunity, infection, vaccine strategies, and tumors. Furthermore, it focuses on the mechanisms of immunopeptides in mediating ocular immunity (autoimmune diseases, inflammatory storms, and tumors). Moreover, it reviews immunopeptides\' application strategies and the therapeutic potential of immunopeptides in the eye. We expect the immune peptide to get attention in treating eye diseases and to provide a direction for eye disease immune peptide research.
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  • 文章类型: Journal Article
    以前,研究人员使用脂质纳米颗粒(LNPs)直接封装药物。在基因治疗领域,研究人员已经开始使用脂质纳米颗粒来封装信使RNA等核酸,小干扰RNA,和质粒DNA,被称为核酸脂质纳米颗粒。最近以LNP为基础的医学的突破为眼部疾病的治疗提供了巨大的前景,比如角膜,脉络膜,和视网膜疾病。使用LNP作为药物和治疗基因的递送机制可以增加其有效性,同时避免不期望的免疫反应。然而,基于LNP的药物可能会引起眼部问题。在这次审查中,我们讨论了LNP的一般框架。此外,我们回顾可调整的方法并评估其可能的风险。此外,我们检查了新描述的眼部疾病,其中LNP被用作递送机制。最后,我们提供了解决这些潜在问题的观点。
    Previously, researchers have employed Lipid nanoparticles (LNPs) to directly encapsulate medicines. In the realm of gene therapy, researchers have begun to employ lipid nanoparticles to encapsulate nucleic acids such as messenger RNA, small interfering RNA, and plasmid DNA, which are known as nucleic acid lipid nanoparticles. Recent breakthroughs in LNP-based medicine have provided significant prospects for the treatment of ocular disorders, such as corneal, choroidal, and retinal diseases. The use of LNP as a delivery mechanism for medicines and therapeutic genes can increase their effectiveness while avoiding undesired immune reactions. However, LNP-based medicines may pose ocular concerns. In this review, we discuss the general framework of LNP. Additionally, we review adjustable approaches and evaluate their possible risks. In addition, we examine newly described ocular illnesses in which LNP was utilized as a delivery mechanism. Finally, we provide perspectives for solving these potential issues.
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  • 文章类型: Journal Article
    基金会疾病,包括糖尿病性视网膜病变(DR)和年龄相关性黄斑变性(AMD),显著影响全球视觉健康,导致视力受损和不可逆转的失明。由于存在多个生理和解剖学屏障,将药物输送到眼睛的后段仍然是一个挑战。常规的药物递送方法通常证明是无效的并且可能引起副作用。纳米材料,其特点是体积小,大表面积,可调属性,和生物相容性,增强渗透性,稳定性,和靶向药物。眼睛纳米材料涵盖了广泛的范围,包括脂质纳米材料,聚合物纳米材料,金属纳米材料,碳纳米材料,量子点纳米材料,等等。这些创新材料,通常与水凝胶和外泌体结合,被设计来解决多种机制,包括巨噬细胞极化,活性氧(ROS)清除,抗血管内皮生长因子(VEGF)。与传统模式相比,纳米药物实现受监管和持续的递送,减少给药频率,长时间的药物作用,和最小化的副作用。这项研究探讨了药物递送到后段所遇到的障碍,并强调了纳米医学促进的进展。Prospective,这些发现为下一代眼部药物递送系统和更深层次的临床研究铺平了道路,旨在改进治疗方法,减轻患者负担,并最终改善全球的视觉健康。
    Funduscopic diseases, including diabetic retinopathy (DR) and age-related macular degeneration (AMD), significantly impact global visual health, leading to impaired vision and irreversible blindness. Delivering drugs to the posterior segment of the eye remains a challenge due to the presence of multiple physiological and anatomical barriers. Conventional drug delivery methods often prove ineffective and may cause side effects. Nanomaterials, characterized by their small size, large surface area, tunable properties, and biocompatibility, enhance the permeability, stability, and targeting of drugs. Ocular nanomaterials encompass a wide range, including lipid nanomaterials, polymer nanomaterials, metal nanomaterials, carbon nanomaterials, quantum dot nanomaterials, and so on. These innovative materials, often combined with hydrogels and exosomes, are engineered to address multiple mechanisms, including macrophage polarization, reactive oxygen species (ROS) scavenging, and anti-vascular endothelial growth factor (VEGF). Compared to conventional modalities, nanomedicines achieve regulated and sustained delivery, reduced administration frequency, prolonged drug action, and minimized side effects. This study delves into the obstacles encountered in drug delivery to the posterior segment and highlights the progress facilitated by nanomedicine. Prospectively, these findings pave the way for next-generation ocular drug delivery systems and deeper clinical research, aiming to refine treatments, alleviate the burden on patients, and ultimately improve visual health globally.
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  • 文章类型: Journal Article
    背景:本研究旨在探讨ANCA相关性血管炎(AAV)的眼部表现,专注于肉芽肿性多血管炎(GPA),嗜酸性肉芽肿性多血管炎(EGPA),和显微镜下多血管炎(MPA),并检查与实验室参数和其他全身表现的关联。
    方法:这项回顾性研究回顾了2016年1月至2023年11月两个主要中国医疗中心的533例AAV患者的数据。包括诊断在内的数据,疾病的颅骨表现,眼部并发症,并对实验室参数进行了分析。单变量和多变量逻辑回归分析评估了疾病表现之间的关联。还利用机器学习模型来预测AAV患者中视网膜/眼睛受累的风险。
    结果:在533例患者中(210GPA,217MPA,99EGPA,和7个未分类的AAV),其中20.64%出现眼部并发症,GPA分布为36.67%,MPA为7.37%,和18.18%在EGPA。最常见的眼部表现包括巩膜炎和眶后肿块/泪囊炎,在GPA患者中尤其普遍。在9.09%的EGPA病例中观察到视网膜受累。机器学习模型得出嗜酸性粒细胞百分比(EOS%),高敏C反应蛋白(hsCRP),CD4+T细胞/CD8+T细胞比值(T4/T8)可以预测视网膜受累。此外,白细胞,EOS%,APTT,IgA,hsCRP,PR3-ANCA,T4/T8可以预测眼部受累。
    结论:眼部表现是所有形式的AAV的普遍并发症。通过机器学习开发的预测模型为早期干预和量身定制的患者护理提供了有前途的工具。这就需要多学科的方法,整合风湿病学和眼科专业知识,以获得最佳患者预后。
    BACKGROUND: This study aimed to explore ocular manifestations in ANCA-associated vasculitis (AAV), focusing on granulomatosis with polyangiitis (GPA), eosinophilic granulomatosis with polyangiitis (EGPA), and microscopic polyangiitis (MPA) and to examine the associations with laboratory parameters and other systemic manifestations.
    METHODS: This retrospective study reviewed data from 533 AAV patients across two major Chinese medical centers from January 2016 to November 2023. Data including diagnosis, cranial manifestations of disease, ocular complications, and laboratory parameters were analyzed. Univariate and multivariable logistic regression analyses assessed associations across disease manifestations. Machine learning models were also utilized to predict the risk of retinal/eye involvement in AAV patients.
    RESULTS: Among 533 patients (210 GPA, 217 MPA, 99 EGPA, and 7 unclassified AAV), ocular complications were observed in 20.64% of them, with a distribution of 36.67% in GPA, 7.37% in MPA, and 18.18% in EGPA. The most common ocular manifestations included scleritis and retro-orbital mass/dacryocystitis, which were notably prevalent in GPA patients. Retinal involvement was observed in 9.09% of EGPA cases. The machine learning models yielded that eosinophil percentage (EOS%), high-sensitivity C-reactive protein (hsCRP), and CD4 + T cell/CD8 + T cell ratio (T4/T8) can predict retinal involvement. Furthermore, the white blood cell, EOS%, APTT, IgA, hsCRP, PR3-ANCA, and T4/T8 can predict eye involvement.
    CONCLUSIONS: Ocular manifestations are a prevalent complication across all forms of AAV. Predictive models developed through machine learning offer promising tools for early intervention and tailored patient care. This necessitates a multidisciplinary approach, integrating rheumatology and ophthalmology expertise for optimal patient outcomes.
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  • 文章类型: Journal Article
    Ferroptosis,近年来提出的一种新型的程序性细胞死亡,主要以活性氧和铁介导的脂质过氧化为特征,不同于程序性细胞死亡,如细胞凋亡,坏死,和自噬。铁凋亡与多种生理和病理生理过程有关。最近的研究表明,铁凋亡可以通过靶向肿瘤中的代谢通路和信号通路来加重或减少疾病的发生和发展。缺血性器官损伤,和其他与脂质过氧化有关的退行性疾病。越来越多的证据表明,铁性凋亡与各种眼科疾病的发生和进展密切相关,包括角膜损伤,青光眼,年龄相关性黄斑变性,糖尿病视网膜病变,视网膜脱离,和视网膜母细胞瘤.我们对眼科疾病中铁死亡的当前研究的回顾揭示了我们对发病机理的理解的重大进展。病因学,以及这些疾病的治疗。
    Ferroptosis, a new type of programmed cell death proposed in recent years, is characterized mainly by reactive oxygen species and iron-mediated lipid peroxidation and differs from programmed cell death, such as apoptosis, necrosis, and autophagy. Ferroptosis is associated with a variety of physiological and pathophysiological processes. Recent studies have shown that ferroptosis can aggravate or reduce the occurrence and development of diseases by targeting metabolic pathways and signaling pathways in tumors, ischemic organ damage, and other degenerative diseases related to lipid peroxidation. Increasing evidence suggests that ferroptosis is closely linked to the onset and progression of various ophthalmic conditions, including corneal injury, glaucoma, age-related macular degeneration, diabetic retinopathy, retinal detachment, and retinoblastoma. Our review of the current research on ferroptosis in ophthalmic diseases reveals significant advancements in our understanding of the pathogenesis, aetiology, and treatment of these conditions.
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