Translational Vision Science & Technology最新文献

{"title":"Evaluating Large Language Models in Ptosis-Related inquiries: A Cross-Lingual Study.","authors":"Ling-Han Niu, Li Wei, Bixuan Qin, Tao Chen, Li Dong, Yueqing He, Xue Jiang, Mingyang Wang, Lan Ma, Jialu Geng, Lechen Wang, Dongmei Li","doi":"10.1167/tvst.14.7.9","DOIUrl":"10.1167/tvst.14.7.9","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this study was to evaluate the performance of large language models (LLMs)-GPT-4, GPT-4o, Qwen2, and Qwen2.5-in addressing patient- and clinician-focused questions on ptosis-related inquiries, emphasizing cross-lingual applicability and patient-centric assessment.</p><p><strong>Methods: </strong>We collected 11 patient-centric and 50 doctor-centric questions covering ptosis symptoms, treatment, and postoperative care. Responses generated by GPT-4, GPT-4o, Qwen2, and Qwen2.5 were evaluated using predefined criteria: accuracy, sufficiency, clarity, and depth (doctor questions); and helpfulness, clarity, and empathy (patient questions). Clinical assessments involved 30 patients with ptosis and 8 oculoplastic surgeons rating responses on a 5-point Likert scale.</p><p><strong>Results: </strong>For doctor questions, GPT-4o outperformed Qwen2.5 in overall performance (53.1% vs. 18.8%, P = 0.035) and completeness (P = 0.049). For patient questions, GPT-4o scored higher in helpfulness (mean rank = 175.28 vs. 155.72, P = 0.035), with no significant differences in clarity or empathy. Qwen2.5 exhibited superior Chinese-language clarity compared to English (P = 0.023).</p><p><strong>Conclusions: </strong>LLMs, particularly GPT-4o, demonstrate robust performance in ptosis-related inquiries, excelling in English and offering clinically valuable insights. Qwen2.5 showed advantages in Chinese clarity. Although promising for patient education and clinician support, these models require rigorous validation, domain-specific training, and cultural adaptation before clinical deployment. Future efforts should focus on refining multilingual capabilities and integrating real-time expert oversight to ensure safety and relevance in diverse healthcare contexts.</p><p><strong>Translational relevance: </strong>This study bridges artificial intelligence (AI) advancements with clinical practice by demonstrating how optimized LLMs can enhance patient education and cross-linguistic clinician support tools in ptosis-related inquiries.</p>","PeriodicalId":23322,"journal":{"name":"Translational Vision Science & Technology","volume":"14 7","pages":"9"},"PeriodicalIF":2.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12279073/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144643565","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Three-Dimensional Quantification of Macular OCT Alterations Improves the Diagnostic Performance of Artificial Intelligence Models.","authors":"Lukas Heine, Anna Vahldiek, Benja Vahldiek, Fabian Hörst, Constantin Seibold, Mael Lever, Laurenz Pauleikhoff, Nikolaos Bechrakis, Daniel Pauleikhoff, Jens Kleesiek","doi":"10.1167/tvst.14.7.8","DOIUrl":"10.1167/tvst.14.7.8","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the performance of state-of-the-art semantic segmentation methods on OCT data for age-related macular degeneration (AMD). We measured variability between annotators to quantify differences in ground truth arising from personal bias.</p><p><strong>Methods: </strong>From 94 patients suffering from exudative neovascular AMD (nAMD), 24 volume scans (49 slices each) were selected. Trained members of a reading center for AMD created pixel-wise masks for 12 retinal layers and two pathological labels (fluid, hyperreflective material) to benchmark two-dimensional (2D) and three-dimensional (3D) segmentation models on clinical data. Models were evaluated using fivefold cross-validation, and the best model was used to quantify errors between ground truth and predictions.</p><p><strong>Results: </strong>The nnU-Net (3D) achieves the best segmentation performance (mean Dice similarity coefficient [DSC] of 0.907), leaving a theoretical gap of 0.036 DSC to the mean interrater agreement, which is the upper bound of model performances. Comparing the volumes calculated for each structure using the model masks with the ground truth produced an average error of 0.065 mm3.</p><p><strong>Conclusions: </strong>Models like nnU-Net can produce high-quality 3D masks, challenging the conventional reliance on 2D slices for optimal performance. Both DSC and low average errors indicate that such a model is fit for the large-scale analysis of cohorts.</p><p><strong>Translational relevance: </strong>The presented approach can streamline clinical workflows by reducing the time and effort required for manual annotations, ultimately supporting more efficient and accurate monitoring of AMD progression and treatment response. We provide open-source access to the model weights, annotation instructions and sample data.</p>","PeriodicalId":23322,"journal":{"name":"Translational Vision Science & Technology","volume":"14 7","pages":"8"},"PeriodicalIF":2.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12279069/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144643567","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"VascX Models: Deep Ensembles for Retinal Vascular Analysis From Color Fundus Images.","authors":"Jose Vargas Quiros, Bart Liefers, Karin A van Garderen, Jeroen P Vermeulen, Caroline Klaver","doi":"10.1167/tvst.14.7.19","DOIUrl":"10.1167/tvst.14.7.19","url":null,"abstract":"<p><strong>Purpose: </strong>To present and validate deep learning model ensembles (VascX) for vessel, artery-vein, optic disc segmentation, and fovea localization for color fundus images (CFIs). VascX preprocessing and inference code and model weights were made publicly available to facilitate research on retinal vasculature.</p><p><strong>Methods: </strong>For model training, we combined over 15 published annotated datasets with CFIs from Dutch studies (mainly the Rotterdam Study). This resulted in diverse development sets with a variety of patient characteristics and imaging conditions. We trained UNet model ensembles using a new, more robust preprocessing algorithm and strong data augmentations. We compared VascX segmentation performance (Dice) to models with publicly available weights: AutoMorph and LittleWNet. We compared the quality of VascX (and previous models') features by measuring agreement (mean absolute error [MAE] and Pearson correlation) with features extracted from grader segmentations.</p><p><strong>Results: </strong>Dice scores revealed better performance from VascX across most datasets evaluated, especially for artery-vein and optic disc segmentation. VascX performed more consistently as the quality of the images decreased and for both disc and fovea-centered images. These improvements translated into higher-quality vascular features. Of 24 features evaluated, 14 showed a significant improvement in MAE when compared to AutoMorph and 23 when compared to LWNet. VascX had the highest correlations with ground-truth features in all but two cases.</p><p><strong>Conclusions: </strong>VascX models perform well across a variety of conditions, likely due to the size and diversity of our development sets. VascX represents an important improvement in segmentation quality that translates into better vascular features to support more robust analyses of the retinal vasculature.</p><p><strong>Translational relevance: </strong>By making VascX public, we aim to facilitate and improve research linking retinal vascular biomarkers to ophthalmic and systemic conditions, relevant for the detection, prevention, and monitoring of disease.</p>","PeriodicalId":23322,"journal":{"name":"Translational Vision Science & Technology","volume":"14 7","pages":"19"},"PeriodicalIF":2.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12306690/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144691654","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Postprandial C-Peptide to Glucose Ratio as a Promising Systemic Marker of Diabetic Retinopathy in Type 2 Diabetes.","authors":"Zhaoxia Zheng, Nianen Liu, Yue Zhang, Xiaoya Gu, Hui Li, Xiaobing Yu","doi":"10.1167/tvst.14.7.27","DOIUrl":"10.1167/tvst.14.7.27","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this study was to assess the association between C-peptide (CP)-related parameters and diabetic retinopathy (DR) in type 2 diabetes mellitus (T2DM), and find a superior parameter in predicting DR.</p><p><strong>Methods: </strong>One thousand seventy-eight patients with T2DM were included in this cross-sectional study. Fasting and postprandial CP (FCP and PCP), delta CP, FCP, or PCP to glucose ratio (FCGR and PCGR), homeostasis model assessment of β-cell function (HOMA-B), and insulin resistance (HOMA-IR) were compared among different stages of DR. Odds ratios (ORs) of these indices for the presence and severity of DR were estimated after adjusting for confounding factors. Multivariate logistic analysis was performed to evaluate the association between PCGR and DR according to PCGR quartiles. Receiver operating characteristic (ROC) curves were generated to determine the discriminative power of DR.</p><p><strong>Results: </strong>Among CP-related indices, PCGR showed the most significant association with mild and moderate nonproliferative DR (NPDR; per SD increase, OR = 0.44, P < 0.001), and vision-threatening DR (VTDR; OR = 0.09, P < 0.001). When grouped by PCGR quartiles, patients in the lower quartile showed a higher risk of developing DR. PCGR was negatively associated with DR and VTDR independent of confounders (Pfor trend < 0.001). PCGR had high predictive abilities of DR and VTDR (area under the curve [AUC] = 0.76 and 0.83), and also increased the AUC values of the standard model.</p><p><strong>Conclusions: </strong>Compared with insulin resistance (IR), DR was more associated with impaired β-cell function. PCGR could be a promising systemic marker for determining patients with T2DM at high risk of developing DR, especially VTDR.</p><p><strong>Translational relevance: </strong>PCGR could be a promising marker of DR assisting individualized management of T2DM patients.</p>","PeriodicalId":23322,"journal":{"name":"Translational Vision Science & Technology","volume":"14 7","pages":"27"},"PeriodicalIF":2.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12315922/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144754399","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Method to Evaluate the Frequency Dependence of Retinal Vascular and Neural Metrics to Stimulus Modulation.","authors":"Anthony E Felder, Giri Balasubramanian, Aldo Arroyo, Jason C Park, Mahnaz Shahidi, J Jason McAnany","doi":"10.1167/tvst.14.7.3","DOIUrl":"10.1167/tvst.14.7.3","url":null,"abstract":"<p><strong>Purpose: </strong>Flickering light stimulation induces functional hyperemia, characterized by vasodilation, blood flow augmentation, and venous oxygen elevation. We present a new method to investigate the frequency dependence of metrics associated with functional hyperemia.</p><p><strong>Methods: </strong>A novel optical imaging system was developed to quantify retinal blood vessel diameter (D), oxygen saturation (SO2), and the inner retinal oxygen extraction fraction (OEF) before and after light flicker at different frequencies. Measurements were performed in 10 visually normal subjects (20-62 years) at flicker frequencies from 2 to 30 Hz. In addition, a measure of neural function was obtained by steady-state pattern electroretinography (ssPERG) across a similar range of frequencies.</p><p><strong>Results: </strong>Flicker stimulation greater than 2 Hz increased D, increased SO2 in veins, and decreased OEF. The maximum response for all metrics was obtained between 16 and 30 Hz, indicating that vascular and oxygenation metrics share a similar frequency response with light flicker. ssPERG amplitudes were positively correlated with flicker-induced increases in venous D and SO2. ssPERG amplitude was negatively correlated with flicker-induced decreases in OEF.</p><p><strong>Conclusions: </strong>We present a novel retinal imaging method to evaluate the frequency dependence of changes in D, SO2, and OEF to light flicker stimulation. The relationship between these metrics and ssPERG amplitudes was evaluated.</p><p><strong>Translational relevance: </strong>The frequency-dependent response of retinal D, SO2, and OEF established in healthy individuals herein has the potential to serve as a biomarker of vascular and tissue abnormality in future studies of retinal disease.</p>","PeriodicalId":23322,"journal":{"name":"Translational Vision Science & Technology","volume":"14 7","pages":"3"},"PeriodicalIF":2.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12227032/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144545020","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Equitable Deep Learning for Diabetic Retinopathy Detection Using Multidimensional Retinal Imaging With Fair Adaptive Scaling.","authors":"Min Shi, Muhammad Muneeb Afzal, Hao Huang, Congcong Wen, Yan Luo, Muhammad Osama Khan, Yu Tian, Leo Kim, Yi Fang, Mengyu Wang","doi":"10.1167/tvst.14.7.1","DOIUrl":"10.1167/tvst.14.7.1","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the fairness of existing deep models for diabetic retinopathy (DR) detection and introduce an equitable model to reduce group performance disparities.</p><p><strong>Methods: </strong>We evaluated the performance and fairness of various deep learning models for DR detection using fundus images and optical coherence tomography (OCT) B-scans. A Fair Adaptive Scaling (FAS) module was developed to reduce group disparities. Model performance was evaluated using the area under the receiver operating characteristic curve (AUC), and equity across various groups was assessed by equity-scaled AUC, which accommodated both overall AUC and AUCs of individual groups.</p><p><strong>Results: </strong>Using color fundus images, the integration of FAS with EfficientNet improved the overall AUC and equity-scaled AUC from 0.88 and 0.83 to 0.90 and 0.84 (P < 0.05) by race. AUCs for Asians and Whites increased by 0.05 and 0.03, respectively (P < 0.01). For gender, both metrics improved by 0.01 (P < 0.05). Using DenseNet121 on OCT B-Scans by race, FAS improved the overall AUC and equity-scaled AUC from 0.875 and 0.81 to 0.884 and 0.82, with gains of 0.03 and 0.02 for Asians and Blacks (P < 0.01). For gender, DenseNet121's metrics rose by 0.04 and 0.03, with gains of 0.05 and 0.04 for females and males (P < 0.01).</p><p><strong>Conclusions: </strong>Deep learning models demonstrate varying accuracies across different groups in DR detection. FAS improves equity and accuracy of deep learning models.</p><p><strong>Translational relevance: </strong>The proposed deep learning model has a potential to improve both model performance and equity of DR detection.</p>","PeriodicalId":23322,"journal":{"name":"Translational Vision Science & Technology","volume":"14 7","pages":"1"},"PeriodicalIF":2.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12227025/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144545021","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Impact of Hypertension on Macular Perfusion in Patients With Referable Diabetic Retinopathy: An OCTA Analysis.","authors":"Janika Shah, Shinji Kakihara, Anna Busza, Amani A Fawzi","doi":"10.1167/tvst.14.7.2","DOIUrl":"10.1167/tvst.14.7.2","url":null,"abstract":"<p><strong>Purpose: </strong>To assess the impact of hypertension (HTN) on microvasculature and vision in clinically referable diabetic retinopathy (DR) eyes using optical coherence tomography angiography.</p><p><strong>Methods: </strong>We conducted a cross-sectional study of 185 eyes (139 patients) with referable DR (moderate/severe nonproliferative to naïve/quiescent proliferative DR), categorizing patients based on presence/absence of HTN. Optical coherence tomography angiography 3 × 3 mm scans were utilized to quantify geometric perfusion deficits (GPD), vessel length density, and vessel density within the superficial capillary plexus and deep capillary plexus (DCP). Linear regression analysis investigated the association between risk factors and GPD.</p><p><strong>Results: </strong>Our DR cohort comprised 52 nonhypertensive and 133 hypertensive eyes. After adjusting for age and dyslipidemia, we found significant differences in DCP metrics (GPD and vessel length density) between groups. The mean DCP GPD was higher in DR eyes with HTN compared with those without (7.06 ± 4.33 vs. 5.58 ± 2.85%; P = 0.032). Conversely, DCP vessel length density was lower in hypertensive DR eyes compared to nonhypertensive DR eyes (0.17 ± 0.02 mm-1 vs. 0.18 ± 0.02 mm-1; P = 0.031). Multivariable analysis confirmed a significant independent association between HTN (β = 0.250; P = 0.036) and DCP GPD. Worse vision was moderately associated with worsening DCP GPD (P < 0.001) in hypertensive DR eyes.</p><p><strong>Conclusions: </strong>In referable DR eyes, HTN is associated with worse DCP nonperfusion and compromised vision. Therefore, heightened surveillance, in addition to blood pressure control, may need to be prioritized for this high-risk population with comorbid diabetes and HTN.</p><p><strong>Translational relevance: </strong>HTN is associated with worse vision and ischemia in the deep capillary layer of referable DR eyes, emphasizing the importance of monitoring patients with both comorbidities.</p>","PeriodicalId":23322,"journal":{"name":"Translational Vision Science & Technology","volume":"14 7","pages":"2"},"PeriodicalIF":2.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12227026/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144545022","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Ocular Parameter Changes Caused by Reading With Remote Image Optical Screen.","authors":"Yinghan Zhang, Jiaxin Tian, Wenrui Shen, Ningli Wang","doi":"10.1167/tvst.14.7.12","DOIUrl":"10.1167/tvst.14.7.12","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to analyze the differences in ocular parameter changes induced by reading with traditional electronic screens (TESs) compared with those associated with the remote image optical screen (RIOS), further evaluating the effects of RIOS on ocular parameters.</p><p><strong>Methods: </strong>Thirty-five healthy participants (70 eyes) were enrolled in the prospective self-controlled study, completing two distinct reading tasks. Task A: near reading using TESs for 20 minutes; and task B: near reading with RIOS for an equivalent duration. The spherical equivalent (SE), anterior segment parameters, choroidal thickness (ChT), and choroidal vascular volume (CVV) were measured both before and after each reading task.</p><p><strong>Results: </strong>Following reading with TESs, significant myopic shifts were observed in the SE (P = 0.024), and there was a notable decrease in both anterior chamber depth and width (all P < 0.001). The lens thickness and vitreous chamber depth increased significantly (all P < 0.05). In the meantime, the ChT and CVV decreased significantly (P = 0.029 and P = 0.013, respectively), particularly beyond a region measuring 9 × 9 mm2 centered on the fovea (all P < 0.05). After reading with RIOS, no significant changes were detected in SE or any other ocular parameters, including ChT and CVV (all P > 0.05).</p><p><strong>Conclusions: </strong>Reading with RIOS effectively alleviates myopic shift, ocular anterior segment changes, and choroidal thinning caused by traditional near work.</p><p><strong>Translational relevance: </strong>The study demonstrates that reading with RIOS can alleviate the ocular anterior segment changes and choroidal thinning caused by TESs. The RIOS may represent a promising strategy for myopic control.</p>","PeriodicalId":23322,"journal":{"name":"Translational Vision Science & Technology","volume":"14 7","pages":"12"},"PeriodicalIF":2.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12302051/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144660371","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Investigating the Role of Autonomic Dysfunction in the Pathogenesis of Depression-Related Dry Eye.","authors":"Dan Wang, Yueni Ma, Mengyu Zhang, Fei Li, Ning Gao, Yuanyuan Qi, Zhenying Shang, Ruibo Yang","doi":"10.1167/tvst.14.7.4","DOIUrl":"10.1167/tvst.14.7.4","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to investigate the functional and pathological changes in the lacrimal gland (LG) of depression-related dry eye (DE), as well as the role of autonomic nerves in this process.</p><p><strong>Methods: </strong>The chronic unpredictable mild stress (CUMS) models were established to induce depression. The depression-like behaviors were evaluated by behavioral tests. DE indicators were detected by corneal fluorescein staining, tear film breakup time, and tear secretion. The systemic and lacrimal autonomic nerves were evaluated by heart rate variability (HRV), ELISA, immunofluorescence staining, and Western blot. The tissue and molecular assays were performed to assess the levels of inflammation, oxidative stress, and apoptosis in the LG. After modeling, 6-hydroxydopamine (6-OHDA) was given to inhibit sympathetic nerves, the changes of DE indicators and LG pathological damage were further observed by repeating the above tests.</p><p><strong>Results: </strong>CUMS could induce depressive-like behaviors while inducing DE, which is manifested by decreased tear secretion and increased corneal staining. Meanwhile, CUMS could induce autonomic dysfunction, especially sympathetic nerve activation, resulting in organizational structure disorders, decreased expression of α-SMA, and elevated reactive oxygen species (ROS) levels and apoptosis in the LG. Sympathetic denervation could improve DE indicators, reduce ROS and apoptosis of the LG, and improve the drainage function of the LG.</p><p><strong>Conclusions: </strong>During the development of depression, CUMS can also cause functional and pathological damages to the LG by activating sympathetic nerves to induce depression-related DE.</p><p><strong>Translational relevance: </strong>This suggests that intervention measures targeting autonomic dysfunction may be a new direction for the treatment of depression-related DE.</p>","PeriodicalId":23322,"journal":{"name":"Translational Vision Science & Technology","volume":"14 7","pages":"4"},"PeriodicalIF":2.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12240206/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144576347","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Influence of Immune Cells on Corneal Nerve Morphological Analysis and Clinical Relevance in Diabetes-Related Dry Eye.","authors":"Baikai Ma, Hongshuo Li, Yi Wang, Wenlong Li, Lei Mou, Yilin Liu, Rongjun Liu, Yalin Zheng, Xinyu Liu, Yitian Zhao, Hong Qi","doi":"10.1167/tvst.14.7.16","DOIUrl":"10.1167/tvst.14.7.16","url":null,"abstract":"<p><strong>Purpose: </strong>Corneal nerve morphology and immune cells are critical biomarkers in the ocular surface. This study aimed to investigate the influence of immune cells on corneal nerve morphology and the clinical significance in diabetes-related dry eye disease (DED).</p><p><strong>Methods: </strong>In the first part, 1075 in vivo confocal microscopy images containing dendritic cells or round cells were included as system validation. Key morphological parameters, including corneal nerve fiber density (CNFD), corneal nerve branch density (CNBD), tortuosity, and box-count fractal dimension (Boxdim), were measured before and after immune cells were excluded. In the second part, a pilot cross-sectional study was conducted involving control (26 eyes), DED without diabetes mellitus (DM) (34 eyes), and DED with DM (17 eyes) groups. The impact of immune cell exclusion on nerve metrics was assessed and correlated with clinical parameters, such as the fluorescein tear breakup time (TBUT), Ocular Surface Disease Index (OSDI), and corneal fluorescein staining (CFS) scores.</p><p><strong>Results: </strong>Exclusion of immune cells resulted in significant reductions in CNFD, CNBD, Boxdim, and tortuosity. Compared to the control group, both DED without DM and DED with DM groups showed substantial reductions in CNFD, CNBD, and Boxdim, along with a significant increase in tortuosity. Moreover, the exclusion of immune cells enhanced the correlations between nerve metrics and fluorescein TBUT.</p><p><strong>Conclusions: </strong>Immune cells contribute to significant biases in the assessments of corneal nerve morphology, primarily false-negative results, in diabetes-related DED. Their exclusion improves the accuracy of nerve measurements, which may enhance the clinical evaluation of corneal nerve morphology.</p><p><strong>Translational relevance: </strong>Advanced segmentation techniques addressing immune cell interference could improve diagnostic precision and inform treatment strategies for DED subtypes.</p>","PeriodicalId":23322,"journal":{"name":"Translational Vision Science & Technology","volume":"14 7","pages":"16"},"PeriodicalIF":2.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12302046/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144691679","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}