中华眼科杂志最新文献

{"title":"[Dislocation into the anterior chamber and spontaneous repositioning of a dexamethasone intravitreal implant: a case report].","authors":"L L Liang, S Ju, Z H Cui","doi":"10.3760/cma.j.cn112142-20231025-00181","DOIUrl":"10.3760/cma.j.cn112142-20231025-00181","url":null,"abstract":"<p><p>A 61-year-old male patient presented with blurred vision in the right eye for 1 day. The patient had previously undergone phacoemulsification with intraocular lens implantation (10 years ago) and intravitreal implantation of dexamethasone (due to uveitis) in the eye. There was edema in the inferior cornea, along with Descemet membrane folds. The rod-shaped dexamethasone implant was visible in the inferior anterior chamber. Without pupil dilation, the patient was asked to keep a supine position and avoid head tilting for 1 day. The implant spontaneously relocated into the vitreous cavity, resulting in a reduction of corneal edema. This suggests that the dislocation of the intravitreal implant into the anterior chamber may be caused by a local zonular abnormality, and the dislocated implant has the potential to reposition itself spontaneously.</p>","PeriodicalId":39688,"journal":{"name":"中华眼科杂志","volume":"60 3","pages":"272-274"},"PeriodicalIF":0.0,"publicationDate":"2024-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140094842","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Preliminary study on automatic quantification and grading of leopard spots fundus based on deep learning technology].","authors":"L Dong, W D Zhou, L Ju, H Q Zhao, Y H Yang, L Shao, K M Song, L Wang, T Ma, Y X Wang, W B Wei","doi":"10.3760/cma.j.cn112142-20231210-00281","DOIUrl":"10.3760/cma.j.cn112142-20231210-00281","url":null,"abstract":"<p><p><b>Objective:</b> To achieve automatic segmentation, quantification, and grading of different regions of leopard spots fundus (FT) using deep learning technology. The analysis includes exploring the correlation between novel quantitative indicators, leopard spot fundus grades, and various systemic and ocular parameters. <b>Methods:</b> This was a cross-sectional study. The data were sourced from the Beijing Eye Study, a population-based longitudinal study. In 2001, a group of individuals aged 40 and above were surveyed in five urban communities in Haidian District and three rural communities in Daxing District of Beijing. A follow-up was conducted in 2011. This study included individuals aged 50 and above who participated in the second 5-year follow-up in 2011, considering only the data from the right eye. Color fundus images centered on the macula of the right eye were input into the leopard spot segmentation model and macular detection network. Using the macular center as the origin, with inner circle diameters of 1 mm, 3 mm, and outer circle diameter of 6 mm, fine segmentation of the fundus was achieved. This allowed the calculation of the leopard spot density (FTD) and leopard spot grade for each region. Further analyses of the differences in ocular and systemic parameters among different regions' FTD and leopard spot grades were conducted. The participants were categorized into three refractive types based on equivalent spherical power (SE): myopia (SE<-0.25 D), emmetropia (-0.25 D≤SE≤0.25 D), and hyperopia (SE>0.25 D). Based on axial length, the participants were divided into groups with axial length<24 mm, 24-26 mm, and>26 mm for the analysis of different types of FTD. Statistical analyses were performed using one-way analysis of variance, Kruskal-Wallis test, Bonferroni test, and Spearman correlation analysis. <b>Results:</b> The study included 3 369 participants (3 369 eyes) with an average age of (63.9±10.6) years; among them, 1 886 were female (56.0%) and 1, 483 were male (64.0%). The overall FTD for all eyes was 0.060 (0.016, 0.163); inner circle FTD was 0.000 (0.000, 0.025); middle circle FTD was 0.030 (0.000, 0.130); outer circle FTD was 0.055 (0.009, 0.171). The results of the univariate analysis indicated that FTD in various regions was correlated with axial length (overall: <i>r</i>=0.38, <i>P</i><0.001; inner circle: <i>r</i>=0.31, <i>P</i><0.001; middle circle: <i>r</i>=0.36, <i>P</i><0.001; outer circle: <i>r</i>=0.39, <i>P</i><0.001), subfoveal choroidal thickness (SFCT) (overall: <i>r</i>=-0.69, <i>P</i><0.001; inner circle: <i>r</i>=-0.57, <i>P</i><0.001; middle circle: <i>r</i>=-0.68, <i>P</i><0.001; outer circle: <i>r</i>=-0.72, <i>P</i><0.001), age (overall: <i>r</i>=0.34, <i>P</i><0.001; inner circle: <i>r</i>=0.30, <i>P</i><0.001; middle circle: <i>r</i>=0.31, <i>P</i><0.001; outer circle: <i>r</i>=0.35, <i>P</i><0.001), gender (overall: <i>r</i>=-0.11, <i>P</i><0.001; inner circle: <i>r</i>=-0.04, <i>P</i><0.001","PeriodicalId":39688,"journal":{"name":"中华眼科杂志","volume":"60 3","pages":"257-264"},"PeriodicalIF":0.0,"publicationDate":"2024-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140094845","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Reflections on the inner limiting membrane peeling and its derivatives in macular hole surgery].","authors":"M X Zhang, Y Zhang","doi":"10.3760/cma.j.cn112142-20231225-00307","DOIUrl":"10.3760/cma.j.cn112142-20231225-00307","url":null,"abstract":"<p><p>Internal limiting membrane (ILM) peeling is a critical step in the process of macular hole surgery, giving rise to various modified techniques such as ILM flip-over coverage, ILM and other tissue tamponade procedures, and foveal-sparing ILM peeling. All these approaches aim to improve the postoperative closure rate of macular holes. The goal of macular hole surgery is to better preserve the integrity of the foveal center structure, with the aim of achieving functional recovery on the basis of anatomical restoration. However, in clinical practice, there is a tendency to excessively choose certain surgical methods solely to pursue the closure rate of the hole, which may not be beneficial for the visual function recovery of the patients. This article discusses how to correctly select the internal limiting membrane and its derivative procedures in macular hole surgery, combining clinical practice and relevant domestic and international research literature. It aims to provide insights for colleagues performing macular hole surgery as a reference regarding this clinical focus issue.</p>","PeriodicalId":39688,"journal":{"name":"中华眼科杂志","volume":"60 3","pages":"220-225"},"PeriodicalIF":0.0,"publicationDate":"2024-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140094846","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Chinese expert consensus on the clinical diagnosis and treatment of autosomal dominant optic atrophy (2024)].","authors":"","doi":"10.3760/cma.j.cn112142-20231225-00308","DOIUrl":"10.3760/cma.j.cn112142-20231225-00308","url":null,"abstract":"<p><p>Autosomal dominant optic atrophy (ADOA) primarily affects retinal ganglion cells and their axons, resulting in varying degrees of central vision loss from childhood. Due to the rarity of ADOA in clinical practice, Chinese ophthalmologists currently lack sufficient understanding of the disease and experience non-standardized diagnostic procedures and high clinical and genetic misdiagnosis rates. To address these issues, the Ophthalmology Group of China Alliance for Rare Diseases/Beijing Society of Rare Disease Clinical Care and Accessibility and the Neuro-ophthalmology Group of Ophthalmology Branch of Chinese Medical Association have established an expert panel to form consensus opinions based on extensive discussions. This consensus would enhance the knowledge and diagnostic capabilities of Chinese clinicians regarding ADOA and promote awareness of related treatment principles and genetic counseling.</p>","PeriodicalId":39688,"journal":{"name":"中华眼科杂志","volume":"60 3","pages":"226-233"},"PeriodicalIF":0.0,"publicationDate":"2024-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140094839","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Analysis of the therapeutic efficacy of pars plana vitrectomy without intraocular tamponade in the treatment of high myopic eyes with myopic foveoschisis and central foveal detachment].","authors":"W Y Tang, X Chen, T Zhang, X Huang, Q Chang, G Z Xu","doi":"10.3760/cma.j.cn112142-20231019-00155","DOIUrl":"10.3760/cma.j.cn112142-20231019-00155","url":null,"abstract":"<p><p><b>Objective:</b> To investigate the efficacy of pars plana vitrectomy (PPV) without intraocular tamponade in the treatment of high myopic eyes with myopic foveoschisis (MF) accompanied by foveal detachment (FD). <b>Methods:</b> A retrospective case series study was conducted. The medical records of patients diagnosed with unilateral MF accompanied by FD at the Eye & ENT Hospital of Fudan University between May 2018 and December 2021 were collected. All patients underwent 23-gauge PPV with posterior vitreous cortex clearance, and no intraocular tamponade was applied. The cases were divided into groups based on whether the internal limiting membrane was peeled during surgery or retained. Follow-up was conducted for at least 12 months. The main outcome measures included postoperative best-corrected visual acuity (BCVA, converted to logarithm of the minimum angle of resolution), central foveal thickness (CFT), MF resolution, and complications. Statistical analyses were performed using <i>t</i>-tests, chi-square tests, Fisher's exact tests, and univariate and multivariate linear regression. <b>Results:</b> A total of 40 patients (40 eyes) with MF and FD were included in the study, with 30.0% being male and 70.0% female. The mean age was (56.9±11.7) years, and the axial length of the eyes was (29.1±1.9) mm. At 12 months postoperatively, BCVA improved from baseline 1.15±0.58 to 0.73±0.39 (<i>t</i>=6.11, <i>P</i><0.001), and CFT decreased from baseline (610.1±207.2) μm to (155.9±104.1) μm (<i>t</i>=13.47, <i>P</i><0.001). Complete resolution of MF with foveal reattachment was observed in 80.0% of eyes, with a median time of 6 (5, 8) months. There was no significant difference in BCVA and CFT between the internal limiting membrane peeled group and retained group [0.68±0.39 <i>vs.</i> 0.79±0.40, <i>t</i>=0.85, <i>P</i>=0.403; (148.3±63.8)<i>vs.</i>(164.3±137.2)um,<i>t</i>=0.48, <i>P</i>=0.634]. One eye experienced macular hole and another eye developed retinal detachment postoperatively. Correlation analysis showed a positive correlation between BCVA at 12 months postoperatively and baseline BCVA (<i>β</i>=0.433, <i>P</i><0.001). <b>Conclusions:</b> Pars plana vitrectomy without intraocular tamponade is effective in treating MF accompanied by FD. The choice between internal limiting membrane peeling and retention does not significantly affect visual prognosis.</p>","PeriodicalId":39688,"journal":{"name":"中华眼科杂志","volume":"60 3","pages":"234-241"},"PeriodicalIF":0.0,"publicationDate":"2024-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140094836","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Changes in OCTA-related parameters and their impact on retinal sensitivity after ILM flap inversion surgery in patients with IMH].","authors":"Y Gao, J Li, W J Wang, X D Zhang, J J Wang, L L Yuan, G H Zhou","doi":"10.3760/cma.j.cn112142-20230926-00115","DOIUrl":"10.3760/cma.j.cn112142-20230926-00115","url":null,"abstract":"<p><p><b>Objective:</b> To analyze the changes in optical coherence tomography angiography(OCTA)-related parameters before and after idiopathic macular hole (IMH) internal limiting membrane (ILM) flap inversion surgery and assess their impact on retinal sensitivity. <b>Methods:</b> A retrospective case series study was conducted, collecting clinical data of 30 patients (30 eyes) diagnosed with IMH who underwent vitrectomy combined with ILM flap inversion surgery at Shanxi Eye Hospital, affiliated with Shanxi Medical University, between January 2020 and December 2021. Visual acuity and best-corrected visual acuity were examined preoperatively and at 1, 3, and 6 months postoperatively. Microperimetry measured retinal sensitivity (RS), and OCTA measured retinal thickness (RT) as well as vessel density (VD) in the superficial capillary plexus (SCP) and deep capillary plexus (DCP). Statistical analysis was performed using t-tests, repeated measures analysis of variance, and Pearson correlation analysis. <b>Results:</b> Thirty patients with IMH (30 eyes) were included, with 3 males (3 eyes) and 27 females (27 eyes). The mean age was (62.5±3.0) years, and the follow-up time was (96.3±1.3) days, with a 100% closure rate of macular holes postoperatively. RT in the macular was significantly lower at 1, 3, and 6 months postoperatively compared to preoperative values (<i>F</i>=46.21, <i>P</i><0.001). The RT in the upper macular region showed statistically significant differences at different time points (<i>P</i><0.001). VD in the SCP layer showed no significant differences between the upper and lower macular regions at various time points (<i>F</i>=3.21, <i>P</i>=0.601). VD in the upper region of the DCP layer increased at 1, 3, and 6 months postoperatively (<i>P</i><0.001). RS in the macular was higher at 1, 3, and 6 months postoperatively compared to preoperative values (<i>F</i>=52.01, <i>P</i><0.001). RS in the lower macular region increased at 3 and 6 months postoperatively (<i>P</i><0.001), while in the upper region, it increased only at 6 months postoperatively (<i>P</i><0.001). There was a positive correlation between RS and RT at 1 and 3 months postoperatively, but not at 6 months postoperatively in the upper macular region (<i>r</i>=0.40, <i>P</i>=0.071). In the lower macular region, there was a positive correlation between RS and RT at 1 and 3 months postoperatively (<i>P</i><0.001). There was no correlation between RS in the upper macular region at 6 months postoperatively and preoperative RT (<i>r</i>=0.43, <i>P</i>=0.072), but there was a positive correlation with RT at 3 months postoperatively (<i>r</i>=0.58, <i>P</i>=0.041). <b>Conclusions:</b> After idiopathic macular hole internal limiting membrane flap inversion surgery, the OCTA-related parameters have changed. There are transient changes in deep vascular parameters and thinning of the retinal layers at the ILM inversion site, leading to decreased sensitivity.</p>","PeriodicalId":39688,"journal":{"name":"中华眼科杂志","volume":"60 3","pages":"250-256"},"PeriodicalIF":0.0,"publicationDate":"2024-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140094838","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Chinese expert consensus on the diagnosis and treatment of contact lens-associated dry eye (2024)].","authors":"","doi":"10.3760/cma.j.cn112142-20231121-00243","DOIUrl":"10.3760/cma.j.cn112142-20231121-00243","url":null,"abstract":"<p><p>The number of contact lens wearers in China is increasing rapidly. Long-term contact lens wearing may induce or exacerbate tear film instability, and consequently affect the visual quality, ocular surface safety, and compliance of the wearers. To promote the safety and effectiveness of contact lens fitting, and to improve the visual quality and satisfaction of contact lens wearers, the Society of Contact Lens Safety Monitoring & Vision Health of Chinese Health Association has targeted to develop an expert consensus on the diagnosis and treatment of contact lens-associated dry eye. By referring to relevant literature and summarizing clinical experience, the clinical experts in corneal disease, pediatric ophthalmology and optometry have made repeated discussions to form this consensus, including the definition, pathological mechanisms, influencing factors, evaluation, prevention and treatment of contact lens-associated dry eye, for the reference of optometrists and ophthalmologists.</p>","PeriodicalId":39688,"journal":{"name":"中华眼科杂志","volume":"60 2","pages":"120-126"},"PeriodicalIF":0.0,"publicationDate":"2024-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139724378","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[A case of fungal keratitis caused by <i>Petriella setifera</i> infection].","authors":"H M Qi, L Zhang, M Du, Y Yang, X T Guo, P Li, Y Shi, X H Lu","doi":"10.3760/cma.j.cn112142-20231024-00168","DOIUrl":"10.3760/cma.j.cn112142-20231024-00168","url":null,"abstract":"<p><p>The patient, a 66-year-old male, suffered from redness, blurred vision, photophobia, and tearing in the right eye after being injured by a wooden board. Anti-inflammatory treatment showed poor effectiveness. A 4 mm × 4 mm infiltrate with white deposits on the surface was observed in the central cornea of the right eye. Microscopic examination of corneal scrapings, fungal culture, and <i>in vivo</i> confocal microscopy all indicated fungal infection. The isolated strain was identified as <i>Scedosporium apiospermum</i> through microscopic morphology and confirmed as <i>Petriella setifera</i> by gene sequencing. The patient received corneal debridement combined with routine anti-inflammatory and antifungal treatment in the outpatient clinic. During the follow-up period, the condition continued to improve. Slit lamp examination at the revisit 40 days after the initial diagnosis revealed thinning of the corneal stroma, basic healing of the epithelium, and an increase in uncorrected visual acuity from 0.3 to 0.6.</p>","PeriodicalId":39688,"journal":{"name":"中华眼科杂志","volume":"60 2","pages":"176-179"},"PeriodicalIF":0.0,"publicationDate":"2024-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139693128","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Efficacy of 0.05% cyclosporine A combined with vitamin A palmitate in the treatment of meibomian gland dysfunction-related dry eye].","authors":"Y R Hao, S Y Li, J Y Bao, J Y Wang, A Li, L Tian, Y Jie","doi":"10.3760/cma.j.cn112142-20231109-00221","DOIUrl":"10.3760/cma.j.cn112142-20231109-00221","url":null,"abstract":"<p><p><b>Objective:</b> To evaluate the efficacy of 0.05% cyclosporine A eye drops combined with vitamin A palmitate eye gel in the treatment of dry eye associated with meibomian gland dysfunction (MGD). <b>Methods:</b> A single-center, prospective, randomized, parallel controlled trial design was used to include patients diagnosed with MGD-associated dry eye. The patients were randomly divided into three groups and administered with medications binocularly for 12 weeks. The CsA+VA group was given 0.05% cyclosporine A eye drops twice a day and vitamin A palmitate eye gel three times a day. The CsA+HA group was given 0.05% cyclosporine A eye drops twice a day and 0.1% sodium hyaluronate eye drops three times a day. The HA group was given 0.1% sodium hyaluronate eye drops 3 times a day. The OSDI score, tear meniscus height, fluorescein tear break-up time, Schirmer Ⅰ test (without anesthesia), tear film lipid layer thickness, meibomian gland morphology and function examination, and corneal fluorescein sodium staining score were evaluated at baseline, 4, 8, and 12 weeks after the initiation of the treatment, respectively. <b>Results:</b> A total of 120 patients with MGD-related dry eye met the enrollment criteria, but 10 patients were lost to follow-up; 110 patients were finally included for observation, including 36 patients in the CsA+VA group, 38 in the CsA+HA group and 36 in the HA group. The OSDI score, tear meniscus height, fluorescein tear break-up time and meibomian gland secretion of the 3 groups were significantly improved. At the 12th week of the treatment, the differences of the CsA+VA group [25.45±15.11, (0.30±0.13) mm, (3.72±1.40) s, (5.03±2.52) points] and the CsA+HA group [26.98±16.89, (0.27±0.10) mm, (4.34±1.76) s, (5.11±2.39) points] from the HA group [24.57±11.26, (0.24±0.06) mm, (3.18±1.11) s, (9.11±3.34) points] were statistically significant (<i>P</i><0.05). Compared with the CsA+HA group [(68.39±26.66) nm], the tear film lipid layer thickness in the CsA+VA group [(72.61±23.65) nm] was significantly increased (<i>P</i><0.05). In the CsA+VA group, the meibomian gland secretion characters and discharge capacity among patients with severe abnormalities [(6.28±2.59) and (5.89±2.77) points at the 12th week of treatment], moderate abnormalities [(4.27±2.02) and (4.64±2.02) points at the 12th week of treatment] and mild abnormalities [(2.80±0.84) and (2.60±0.55) points at the 12th week of treatment] were significantly different (<i>P</i><0.05). <b>Conclusion:</b> 0.05% cyclosporine A combined with vitamin A palmitate can significantly improve the symptoms and signs of patients with MGD-related dry eye, especially the tear film lipid layer thickness and the meibomian gland secretion characters and discharge capacity in severe cases.</p>","PeriodicalId":39688,"journal":{"name":"中华眼科杂志","volume":"60 2","pages":"127-136"},"PeriodicalIF":0.0,"publicationDate":"2024-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139693129","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Risk factors of cytomegalovirus infection in patients with failed corneal grafts].","authors":"Y X Zang, R M Peng, Y Qu, X Z Liu, J Hong","doi":"10.3760/cma.j.cn112142-20231120-00242","DOIUrl":"10.3760/cma.j.cn112142-20231120-00242","url":null,"abstract":"<p><p><b>Objective:</b> To investigate the levels of cytomegalovirus (CMV) infection and associated risk factors in corneal transplant recipients who experienced transplant failure. <b>Methods:</b> This was a case-control study. Clinical data from 576 cases (576 eyes) of patients who underwent repeat corneal transplant surgery at the Department of Ophthalmology, Peking University Third Hospital, due to corneal transplant failure from January 2016 to May 2022 were collected. Of these, 305 were male and 271 were female, with a median age of 44.0 (0.7, 91.0) years. The CMV infection rate was analyzed based on the detection of CMV DNA in aqueous humor or corneal tissue during corneal transplant surgery. Patients were divided into the CMV group (CMV DNA positive) and the control group (herpes virus DNA negative). The main research indicators included the CMV infection rate, clinical characteristics, and risk factors in corneal transplant recipients. Chi-square tests and binary logistic analysis were used to compare differences between the two groups in general information, systemic diseases, ocular lesions, ocular surgical history, and local and systemic medications. Odds ratios (<i>OR</i>) and 95% confidence intervals (<i>CI</i>) were calculated for each CMV infection risk factor. <b>Results:</b> The overall CMV infection rate was 21.9%(126/576), with annual rates ranging from 10.9% to 37.7% from 2016 to 2021. After applying inclusion and exclusion criteria, 378 patients were included in the control trial, with 126 in the CMV group and 252 in the control group. Statistically significant differences between the two groups were observed in systemic immune-related corneal lesions [CMV group: 38 (30.2%), control group: 26 (10.3%)], local immune and inflammatory corneal lesions [CMV group: 46 (36.5%), control group: 40 (15.9%)], congenital corneal opacity [CMV group: 46 (36.5%), control group: 48 (19.0%)] total number of corneal transplants (CMV group: 178 times, control group: 276 times), corneal deep neovascularization crossing the graft [CMV group: 104 (82.5%), control group: 68 (27.0%)] and severe opacity [CMV group: 44 (34.9%), control group: 30 (11.0%)]. Binary logistic regression analysis showed that systemic immune-related corneal lesions (<i>OR=</i>4.044, 95%<i>CI</i> 1.810-9.033, <i>P</i><0.001), local immune and inflammatory corneal lesions (<i>OR=</i>3.554, 95%<i>CI</i> 1.569-8.052, <i>P</i>=0.002), congenital corneal opacity (<i>OR=</i>2.606, 95%<i>CI</i> 1.216-5.589, <i>P</i>=0.014), total number of corneal transplants (<i>OR=</i>3.206, 95%<i>CI</i> 1.753-5.864, <i>P</i><0.001), corneal deep neovascularization crossing the graft (<i>OR=</i>8.347, 95%<i>CI</i> 3.967-17.559, <i>P</i><0.001), and severe opacity (<i>OR=</i>3.063, 95%<i>CI</i> 1.221-7.682, <i>P</i>=0.017) were independent risk factors for CMV infection after corneal transplant. <b>Conclusions:</b> CMV infection was present in more than 1/5 of corneal transplant recipients who exp","PeriodicalId":39688,"journal":{"name":"中华眼科杂志","volume":"60 2","pages":"137-146"},"PeriodicalIF":0.0,"publicationDate":"2024-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139698541","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}