Lan Gong

This study aimed to investigate the diagnostic value of the tear lymphotoxin-α (LTA) concentration for dry eye disease (DED). A total of 160 subjects-75 patients with DED, 55 individuals without DED, and 30 pain-without-stain patients were included. Ocular Surface Disease Index (OSDI), the tear LTA concentration, tear break-up time (TBUT), MMP-9, IL-1ra, IL-1β, IL-6, IL-8, IL-17, and IFN-γ, and MUC5AC levels, corneal fluorescein staining (CFS), conjunctival lissamine green staining (CLGS), conjunctival impression cytology (IC), Schirmer I test, and conjunctival goblet cell counts were determined. Tear LTA concentration varied among the three groups, being the lowest in the DED group and the highest in the pain-without-stain group. The overall agreement rate between LTA diagnosis and expert consensus diagnose was 83.85%. The kappa coefficient was 0.670 (P < 0.001). Significant differences in tear LTA concentration were observed among all severity groups. Receiver operating characteristic (ROC) curve analysis revealed cutoff values of 105 pg/mL, 855 pg/mL, and 1580 pg.mL as an exploratory stratification thresholds for distinguishing the severe DED (LTA 1580 pg/mL). Moreover, significant differences in the OSDI, the TBUT, CFS results, CLGS results, IC results, MMP-9, IL-1ra, IL-1β, IL-6, IL-8, IL-17, IFN-γ, and MUC5AC concentrations were detected among the different LTA groups. Throughout the cohort, we explored the potential of tear LTA concentration for the diagnosis and graded classification diagnosis of dry eye. Tear LTA is a potential biomarker for the graded classification and subtyping of dry eye, and is expected to become a novel biomarker in the diagnosis and management of dry eye.

Ocular infections such as keratitis and conjunctivitis pose severe vision‐threatening risks, exacerbated by diverse pathogens and escalating antimicrobial resistance. Conventional treatments are limited by inadequate ocular bioavailability and frequent dosing. Nanotechnology offers transformative solutions by enabling targeted, sustained drug delivery and enhanced penetration through ocular barriers while augmenting antimicrobial potency. This review systematically examines the rational design, composition, and synthesis of advanced nanomaterials, specifically metal‐based, polymer‐based, and lipid‐based nanostructures. Furthermore, it critically analyzes multimodal hybrid systems and stimuli‐responsive platforms for combating ocular pathogens. Key strategies explored encompass direct antimicrobial mechanisms, biofilm penetration and disruption, and immunomodulation. We next examine the preclinical efficacy and emerging clinical evidence, while also addressing persistent challenges in biocompatibility, biodegradation kinetics, scalable manufacturing, and regulatory pathways. Finally, we summarize future directions including artificial intelligence (AI)‐driven nanomaterial design, personalized nanomedicine, and wearable nanodevices. Collectively, these advances position nanotherapeutics as promising candidates for next‐generation ocular anti‐infectives.

Objectives Understanding the developmental anatomy of the lacrimal sac fossa (LF) and nasolacrimal canal (NLC) is critical for paediatric lacrimal diseases. Methods This observational study analysed cranial CT images of 144 paediatric patients undergoing imaging for non-ocular conditions and 80 adults with phthisis bulbi as a matched comparison. Measurements included LF vertical dimension (height) and anteroposterior dimension (width), NLC diameter and vertical dimension, and frontal process of the maxilla (FPM) structures. Developmental changes were assessed using the generalised additive model (GAM), with structural comparisons between children and adults. Results Children enrolled had an even distribution in age and gender (77 males and 67 females, average ages of 9.83 and 9.44 years, respectively). Except for the proportion of FPM contributing to the LF and inferior LF height (part below the operculum of middle turbinate), which showed minimal age-related change, the GAM model revealed that most structures grew rapidly before age 10, then slowed. The NLC vertical dimension exhibited the fastest growth, increasing approximately threefold from birth to adulthood, while other structures generally increased by 1.5 to 2 times. Males consistently had larger dimensions than females in most measurements. Differences compared to adults were more significant in children under 10. Conclusions The various segments of the lacrimal drainage system exhibit different developmental patterns in children. While most LF and NLC structures grow rapidly before age 10, a few remains minimal age-related change. This study provides predictive values by age, which may serve as useful references for surgical planning in CNLDO.

Background: Lacrimal sac cysts (LSCs) are rare lacrimal drainage system (LDS) lesions that often present as medial canthal masses or epiphoras in adults. Computed tomography (CT) and computed tomography dacryocystography (CT-DCG) can aid in the diagnosis of LDS; however, the literature is limited to case reports and adult systematic studies, and discriminative imaging pattern and LDS anatomical change analyses are lacking, hindering treatment. Thus, this study sought to analyze the CT/CT-DCG features and LDS anatomy of adults to address these gaps in the literature. Methods: This single-center retrospective case-control study included patients diagnosed with LSCs at the Eye & ENT Hospital of Fudan University. Patients with a history of prior surgeries, trauma, tumors, or thyroid-associated ophthalmopathy were excluded from the study. The control subjects comprised individuals with normal LDS undergoing CT for unrelated conditions. CT and CT-DCG imaging were analyzed for radiological patterns, while the anatomical measurements included the nasolacrimal duct (NLD) width, lacrimal sac fossa (LSF) dimensions, and nasal abnormalities. Results: A total of 60 participants (50 females, 10 males; mean age: 47.43±13.60 years) were included in the study. CT and CT-DCG imaging revealed four distinct patterns: contrast agent reflux without enhancement, partial thin rim enhancement of the cyst wall, fluid level, and a fluid-filled lightbulb sign. The patients with LSCs exhibited a widened LSF, a thinner frontal process, and larger lacrimal bone angles than the controls, indicating bone remodeling. The average distance from the middle turbinate axilla (MTA) to the upper and lower limits of the LSF were 3.34±3.37 and 11.00±4.40 mm, respectively. Conclusions: CT and CT-DCG imaging are critical in the diagnosis LSCs; specific patterns and anatomical changes can enhance diagnostic accuracy and guide surgical planning. These findings provide vital insights into the clinical management of LSCs, particularly in relation to dacryocystorhinostomy procedures.

Background: Investigating the anatomic features of congenital nasolacrimal duct obstruction (CNLDO) is crucial for understanding its etiology and guiding surgical management. This study aimed to compare the computed tomography (CT)-based features of the lacrimal sac fossa (LF) and nasolacrimal duct (NLD) in CNLDO patients against matched controls. Methods: This retrospective comparative observational study included 39 CNLDO patients who underwent cranial CT for preoperative evaluation, subdivided into 18 cases with chronic dacryocystitis and 21 cases without. For each patient, an age- and gender-matched control undergoing cochlear implantation CT assessment and screened to exclude craniofacial anomalies was enrolled. Measurements were conducted on CT images, including LF height and width, NLD height and width, frontal process thickness, and the presence of sinusitis. Comparisons were made among the obstructed, non-obstructed, and matched control sides. Results: Mean ages in the non-dacryocystitis and dacryocystitis groups were 2.58 and 3.08 years, respectively. In the non-dacryocystitis group, the narrowest NLD width on the obstructed side was significantly larger than that on the control side (3.38±0.70 vs. 2.82±0.47 mm, P=0.009). In the dacryocystitis group, the narrowest NLD, upper NLD, and LF widths on the obstructed side were significantly larger than those on the control side (3.90±0.70 vs. 2.82±0.47 mm; 4.72±1.10 vs. 3.43±0.79 mm; 5.57±1.40 vs. 4.48±0.89 mm; PConclusions: All obstructed sides of CNLDO exhibit an increase in NLD width. Besides, in CNLDO with chronic dacryocystitis, LF enlargement can also be observed in obstructed sides, with the anatomic changes more pronounced. We hypothesize that, in addition to elevated hydrostatic pressure, infectious factors are a significant cause of these structural expansions.

Purpose: To investigate the synergistic effects of duration of glaucoma and number of medications on meibomian gland orifice obstruction severity in glaucoma patients, aiming to optimize therapeutic strategies for ocular surface protection. Methods: This retrospective study analyzed 120 glaucoma patients with concurrent MGD. Meibomian gland orifice obstruction was scored using standardized criteria. The relationship between obstruction scores and clinical factors was evaluated using Spearman correlation and generalized linear modeling. Results: Significant correlations were found between MG orifice obstruction score and duration of glaucoma (r = 0.309, P < 0.001), number of medications (r = 0.340, P < 0.001), number of preserved eye drop products (r = 0.300, P < 0.001) and duration of medication (r = 0.398, P < 0.001). Generalized linear modeling revealed significant main effects of duration of glaucoma and number of medications (P = 0.012 and P = 0.005), with a significant interaction (P = 0.020). After 3 years of glaucoma, any medication regimen significantly increased obstruction scores compared to no treatment (all P < 0.05). Triple or quadruple therapy showed significantly higher obstruction scores versus no medication (P = 0.002 and P = 0.008). Conclusion: Duration of glaucoma and number of medications synergistically worsen MG orifice obstruction, with a critical threshold after one year of disease. These findings suggest the importance of reducing medication burden in long-term glaucoma patients.

Corneal frostbite is a rarely reported condition, with unique pathophysiological characteristics distinct from classical frostbite of the extremities due to the cornea’s specific anatomy and physiology. We present a case of corneal frostbite caused by natural environmental exposure. Following a 3-hour marathon on ice at temperatures ranging from − 16 °C to -23 °C, the patient developed blurred vision in the right eye and bilateral photophobia with eye irritation. Clinical examination revealed stromal and endothelial edema of cornea in the right eye, with bilateral punctate corneal epithelial defects and conjunctival congestion. After 4 weeks of topical treatment, the patient’s visual acuity and epithelial integrity were fully restored, though a permanent filiform endothelial scar remained. Under the condition of corneal frostbite, the formation of ice crystals possibly directly damage both the epithelial and endothelial layers. This case report provides valuable insights for future research in ophthalmic emergency medicine.