Objective This study aims to assess the feasibility of the styloid process via retroauricular sulcus approach in patients diagnosed with Eagle's syndrome. Methods Sixty patients diagnosed with Eagle's syndrome at the Department of Otorhinolaryngology Head and Neck Surgery, Linyi People's Hospital, between January 1, 2018, and May 15, 2024, were enrolled and randomly assigned to either the experimental group(Group A, n=30)or the control group(Group B, n=30). Group A underwent styloid process resection via a retroauricular sulcus approach, while Group B received transoral tonsillectomy combined with styloid process resection. Outcome measures included operative time, length of styloid resection, Visual Analogue Scale(VAS)pain scores, swallowing function scores, clinical efficacy, and postoperative complications. Results Compared with Group B, Group A exhibited significantly shorter operative time, greater resection length, GEE showed significant time effects and group-by-time interactions for VAS pain and swallowing function scores(all P<0.001); scores in Group A were lower than those in Group B at postoperative days 3 and 7(all P<0.001). No statistically significant differences were observed in clinical efficacy or postoperative complications between the two groups(P>0.05). Conclusion The retroauricular sulcus approach for styloid process resection offers advantages including reduced operative time, minimal invasiveness, decreased postoperative pain, and less impact on swallowing function, without compromising clinical efficacy or safety. This technique warrants broader clinical application.

Objective To develop a method for labeling cell-surface proteins of cochlear hair cells in mice and establish conditions for profiling the cell-surface proteome of these cells. Methods A recombinant adeno-associated virus(rAAV)was engineered to express a horseradish peroxidase fusion protein(HRP-TM)specifically in hair cells, targeting the outer surface of the cell membrane. The virus was microinjected into the posterior semicircular canal of 2-day-old C57BL/6 mice. At 1 month of age, auditory brainstem response(ABR)was measured, and HRP expression and protein labeling were assessed via basilar membrane immunofluorescence staining. Results ABR results showed no significant hearing differences between virus-injected and control mice. Immunofluorescence revealed HRP-TM was specifically expressed in hair cells, with >95% transduction efficiency in inner hair cells and ~80% transduction efficiency in outer hair cells. Hair cell morphology and arrangement remained normal. Fluorescent streptavidin staining confirmed membrane-specific labeling exclusively in HRP-TM-expressing hair cells. Conclusion The rAAV-HRP-TM system efficiently and specifically labels cochlear hair cell surface proteins without cytotoxicity or functional impairment, providing a foundation for isolating and analyzing these proteins via mass spectrometry.

Objective This study aimed to characterise the temporal changes in the conjunctival sac microbiota of both the operated and contralateral eyes following endoscopic dacryocystorhinostomy(EN-DCR), and to provide microbiological evidence to optimise the timing of subsequent intraocular procedures. Methods This study included 16 patients(32 eyes)who underwent EN-DCR at our institution. Bilateral conjunctival sac swabs were collected from each patient and processed for conventional bacterial culture. In addition, 16S rRNA gene sequencing was conducted on samples obtained from three randomly selected patients. Results In the operated eyes, the rate of positive bacterial cultures declined significantly from 10/16(62.5%)preoperatively to 2/16(12.5%)on postoperative day 2(P=0.001). The number of bacterial species decreased from 34 preoperatively to 20 on postoperative day 1 and to 2 on day 2, and remained sterile throughout the subsequent follow-up period. 16S rRNA gene sequencing revealed significant temporal changes in alpha diversity, as measured by the Pielou index(P=0.031), while β diversity remained statistically unchanged over time. Conclusions EN-DCR leads to a marked reduction in the bacterial evenness within the conjunctival sac of the operated eye, with negligible effect on the contralateral eye. The postoperative decrease in microbial load may mitigate the risk of infection and provides microbiological evidence to guide the timing of subsequent intraocular procedures.

Objective To investigate the level of benefit finding in patients with allergic rhinitis and analyze its influencing factors. Methods A total of 232 patients were selected by convenience sampling method. The general questionnaire, the benefit finding scale, the social support scale, and the visual analog score of symptoms of allergic rhinitis patients were used. The factors influencing the benefit finding of allergic rhinitis patients were analyzed by multiple linear regression. Results At present, the total score of benefit finding of patients with allergic rhinitis was(64.19±13.036), among which, nasal symptom score, subjective support, objective support, age, educational level, marital status,medical insurance type, rhinitis classification and treatment methods entered regression equation(P<0.001). These factors could explain 75.2% of the total variable of patients' benefit finding of disease. Conclusion The benefit finding of allergic rhinitis patients is at a lower level than medium. Medical staff should attach importance to the assessment of the benefit finding of allergic rhinitis patients, focusing on patients in the active stage of the disease, encourage patients to express disease-related feelings, improve the intimate relationship and social adaptability of patients' family members, so as to enhance the levels of benefit finding of these patients.

Objective To analyze the influencing factors of laryngeal carcinogenesis, incorporating traditional Chinese medicine(TCM)syndrome patterns, and to develop a nomogram prediction model. Methods The clinical data of 219 patients who were first diagnosed with early laryngeal cancer and precancerous lesions in the Department of Otorhinolaryngology of Zhongshan Hospital of Traditional Chinese Medicine from January 2013 to December 2023 were collected retrospectively as the case group, and 125 patients with vocal cord polyps during the same period were selected as the control group. Independent risk factors for laryngeal carcinogenesis were identified using Logistic regression analysis. A nomogram was constructed based on these factors. The model's discrimination was evaluated using the receiver operating characteristic(ROC)curve, the area under the curve(AUC), and the Concordance Index(C-index). The model's calibration was assessed using the Hosmer-Lemeshow test and a calibration curve. Results Multivariate regression analysis showed that advanced age, male sex, smoking, alcohol consumption, Qi stagnation and blood stasis syndrome, elevated WBC, and elevated NLR were significant independent risk factors for laryngeal carcinogenesis(all P<0.05). A nomogram was constructed based on these seven factors. The area under the ROC curve(AUC)for the combined model was 0.923(95% CI: 0.895-0.952), with a sensitivity of 83.6% and a specificity of 87.2%. The Hosmer-Lemeshow test indicated good goodness-of-fit for the nomogram(χ2=8.853, P=0.355). The calibration curve demonstrated good agreement(mean absolute error=0.009), and the model showed excellent discrimination(C-index=0.923). Conclusion Advanced age, male sex, smoking, alcohol consumption, Qi stagnation and blood stasis syndrome, elevated WBC, and elevated NLR are independent risk factors for laryngeal carcinogenesis. The established nomogram, which integrates factors from both TCM and Western medicine, can effectively predict the risk of laryngeal carcinogenesis, providing a valuable reference for its early prevention and clinical management.

Objective To investigate the optical properties of aspheric monofocal intraocular lenses(IOLs)with different diopters under centered and the effects of different degrees of decentration and tilt on the optical quality of IOLs with different diopters. Methods OptiSpheric IOL R&D, an in vitro optical quality testing system, was used to evaluate the optical quality of aspheric monofocal IOL AcrySof IQ SN60WF with three different diopters of +10 m^-1, +20 m^-1 and +30 m^-1. The modulation transfer function(MTF)values at spatial frequencies of 50 lp/mm and 100 lp/mm, the MTF curve and the United States air force(USAF)resolution test chart were measured and compared for the IOLs under centered, different degrees of decentration, and tilt at apertures of 3.0 mm and 4.5 mm. Results The higher diopter of the IOL, the higher the of MTF values and the higher of USAF resolution under the centered position, and the faster decreases of the MTF values and USAF resolution when decentered and tilted. The greater the degree of decentration and tilt, the greater the decrease of MTF value and USAF resolution of the three diopter IOLs. At 2 aperture sizes, MTF values at spatial frequencies of 50 lp/mm and 100 lp/mm of IOLs decreased by 0.3 mm from the centered position when they were decentered. The MTF values at 50 lp/mm spatial frequency for the +10 m^-1 IOL at an aperture of 3.0 mm started to decrease at a tilt of 5°, whereas at an aperture of 4.5 mm and 2 spatial frequencies, the MTF value started to decrease at a tilt of 3°. The MTF values of +20 m^-1 and +30 m^-1 IOL started decreasing from a tilt of 3° at both apertures. MTF values and USAF resolution of the IOLs measured at 3.0 mm aperture were higher than at 4.5 mm aperture at the same positional conditions. Conclusion The higher the diopter of aspheric monofocal IOL SN60WF, the better the optical quality when centered, and the faster the optical quality decreased when decentered and tilted. Optical quality decreased at 0.30 mm decentration and tilts of 5° and above for the IOLs compared to when centered. Additionally, the optical quality of IOLs measured at small apertures is superior to that of large apertures.

Objective To study the effect of the IOL Alpha angle on visual quality following the implantation of the EDOF IOL(ZXR00). Methods A total of 50 cases(50 eyes)that underwent phacoemulsification combined with EDOF IOL implantation were included in the study. Preoperative and IOL Alpha angle assessments were conducted using the OPD Scan Ⅲ wavefront aberrometer. The study eyes were then categorized into three distinct groups based on the IOL Alpha angle values ascertained: Group A(19 eyes, 0 mm < Alpha angle ≤0.2 mm), Group B(19 eyes, 0.2 mm < Alpha angle≤0.4 mm), and Group C(12 eyes, Alpha angle >0.4 mm). UDVA was recorded three months postoperatively. The OPD Scan Ⅲ was employed to evaluate intraocular aberrations, including SR, total HOA, Coma and Trefoil. The assessment of photic phenomena were conducted utilising the Visual Functioning Index-14. Results The preoperative and IOL Alpha angle were no statistically significant difference(t=0.11, P=0.915). Pearson correlation analysis revealed a significant positive correlation between the preoperative and the IOL Alpha angle(r=0.983, P<0.001). The differences in UDVA, intraocular aberration, SR, total HOA, Coma and Trefoil values among the three groups were statistically significant(all P<0.05). Statistically significant differences in intraocular aberrations were observed in pairwise comparisons among groups(all P<0.05). A statistically significant difference in Trefoil values was found between Group A and Group C(P=0.030), as well as in total HOA values between these two groups(P=0.001). The results of the questionnaire survey indicated that the prevalence of glare/halos among patients in the three groups was 47.4%(9/19), 68.4%(13/19)and 100%(12/12), respectively, with these differences being statistically significant(χ2=9.365, P=0.009). Conclusion The IOL Alpha angle may reflect the decentration and actual position of the IOL within the eye. The IOL Alpha angle may affect the postoperative visual acuity and reflect the actual visual quality after surgery. Larger IOL Alpha angle will increase the incidence of postoperative glare/halos, which may affect the patient's quality of life.

Objective To investigate the clinical efficacy of tocilizumab(TCZ)in the treatment of moderate-to-severe thyroid-associated ophthalmopathy(TAO)with steroid resistance or intolerance. Methods Relevant clinical studies on tocilizumab for moderate-to-severe TAO with steroid resistance or intolerance were retrieved from the following Chinese and English databases: CNKI, CBM, Wanfang Data, VIP, PubMed, Web of Science, Embase, and Cochrane Library. The retrieval period was from the establishment of each database to April 11, 2024. Evaluation indicators included clinical activity score(CAS), exophthalmos, thyroid-stimulating immunoglobulin(TSI)or thyroid-stimulating hormone receptor antibody(TRAb), and adverse reactions. The quality of included randomized controlled trials(RCTs)was assessed using the Jadad scale, while the quality of non-randomized controlled trials was evaluated with the Minors scale. After data extraction, meta-analysis was performed using Stata 18.0 software. For continuous variables, the combined effect size was expressed as standardized mean difference(SMD)with 95% confidence interval(CI). For count data, the rate with 95%CI was used. Results A total of 1 RCT, 1 retrospective cohort study, and 8 before-after self-controlled trials were included, involving 194 subjects. The meta-analysis results showed that tocilizumab significantly reduced CAS ［SMD=-4.99, 95%CI(-6.30, -3.67), P<0.05］, decreased exophthalmos ［SMD=-0.81, 95%CI(-1.35, -0.27), P<0.05］, and lowered TSI/TRAb ［SMD=-0.86, 95%CI(-1.17, -0.55), P<0.05］. The incidence of adverse reactions was 0.35［95%CI(0.20, 0.51), P<0.05］, with most being mild to moderate and severe adverse reactions being rare. Conclusion Tocilizumab has a good therapeutic effect and favorable tolerance in the treatment of moderate-to-severe TAO with steroid resistance or intolerance.

Objective To analyze the application effect of an artificial intelligence(AI)screening system based on optical coherence tomography(OCT)/optical coherence tomography angiography(OCTA)in the evaluation of the efficacy of anti-vascular endothelial growth factor(VEGF)in the treatment of patients with diabetic macular edema. Methods 120 patients with diabetic macular edema diagnosed and treated from January 1, 2022 to January 31, 2024 were selected. According to the diabetic macular edema, they were divided into 42 cases of diffuse edema, 40 cases of cystic edema, and 38 cases of mixed macular edema. All patients underwent anti-VEGF treatment for 3 months. The AI screening system based on OCT/OCTA was used to measure and compare the area of the fovea avascular area, the thickness of the macular central retinal center, the thickness of the retinal ganglion cell layer, the thickness of the retinal nerve fiber layer, and the blood flow density of the retinal blood flow(deep capillary plexus in the retinal layer, and the superficial capillary plexus in the retinal layer)before and after treatment. Results The area of the fovea avascular area, the thickness of the macular central retinal, the thickness of the retinal ganglion cell layer, the thickness of the retinal nerve fiber layer, and the blood flow density of the retinal patients after treatment were better than before treatment(P all <0.05). The area of the fovea avascular area, the thickness of the macular central retinal, the thickness of the retinal ganglion cell layer, the thickness of the retinal nerve fiber layer, and the blood flow density of the retinal blood flow density of the retinal patients after treatment were better than those of the mixed macular edema(P all <0.05). Conclusion The AI screening system based on OCT/OCTA can more accurately evaluate the anti-VEGF treatment effect of patients with different types of diabetic macular edema, providing assistance in guiding future clinical treatment work and is worthy of promotion and application.

Objective To investigate the prognostic value of circulatory metabolic characteristics as predictors of treatment response to ranibizumab in patients with diabetic macular edema(DME). Methods This study was an observational clinical trial involving 46 patients diagnosed with DME involving the central fovea ［baseline central retinal thickness(CRT)≥320 μm］. All participants received intravitreal injections of ranibizumab for 3 months. CRT and best-corrected visual acuity(BCVA)were assessed at baseline and 3 months post-treatment. Baseline blood levels of metabolic markers related to glucose metabolism, cysteine metabolism, and creatine metabolism were measured. Univariate analyses were first performed to screen candidate variables, and then multivariate logistic regression analyses(adjusted for confounding factors such as age and sex)were conducted to investigate the associations between baseline metabolic markers and anatomical(CRT)and functional(BCVA)treatment responses. Results After 3 months of treatment, CRT significantly decreased from(568.20±103.30)μm to(453.6±103.30 )μm(P=0.000 4), and BCVA improved from 0.90±0.56 to 0.69±0.54(P<0.000 1). Analysis of systemic factors and clinical outcomes revealed significant negative correlations between glucose metabolism-related indicators(pyruvate, P=0.020 0; lactate, P=0.010 3; glucose, P=0.005 1; glycated hemoglobin, P=0.005 3)and CRT improvement. Additionally, creatinine levels related to creatine metabolism(P=0.031 8)were significantly negatively correlated with CRT improvement. Further analysis of systemic factors and visual prognosis showed significant negative correlations between lactate(P=0.030 0), glucose(P=0.028 3), glycated hemoglobin(P=0.013 9), and cysteine metabolism-related cystatin(P=0.019 7)with BCVA improvement. Multivariate logistic regression analysis further confirmed that glucose metabolism markers ［glucose odds ratio(OR)=1.66, HbA1c OR=1.71, lactate OR=2.19］ and creatinine(OR=1.02)independently predicted CRT improvement(all P<0.05), cystatin C(OR=8.55)combined with glucose metabolism indicators(glucose OR=1.42, HbA1c OR=1.64, lactate OR=1.91)independently predicted improvements in BCVA(all P<0.05). Conclusion Circulating metabolic characteristics in DME patients, particularly indicators related to glucose metabolism, creatine metabolism, and cysteine metabolism, can effectively predict the response to ranibizumab treatment, providing potential biomarkers for clinical practice.

Objective To retrospectively analyze the clinical characteristics and treatment outcomes of active ocular toxoplasmosis. Methods Clinical data were retrospectively analyzed from patients diagnosed with ocular toxoplasmosis. The diagnosis was confirmed through intraocular fluid and serological testing. Results The study included 12 cases(13 eyes), comprising 2 males(3 eyes)and 10 females(10 eyes). The age at initial diagnosis ranged from 17 to 73, with a mean of 37.4±16.7 years. The follow-up period ranged from 6 to 32 months, with a median duration of 8 months. At the initial visit, 12 eyes(92.3%)showed anterior segment inflammation, including 3 eyes(23.1%)with posterior synechiae. 4 eyes(30.8%)developed secondary ocular hypertension. All patients exhibited varying degrees of vitreous inflammatory haze, with 3 eyes(23.1%)showing severe vitreous opacity that nearly completely obscured the fundus view. Fundus manifestations were diverse. 10 eyes(76.9%)displayed necrotizing chorioretinal lesions, including 3 eyes(23.1%)with macular involvement. 2 eyes exhibited macular edema alongside extramacular lesions. 5 eyes(38.5%)had optic disc edema, among which 2 eyes showed yellowish-white peripapillary lesions approximately half a disc diameter in size. 6 eyes(46.2%)presented with pigmented chorioretinal scars adjacent to active lesions. Diagnosis was confirmed by intraocular fluid testing in 8 eyes(61.5%)during their first visit. However, 4 cases(5 eyes, 38.5%)were initially missed. Among them, 2 cases(2 eyes)showed significant optic nerve edema with peripapillary lesions; 1 case(1 eye)had a large necrotizing lesion involving nearly the entire superonasal quadrant; and 1 case(2 eyes)had severe vitreous opacity that prevented fundus examination. The intervals from initial visit to confirmatory intraocular fluid testing for these 4 cases were 0.87, 7.77, 0.45, and 1.0 months, respectively. All diagnosed patients received systemic and topical antibiotic, as well as corticosteroid therapy, with 3 cases undergoing vitrectomy. During follow-up, 1 patient experienced continuous deterioration, and another had recurrence with worsening after 2 years of stability. The remaining 11 eyes showed improvement and remained stable, with better log MAR BCVA at the last visit compared to initial presentation. Two eyes developed epiretinal membranes, and 1 eye developed vitreomacular traction. Conclusion Ocular toxoplasmosis presents complex and varied clinical manifestations. Necrotizing chorioretinal inflammatory lesions differ greatly in location and size. Specifically, small peripapillary lesions may be overlooked because of severe optic disc edema, while extensive necrotic lesions might cause diagnostic confusion. Moreover, inflammation frequently affects the vitreous, optic nerve, and macula. Patient prognosis largely depends on lesion severity. Clinical diagnosis should comprehensively consider patient history, symptoms, imaging, and laboratory tests. In suspected cases, timely testing of intraocular fluid and serum for Toxoplasma antibodies or DNA is essential. This approach facilitates early diagnosis and treatment, thereby improving patient outcomes.

Objective To study the clinical characteristics and comprehensive management of rhino-orbital cerebral mucormycosis. Methods A retrospective analysis of the clinical data of patients with rhino-orbital cerebral mucormycosis was performed, summarising the clinical features, diagnosis and treatment methods. Results Postoperative bacterial and fungal cultures suggested methicillin-resistant Staphylococcus epidermidis and filamentous fungal infection. Linezolide and voriconazole were not effective in treating the disease. After a repeat fungal culture, the patient was considered to have a Mucor infection and was treated with isavuconazole. After 6 months of follow-up, the swelling and pain in the left orbital area had disappeared and the left eyelid elevation function had fully recovered. However, vision did not improve. Conclusion The specific type of filamentous fungal infection of the nasal cavity and sinuses is sometimes difficult to identify and requires repeated testing. Early identification of the type of fungal infection can save valuable time in the comprehensive treatment of this disease. Rhino-orbital cerebral mucormycosis progresses rapidly, and timely surgical intervention and antifungal treatment of mucormycosis can effectively control the progression of the disease.

Objective To explore the clinicopathological characteristics, diagnosis, and therapies of non-intestinal-type adenocarcinoma of the nasal cavity and paranasal sinuses. Methods Retrospectively analyzed the clinical presentation, imaging manifestations, pathological findings, and follow-up data of a pediatric case of high-grade NITA. Summarize the diagnosis and treatment strategies, as well as the prognosis of NITA of the nasal cavity and paranasal sinuses, based on literature reviews. Results The patient underwent tumor resection of the left nasal cavity + sinus opening surgery by nasal endoscopy. Postoperative pathology confirmed a malignant nasal cavity tumor, immunohistochemistry showing positivity for CK7 and negativity for CK20, CDX2 and SOX10. No recurrence was observed during follow-up. Conclusion High-grade NITA of the nasal cavity and paranasal sinuses is rare, and pathological biopsy remains the gold standard for diagnosis. Complete surgical resection with negative margins is the primary treatment, and the state of the margins is a critical prognostic factor.

Objective The aim is to investigate the etiology, pathogenesis, clinical manifestations, diagnostic and treatment methods of posterior scleritis, with a focus on differential diagnosis, treatment strategies, and prognosis. Methods A retrospective analysis of a patient with posterior scleritis was conducted, along with literature review, to summarize the diagnostic and therapeutic processes. Results Numerous misdiagnoses given to the patient over eight years were finally rectified. After one week of appropriate treatment, the best-corrected visual acuity(BCVA)in the right eye improved from 0.12 to 0.30, with a significant reduction in optic and macular edema. One month afterwards, the BCVA in the right eye further stabilized at 0.60. Conclusion Posterior scleritis can present with diverse clinical manifestations, potentially leading to misdiagnosis such as central serous chorioretinopathy or retinitis. A detailed medical history and thorough physical examination can significantly improve the early diagnosis accuracy, thereby preventing misdiagnosis and inappropriate treatment.

Allergic rhinitis(AR)is a chronic inflammatory disease occurring in the nasal cavity of atopic individuals following inhalation of allergens such as pollen, dust mites, pet dander, and molds, and is increasing in incidence worldwide. Allergen immunotherapy(AIT)is a treatment that aims to alter the natural course of AR by modulating the patient's own immune function. However, its efficacy varies greatly due to individual allergen differences and the diversity of immune targets. The unique physicochemical properties of nanomaterials allow for more precise control of drug release, maintaining drug stability, reducing side effects, and enhancing immunomodulatory effects. AIT based on nanomedicine delivery systems aims to improve their efficacy and safety using nanoscale carriers. This emerging technology has broad research prospects and offers new strategies for the treatment of AR. This article reviews the application strategies and research progress of nanomedicine delivery systems in allergen immunotherapy for allergic rhinitis.

The emergence of deep learning has played a huge role in the promotion of medical quality, especially in the advancement of medical examination, and some areas of otolaryngology and head and neck surgery have benefited from it. On the basis of deep learning, the field of endoscopic analysis of the pharynx and larynx has made very effective attempts in the past five years. This article discusses the research and related research based on deep learning in pharyngeal and laryngeal endoscopic application in the past five years, analyzes the research progress in this field, and divides its development stage into three stages: the stage of neural network germination, the blending of neural network and medicine, and the development of neural network applicability. Based on clinical, sample information and other three aspects, this article discusses current research bottlenecks, expounds possible solutions and development prospects in the future, points out the main obstacles in the application of deep learning in current pharyngeal and laryngeal endoscopic research, and gives a possible development trend outlook in multiple aspects such as multicenter research, multitask learning, high-level data information collection in the future.

Chronic airway inflammatory disease is a kind of heterogeneous disease affecting the upper and lower respiratory tracts and lung parenchyma. Glucocorticoid(GC)is one of the most commonly used anti-inflammatory drugs in the clinical treatment of these diseases. However, some patients with sufficient GC treatment have unsatisfactory efficacy, that is, the phenomenon of glucocorticoid resistance(GCR), increasing the difficulty in the treatment of these diseases. Therefore, elucidating the pathogenesis of GCR is the key to its prevention and treatment. In recent years, relevant studies have suggested that the decrease in histone deacetylase 2(HDAC2)expression level and activity reduces the ability of the glucocorticoid receptor α(GRα)to inhibit the expression of pro-inflammatory genes, leading to the occurrence of GCR. Furthermore, the decrease in HDAC2 expression and activity in chronic inflammatory diseases of the airways is the result of covalent modification of HDAC2, the increase of PI3Κ/Akt signaling pathway, and the activation of the STING pathway under the background of airway oxidative stress, which will provide a new theoretical basis and idea for recovering GC sensitivity in chronic inflammatory diseases of the airways.

Systemic diseases refer to conditions that affect multiple organs throughout the body. Many systemic diseases have different degrees of damage to the eye. An in-depth study of the relationship between ophthalmology and systemic diseases can enhance the comprehensive diagnostic and therapeutic level in both fields. Optical coherence tomography angiography(OCTA)provides non-invasive, high-resolution three-dimensional images allowing for detailed observation of the conjunctival, iris, retinal, and choroidal blood vessels. OCTA has been widely used in ophthalmology, which is of great significance in the observation and follow-up of fundus diseases, such as macular edema, choroidal neovascularization, diabetic retinopathy, and retinal branch vein occlusion. Recent studies have shown that OCTA can not only be used for the early screening and diagnosis of neurodegenerative diseases, but also for assessing the severity of critical illnesses and carotid artery stenosis, as well as evaluating the effects of treatment. Furthermore, OCTA has been applied in assessing disease activity in systemic lupus erythematosus and has demonstrated significant value in constructing disease risk prediction models. In this article, we review the latest advances in the application of OCTA in various systemic diseases, discusses its potential clinical value, and provides insights for further application of OCTA in the field of systemic diseases.

Exosomes are nanoscale extracellular vesicles secreted by a variety of living cells. They have a lipid bilayer membrane structure and are widely distributed in various body fluids. They play an important role in information exchange between cells, immune response, repair and regeneration, etc. Exosomes from different sources have different functions. In recent years exosomes have shown great research potential in the diagnosis, treatment and prognosis evaluation of eye diseases, which may lead to more personalised treatment for patients with eye diseases and provide a basis for the selection of treatment methods for eye diseases. This article reviews the role of exosomes in the pathogenesis, diagnosis, and treatment of ophthalmic diseases.

Shh, PI3K/AKT and MMP-2 are important regulatory signaling pathways widely expressed in the body, and are closely related to embryonic development, cell growth, proliferation and differentiation. More and more studies have found that Shh, PI3K/AKT and MMP-2 signaling pathways play a crucial role in maintaining the normal growth and development of the eye, the regeneration and repair of eye tissues, and the occurrence and development of various ocular diseases. It has been reported that there are abnormal expressions of Shh, PI3K/AKT and MMP-2 signaling pathways in the occurrence and development of myopia, which indicates that Shh, PI3K/AKT and MMP-2 signaling pathways are particularly important in the occurrence and development of myopia. In recent years, the search for signaling pathways related to the pathogenesis of myopia has become a hot topic at present. Therefore, it is of great significance to explore the expression changes and correlation of Shh, PI3K/AKT and MMP-2 signaling pathways in the occurrence and development of myopia. This paper focuses on the expression changes of Shh, PI3K/AKT and MMP-2 signaling pathways in myopia, and on this basis, the correlation between these pathways is discussed.

Scleral contact lens, commonly called scleral lens, is a new type of large-diameter, highly oxygen-permeable, rigid ocular surface contact lens that can cover the cornea, limbus and part of the sclera. Compared to the traditional rigid gas permeable(RGP)corneal contact lens, the scleral lens has a wide range of indications and can effectively reduce pain and irritation. It also has advantages in maintaining ocular surface hydration, promoting corneal epithelial repair and prolonging drug action. These properties enable it to demonstrate significant clinical efficacy in the treatment of ocular surface diseases such as keratoconus, dry eye, post-keratoplasty astigmatism, refractive errors, corneal degeneration or dystrophy and corneal trauma. What's more, scleral lenses can solve problems that are difficult to overcome with traditional RGPs. This article mainly provides a detailed summary of the treatment principles, efficacy and safety of scleral lenses in the treatment of ocular surface diseases, as well as the advantages and limitations of clinical treatment, with the aim of giving full play to their clinical therapeutic value.