High-altitude retinopathy(HAR)is a retinal vascular disorder induced by exposure to high-altitude environments. With the increasing popularity of high-altitude travel, mountaineering, and special occupational activities, worldwide, the incidence of HAR has risen, particularly among individuals with rapid or short-term exposure to elevated altitudes. Most cases of HAR are self-limiting and gradually resolve with descent to lower altitudes. However, severe cases may result in permanent visual function impairment if not recognized and managed promptly. This review systematically summarizes the epidemiology, diagnostic progress, pathogenesis, and prevention and treatment strategies of HAR, with particular emphasis on hypoxia-associated molecular pathways involved in retinal damage, and evaluates current evidence for clinical interventions. Deepened understanding of its pathological mechanisms and clinical management strategies facilitates early identification, targeted intervention, and ocular health protection for populations exposed to high altitudes.

Abstract: Objective　To investigate the allelic mutations of kdr and ace-1 in Anopheles gambiae s.l., providing a scientific basis for mosquito-borne disease prevention and control in the region. Methods Mosquitoes were collected from six villages in two malaria-prone areas, Est-mono (Ogou koulidé, Kepssi, Igbomedji) and Anié (Kolocopé, Bana, Afolé). All mosquitoes were used for DNA extraction, species identification, and genotyping of kdr and ace-1. Results An. coluzzii and An. gambiae, two closely related species within the An. gambiae complex, were identified across six collection sites, with An. gambiae being predominant, constituting approximately 96.53% of the samples. Among all mosquito samples detected, high-frequency mutations were observed at the kdr 1014 locus in the An. gambiae complex, with mutation frequencies reaching 100.0% in Ogou koulidé, Bana, and Afolé, 97.5% in Kepssi and Igbomedji, and 91.1% in Kolocopé district. The allelic frequency of 1014F ranged from 85.5% to 100%. Mutation frequency of An. coluzzii 1014 locus in all three regions was 100%, with an allelic frequency of 1014F ranging from 90% to 100%, indicating a high rate of homozygosity. The kdr 1575 mutation frequency in An. gambiae ranged from 6.6% to 24.3%, with the allelic frequency of 1575Y ranging from 3.2% to 12.2%, all detected mutations were heterozygous, and no mutations were detected at the 1575 locus in An. coluzzii. Mutations at the ace-1 G119 locus were also observed in the An. gambiae complex, with mutation frequencies in An. gambiae ranging from 8.8% to 15% and the allelic frequency of 119S from 4.4% to 7.5%. In An. coluzzii, mutation frequencies ranged from 0 to 20.0%, with an allelic frequency of 119S from 0 to 10%, and all detected 119S mutations were heterozygous. Conclusions The high frequencies of the Anopheles gambiae kdr mutation observed suggest that malaria mosquito vectors in Togo may have developed a high level of resistance to pyrethroid insecticides and possibly a moderate resistance to organophosphorus or carbamate insecticides. This indicates that local vector management authorities should prioritize insecticide resistance issues in future malaria vector control and resistance management planning, and conduct regular monitoring.