Diabetic retinopathy(DR)-related neovascular glaucoma(NVG)is a severe ocular complication of diabe-tes,characterized by a high blindness rate and complex diagnosis and treatment.Currently,there is a lack of systematic,whole-process management guidelines for DR-NVG in China.To standardize the clinical diagnosis,treatment,and health management of DR-NVG,domestic retinal disease and glaucoma experts have developed the first expert consensus on the whole-process management of neovascular glaucoma associated with diabetic retinopathy,by integrating the latest evi-dence-based medical evidence and clinical practice experience from both domestic and intemational sources.Centering on the disease characteristics of DR-NVG,this consensus proposes scientific and standardized whole-process management strategies,encompassing early screening and risk assessment,precise diagnosis and staging,multi-mode combination ther-apy,perioperative management,and long-term follow-up.It mainly covers the screening and diagnosis of high-risk popula-tions,the timing of anti-VEGF therapy and pan-retinal photocoagulation application,and indications for surgical interven-tion.The aim is to provide standardized guidance for ophthalmologists and public health workers,improve the prevention and treatment level of DR-NVG,and reduce the incidence of irreversible visual impairment.

Objective To explore the protective effect of Bilobalide on retinal ganglion cells(RGCs)in rats with op-tic nerve injury and its mechanism.Methods Sixty rats were randomly selected from 75 Sprague-Dawley rats to establish an optic nerve crush injury model.The 60 successfully modeled rats were then randomly divided into a model group,and low-,medium-,and high-dose Bilobalide groups,with 15 rats in each group.Another 15 rats served as the sham-operated group,undergoing optic nerve exposure without crushing.Rats in the low-,medium-,and high-dose Bilobalide groups were intraperitoneally injected with 5,10 and 20 mg·kg-1 Bilobalide,respectively,once daily for 7 days.Rats in the sham-operated and model groups were intraperitoneally injected with an equal volume of normal saline once daily for 7 days.The superoxide dismutase(SOD)activity and malondialdehyde(MDA)content in the retinal tissue of rats in each group were measured.Immunofluorescence staining was used to assess RGCs proliferation.Hematoxylin-eosin(HE)stai-ning was used to observe histopathological changes in the retinal structure.TUNEL staining was used to detect RGCs apop-tosis.Immunofluorescence staining was used to observe the activation state of retinal microglia.Western blot was used to detect the expression of growth-associated protein 43(GAP43)and proteins related to the extracellular signal-regulated ki-nase 1/2(ERK1/2)pathway.Results Compared with the sham-operated group,the model group showed significantly decreased SOD activity and increased MDA content in the retinal tissue(all P＜0.05),a significant decrease in RGCs densi-ty(P＜0.05),significant increases in the apoptosis rate and microglial activation ratio(all P＜0.05),and significant downregulation of p-ERK1/2 and GAP43 protein expression(all P＜0.05).Histomorphology revealed edema and vacuola-tion in the ganglion cell layer,disordered arrangement of RGCs,and thinning of the inner nuclear layer and outer nuclear layer in the model group.After intervention with various doses of Bilobalide,all the above indices were significantly im-proved(all P＜0.05):SOD activity increased,MDA content decreased,RGCs density recovered,RGCs apoptosis rate and microglial activation decreased,the expressions of p-ERK1/2 and GAP43 were upregulated,the structural damage to each retinal layer was alleviated,showing a dose-dependent recovery.Conclusion Bilobalide can exert a protective effect on RGCs after optic nerve injury through multiple mechanisms,including alleviating oxidative stress,inhibiting apoptosis and microglial overactivation,promoting axonal regeneration,and activating the ERK1/2 signaling pathway.

Objective To investigate whether Piceatannol(PIC)improves diabetic retinopathy(DR)mediated by microglial polarization and to elucidate the underlying molecular mechanisms.Methods Network pharmacology and bioinformatics were used to analyze the common targets of DR,PIC,and microglia.Human retinal vascular endothelial cells(HRVECs)were cultured in vitro and randomly divided into the NG-HRVECs group,HG-HRVECs group,and HG+PIC-HRVECs group.Cell viability was assessed by the CCK-8 assay,apoptosis was detected by the TUNEL assay,and the concentrations of tumor necrosis factor-α(TNF-α)and interleukin-6(IL-6)were measured using ELISA kits.BV-2 cells were cultured in vitro and randomly divided into the NG-BV-2 group,HG-BV-2 group,HG+PIC-BV-2 group,HG+Si-NC-BV-2 group,HG+Si-CXCR4-BV-2 group,and HG+Ibrutinib-BV-2 group.The levels of arginase-1(Arg-1)and inducible ni-tric oxide synthase(iNOS)were measured using ELISA kits.Furthermore,conditioned medium(CM)from BV-2 cells of each group was collected to treat HRVECs,after which the viability,apoptosis rate,and TNF-α and IL-6 concentrations of the HRVECs were measured.A DR rat model was established and intervened with PIC to investigate the ameliorative effects of PIC on retinal pathology.Results Bioinformatics analysis identified CXCR4 as the key target of this study.Compared with the NG-HRVECs group,the apoptosis rate and the concentrations of TNF-α and IL-6 were increased in the HG-HRVECs group.Compared with the HG-HRVECs group,the HG+PIC-HRVECs group showed a decreased apoptosis rate and reduced concentrations of TNF-α and IL-6(all P＜0.05).Compared with the NG-BV-2 group,the HG-BV-2 group ex-hibited decreased Arg-1 levels and increased iNOS levels.Compared with the HG-BV-2 group,the HG+PIC-BV-2,HG+Si-CXCR4-BV-2,and HG+Ibrutinib-BV-2 groups all showed increased Arg-1 levels and decreased iNOS levels(all P＜0.05).Compared with the NG-BV-2-CM group,the HG-BV-2-CM group led to decreased viability,increased apoptosis rate,and in-creased concentrations of TNF-α and IL-6 in HRVECs.In contrast,the HG+PIC-BV-2-CM,HG+Si-CXCR4-BV-2-CM,and HG+Ibrutinib-BV-2-CM groups reversed the effects induced by HG-BV-2-CM on HRVECs(all P＜0.05).Animal experiment results showed that compared with DR model rats,rats treated with different doses of PIC exhibited significantly ameliora-ted retinal histopathological damage,and the protein expressions of Arg-1,iNOS,CXCR4,and p-BTK were reversed.Con-clusion PIC ameliorates DR progression mediated by microglial polarization by inhibiting the CXCR4/BTK pathway.

Objective To investigate the expression and mechanistic role of the M2-type pyruvate kinase(PKM2)/signal transducer and activator of transcription 3(STAT3)signaling pathway in the development of experimental autoim-mune uveitis(EAU).Methods Eighteen 4-to 5-week-old C57BL/6J mice were selected and randomly divided into a control group(normal breeding,set as the 0-day state post-modeling),Experimental Group A,and Experimental Group B(both established as stable EAU mouse models using the interphotoreceptor retinoid-binding protein peptide 651-670,com-plete Freund's adjuvant,and pertussis toxin,designated as the 14-day and 21-day states post-modeling,respectively),with 6 mice in each group.The anterior segment of the mice was observed using a slit-lamp microscope,fundus findings were collected using a fundus camera,and clinical and histopathological scores were evaluated after hematoxylin-eosin stai-ning.The protein expression level of serum interleukin(IL)-17A was detected by ELISA.The expression level of PKM2 protein in retinal tissue was detected by immunohistochemistry.The protein expression levels of PKM2,phosphorylated STAT3(p-STAT3),and STAT3 in mouse retinal tissue were detected by Western blot.Results The clinical scores of the anterior segment and fundus,as well as the retinal histopathological scores in Experimental Group A and Experimental Group B,were all significantly higher than those in the control group(all P＜0.05).The serum IL-17A protein expression levels in the control group,Experimental Group A,and Experimental Group B were(69.05±0.45)ng·L-1,(75.06±0.46)ng·L-1,and(72.04±0.82)ng·L-1,respectively.The optical density values of PKM2 protein expression in retinal tissue were(18.51±2.59)％,(37.35±4.67)％,and(29.75±2.17)％,respectively.The expression levels of serum IL-17A protein,retinal PKM2 protein,and retinal STAT3 and p-STAT3 proteins in Experimental Group A and Experimental Group B were all significantly higher than those in the control group(all P＜0.05).Conclusion The expression levels of key factors in the PKM2/STAT3 signaling pathway are positively correlated with the severity of EAU,indicating that this sig-naling pathway,as a positive regulator of the immune response,is involved in the pathological process of EAU.

Objective To investigate the effects of Icariin(ICA)on the proliferation,angiogenesis,and migration of human retinal pigment epithelial(RPE)cells in a high-glucose environment and its mechanism.Methods ARPE-19 cells in good growth state were selected and divided into five groups:control group(Control group),high glucose group(HG group),high glucose+low-dose Icariin group(HG+ICA-L group),high glucose+medium-dose Icariin group(HG+ICA-M group),and high glucose+high-dose Icariin group(HG+ICA-H group).The cells in the control group were cul-tured in a medium containing 5.5 mmol·L-1 glucose.Cells in the HG group were cultured in a medium containing 30.0 mmol·L-1 glucose.The cells in each ICA intervention group were first cultured in a medium containing 30.0 mmol·L-1 glucose,and then 10.0 μmol·L-1,20.0 μmol·L-1 and 40.0 μmol·L-1 ICA were added for culture,respectively.The CCK-8 assay was used to detect cell proliferation activity,the EdU assay was used to detect cell proliferation,the Transwell assay was used to detect cell migration ability,and the Matrigel assay was used to detect in vitro tube formation ability.The expression levels of α-smooth muscle actin(α-SMA),matrix metalloproteinase-2(MMP-2),vascular endothelial growth factor A(VEGFA),epidermal growth factor receptor(EGFR),and proteins related to the phosphatidylinositol 3-kinase(PI3K)/protein kinase B(Akt)pathway were detected by Western blot.Results The cell viability and EdU-positive rate of ARPE-19 cells in the HG group were higher than those in the Control group(all P＜0.05).The cell viability and EdU-positive rate in the HG+ICA-L,HG+ICA-M,and HG+ICA-H groups were lower than those in the HG group(all P＜0.05).The number of migrated cells and tubes formed in the HG+ICA-L,HG+ICA-M,and HG+ICA-H groups were less than those in the HG group,and the expression levels of α-SMA,MMP-2,VEGFA,and EGFR proteins were lower than those in the HG group(all P＜0.05).The levels of p-PI3K and p-Akt in the HG+ICA-L,HG+ICA-M,and HG+ICA-H groups were lower than those in the HG group(all P＜0.05).Conclusion ICA inhibits the proliferation,migration,and angiogenesis of ARPE-19 cells stimulated by high glucose by suppressing the activation of the PI3K/Akt pathway.

Objective To investigate the mechanism of serine protease inhibitor A3N(SerpinA3N)in alleviating reti-nal neural injury in diabetic mice by inhibiting Müller cell inflammation.Methods Thirty-six db/db mice(72 eyes)were randomly divided into the db/db group,the db/db+SerpinA3N-overexpressing adeno-associated virus(AAV-SerpinA3N)group,and the db/db+empty vector adeno-associated virus(NC-SerpinA3N)group,with 12 mice in each group.Twelve age-matched healthy male littermate mice were randomly selected as the healthy control group(db/m group).Mice in each group were sacrificed 4 weeks after the corresponding treatments.Immunofluorescence staining was used to detect the co-localization of SerpinA3N and glial fibrillary acidic protein(GFAP)in the mouse retina.Hematoxylin-eosin(HE)staining was used to observe histopathological changes in the retinal tissue.TUNEL staining was used to detect the apoptosis of reti-nal ganglion cells(RGCs).Immunohistochemistry was used to detect GFAP expression.ELISA was used to measure the levels of inflammatory factors[interleukin(IL)-1 β,IL-6,IL-18,and tumor necrosis factor-α(TNF-α)]in the retinal tis-sue.The predicted target genes of SerpinA3N were imported into the STRING database to construct a protein-protein inter-action(PPI)network.The highest-scoring target was selected based on the scores for molecular docking.Western blot was used to detect the expression levels of SerpinA3N,nuclear factor kappa B(NF-κB),and spleen focus-forming virus proviral integration oncogene(Spi1)proteins in the retinal tissue.Results Immunofluorescence staining showed co-lo-calized expression of SerpinA3N and GFAP in the retinal tissue.Compared with the db/m group,the db/db,db/db+NC-SerpinA3N,and db/db+AAV-SerpinA3N groups showed decreased retinal thickness and RGC count,and increased number of TUNEL-positive cells,relative GFAP-positive expression intensity,levels of all inflammatory factors,and expression lev-els of NF-κB and Spi1 proteins,while SerpinA3N protein expression was decreased(all P＜0.05).Compared with the db/db group,the db/db+AAV-SerpinA3N group showed increased retinal thickness and RGC count,and decreased number of TUNEL-positive cells,relative GFAP-positive expression intensity,levels of all inflammatory factors,and expression levels of NF-κB and Spi1 proteins,while SerpinA3N protein expression was increased(all P＜0.05).Compared with the db/db+AAV-SerpinA3N group,the db/db+NC-SerpinA3N group showed decreased retinal thickness and RGC count,and increased number of TUNEL-positive cells,relative GFAP-positive expression intensity,levels of all inflammatory factors,and ex-pression levels of NF-κB and Spi1 proteins,while SerpinA3N protein expression was decreased(all P＜0.05).The PPI re-sults indicated an interaction between SerpinA3N and Spi1.Molecular docking results showed that Spi1 could form hydro-gen bonds with residues surrounding SerpinA3N.Conclusion Overexpression of SerpinA3N can inhibit Müller cell in-flammation and ameliorate retinal neural injury in diabetic mice,and the mechanism may be associated with the inhibition of the Spi1/NF-κB signaling pathway.

Objective To analyze the changing trends and epidemiological characteristics of the disease burden of blindness caused by type 2 diabetes mellitus(T2DM)in China from 1990 to 2021,and to predict the trends up to 2035.Methods Based on the standardized methodology of the Global Burden of Disease Study 2021,the age-standardized rates(ASRs)and their corresponding 95％uncertainty intervals(UI)for prevalence and years lived with disability(YLDs)rate were used to systematically describe the disease burden of blindness caused by T2DM in China.The temporal trends[esti-mated annual percentage change(EAPC)]and epidemiological characteristics were assessed,with attention to age and sex differences,to predict the trends in the disease burden up to 2035.Results From 1990 to 2021,the age-standardized prevalence rate increased from 6.03 per 100 000(95％UI:4.46-8.18)to 10.35 per 100 000(7.60-13.69),and the age-standardized YLDs rate increased from 1.09 per 100 000(95％UI:0.67-1.70)to 1.88 per 100 000(95％UI:1.21-2.90),with an EAPC of 2.18(95％CI:1.73-2.64).The disease burden was relatively heavier in females and the elderly population.Epidemiological changes,population growth,and aging collectively drove the increase in the burden of blind-ness caused by T2DM.The disease burden of blindness caused by T2DM is projected to continue rising by 2035.Conclu-sion The disease burden of blindness caused by T2DM in China continues to increase,with a relatively heavier burden on females and the elderly population.Future research should optimize the equity of medical resource allocation and conduct studies on the mechanisms of sex differences to enable precise interventions with evidence-based strategies.

Objective To compare and analyze the impact of intraocular higher-order aberrations and total ocular higher-order aberrations on visual quality after the implantation of different types of multifocal intraocular lenses(MIOL),in order to provide personalized MIOL selection recommendations for patients.Methods A total of 107 patients(107 eyes)with age-related cataract were selected and divided into the SBL-3,MF15,ZMB00,and Zeiss809 groups based on the type of MIOL implanted.Uncorrected distance visual acuity(UCDVA),best-corrected distance visual acuity(BCDVA),best-corrected near visual acuity(BCNVA),optical parameters and wavefront aberrations were compared 3 months postop-eratively.Results Preoperatively,there were no statistically significant differences in any optical parameters or visual acuity among the four groups(all P＞0.05).At three months postoperatively,there were no significant differences in UCD-VA,BCDVA,BCNVA,corneal aberration,or intraocular spherical aberration among the four groups(all P＞0.05).How-ever,significant differences were observed in the predicted visual acuity at 100％,20％,and 9％contrast(100％VA,20％VA,9％VA),streller ratio(SR),modulation transfer function cutoff frequency(MTF cutoff),intraocular coma,intraocu-lar trefoil,total higher-order aberrations,and the average modulation transfer function height values(MTF AH)of the en-tire eye across various spatial frequencies showed significant differences(all P＜0.05).Pairwise comparisons showed that the ZMB00 and Zeiss809 groups had significantly better 100％VA,20％VA,9％VA,SR,MTF cutoff,and MTF AH,and sig-nificantly lower intraocular coma,intraocular trefoil,and total higher-order aberrations than the SBL-3 group(all P＜0.05).The MF15 group only had significantly lower intraocular trefoil than the SBL-3 group(P＜0.05).Correlation analy-sis results at 3 months postoperatively showed that in the SBL-3 and MF15 groups,UCDVA(logMAR)was positively corre-lated with the objective scattering index and negatively correlated with 100％VA,20％VA,9％VA,SR,and MTF cutoff(all P＜0.05).MTF AH was negatively correlated with intraocular coma and total higher-order aberrations,and positively cor-related with intraocular spherical aberration(all P＜0.05).In the ZMB00 and Zeiss809 groups,MTF AH was negatively cor-related with intraocular coma,intraocular trefoil,and total higher-order aberrations(all P＜0.05),but showed no correla-tion with intraocular spherical aberration(all P＞0.05).Conclusion There are no differences in UCDVA,BCDVA,or BCNVA among patients implanted with the four types of MIOLs,but differences existed in objective visual quality.The ob-jective visual quality of ZMB00 and Zeiss809 is significantly better than that of SBL-3,making them the preferred choices for patients with high-quality visual demands;SBL-3 is suitable for basic demand scenarios;MF15,which is only superior to SBL-3 in terms of intraocular trefoil,can be a compromise option for those sensitive to trefoil aberration.

Objective To investigate the roles of peripheral defocus lenses(DIMS)and reduced contrast sensitivity(CS)lenses[e.g.,those utilizing optical diffusion technology(DOT)]in myopia control efficacy and their impact on visu-al quality in myopic patients.Methods A prospective controlled study was conducted to select 160 myopic children(160 eyes)aged 7-12 years old who were fitted with lenses at Harbin Purui Eye Hospital from April 2023 to April 2024.They were divided into a DIMS group(n=80)and a DOT group(n=80)according to the type of lens fitted.Spherical equiva-lent(SE),axial length(AL),choroidal thickness(CT)in various regions,and contrast sensitivity(CS)under photopic and scotopic conditions at different spatial frequencies were recorded and compared between the two groups before lens wear,and at 6 and 12 months after lens wear.Results At 6 and 12 months after lens wear,the DOT group showed lower SE,lower CT in all regions,and lower CS under both photopic and scotopic conditions at three different spatial frequen-cies,alongside higher AL,compared to the DIMS group(all P＜0.05).Compared with baseline(before lens wear),the DOT group showed decreased SE and increased AL at both 6 and 12 months(all P＜0.05).In the DIMS group,compared with baseline,the change in SE at 6 months was not statistically significant(P＞0.05),while at 12 months,SE was de-creased and AL was increased(both P＜0.05).Compared to the 6-month time point,both groups showed decreased SE and increased AL at 12 months(all P＜0.05).Compared with baseline,CT in all regions increased in both groups at 6 and 12 months(all P＜0.05).Compared to the 6-month time point,CT in all regions increased in both groups at 12 months(all P＜0.05).Compared with baseline,CS within the same spatial frequencies under both photopic and scotopic conditions in the DOT group,and CS under scotopic conditions within the same spatial frequencies in the DIMS group,were decreased at both 6 and 12 months(all P＜0.05).Compared to the 6-month time point,CS within the same spatial frequencies under both photopic and scotopic conditions in the DOT group,and CS under scotopic conditions within the same spatial frequen-cies in the DIMS group,were decreased at 12 months(all P＜0.05).Conclusion Wearing DIMS lenses provides superi-or control over myopia progression(SE change,AL growth,CT increase)compared to DOT lenses,with less impairment to visual quality.This finding can serve as a reference for clinicians selecting myopia control interventions.

The incidence of age-related macular degeneration(AMD)is rising with the intensifying aging trend,be-coming a critical challenge that demands urgent solutions.Dry AMD(dAMD)accounts for approximately 80％of all AMD cases,and there is currently a lack of highly effective treatment options.In recent years,traditional Chinese medicine(TCM)has been proven to effectively treat dAMD through actions such as antioxidation,anti-apoptosis,anti-inflammation,and lipid-lowering.By reviewing domestic and international literature,this article discusses TCM monomers,extracts,and compound formulations for dAMD,analyzing their various mechanisms.Based on traditional TCM efficacy theories and in-tegrated with modern mechanisms of action,it targets the active components of TCM to elucidate the connection between effective medicinal targets of TCM and dAMD,thereby clarifying the efficacy and scientific basis of TCM monomers,com-pounds,and extracts in treating dAMD.The aim is to provide new perspectives for the prevention and clinical treatment of dAMD.