The mitochondrial unfolded protein response(UPRmt)represents a crucial intracellular stress response mechanism that plays a fundamental role in maintaining mitochondrial and cellular homeostasis. Growing evidence suggests that dysregulation of UPRmt contributes significantly to the pathogenesis of various systemic disorders, including neurodegenerative diseases such as Parkinson's and Alzheimer's diseases, as well as age-related pathologies. Emerging research has particularly highlighted the involvement of UPRmt in ocular diseases, including cataracts, glaucoma, and diabetic retinopathy. This comprehensive review examines the physiological functions of UPRmt and its regulatory mechanisms in age-related eye diseases. The roles of key UPRmt downstream effector molecules in ocular cell populations such as lens epithelial cells, retinal pigment epithelial cells, and retinal ganglion cells are systematically analyzed. Importantly, the dual regulatory nature of UPRmt in ocular pathophysiology is discussed, that is, its moderate activation promotes mitochondrial homeostasis, mitigates oxidative stress, and suppresses inflammatory responses, its chronic or excessive activation triggers apoptotic pathways, induces metabolic dysfunction, and ultimately accelerates disease progression. By elucidating these mechanisms, our review provides novel insights into ocular disease pathogenesis and proposes potential therapeutic strategies targeting UPRmt modulation for the prevention and treatment of age-related eye disorders.

Epidemiologic study is an essential scientific basis for disease prevention,intervention and health policy making.Predisease often refers to the abnormal state found in epidemiologic study/screening,which has not yet reached the diagnostic criteria for the disease.It is the"in-between"state from a healthy state to a diseased state;if not intervened properly,it will develop into a disease.Predisease includes precancerous lesions,prediabetes,prehypertension,as well as eye diseases in the predisease stage,such as premyopia,preglaucoma and ocular complications of prediabetes.Proper in-tervention in predisease,when no clinical manifestations were found,or the very early stage can prevent the occurrence of diseases.However,ophthalmologists have not paid enough attention to the epidemiologic study of eye diseases in the pre-disease stage and have known little about how to conduct the epidemiologic study.Herein,this paper discussed the epide-miologic study of several common eye diseases with high prevalence and significant visual impairment in the predisease sta-ges based on experience in the relevant field.

In recent years, research on gut microbiota has been increasing.Multiple studies have shown that the dysbiosis of gut microbiota plays a key role in the occurrence and development of various diseases, potentially revealing a new target for disease prevention and treatment intervention.This article reviews the role of gut microbiota in the pathogenesis and treatment of ophthalmic diseases, including autoimmune uveitis, age-related macular degeneration, diabetic retinopathy, primary open-angle glaucoma and Sj?gren syndrome, etc.The mechanism of ocular tissue damage may be the imbalance of the gut microbiota affects microbial metabolites such as butyrate, which influences the intestinal epithelial cell barrier, or mediates immune responses.Investigating the role of gut microbiota dysbiosis in the development and progression of ocular diseases may improve our understanding of the mechanisms of related diseases.Regulation of the gut microbiota or modulation of the metabolites may be a potential way to treat certain eye diseases.It provides new ideas for further exploration of the pathogenesis and adjuvant treatment of such eye diseases.

Objective To investigate the influence of Nei endonuclease Ⅷ-like protein 1(NEIL1)on H2O2-induced apoptosis and autophagy in lens epithelial cells(LECs).Methods Reverse transcription polymerase chain reaction(RT-PCR)was used to detect the expression of NEIL1 messenger ribonucleic acid(mRNA)in the anterior lens capsule and LEC line SRA01/04 cells from age-related cataract(ARC)patients and macular epiretinal membrane patients who underwent the clear lens extraction.SRA01/04 cells were then divided into the control group,OE-Vector group and OE-NEIL1 group.RT-PCR and Western blot(WB)were used to detect the overexpression efficiency.Subsequently,the cells were divided into the control group,H2O2 group,OE-Vector H2O2 group and OE-NEIL1 H2O2 group;cell viability was detected by Cell Count-ing Kit-8,WB was used to evaluate the expression of autophagy-related proteins(ATG7,P62,Beclinl,LC3-Ⅰ and LC3-Ⅱ)and apoptosis-related proteins(Bax and Bcl-2),and fluorescent staining was adopted to measure cell apoptosis and mito-chondrial membrane potential.Results The expression of NEIL1 mRNA in the anterior lens capsule samples from ARC patients was significantly lower than that of macular epiretinal membrane patients,and the expression of NEIL1 mRNA in the SRA01/04 cells in the H2O2 group was also lower than that in the control group(both P＜0.05).The results of RT-PCR and WB revealed that the expressions of NEIL1 mRNA and protein in the SRA01/04 cells of the OE-NEIL1 group were signif-icantly higher than those in the OE-Vector group(both P=0.000).Compared with the control group,the viability of SRA01/04 cells in the H2O2 group decreased,the expression of the Bax protein was up-regulated,the Bcl-2 protein was down-regulated,viable cells labeled with Mito-Tracker decreased,and apoptotic cells labeled with Annexin V-FITC in-creased,with statistical significances(all P＜0.05).Compared with the OE-Vector H2O2 group,in the OE-NEIL1 H2O2 group,the viability of SRA01/04 cells significantly improved,the autophagy-related proteins(ATG7,P62,Beclin1,LC3-Ⅰand LC3-Ⅱ)and Bcl-2 protein were significantly up-regulated,the Bax protein was down-regulated,viable cells marked with Mito-Tracker increased,and apoptotic cells labeled with Annexin V-FITC decreased(all P＜0.05).Conclusion Under the oxidative stress induced by H2O2,NEIL1 can promote autophagy of LECs,maintain homeostasis of LECs,and then increase cell viability and reduce apoptosis of LECs,participating in the occurrence and development of ARC.

Peripapillary intrachoroidal cavitation(PICC)is a common fundus lesion in high myopia.The typical mani-festation of PICC in fundus color photography is orange lesions with clear boundaries,which often occur below the myopic arc,and a weak reflection cavity in the choroid in optical coherence tomography(OCT).With the development and wide-spread application of OCT technology,researchers have gained a clearer understanding of the imaging features,pathogene-sis and clinical significance of PICC.This article introduces the definition,imaging features,pathogenesis,and relationship with glaucoma of PICC to provide new ideas for further elucidating the pathogenesis and clinical significance of PICC.

Long non-coding RNA (lncRNA) is a class of transcripts longer than 200 nucleotides, which do not have the function of coding proteins.Widely involved in the progress of various human diseases, lncRNA has become a new research hotspot and the regulatory role of it has been paid more and more attention.Studies in recent years found that lncRNA is abnormally expressed in age-related macular degeneration (AMD) and age-related cataract (ARC) compared with healthy individuals.LncRNA ZNF503-AS1, BANCR and MEG3 can play important roles in regulating function of retinal pigment epithelial cell, which can lead to the development of AMD.LncRNA MIAT, TUG1 and H19 can have important regulatory effects through competitive binding with microRNAs, thus affecting the occurrence and development of ARC.This article reviewed the research progress of lncRNA in the AMD and ARC related field, revealed the role of different lncRNAs in the diseases, provided a new perspective for elucidating the mechanism of the diseases and found a new biomarker for the diagnosis and treatment of the diseases.

Although phacoemulsification is quite minimally invasive, effective and safe, it can still injure the structure of eyes and cause and/or aggravate posterior vitreous detachment, retinal detachment, macular edema, diabetic vitreoretinopathy, age-related macular degeneration and high myopic retinopathy due to the turbulence of operation and instrument to intraocular tissue, which disturbs the stability of anterior chamber and vitreous body, damages blood-ocular barrier and results in the release of inflammatory cytokines.Ophthalmologists should have a thorough understanding of relevant knowledge to emphasize the operating risk evaluation and management in perioperative period in order to control the energy and operation time of phacoemulsification as much as possible, especially for the patients with serious fundus diseases and systemic diseases.Ophthalmologist should avoid the operating disturbance of intraocular tissue to the utmost extent by reducing the phacoemulsification energy and duration.It is very important for us to realize the management of whole process of cataract surgery "from anterior segment to posterior segment" and "from eye to whole body" so as to further improve the postoperative visual quality and satisfaction of patients.

Objective:To investigate the feasibility of real-time screening and diagnosing fundus diseases with Wild Field Imaging System (WFIS SW-8000) in the eyes with dense cataract patients.Methods:A series of case-observational study was carried out.Ninety-six dense cataractous eyes of 90 patients with suspected fundus diseases were included in Affiliated Hospital of Nantong University from April to July 2019.Lens phacoemulsification combined with intraocular lens implantation was performed after the opacity lens was removed, and fundus examination was performed with WFIS SW-8000.Super field lens, optical coherence tomography (OCT) and fundus fluorescein angiography (FFA) was used to verify the fundus findings after surgery, which were compared with WFIS SW-8000.This study protocol was approved by Ethics Committee of Affiliated Hospital of Nantong University and followed the Declaration of Helsinki.Written informed consent was obtained from each patient prior to any medical examination.Results:Among 96 eyes, fundus diseases were detected in 40 eyes with the detection rate of 41.67% by WFIS SW-8000 examination, including dry age-related macular degeneration (AMD) in 2 eyes, wet AMD in 3 eyes, polypoidal choroidal vasculopathy (PCV) in 1 eye, high myopia retinopathy (HMR) in 7 eyes, central retinal vein occlusion (CRVO) with macular edema (ME) in 1 eye, mild non-proliferative diabetic retinopathy (NPDR) in 12 eyes, moderate NPDR in 7 eyes, severe NPDR in 4 eyes and proliferative diabetic retinopathy (PDR) in 3 eyes.Fundus diseases were detected in 45 eyes with detection rate of 46.88% after surgery by a super field lens, OCT and FFA.The detectable rate of digital retinal camera examination and super field lens, OCT and FFA showed no significant difference between intraoperation and postoperation (χ 2=0.528, P=0.468). Twenty-two eyes with fundus neovascular disease or macular edema requiring drug intervention were identified intraoperatively, and intravitreal anti-inflammatory and/or anti-vascular endothelial growth factor (VEGF) drugs were injected in 11 eyes during the operation. Conclusions:WFIS SW-8000 is a useful tool for the accurate and convenient method in real-time fundus examination during phacoemulsification, which is feasible and helpful for timely intervention in and treatment of fundus diseases.

Nucleotide binding oligomerization domain-like receptor family pyrin domain containing 3 (NLRP3) inflammasome is a set of intracellular protein complexes.NLRP3 inflammasome can trigger the activation of caspase-1 and contribute to the maturation of interleukin, and finally result in a series of inflammation responses in host.Inflammasomes are activated in a variety of cases, including multiple inflammation-related eye diseases, such as xerophthalmia, glaucoma, age-related macular degeneration and so on.This article aimed to interpret the effect and mechanism of the activation of NLRP3 inflammasome, and reviewed how the mutation of gene or the structure disturbance of protein related to NLRP3 inflammasome affects the occurrence and development of inflammation-related eye diseases.

Objective To analysis the distribution of posterior corneal astigmatism (PA) and evaluate the influence of keratometric astigmatism (KA) and total corneal astigmatism (TCA) on the calculation of Toric intraocular lens (Toric IOL) in patients with age-related cataract (ARC) and high corneal astigmatism.Methods An observational study design was adopted.Pentacam was used to measure 200 eyes of 181 patients with ARC and KA＞0.75 D in Affiliated Hospital of Nantong University from August 2016 to April 2017.KA,PA,TCA and anterior corneal astigmatism (AA) were recorded.The astigmatism magnitude and axis of PA was studied.The subjects were divided into astigmatism with the rule group,astigmatism against the rule group and oblique astigmatism group according to the axis of AA.The correlations of decomposition values between PA and AA or KA and TCA in each group were analyzed by Pearson linear correlation analysis.The difference of decomposition values between KA and TCA in each group was compared by paired sample t test.The type and axis of Toric IOL were calculated by online formula according to KA and TCA.This study followed the Declaration of Helsinki and written informed consent was obtained from each patient prior to any medical examination.Results The mean astigmatic magnitudes of PA was -0.32 D×93.1°.PA exceeded 0.5 D in 22 eyes (11％).The steepest posterior corneal meridian was vertically aligned in 163 eyes (81.5％).The decomposition value KP(0) and KP (45) of PA were positively correlated with those ofAA (r=0.480,P＜0.001;r=0.251,P＜0.001).The mean astigmatic magnitudes of KA and TCA were 1.44D×89.6° and 1.32 D×89.5° in astigmatism with the rule group,1.39 D×153.4° and 1.71 D×154.4° in astigmatism against the rule group and 1.13 D× 122.0° and 1.24 D× 124.2° in oblique astigmatism group.53 eyes (69.7％) had KA higher than TCA in astigmatism with the rule group.82 eyes (87.3％) had KA lower than TCA in astigmatism against the rule group;20 eyes (66.7％) had KA lower than TCA in oblique astigmatism group.There were significant differences in KP (0) between KA and TCA in different astigmatism groups (all at P＜0.001).The calculated Toric IOL type were inconsistent in 85 eyes(42.5％) and the calculated axis were inconsistent in 176 eye s (88.2％).Conclusions In patients with high corneal astigmatism,the astigmatism type of PA is mostly astigmatism against the rule.Ignoring the PA can lead to deviation of Toric IOL type selection and axis placement in some patients.For patients who cannot measure PA or TCA,the type of Toric IOL should be adjusted appropriately.