The Asian expert working group completed the 2022 consensus on vernal keratitis (VKC), which provides detailed information on the definition, classification, clinical manifestation, diagnosis and treatment of VKC in Asia and identifies unmet treatment needs, including: (1) lack of clear criteria for the diagnosis and treatment of patients with VKC.The pathogenesis of the disease is unclear, and anti-allergy therapy is often ineffective in patients with moderate or severe VKC; (2) the need for standardized treatment and management strategies.Treatment and management of patients with the same severity varies widely among Asian countries, with a lack of clear, standardized guidelines and grading systems; (3) safety and iatrogenic complications; (4) optimal dosing regimen for pharmacologic treatment.In this article, the aspects mentioned above were interpreted and analyzed in the context of the Expert Consensus on the Diagnosis and Treatment of Allergic Conjunctivitis in China ( 2018), with a view to helping the prevention and treatment of VKC in China.

AIM: To investigate the efficacy and safety of ZKY001 eye drops with different concentrations in the treatment of corneal epithelial defects(CED)after primary pterygium excision.METHODS: This was a multicenter, randomized, double-blinded, placebo-controlled phase II clinical trial. From March 15, 2022 to November 14, 2022, patients with primary pterygium who had undergone surgery were recruited from 12 tertiary hospitals across China. Using block randomization, 178 patients(178 eyes)were randomly assigned to 3 groups in a 1:1:1 ratio: 0.002% ZKY001 group(n=59), 0.004% ZKY001 group(n=59), and placebo group(n=60, receiving ZKY001 sham eye drops). Subjects in each group received 1 drop of the study drug 4 times per day for 4 d. The percentage of CED area recovery from baseline, the first complete healing time of CED area, the number of first complete healing cases of CED, and changes in visual analogue scale(VAS)scores for eye discomfort including eye pain, foreign body sensation, tearing and photophobia were observed.RESULTS: In terms of improvement in CED, there were no statistically significant differences among the three groups including the first healing time of CED, the percentage improvement in CED area compared to baseline, and the percentage of first healing cases at different follow-up visits(all P>0.05). Numerically, the first healing time of CED was shorter in the test groups compared to the placebo group(67.87±21.688 h for the 0.002% ZKY001 group, 61.48±22.091 h for the 0.004% ZKY001 group, and 68.85±20.851 h for the placebo group). On D1 morning, the percentage improvement in CED area compared to baseline was maximally different from the placebo group, and the numerical difference advantage was maintained at subsequent follow-up visits. The number of first healing cases in the CED area at different follow-up visits was higher in the test groups than the placebo group. In terms of improvement in ocular discomfort, the total VAS scores were lower in the test groups compared to the placebo group, mainly due to reductions in foreign body sensation and pain scores. At D3, the 0.004% ZKY001 group showed statistically significant improvement in foreign body sensation(P<0.017). In terms of safety, the overall incidence of adverse events was low(9.0%)and similar among groups.CONCLUSION: The use of ZKY001 eyedrops after primary pterygium surgery can safely improve the CED repair, and alleviate postoperative symptoms caused by CED.

Tear film hyperosmolarity plays a core role in the development of dry eye disease (DED) by mediating the disruption of ocular surface homeostasis and triggering inflammation in ocular surface epithelium. In this study, the mechanisms involving the hyperosmolar microenvironment, glycolysis mediating metabolic reprogramming, and pyroptosis were explored clinically, in vitro, and in vivo. Data from DED clinical samples indicated that the expression of glycolysis and pyroptosis-related genes, including PKM2 and GSDMD, was significantly upregulated and that the secretion of IL-1β significantly increased. In vitro, the indirect coculture of macrophages derived from THP-1 and human corneal epithelial cells (HCECs) was used to discuss the interaction among cells. The hyperosmolar environment was found to greatly induce HCECs' metabolic reprogramming, which may be the primary cause of the subsequent inflammation in macrophages upon the activation of the related gene and protein expression. 2-Deoxy-d-glucose (2-DG) could inhibit the glycolysis of HCECs and subsequently suppress the pyroptosis of macrophages. In vivo, 2-DG showed potential efficacy in relieving DED activity and could significantly reduce the overexpression of genes and proteins related to glycolysis and pyroptosis. In summary, our findings suggested that hyperosmolar-induced glycolytic reprogramming played an active role in promoting DED inflammation by mediating pyroptosis.

In recent years, corneal neuralgia in dry eye patients has received more and more clinical attention.Corneal neuralgia refers to the increasing pain of cornea in response to normal painless stimuli, which has a serious negative effect on patients' work and daily life.Corneal neuralgia is often one of the common symptoms of dry eye.Dry eye can also cause corneal sensation decline and the mechanism is still unclear.Patients with dry eye often exhibit structural and functional changes in ocular surface nerve, so understanding the mechanism of dry eye-related neurological abnormalities will help to treat and prevent dry eye-related neurological abnormalities.Various factors such as instability of tear film, abnormal tear secretion, ocular surface inflammation, and increased osmotic pressure of tear film may be involved in dry eye-associated corneal neuralgia.Clinically, anti-inflammatory therapy, lubricating ocular surface, promoting regeneration of corneal nerve fibers, analgesic therapy targeting receptors, palpebral edge treatment, and systemic intervention if necessary are mainly performed based on the pathogenesis of dry eye related corneal neuralgia.In this article, the pathologic and influencing factors of corneal neuralgia were summarized, and the pathogenesis of dry eye-related corneal neuralgia were investigated to help the clinical diagnosis and treatment of dry eye-related corneal neuralgia.

OBJECTIVE: To analyze the hematological phenotypes of Hb J-Bangkok and concomitant thalassemia. METHODS: In total 72 397 samples were screened by using capillary electrophoresis. Samples with Hb J-Bangkok were identified by DNA sequencing and analysis of red blood cell parameters. Gap-PCR and PCR-reverse dot blotting (PCR-RDB) were used for analyzing the thalassemia genes. RESULTS: Thirty one cases of Hb J-Bangkok were identified, all of which were heterozygotes. The hematological phenotype index (Hb, mean corpuscular volume, mean corpuscular hemoglobin, Hb J-Bangkok, Hb A CONCLUSION Hb J-Bangkok heterozygotes have normal hematological phenotypes, though they may show different hematological characteristics when concomitant with different types of thalassemia, for which genetic counseling should be provided accordingly.
Female ; Hemoglobins, Abnormal/genetics* ; Heterozygote ; Humans ; Male ; Phenotype ; Thailand ; beta-Thalassemia/genetics*

An expert consensus about the clinical diagnosis and treatment of dry eye was documented in 2013 by a corneal expert group of Chinese Ophthalmological Society.However, due to the rapid development of diagnostic and therapeutic devices of dry eye, researoh on dry eye has made significont progress in China since then.Consequently, the existing expert consensus cannot meet the needs of clinical practice.It is therefore urgent to develop a series of standardized diagnosis and treatment protocols, and publish a new consensus of experts and an operating guideline.At the same time, basic, clinical, and translational research on dry eye should be promoted to provide better services to the patients with dry eyes.On January 12, 2019 many experts in the field of dry eye in China held a panel discussion of dry eye study in Guangzhou to analyze the current development status and trends in the field of dry eye in China and abroad.In that meeting, opinions and recommendations were put forward based on a new understanding of the definition of dry eye, new concepts of dysfunctional dry eye, advances its diagnosis and classification, refinement and standardization of dry eye treatment, and the future development of dry eye research.

With the popularity of cataract and refractive surgery, especially the increasing implantation of advanced technology lens implants, dry eye significantly affects image quality.In 2017, the Asia-Pacific Association of Cataract and Refractive Surgeons (APACRS) produced the new Principles of Preferred Practice for the Management of the Ocular Surface in Cataract and Refractive surgery (hereafter referred to as the PPP). This document provides detailed evidence-based discussions on the incidence rate, pathogenesis, diagnosis, evaluation, clinical symptoms, and treatment of dry eyes during perioperative period of refractive surgery and cataract surgery.The article which interpreted the PPP is aimed to remind general ophthalmologists to pay more attention to the dry eye in cataract and refractive surgery, and make the management of the ocular surface more standardized.

As a P2Y 2 receptor agonist, Diquafosol used as a 3% solution can promote tear fluid and mucin secretion and accelerate the healing of corneal and conjunctival epithelium.It fills an unmet need in ophthalmology in China for the treatment of corneal and conjunctival epithelium injury caused by aqueous solutions and mucin deficiency.This article reviews the mechanisms of 3% Diquafosol in the healing of corneal and conjunctival epithelial damage, hoping to provide a theoretical basis for clinical practice.

Dry eye is an ocular surface disease caused by multiple factors,which is characterized by imbalance of tear film homeostasis,changes of ocular surface micro-environments and ocular uncomfortable symptoms.Tear film instability,tear hyperosmolarity,ocular surface inflammation and damage and corneal neurosensory abnormalities play etiological roles in the process of dry eye.Dry eye seriously affects work and life quality of the patients.With the progress of science and technology,the treatment of dry eye is becoming more diversified.The therapeutic methods are different for mild,moderate and serous dry eye.The choice of therapies actually depends on the individual state and condition of therapeutic institutions.A systemic,standardized and comprehensive therapy is associated with the improvement of treatment outcome.This article systematically summarizes the traditional and emerging treatments of dry eye,which are clinically feasible and can provide reference for choosing treatment methods.

Objective To isolate and identificate Streptomyce strain from cow dung and observe its antimicrobial activity. Methods Strains were isolated from cow dung by dilution coating method.Strong antibacterial strains were screened out by agar block method with fixed Staphylococcus aureus and Escherichia coli as indicative bacteria.The strains were identified based on physiological and biochemical characteristics as well as 16S rDNA gene sequence analysis.Active antibacterial fermentation broth substance was determined by disk diffusion method,and antibacterial active substance of strains fermentation broth was extracted by water-saturated n-butanol.Antibacterial substance of strains was identified by Molish reaction,biuret test and ninhydrin reaction. Results Eight strains were isolated from cow dung and one strong antibacterial strain was screened out and named B5-2,identified as Streptomyces.The results showed that the strain had the highly antibacterial effect on Staphylococcus aureus,Escherichia coli,Citrobacter freundii,Enterobacter cloacae,Klebsiella pneumoniae,Enterobacter aerogenes.The strain antibacterial active substance of fermentation broth preliminary analysis showed that strong antibacterial active substance of B5-2 was the water-soluble substance.Antibacterial substance of B5-2 was preliminarily identified as glycoside and protein by Molish reaction,biuret test and ninhydrin reaction. Conclusion The strain isolated have a strong inhibition effect on clinical pathogenic bacteria in clinical practice.