To define the prevalence and anatomical patterns of paranasal sinus abnormalities (PSA) in thyroid-associated ophthalmopathy (TAO) and to test the hypothesis that TAO is partially driven by contiguous orbital inflammation rather than systemic autoimmunity or generalized orbital pressure.

Data included ophthalmic assessments and a panel of thyroid function and autoimmune biomarkers. Blinded radiological analysis of orbital computed tomography (CT) scans was performed to quantify sinus abnormalities and extraocular muscles (EOMs) involvement. Patients were categorized into two groups based on CT findings, those with no radiological evidence of sinus abnormalities (non-PSA control group) and those with identifiable PSA. Furthermore, ethmoid sinus mucosal biopsies from a subset of TAO patients and non-inflammatory controls were subjected to histopathological analysis.

Totally 121 TAO patients (mean age 42.4±12.8y, range 10–78y), male:female=42:79, were included. PSA was identified in 44.6% (n=54) of patients, with a distribution anatomically restricted to the maxillary (50.0% isolated) and ethmoid sinuses (18.5% isolated; 29.6% combined). Compared to the non-PSA group (n=67), patients with PSA were significantly older (45.1±11.8 vs 40.3±13.2y; P=0.040) and were more likely to be male (55.6% vs 17.9%; P<0.001). They also had significantly higher proptosis (22.1±3.2 vs 20.7±2.9 mm; P<0.001). Medial/inferior rectus involvement was most frequent (88.4% vs 89.3%). Histopathological analysis of sinus mucosa from PSA patients provided direct evidence of pathology, revealing a dense, chronic lymphoplasmacytic infiltrate and submucosal edema, validating the radiological findings as a true inflammatory process. No significant correlation was found with systemic autoimmune markers, including thyroid-stimulating hormone (TSH) receptor antibodies (TRAb, median 4.86 vs 2.71 IU/L, P=0.104).

TAO is associated with a high prevalence of PSA in a pattern consistent with the orbital anatomy. The correlation with ipsilateral muscle thickening combined with the lack of association with proptosis laterality or systemic biomarkers lend strong support to a model of contiguous inflammation over systemic autoimmunity, a hypothesis that warrants further validation through longitudinal and mechanistic studies.

To explore the relationship between matrix metalloproteinases (MMPs) expression levels in the tumor and the prognosis of uveal melanoma (UM) and to construct prognostic prediction models.

Transcriptome sequencing data from 17 normal choroid tissues and 53 UM tumor tissues were collected. Based on the differential gene expression levels and their function, MMPs family was selected for establishing risk-score system and prognostic prediction model with machine learning. Tumor microenvironment (TME) analysis was also applied for the impact of immune cell infiltration on prognosis of the disease.

Eight MMPs were significantly different expression levels between normal and the tumor tissues. MMP-2 and MMP-28 were selected to construct a risk-score system and divided patients accordingly into high- and low-risk groups. The prediction model based on the risk-score achieved an accuracy of approximately 80% at 1-, 3-, and 5-year after diagnosis. Besides, a Nomogram prognostic prediction model which based on risk-score and pathological type (independent prognostic factors after Cox regression analysis) demonstrated good consistency between the predicted outcomes at 1-, 3-, and 5-year after diagnosis and the actual prognosis of patients. TME analysis revealed that the high-risk group exhibited higher immune and stromal scores and increased infiltration of tumor-associated macrophages (TAMs) and regulatory T cells compared to the low-risk group.

Based on MMP-2 and MMP-28 expression levels, our prediction model demonstrates accurate long-term prognosis prediction for UM patients. The aggregation of TAMs and regulatory T cells in the TME of UM may be associated with an unfavorable prognosis.