To evaluate the clinical features, diagnosis, treatment, and outcome of peripheral exudative hemorrhagic chorioretinopathy (PEHCR), a variant of polypoidal choroidal vasculopathy (PCV), in a case series of Chinese patients.

This study was retrospectively conducted from September 2018 to March 2025. Clinical examinations included color fundus photography, B-scan ultrasonography, fluorescein angiography (FA), indocyanine green angiography (ICGA), swept-source optical coherence tomography (SS-OCT), and optical coherence tomography angiography (OCTA), and two active or inactive subgroups and misdiagnosed cases were analyzed.

Totally 19 patients (21 eyes) with a mean age of 54.3±9.4 (range, 36–68)y were included, with a majority of women (n=13, 68.4%). The mean follow-up period was 13±1.4 (range: 1–57)mo. Decreased visual acuity was the most frequent initial manifestation (17 eyes, 84.2%), and lesions were mainly distributed in the inferotemporal or temporal quadrant (14 eyes, 66.7%), with choroidal polyps and branching neovascular networks revealed by OCTA and ICGA. Nine patients had been previously misdiagnosed with choroidal melanoma, and 6 of them had massive vitreous hemorrhage (VH). PEHCR manifested along a spectrum ranging from active or inactive subretinal hemorrhagic forms to chronic fibrotic or atrophic forms. One patient experienced natural regression. Ten eyes received a mean of 4.7±1.1 (range: 3–7) intravitreal anti-vascular endothelial growth factor (VEGF) injections, two eyes underwent vitrectomy, and six eyes were treated with vitrectomy combined with anti-VEGF therapy. Best-corrected visual acuity (logMAR) in treated eyes (18 eyes) improved to 0.31±0.25 from the baseline of 1.50±0.75 (P<0.001).

PEHCR is a variant of PCV. Chinese patients with PEHCR have a relatively younger age of onset. Anti-VEGF injections and/or vitrectomy are treatment options for lesion regression or dense VH to gain better visual outcomes.

To investigate the risk and protective factors associated with the retinal nerve fiber layer defect (RNFLD) in a Chinese adult population.

This study was a cross-sectional population-based investigation including employees and retirees of a coal mining company in Kailuan City, Hebei Province. All the study participants underwent a comprehensive systemic and ophthalmic examination. RNFLD was diagnosed on fundus photographs. Binary logistic regression was used to investigate the risk and protective factors associated with the RNFLD.

The community-based study included 14440 participants. There were 10473 participants in our study, including 7120 males (68.0%) and 3353 females (32.0%). The age range was 45-108y, averaging 59.56±8.66y. Totally 568 participants had RNFLD and the prevalence rate was 5.42%. A higher prevalence of RNFLD was associated with older age [P<0.001, odds ratio (OR): 1.032; 95% confidence interval (CI): 1.018-1.046], longer axial length (P=0.010, OR: 1.190; 95%CI: 1.042-1.359), hypertension (P=0.007, OR: 0.639; 95%CI: 0.460-0.887), and diabetes mellitus (P=0.019, OR: 0.684; 95%CI: 0.499-0.939). The protective factors of RNFLD were visual acuity (P=0.038, OR: 0.617; 95%CI: 0.391-0.975), and central anterior chamber depth (P=0.046, OR: 0.595; 95%CI: 0.358-0.990).

In our cross-sectional community-based study, with an age range of 45-108y, RNFLD is associated with older age, longer axial length, hypertension, and diabetes mellitus. The protective factors of RNFLD are visual acuity and central anterior chamber depth. These can help to predict and evaluate RNFLD related diseases and identify high-risk populations early.

To evaluate dry eye disease (DED) symptomatology and mental health status in different COVID-19 patients.

A cross-sectional observational design was used. Totally 123 eligible adults (46.34% of men, age range, 18-59y) with COVID-19 included in the study from August to November, 2022. Ocular Surface Disease Index (OSDI), Five-item Dry Eye Questionnaire (DEQ-5), Hospital Anxiety and Depression Scale (HADS), and Pittsburgh Sleep Quality Index (PSQI) were used in this study.

OSDI scores were 6.82 (1.25, 15.91) in asymptomatic carriers, 7.35 (2.50, 18.38) in mild cases, and 16.67 (4.43, 28.04) in recurrent cases, with 30.00%, 35.56%, and 57.89%, respectively evaluated as having DED symptoms (χ²=7.049, P=0.029). DEQ-5 score varied from 2.00 (0, 6.00) in asymptomatic carriers, 3.00 (0, 8.00) in mild cases, and 8.00 (5.00, 10.00) in recurrent cases, with 27.50%, 33.33%, and 55.26%, respectively assessed as having DED symptoms (χ²=8.532, P=0.014). The prevalence of clinical anxiety (50.00%) and depression (47.37%) symptoms were also significantly higher in patients with recurrent infection (χ²=24.541, P<0.001; χ²=30.871, P<0.001). Recurrent infection was a risk factor for high OSDI scores [odds ratio, 2.562; 95% confidence interval (CI), 1.631-7.979; P=0.033] and DEQ-5 scores (odds ratio, 3.353; 95%CI, 1.038-8.834; P=0.043), whereas having a fixed occupation was a protective factor for OSDI scores (odds ratio, 0.088; 95%CI, 0.022-0.360; P=0.001) and DEQ-5 scores (odds ratio, 0.126; 95%CI, 0.039-0.405; P=0.001).

Patients with recurrent COVID-19 have more severe symptoms of DED, anxiety, and depression.

To investigate whether retinal nerve fiber layer defects (RNFLDs) is a potential risk factor for chronic kidney disease (CKD) in Chinese adults.

The Kailuan Eye Study was a population-based study that included 14440 participants. All participants underwent detailed assessments, RNFLDs were diagnosed using color fundus photographs.

Overall, 12507 participants [8533 males (68.23%)] had complete systemic examination data and at least one evaluable fundus photograph. RNFLDs were found in 621 participants [5.0%; 95% confidence interval (CI): 4.6%-5.34%], and 70 cases of multiple RNFLDs were found (11.27%). After adjusting multiple factors, RNFLDs was significantly associated with CKD severity, the ORs of CKD stage 3, stage 4 and stage 5 were 1.698, 4.167, and 9.512, respectively. Multiple RNFLDs were also associated with CKD severity after adjusting multiple factors, the ORs of CKD stage 3 and stage 5 were 4.465 and 11.833 respectively. Furthermore, 2294 participants had CKD (18.34%, 95%CI: 17.68%-18.99%). After adjusting for other factors, CKD presence was significantly correlated with the presence of RNFLDs.

The strongest risk factors for RNFLDs are CKD and hypertension. Conversely, RNFLDs can be an ocular feature in patients with CKD. Fundoscopy can help detect systemic diseases, and assessment for RNFLDs should be considered in CKD patients.

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.