Purpose. To investigate the incidence and risk factors of intraocular foreign body- (IOFB-) related endophthalmitis.Methods. A total of 1701 patients diagnosed with IOFB between January 1, 2005 and June 30, 2015 were included. Two groups of patients were defined according to the presence or absence of endophthalmitis, and a comparison of personal information, IOFB characteristics, and wound location were performed.Results. In total, 279 patients (16.4%) developed endophthalmitis, older age (P=0.01) was a risk factor. IOFBs retained in the crystal lens or wall of the eyeball conferred lower risks (P=0.01and 0.04, respectively) compared to the vitreous chamber. The coexistence of different IOFB types and plant IOFBs conferred higher risks (P=0.02and 0.03, respectively), while glass/plastic IOFBs conferred a lower risk (P=0.03) compared to metallic IOFBs.Conclusions. Age, IOFB locations, and types were related to development of endophthalmitis, while IOFB number, size, or timing of primary repairs was not related.

In this study, we investigated the protective effect of mouse nerve growth factor (NGF) on retinal ganglion cell (RGC) injury induced by retinal ischemia–reperfusion (RIR) in rats and explored its possible mechanisms of action. RIR caused a significant injury to RGCs and an obvious impairment of the inner retina functions, which could be seen from flash electroretinogram and flash visual evoked potential recordings. RIR also increased the expression of the apoptotic protein Bax while decreasing the expression of Bcl-2 and the phosphorylation of protein kinase B (Akt) in RGCs. Preinjection (i.m.) of NGF for 22 d reversed the injury induced by RIR and ameliorated the inner retina functions. NGF also reduced the expression of Bax and reversed the reduction of Bcl-2 and the phosphorylated Akt induced by RIR. These results indicate that NGF produces a neuroprotective effect on RGCs against RIR injury and the protective effect of NGF is mainly mediated by the PI-3K/Akt signaling pathway.

Traumatic optic neuropathy (TON) is a significant cause of vision loss and irreversible blindness worldwide. It is defined as retinal ganglion cell death and axon degeneration caused by injury. Optic nerve crush (ONC), a well-validated model of TON, activates retinal microglia and initiates neuroinflammation. High-mobility group box 1 (HMGB1), a non-histone chromosomal binding protein in the nucleus of eukaryotic cells, is an important inducer of microglial activation and pro-inflammatory cytokine release. The purpose of this study was to examine the protective effects and mechanism of the HMGB1 inhibitor BoxA to neuroinflammation-induced retinal ganglion cells (RGCs) damage in traumatic optic neuropathy. For that purpose, an optic nerve crush model was established in C57BL/6J mice at 10–12 weeks. Model mice received an intravitreal injection of PBS and the HMGB1 inhibitor BoxA. Our data demonstrated that HMGB1 expression increased after optic nerve crush. Retinal ganglion cell function and morphology were damaged, and retinal ganglion cell numbers were reduced after optic nerve crush. Intravitreal injection of BoxA after ONC can alleviate damage. Furthermore, BoxA reduced microglial activation and expression levels of nuclear factor κB (NF-kB), nucleotide-binding domain, leucine-rich repeat containing protein 3 (NLRP3), and apoptosis-associated speck-like protein containing a CARD (ASC) in experimental ONC mice. In summary, HMGB1 mediates NLRP3 inflammasome via NF-kB to participate in retinal inflammatory injury after ONC. Thus, intravitreal injection of BoxA has potential therapeutic benefits for the effective treatment of RGC death to prevent TON.

Purpose. To report the causative organisms, management strategies, and visual outcomes of culture-proven endogenous fungal endophthalmitis in a case series from southern China. Methods. We reviewed the microbiological and medical records of patients with culture-positive endogenous fungal endophthalmitis visiting the Zhongshan Ophthalmic Center, Guangzhou, China, between January 1, 2006, and March 31, 2016. Results. The inclusion criteria were met in 32 eyes of 29 patients. Molds were a common causative organism in 15 patients (51.7%), while yeasts appeared in 14 patients (48.3%). Initial visual acuity (VA) at the level of finger counting or better was significantly related to a good visual outcome (P=0.002). Molds as a causative agent were significantly associated with worse visual outcome than yeasts (P=0.020). Conclusion. Molds were a common cause of culture-proven fungal endophthalmitis. Endogenous fungal endophthalmitis is generally associated with poor VA outcomes, especially if caused by molds and if the patient’s initial VA is too low to permit finger counting.

Purpose: To describe characteristics of eye-related emergency department (ED) visits and investigate differences in priorities assigned to patients by triage nurses and ophthalmologists.Methods: A prospective survey was conducted at the ED of Zhongshan Ophthalmic Center from January 1, 2021, to May 31, 2021. Clinical data from patients with acute ophthalmic conditions lasting less than 7 days were collected via a standard questionnaire and the urgency levels assigned by nurses and physicians were also recorded. Binary logistic regression was performed to identify characteristics associated with truly emergency conditions and up- or down-triage.Results: A total of 1907 patients were enrolled, with 582 (30.5%) classified as “non-emergency.” Red eye (69.7%), eye pain (53.0%), ocular trauma (44.1%), tearing (43.6%), and blurred vision (43.1%) were the most common complaints. Truly emergency tended to be male (OR 2.019, p < 0.001) and with unilateral eye involvement (OR 2.992, p < 0.001). Nurses prioritized conjunctival, scleral, closed ocular trauma and eyelid diseases over doctors while giving less priority to open ocular trauma, cornea, uveitis, and vitreoretinal diseases (p < 0.05). Overemphasis on mild blurred vision (OR 3.718, p = 0.001) and insufficient understanding of conjunctival diseases without red eye (OR 0.254, p = 0.001) were associated with conjunctival disease “up-triage.” Insufficient awareness of moderate and severe blurred vision was associated with “down-triage” for ocular trauma (OR 3.475, p = 0.001 and OR 2.422, p = 0.020, respectively).Conclusion: Ophthalmic EDs are typically flooded with patients suffering from acute ocular problems, with a considerable portion for non-emergency conditions. The identification of characteristics associated with truly emergency cases and nurses’ triage preferences is valuable in providing target guidance for future ED practice and facilitating the proper allocation of emergency resources.