Volume 62 · Issue 09 · 2026

This issue focuses on research progress in the diagnosis and treatment of glaucoma. Professor Zhang Hong is the editorial board member responsible for planning, compiling, and reviewing manuscripts for this issue.

Glaucoma is a major cause of irreversible blindness worldwide, and patients often require long-term or even lifelong topical intraocular pressure-lowering therapy. With prolonged treatment, the combined effects of active drug ingredients, preservative exposure, age-related ocular surface changes, and surgery-related factors make ocular surface disease a common yet easily overlooked comorbidity in patients with glaucoma. Ocular surface abnormalities may cause ocular discomfort and fluctuating vision, reduce medication adherence, interfere with intraocular pressure measurement and disease assessment, increase the difficulty of perioperative management, and affect long-term treatment efficacy and quality of life. This article emphasizes the need to change the clinical tendency of focusing on intraocular pressure while neglecting the ocular surface, and to incorporate ocular surface assessment and intervention into the entire course of glaucoma diagnosis and management. While protecting the optic nerve, clinicians should also maintain the homeostasis of the ocular surface microenvironment, thereby promoting long-term individualized management of glaucoma.

Vernal keratoconjunctivitis (VKC) is a chronic, seasonal, recurrent, bilateral allergic inflammatory disease that predominantly affects children, severely impacting patients′ quality of life. The early diagnosis rate of VKC in Chinese children is relatively low, treatment regimens vary, and clinical efficacy is difficult to guarantee. To guide the related clinical practice, the Cornea Group of Ophthalmology Branch of Chinese Medical Association, together with the Chinese Association for Pediatric Ophthalmology and Strabismus, developed expert consensus recommendations for the diagnosis and treatment of pediatric VKC. These recommendations were formulated by integrating evidence-based medical research results from both domestic and international sources and expert clinical experience, and using standardized guideline and consensus development methods.

Central anterior chamber depth (cACD), defined as the shortest distance between the posterior corneal surface and the anterior lens surface, is a key anatomical parameter for assessing the risk of primary angle-closure glaucoma (PACG). Traditional views often regard a shallow anterior chamber as a static anatomical consequence of a short axial length or a thickened lens; however, this perspective fails to fully explain the physiological fluctuations of cACD or the variability in angle-closure progression among individuals. Integrating recent high-resolution in vivo imaging and fluid dynamic evidence, this review explores the dynamic mechanisms underlying the formation of a shallow anterior chamber. We highlight that forward aqueous flow encounters a dual-bottleneck: cilio-lenticular block (proximal resistance) and pupillary block (distal resistance). When the cilio-lenticular space is severely compromised, aqueous flow is severely hindered and misdirects posteriorly, generating a substantial Trans-lens Pressure Difference (TLPD). Acting as the core mechanical driving force, TLPD pushes the entire lens-ciliary diaphragm forward, precipitating a shallowing of the anterior chamber. From this perspective, a shallow anterior chamber may be reinterpreted as the result of the combined effects of anatomic susceptibility and abnormal fluid dynamics. This understanding may offer important insights for the early identification of individuals at high risk for primary angle-closure glaucoma and for the development of individualized intervention strategies.

To evaluate the efficacy and safety of a preservative-free tafluprost/timolol maleate fixed-dose combination compared with preservative-free tafluprost monotherapy in Chinese patients with open-angle glaucoma (OAG) or ocular hypertension (OHT).

This was a multicenter, randomized, double-blind, parallel-controlled clinical trial conducted across 25 centers, including the Eye & ENT Hospital of Fudan University, from January 2019 to November 2022. Patients diagnosed with OAG or OHT who required enhanced intraocular pressure (IOP) reduction after a 4-week washout period were enrolled. Participants were randomized 1∶1 to receive either tafluprost/timolol or tafluprost once daily for 3 months. The primary endpoint was the change from baseline in mean diurnal IOP (the average of measurements at 8:00, 10:00, and 16:00) at Month 3. Secondary endpoints included IOP changes at individual time points and the proportion of responders achieving predefined IOP reduction thresholds. Safety was assessed via the incidence of adverse events (AEs). Analysis of covariance (ANCOVA) using the Markov Chain Monte Carlo (MCMC) method was employed for the primary endpoint; superiority was established if the upper limit of the 95% confidence interval (CI) was<0 mmHg (1 mmHg=0.133 kPa). Continuous variables in secondary endpoints were compared using ANCOVA, and responder rates were analyzed using Fisher′s exact test.

A total of 219 patients were enrolled (tafluprost/timolol group: n=110; tafluprost group: n=109). The primary efficacy analysis set included 215 patients (tafluprost/timolol: n=107; tafluprost: n=108). Baseline characteristics were well-balanced between the two groups. The majority of patients were male [127 (59.1%)] with a mean age of (44.80±15.71) years at screening. At Month 3, the mean diurnal IOP reduction from baseline was (6.56±3.44) mmHg in the tafluprost/timolol group and (5.36±2.94) mmHg in the tafluprost group. After adjusting for baseline IOP, the between-group difference was -1.312 mmHg (95%CI: -2.010 to -0.696); as the upper limit was<0 mmHg, tafluprost/timolol demonstrated superior IOP-lowering efficacy to tafluprost. Responder rates for IOP reductions of≥15%,≥25%, and≥30% were significantly higher in the tafluprost/timolol group (P=0.016, 0.028, and 0.032, respectively). The incidence of ocular AEs was 20.0% (22/110) in the tafluprost/timolol group and 26.6% (29/109) in the tafluprost group. The most common AE was conjunctival hyperemia, occurring in 2.7% (3/110) and 8.3% (9/109) of the groups, respectively.

Compared with preservative-free tafluprost monotherapy, the tafluprost/timolol combination provides significantly greater IOP reduction in patients with OAG and OHT, while maintaining a favorable safety profile.

To compare the measurement results of a home-use self-tonometer and the Goldmann applanation tonometer (GAT) in glaucoma and non-glaucoma subjects, evaluate the accuracy of the home-use self-tonometer, and investigate potential factors influencing the measurement outcomes.

It was a cross-sectional study. Non-glaucoma and glaucoma subjects were consecutively recruited from the Glaucoma Clinic of the Zhongshan Ophthalmic Center, Sun Yat-sen University, between August 2025 and November 2025. After receiving standardized training and certification for the home-use self-tonometer, subjects underwent three sequential intraocular pressure (IOP) measurements: self-measurement by the subject, measurement by a physician (using the home tonometer), and GAT measurement. Differences, correlations, and agreement among the three IOP measurements were analyzed using paired one-way analysis of variance (ANOVA), Pearson correlation coefficients, and Bland-Altman analysis with 95% limits of agreement. Paired t-tests were used to analyze whether there were differences in measurement errors between the left and right eyes during subject self-measurement. Univariate and multivariate regression analysis were performed to evaluate factors associated with measurement errors of the home-use self-rebound tonometer Both eyes were included when analyzing the difference in measurement errors between left and right eyes; for all other statistical analyses, only data from one eye per subject were included.

A total of 69 subjects (132 eyes) were recruited, with a mean age of (38.16±11.57) years, including 15 non-glaucoma subjects (30 eyes) and 54 glaucoma patients (102 eyes). Sixty-six subjects (95.65%) passed the certification. The IOP values obtained from subject self-measurement, physician measurement, and GAT were (15.74±4.40) mmHg, (15.70±5.22) mmHg (1 mmHg=0.133 kPa), and (15.88±5.10) mmHg, respectively, with no statistically significant differences among the three methods (F=0.12, P=0.874). Strong correlations were observed between GAT measurements and physician measurements, between GAT measurements and subject self-measurements, and between physician measurements and subject self-measurements (r=0.86, 0.75, and 0.78, respectively; all P<0.001). Using GAT values as the reference, the mean biases between GAT and physician measurements and between GAT and subject self-measurements were (0.19±2.70) mmHg and (0.14±3.41) mmHg, respectively, while the mean bias between the physician and the subject using the home-use self-tonometer was (-0.05±3.27) mmHg. Compared with GAT measurements, the measurement errors of subject self-measurement in the right and left eyes were (-0.05±3.21) mmHg and (-0.03±2.72) mmHg, respectively, with no significant difference between eyes (P=0.872). In univariate linear regression analysis, the measurement error of subject self-measurement was positively associated with GAT-measured IOP (β=0.35, 95%CI: 0.21-0.49, P<0.001). The measurement differences between physician and subject measurements using the home-use self-rebound tonometer were positively associated with best-corrected visual acuity (BCVA) and GAT-measured IOP (β=5.26 and 0.24, respectively; 95%CI: 2.04-8.48 and 0.09-0.38, respectively; both P=0.002). Glaucoma was associated with increased measurement differences between physician and subject measurements using the home-use self-rebound tonometer (β=2.10, 95%CI: 0.27-3.92, P=0.028). In multivariate linear regression analysis, GAT-measured IOP was an independent factor associated with physician measurement error (β=-0.29, 95%CI: 0.06-0.55, P=0.022).

The home-use self-rebound-tonometer showed good agreement with the Goldmann applanation tonometer in both glaucoma and non-glaucoma subjects, indicating that the measurement results obtained using the home-use self-rebound tonometer are reliable.

To investigate the effectiveness and prognosis of uveal melanoma treated with proton or heavy ion therapy.

A retrospective analysis was performed. We enrolled patients diagnosed with uveal melanoma at the Department of Ophthalmology, Eye & ENT Hospital of Fudan University between 2015 and 2020 and receiving proton beam therapy overseas, as well as patients diagnosed with uveal melanoma and treated with heavy ion radiotherapy at the Department of Ophthalmology, Eye & ENT Hospital of Fudan University and the Department of Radiotherapy, Shanghai Proton and Heavy Ion Center from July 2020 to August 2025. Patients′ information was collected, including the gender, age, best-corrected visual acuity and its changes, largest basal diameter and thickness of the tumor and their changes, tumor stage, radiotherapy type and complications, supplementary treatments after radiotherapy, and follow-up duration and modalities. The t-test was used to compare the changes in tumor diameter and thickness before and after radiotherapy. The local control rate of the tumor was summarized. Survival curves were drawn. The Kaplan-Meier product-limit method was used to calculate the cumulative metastasis-free survival rate and cumulative eye preservation rate at 3 and 5 years.

A total of 69 patients (69 eyes) were included. There were 31 males (44.9%) and 38 females (55.1%), with an average age of (46.5±12.2) years. The tumor stage (tumor-lymph node-distant metastasis staging system) was mainly T2 (33/69, 47.8%) and T3 stage (23/69, 33.3%). Twelve patients (17.4%) received proton radiotherapy, and 57 patients (82.6%) received heavy ion radiotherapy. The follow-up, which was conducted through outpatient visits and telephone interviews, lasted (40.2±31.8) months. The largest basal diameter of the tumor significantly decreased from (11.3±2.9) mm at baseline to (9.5±3.5) mm after radiotherapy, and the tumor thickness was reduced from (6.7±2.3) mm to (5.5±2.7) mm; both were statistically significant (both P<0.05). After treatment, 19 patients retained best-corrected visual acuity of≥0.1, and the major complications were radiation-induced retinopathy (29/69, 42.0%), macular edema (26/69, 37.7%), retinal detachment (24/69, 34.8%), and cataracts (23/69, 33.3%). Four patients (5.8%) ultimately underwent enucleation, including three cases due to neovascular glaucoma, and one case of anterior chamber seeding recurrence after local tumor resection. The local tumor control rate was 98.6% (68/69), and the 5-year cumulative eye preservation rate was 90.6%. In terms of survival prognosis, four patients had liver metastasis of the tumor, one patient had breast metastasis, and the 3-and 5-year cumulative metastasis-free survival rates were 93.7% and 90.3%, respectively.

Both proton radiotherapy and heavy ion radiotherapy for uveal melanoma not only achieve high local tumor control and eye preservation rates with a favorable safety profile, but also help to preserve partial visual acuity, holding promising prospects.

To investigate the mechanism by which severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) disrupts the blood-retinal barrier and induces retinal inflammatory response in mice, and to observe the intervention effect of poly(ADP-ribose) polymerase 1 (PARP-1) inhibitor.

This experimental study was conducted from September 2022 to December 2024. Six-to eight-week-old hACE2-ALL CDs-B6J transgenic mice were divided into a control group, an infection group and a PARP-1 intervention group, with 3 mice in each group. Mice in the control group received intranasal instillation of phosphate buffered saline (PBS); mice in the infection group were intranasally inoculated with green fluorescent protein-labeled SARS-CoV-2 pseudovirus, and samples were collected at 3, 5 and 7 days after intervention respectively; for the PARP-1 group, mice were intraperitoneally injected with PARP-1 inhibitor for 48 hours after 5 days of intranasal inoculation with the same pseudovirus. The localization and distribution of retinal Spike protein were observed by immunofluorescence staining, and the vascular leakage rate was quantified by fluorescence microscopy after intravenous injection of dextran. The mRNA and protein expression levels of zonula occludens-1 (ZO-1, a blood-retinal barrier-related molecule), as well as inflammatory factors including interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α) and transforming growth factor-β (TGF-β) were detected by quantitative real-time reverse transcription polymerase chain reaction (qRT-PCR) and Western blotting. Co-immunoprecipitation was performed to verify the interaction between Spike protein and PARP-1, and the effect of PARP-1 inhibitor on the above indicators was analyzed. One-way analysis of variance and t-test were used for statistical analysis.

Compared with the control group (0.21±0.05), the expression of Spike protein in the retina of the infection group increased with the prolongation of infection time (1.51±0.24, 2.60±0.27, 2.74±0.17), and the differences were statistically significant (all P<0.01). With the extension of infection time, the retinal dextran leakage rate increased compared with the control group (0.03±0.18), which was 0.75±0.05, 1.12±0.03 and 1.20±0.09 at 3, 5 and 7 days after infection respectively, with statistically significant differences (all P<0.01). The expression of ZO-1, a key factor of the blood-retinal barrier, in the infection group (0.17±0.05) was lower than that in the control group (0.81±0.11) (P<0.05). The expression levels of inflammatory factors IL-6, TNF-α and TGF-β in the retina of the infection group (1.51±0.12, 1.57±0.21, 1.38±0.17) were higher than those in the control group (0.71±0.28, 0.39±0.13, 0.28±0.1), with statistically significant differences (all P<0.05). In angiotensin-converting enzyme 2-overexpressing photoreceptor cells (661w cell line), the expression levels of Spike and PARP-1 in the infection group (0.52±0.12, 0.77±0.09) were upregulated compared with the control group (0.04±0.09, 0.29±0.15) (both P<0.01). In addition, co-immunoprecipitation results showed that there was an interaction between Spike protein and PARP-1 protein in the retina and photoreceptor cells of infected mice. Compared with the infection group (1.31±0.04), the expression level of Spike protein in the retina of the PARP-1 group (0.38±0.19) was decreased (P<0.01). Compared with the infection group (1.38±0.13, 1.41±0.15, 0.89±0.21), the expression levels of inflammatory factors IL-6, TNF-α and TGF-β in the PARP-1 group (0.52±0.11, 0.45±0.07, 0.42±0.07) were downregulated (all P<0.01).

In the hACE2-ALL CDs-B6J mouse model, SARS-CoV-2 infection disrupts the blood-retinal barrier and induces retinal inflammatory response by mediating the interaction between its Spike protein and host PARP-1 protein. Intervention with PARP-1 inhibitor can inhibit the above pathological changes.

A 17-year-old female patient presented with acute ocular pain and rapidly progressive visual loss in one eye. Ophthalmic examination revealed leukocoria and neovascular glaucoma. Ocular ultrasonography, computed tomography, and magnetic resonance imaging demonstrated an intraocular space-occupying lesion with calcification foci. Enucleation of the affected eye was performed due to the advanced stage of intraocular disease. Histopathological examination showed a malignant small round cell tumor with Flexner-Wintersteiner rosettes, with extensive choroidal invasion, and the pathological diagnosis was confirmed as retinoblastoma (pT3a). Postoperatively, the patient received two cycles of systemic chemotherapy with vincristine, etoposide, and carboplatin. During a 8-year follow-up, no local recurrence, distant metastasis, or secondary malignant tumor was observed.

The patient was a female, 7 years old. Due to intermittent left eye pain accompanied by dizziness for 1 week, visual acuity in the left eye decreased for 2 hours, and the patient was admitted to Ningbo Eye Hospital. There was no prior medical history or family history. General physical examination: MRI plain scans of the cervical spinal cord, thoracic spinal cord, and lumbosacral spinal cord were performed in another hospital, and no obvious abnormalities were found. Eye examination: the conjunctiva of the left eye was not congested, the cornea was clear, the anterior chamber was clear, the depth was normal, the lens was not obviously cloudy, and the vitreous body was clear. Ultra-wide-angle fundus examination revealed a blurred boundary of the optic disc in the left eye, scattered punctate hemorrhages around the periphery, and tortuous dilation of the retinal veins (Featured Image 1). Coherence light tomography examination revealed significant edema of the optic disc in the left eye (excerpt Figure 2A) and a small amount of exudation under the retinal neuroepithelial layer in the macular region (excerpt Figure 2B). Plain and enhanced orbital MRI scans showed thickening of the optic nerve in the left eye, slightly higher signal on T2-weighted imaging (Excerpt Figure 3A), rough edges, and significant enhancement of the optic nerve in the left eye after contrast injection (Excerpt Figure 3B). Clinical diagnosis: optic neuritis of the left eye.

The distal aqueous humor outflow pathway is an essential component of aqueous humor drainage and is closely associated with intraocular pressure control after minimally invasive glaucoma surgery (MIGS). However, in vivo assessment of its structure and function remains a major clinical challenge. Optical coherence tomography enables continuous visualization of the distal outflow pathway beyond Schlemm′s canal through improved micrometer-scale axial resolution, although its performance is limited by tissue overlap and similar optical signals. Aqueous angiography visualizes segmental aqueous humor outflow intraoperatively and assesses distal outflow patency. Hemoglobin video imaging exploits the differential optical absorption of hemoglobin and aqueous humor to enable dynamic, quantitative evaluation of aqueous humor outflow. This review summarizes recent advances in imaging of the distal aqueous humor outflow pathway and discusses their potential applications in evaluating MIGS outcomes and guiding individualized treatment.

Mucosa-associated lymphoid tissue (MALT) lymphoma, a subtype of extranodal marginal zone lymphoma, is the most prevalent primary non-Hodgkin lymphoma involving ocular adnexal structures, including the orbit, conjunctiva, and lacrimal gland. Epidemiological studies have consistently shown a global upward trend in its incidence over recent decades. Accumulating evidence underscores that the synergistic effects of genetic alterations and chronic antigen stimulation (such as microbial infections or autoimmune responses) play a critical role in driving tumorigenesis through tumor microenvironmental remodeling. However, the distinct histopathological characteristics and intricate molecular regulatory networks pose substantial challenges to clinical management, especially in terms of differential diagnosis and therapeutic optimization. This review systematically summarizes the latest advances in genetic heterogeneity and immune microenvironment dynamics of ocular adnexal MALT lymphoma, and proposes multi-omics integrated analytical approaches to inform precision diagnostic frameworks and targeted therapeutic strategies.

Noninfectious Uveitis (NIU) is a category of sight-threatening ophthalmic disorders characterized by intraocular inflammation. In recent years, biologic agents, particularly tumor necrosis factor-α inhibitors (TNFi), have become a cornerstone of NIU management, markedly improving the prognosis of a subset of patients. However, some patients still exhibit suboptimal response to TNFi therapy, or experience progressive loss of therapeutic efficacy during treatment, which is potentially attributed to the production of anti-drug antibodies (ADA) secondary to the immunogenicity of these biologic agents. Serum drug concentration and ADA levels are well-established key determinants of the therapeutic efficacy of TNFi. At present, research data on the correlation between serum drug concentration, ADA levels and clinical therapeutic efficacy in NIU patients remain relatively limited, and the mechanisms underlying ADA development, as well as the drivers of individual variability in ADA production, have yet to be fully elucidated by further studies. This review summarizes the research progress on the generation and underlying mechanisms of ADA, influencing factors of ADA development, and corresponding clinical management strategies during TNFi treatment for NIU. It aims to provide a theoretical basis for improving the therapeutic efficacy of TNFi and optimizing personalized treatment regimens for patients with NIU.

Exercise is a key intervention for proactive health, the benefits of aerobic exercise for glaucoma have been widely recognized, however, the mechanisms underlying the effects of exercise on intraocular pressure and glaucoma remain unclear. As a result, there is no sufficient evidence for clinicians to provide clear exercise prescriptions for patients with glaucoma. This article summarizes and analyzes the effects of different exercise regimens on glaucoma, the mechanisms underlying the benefits of exercise for glaucoma, and the promotion of the concept that exercise is beneficial to glaucoma management. It aims to inspire researchers to conduct further investigations into the mechanisms and practical applications of exercise interventions for glaucoma.

Dry eye disease is a multifactorial chronic ocular surface disorder, in which inflammatory response plays a pivotal role in its onset and progression. In recent years, with a deepening understanding of the pathogenesis of dry eye and an increasing clinical application of various anti-inflammatory drugs, the appropriate and precise selection of these agents for anti-inflammatory therapy has become of paramount significance in improving clinical outcomes. Starting with the importance of anti-inflammatory therapy for dry eye, this article discusses and summarizes current research evidence and clinical experience regarding the clinical evaluation of inflammation in dry eye, anti-inflammatory therapy, combination anti-inflammatory therapy and its drug selection, perioperative management, and patient education. The aim is to provide a scientific, standardized, and practical diagnostic and therapeutic reference for clinical practice.

The 14th Chinese Congress of Research In Vision And Ophthalmology 2026 (CCRVO 2026), hosted by the Chinese Medical Association And the Ophthalmology Branch of the Chinese Medical Association, And co-organized by the Henan Academy of Medical Sciences, the First Affiliated Hospital of Zhengzhou University, And the Second People's Hospital of Zhengzhou, was held In Zhengzhou, Henan Province from April 23 to 26, 2026. The theme of this Congress was "Intelligent Ophthalmology, Creating the Future".

On June 14, 2026, the "Retracing the Long March: Grassroots Tour of the Ophthalmology Branch of the Chinese Medical Association (Ganzhou Station)" event, hosted by the Ophthalmology Branch of the Chinese Medical Association and organized by the First Affiliated Hospital of Gannan Medical University, was grandly held in Ganzhou City, Jiangxi Province (Figure 1). The location of this event is of special significance, as Ganzhou City was the assembly and departure point of the Central Red Army's Long March. This year marks the 90th anniversary of the victory of the Long March. Revisiting this glorious history, we deeply realize that the broad masses of people were the source of strength for the victory of the Long March. In the development of ophthalmology, "coming from the masses and going to the masses" is equally crucial. Developing according to the needs of the people and giving back the fruits of development to the grassroots people is the fundamental guarantee for overcoming difficulties and obstacles in the development of the discipline.