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Comparison of macular changes and visual outcomes between femtosecond laser-assisted cataract surgery and conventional phacoemulsification surgery for high myopic cataract patients

To evaluate differences in log MAR best-corrected visual acuity (BCVA) improvement and postoperative central foveal thickness (CFT) and choroidal thickness (CT) changes between conventional phacoemulsification...

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Association of myopia and astigmatism with postoperative ocular high order aberration after small incision lenticule extraction

To investigate the correlation between higher-order aberrations (HOA) after small incision lenticule extraction (SMILE) and the severity of myopia and astigmatism, along with the relevant factors. These findin...

Lens subluxation combined with parry-romberg syndrome: case report

Parry-Romberg syndrome (PRS) is a rare progressive degenerative disorder of unknown etiology. Here we report a rare case of PRS combined with lens subluxation in Eye and ENT hospital of Fudan University, Shang...

Associations of long-term fluctuation in blood pressure and ocular perfusion pressure with visual field progression in normal-tension glaucoma

The aim of this study was to investigate the associations between fluctuation in blood pressure (BP), ocular perfusion pressure (OPP) and visual field (VF) progression in normal-tension glaucoma (NTG).

Observation of structural and vascular features of retina and choroid in myopia using ultra-widefield SS-OCTA

To find the relationship between the changes of retinal and choriodal structure/ vascular densities (VD) and the myopia progress.

Refraction and ocular biometric parameters in 3-to 6-year-old preschool children : a large-scale population-based study in Chengdu, China

To understand the ocular biometric parameters characteristics and refractive errors in 3-to 6-year-old preschool children in Chengdu, China, and to investigate the prevalence of refractive errors.

Intraoperative quantitative crystalline lens nuclear opacities analysis based on crystalline lenSx platform

The main objective is to quantify the lens nuclear opacity using spectral-domain optical coherence tomography (SD-OCT) and to evaluate its association with Lens Opacities Classification System III (LOCS-III) s...

The outcomes of corneal sight rehabilitating surgery in Stevens-Johnson syndrome: case series

To summarize the outcomes of corneal sight rehabilitating surgery in Stevens-Johnson syndrome (SJS).

Does collagen cross linking have any effect on retinal circulation in patients with keratoconus? An optical coherence tomography angiography (OCTA) study

We aimed to employ Optical Coherence Tomography Angiography (OCTA) to comprehensively assess changes in the optic nerve head (ONH) and macular perfusion before and after the Corneal Collagen Cross-Linking (CCL...

Construction of oxidative phosphorylation-related prognostic risk score model in uveal melanoma

Uveal melanoma (UVM) is a malignant intraocular tumor in adults. Targeting genes related to oxidative phosphorylation (OXPHOS) may play a role in anti-tumor therapy. However, the clinical significance of oxida...

Zonular instability-associated morphologic features in eyes with primary angle closure disease using the swept-source anterior segment – optical coherence tomography system

This study aims to investigate the morphologic features of the crystalline lens in Primary Angle Closure Disease (PACD) patients with zonular instability during cataract surgery using the swept-source CASIA 2 ...

Association between ambient air pollution and age-related macular degeneration: a meta-analysis

Several epidemiological studies have investigated the association between ambient air pollution and age-related macular degeneration (AMD). However, a consensus has not yet been reached. Our meta-analysis aime...

Central retinal artery occlusion after intravitreal brolucizumab injection for treatment-naïve neovascular age-related macular degeneration; a case report

To report a case of central retinal artery occlusion (CRAO) after intravitreal injection of brolucizumab for a treatment-naïve neovascular age-related macular degeneration (nAMD) patient without comorbid cardi...

Choroidal manifestations of non-ocular sarcoidosis: an enhanced depth imaging OCT study

Although choroidal thickening was reported as a sign of active inflammation in ocular sarcoidosis, there has been no research on the choroidal changes in non-ocular sarcoidosis (defined as systemic sarcoidosis...

Comparatively analysing the postoperative optical performance of different intraocular lenses: a prospective observational study

Postoperative performance, including best corrected distance visual acuity (BCDVA) and optical metrics (from the OQAS and iTrace devices), was compared among 4 different intraocular lenses (IOLs).

Clinical features and comprehensive treatment of persistent corneal epithelial dysfunction after cataract surgery

Evaluation of clinical efficacy and safety of tobramycin/dexamethasone eye ointment in treating persistent corneal epithelial dysfunction (PED) after cataract surgery.

New-onset or relapse of uveitis after rapid spreading of COVID-19 infection in China and risk factor analysis for relapse

The aim of this study was to report the clinical profile of new-onset and relapse of uveitis following rapid spreading of coronavirus disease 2019 (COVID-19) infection due to change of anti-COVID-19 policies i...

Epidemiological variations and trends in glaucoma burden in the Belt and Road countries

Analyzing the glaucoma burden in "Belt and Road" (B&R) countries based on age, gender, and risk factors from 1990 to 2019 in order to provide evidence for future prevention strategies.

Swept-source optical coherence tomography angiography findings in a case of primary vitreoretinal lymphoma over a three-year follow-up

Vitreoretinal lymphoma (VRL) still represents a diagnostic challenge for retinal specialists. Early diagnosis and treatment are critical for a better prognosis. Several diagnostic tools have proven helpful in ...

Optical coherence tomography biomarkers as outcome predictors to guide dexamethasone implant use in patients with iERM: a randomized controlled trial

We aimed to investigate the anatomical features of optical coherence tomography (OCT) and vitreous cytokine levels as predictors of outcomes of combined phacovitrectomy with intravitreal dexamethasone (DEX) im...

Isolated ectopia lentis with partial anterior dislocation and pupillary block: a case report

Ectopia lentis is the dislocation of the natural crystalline lens and usually presents in the setting of trauma or other systemic diseases. Herein, we describe a case of an otherwise healthy four-year-old boy ...

A retrospective study of cumulative absolute reduction in axial length after photobiomodulation therapy

To assess the age and timeline distribution of ocular axial length shortening among myopic children treated with photobiomodulation therapy in the real world situations.

Local resection via partial lamellar sclerouvectomy for ciliary body tumors — a case series

Ciliary body tumor is extremely rare and treatment is challenging. The aim of this study is to present our experience in treating this rare entity, especially large tumors with more than 5 clock hours of invol...

Comparison of short-term clinical outcomes of a diffractive trifocal intraocular lens with phacoemulsification and femtosecond laser assisted cataract surgery

To evaluate short-term visual and refractive outcomes after implantation of a diffractive trifocal intraocular lens (IOL) in cataract patients with phacoemulsification (PHACO) and femtosecond laser assisted ca...

Iris neovascularization and neurotrophic keratopathy following ultrasound cycloplasty in refractory glaucoma: case series

Ultrasound cycloplasty is a noninvasive surgery used to reduce intraocular pressure in patients with glaucoma, with fewer severe complications. This report presents several cases of iris neovascularization and...

Relationship between lymphocytes and idiopathic macular hole

An idiopathic macular hole (IMH) is a full-thickness anatomic defect extending from the internal limiting membrane to the photoreceptor layer of the macula without any known cause. Recently, clinical laborator...

Macular hypoplasia and high myopia in 48, xxyy syndrome: a unique case of 48, xxyy syndrome that presents with high myopia and macular dysplasia

Among sex chromosome aneuploidies, 48, XXYY syndrome is a rare variant. This condition is marked by the existence of an additional X and Y chromosome in males, leading to a diverse range of physical, neurocogn...

Effect of intravitreal injections due to neovascular age-related macular degeneration on retinal nerve fiber layer thickness and minimum rim width: a cross sectional study

The present study tested the hypothesis that repeated anti-VEGF injections are associated with reduced retinal nerve fiber layer (RNFL) and minimum rim width (MRW) of the optic nerve head.

Management of macula-on giant retinal tear detachments– outcome of pars-plana-vitrectomy with silicone oil versus gas tamponade

To compare the outcome of eyes with a macula-on giant retinal tear (GRT) detachment treated with pars-plana-vitrectomy (PPV) depending on the used endotamponade.

Extended depth of focus IOL in eyes with different axial myopia and targeted refraction

To evaluate the objective visual outcomes following implantation of extended depth of focus intraocular lens (EDOF IOL) in individuals with varying axial lengths (AL) and targeted refraction.

Repeatability assessment of anterior segment measurements in myopic patients using an anterior segment OCT with placido corneal topography and agreement with a swept-source OCT

The precision of anterior segment biometric measurements in eyes has become increasingly important in refractive surgery. The purpose of this study is to assess the repeatability of the automatic measurements ...

Prevalence, clinical characteristics, and independent predictors of uveitic macular edema in an Asian population: a retrospective cohort study

To determine the prevalence, clinical characteristics, and independent predictors of uveitic macular edema (UME) in patients with intermediate, posterior and panuveitis.

Non-surgical treatment of stage 4A retinopathy of prematurity

Retinopathy of prematurity (ROP) is a major cause of visual impairment in premature infants, often requiring surgical interventions in advanced stages. This retrospective case series study investigates non-sur...

Comparison of photorefraction by Plusoptix A12 and cycloplegic autorefraction in children

Plusoptix photoscreeners are capable of measuring refractive errors of children from 1 meter distance, without cyloplegia. We aimed to compare refractive data obtained from the newest version of Plusoptix (mod...

Correction: Long-term real-life outcomes of the Clareon® hydrophobic intraocular lens: the Clarte study in 191 eyes

The original article was published in BMC Ophthalmology 2024 24 :133

Giant retinal pigment epithelium tears with membranous nephropathy: a case report and literature review

Kidney and eye diseases may be closely linked. Tears of the retinal pigment epithelium (RPE) have been reported to be related to kidney diseases, such as IgA nephropathy and light-chain deposition disease. How...

Quantitative assessment of choroidal parameters and retinal thickness in central serous chorioretinopathy using ultra-widefield swept-source optical coherence tomography: a cross-sectional study

In this study, we used ultra-wide field swept-source optical coherence tomography angiography (UWF SS-OCTA) to assess changes in retinal thickness (RT) and choroidal parameters in individuals who had received ...

Comparison of pain between bilateral ICL surgeries in patients with myopia

The purpose of this study was to compare the preoperative anxiety, aqueous humor monocyte chemoattractant protein-1 (MCP-1) concentration, intraoperative pain, and degree of cooperation of the first eye implan...

Femtosecond thin-flap laser assisted in situ keratomileusis for correction of post-penetrating keratoplasty ametropia: long-term outcome

To evaluate the long-term clinical outcomes of femtosecond thin-flap LASIK (femto-LASIK) for correction of refractive error after penetrating keratoplasty in keratoconus-affected eyes.

Efficacy and adverse reactions of peripheral add multifocal soft contact lenses in childhood myopia: a meta-analysis

This study aims to compare the efficacy of peripheral add multifocal soft contact lenses (SCLs) (excluding bifocal SCLs) with single vision contact lenses or spectacles in controlling myopia progression.

Comparative efficacy and safety of all kinds of intraocular lenses in presbyopia-correcting cataract surgery: a systematic review and meta-analysis

To assess the efficacy and safety of various intraocular lenses (IOLs), including standard monofocal, bifocal, trifocal, extended depth of focus (EDOF), and enhanced monofocal IOLs, post-cataract surgery throu...

No side effects on rabbit retina or vitreous microenvironment by nd:YAG laser vitreolysis

To explore the safety of Neodymium:Yttrium-aluminum-garnet (Nd:YAG) laser vitreolysis based on the histological examination of the retina and the alteration of vitreous cytokines in the rabbits.

Evaluation of objective and subjective binocular ocular refraction with looking in type

This study aimed to compare the results of the Chronos binocular/monocular refraction system, that measures objective and subjective ocular refraction in one unit, to objective findings obtained from a convent...

Clinical characteristics and surgical outcomes of transcutaneous versus transconjunctival excision of Wolfring gland ductal cysts

To analyze the clinicopathological characteristics and surgical outcomes of patients with Wolfring gland ductal cysts (WGDCs).

Home vision therapy and prism prescription in presbyopic persons with convergence insufficiency: study protocol for a randomized controlled trial

Convergence insufficiency is a common issue in the field of binocular vision. Various treatment options have been suggested for managing this condition, but their efficacy in individuals with presbyopia remain...

Changes in corneal biomechanics in patients with glaucoma: a systematic review and meta-analysis

Corneal biomechanics has been implicated in a variety of ocular diseases. The purpose of this study was to evaluate the relationship between the glaucoma and corneal biomechanical properties, and exploring the...

Genotype-phenotype associations in CRB1 bi-allelic patients: a novel mutation, a systematic review and meta-analysis

The goal of the study was to search for novel bi-allelic CRB1 mutations, and then to analyze the CRB1 literature at the genotypic and phenotypic levels.

Association between the response of intravitreal antivascular endothelial growth factor injection and systemic factors of diabetic macular edema

This study investigated the effects of systemic factors in response to intravitreal injections in patients with macular edema due to non-proliferative diabetic retinopathy (NPDR).

Corneal endothelial cell density and associated factors among adults at a regional referral hospital in Uganda: a cross-sectional study

To assess the prevalence of low corneal endothelial cell density and correlates of corneal endothelial cell density among adults attending Mbarara University and Referral Hospital Eye Centre in Uganda.

Study of association between corneal shape parameters and axial length elongation during orthokeratology using image-pro plus software

The aim was to validate the correlation between corneal shape parameters and axial length growth (ALG) during orthokeratology using Image-Pro Plus (IPP) 6.0 software.

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Hotspots and trends in ophthalmology in recent 5 years: Bibliometric analysis in 2017–2021

1 State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China

2 Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, China

3 Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China

Weining Zhu

4 Zhongshan Medical School, Sun Yat-sen University, Guangzhou, China

Yingshi Zou

Bowen zhang, guangming jin, zhenzhen liu, associated data.

Publicly available datasets were analyzed in this study. This data can be found here: https://www.webofscience.com/wos/alldb/basic-search .

The purpose of this study was to investigate the hotspots and research trends of ophthalmology research.

Ophthalmology research literature published between 2017 and 2021 was obtained in the Web of Science Core Collection database. The bibliometric analysis and network visualization were performed with the VOSviewer and CiteSpace. Publication-related information, including publication volume, citation counts, countries, journals, keywords, subject categories, and publication time, was analyzed.

A total of 10,469 included ophthalmology publications had been cited a total of 7,995 times during the past 5 years. The top countries and journals for the number of publications were the United States and the Ophthalmology. The top 25 global high-impact documents had been identified using the citation ranking. Keyword co-occurrence analysis showed that the hotspots in ophthalmology research were epidemiological characteristics and treatment modalities of ocular diseases, artificial intelligence and fundus imaging technology, COVID-19-related telemedicine, and screening and prevention of ocular diseases. Keyword burst analysis revealed that “neural network,” “pharmacokinetics,” “geographic atrophy,” “implementation,” “variability,” “adverse events,” “automated detection,” and “retinal images” were the research trends of research in the field of ophthalmology through 2021. The analysis of the subject categories demonstrated the close cooperation relationships that existed between different subject categories, and collaborations with non-ophthalmology-related subject categories were increasing over time in the field of ophthalmology research.

Conclusions

The hotspots in ophthalmology research were epidemiology, prevention, screening, and treatment of ocular diseases, as well as artificial intelligence and fundus imaging technology and telemedicine. Research trends in ophthalmology research were artificial intelligence, drug development, and fundus diseases. Knowledge from non-ophthalmology fields is likely to be more involved in ophthalmology research.

Introduction

More than 2.2 billion people worldwide were visually impaired or blind to date, with an annual economic burden of more than $269.4 billion ( 1 ). Development in ophthalmology is essential for the prevention and treatment of eye diseases, and relevant research is growing rapidly in breadth and depth and forming complex knowledge networks. Glaucoma, age-related macular degeneration, and some hereditary eye diseases were previously considered irreversible blindness-causing diseases, and progress had been made to cure or alleviate them by modulating new targets or using new technologies ( 2 – 4 ). Cataracts and posterior capsular opacification were previously thought to be treated only with surgery, but in the recent years, there had been new developments in research into drugs that inhibit cataract formation ( 5 , 6 ). With the advances in the field of ophthalmology, new hope has emerged in areas previously considered untreatable or treatable only through non-pharmaceutical interventions ( 7 – 10 ). However, it is not feasible to analyze the overall overview of the field of ophthalmology and to explore its research hotspots and trends with a traditional systematic review, which is not conducive to the development of the field.

Bibliometric analysis is the quantitative analysis of the universal scientific production data in a specific field ( 11 ). Bibliometric method obtains the history and current status of the research field development by analyzing the scientific research results and can make predictions of the research field ( 12 ). Previous studies have conducted bibliometric analysis on individual country contributions or focused only on randomized controlled studies in ophthalmology and citation patterns in ophthalmology journals ( 13 – 19 ). Unsolved questions still remain as to how to quantitatively evaluate the contribution of different global research forces (countries, journals) in ophthalmology and identify hotspots and future research trends in ophthalmology based on a wide range of research results in different subfields of ophthalmology.

This study was intended to quantitatively analyze and visualize the global ophthalmology publication from 2017 to 2021 using bibliometric methods to explore the global research forces (countries, journals), possible hotspots, and future trends of ophthalmology research and to provide insight for research development and public health policy formulation in the field of ophthalmology.

Data sources

All the data used in this study were obtained from the Web of Science Core Collection (Clarivate Analytics, Philadelphia, PA, USA). The search was conducted by searching the Topic Subject retrieval field using “ophthalmology” as the subject word. Articles published between 2017 and 2021 were included, with no restrictions on the language type or document type of the articles. Data were collected on 28 January 2022.

Data collection and processing

To describe the number of articles published per year, the number of annual citations of the articles, the number of country publications, and the number of journal publications in the field of ophthalmology, relevant data were downloaded in the Web of Science Core Collection. All ophthalmology-related articles with their corresponding references and all publication-related information were exported as plain text for country collaboration analysis, keyword co-occurrence analysis, keyword burst analysis, and subject category co-occurrence analysis. To make the results more informative, keywords that were not relevant or meaningful to the analysis were filtered and removed during the data processing.

Statistical and bibliometric analysis

Statistical descriptions of the number of annual publications, the number of annual citations, the number of country publications, and the number of journal publications were performed using Microsoft Excel 2019 (Microsoft Corporation, Redmond, WA, USA) and GraphPad Prism version 8.4.2 (GraphPad Software, La Jolla, CA, USA).

Bibliometric analysis was carried out using VOSviewer (Leiden University's Centre for Science and Technology Studies, Leiden, the Netherlands) to obtain country collaborations and research hotspots. Several clusters were formed based on the country cooperation analysis, with countries of the same color belonging to the same cluster. Countries within clusters cooperated relatively closely, whereas cooperation among countries between clusters was relatively weak. The research hotspots were obtained from the clusters formed by the co-occurrence analysis of high-frequency keywords. The common characteristics of high-frequency keywords within the same cluster revealed the research hotspots. The frequency of keyword occurrences was used to weight the size of the keywords. The larger the keyword, the higher the frequency of occurrence.

Furthermore, CiteSpace V version 5.8.R3 (Drexel University, Philadelphia, PA, USA) was used for bibliometric analysis to obtain the burst keywords and subject category cooperation. The keyword burst analysis was performed to obtain temporal trends in keywords in the field of ophthalmology. The most recent burst keywords were defined as research frontier topics, indicating the potential for continued research breakthroughs in these topics. The co-occurrence of subject categories was analyzed to obtain the collaboration of subject categories. The number of occurrences of a subject category was used to weight the subject category. The more occurrences a subject category had, the larger it was. Temporal trends in subject category occurrences were represented by temporal rings of subject categories, the thickness of which represented the number of subject category occurrences in the corresponding year. Interdisciplinary cooperation was represented by the connecting line between subject categories. The thicker the connecting line, the closer the collaboration.

Global research output distribution

A total of 139 countries contributed to the publications related to ophthalmology research, with a total of 10,469 articles, which were cited 7,995 times. The number of publications had increased year by year, but there was an inflection point in citation counts. Citation counts increased year by year from 2017, reaching 2,650 citations in 2020, whereas citations in 2021 decreased compared to 2020 ( Figure 1A ). The analysis of countries showed that the United States had the highest number of publications, more than three to four times the number of other countries, followed by the United Kingdom, India, Germany, and China ( Figure 1B ). Country collaboration analysis yielded four clusters, with close cooperation between countries within each cluster ( Figure 1C ). Publications related to ophthalmology research were distributed in 1,876 journals, and the top 10 journals in terms of the number of articles published were the Ophthalmology ( n = 1,263, 12.06%), the Ophthalmology. Retina ( n = 580, 5.54%), the BMJ Case Reports ( n = 270, 2.58%), the Journal of Neuro-Ophthalmology: the official journal of the North American Neuro-Ophthalmology Society ( n = 260, 2.48%), the Investigative Ophthalmology & Visual Science ( n = 214, 2.04%), the Ophthalmology, Glaucoma ( n = 204, 1.95%), the Journal of Current Ophthalmology ( n = 200, 1.91%), the European Journal of Ophthalmology ( n = 191, 1.82%), the Indian Journal of Ophthalmology ( n = 173, 1.65%), and Journal of Cataract and Refractive Surgery ( n = 171, 1.63%) ( Figure 1D ).

Global distribution of research output. (A) Annual publications and citations of ophthalmology research from 2017 to 2021. (B) Top 10 countries in terms of total publications. (C) Country cooperation networks. (D) Top 10 journals by total publication volume of ophthalmology research in a 5-year period.

Global high-impact documents

The top 25 high-impact articles in ophthalmology published between 2017 and 2021, ranked by total citations, are shown in Table 1 . All the articles had been cited more than 150 times, with the highest number of citations being 419. Of these articles, 10 were published in 2017, 12 in 2018, one in 2019, and two in 2020. In total, 12 of these articles were published in the Ophthalmology and three in the Progress in Retinal and Eye Research. According to the type of publication, there were 16 original research articles and 9 review articles. The keywords involved in the articles are listed in Table 1 , including 5 articles each on OCT and deep learning, 4 articles each on diabetes and macular degeneration, and other related research topics such as glaucoma, artificial intelligence, and drugs.

Top 25 most cited documents published between 2017 and 2021.

Research hotspots

Keyword co-occurrence analysis demonstrated that the three most frequent of all keywords were “glaucoma” ( n = 395), “retina” ( n = 321), and “optical coherence tomography” ( n = 230). In the past 5 years, 157 high-frequency keywords in the field of ophthalmology were identified by setting the minimum frequency of keyword occurrence at 20 times. These keywords formed four clusters: the “glaucoma” cluster (red; 86 items), the “retina” cluster (green; 47 items), the “COVID-19” cluster (blue; 13 items), and the “screening” cluster (yellow; 8 items) ( Figure 2 ). After summarizing the keyword clusters, four research hotspots were identified: epidemiological characteristics and treatment modalities of diseases such as glaucoma and diabetic retinopathy, artificial intelligence and fundus imaging technology, COVID-19-related telemedicine, and screening and prevention of eye diseases.

Ophthalmology research hotspots analysis. The keywords formed four clusters, which were differentiated by color in the diagram, with the same color being the same cluster. The keyword size indicated the number of occurrences of the keyword, whereas the thickness and distance of the connecting lines between the keywords indicated the frequency of co-occurrence between the two keywords.

Research trends

Keyword burst analysis showed that “neural network,” “pharmacokinetics,” “geographic atrophy,” “implementation,” “variability,” “adverse events,” “automated detection,” and “retinal images” were the hot topics of research in the field of ophthalmology through 2021 and displayed the potential to become the research frontiers to achieve breakthroughs shortly ( Figure 3A ).

Ophthalmology research trends analysis. (A) Keyword burst analysis. The red line indicates the year in which the burst of the corresponding keyword began and ended. (B) Subject category analysis. The larger subject categories indicate their greater frequency and importance, and the distance between subject categories indicates how closely they collaborate. The lines between subject categories indicate the collaboration between the subject categories at either end, with the color of the different lines representing the collaboration time in the different subject categories and the thickness representing the degree of collaboration closeness. The color of the temporal rings represents the occurrence of that subject category in different years, the thicker the corresponding temporal rings, the more frequently it occurs, with the time scale at the bottom right.

In terms of subject categories, the top three subject categories with the highest volume of ophthalmology-related research publications were medicine general internal ( n = 1,138, 10.87%), clinical neurology ( n = 482, 4.604%), and surgery ( n = 368, 3.515%) ( Table 2 ). The subject categories of ophthalmology research were divided into two types: one was the traditional ophthalmology-related subject categories, such as medicine general internal, clinical neurology, and surgery, and the other one was the non-ophthalmology-related subject categories, such as engineering, computer science, and chemistry. The analysis of subject category collaboration relationships indicated that over time more collaborative relationships had emerged between non-ophthalmology-related subject categories ( Figure 3B ).

Subject categories in ophthalmology from 2017 to 2021.

Research in the field of ophthalmology showed a year-on-year increase in the number of articles published in the last 5 years, with the most published country being the United States and the most prolific journal being the Ophthalmology. The top 25 high-impact articles worldwide were cited more than 150 times per article. A total of four research hotspots were identified: epidemiological characteristics and treatment modalities of diseases such as glaucoma and diabetic retinopathy, artificial intelligence and fundus imaging technology, COVID-19-related telemedicine, and screening and prevention of eye diseases. Cross-talk between different non-ophthalmology subject categories was also an important trend in ophthalmology.

The annual publication volume, country distribution, and journal distribution of the ophthalmology research articles revealed a global overview of research output in the field of ophthalmology. The output of ophthalmology research showed an increasing trend in the last 5 years, suggesting that the socioeconomic input and scientific output of the subject area were also developing ( 20 ). The individual contributions of some countries to ophthalmology research were previously reported, but there were limitations on the overall evaluation of all countries' contributions to ophthalmology research and of country collaboration ( 13 – 17 ). This study showed that the predominant countries in ophthalmology research included the United States, the United Kingdom, and India, and countries such as Germany, China, and Australia also played an important role in the contribution. Several stable collaborative networks have been formed between countries, which can facilitate cross-border research data sharing and the globalization of scientific research. The top five most published journals showed that ophthalmology research was mainly focused on clinical ophthalmology (Ophthalmology, BMJ Case Reports), basic ophthalmology research (Investigative Ophthalmology and Visual Science) and neuro-ophthalmology (Journal of Neuro-Ophthalmology, Ophthalmology Retina).

The high-impact articles in ophthalmology indicated that researchers in the field of ophthalmology were primarily concerned with ophthalmological health or disease states, as well as ophthalmological technologies and applications. In terms of health or disease conditions, age-related macular degeneration ( 21 – 24 ), glaucomatous optic neuropathy ( 25 , 26 ), corneal blindness ( 27 ), and other blinding eye diseases occupied important research positions. Research directions such as screening for diabetic retinopathy ( 28 , 29 ), preventing myopia ( 30 ), optimizing visual outcomes, and controlling complications after IOL implantation following cataract surgery were dedicated to the active identification, management, and control of disease risk factors, making the eye disease controllable and manageable ( 31 , 32 ). In addition, researchers were also concerned with the management of Behcet's syndrome ( 33 ) and COVID-19 infection prevention in ophthalmology ( 34 ). In ophthalmology-related technologies, the frontiers were artificial intelligence algorithms ( 23 , 25 , 26 , 35 – 38 ), new pathways for drug delivery ( 39 , 40 ), and new materials for therapy ( 41 ). In ophthalmology-related applications, the pioneering applications were optical coherence tomography ( 23 , 24 , 35 , 42 – 44 ), stem cell therapy, and tissue repair ( 45 ).

After clustering the high-frequency keywords in the past 5 years, four research hotspots in the field of ophthalmology were obtained. First, the epidemiological characteristics and treatment modalities of diseases such as glaucoma and diabetic retinopathy were the hot topics of ophthalmology research. The emergence of these hot topics was consistent with the increasing prevalence of systemic chronic diseases such as diabetes in the last 5 years, and several studies have revealed associations and common biomarkers of ophthalmology and systemic diseases ( 46 – 49 ). More future work needs to further focus on the diagnosis and optimal treatment strategies for blinding diseases associated with systemic conditions ( 50 ). Moreover, deep learning algorithms that could rapidly and non-invasively identify pathological features of eye diseases joined ophthalmology research ( 23 ). Deep learning algorithms could classify age-related cataract types based on slit-lamp photographs, and fully automated AI-based screening systems had been approved for the use in diabetic retinopathy ( 37 , 51 ). Furthermore, the emergence of the COVID-19 pandemic brought about an increase in the length of patient visits due to disease control and health-related problems associated with COVID-19 infections, which had a dramatic impact on ophthalmology health care. On the one hand, the close contacts physicians need when attending to patients could increase the risk of cross-infection between patients or between health care workers and patients, resulting in infection control to be optimized in ophthalmology practice. On the other hand, the need for timely intervention for patients was driving the development of telemedicine during the pandemic ( 34 , 52 ). Finally, the development of diagnostic technology has driven ophthalmology research toward early screening and disease prevention.

The keywords that were still bursting until 2021 were research trends. The keywords “neural networks,” “pharmacokinetics,” “automated detection,” and “retinal images” in this part of the keyword list were consistent with the hot research directions obtained by keyword clustering. Other keywords that had burst to 2021 could be newly emerging keywords that had not yet had time to be highly cited, were hotspots for research in ophthalmology, and were likely to continue to be of interest for some times to come. Concerning the disciplinary analysis, the analysis of this study revealed that there was extensive cross-collaboration in various basic areas of non-ophthalmology-related research. Knowledge from non-ophthalmology fields is likely to be more involved in ophthalmology research.

Strengths of the study include a global view of research forces in ophthalmology from a wide range of the literature. Additional study strengths include the revealing of highly cited documents in ophthalmology that provide useful information for researchers. Outcome measures addressed the global research force contributions, research hotspots, and research trends of ophthalmology research, providing an in-depth study of the field of ophthalmology.

Only data from the Web of Science Core Collection database were included in this study, but the Web of Science Core Collection database, as a citation database, already contained comprehensive data on the articles and corresponding citations, which was sufficient for capturing the overall development of the scientific field. In addition, the results of the analysis by the visualization software may include some repetitive and meaningless information. We tried to identify some of the hot topics that were influencing ophthalmology research, so the raw data had been further filtered to remove irrelevant or meaningless words.

In conclusion, this study provided a comprehensive analysis of ophthalmology-related research based on the Web of Science Core Collection database. The hotspots in ophthalmology research were epidemiology, prevention, screening, and treatment of ocular diseases, as well as artificial intelligence and fundus imaging technology and telemedicine. Research trends in ophthalmology research were artificial intelligence, drug development, and fundus diseases. There was an extensive cross-talk of ophthalmology-related research in various basic areas. Knowledge from non-ophthalmology fields is likely to be more involved in ophthalmology research.

Data availability statement

Author contributions.

ZL and GJ designed the study and provided a critical review for the manuscript. YT and WZ wrote the manuscript. YT, WZ, YZ, BZ, YY, and WL collected and analyzed the data. All authors contributed to the article and approved the submitted version.

This study was supported by the National Natural Science Foundation of China (81873675), the Guangdong Basic and Applied Basic Research Foundation (2022A1515011181), the Teaching Reform Research Program of Sun Yat-sen University (JX3030604024), and the Youth Project of State Key Laboratory of Ophthalmology (2021QN02).

Conflict of interest

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Publisher's note

All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.

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COVID-19 Virus Could Damage Vision

The blood-retinal barrier is designed to protect our vision from infections by preventing microbial pathogens from reaching the retina where they could trigger an inflammatory response with potential vision loss. But researchers at the University of Missouri School of Medicine have discovered the virus that causes COVID-19 can breach this protective retinal barrier with potential long-term consequences in the eye.

Pawan Kumar Singh, PhD , an assistant professor of ophthalmology, leads a team researching new ways to prevent and treat ocular infectious diseases. Using a humanized ACE2 mice model, the team found that SARS-CoV-2, the virus that causes COVID-19, can infect the inside of the eyes even when the virus doesn’t enter the body through the surface of the eyes. Instead, they found that when viruses enter the body through inhalation, it not only infects organs like lungs, but also reaches highly protected organs like eyes through the blood-retinal barrier by infecting the cells lining this barrier.

 “This finding is important as we increase our understanding of the long-term effects of SARS-CoV-2 infection,” said Singh. “Earlier, researchers were primarily focused on the ocular surface exposure of the virus. However, our findings reveal that SARS-CoV-2 not only reaches the eye during systemic infection but induces a hyperinflammatory response in the retina and causes cell death in the blood-retinal barrier. The longer viral remnants remain in the eye, the risk of damage to the retina and visual function increases.”

Singh also discovered that extended presence of SARS-CoV-2 spike antigen can cause retinal microaneurysm, retinal artery and vein occlusion, and vascular leakage. 

“For those who have been diagnosed with COVID-19, we recommend you ask your ophthalmologist to check for signs of pathological changes to the retina,” Singh said. “Even those who were asymptomatic could suffer from damage in the eyes over time because of COVID-19 associated complications.”

While viruses and bacteria have been found to breach the blood-retinal-barrier in immunocompromised people, this research is the first to suggest that the virus that causes COVID-19 could breach the barrier even in otherwise healthy individuals, leading to an infection that manifests inside the eye itself. Immunocompromised patients or those with hypertension or diabetes may experience worse outcomes if they remain undiagnosed for COVID-19 associated ocular symptoms.

“Now that we know the risk of COVID-19 to the retina, our goal is to better understand the cellular and molecular mechanisms of how this virus breaches the blood-retinal barrier and associated pathological consequences in hopes of informing development of therapies to prevent and treat COVID-19 induced eye complications before a patient’s vision is compromised,” Singh said.

This groundbreaking study entitled “ SARS-CoV-2 infects cells lining the blood-retinal barrier and induces a hyperinflammatory immune response in the retina via systemic exposure ” was recently published in PLOS Pathogens. In addition to Singh, the research team from the University of Missouri School of Medicine included Vaishnavi Balendiran, MD, vitreoretinal surgery fellow; Monu Monu and Faraz Ahmad, post-doctoral fellows in the Department of Ophthalmology; and Rachel M. Olson, PhD, Chief Scientific Officer, Laboratory for Infectious Disease Research at the College of Veterinary Medicine.

This research was supported through fundings from the University of Missouri and the National Institutes of Health (NIH)/National Eye Institute (NEI) grant R01EY032495.

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Research Topics

The Department of Ophthalmology and Visual Sciences offers medical students and residents a variety of research opportunities. Please browse the basic science, translational and clinical research projects currently underway below.

Research Topic: Corneal endothelial health judged by endothelial image analysis

Description.

Endothelium is critical for dehydrating the cornea and keeping it clear. With loss of its barrier and pump function, the cornea swells and corneal transplantation may be needed.

Changes in the number, shape and size of the cells may predict loss of function.

Key Research Question/Hypothesis 

Effect of drugs, surgery, devices, and preservation media on the endothelium.

Images of the endothelium captured with either a specular or confocal microscope that can take repeated pictures of the endothelial cells non-invasively in patients. Once images are captured, they can be analyzed with special software in the Cornea Image Analysis Reading Center (CIARC) of the Department.

Student learn these techniques working with both patients and technicians, depending on the project.

Ongoing projects.

Status of IRB/IACUC approval

Image analysis studies in CIARC approved; ongoing projects have IRB approval. If launching a new project, IRB approval will need to be obtained.

Prospects for Publishing and Presenting

Excellent; we have a long track record of publications in major journals and presentations at national and international conferences.

Contact Information

Tanisha Rankins

Secretary to Dr. Jonathan Lass

• Email:  [email protected]  
• Phone: 216.983.5164

Research Topic: Retinopathy of Prematurity and other Pediatric Studies

Effect of low birth weight on the eye’s development.

Data analysis, chart review.

Several ongoing projects—long-term data collection.

Current study has IRB approval. Any new studies will need IRB approval.

Excellent; the data base study has been presented at ARVO and is in preparation for publication in a major pediatric journal.

Dr. Faruk Orge

• Email:  [email protected]
• Phone: 440.684.1743

Research Topic: Cholesterol and function of the retina

Cholesterol is essential for life in mammal. Yet, if it is chronically in excess, it is a risk factor for cardiovascular and Alzheimer's disease and likely age-related macular degeneration.

To delineate the putative link between cholesterol and age-related macular degeneration.

Characterization of retinal function of mice deficient in different enzymes involved in cholesterol elimination. Animals are assessed by optical coherence tomography, electroretinography, fluorescein angiography and optomotor response.

Students learn these techniques working with post-doctoral researchers responsible for these projects.

All studies are approved by the IACUC.

Dr. Irina Pikuleva

• Email:  [email protected]
• Phone: 216.368.3823

Research Topic: Contact Lens Related Complications

Ongoing clinical trials related to corneal infiltrative events associated with daily or extended wear of soft contact lenses. Fungal and bacterial biofilm-contact lens models and susceptibility to contact lens care products.

Assessment of sub-clinical corneal inflammation with confocal microscopy. Assessment of bacterial endotoxin and relationship to infiltrative events with soft lenses.

• Ocular and lens cultures for assessment of bioburden
• Reading/Assessment of stored confocal images
• Collection of worn lenses for biofilm formation
• Lab Assays (in conjunction with Dr. Pearlman’s lab) for endotoxin on lens surfaces or within solution

Active approved IRB protocols exist for current clinical trials on infiltrative events, biofilm studies, and assays of previously collected lenses, tears and images.

Excellent chance for authorship on investigator initiated studies of biofilm and endotoxin assays. Listing of authors will follow standard publishing guidelines. 

Other corporate-funded work may or may not allow authorship.

Dr. Loretta Szcztoka-Flynn

• Email:  [email protected]

Research Topic: Mechanisms of retinal degenerations

How do mutations in the light receptor rhodopsin cause retinal degenerations like retinitis pigmentosa? How does the retina protect against oxidative stresses that can lead to retinal degenerations such as retinitis pigmentosa and age-related macular degeneration?

A multi-disciplinary approach is employed that includes biochemistry, molecular biology, animal models and biophysics.

All animal studies have approved IACUC protocols.

Excellent with track record of publications in major journals and presentations at national and international conferences.

Information about the laboratory can be found by browsing the Park Lab webpage.

Study links sleep apnea severity during REM stage to verbal memory decline

Novel findings among elders at risk for alzheimer's open door to personalized interventions.

A research team led by the University of California, Irvine has revealed the link between the frequency of sleep apnea events during the rapid-eye-movement stage and the severity of verbal memory impairment in older adults at risk for Alzheimer's disease. Verbal memory refers to the cognitive ability to retain and recall information presented through spoken words or written text and is particularly vulnerable to Alzheimer's.

The study, recently published online in the journal Alzheimer's Research & Therapy , discovered a specific correlation between the severity of sleep apnea -- when breathing pauses while an individual is sleeping -- and diminished cognition. Higher ratios during REM compared to non-REM stages were associated with worse memory performance.

"Our findings identified the specific features of sleep apnea that are associated with memory, which is important because clinically, events occurring during REM sleep are often overlooked or minimized," said co-corresponding author Bryce Mander, UC Irvine associate professor of psychiatry & human behavior. "Most hours of sleep are non-REM, so the overall averages of apnea severity can look much lower than what is typically observed during REM sleep. This means that someone at risk can be misdiagnosed and undertreated because current evaluation standards are not focused on sleep-stage-specific apnea severity."

"Furthermore," said co-corresponding author Ruth Benca, professor and chair of psychiatry and behavioral medicine at Wake Forest University School of Medicine, "we found that women are more likely to have a greater proportion of their apneic events in REM sleep in comparison to men, which could potentially be contributing to their greater risk for Alzheimer's disease."

The study involved 81 middle-aged and older adults from the Wisconsin Alzheimer's Disease Research Center with heightened risk factors, of whom 62 percent were female. Participants underwent polysomnography -- a comprehensive test that records brain waves, eye movements, muscle activity, blood oxygen levels, heart rate and breathing during sleep -- and verbal memory assessments. Results showed apnea events during REM to be a critical factor contributing to verbal memory decline, especially among individuals with a genetic predisposition to Alzheimer's and those with a parental history of the disease.

"Our findings highlight the intricate relationship among sleep apnea, memory function and Alzheimer's risk," Mander said. "Identifying and addressing REM-specific events are crucial for developing proactive, personalized approaches to assessment and treatment that are tailored to individual sleep patterns."

The team also included lead author Kitty K. Lui, a graduate student in the San Diego State University/University of California, San Diego joint doctoral program in clinical psychology, and faculty and graduate students from UC Irvine, UC San Diego, the Wisconsin Alzheimer's Disease Research Center and the University of Kentucky.

This work was supported by the National Institute on Aging under grants R56 AG052698, R01 AG027161, R01 AG021155, ADRC P50 AG033514, R01 AG037639 and K01 AG068353; by the National Institutes of Health's Ruth L. Kirschstein National Research Service Award F31 AG048732; and by the National Center for Advancing Translational Sciences' Clinical and Translational Science Awards Program under grant UL1TR000427.

• Sleep Disorder Research
• Insomnia Research
• Alzheimer's Research
• Diseases and Conditions
• Sleep Disorders
• Obstructive Sleep Apnea
• Alzheimer's
• Alzheimer's disease
• Memory bias
• Rapid eye movement
• Sleep apnea
• Dementia with Lewy bodies

Story Source:

Materials provided by University of California - Irvine . Note: Content may be edited for style and length.

Journal Reference :

• Kitty K. Lui, Abhishek Dave, Kate E. Sprecher, Miranda G. Chappel-Farley, Brady A. Riedner, Margo B. Heston, Chase E. Taylor, Cynthia M. Carlsson, Ozioma C. Okonkwo, Sanjay Asthana, Sterling C. Johnson, Barbara B. Bendlin, Bryce A. Mander, Ruth M. Benca. Older adults at greater risk for Alzheimer’s disease show stronger associations between sleep apnea severity in REM sleep and verbal memory . Alzheimer's Research & Therapy , 2024; 16 (1) DOI: 10.1186/s13195-024-01446-3

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Insights in Surgical Ophthalmology: 2023

Systematic Review 11 December 2023 Meta-analysis of Molteno glaucoma implants and Ahmed glaucoma valves: insights into efficacy and safety for complex glaucoma Adarsh Raja ,  7 more  and  Muhammad Ahmed 655 views 0 citations

Clinical Trial 11 January 2023 Outcomes of the advanced visualization in corneal surgery evaluation trial; a non-inferiority randomized control trial to evaluate the use of intraoperative OCT during Descemet membrane endothelial keratoplasty Marc B. Muijzer ,  5 more  and  Robert P. L. Wisse 737 views 2 citations

Loading... Review 26 August 2022 The role of the lateral tarsal strip procedure in modern ophthalmic plastic surgery—A review Adam Kopecký ,  1 more  and  Ludwig M. Heindl 9,360 views 0 citations

Loading... Original Research 17 August 2022 Safety and anterior chamber structure of evolution implantable Collamer lens implantation with short white-to-white corneal diameters Xun Chen ,  6 more  and  Xingtao Zhou 1,918 views 2 citations

Specialty Grand Challenge 04 July 2022 Grand Challenges and Opportunities in Surgical Ophthalmology: Together for a Shared Future Yongwei Guo ,  7 more  and  Ludwig M. Heindl 4,717 views 1 citations

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Current Topics in Eye Research

This article is only available in the PDF format. Download the PDF to view the article, as well as its associated figures and tables.

This series continues to present basic research topics to the ophthalmic community. Some of the chapters are difficult reading for anyone not well grounded in biochemistry or molecular biology. The article most pertinent to clinical ophthalmology is by Ronald A. Laing of Boston University on specular microscopy of the cornea. The chapter by Eugene Copeland of Woods Hole, Mass, on the eyes of fish is also fascinating reading. Who would have thought only ten years ago that the oxygen tension in the retinal area of fish is ten times that of the blood in other organs (the swim bladder excepted). The chapter on accommodation in vertebrates by J. G. Sivak of Waterloo, Ontario, is as complete a survey as you can hope for.

Blodi FC. Current Topics in Eye Research. Arch Ophthalmol. 1980;98(12):2248. doi:10.1001/archopht.1980.01020041100038

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