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This study was designed to assess the efficacy of using povidone-iodine (PVI) 10% and levofloxacin 0.5% about one hour before cataract surgery in minimizing aqueous contamination compared with using PVI 10%. The intervention group received three drops of mixed povidone-iodine and levofloxacin (PVI/Levofloxacin) solution one hour before surgery. After making the corneal incision in cataract surgery, 0.1 cc aqueous humor sample was taken and sent for culture. We compared the intervention group and control group using t-test and chi-square test in SPSS 25(Chicago IL, USA). 147 eyes of 147 patients were analyzed. The intervention and control groups consisted of 72 and 75 patients, respectively. The Control group showed significantly more positive cultures (16 cultures: 22.2%). the intervention group had four positive cultures (5.3%). ( P -value = 0.005). Topical levofloxacin 0.5% and povidone-iodine 10% mixture showed promising results in reducing the number of bacteria in the aqueous humor.

Background This analysis evaluated aqueous humour (AH) interleukin (IL)-6 concentrations and the association between AH IL-6 and visual outcomes in patients with neovascular age-related macular degeneration (nAMD) or diabetic macular oedema (DMO) receiving anti–vascular endothelial growth factor (VEGF) monotherapy. Methods Post hoc analysis of the multicentre, double-masked, randomised HARBOR (NCT00891735) and READ-3 (NCT01077401) trials. HARBOR enrolled treatment-naïve nAMD patients. READ-3 enrolled treatment-naïve/previously treated DMO patients. HARBOR patients received ranibizumab 0.5 or 2.0 mg monthly or as needed; AH samples were collected at month 2, after two previous intravitreal injections. READ-3 patients received ranibizumab 0.5 or 2.0 mg as needed; AH samples were collected at baseline and months 3, 6, 9, and 12. Main outcome measure: association between AH IL-6 concentrations and month 24 best-corrected visual acuity (BCVA). Results In both trials (HARBOR, N  = 36; READ-3, N  = 137), patients with higher AH IL-6 concentrations had worse visual outcomes. HARBOR patients with low AH IL-6 concentrations at month 2 had a mean (95% CI) BCVA change at month 24 of +2.9 (−2.6, 8.3) letters, whereas patients with high AH concentrations had a mean (95% CI) BCVA change of −9.0 (−22.7, 4.7) letters. READ-3 patients with low AH concentrations at baseline had a mean (95% CI) BCVA change at month 12 of +9.3 (7.4, 11.3) letters, whereas patients with high AH concentrations had a mean (95% CI) BCVA change of +5.6 (2.2, 9.1) letters. Conclusions Higher IL-6 AH concentrations may predict suboptimal visual responses to anti–VEGF monotherapy in patients with nAMD/DMO.

Cataracts or clouding of the lens is the leading cause of blindness in the world. Age and diabetes are major risk factors, and with an increasing aging and diabetic population, the burden of cataracts will grow. Cataract surgery is an effective way to restore vision; however, alternatives to cataract surgery are required to reduce the looming cataract epidemic. Since it is well established that oxidative damage plays a major role in the etiology of cataracts, antioxidants have been promoted as therapies to delay and/or prevent cataracts. However, many antioxidant interventions including vitamin C have produced mixed results as anti-cataract therapies. Progress has been made towards our understanding of lens physiology and the mechanisms involved in the delivery and uptake of antioxidants to the lens which may guide future studies aimed at addressing some of the inconsistencies seen in previous animal and human studies. Of interest is the potential for vitamin C based supplements in delaying the onset of cataracts post vitrectomy which occurs in up to 80% of patients within two years. These targeted approaches are required to reduce the burden of cataract on hospitals and improve the quality of life of our aging and diabetic population.

Purpose Myopic choroidal neovascularization (CNV) is a common reason for visual impairment. This study investigated the clinical effects of repeated intravitreal injections of ranibizumab among patients with CNV secondary to pathologic myopia. Methods This study involved a single-center, non-randomized clinical prospective cohort research design including 39 patients with myopic CNV and a control group of 10 patients with cataract. Plasma and aqueous humor samples were analyzed to compare cytokine concentrations between the two groups and assess changes after intravitreal ranibizumab injections. Best-corrected visual acuity (BCVA) and central macular thickness (CMT) were also monitored. Results BCVA values and CMT varied significantly after intravitreal ranibizumab injections. The study group had significantly higher plasma concentrations of vascular endothelial growth factor (VEGF)-A and significantly lower epidermal growth factor (EGF) and angiopoietin-2 concentrations than the control group. Likewise, in the aqueous humor, the study group had significantly higher concentrations of fibroblast growth factor and significantly lower concentrations of EGF and VEGF-A than the control group. The average VEGF-A content decreased significantly after 1 and 2 months relative to the baseline. Mean VEGF-D and endoglin contents at two months were significantly reduced compared to the baseline and at 1 month. The average EGF contents were significantly higher at 2 months than the baseline. Conclusion Ranibizumab could increase the BCVA and lower the CMT and cytokines involved in angiogenesis. This study contributes to further understanding the pathogenesis of myopic CNV and promoting new drug research and development for patients with this condition.

Objective The stability of ascorbic acid (AA) in the human aqueous humor (AqH) remains unclear. This study aimed to investigate the stability of AqH AA under varying conditions (27, 4, − 20, and − 80 °C) without acidification. Results Rapid AA degradation occurred at 27 °C. At 4 °C, a significant 12.2% degradation was observed after 24 h. Storage at − 20 °C resulted in a notable 37.5% degradation after 28 days, whereas storage at − 80 °C resulted in 10.7% degradation after 28 days. Unacidified AqH samples recorded early decomposition at 27 °C and 4 °C. In conclusion, it is recommended to conduct measurements within 28 days for samples stored at − 80 °C.

Purpose This study aimed to investigate the potential of microRNAs (miRNAs) in tears, blood, and aqueous humor as biomarkers for predicting treatment response in wet age-related macular degeneration (AMD) patients undergoing anti-vascular endothelial growth factor (anti-VEGF) therapy. Methods In a single-center prospective cohort study, treatment-naïve wet AMD patients and age-matched controls were enrolled. Clinical data and miRNA levels (miR-199a-3p, miR-365-3p, miR-200b-3p, miR-195-5p, miR-335-5p, and miR-185-5p) in tears, blood, and aqueous humor were collected. Treatment response was categorized into responders and non-responders based on visual acuity and central subfield thickness. MiRNA levels were quantified using reverse-transcription PCR. Statistical analyses were performed, including ROC analysis, to evaluate predictive accuracy. Results Dysregulated miRNA profiles were observed in wet AMD tears and blood compared to controls. Specifically, miR-199a-3p, miR-195-5p, and miR-185-5p were upregulated, while miR-200b-3p was downregulated in tears. All six miRNAs were elevated in wet AMD blood samples. Notably, responders showed higher tear expression of miR-195-5p and miR-185-5p. Combining these miRNAs yielded the highest predictive power (AUC = 0.878, p  = 0.006) for anti-VEGF responders. Conclusions Dysregulated miRNA profiles in tears and blood suggest their potential as biomarkers for wet AMD. MiR-195-5p and miR-185-5p in tears demonstrate predictive value for anti-VEGF treatment responders. This study underscores the non-invasive prediction potential of miRNA tear analysis in wet AMD treatment responses.

Background Commercial tobramycin ophthalmic solution is frequently used empirically to treat ocular disorders in equines, despite being primarily formulated for use in humans. It has been noted that tobramycin MIC90 concentration (minimal inhibitory concentration to 90% of microbial growth) rapidly declined following topical administration. It is hypothesized that adjustment of the pH of the empirically used tobramycin ophthalmic solution -prepared for human use- with the pH of the tears of donkeys, could increase the bioavailability of the drug and subsequently improve its penetration to the aqueous humor. Therefore, this study aimed to evaluate the impact of pH adjustment of the empirically used tobramycin ophthalmic solution on MIC90 concentration in tears and aqueous humor of donkeys ( Equus asinus ). The study was conducted on six ( n  = 6) clinically healthy donkeys. In each donkey, one eye was randomly selected to receive 210 µg tobramycin of the commercial tobramycin (CT) and used as a positive control (C group, n  = 6). The other eye (treated eye) received 210 µg of the modified tobramycin ophthalmic solution (MT) (T group, n  = 6). Tears and aqueous humor samples were collected 5-, 10-, 15-, 30- min, and 1-, 2-, 4-, and 6 h post-instillation. Results Modifying the pH of the empirically used commercial tobramycin ophthalmic solution in donkeys at a pH of 8.26 enhanced the drug’s bioavailability. The MIC90 of the most hazardous bacteria isolated from equines’ eyes such as Pseudomonas aeruginosa (MIC90 = 128 µg/ml) and Staphylococcus aureus (MIC90 = 256 µg/ml) was covered early (5 min post-instillation) and over a longer period in donkey tears (239–342 min) and aqueous humor (238–330 min) with the modified tobramycin solution. Conclusions Adjustment of the pH of the commercial tobramycin ophthalmic solution, empirically used by veterinarians to treat donkeys’ ophthalmic infections at a pH of 8.26, isotonic with the donkeys’ tears pH, resulting in higher concentrations of tobramycin in tears and aqueous humor for a longer time.

Low influenza vaccination rates in China pose a serious public health threat. The vaccination prevents infection, but widespread vaccine hesitancy remains a significant barrier. Short, animated storytelling videos may help by conveying health messages in an engaging, culturally neutral format that transcends literacy barriers. We aim to investigate whether scalable, short, animated storytelling videos, using different storytelling techniques-humor, analogy, and emotion-could reduce influenza vaccine hesitancy among Chinese adults. In this single-blind, parallel-group, randomized controlled trial, we recruited adults in China through quota sampling. Participants were randomly assigned to 1 of 3 short, animated storytelling video intervention groups, each using a different storytelling technique (humor, analogy, or emotion) or a control group in a 1:1:1:1 ratio. After watching the video or being assigned to the control group, participants completed the questionnaire. Influenza vaccine hesitancy was compared between each intervention group and the control group, respectively, as well as between different intervention groups, with P values adjusted for multiple comparisons. A total of 12,000 participants met the inclusion criteria. Participants in any scalable animated storytelling video group showed lower hesitancy than controls (mean difference -0.41, 95% CI -0.60 to -0.23; P<.001). Specifically, both intervention groups with humor (video A) and analogy (video B) storytelling techniques resulted in significantly lower hesitancy compared to the control group, with mean differences of -0.44 (99.17% CI -0.75 to -0.13; P<.001) for video A and -0.55 (99.17% CI -0.86 to -0.24; P<.001) for video B. However, the intervention group with emotion video (video C) did not show significant effects compared to the control group, nor were there significant differences compared with the other 2 intervention groups. In subgroup analyses, video A effectively reduced vaccine hesitancy among urban residents and participants from southern and southwestern China. Video B was effective within participants aged 40-49 years, both sexes, both urban and rural residents, those with a college education or higher, households with an income of CN ¥90,000-180,000 (the 2021 official exchange rate of CN ¥1=US $0.155 was used for reference, based on World Bank data), and participants from the southwestern region and the western economic belt. Our study showed that storytelling videos, especially with humor and analogy, reduced hesitancy among Chinese adults. Our results highlight the importance of selecting appropriate narrative strategies for health communication, particularly for vaccine hesitancy across various demographic and regional contexts. Given the scalability, low cost, and high accessibility of short, animated storytelling videos, integrating them into national health campaigns could enhance vaccine uptake and mitigate hesitancy in underserved populations. Future research should explore the long-term impacts of these interventions on vaccine uptake and their adaptability to other preventive health measures.

Conflicts between ICU staff and patient/relatives are common and are a source of additional stress in an already tense environment. These conflicts vary from disagreements to serious controversies, which may lead to legal process or even violence. Unsuccessful communication is recognised as a common denominator for such disagreements. Both conflict prevention and conflict management/resolution rely on understanding and addressing the main reasons behind it. Using a case-example, we propose a ‘mentalisation-based’ approach to family meetings may improve communication and decrease conflict.