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AIM: To explore the neuro-ophthalmological characteristics of acute macular neuroretinopathy(AMN)after SARS-CoV-2 infection.METHODS: A total of 8 patients(14 eyes), including 6 females and 2 males, who were diagnosed with AMN in the neuro-ophthalmology department of Xi'an No.1 Hospital(The First Affiliated Hospital of Northwest University)from December 27, 2022 to February 1, 2023 were included in the study. All patients had a history of SARS-CoV-2 infection before the disease, and the results of best corrected visual acuity(BCVA), non-contact indirect intraocular pressure measurement, fundus color photography, near infrared(IR), spectral-domain optical coherence tomography(SD-OCT), OCT angiography(OCTA), fundus fluorescein angiography(FFA), indocyanine green angiography(ICGA), visual field, visual evoked potential(VEP), and electroretinogram(ERG)were collected. Furthermore, the neuro-opthalmology characteristics of the included patients were analyzed and summarized.RESULTS: The included 8 patients aged from 20 to 43, with an average age of(30±6.63)years old. The patients had a history of SARS-CoV-2 infection 3 to 11(mean 5±3.51)d before the disease, and 6 out of 8 patients developed visual symptoms within 5 d of infection with SARS-CoV-2, with manifestated with decreased vision or visual scotoma. The visual acuity varied from 0.08 to 1.0, with visual field defect characterized by central, paracentral or peripheral scotoma. VEP showed prolongation latency of P100 or P2, and ERG revealed impaired function of retinal photoreceptor cell. In the early stage of the disease, the size and shape of early visual acuity, visual field, and extraretinal lesions in patients with AMN associated with SARS-CoV-2 infection may not match, and the lower the visual acuity, the later the VEP peaks.CONCLUSION: The neuro-ophthalmic features of SARS-CoV-2 infection-associated AMN require the attention of clinicians. In addition to multi-mode fundus imaging, clinicians should use a variety of methods to comprehensively evaluate visual function and prognosis of patients.

目的 探讨动脉内溶栓（intra-arterial thrombolysis，IAT）治疗视网膜中央动脉阻塞（central retinal artery occlusion，CRAO）患者的临床特征及功能性视觉恢复情况。 方法 纳入2018年1月—2023年8月西北大学附属第一医院神经内科和神经眼科连续收治的非动脉炎性CRAO患者，根据入院后是否进行IAT治疗分为IAT组和非IAT组。功能性视觉定义为 视力≥20/100。比较分析两组患者的临床特征和不同时间段（入院、出院时和出院1个月时）功能性视觉恢复情况。 结果 共纳入131例（131只眼）非动脉炎性CRAO患者，男性93例（71.0%），平均年龄为（61.6±12.6）岁， 其中IAT组57例（43.5%），非IAT组74例（56.5%）。与非IAT组患者相比，IAT组患者年龄更低[（58.4±12.5）岁 vs.（64.1±12.2）岁，P=0.011]、合并卒中病史者比例更低[10（17.5%）vs. 25（33.8%）， P=0.037]、发病至就诊时间更短[10.0（6.0～24.0）h vs. 55.0（20.2～162.0）h，P＜0.001]、醒后发病者比例更高[26（45.6%）vs. 15（20.3%），P=0.002]和患侧颈内动脉血管状态更佳（无狭窄∶轻度狭窄∶中-重度狭窄∶闭塞=41∶7∶7∶2 vs. 32∶11∶21∶10，P=0.006）。IAT组患者出院1个月时功能性视觉比例较非IAT组患者更高[25（43.9%）vs. 18（24.3%），P=0.018]，而入院和出院时差异无统计学意义 （P＞0.05）。多因素logistic回归分析显示，IAT组患者出院1个月时的功能性视觉较非IAT组患者显著改善（OR 3.24，95%CI 1.08～9.69，P=0.036）。IAT组患者术中发生眼动脉痉挛2例（3.5%）、穿刺部位皮肤出血2例（3.5%）和新发脑栓塞（均为无症状性栓塞）事件4例（7.0%）。 结论 是否进行IAT治疗的CRAO患者部分临床特征存在差异，IAT治疗可显著提高CRAO患者出院1个月时的功能性视觉，且手术安全性较好。提示临床医师需重视CRAO患者的IAT治疗，以期改善患者的视觉功能。 Abstract: Objective To investigate the clinical characteristics and functional visual recovery of patients with central retinal artery occlusion (CRAO) treated with intra-arterial thrombolysis (IAT). Methods The non-arteriotic CRAO patients admitted to the Department of Neurology and Neuro-ophthalmology of the First Affiliated Hospital of Northwest University from January 2018 to August 2023 were included. They were divided into IAT group and non-IAT group according to whether IAT was performed after admission. Functional vision is defined as visual acuity≥20/100. The clinical features and functional visual recovery at different time periods (admission, discharge and 1 month after discharge) were compared and analyzed between the two groups. Results A total of 131 patients (131 eyes) with non-arteriotic CRAO were included, including 93 males (71.0%) with a mean age of (61.6±12.6) years. There were 57 patients (43.5%) in IAT group and 74 patients (56.5%) in non-IAT group. Compared with patients in non-IAT group, patients in IAT group had younger age [(58.4±12.5) years vs. (64.1±12.2) years, P=0.011], lower proportion of stroke history [10 (17.5%) vs. 25 (33.8%), P=0.037], shorter time from onset to visit [10.0 (6.0-24.0) h vs. 55.0 (20.2-162.0) h, P0.05). Multivariate logistic regression analysis showed that the functional vision of CRAO patients in the IAT group at 1 month after discharge was significantly improved compared with those in the non-IAT group (OR 3.24, 95%CI 1.08-9.69, P=0.036). In the IAT group, ophthalmic artery spasm occurred in 2 cases (3.5%), skin bleeding at the puncture site in 2 cases (3.5%), and new cerebral embolism (all asymptomatic embolism) occurred in 4 cases (7.0%). Conclusions Some clinical features of CRAO patients who were treated with or without IAT were different. IAT can significantly improve the functional vision of CRAO patients at 1 month after discharge, and the surgical safety is good. This suggests that clinicians should pay more attention to IAT in CRAO patients in order to improve their visual function.

Background: The exploration of age-related clinical features and adverse outcomes of non-disabling ischemic cerebrovascular disease (NICE) has been largely unaddressed in current research. This study aimed to analyze the differences in clinical characteristics and prognostic outcomes of NICE across various age groups, utilizing data from the Xi'an Stroke Registry Study in China. Methods: The age distribution of NICE was categorized into four groups: age ≤ 54 years, age 55–64 years, age 65–74 years, and age ≥ 75 years. Multivariate Cox logistic regression analysis was employed to evaluate the 1-year risk of outcome events in each age group of patients with NICE. A subgroup analysis was conducted to explore interaction factors influencing age-dependent outcomes in patients with NICE. Results: This study included 1,121 patients with NICE aged between 23 and 96 years, with an average age of 63.7 ± 12.2 years. Patients aged ≥ 75 years had a higher proportion of women, lower education levels, and a greater likelihood of having urban employee medical insurance. Those aged < 55 years had a higher prevalence of smoking, while individuals aged > 65 years showed a higher prevalence of comorbidities. Furthermore, there was a significant decrease in body mass index among patients aged ≥ 75 years. Laboratory tests indicated well-controlled blood lipids, liver function, and inflammation across all age groups, but renal function was notably reduced in patients with NICE aged ≥ 75 years. Adjusting for potential confounding factors revealed a significant increase in the one-year risk of all-cause mortality and poor prognosis among patients aged ≥ 75 years compared to those aged < 55 years, with no significant gender difference observed. Subgroup analysis indicated that patients with NICE who consumed alcohol were more prone to experience all-cause mortality with advancing age. Conclusions: Age significantly influences the clinical characteristics and prognostic outcomes of NICE patients. Clinicians should consider age-specific characteristics when diagnosing, treating, and developing prevention strategies. Tailored prevention and treatment strategies for different age groups can enhance prognosis and reduce adverse outcomes in NICE patients. [ABSTRACT FROM AUTHOR]

Introduction: The triglyceride-glucose (TyG) index is reported to be related to poor functional outcomes and all-cause mortality post-stroke. However, the association between TyG index and recurrent stroke after acute ischemic stroke (AIS) has not been well described. We aimed to identify whether the TyG index was associated with 1-year recurrent stroke after AIS. Methods: Baseline patient information was collected at admission, and the TyG index was calculated. Recurrent stroke events were followed up at 1, 3, 6, and 12 months after diagnosis. We then examined the association between the TyG index and risk of 1-year recurrent stroke using multivariable Cox regression models and restricted cubic spline analyses. Results: Among 2,288 participants, the mean TyG index was 8.8 ± 0.7. Those in the fourth quartile (Q4) demonstrated higher recurrent stroke risk than those in Q1 (adjusted hazard ratio [HR] = 1.63; 95% confidence interval [CI], 0.98–2.72; p = 0.059). Subgroup analysis revealed a sex-specific association between TyG index and recurrent stroke (p for interaction = 0.022). Additionally, restricted cubic splines analyses showed a nonlinear association between the TyG index and 1-year recurrent stroke. In females, patients in the Q4 had a 2.95-fold increased recurrent stroke risk than did patients in the Q1 (adjusted HR = 2.95; 95% CI: 1.09–7.94; p = 0.032); the risk increased when the TyG index was >8.73. However, no significant correlation was observed in males. Conclusion: A nonlinear association was found between the TyG index and 1-year recurrent stroke risk. Subsequently, a high TyG index could predict an increased 1-year recurrent stroke risk in female AIS patients. [ABSTRACT FROM AUTHOR]

To evaluate the value of nanopore targeted sequencing in diagnosing pneumonia pathogens. This large-scale multicentre prospective study performed in 8 hospitals across China from April to October 2022. Hospitalised patients with a diagnosis of pneumonia at admission were included. Complete clinical data were collected, and bronchoalveolar lavage fluid were obtained from each patient. These samples underwent simultaneous testing using conventional microbial testing, metagenomic next-generation sequencing, and nanopore targeted sequencing. A total of 218 patients were included. Among the 168 cases of pulmonary infection, 246 strains of pathogens were confirmed. Nanopore targeted sequencing outperformed conventional microbial testing, identifying more pathogens with a sensitivity increase of 47.9% (77.2% vs. 29.3%). Metagenomic next-generation sequencing had a sensitivity of 82.9%. Total of 70.1% patients had consistent results in both metagenomic next-generation sequencing and nanopore targeted sequencing. Nanopore targeted sequencing exhibited significantly higher sensitivity in detecting Pneumocystis jiroveci, cytomegalovirus, Mycobacterium tuberculosis, Nontuberculous mycobacteria, Streptococcus pneumoniae, and Mycoplasma pneumoniae compared to conventional microbial testing. However, metagenomic next-generation sequencing demonstrated higher sensitivity than nanopore targeted sequencing for Aspergillus (88.5% vs. 53.8%). Regarding the detection of co-infections, nanopore targeted sequencing displayed significantly higher sensitivity than conventional microbial testing (76.7% vs. 28.7%) and was on par with metagenomic next-generation sequencing (76.7% vs. 82.9%). Nanopore targeted sequencing performs equally well as metagenomic next-generation sequencing in bronchoalveolar lavage fluid for pathogen diagnosis in pneumonia, both methods showing higher sensitivity than conventional microbial testing. Nanopore targeted sequencing can be considered a reliable method for diagnosing pathogens in pneumonia. [ABSTRACT FROM AUTHOR]