Abstract:AIM: To analyze the findings of retinopathy of prematurity(ROP)exam in Tianjin, and study the impact of pulmonary surfactant Curosurf and nasal continuous positive airway pressure(NCPAP)in ROP.

METHODS: A multicenter retrospective review. Totally 2894 preterm infants(1592 males, 1302 females)from several hospitals in Tianjin were screened from January 2009 to December 2013. Demographic information, ophthalmic outcomes and possible systemic risk factors were recorded. Gestation age, birth weight, oxygen supplementation, Curosurf and NCPAP were used to estimate risk factors for ROP.

RESULTS: ROP was found in 448 eyes of 224 patients(7.7%). Among which, severe ROP developed in 98 eyes of 49 patients(21.9%). There was significant statistical difference in respiratory distress syndrome(RDS), NCPAP, and Curosurf usage between control and ROP groups(P<0.001). Multiple logistic regression analyses of ROP indicated that lower birth weight, younger gestational age, and oxygen supplementation were the risk factors leading to ROP. As the usage rate of Curosurf and NCPAP increased year by year, the usage of oxygen supplementation gradually decreased, the incidence of ROP was also on the decline.

CONCLUSION: Low birth weight, young gestational age and oxygen supplementation are associated with ROP. The use of Curosurf and NCPAP may be the factor that reduces the occurrence of ROP.

Abstract:AIM: To investigate diffusion tensor imaging(DTI)evaluations of visual pathways in patients with acute and chronic optic neuritis(ON), and investigate the correlations between visual disability, retinal nerve fiber layer thickness(RNFLT)and diffusion index changes.

METHODS: We performed DTI in 26 patients and 13 healthy controls. Patients had acute ON in 17 eyes, chronic ON in 20 eyes and 15 unaffected eyes. In all participants, the visual afferent system was evaluated with neuro-ophthalmological examinations, optical coherence tomography(OCT), visual evoked potential(VEP), orbital and cranial MRI.

RESULTS: Fractional anisotropy(FA)in the optic nerves was lower in patients with acute ON and chronic ON than controls(P=0.28). Mean diffusivity(MD)in the optic nerves was higher in patients with acute and chronic ON than the unaffected eyes of patients and controls(P<0.01). Retinal nerve fiber layer thickness, P100 amplitude and latency and visual acuity(VA)were significantly different between patient and control groups(P<0.01). Optic chiasm MD values were higher in the patient group compared to the control group(P=0.011). FA and MD measured in the optic tracts significantly were different between groups(P=0.032, P=0.013, respectively). In the correlation analysis, fractional anisotropy in the optic nerves was correlated with P100 latency in acute ON(P=0.021). Mean diffusivity was correlated with RNFLT, visual acuity and P100 latency(P<0.05). Fractional anisotropy was correlated with mean diffusivity and visual acuity, and, mean diffusivity was correlated with P100 amplitude and RNLF thickness in chronic ON(P<0.05). Reduction in visual acuity was correlated with increase in mean diffusivity and decrease in fractional anisotropy(P<0.05).

CONCLUSION: DTI can demonstrate abnormalities in a tissue that appears normal in orbital MRI. Our results suggested that DTI derived measurements correlate with visual disability and tissue injury and therefore they are important from a clinical point of view and also in understanding the pathological processes.

Abstract:AIM: To evaluate the prevalence of allergic disorders and skin prick test sensitivity to different allergens among patients with pterygium.

METHODS: Sixty two patients with pterygium and equal number of age/ sex matched healthy controls were enrolled in this study. All patients and controls examined by an ophthalmologist and allergist. Skin prick test performed with a battery of common allergens and serum total IgE level determined by ELISA method.

RESULTS: Prevalence of allergic rhinoconjunctivitis was significantly higher in patient group(19.3% vs 3.2%, P=0.002)but there was no significant differences in other allergies and symptoms between two groups. The rate of skin reactivity to at least one allergen was significantly higher in pterygium group than healthy controls(38.7% vs 6.5%, P=0.003). Cockroach and house dust mites were the most prevalent allergens among patients(16.1% and 12.9%).

CONCLUSION: The results of current study showed higher prevalence of rhinoconjunctivits and skin prick sensitivity to allergen among pterygium patients. This may has implication in prevention and treatment of pterygium.

Abstract:AIM: To invesitigate the effect of invigorating blood and dissipating masses traditional Chinese medicine compound drug-containing plasma on the proliferation of rabbit retinal pigment epithelium(RPE)cells treated with platelet derived growth factor(PDGF).

METHODS: Primary cells of RPE cells were obtained by enzymatic digestion, and the primitive culture and subculture of RPE cells were proceeded; prepared blood plasma-contained traditional Chinese medicine compound drug-containing plasma; the fourth genertation rabbit RPE cells were selected as the experimental cells by PDGF of low, medium and high doses(5μg/L, 10μg/L, 20μg/L)for 48h. Suitable concentration was detected and selected in cells experiment by using CCK-8 method. Establishing rabbit model of RPE cell proliferation treated with PDGF. The experimental groups were blank control group(DMEM), normal plasma group, PDGF(10 μg/L)group, PDGF(10 μg/L)+ AG1296(10 μmol/L)group, PDGF(10 μg/L)+ 10% drug-containing plasma, PDGF(10 μg/L)+ 20% drug-containing plasma. Respectively, transwell method was used to determine the migration of rabbit RPE cells after 24h intervention in each group; CCK-8 was used to determine the cell viability OD value of rabbit RPE cells after 48h of intervention in each group.

RESULTS: The plasma containing 10% and 20% concentration of invigorating blood and dissipating masses traditional Chinese medicine compound drug can effectively inhibit cell viability and cell migration of RPE cells treated with PDGF.

CONCLUSION: We found the certain concentration of invigorating blood and dissipating masses traditional Chinese medicine compound drug can effectively inhibit cell viability and cell migration of RPE cells treated with PDGF, which may be an effective treatment for proliferative vitreoretinopathy and provide a new way to study the mechanism of proliferative vitreoretinopathy.

Abstract:AIM: To explore the role of lipocalin-2(LCN-2)in retinal angiogenesis in vitro by observing its effects on proliferation, migration and capillary-like tube formation of murine retinal vascular endothelial cells(RVECs).

METHODS: Well cultured RVECs were divided to different groups which were treated with 0, 5, 10 μmol/L LCN-2 for 48h, respectively. Cell proliferation, migration and tube formation were detected by using the EDU assay, transwell assay and matrigel assay, respectively.

RESULTS: The cell proliferation rate was promoted in both low and high dose of LCN-2 groups compared to the control cells(P<0.05). The number of migrated cells in both LCN-2 groups was significantly larger than that of the control group(P<0.05). The number of capillary-like tube structures of both LCN-2 groups was significantly larger than that of the control cells(P<0.05). In addition, cell proliferation, migration and tube formation were all increased with the increase of LCN-2 concentration.

CONCLUSION: LCN-2 could obviously promote the angiogenesis capacity of RVECs, suggesting that LCN-2 is an important pro-angiogenic factor in retinal angiogenesis.

Abstract:AIM: To research the protection of Mcc950, the inhibitor of NLRP3, against the inflammatory injury to human retinal pigment epithelium cell line ARPE-19.

METHODS: Cultured cell line ARPE-19 was divided into control group, H₂O₂ treating group, Mcc950 treating group and Mcc950+H₂O₂ treating group. Different concentrations of H₂O₂ and Mcc950 were used to treat the cells. Cell activity was detected by using CKK8 and proper experimental concentration of H₂O₂ and Mcc950 were determined. After the treatment, the concentration of IL-1β were detected by using ELISA. The change of NLRP3 related proteins were detected by Western blot. And cell apoptosis was examined by TUNEL stain.

RESULTS: Cell ability was gradually decreased along with the increasing treating concentrations of H₂O₂. Cell ability showed statistical difference when the concentration of H₂O₂ arrived 400μmol/L. With the concentration of 0.1 and 1μmol/L, Mcc950 had no effect on cell ability. So we chose 400μmol/L H₂O₂ and 1μmol/L Mcc950 as the experimental concentrations. Compared with the normal control group, the cell viability in the H₂O₂ treating group was significantly reduced, the IL-1β in the supernatant was significantly increased, and the apoptosis rate was significantly increased, with statistically significant differences(P<0.05). In Mcc950+H₂O₂ treating group, cell viability was significantly increased, the IL-1β in the supernatant and the apoptosis rate were significantly decreased(P<0.05). By Western blot, after treated with 400μmol/L H₂O₂, the IL-1β, NLRP3, pro-caspase1 and caspase1 were obviously increased compared to control group. After treated with Mcc950, the NLRP3 and pro-caspase1 still were at high level, the expression of caspase1 was suppressed, which indicated that Mcc950 effectively inhibited the activation of NLRP3 inflammasome consequently disturbed the formation of caspase1.

CONCLUSION: Mcc950 can inhibits the function of NLRP3, leading to increasing of the cell ability and decreasing of the cell apoptosis.

Abstract:AIM: To observe the effect of external scleral ring ligation and external scleral ring ligation combined with scleral external pressure on the ocular structure and intraocular pressure of patients with rhegmatogenous retinal detachment(RRD).

METHODS:In May 2014 to May 2017, 240 patients(240 eyes)with RRD were selected as research objects, in which 100 eyes(scleral cerclage group)were treated by scleral cerclage, 140 eyes(joint group)were treated by scleral cerclage combined external sclera pressure. Preoperative and postoperative 2, 4 and 12wk, intraocular pressure, corneal thickness and corneal horizontal and vertical curvature, anterior chamber depth, lens thickness and axial length, ciliary body thickness and the trabecular iris angle degree of two groups were detected.

RESULTS: At 12wk after surgery, all the 240 eyes got anatomical reattachment. Two weeks after surgery, intraocular pressure, corneal thickness, horizontal and vertical curvature of the cornea, lens thickness and ciliary body thickness increased significantly in both groups(P<0.05), and the anterior chamber depth and the degree of angle between the trabecular and iris decreased significantly(P<0.05). The postoperative visual acuity of the two groups was significantly better compared with that before surgery(P<0.05). The visual acuity of joint group was significantly better than that of the scleral cerclage group 2wk after surgery(P<0.05).

CONCLUSION: The scleral cerclage and external sclera cerclage combined with external sclera pressure on the cornea, anterior chamber, anterior chamber depth, lens thickness and degree of angle between the trabecular and iris were significantly influence in the early days. Effect of scleral cerclage combined with external sclera compression on intraocular pressure is longer, which should be paid attention to.

Abstract:AIM:To explore the effect of retinal photocoagulation combined with Ranibizumab or Conbercept on central macular thickness, visual acuity recovery and adverse reactions in patients with macular edema(ME)secondary to retinal vein occlusion(RVO).

METHODS: Totally 384 cases of patients(384 eyes)with RVO-ME in our hospital were divided into Group A(205 cases)and Group B(179 cases). Group A was given retinal photocoagulation and ranibizumab intravitreal injection, and Group B was given retinal photocoagulation and conbercept intravitreal injection. The postoperative central macular thickness(CMT), best corrected visual acuity(BCVA), intraocular pressure(IOP)and adverse reactions were compared between the two groups.

RESULTS:There was no significant difference in the total effective rate of fundus fluorescein angiography(FFA)between the two groups after 3mo(P>0.05). There were significant differences in BCVA in the two groups at each time point(P<0.05). There was no significant difference in BCVA between the two groups(P>0.05). The BCVA in two groups showed an upward trend after operation(P<0.05). There was a statistically significant difference in MCT in the two groups at each time point(P<0.05). There was no significant difference in MCT between the two groups(P>0.05). The MCT showed a downward trend in two groups after operation(P<0.05). There was no significant difference in IOP in the two groups at each time point(P>0.05). There was no significant difference in IOP between the two groups(P>0.05). And there was no significant increase in IOP after operation(P>0.05). The drug injection frequency within 3mo in Group B was significantly less than that in Group A(P<0.05), and there was no significant difference in the total incidence rate of adverse reactions between the two groups(5.4% vs 4.5%, P>0.05).

CONCLUSION: Retinal photocoagulation combined with ranibizumab or conbercept intravitreal injection can control the condition of RVO-ME patients, promote ME absorption, reduce CMT and improve visual acuity. The two drugs have effective time in single administration, and the drug administration frequency of conbercept are better than those of ranibizumab.

Abstract:AIM: To systematically review and assess the efficacy and safety of phacoemulsification combined with intraocular lens(IOL)implantation versus trabeculectomy for angle closure glaucoma with cataract.

METHODS: Databases including CNKI, CBM, WangFang, VIP, Medline, EMBASE, Cochrane library were searched to collect randomized controlled trails(RCTs)about phacoemulsification combined with intraocular lens implantation versus trabeculectomy. Cochrane collaboration's tool were used to assess the risk of bias of included studies and the meta-analysis was conducted by Revman 5.3 software.

RESULTS: Nine eligible studies involving 696 patients were included. The results of meta-analysis shows that: there were no significant differences between two groups in postoperative intraocular pressure(P>0.05). While phacoemulsification combined with intraocular lens implantation has lower complications rate(Z=4.32, P<0.0001).

CONCLUSION: Current evidence shows that phacoemulsification combined with intraocular lens implantation and trabeculectomy may has the similar efficacy for angle-closure glaucoma with cataract. But the former operation are more safer for patients.

Abstract:Age-related macular degeneration(ARMD)is one of the major senile blinding eye diseases in the world. Among them, wet age-related macular degeneration(wARMD)causes severe visual impairment. In our country, age-related degenerative diseases pose a serious medical burden as the population tends to age. With the deep research of wARMD risk factors by domestic and foreign scholars, the prevention and control of wARMD has become an important research topic. Therefore, by studying the risk factors of wARMD and taking effective preventive measures, it is expected to reduce the incidence of wARMD and delay the development of the disease. This article reviews the research progress of wARMD risk factors.

Abstract:Retinitis Pigmentosa(RP)is a group of inherited retinal diseases characterized by progressive photoreceptor cells loss and pigment epithelial cell dysfunction. It is one of the most common disease worldwide which leads to blindness, and there were no effective treatments for RP in the past decades. Recently, lots of methods were considered effective to treat with RP, including stem cell therapy, gene therapy, neuroprotective therapy, nutritional therapy, hyperbaric oxygen therapy, retinal transplantation and traditional Chinese medicine. In this review, we conducted a comprehensive analysis and assessment on the findings of the progress of RP treatment at domestic and overseas.

Abstract:LSCs(limbal stem cells)are one of the adult unipotent stem cells located in the Vogt palisade area of the limbal cornea. It can supplement the repair of corneal epithelium by self renewal and play an important role in maintaining normal corneal epithelial integrity, corneal transparency and maintaining normal vision. The lack of corneal limbus stem cells caused by various reasons will lead to corneal turbid, ocular surface vascularization, and final blindness. The main methord to treat related diseases is to cultivate corneal limbal stem cells in vitro and retransplantation. How to effectively expand the limbal stem cells in vitro is the key to the success of the treatment. The location, acquisition methods and expansion methods of limbal stem cells were reviewed.

Abstract:Age-related macular degeneration(ARMD)is the leading cause of blindness in the individuals older than 65 years in developed countries. It is a complex disease influenced by interaction of heredity, age, environment, diet, smoking and many other risk factors. Dry ARMD first damages Bruch's membrane, then affect the retinal pigment epithelium(retinal pigmented epithelium, RPE)and photoreceptors. Pathological angiogenesis and vascular permeability increasing are mediated by vascular endothelial growth factor(VEGF), resulting the formation of choroidal neovascularization. ARMD in human will not be caused by none of the single risk factors. Animal models that mimic a single factor cannot reproduce all the phenotypes of ARMD but can reproduce different characteristics. These animal models provide an entry point for studying the disease mechanism and finding the target of drug action. Specific modeling methods include laser modeling, gene modeling, feeding, oxidation and other models. This article summarizes and reviews the domestic and foreign classic literatures in this field to help researchers to select the suitable methods and provide new ideas for modeling.

Abstract:The choroidal neovascularization(CNV)secondary to pathological myopia is a common cause of irreversible central vision loss, with high incidence and serious impact on the quality of life of the patients. The traditional therapeutic modalities for CNV secondary to pathologic myopia include thermal laser photocoagulation, transpupillary thermotherapy, and photodynamic therapy with verteporfin. However, the long-term outcome of these treatments are disappointing. Recently, the intravitreal injection of anti- vascular endothelial growth factor(VEGF)treatment can improve the visual acuity and reduce the central retina thickness more effectively than the traditional method. Therefore, these anti-VEGF agents may become first-line drugs for the treatment of CNV secondary to pathological myopia. This review is aim to discuss the pathogenesis of myopic CNV, the molecular structure and mechanism of anti-VEGF drugs, and compare the therapeutic efficacy and safety of anti-VEGF drugs to CNV secondary to pathologic myopia.

Abstract:Rhegmatogenous retinal detachment is an eye disease that can lead to blindness. Timely and effective surgical treatment is the key to cure this disease, including pars plana vitrectomy and scleral buckling surgery, at present. Scleral buckling is a simple and effective treatment for the uncomplicated retinal detachment, but the recovery of visual acuity is influenced by many factors. The subretinal fluid is an important factor that can lead to the delayed recovery of visual acuity. This review is aimed at the present study of subretinal fluid after scleral buckling surgery.

Abstract:With the rapid development of the modern artificial intelligent technology, the machine learning based artificial intelligence(AI)technology has been gradually carried out widely in many different fields including medical field and it has also shown great potential in Ophthalmology. Most diagnostics of eye diseases, to a large extent, rely on accessory examination, which mostly output the results in the form of images. However, since the ocular image is usually very fine and complex that contains amount of information, it is difficult for doctors to diagnose correctly every time and even they do, it is still subjective and time consuming. Combined with computer, the application of machine learning based AI technology can largely improve the diagnostic accuracy, ease the burden of ophthalmologists and patient. The article aims to synthesize the researches on the applications of machine learning based AI technology in ophthalmology by local and foreign scholars and give a review on the progress, existing problems and personal future outlook.

Abstract:AIM: To explore the clinical effect of femtosecond laser combined with cataract phacoemulsification(PHACO)in the treatment of senile patients with cataract.

METHODS: The clinical data of 78(78 eyes)patients with cataract were retrospectively analyzed. Patients with femtosecond laser combined with PHACO were included in observation group(40 cases in 40 eyes), and patients with PHACO alone were included in control group(38 cases in 38 eyes). The changes of intraocular pressure(IOP), best corrected visual acuity(BCVA)\〖logarithmic visual acuity chart(LogMAR)\〗, central corneal thickness(CCT), corneal endothelial cells(CEC)count and tear oxidative stress indexes \〖prostaglandin E₂(PGE₂), glutathione peroxidase(GSH-Px)\〗 were compared before operation, at 1d,1wk and 1mo after operation, and phacoemulsification time and the occurrence of complications within 1mo after operation were analyzed in the two groups.

RESULTS: At 1d, 1wk and 1mo after operation, the values of IOP and BCVA in two groups were decreased significantly compared with those before operation, and the values showed significantly decreasing trend with the prolongation of postoperative observation time, and the values in the observation group were significantly lower than those in the control group after treatment(P<0.05). The levels of CCT and PGE₂ in two groups were significantly increased compared with those before operation, and the levels showed significantly decreasing trend with the prolonged observation time, and the levels in the observation group were significantly lower than those in the control group(P<0.05). The levels of CEC count and GSH-Px in two groups were significantly decreased compared with those before operation, and the levels showed an obvious upward trend with the prolonged observation time, and the levels in the observation group were significantly higher than those in the control group(P<0.05). The phacoemulsification time and the total incidence rate of complications within 1mo after operation in observation group were significantly lower than those in control group(P<0.05).

CONCLUSION: Femtosecond laser combined with PHACO can effectively improve the levels of IOP, CCT and CEC count in elderly patients with cataract, and reduce the occurrence risk of postoperative complications, and it is beneficial to prognosis and recovery.

Abstract:AIM: To observe the visual recovery and complications in patients with proliferative diabetic retinopathy(PDR)after vitrectomy combined with phacoemulsification.

METHODS: According to different surgical methods, 95 cases(95 eyes)with PDR were divided into the observation group(50 cases)and the control group(45 cases). The observation group was treated with vitrectomy and phacoemulsification, while the control group was treated with vitrectomy and lensectomy. The visual recovery, changes of intraocular pressure before and after surgery and the complications were compared between the two groups.

RESULTS: The visual acuity of the two groups was significantly improved after surgery(P<0.05), and the improvement in observation group was significantly greater than that in the control group(P<0.05). The intraocular pressure of the two groups was increased significantly at 1, 3 and 6mo after surgery(P<0.05), without significant difference between the two groups(P>0.05). The incidence of iris neovascularization and capsule opacification in the observation group(2%, 6%)were significantly lower than those in the control group(18%, 27%; P<0.05).

CONCLUSION: Vitrectomy combined with phacoemulsification can obviously improve the visual acuity of patients with PDR, and the incidence of complications is low. Although it will lead to an increase in intraocular pressure, it can be improved after symptomatic treatment.

Abstract:AIM: To analyze the clinical effect and security of phacoemulsification combining goniosynechialysis to treat cataract accompanied with acute angle-closure glaucoma.

METHODS: The clinical data of totally 45 patients(48 eyes)with cataract and acute angle-closure glaucoma was retrospectively analyzed, including 28 patients(30 eyes)treated with phacoemulsification with goniosynechialysis(the study group)and 17 patients(18 eyes)treated with phacoemulsification with trabeculectomy(the control group). The visual acuity, intraocular pressure, iridocornealis, central anterior chamber depth and complications were compared between groups.

RESULTS: Before surgery, there was no significant difference in best corrected visual acuity and iridocornealis angle between groups(P>0.05). At 7d, 1mo, 3mo, 6mo and 1a after surgery, the best corrected visual acuity of both groups increased, and the study group was higher than the control group; the iridocornealis angle close degree of both groups decreased, and the study group was lower than the control group(P<0.05). Both groups and time had an effect on intraocular pressure and chamber depth of patients(P<0.05), and there was no reciprocal action between the two factors(P>0.05). Compare in groups: 7d, 1mo, 3mo, 6mo and 1a after surgery, the intraocular pressure of both groups decreased, and at 3mo, 6mo and 1a after surgery, the study group was lower than that at 7d after surgery(P<0.05), the control group was similar to that at 7d after surgery(P>0.05). At 7d, 1, 3, 6mo and 1a after surgery, the chamber depth of both groups were higher than 1d before surgery, 3, 6mo and 1a after surgery, the study group was similar to that at 7d after surgery(P>0.05), the control group after 12mo was lower than that at 7d after surgery(P<0.05). Compare between groups: Before treatment, 7d, 1, 3 and 6mo after treatment, there was no significant difference between groups in intraocular pressure(P>0.05); at 1a after surgery, IOP of the study group was lower than the control(P<0.05). Before treatment, there was no significant difference between groups in anterior chamber depth(P>0.05); at 3, 6mo and 1a after surgery, the study group was higher than the control group(P<0.05).

CONCLUSION: Phacoemulsification combined with goniosynechialysis is effective to treat acute angle-closure glaucoma, with prominent long-term efficacy and the risk is not increased.

Abstract:AIM: To discuss the clinical effects of laser iridoplasty combined with YAG laser or traditional trabeculectomy in the treatment of glaucoma.

METHODS: The clinical data of 60 cases(60 eyes)of patients with glaucoma were retrospectively analyzed. The patients who underwent laser iridoplasty combined with YAG laser iridotomy were included in observation group(n=38, 38 eyes), and those who underwent traditional trabeculectomy were included in control group(n=22, 22 eyes). The changes of intraocular pressure(IOP), angle opening distance(AOD500), central anterior chamber depth(ACD), corneal endothelial cell density(ECD)were compared between the two groups before operation and at 1mo, 3mo and 12mo after operation, and the occurrence of complications within 12mo after operation were analyzed in the two groups.

RESULTS: At 1mo, 3mo and 12mo after operation, the IOP level in the two groups was decreased significantly compared with that before operation, and the level in observation group was significantly lower than that in control group(P<0.05). The levels of AOD500 and ACD in observation group were significantly higher than those before treatment and than those in control group(P<0.05). There was no statistically significant difference in the ECD level of observation group compared with that before operation(P>0.05), but the level was significantly higher than that in control group(P<0.05). Within 12mo after operation, the total incidence rate of complications in observation group was significantly lower than that in control group(P<0.05).

CONCLUSION: Laser iridoplasty combined with YAG laser for glaucoma can obtain an ideal treatment effect, and its safety is better than traditional trabeculectomy and it is beneficial to the recovery of ocular function.

Abstract:AIM: To explore the application value of optic disc parameters and retinal nerve fiber layer(RNFL)thickness by swept source optical coherence tomography(SS-OCT)in the efficacy evaluation of primary angle-closure glaucoma(PACG).

METHODS: Totally 60 PACG patients(68 eyes)who was treated with peripheral iridotomy and trabeculectomy was selected. According to the intraocular pressure during postoperative follow-up, all the patients were divided into controlled group(<21mmHg, 39 cases 45 eyes), uncontrolled group(≥21mmHg, 21 cases 23 eyes). The SS-OCT was used to detect the RNFL thickness and optic disc parameters before and after treatment in both groups, and the therapeutic effect was evaluated.

RESULTS: The intraocular pressure in both groups were significantly reduced after treatment, and the controlled group was significantly lower than that in uncontrolled group(P<0.05). After treatment, the RNFL thickness in controlled group had not obvious difference compared with that before treatment(P>0.05), but it was obviously thinned in uncontrolled group compared with before treatment and control group(P<0.05). After treatment, disc area(DA)in uncontrolled group was increased obviously, and rim area(RA), rim volume(RV)was significantly reduced(P<0.05), and the optic disc parameters in controlled group were obviously better than those in uncontrolled group(P<0.05). Intraocular pressure was positively correlated with optic disc parameter DA, and negatively correlated with RA(r=0.415, -0.399; P<0.05).

CONCLUSION: SS-OCT can accurately reflect the change of optic disc parameters and RNFL thickness after intraocular pressure controlled in PACG patients. It has a certain clinical value in follow-up and efficacy evaluation for PACG.

Abstract:AIM: To investigate the changes of vascular endothelial function and hemorheological indexes in patients with primary open angle glaucoma(POAG)and to analyze the risk factors of POAG.

METHODS: A total of 86 cases of POAG patients were selected as the research object(observation group), and they were divided into mild group(n=27), moderate group(n=29)and severe group(n=30)according to the visual field defect, another 30 cases normal healthy volunteers were selected as the control group. The levels of vascular endothelial function and blood hemorheology between the groups were compared, and to analysis the risk factors of the disease.

RESULTS: The results of single factor analysis showed that there was no significant difference in the sex ratio, average age, history of alcoholism and cardiovascular disease between the control group and the observation group(P>0.05); the smoking history, hypertension history, diabetes history, and family history were statistically significant(P<0.05). The level of NO in the observation group was significantly lower than that in the control group, and the level of the severe group was significantly lower than that in the moderate group, which was significantly lower than that of the mild group, and the difference was statistically significant(P<0.05). Compared with the control group, the levels of endothelin-1(ET-1), plasma viscosity(PV), hematocrit(HCT)and fibrinogen(FIB)in the observation group were significantly increased, and the ET-1 and HCT levels in the severe group were significantly higher than those in the moderate group, which were significantly higher than those in the mild group(P<0.05); and the levels of PV and FIB in the severe group were significantly higher than those in the mild group, the difference was statistically significant(P<0.05). Logistic regression analysis showed that smoking history, hypertension history, diabetes history, family history, ET-1, PV, HCT and FIB were risk factors for primary glaucoma, and NO was a protective factor(P<0.05).

CONCLUSION: There are endothelial dysfunction and hemorrheology abnormality in patients with POAG. Smoking history, hypertension history, diabetes history, family history are related to the occurrence of POAG.

Abstract:AIM: To investigate the clinical effect of vitrectomy combined with intravitreal injection of Conbercept for polypoidal choroidal vasculopathy(PCV)associated with vitreous hemorrhage.

METHODS: The clinical data of 59 patients(59 eyes)underwent vitrectomy in a hospital from May 2013 to August 2016 were retrospectively analyzed. Among them, 21 cases treated with vitrectomy were set as the control group; 38 cases treated with vitrectomy combined with intravitreal injection of conbercept were set up as the observation group. The efficacy and safety of the two groups were observed.

RESULTS: After the 12-month follow-up, the fundus examination of the observation group revealed that the deep, superficial retina hemorrhage and exudation of 38 patients were completely absorbed, and B-ultrasound showed that all patients with subretinal hemorrhage were also completely absorbed. However, B-ultrasound showed that subretinal hemorrhage and exudation still existed in 18 patients with varying degrees. The total BCVA changes before and after treatment in the two groups were statistically significant(P<0.01). After 1, 3, 6 and 12mo of treatment, the BCVA in the observation group was all significantly better than that in the control group, and the statistical difference between the groups was significant(P<0.05). After treatment, the changes of central retinal thickness(CRT)in the two groups were statistically different(P<0.01). After 1wk, 1, 3, 6 and 12mo of treatment, the CRT in the observation group was all significantly lower than that in the control group, and the statistical difference between the groups was significant(P<0.05). After 1wk of intravitreal Conbercept injection in observation group, the neovascularization of anterior chamber and iris of 37 cases completely subsided, only one case had a small residual neovascularization, the regression rate was 97%. After 1wk of vitrectomy in control group, the neovascularization of 16 cases subsided obviously with a regression rate of 76%. There was significant difference between groups(χ²=35.680, P<0.001). No serious complications were observed in the two groups during follow-up, and there was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).

CONCLUSION: Vitrectomy combined with intravitreal injection of conbercept is an effective and safe way for PCV associated with vitreous hemorrhage.

Abstract:AIM:To investigate the effectiveness of three cycloplegia drugs: atropine, cyclopentolate and tropicamide on school-age children, and provid theoretical basis in choosing cycloplegic drugs for school-age children.

METHODS: Totally 420 myopic school-age students(818 eyes)in out-patients department were selected during July to August 2017. Candidates were divided into three medicine groups according to their age: Group A: <8 years old, utilizing 1% atropine; Group B: 8-12 years old, utilizing the cyclopentolate; Group C: >12 years old, utilizing the tropicamide. The difference of refraction degree before and after medicine application were calculated.

RESULTS: The coincidence rate of spherical equivalent refraction with cycloplegia and without cycloplegia was 81.0% in atropine group, 81.3% in cyclopentolate group and 79.4% in tropicamide group respectively. There was statistical difference of refraction results of the Group A between with atropine cycloplegia and without cycloplegia. The mean difference was -0.113±0.226D(t=-4.663, P<0.001). There was no statistical refraction difference of the Group B between with cyclopentolate cycloplegia and without cycloplegia, the mean difference was -0.025±0.192D(t=-1.665, P=0.099). So does the difference of Group C between with tropicamide cycloplegia and without cycloplegia, which was -0.026±0.193D(t=1.760, P=0.080).

CONCLUSION: For children older than 8-years old and without strabismus and amblyopia, cyclopentolate or tropicamide can be used to give cycloplegia refraction for the first time, which is convenient for their daily activities. The cycloplegia refraction results should been re-checked after used atropine, and giving prescription by using the principle of maximum plus to maximum visual acuity(MPMVA).

Abstract:AIM: To investigate the effect of Mingmu Yanggan Pills combined with sodium hyaluronate eye drops on the clinical efficacy of patients with dry eye(DE)in perimenopausal women and the influence on the levels of IL-33 and IL-6 in tears.

METHODS: Eighty patients(160 eyes)with perimenopausal women with dry eye were enrolled in this study. They were randomly divided into observation group(n=40)and control group(n=40). The control group was given sodium hyaluronate eye drops. The observation group was given Mingyu yanggan Pill on the basis of the control group. The curative effect of the two groups were observed. The changes of ocular surface disease index(OSDI)score, tear film break-up time(BUT), tear secretion test(SⅠt)and corneal fluorescein staining(FL)and IL-33 and IL-6 levels in tears before and after treatment were compared.

RESULTS: The total score of OSDI for the two groups after treatment were significantly lower than those before treatment(P<0.01). SⅠt and BUT were significantly higher than those before treatment(P<0.01). The indicators in the observation group were better than those in the control group(P<0.01). After treatment, the levels of IL-33 and IL-6 in tears of the two groups were significantly lower than those before treatment. The levels of IL-33 and IL-6 in tears of the observation group were significantly lower than those of the control group(P<0.05). The total effective rate in the observation group was 87.5%, which was higher than 65.0% in the control group, with significant difference(χ²=5.591, P=0.018).

CONCLUSION: Mingmu Yanggan Pills combined with sodium hyaluronate eye drops has a good curative effect on the treatment of dry eye in perimenopausal women, which may be related to the decrease of IL-33 and IL-6 levels in tears.

Abstract:AIM:To investigate the operation opportunity and therapeutic effect of intermittent exotropia.

METHODS: A prospective study of 139 patients with intermittent exotropia admitted to our hospital from May 2014 to December 2016 was conducted. Patients were divided into three groups according to their ages: Group A with 58 cases aged between 3 and 7 years old, Group B with 41 cases aged from 8 to 12 years old and Group C with 40 cases aged more than 12 years old. The therapeutic effect of each group was observed.

RESULTS: The postoperative orthographic rate between the three groups at 3d, 1, 3 and 6mo postoperatively had statistical differences(P<0.05). The postoperative orthographic rate of Group A was significantly higher than that of the other two groups at different time points(P<0.05). The postoperative orthographic rate of of Group B at 3d and 1mo after operation was significantly higher than that of Group C(P<0.05). After operation, the stereoscopic function of each group at 6mo postoperatively was significantly improved, and the statistical difference between the groups was significant(P<0.05). The proportion of patients with stereopsis recovered in Group A was significantly higher than those in Groups B and C(P<0.05). There was no significant difference in the preoperative strabismus degree between either two groups(P>0.05), while the degree of strabismus in each group after 6mo was significantly different(P<0.05). And the proportion of strabismus ≤30^△ in Group A was higher than the other two groups(P<0.05). The changes of BCVA among the three groups after operation had significant differences(P<0.01). The BCVA of Group A was better than the other two groups at 3d, 1,3 and 6mo after operation(P<0.05). There were no significant differences between BCVA of 3mo and 6mo after operation in each group(P>0.05). There was a statistically significant difference in the incidence of ocular regression rate in three groups during the 6mo follow-up(P<0.05); that of Group A was lower than Group B and Group C(P<0.05)and Group B were lower than Group C, and the statistical difference between groups was significant(P<0.05).

CONCLUSION: The surgical type of the intermittent exotropia should be based on the classification of strabismus, which can promote postoperative recovery of the eye position and visual function, improve visual acuity, and then avoid ocular regresses.

Abstract:AIM: To observe and analyze the safety and clinical efficacy of full-thickness scleral incision and in situ paracentesis in the treatment of patients with coexisting rhegmatogenous retinal detachment and choroidal detachment using minimally invasive vitrectomy.

METHODS: From April 2015 to April 2017, 20 patients(20 eyes)with coexisting rhegmatogenous retinal detachment and choroidal detachment who were treated in Department of Ophthalmology, Jiangsu Province Hospital were enrolled in this retrospective analysis. All patients received modified scleral puncture drainage combined with 23G minimally invasive vitrectomy. This study analyzed and compared intraoperative paracentesis success rate, the incidence of intraoperative, postoperative visual acuity, intraocular pressure, and postoperative retinal reattachment rate.

RESULTS: Suprachoroidal fluid from all patients were drainaged successfully. Compared with preoperative conditions, the postoperative visual acuity was significantly improved(P<0.01). There was a significant difference in average intraocular pressure(IOP)between preoperative one and postoperative one(7.00±2.05mmHg and 15.38±2.66mmHg respectively, P<0.01). The origin retinal reattachment rate was 90%(18/20), and the final retinal reattachment rate was 95%(19/20).

CONCLUSION: The modified scleral puncture surgery in the treatment of patients with coexisting rhegmatogenous retinal detachment and choroidal detachment in 23G vitrectomy has great clinical effects. It not only simplifies the procedure of operation, but also reduces the difficulty and complication of operation.

Abstract:AIM: To investigate the cause and the description of pathogenic characteristics of chronic infective keratitis in different age groups.

METHODS: Totally 89 patients(89 eyes)with chronic infective keratitis were diagnosed in our hospital from January 2015 to December 2017 were selected as the research objects and the cause of the disease and pathogenic characteristics of different age groups, including 13-32 years group(35 eyes in 35 patiens), 33-52 years group(28 eyes in 28 patiens)and 53-73 years group(26 eyes in 26 patiens), were retrospectively studied.

RESULTS: There were no significant differences in the etiological distribution of patients in the three groups(P=0.290). There was no significant difference in the distribution of microbial composition among the three groups(χ²=0.258, P=1.000). The incidence of chronic infectious keratitis caused by fungal infection in the three groups was higher than that of other pathogenic microbes. In this study, 26 cases were positive in bacterial culture, including Staphylococcus epidermidis(50%), Pseudomonas aeruginosa(15%), Streptococcus salivarius(12%), Streptococcus pneumoniae(8%), Escherichia coli(8%)and Neisseria gonorrhoeae(8%). Pseudomonas aeruginosa and Staphylococcus epidermidis were the common bacterial strains in the positive culture results. In the cultivation of fungal strains 24 were positive cultures including Fusarium(46%), Aspergillus(17%), Alternaria(21%), Mycelium(no spore,4%), Penicillium(4%)and Curvularia(8%). Two strains of Fusarium spp. and Alternaria spp. were high of all patients.

CONCLUSION: There were no significant differences in the etiology of infectious keratitis among different age groups. Fungal infection is the main pathogen in the distribution of pathogens, the bacteria were mainly Streptococcus epidermidis in etiological features but in fungi, Fusarium dominates. So early prevention and prevention of infective keratitis should be strengthened and early treatment should be given.

Abstract:AIM: To investigate the relationship of TNF-α and IL-6 with the pathogenesis and development of the neovascular glaucoma(NVG).

METHODS: Totally 64 eyes of 64 NVG patients, 58 eyes of 58 primary open angle glaucoma(POAG)patients and 56 eyes of 56 age-related cataract(ARC)patients were enrolled in our Hospital from January 2017 to January 2018. The periphery blood was collected from all the patients and 0.3mL aqueous humor was collected during the surgery from each eye. The levels of TNF-α and IL-6 in serum and aqueous humor of the three groups were measured by ELISA.

RESULTS: The concentrations of TNF-α and IL-6 in aqueous humor and serum in NVG patients were higher than those in POAG patients as well as in ARC patients, with significant differences among the three groups(P<0.05). The TNF-α and IL-6 in aqueous humor and serum in NVG patients were significantly positively correlated(r=0.642, 0.415; P<0.05).

CONCLUSION: The aqueous and serum TNF-α and IL-6 are considerably higher in NVG patients than those in POAG patients and ARC patients, suggesting that TNF-α and IL-6 play important roles in the pathogenesis and development of the NVG.

Abstract:AIM: To evaluate the incidence of supraciliochoroidal fluid(SCF)within 1wk after phacoemulsification combined with goniosynechialysis by anterior segment optical coherence tomography(AS-OCT).

METHODS: AS-OCT was used to analyze the incidence of SCF in 40 eyes of 40 patients who received phacoemulsification combined with goniosynechialysis from January 2016 to June 2017. All the patients were diagnosed with primary acute angle-closure glaucoma(PACG)along with cataract. Patients with SCF occurring in 1wk after surgery were included in the SCF group(10 cases with 10 eyes), and patients without SCF were included in the non-occurrence SCF group(30 cases with 30 eyes). Data of intraocular pressure(IOP), central depth of anterior chamber, central macular thickness(CMT), and best corrected visual acuity(BCVA)were collected to further analysis.

RESULTS: All the 40 eyes displayed no SCF before surgery. SCF was detected in 10 eyes(25%), which first occurred on 1d(2 eyes), 3d(7 eyes), and 1wk(1 eye)within 1wk postoperatively. SCF was detected in four(7 eyes), two(2 eyes), and one quadrant(1 eye). The whole 10 eyes showed grade Ⅰ(8 eyes)or grade Ⅱ detachment(2 eyes), with no eyes showing grade Ⅲ detachment. Nine eyes had showed no SCF by 4wk, and all SCF disappeared on 8wk. The lowest IOP was significantly lower in eyes with SCF(8.9±0.9mmHg)than in those without(12.5±2.6mmHg)(P<0.001). The IOP rose from 10.0±1.2mmHg at the detection of SCF to 14.3±1.5mmHg at the disappearance of SCF(P<0.001). BCVA(LogMAR)showed significant positive correlation with central macula thickness(CMT)on postoperatively 8wk(r_s=0.838, P<0.001).

CONCLUSION: SCF can be detected frequently with AS-OCT at the very early stages after phacoemulsification combined with goniosynechialysis(within 1wk postoperatively), which has fine clinical value.

Abstract:AIM: To evaluate the early changes of retinal function in patients with wet age-related macular degeneration(ARMD)after intravitreal Conbercept treatment by multifocal electroretinography(mfERG).

METHODS: Wet ARMD patients diagnosed by fundus fluorescein angiography and received intravitreal injection of Conbercept(0.05mL/0.5mg)were included. Best corrected visual acuity(BCVA), incubation of N1, P1 and amplitude of P1 in mfERG test were recorded before and 1mo after treatment.

RESULTS: Twenty patients(20 eyes)were enrolled in total. The mean BCVA was 0.80±0.48 LogMAR at baseline and improved to 0.65±0.50 LogMAR after treatment(P<0.001). Mean P1 amplitude density of the mfERG Ring 1 increased from 39.59±16.60nV/deg² to 53.81±20.41nV/deg²(P=0.006). The change in visual acuity was positively correlated with the change in P1 amplitude density of Ring 1(r=-0.776, P<0.001).

CONCLUSION: Intravitreal conbercept injection can improve the central retinal function of wet ARMD patients in the short term.

Abstract:AIM: To study the clinical efficacy of Conbercept intravitreal injection(0.5mg/0.05mL)in the treatment of exudative age-related macular degeneration(ARMD).

METHODS: Forty-five patients(45 eyes)with exudative age-related macular degeneration diagnosed in our hospital from July 2015 to January 2016 were retrospectively studied. A monthly intravitreal injection of conbercep was carried out. After 3-month injection, conbercep was given if necessary(3+PRN), and all patients were followed up for 2a. Before and after treatment, the intraocular pressure, the best corrected visual acuity(BCVA), central macular thickness(CMT)changes were observed.

RESULTS: The BCVA at 1, 2, 3mo, 1 and 2a after treatment was better than that before treatment(t=5.208, 5.111, 4. 323, 4.701, 5.156; P<0.05). CMT was significantly lower than before treatment(t=3.807, 4.556, 2.841, 2.707, 3.145; P<0.05).

CONCLUSION: Conbercept injection, as 3+PRN, can effectively improve visual acuity, reduce macular edema.

Abstract:AIM:To evaluate the effects and safety of intravitreal injection of Ranibizumab on noninfectious uveitic macular edema(UME).

METHODS: This was an open and prospective study without control trial. Seventeen eyes from 17 patients with UME diagnosed by fundus fluorescein angiography(FFA)and optical coherence tomography(OCT)were enrolled in this study. Before the injection, best-corrected visual acuity(BCVA)of early treatment of diabetic retinopathy study(ETDRS)and central macular thickness(CMT)measured by OCT were examined. All affected eyes were treated with intravitreal ranibizumab 0.05mL(0.5mg). The BCVA, CMT and intraocular pressure(IOP)were compared with baseline at 2, 4, 8 and 12wk after treatment. Related complications were recorded.

RESULTS: The median BCVA before treatment was 57(P₂₅ and P₇₅ were 52.5 and 64.5, respectively). The median CMT was 524μm(P₂₅ and P₇₅ were 365.5 and 571, respectively). At 2, 4, 8, and 12wk after injection, the median BCVA of the affected eyes was 76(P₂₅ and P₇₅ were 71 and 80, respectively), 81(P₂₅ and P₇₅ were 78.5 and 83, respectively), 82(P₂₅ and P₇₅ were 68.5 and 84, respectively), and 82(P₂₅ and P₇₅ are 78.5 and 83, respectively). The Friedman M test showed that there were differences in the BCVA in the four groups at different follow-up times, that was, BCVA after injection was higher than before injection(χ²=47.58, P<0.01). At 2, 4, 8, and 12wk after injection, the median CMT was 307μm(P₂₅ and P₇₅ were 249.5 and 374.5, respectively),231μm(P₂₅ and P₇₅ were 212.5 and 267), 219μm(P₂₅ and P₇₅ were 210.5 and 365.5,respectively), and 217μm(P₂₅ and P₇₅ were 201.5 and 366.5,respectively). The Friedman M test showed that there was difference in the CMT in the four groups at different follow-up times(χ²=40.33, P<0.01), that was, CMT after injection was lower than before injection. At the 12wk after injection, increased CMT and decreased BCVA were found in 35% of study eyes(6/17)that had uncontrolled intraocular inflammation, and all these patients needed to increase prednisone again. No adverse events were found during the follow-up duration.

CONCLUSION: Intravitreal ranibizumab is a safe and effective approach for noninfectious uveitic macular edema in the short term, which can significantly improve visual acuity and reduce CMT in patients refractory to or intolerant of standard corticosteroid/ immunomodulatory therapy.

Abstract:AIM: To investigate the correlation between elipsode zone(EZ)integrity and best corrected visual acuity(BCVA)of eyes with diabetic macular edema(DME), and to determine the prognostic factors of visual acuity.

METHODS: We studied 62 eyes of 39 patients with DME. Using spectral domain optical coherence tomography(SD-OCT), disrupted elipsode zone length were measured, and the eyes were categorized into three groups according to elipsode zone: 1)Group A: with a completely visible elipsode zone; 2)Group B: with a disrupted elipsode zone and the length of disruption within 200μm;(3)Group C: with a disrupted elipsode zone and the length of disruption longer than 200μm. We also evaluated the presence or absence of hard exudates(HE), serous retinal detachment(SRD), central macular thickness(CMT)using SD-OCT. Pearson analysis testing was performed over the BCVA and the elipsode zone integrity, CMT, existence of SRD and HE, age, sex, duration of diabetes, HbA1c, duration of DME, stage of diabetic retinopathy, and DME type.

RESULTS: Before treatment, BCVA(LogMAR)in the Group A(0.44±0.18)or Group B(0.64±0.16)was significantly better than that in the Group C(0.74±0.21)(P<0.001). CMT had no difference between Group A(403.40±90.32μm), Group B(408.44±95.98μm)or Group C(421.29± 98.32μm, P=0.805). Analysis showed that elipsode zone integrity had close correlation coefficient with BCVA(r=-0.673, P<0.001), CMT had weak correlation with BCVA(r=-0.344, P<0.001). Other factors SRD, HE and duration of DME did not correlate with BCVA.

CONCLUSION: The integrity of elipsode zone are closely associated with BCVA in DME. CMT are weakly associated with BCVA in DME.

Abstract:AIM: To investigate the characteristics of near-infrared fundus autofluorescence(NIR-FAF)at the leakage site in acute central serous chorioretinopathy(CSC).

METHODS: Twenty-five eyes of the 25 patients diagnosed with acute CSC(mean age 44.52±6.17 years)were included in this retrospective study. Fundus fluorescein angiography and NIR-FAF imaging were performed using a confocal scanning laser ophthalmoscope. The imaging features of NIR-FAF at the leakage site were analyzed.

RESULTS: There were four patterns of NIR-FAF at the leakage site in acute CSC eyes: no NIR-FAF abnormal changes, hypoautofluorescence(hypo-AF), mottled autofluorescence(AF)and hyperautofluorescence(hyper-AF). Only 1 eye(4%)among 25 eyes of NIR-FAF imaging at the leakage site had no obvious abnormalities, while other 24 eyes(96%)had abnormal changes. Among them, 7 eyes had dot-like hypo-AF, 10 eyes had expanded hypo-AF, 5 eyes had expanded mottled AF and the remaining 2 eyes had expanded hyper-AF. All eyes had abnormal NIR-FAF corresponding to the area of the serous retinal detachment, including 17 eyes with hypo-AF and 8 eyes with mottled AF.

CONCLUSION: There are characteristic NIR-FAF changes at the leakage sites of acute CSC eyes. NIR-FAF photography can be used as a fast, effective and non-invasive method for the early detection of RPE abnormality in acute CSC.

Abstract:AIM: To evaluate the therapeutic effect of intravitreal injection of ranibizumab(IVR)combined with extra panrentinal photocoagulation(E-PRP)for diabetic neovascularization on the disc(DNVD).

METHODS: A total of 36 eyes of 32 patients with DNVD underwent IVR combined with E-PRP. The examinations of visual acuity, funds fluorescein angiography(FFA)and optical coherence tomography(OCT)were performed on all of the patients before and 6mo after the treatment; the result of the examinations before and after the treatment were compared and analyzed.

RESULTS: Before the treatment, best corrected visual acuity(BCVA, LogMAR)was 0.89±0.35, 6mo after treatment was 0.42±0.13; the difference was significant(P<0.01). After the treatment, BCVA was improved in 19 eyes(53%), unchanged in 14 eyes(39%)and decreased in 3 eyes(8%). Retinal nerve fiber layer(RNFL)was 110.64±12.06μm at 6mo after IVR+E-PRP, which was significantly different to those before treatment and 7d after treatment(t=5.612, 3.304; P<0.05). Neovascularization regressed in 32 eyes(89%), and unchanged or aggravated in 4 eyes(11%). The results of FFA after E-PRP showed that the one-off efficiency of E-PRP was 69%(25 eyes), 7 eyes(19%)need an additional laser, in which 4 eyes(11%)underwent vitreous surgery.

CONCLUSION: IVR combined with E-PRP as a treatment for DNVD may improve the regression of retinal neovascularization and the reduction of vascular permeability, and improve the therapeutic effect and safety.

Abstract:AIM: To research and discuss the value and features of fluorescence fundus angiography(FFA)in patients with diabetic retinopathy.

METHODS: We selected 130 hospitalized diabetic patients suspected with diabetic retinopathy from January 2014 to February 2018 in our hospital. All patients underwent fundus photography and FFA examination. We analyzed the detected retinopathy. The reference was the clinical diagnosis, to calculate the sensitivity, specificity and accuracy of fundus photography and FFA in diagnosis of diabetic retinopathy and to compare the diagnostic accuracy of fundus photography and FFA for different degrees of diabetic retinopathy. The FFA characteristics of diabetic retinopathy was analyzed. Kappa consistency test was used to analyze the consistency between the two diagnostic methods and the clinical diagnosis results.

RESULTS: The sensitivity, specificity and accuracy of FFA on diabetic retinopathy were 96.8%, 97.1%, 96.9%, all of which were above the fundus photography(P<0.05). The diagnostic accuracy of FFA in mild, moderate, severe diabetic retinopathy were 97.1%, 97.0%, 96.4%, all above the fundus photography without significance(P>0.05). The Kappa consistency test showed the consistency between the diagnosis results of FFA and clinical was good; and the consistency between the results of the clinical and fundus photography was only moderate. FFA test results showed that diabetic retinopathy were more visible in nasal retinal lesions and in the peripheral part from the optic disc, and intraretinal microvascular abnormalitie could be seen. In diabetic retinopathy, the number and distribution of retinal microangiomas, hemorrhagic spots, vein beads, and capillary non-perfusion zone were different. Some patients, before the formation of retinal microangiomas and hemorrhagic spots, had increased foveal thickness, focal cotton-wool spot and focal capillary non-perfusion zone.

CONCLUSION: FFA has high sensitivity, specificity and accuracy in the diagnosis of diabetic retinopathy. The consistency between FFA diagnosis and clinical diagnosis is strong. FFA has accurate diagnosis for suspected changes in fundus photography.

Abstract:AIM:To observe, analyze and compare the effect of minimally external surgery under microscopy and traditional external surgery on the treatment of non-complicated rhegmatogenous retinal detachment.

METHODS:The clinical data of 53 patients with 53 eyes of non-complicated rhegmatogenous retinal detachment in our hospital was analyzed retrospectively, of which the minimally external retinal detachment surgery under microscopy was performed in 25 patients with 25 eyes of non-complicated rhegmatogenous retinal detachment(the research group), and the traditional external retinal detachment surgery was performed in 28 patients with 28 eyes of non-complicated rhegmatogenous retinal detachment(the control group). All surgeries were performed by the same surgeon, and the clinical efficacy and complications of the two groups were compared and analyzed.

RESULTS: In postoperative hole closure, there was no significant difference in the primary rate of reattachment of the retina between the two groups(P>0.05). There was a statistically significant difference in postoperative complications between the two groups(P<0.05). The best corrected visual acuity after surgery was better than that before surgery in both groups. There was no significant difference in the increase of postoperative visual acuity between the two groups(P>0.05). There was a statistically significant difference in operative time between the two groups(P<0.05).

CONCLUSION: The effect of minimally external retinal surgery under microscopy and traditional external retinal surgery is similar in the treatment of non-complicated rhegmatogenous retinal detachment, but the minimally external retinal surgery has the advantages of shorter time, less damage and fewer complications.

Abstract:AIM:To analyze incidence and trends of retinopathy of prematurity(ROP)from 2011 to 2015 in Suzhou.

METHODS: A total of 2 527 infants were screened for ROP in Suzhou from January 2011 to December 2015 using RetCamII. First examination was performed from 4-6wk after birth. Of all the 2 527 infants, the birth weight was 640-4 200g with an average of 1694.99±370.875g. The gestational age were 24.5-41.1wk with an average of 32.397±2.2171wk. The ocular findings were recorded according to the International Classification of ROP and The Early Treatment for ROP. Only the more aggressive eye of bilateral asymmetrical cases was counted for statistical purpose. And the cases required surgeries(pre-threshold ROP type Ⅰ and threshold ROP)were defined as severe cases.

RESULTS: Of all the 2 527 infants, 408 infants were screened with ROP, in which 30 were severe ROP, the incidence of ROP and severe ROP was 16.15%and 1.19%. The incidence of ROP from 2011 to 2015 were 10.14%, 14.91%, 14.26%, 19.64%, 20.15% respectively, turned out a gradual upward trend(χ²=24.625, P<0.01). The incidence of severe ROP were 1.18%, 0.94%, 0.63%, 0.90%, 2.22%, no significant differences between the groups(P>0.05). The incidence of ROP in the four seasons were 17.62%, 15.20%, 16.12%, 15.82% respectively and no significant differences between the groups(χ²=1.397, P=0.706).

CONCLUSION: The incidence of ROP in Suzhou increased from 2011 to 2015, which was related to the decline of the gestational age and birth weight. The distribution of ROP was not seasonal.

Abstract:AIM: To compare the overall surgical outcome of chalazion surgery under general anesthesia or local anesthesia in children.

METHODS: This was a retrospective case-control study. Pediatric patients(4-year-old to 10-year-old)with bilateral chalazion who were treated with extraction surgery were included during January 2015 to December 2016. These subjects were divided into two groups according to type of anesthesia: general anesthesia group(GA group, 67 cases, 134 eyes)and local anesthesia group(LA group, 72 cases, 144 eyes). The pain score(FPS-R)and post-operative psychological destruction scores, condition of tear film and Meibomian gland, the recurrent rate and postoperative complications were recorded and statistically analyzed.

RESULTS: No anesthesia-associated complication were recorded in both groups. The children in GA group felt no pain during operations. The FPS-R score at 3h after surgery in GA group was 4.94SymbolqB@1.23, which was significantly lower than that of LA group(7.00SymbolqB@1.14, P<0.001). And 12 cases in GA group showed resistance to re-examination at hospital, while 35 cases showed resistance in LA group(P<0.01). The tear break-up time, tear meniscus height and lipid layer thickness were higher than those in LA group(P<0.001), while the meibum score were significantly lower(P<0.01). The recurrent rate of chalazion was 6.0% in GA group and 20.8% in LA group(P<0.05). The rate of post-operative complications reached 15.3% in LA group, while only 4.5% in GA group(P<0.05).

CONCLUSION: Chalazion surgery under general anesthesia has the advantage of mild pain and good compliance in children. After surgery, the patients presented with better tear film and Meibomian gland status, and fewer complications under general anesthesia.

Abstract:AIM: To evaluate the effect of glass rod massage combined with conventional Meibomian gland dredging for Meibomian gland dysfunction(MGD).

METHODS: Totally 130 cases(220 eyes)of MGD treated in our hospital from August 2016 to June 2017 were analyzed retrospectively. The combined group(n=65, 108 eyes)were treated with glass rod massage combined with conventional Meibomian gland dredging; controlled group(n=65, 112 eyes)was given conventional therapy. The duration was 2wk.The ocular surface disease index scale(OSDI), ocular symptoms score \〖tear break-up time(BUT), Schirmer test(SⅠt), corneal fluorescein staining(CFS), limbi palpebralis scores, property of Meibomian secretion\〗, intraocular pressure, efficient rate were monitored.

RESULTS: Before treatment, the OSDI score, BUT, SⅠt, CFS, limbi palpebralis scores, property of Meibomian secretion and IOP were not significantly different between the two groups(P>0.05). OSDI score, CFS, limbi palpebralis scores, property of Meibomian secretion of the combined group was significantly lower than that of the control group(P<0.01). The post-treatment BUT and SⅠt of the combined group were significantly higher than those of the control group(P<0.01). No significant difference was found in post-treatment IOP between the two groups, either of the two groups higher than 21mmHg(P>0.05). The total effective rate of the combined group was 92.6%(100/108), while the total effective rate of control group was 78.6%(88/112, P<0.05).

CONCLUSION: Glass rod massage combined with conventional Meibomian gland dredging in the treatment of MGD can effectively ameliorate the ocular surface symptoms, Meibomian secretion function, and promote tear secretion.

Abstract:AIM: To observe the clinical efficacy of Xiaoyao Powder combined with tobramycin dexamethasone in treating dry eye syndrome caused by Meibomian gland dysfunction(MGD).

METHODS: Totally 134 eyes of 106 dry eye patients with MGD in the First People's Hospital of Wolong District, Nanyang City from November 2015 to November 2017. They were randomly divided into the control group and the observation group, each with 53 cases(67 eyes). The two groups were all given hot compress massage, and other basic treatment. The control group was given tobramycin dexamethasone treatment, while the observation group was treated with Xiaoyao Powder on the basis of the control group. The clinical effect of two groups of patients, the symptoms of dry eye, corneal fluorescence staining(FL), the scale of quality of life for diseases with visual impairment(SQOL DVI), tear film break-up time(BUT)and the Schirmer test(SⅠT)were observed.

RESULTS: After treatment, the total effective rate of treatment in the observation group(86.6%)was significantly higher than that of the control group(67.2%). The symptoms of dry eye, corneal FL and SQOL DVI scores were significantly lower than those in the control group, and the values of BUT and SⅠT were significantly higher than those in the control group, the difference was statistically significant(P<0.01). During the treatment period, the incidence of intraocular pressure elevation in the observation group was significantly lower than that in the control group, the difference was statistically significant(P<0.05).

CONCLUSION: The Xiaoyao Powder combined with tobramycin dexamethasone in the treatment of MGD dry eye can significantly improve the curative effect and improve the prognosis of the patients.

Abstract:AIM: To compare the efficacy and characteristic of human fibrin sealant in the surgery of pterygium.

METHODS: A prospective randomized controlled study was conducted. A total of 148 eyes of 148 patients with pterygium were involved in the study from June 2016 to September 2017. All patients were divided into two groups receiving 10-0 vicryl sutures or human fibrin sealant respectively. Patients were seen on postoperative 1, 3d, 1wk, 1, 3, and 6mo after surgery. The duration of surgery, level of patient discomfort, pterygium recurrence, and complications were retrospectively analyzed between two groups.

RESULTS: The duration of surgery in observer group was 15.23±2.26min and 28.22±2.70min in control group, the difference was statistically significant(t=-31.75, P<0.01). One week later, the level of patient discomfort at 1, 3 and 7d after surgery were 0.62±0.69, 0.34±0.50, 0.16±0.37 in observation group, and the level of patient discomfort were 1.15±0.92, 0.54±0.60, 0.18±0.38 in control group, and the difference were statistically significant in observer group and control group(P<0.01); comparison between any two means in either group was significantly different(P<0.01). There were significant difference between the two groups on postoperative 1, 3d after surgery(t=-3.94, -2.22; P<0.05), and there was not significant difference between the two groups on postoperative 7d after surgery(t=-0.22, P>0.05). Two eyes(2.7%)were recurrent on postoperative 6mo after surgery in observation group and 4 of 74 eyes(5.4%)in control group, demonstrated no significant differences(χ²=24.2, P>0.05). Five of 74 eyes(6.8%)were with complications in observation group and 6 of 74 eyes(8.1%)in control group, demonstrated no significant differences(χ²=16.32, P>0.05).

CONCLUSION: The duration of surgery, patient discomfort level were reduced markedly, as less flap dislocation and postoperative reaction with human fibrin sealant compared with 10-0 vicryl sutures. A good result can be obtained by using the human fibrin sealant in the surgery of pterygium.

Abstract:AIM: To explore the clinical effect of Tongzhihuoluo Granules combined with compound anisodine on the acquired ophthalmoplegia in the middle-aged and elderly.

METHODS:We selected 81 patients(81 eyes)with acquired ophthalmoplegia in the middle-aged and elderly who were diagnosed and treated in our hospital from January 2015 to October 2017. All patients were divided into observation group(n=40)and control group(n=41)by treatment methods. The control group was given subcutaneous injection of compound anisodine 2mL near the superficial temporal artery of the affected side. The observation group was combined with Tongzhihuoluo Granules. The clinical efficacy and diplopia distance were compared between the two groups. The pulsatility index and blood flow velocity of the basilar artery before and after treatment were compared between the two groups.

RESULTS: The effective rate of ophthalmoplegia in the observation group was 92%(37/40), which was significantly higher than that in the control group(73%, 30/41; P<0.05). The incidence of cure time ≤ 2wk in the observation group was significantly higher than that in the control group(P<0.05). The recombination distances after treatment in both groups were significantly shortened(P<0.01), and the diplopia distance in the observation group was significantly shorter than that in the control group(P<0.01). The pulsation index of both groups were significantly lower after treatment(P<0.01), and the blood flow velocity was significantly increased(P<0.01), and those of the observation group changed more(P<0.01).

CONCLUSION: The clinical therapeutic effect of Tongzhihuoluo Granules combined with compound anisodine on the acquired ophthalmoplegia in middle-aged and elderly patients is significantly better than that of compound anisodine, which can effectively improve the blood flow of vertebral-basal artery and has high clinical efficacy.

Abstract:AIM: To observe the effectiveness of AC custom-made orthokeratology(Ortho-K)lens in overnight orthokeratology fitting.

METHODS: A prospective study was conducted for 84 patients(165 eyes)with myopia who wore overnight Ortho-K lens for the first time. All patients were randomly divided into two groups with 38 patients(76 eyes)in observation group wearing AC custom-made Ortho-K lens and 46 patients(89 eyes)in control group wearing standard Ortho-K lens. Three items including the uncorrected visual acuity(UCVA), corneal topography, and the complications of corneal epithelium were observed and quantized to be evaluated at 1mo after Ortho-K lens wearing.

RESULTS: The assessment of 156 eyes(94.5%, including 73 eyes in observation group and 83 eyes in control group)in Ortho-K lens fitting were fine or acceptable at 1mo. Only 9 eyes(5.5%, including 3 eyes in observation group and 6 eyes in control group)were not good or unacceptable at that time, so that their Ortho-K lens had to be followed-up ulteriorly or changed instead. In all examination of this study, the UCVA of 159 eyes(96.4%, including 74 eyes in observation group and 85 eyes in control group)could reach one line lower to the BVCA or better in standard logarithmic visual acuity chart. The assessment of 157 eyes(95.2%, including 73 eyes in observation group and 84 eyes in control group)in corneal topography were fine or acceptable and there were no patients that had any serious complications in corneal epithelium. The observation group wearing AC custom-made Ortho-K lens performed better than the control group wearing standard Ortho-K lens in the result of UCVA, corneal topography, and the complications in corneal epithelium(P<0.05).

CONCLUSION: The overnight orthokeratology was effective and satisfying. AC custom-made Ortho-K lens performed better than standard Ortho-K lens in the assessment after wearing for 1mo.

Abstract:AIM: To explore the effect of binocular visual function training on the reconstruction of binocular visual function and maintaining the stable eye position in postoperative patients with intermittent exotropia.

METHODS: A total of 142 patients with intermittent exotropia underwent strabismus surgery in our hospital from January 2010 to December 2015 were enrolled. These patients were divided into two groups according to whether had binocular visual function training after surgery. The treatment group was used the DV-100 system to train the three-level visual function after surgery. For the control group, no intervention was performed after the operation. Respectively analysis the differences of binocular visual function and eye position in the two groups of patients before and 1mo after surgery, 3mo after surgery, 6mo after surgery, and 1a after surgery.

RESULTS: The rate of the positive eye position in the treatment group was higher than the control group in the 6mo and 1a after surgery, and statistically significant difference was found(P<0.05). In 1, 3, 6mo and 1a after surgery, there were statistically significant differences in binocular visual function between the two groups. The recovery of binocular visual function in the treatment group was significantly better than that in the control group.

CONCLUSION: The binocular visual function may have a certain degree of recovery in the patients with intermittent exotropia after surgery to obtain positive eye position. Through the postoperative visual perception learning and binocular visual function training, the binocular visual function can be better and faster recovered and reconstructed so as to obtain stereoscopic vision. It can better stabilize the eye position and help to reduce the rate of the patient's eye position fallback after surgery.

Abstract:AIM:To analyze the pathogenesis, refraction states, refractive error correction with glasses and distant vision rehabilitation using optical far-range visual aids in children with childhood blindness and low vision.

METHODS: A selection of 212 blind and low vision children, 422 eyes, aged 6-16, were examined by our team at the Kunming Children's Hospital Opthalmology Clinic and Kunming School of the Blind during opthalmic screening from December 2015 to April 2018 for their pathogenesis and refraction states. A portion of those patients were able to receive refractive error correction and be fitted with optical far-range visual aids to have their rehabilitation condition analyzed afterwafrds.

RESULTS: The most common pathogenesis discovered in blind and low vision children was congenital genetic oculopathy with congenital cataracts reported as the leading disease in our group(19.3%). Mild, moderate myopia and hyperopia was the most common in subjects with low vision refractive error(65.3%). Children achieved blindness correction(26.4%)and disability correction(14.6%)with refractive error correction alone was much less than those achieved blindness correction(58.3%)and disability correction(91.1%)using refractive correction alongside fitted far-range visual aids; differences were statistically significant(P<0.01).

CONCLUSION: The pathogenesis of children with blindness and low vision is multi-faceted and complex; priority should be given to prevention by working to provide regular opthalmic screening. Children with low vision should receive routine refraction examinations and be prescribed glasses as well as fitted far-range visual aids for satisfactory rehabilitation results.

Abstract:AIM: To observe the changes of intraocular pressure and choroidal thickness after hemodialysis in patients with chronic renal failure, and to explore the impact of hemodialysis on blood supply.

METHODS: Totally 55 patients(110 eyes)with chronic renal failure who had been treated for a long time in our hospital were selected to test plasma osmotic pressure. Before and after hemodialysis 5min, hemodialysis venous blood was collected, and plasma osmotic pressure was measured. Before hemodialysis 1h and after hemodialysis 1h, intraocular pressure was measured; intraocular pressure and choroidal thickness were compared before and after hemodialysis measured by enhanced depth imaging technique of optical coherence tomography(OCT).

RESULTS: After hemodialysis plasma osmotic pressure reduced, and the difference was statistically significant(t=12.73, P<0.01); and intraocular pressure increased after hemodialysis and the difference was statistically significant(t=2.07, P<0.05). The choroid thickness was thinner after hemodialysis, and the differences before and after hemodialysis at every measurement points(under central fovea, nasal, temporal, superior and inferior 1 and 3mm from the central fovea)were statistically significant(P<0.05).

CONCLUSION: After hemodialysis ocular pressure increased and the choroid thickness became thinner in chronic renal failure patients, which might affect the ocular blood flow state. It is suggested that the osmotic pressure gradient should be adjusted in hemodialysis patients and eye test and treatment must be given in necessity.