Abstract:AIM: To compare of intravitreal bevacizumab and intravitreal bevacizumab and triamcinolone acetonide in eyes with bilateral diabetic macular edema.

METHODS: In this retrospective comparative-randomized study, 42 eyes of 21 diabetic patients with bilateral macular edema were evaluated. In one eye intravitreal injection of 1.25 mg bevacizumab(IVB group)was performed and in the fellow eye intravitreal injection of combined 1.25 mg bevacizumab and 1 mg triamcinolone acetonide(IVTA-IVB group)was performed. Main outcomes were the central macular thickness(CMT)measured with optical coherence tomography(OCT), ETDRS visual acuity(VA)and intraocular pressure(IOP).

RESULTS: Mean follow-up time was 4.7±1.5mo. In the IVB and IVTA-IVB groups, mean CMT was 494.7±114.4 μm and 546.8±165.6 μm before injections; 430.4±133.2 μm and 363.7±105.3 μm in first month; 484.8±167.4 μm and 407.3±108.7 μm in 3^rd month; 550.4±191.5 μm and 516.8±158 μm after 6mo respectively. Differences were significant in first and 3^rd months(P<0.05). In the IVB and IVTA-IVB groups, mean ETDRS VA score was 57.1±13.5 and 48.9±13.9 before injections; 62.2±14 and 58.8±12.1 in first month; 59±13.7 and 59.3±13.6 in 3^rd month; 55.6±14.9 and 55.5±8.7 after 6mo respectively. Differences were significant in first and 3^rd and 6mo(P<0.05). There was no IOP difference. IVTA-IVB group gains best VA in 3^rd month after the first injection and maintains it for 6mo whereas IVB group gains best VA at first month and can be able to maintain for 3mo.

CONCLUSION: Injection of 1 mg IVTA-IVB seems to be better than IVB alone in improving VA for 6mo without any steroid dependent complications.

Abstract:AIM: To evaluate the clinical efficacy of a newly designed silicone tube for the repair of canalicular lacerations.

METHODS: This was a prospective clinical study. Data were analyzed from 47 eyes of 47 patients presenting with traumatic canalicular laceration in our hospital from January 2013 to October 2015. The newly designed silicone tubes were inserted through the lacrimal punctum and left in the bicanaliculi for 3mo. Data of the lacrimal duct patency, epiphora, and eyelid shape were recorded.

RESULTS: Surgery was performed successfully in all cases. No complications associated with the silicone tubes occurred. In total, 41 patients(87.23%)achieved complete success, 4 patients(8.51%)achieved partial success, and 2 patients(4.26%)had surgical failure.

CONCLUSION: The newly designed silicone tube is an effective and atraumatic tool for the management of canalicular lacerations. The operation process is simple, and is easy to grasp for the surgeon.

Abstract:AIM: To Study the anti-fungal effect of corneal collagen cross-linking combined with natamycin in vivo and in vitro, so as to provide the treatment and experimental basis for the treatment of clinical fungal keratitis.

METHODS: Three common pathogenic fungi(Aspergillus flavus, Fusarium Solani and Candida albicans)were used. The experimental group was divided into cross-linking combined natamycin group, natamycin combined riboflavin group, natamycin combined UVA irradiation group, cross-linking group and natamycin group as the control group. The drug was added to the center of the Sabouraud dextrose agar(SDA)plate coated with liquid with each fungal spores with the same maid turbidity of 1.5. Ten minutes later, it was irradiated with collagen cross-linking instrument for 10min and cultured at 28℃ for 36h, and then the inhibition zone size was measured and analyzed statistically. The rabbit model of Fusarium Solani corneal infection was prepared. The model rabbits were randomly divided into model control group, cross-linking treatment group, natamycin treatment group, cross-linking combined natamycin group, 5 rabbits in each group. And another 5 normal rabbits were taken as control, and five rabbits were irradiated in accordance with corneal collagen cross-linking therapy. The results were observed by anterior segment photography, corneal scraping and confocal microscopy, and the ultra micro structural changes of the corneas were observed by electron microscope after the treatment.

RESULTS: Corneal collagen cross-linking alone had shown no effect on each fungus in vitro. Corneal collagen cross-linking combined with natamycin produced significant anti-fungal effect(P<0.05). However, the anti-fungal effect of natamycin combined riboflavin group and natamycin combined ultraviolet light group showed no statistical difference(P>0.05)comparing with the control group. For the model of rabbit fungal infection, the course of disease was about 14d in the natamycin group and CXL combined with natamycin group, and it was about 21d in CXL group. After the treatment, all the groups healed. There were no defects in the corneal epithelium, no mycelium in the corneas, except for more corneal neovascularization. The results of the anterior segment photography showed that the treatment effect of the cross-linking combined natamycin group was better than other groups, with fewer scar tissue, better corneal healing and relatively short course of disease.

CONCLUSION: Corneal collagen cross-linking combined with natamycin treatment is able to enhance anti-fungal effect, promote corneal healing, and shorten the course of disease. So it is a promising therapeutic technique for the clinical treatment of fungal keratitis.

Abstract:AIM: To observe the effect of pigment epithelium-derived factor(PEDF)on retinal neovascularization(RNV)and monocyte chemoattractant protein-1(MCP-1)expressions in mice retina of oxygen-induced retinopathy(OIR), and to investigate the protective effect of PEDF on ischemia hypoxia retinopathy and the possible mechanism.

METHODS: A total of 160 postnatal day(P)7 C57BL/6 mice were obtained. All mice except normal control group were exposed to(75±2)% oxygen environment for 5d and then kept in room air for another 5d to establish the OIR mice model. All mice in normal control group(40 mice)were exposed to room air only. At P12 and P14, respectively, mice in PEDF treatment group were injected intravitreously with recombinant human PEDF(2μg/eye,1μL)in the right eye, while mice in treatment control group were injected intravitreously with the same volume of vehicle [1μL, 10mmol/L phosphate buffered saline(PH7.4), PBS] in the right eye. All mice were euthanized at P17. Eyes were whole mounted and stained with Lectin to observe the growth of abnormal RNV; And retinal specimens were prepared for PEDF, MCP-1 protein and mRNA analysis by Western blot and real time RT-PCR respectively.

RESULTS: Changes of retinal vessels had been detected by fluorescence microscopy on flat-mounted retina. The relative RNV areas were significantly increased in OIR model group compared with those in normal control group(P<0.01). However, the relative RNV areas were significantly reduced in PEDF treatment group compared with those in PBS treatment control group(P<0.01). The specific expression of MCP-1 protein and mRNA in the OIR model group were higher than those of normal control group, presenting a statistically significance(both P<0.05). The specific expression of PEDF protein and mRNA in the OIR model group showed a considerable decline in comparison with normal control group, presenting a statistically significance(both P<0.01). And the specific expression of MCP-1 protein and mRNA in those of PEDF-treated group showed a considerable decline in comparison with PBS-treated group, and the differences were statistically significant(both P<0.05). However, there were increase of the expression of MCP-1 protein and mRNA between normal control group and PEDF-treated group, presenting no statistically significance(both P>0.05).

CONCLUSION: PEDF could inhibit oxygen-induced retinal neovascularization and down-regulate retinal MCP-1 expression under hypoxia, which may underlie its anti-neovascularization effects and play a role of protection in ischemic retinopathy.

Abstract:AIM: To explore the differences of expression pattern of microRNA(miRNA)in plasma from Behçet's disease(BD)syndrome patients and normal controls, searching for diseases-relating biomarkers.

METHODS: Blood samples from 15 cases of BD patients and 15 cases of normal control were collected to extracted total RNA in plasma. The miRNAs was labeled, miRNAs array hybridization was performed and then array-scanned and analyzed. We searched verified target genes and selected meaningful miRNAs to underwent real time PCR.

RESULTS: In comparison with the healthy controls, there were 8 anomalous miRNAs, in which 3 miRNAs(hsa-miR-34c-5p, hsa-miR-144-3p, hsa-miR-483-3p)were up regulated and 5 miRNAs(hsa-miR-301a-3p, hsa-miR-224-5p, hsa-miR-454-3p, hsa-miR-17-5p, hsa-miR-199a-5p)were down regulated(all P<0.05).

CONCLUSION: The present examination suggests that aberrant levels of miRNAs could contribute to the pathogenesis of BD. Deviant expression of miRNAs may be involved in the activation of Notch1 and SMAD4 pathway in BD, which could offer a novel therapeutic approach for BD.

Abstract:AIM:To explore the correlation between glucose metabolism, insulin resistance and inflammatory factors in aqueous humor and serum in patients with diabetic cataract.

METHODS:Sixty-nine patients with diabetic cataract and sixty-five patients with simple cataract were randomly selected from February 2017 to January 2018 in our hospital. The fasting blood glucose(FPG),glycosylated hemoglobin(HbA1c),insulin resistance index(HOMA-IR)in serum, and IGF-1, IL-6 in aqueous humorand serum were compared between the two groups. HbA1c,HOMA-IR, IGF-1 and IL-6 for correlation were analyzed respectively.

RESULTS: The levels of FPG,HbA1c, HOMA-IR in serum, and IGF-1, IL-6 in aqueous humor and serum in the control group were significantly lower than those in the observation group(P<0.05). Positive correlation between HbA1c and IGF-1, IL-6 in aqueous humor and serum(P<0.05). Positive correlation between HOMA-IR and IGF-1, IL-6 in aqueous humorand serum(P<0.05).

CONCLUSION: HbA1c and HOMA-IR in diabetic cataract patients are correlated with IGF-1 and IL-6 contents in aqueous humor and serum. The above indicators can be used to determine the condition.

Abstract:AIM: To observe the clinical therapeutic efficiency of 1g/L sodium hyaluronate eye drops on ocular surface disorders in patients with proliferative diabetic retinopathy(PDR)after 20G pars plana vitrectomy(PPV).

METHODS: Randomized single blind case control study was used. Patients with type 2 diabetes who were admitted to the department of ophthalmology, Xi'an No.4 Hospital for PDR and underwent 20G PPV surgery by the same surgeon were randomly divided into PDR control group(Group A)and sodium hyaluronate treatment group(Group B). Group B received continuous 1g/L sodium hyaluronate eye drops from 1d to 2mo after surgery. Before and 1wk, 1, 3mo after surgery, OSDI, SⅠt, BUT, fluorescein cornea staining(FL)and the tear film and corneal epithelial cell layer under corneal laser scanning confocal microscopy of the two groups were compared.

RESULTS:A total of 90 cases and 90 eyes were studied. In preoperative time, the two groups showed obvious dry eye syndrome, and compared with the control subjects, there were no significant difference existed between the two groups(P>0.05). In group A, ocular surface injury was further aggravated after surgery and failed to recover with time extension during the observation period.Some indexes of Group B improved at different observation time after surgery compared with those before surgery, and there were significant differences between group A and Group B after surgery(P<0.05).

CONCLUSION: Applying 1g/L sodium hyaluronate eye drops could relief the uncomfortable feeling of ocular surface in patients with PDR after 20G vitrectomy and accelerate the recovery of ocular surface disorders.

Abstract:AIM: To analyze the correlation between levels of serum soluble intercellular adhesion molecule-1(sICAM-1), soluble vascular cell adhesion molecule-1(sVCAM-1)and the severity of thyroid-associated ophthalmopathy(TAO).

METHODS: A total of 120 patients with TAO admitted to the hospital from August 2016 to March 2018 were selected and included in the study. According to the clinical activity score(CAS), the patients were divided into active stage group and inactive stage group. According to the severity, they were divided into mild group, moderate group and severe group. There were 90 healthy persons were selected as the control group at the same time. The general data, serum sICAM-1 and sVCAM-1 levels were compared among groups and the correlation of sICAM-1 and sVCAM-1 levels with the severity of TAO was analyzed.

RESULTS: There were no significant differences in the clinical basic data of patients in between the different clinical active stage groups and the control group, and between the different severity groups and the control group(P>0.05). The levels of serum sICAM-1 and sVCAM-1 in the active stage group were significantly higher than those in the inactive stage group and the control group(P<0.01). The levels of serum sICAM-1 and sVCAM-1 in active stage patients of different severity groups were significantly higher than those in inactive stage patients and of control groups(P<0.01). There were no significant differences in levels of serum sICAM-1 and sVCAM-1 in inactive stage patients of different severity groups. The levels of serum sICAM-1 and sVCAM-1 in active stage patients of different severity groups increased gradually with the severity of the disease. There was no significant correlation between levels of serum sICAM-1 and sVCAM-1 in inactive stage patients and the severity of disease(r=0.102, 0.095, P=0.135, 0.167). Levels of serum sICAM-1 and sVCAM-1 in active stage patients were positively correlated to severity of disease(r=0.695, 0.824, P=0.005, 0.002).

CONCLUSION: The levels of serum sICAM-1 and sVCAM-1 in inactive patients will not increase with the severity of the disease. However, the levels in patients with active disease will increase with the severity of the disease, which can be used for clinical diagnosis and staging of TAO and monitoring of the prognosis.

Abstract:AIM:To compare the curative effect between monocular lateral rectus recession(BLR)and Binocular recession resection(R & R)for basic intermittent exotropia.

METHODS:A literature review using the MEDLINE, EMBASE, The Cochrane Library, Web of Science, Clinical Trial, CBM, Wanfang Databases and paper collections of conferences was performed. Randomized controlled trials comparing the effects of BLR and R & R for basic intermittent exotropia with a duration of follow-up at least half a year were eligible for inclusion. The methodologic quality of included studies was evaluated independently by 2 authors. Statistical analysis was performed by using the STATA 14 software(StataCorp Texas USA).

RESULTS:Five prospective random controlled clinical trials involving 529 patients were included. Compared with R & R procedure,the BLR procedure group showed lower successful rate(RR:0.85; 95% CI:0.72-0.99; P=0.043)and postoperative undercorrection(RR:3.975; 95% CI:2.097-7.537; P<0.01). The P value of long-term postoperative corrected rate in Meta analysis was decreased near to 0.05 when the included references increased. There was no significant difference in overcorrection rate between the BLR and R & R procedures(RR:0.336; 95% CI:0.049-2.294; P=0.266).

CONCLUSION:Current evidences suggested that BLR procedure is related to lower successful and higher undercorrection rates for basic intermittent exotropia compared to conventional R & R procedure.

Abstract:Keratoplasty is routinely used to treat end-stage corneal diseases. However, immune-mediated graft rejection remains the major cause of surgical failure. Organ transplant rejection is often due to the directional migration and homing of inflammatory cells to lymphoid tissues and local inflammatory sites, which is regulated by various adhesion molecules and chemokines. Regulatory T cells play a key role in immune regulation and are essential for maintaining peripheral tolerance. Recent studies have revealed that regulatory T cells play important roles in preventing organ transplant rejection and the development of autoimmune diseases. This review will summarize the recent research on the induction of ocular immune privilege by regulatory T cells, with special focus on how regulatory T cells mediate tolerance in the eye and clinical potential of modulating these mechanisms during corneal transplantation.

Abstract:As the morbidity of myopia increasing gradually, the prevention-control of myopia has been given more attentions. Orthokeratology(OK-lens), is now widely approved and used in clinical treatment as a non-surgical measure. The OK-lens directly contact the corneal anterior surface, therefore having some effects on the morphology and biological characteristics of the cornea. The purpose of this paper is to put forward suggestions and advices for clinic, by reviewing the influence of OK-lens on the corneal sub-basal nerve plexus in the current studies.

Abstract:Posterior scleral reinforcement surgery is a common method for the treatment for high myopia, which can strengthen the intensity of sclera and inhibit the progression of high myopia. The posterior scleral reinforcement materials are very important, including biological materials such as pericardium, donor sclera, umbilical cord, dura mater, acellular allograft dermis and so on; non biological synthetic materials such as polyester fiber, polyester mesh sponge and plasma-modified silicone graft and so on. These materials were used in the experimental animals and clinical patients, and showed obvious effect on controlling the progress of high myopia.

Abstract:The corneal epithelial cells are the outermost layer of the cornea. When they are turnover or trauma, the corneal epithelial cells are supplemented by continuous self-renewal of stem cells located in the basal epithelium at the corneoscleral limbus. If limbal stem cells are deficient(LSCD), this balance would be broken, resulting in corneal diseases. Currently, transplantation of cultured limbal stem cells is one of the best curative option of reconstruction of the ocular surface. This article reviews the recent progress on identification, different sources of stem cells, and expansion of limbal stem cells.

Abstract:Anti-vascular endothelial growth factor(VEGF)agents are revolutionary in the treatment of retinal diseases, such as exudative age-related macular degeneration,diabetic retinopathy(DR), and retinal vein occlusion. Intravitreal injection of anti-VEGF agents can reduce macular edema significantly, but whether anti-VEGF therapy impairs retinal microcirculation and facilitates retinal vascular occlusion. This article reviews on the effect of anti-VEGF therapy on retinal capillary in diabetic macular edema, from three aspects of foveal avascular zones, areas of nonperfusion and retinal capillary density, using optical coherence tomography angiography(OCTA)and ultra-wide field fluorescein angiography(UWFA).

Abstract:Diabetic retinopathy is one of the serious complications of diabetes, which often results in decreased vision, visual field defects, vitreous hemorrhage,even traction retinal detachment, and blindness in the end. The disease is a major cause of blindness in diabetics, which seriously affects the quality of patients' life. This article reviews new progress in laser, drug and gene treatment of diabetic retinopathy.

Abstract:Diabetic retinopathy(DR)is the most common retinal vascular disease, seriously compromising visual function and quality-of-life. Retinal laser photocoagulation is one of the safest, most effective, and economical methods used to treat DR, but is associated with certain side-effects developing at the time of treatment. Given the continuous developments in diagnostic and treatment modalities, the complications associated with the use of traditional single-point lasers are becoming better understood. Today, the clinical demand for multi-point scanning lasers is increasing, but the effectiveness and safety of both treatments require further exploration. Here, we review the effects of laser treatment on vision, fundus fluorescein angiography, the visual field, visual function, macular edema, and the corneal nerve.

Abstract:AIM:To study the variation of ocular biometric parameters and their relationship before and after phacoemulsification in cataract patients with over-long axial length.

METHODS:A total of 44 cases(61 eyes)were collected from September 2013 to March 2015 in Xuanwu Hospital which had underwent phacoemulsification and intraocular lens(IOL)implantation. The study contained 29 eyes of 20 patients with over-long axial length and 32 eyes of 24 patients with normal axial length. Before cataract surgery, the optical biometric measurements had been measured by IOL Master. And 3mo after surgery, the ocular biometric parameters had been recorded by IOL Master and ultrasound biomicroscopy(UBM). The changes and correlation of biometric parameters was performed using the SPSS software(version 17.0).

RESULTS: Pearson correlation analysis showed there was no correlation between postoperative anterior chamber depth and age, preoperative axial length, or preoperative corneal curvature in over-long axial length group(P>0.05). There was a positive correlation between the postoperative anterior chamber depth and the preoperative anterior chamber depth(r=0.402, P=0.031). Compared with the preoperative biometric parameters in over-long axial length group, axial length shortened, corneal curvature increased, anterior chamber depth deepened after surgery, and the difference was statistically significant(P<0.05). However, in the normal axial control group there was no correlation between the postoperative anterior chamber depth and age, preoperative axial length, or preoperative anterior chamber depth(P>0.05). There was a positive correlation between the postoperative anterior chamber depth and the preoperative corneal curvature(r=0.538, P=0.001). And in normal axial control group, the axial length was significantly shorter than that before surgery(P<0.05). The anterior chamber depth was significantly increased compared with the preoperative(P<0.05), and the corneal curvature was unchanged(P>0.05). The percent change of corneal curvature was statistically significant between two groups(P<0.05), and the percent change of corneal curvature in over-long axial length group was bigger than normal axial length group. There was no significant difference in the percent change of axial length and anterior chamber depth(P>0.05).

CONCLUSION: In cataract patients with over- long axial length, postoperative axial length shortened, and postoperative corneal curvature increased. A certain number of degrees should be added when calculating the degree of intraocular lens in order to obtain better postoperative visual acuity. The prediction of postoperative anterior chamber depth in cataract patients with over-long axial length has complexity and unpredictability of individual differences, and requires further research.

Abstract:AIM:To analyze the effect of phacoemulsification and astigmatism corrected multifocal intraocular lens(IOL)implantation on corneal astigmatism and visual quality in cataract patients.

METHODS:Ninety-five patients who underwent ophthalmic surgery in our hospital for cataract disease between December 2016 and February 2018 were studied. All subjects were randomized and compared. Both groups were treated with phacoemulsification. The control group was treated with astigmatism-corrected monofocal intraocular lens implantation. The observation group was combined with astigmatism-corrected multifocal intraocular lens implantation. The differences in corneal astigmatism, visual quality, and vision improvement were compared between the two groups.

RESULTS: Uncorrected distance vision, best corrected distance vision, uncorrected near vision and best corrected near vision were significantly improved in the two groups after treatment at 3mo after operation. The degree of improvement in the observation group was significantly higher than that in the control group(P<0.05). The corneal astigmatism of the two groups was significantly improved after treatment(P<0.05). There was no significant difference between the two groups(P>0.05). After the treatment,the visual contrast sensitivity was significantly increased(P<0.05). The visual contrast at the 18 cpd spatial frequency in the observation group was significantly lower than that in the control group(P<0.01).One day after surgery, only two eyes in the observation group showed corneal endothelial edema, and only one eye in the control group showed corneal endothelial edema. There was no significant difference in the incidence of complications between the observation group and the control group(P>0.05).

CONCLUSION: The treatment of cataract patients with phacoemulsification and astigmatism-corrected multifocal IOL implantation can effectively correct vision, reduce corneal astigmatism, and improve visual contrast. The entire surgical procedure is safe and has fewer postoperative complications.

Abstract:AIM: To analyze the application value of optical coherence tomography(OCT)combined with isolated-check visual evoked potential(Ic-VEP)in the diagnosis and treatment of primary open angle glaucoma(POAG).

METHODS: Prospective cohort study. Totally 32 eyes of 32 suspected glaucoma cases, 30 eyes of 30 early POAG cases, 25 eyes of 25 moderate and late POAG cases were selected from the patients treated in our hospital from October 2014 to May 2018 were enrolled, and 30 eyes of 30 normal subjects were selected as control group. All subjects received OCT, Ic-VEP, visual field test, measurement results were analyzed.

RESULTS: The sensitivity and specificity of Ic-VEP in diagnose of early POAG was 83% and 93% respectively. The difference between the early POAG group and the suspected glaucoma group was no statistically significant in the signal-to-noise ratio of 8% SNR(P>0.05), but were statistically significant in other groups(P<0.05). The differences of 16%SNR and 32%SNR between the control group and the moderate and late POAG group, the suspected glaucoma group and the moderate and late POAG group, the early POAG group and the moderate and late POAG group were statistically significant(P<0.01), but were no statistically significant in other groups(P>0.05). The retinal nerve fiber layer(RNFL)thickness parameters in four groups became thinner with the aggravation of the disease, and the differences between the four groups were statistically significant(P<0.05). The mean defect of the four groups decreased gradually, there were no significant differences between the suspected glaucoma group and the control group(P=0.08), the differences between the other groups were statistically significant(P<0.05). The area under the ROC curve of 8%SNR, mean RNFL and MD in the suspected glaucoma group were 0.824, 0.846 and 0.661 respectively, the early POAG group of those were 0.898, 0.969, 0.889, respectively.

CONCLUSION: OCT and Ic-VEP have high diagnostic ability for the early changes of POAG and can evaluate the degree of optic nerve injury, which can be combined used for early diagnosis and efficacy evaluation of POAG.

Abstract:AIM:To study the effect of Yijing Buyang Huanwu Decoction on intraocular pressure control and prognosis in patients with open angle glaucoma.

METHODS: Totally 93 patients(186 eyes)with open angle glaucoma admitted to our hospital from July 2015 to July 2017 were selected. All patients were divided into two groups according to the random number table method. In the observation group, 47 cases(94 eyes)were treated with timolol eye drop combined with Yijing Buyang Huanwu Decoction, and in the control group, 46 cases(92 eyes)were treated with timolol eye drop only. The clinical effect, visual acuity, intraocular pressure, central retinal artery blood flow, mean defect area, visual field average photosensitivity and image evoked visual potential were observed and compared before and after treatment.

RESULTS: The total effective rate of the observation group after treatment was significantly higher than that of the control group(85.1% vs 63.0%, P<0.01). After treatment, the intraocular pressure in the observation group was significantly lower than that in the control group(P<0.01). After treatment, RI values of central retinal artery blood flow in observation group were significantly lower than those in control group(P<0.01). PSA and EDV values were significantly higher than those in control group(P=0.011,<0.01). After treatment, the average photosensitivity of the observation group was significantly higher than that of the control group(P=0.001), and the average defect area was significantly less than that of the control group(P=0.011).

CONCLUSION: Yijing Buyang Huanwu Decoction is effective in the treatment of open angle glaucoma. It can effectively control the level of intraocular pressure, enlarge the visual field, promote blood circulation and improve the prognosis.

Abstract:AIM: To investigate the expression levels of serum miR-23a and miR-34a in patients with age-related macular degeneration(ARMD)and its relationship with the development of ARMD.

METHODS: Totally 102 patients with ARMD who were treated in our hospital from May 2015 to February 2018 were enrolled in the case group, and 70 healthy subjects in the same period were used as control group. The relative expression levels of miR-23a and miR-34a in serum were detected by RT-PCR, and the levels of serum tumor necrosis factor alpha(TNF-α)and nuclear factor kB(NF-kB)were detected by enzyme linked immunosorbent assay(ELISA). Analysis on the relationship of miR-23a, miR-34a expression levels with TNF-a, NF-kB in patients with ARMD and its diagnostic value for ARMD were taken.

RESULTS: The relative expression levels of serum miR-23a and miR-34a in the case group were significantly higher than those in the control group(P<0.01). The relative expression levels of serum miR-23a and miR-34a in the advanced group were significantly higher than those in the middle and early stage(P<0.01). The relative expression levels of serum miR-23a and miR-34a in the middle term patients were significantly higher than those in the early stage(P<0.01). The serum levels of TNF- α and NF-κB in the case group were significantly higher than those in the control group(P<0.01). There was a significant positive correlation between serum miR-23a and TNF-α and NF-kB in the case group(r=0.798, 0.720, both P<0.01), and serum miR-34a was significantly positively correlated with TNF-α and NF-kB(r=0.814, 0.740, both P<0.01). The area under the ROC curve(AUC)of serum miR-23a and miR-34a for diagnosis of ARMD was 0.831 and 0.867, respectively.

CONCLUSION: The expression of miR-23a and miR-34a in serum of ARMD patients is up-regulated, which may be involved in the development and progression of ARMD by promoting inflammation and oxidative stress. Detection of serum miR-23a and miR-34a may be helpful for early diagnosis and prevention of ARMD.

Abstract:AIM:To explore the influence of compound anisodine combined with triamcinolone acetonide on the oxygen saturation of retinal vessels and serum Apelin in patients with diabetic retinopathy(DR).

METHODS:Totally 58 cases of patients(60 eyes)with diabetic retinopathy from June 2014 to December 2016 in our hospital were selected as the research object. All of them were randomly divided into control group(29 cases, 30 eyes)and observation group(29 cases, 30 eyes). The control group received panretinal photocoagulation; the observation group was given intravitreal injection of triamcinolone acetonide before panretinal photocoagulation combined with compound anisodine after panretinal photocoagulation. After treatment, the postoperative visual recovery and the complications were recorded. The oxygen saturation of retinal vessels and the serum levels of Apelin of the two groups were analyzed and compared as well.

RESULTS:After the treatment, the visual acuity of the two groups increased significantly, the proportion of vision improvement in the observation group(90%)was significantly higher than that in the control group(67%, P<0.05). The mean sensitivities of visual field in the observation group in 1d,1mo and 2mo after photocoagulation were significantly higher than those in the control group(P<0.05). Compared with the before treatment, the oxygen saturation of retinal vessels had decreased after treatment in both groups, that in observation group was significantly higher than control group(P<0.05). Compared with the before treatment, the level of Apelin had decreased after treatment in both groups, the Apelin levels was significantly lower in observation group than control group(P<0.05). The complication rate in the observation group was 3% while the complication rate in the control group was 17%, no difference was found on the incidence of complication between the observation group and control group(P=0.109).

CONCLUSION:The implementation of intravitreal injection of triamcinolone acetonide combined with the injection of compound anisodine via temporal subcutaneous tissue for patients with diabetic retinopathy is significantly effective, it can effectively reduce the level of the Apelin to inhibit the proliferation of retinal vessels, relieve the ischemic and hypoxia injury, which benefits the postoperative vision recovery with high safety.

Abstract:AIM:To study the ocular surface and corneal lesions under different degrees of retinopathy in patients with type 2 diabetes mellitus(T2DM).

METHODS: A total of 123 patients(246 eyes)with T2DM were enrolled in this study. All of patients were divided into non-diabetic retinopathy group(46 patients 92 eyes), non-proliferative diabetic retinopathy group(50 patients 100 eyes)and proliferative diabetic retinopathy group(27 patients 54 eyes)according to the type of retinopathy. Dry eye questionnaire, ocular surface disease index(OSDI), Schirmer Ⅰ text(SⅠt), tear break-up time(BUT), fluorescein staining of cornea(FL), corneal endoscopy and central corneal thickness measurement were used to analyze the differences of three groups.

RESULTS: There was no statistically significant difference in general data between the three groups. Significant differences existed in eye pain, dry eyes, lacrimation, eye fatigue, burning sensation, vision fluctuations in three groups(P<0.05). Foreign body sensation, itchy eyes, red eyes showed no significant difference in groups(P>0.05). There were significant differences in ODSI value, FL positive rate, BUT, SIt, corneal endothelial cell density and central corneal thickness in three groups(P<0.05). variable coefficient of corneal endothelial cell showed no Significant difference in groups(P>0.05).

CONCLUSION: The findings of this study show that patients with type 2 diabetes mellitus presented obviously discomfort symptoms of ocular surface, decreased tear film stability, increased positive rate of corneal fluorescein staining; decreased density of corneal endothelial cells; increased central corneal thickness in diabetic patients, all of which were associated with degree of retinopathy.

Abstract:AIM:To study the effects of long-term wearing monocular orthokeratology on ocular surface.

METHODS: A retrospective study was conducted in patients with unilateral myopia(The contralateral eye of each patient was emmetropic.)who used orthokeratology lens for more than half a year. The patients were recruited from January 2013 to December 2015, in ophthalmological clinic, 101 Hospital of PLA, Wuxi. The tear break-up time(BUT), basal tear secretion, central corneal thickness, corneal endothelial cell density, conjunctival congestion and corneal epithelium fluorescein staining were observed before wearing orthokeratology and at different time points during wearing orthokeratology.

RESULTS: Fifty-three young patients(53 eyes)with long-term wearing a monocular orthokeratology lens were observed, whose ages were 10.43±1.70 years old and their spherical equivalents(SEs)were -3.37±1.50D. For the myopic eyes, after 1-week treatment of monocular orthokeratology, the BUT was shortened, but there was no significant difference compared with those after 1-month, 3-month, 6-month treatment of monocular orthokeratology(P>0.05). For the emmetropic eyes, there was no significant difference in changing the BUT at above different time points(P>0.05). There was no significant difference in the value of basal tear secretion at those time points between two different kinds of eyes(The myopic eyes with orthokeratology and the emmetropic eyes without orthokeratology)(P>0.05). Compared with before wearing orthokeratology lens, there was no significant difference in both corneal center thickness and corneal endothelial cell density at those time points after wearing orthokeratology lens(P>0.05). After wearing orthokeratology lens, the corneal epithelial stain was mostly Ⅰ dyed. After 1wk, 1, 3 and 6mo respectively, the Ⅰ dyed amounts were 10 eyes(19%), 6 eyes(11%), 8 eyes(15%), 6 eyes(11%),the Ⅱ dyed amounts were 1 eye(2%), 0, 0, 1 eye(2%). The conjunctival congestion(score 1)showed up on 10 patients after wearing the orthokeratology lens. After all the 10 cases stopping wearing orthokeratology lens, but taking some antibiotics and corneal repair agents, the corneal epithelium stain disappeared and the conjunctival congestion faded away. For the emmetropic eyes, no obvious conjunctival congestion was observed during the observation period, and the corneal epithelial stain was 0.

CONCLUSION: Continuous wearing orthokeratology can cause the decrease of the stability of tear film. And it also affects the conjunctiva and corneal epithelium by degrees. But it has no significant effect on tear secretion, corneal thickness and corneal endothelial cells. There will be no apparent ocular surface damage on non-wearing eyes.

Abstract:AIM: To evaluate the agreement and interchangeability of a Scheimpflug camera(Pentacam)and a partial coherence interferometry keratometer(IOL Master)in eyes having preoperative assessment for routine cataract surgery.

METHODS: In this prospective clinical study, 41 patients(64 eyes)with normal cornea from January 2017 to June 2017 in our hospital were enrolled. Simulated K, true net power and Holladay equivalent K(EKR)measured at 1.0 to 7.0 mm corneal diameters were measured by the Pentacam system and mean keratometer(Km)was measured by the IOL Master. Paired samples t test, Pearson correlation analysis and Bland-Altman method were used for statistical analysis.

RESULTS: Among patients with cataract of normal cornea, the mean Scheimpflug K for true net power and EKR at 1.0mm, 2.0mm, 3.0mm corneal diameters were statistically significantly less than the mean Km(IOL Master). The EKR at 4.5mm, 5.0mm, 6.0mm, 7.0mm of corneal diameters were significantly greater than the mean Km(IOL Master)(P<0.01 for all). The difference between Sim K and EKR at 4.0mm measured by Pentacam and Km measured by IOL Master was the smallest(-0.03D±0.252D and 0.04D±0.244D, respectively; t=-1.018, P=0.313; t=1.461, P=0.149), and it had the best uniformity with 95% credible interval of -0.53D to 0.46D(sim K)and -0.43D to 0.52D(equivalent K at 4.0mm). A Pearson correlation revealed a high correlation for corneal power measurements between the two devices(r>0.9 for all, P<0.01 for all).

CONCLUSION: The sim K and EKR at 4.0mm had the closest match with the Km(IOL Master)for Chinese patients with cataract of normal cornea. However, the application of these devices should be combined with clinical features.

Abstract:AIM:To observe the different effect of controlling myopia by orthokeratopraxis with different width between defocus circle and the rim around the cornea.

METHODS: A retrospective case-control study. A total of 45 patients(85 eyes)who came to our hospital for orthokeratopraxis lens fitting during January 2014 to December 2015 were selected. The diameter of the orthokeratopraxis lens was 90%-95% of the diameter of the cornea. So the patients were divided into three groups according to the different diameter of the orthokeratopraxis lens. The diameter of the orthokeratopraxis lens for the patients whose corneal diameter was between 12.1 to 13.00mm was 11.0-11.2mm(Group A). The diameter of the orthokeratopraxis lens for the patients whose corneal diameter was between 11.1-12.00mm was 10.5-10.9mm(Group B). The diameter of the orthokeratopraxis lens for the patients whose corneal diameter was between 10.0-11.00mm was 10.0-10.4mm(Group C). The change of the spherical equivalent(SE)and axial length(AL)were analyzed after wearing the lens for 1a and 2a.

RESULTS: Before wearing lens, the age, SE(D)and AL(mm)was not statistically significant in the three groups(P>0.05). After wearing lens for 1a and 2a, the change of SE(D)and AL(mm)was not statistically significant in Group A and Group B(P>0.05)and the change was statistically significant in Group C(P<0.05). The change of the SE and AL was also significantly different between Group A and Group C after wearing orthokeratopraxis lens for 2a(P<0.05). A similar result was found between Group B and Group C(P<0.05).

CONCLUSION: The effect of controlling myopia by orthokeratopraxis with different position of defocus circle on cornea is different. The position of defocus circle is more close to the corneal limbus, the effect is weaker.

Abstract:AIM: To compare the clinical effect, safety and visual outcome after laser in situ keratomileusis(LASIK)using femtosecond laser or a mechanical microkeratome.

METHODS: By retrospective study, 120 cases(240 eyes)of myopia patients had refractive surgery from July 2016 to June 2017. There were 62 cases(124 eyes)were treated with traditional LASIK, and 58 cases(116 eyes)were treated with LASIK using femtosecond laser to create corneal flaps. Visual acuity,corneal flap thickness and aberration were evaluated at 1, 6 and 12mo.

RESULTS: The corneal flap was successfully made in all patients, and the operation was successfully completed. There were no obvious complications during and after the operation. There were no statistical differences between the two groups about visual acuity or refractive error after operation(P>0.05). However,the result of corneal flap thickness in the Femto-LASIK was better than the result in the traditional LASIK(t=26.67, P<0.01). In addition, the added values of spherical aberration, coma aberration and total higher-order aberrations in the Femto group were smaller than those in the traditional group(t=-4.16, -4.92, -22.19; P<0.01). The post operative surface regularity index(SRI)of traditional LASIK was higher than that of Femto-LASIK(0.31±0.09 vs 0.25±0.04; t=6.59, P<0.01).

CONCLUSION: Femtosecond laser made corneal flap is more accurate than lamellar knife flap. Aberrations of femtosecond laser flap LASIK surgery are smaller than the traditional LASIK.Femto-LASIK may provide relatively better visual quality. However, both of the different surgery can result in satisfactory visual acuity.

Abstract:AIM:To analyze the visual acuity and diopter of students at different learning stages in Baoshan District, Shanghai.

METHODS: By stratified random sampling, 3002 students were randomly selected from 14 grades of Baoshan from middle class in kindergarten to senior three in middle school. Chi-square analysis and Kruskal-Wallis H test were used to compare the difference of myopia rate, refractive error rate and visual impairment among students at different learning stages and gender.

RESULTS: With the increase of learning stage, the rate of poor eyesight increased from 18.52% to 87.12%. There were differences in the rate of poor eyesight among different learning stages(P<0.05). There were differences in the proportion of poor eyesight between boys and girls in junior and senior middle schools(P<0.05). There were differences in the rate of poor eyesight with different degrees(P<0.01). The proportion of myopia in different learning stages was different(P<0.05).

CONCLUSION:The rate of poor eyesight in students is high in Baoshan District. Attention should be paid to eye care of students.

Abstract:AIM: To explore the mutation type of TGFBI gene in a lattice-like corneal dystrophy(LCD)family in northeast China.

METHODS: A basic ophthalmologic examination was performed on the patients and two normal persons in the family. Genomic DNA of three affected, two unaffected family members and 50 normal individuals was extracted from peripheral leukocytes. All exons of TGFBI were amplified by polymerase chain reaction(PCR)methods and direct sequencing was carried out for mutation analysis.

RESULTS: A missense mutation(c.370C>T)in exon 4 of TGFBI led to an amino acid substitution R124C in the TGFBI protein in all affected family members, but the mutation was not detected in normal subjects of the family and control individuals.

CONCLUSION: We conclude that the novel mutation R124C causes lattice corneal dystrophy type I in the studied family. It was verified that R124C is a hot spot mutation in LCD I.

Abstract:AIM: To investigate the relationship between retinal arteriosclerosisand cardiovascular and cerebrovascular diseases in type 2 diabetes mellitus.

METHODS:Totally 85 patients with type 2 diabetes mellitus in our hospital from January 2016 to January 2017 were selected as the research subjects. Fundus examination was carried out to determine the classification of ophthalmic arteriosclerosis. The blood glucose level of the patients was detected and the glycosylated hemoglobin,fasting blood glucose and postprandial blood glucose levels were measured. All patients were followed up for at least 1 and a half years, and the cardiovascular and cerebrovascular diseases rate was statistically analyzed during the follow up period. The blood glucose level and cardiovascular and cerebrovascular diseases rate in patients with different ocular fundus arteriosclerosis grades were compared, meanwhile the relationship between ocular fundus arteriosclerosis grades with the blood glucose levels and cardiovascular and cerebrovascular diseases rate were analyzed.

RESULTS: Among the 85 patients, 15%(13/85), 52%(44/85)and 33%(28/85)of the patients were classified asocular fundus arteriosclerosis grades Ⅰ, Ⅱ and Ⅲ respectively. The cardiovascular and cerebrovascular diseases rate during the follow up period was 27%(23/85). The glycosylated hemoglobin,fasting blood glucose, postprandial blood glucose and cardiovascular and cerebrovascular diseases rates were all increased with the elevation of ophthalmic arteriosclerosis(P<0.05). Spearman correlation analysis showed that the classification of ophthalmic arteriosclerosis in type 2 diabetes mellitus was positively correlated with glycosylated hemoglobin,fasting blood glucose, postprandial blood glucose level and cardiovascular and cerebrovascular diseases rate(r_s=0.875, 0.792, 0.835, 0.878; P<0.05).

CONCLUSION:Type 2 diabetes mellitus patients has severe fundus arteriosclerosis, which is closely related to blood glucose level and cardiovascular and cerebrovascular diseases.

Abstract:AIM:To observe and analyze the effect of non-mydriatic fundus photography in screening diabetic retinopathy(DR), so as to provide the basis for clinical screening.

METHODS:In our hospital from December 2016 to November 2017, 120 patients(240 eyes)was diagnosed as diabetes(DM), which were treated as the subjects of observation. By the same operator with non-mydriatic fundus photography, fundus photography and 7 range fundus fluorescein angiography(FFA)after mydriasis were taken. Taking the international clinical classification of diabetic retinopathy(DR)as the standard, the above three examinations were review, grade and record by the same physician by blind method. The fundus fluorescein angiography as the gold standard, the other two results were compared to detect the sensitivity, specificity, Youden index, Kappa value of the two for DR with different grade.

RESULTS: There was 70.0% eyes diagnosed as diabetic retinopathy after screened by fundus angiography, 66.7% by post-mydriatic fundus photography, 65.0% by non-mydriatic fundus photography. The grading results of diabetic retinopathy screened by different methods were basically consistent, with no significant difference(P>0.05). When screening for diabetic retinopathy of different degrees, the sensitivity and specificity of the non-mydriatic group were 92.9% and 90.3%, respectively. There was no significant difference between the results of the non-mydriatic group and the non-mydriatic group. Compared with the gold standard group(FFA), the Youden index(83.14%)was close to 1, with high reliability; Kappa=0.81, and the validation was consistent. When screening for moderately nonproliferative diabetic retinopathy, the sensitivity and specificity of non-mydriatic fundus photography were 90.6% and 95.5%; there was no significant difference between the results of non-mydriatic and the results of fundus photography after mydriasis. Compared to the gold standard group, the Youden index was 86.09%, the reliability is high, Kappa=0.86, and the test was consistency.

CONCLUSION:Non-mydriatic fundus photography can be used as a simple and accurate method for screening diabetic retinopathy. It is simple and easy to carry out without risk. It is easy to train specialist technicians for multi-point operation. With the help of today's convenient network, the image is transmitted to an experienced ophthalmologist for reading and diagnosis, which is convenient and fast, so that the patient can be diagnosed and treated nearby, which has positive significance for the society.

Abstract:AIM: To investigate the changes of retinal nerve fiber layer(RNFL)thickness in patients with diabetic retinopathy(DR)after 1a of panretinal photocoagulation(PRP)treatment.

METHODS: A total of 92 patients(92 eyes)with DR who underwent PRP in our hospital from May 2014 to June 2017 were enrolled. The DISC CIRCLE procedure of OCT was used to measure the preoperative and one-year postoperative RNFL of patients with DR in the range of 3.45mm diameter around the optic disc, using Follow-Up program automatic tracking mode. The statistical analysis was conducted according to the values obtained in the four quadrant(superior, nasal, temple and inferior).

RESULTS: The average RNFL thickness around optic disc of the patients with DR after 1a of PRP was significantly thinner than the preoperative, the difference was statistically significant(P<0.05).

CONCLUSION: PRP treatment can lead to thinning of RNFL in the retina, which should given full attention and consideration the damage of RNFL in clinical practice. The function of protecting retinal nerve cells is of great significance for DR treatment.

Abstract:AIM: To understand the prevalence of diabetic retinopathy(DR)in patients with type 2 diabetes mellitus in the southern medical treatment combination of Chaoyang District, Beijing, and to analyze the risk factors.

METHODS:A stratified cluster random sampling method was used to randomly select 840 residents aged 40 years and older who were diagnosed with type 2 diabetes mellitus as the target population for the survey from the residents health records of five Community Health Service Centers in the southern medical treatment combination of Chaoyang District, Beijing from November 2016 to November 2017. General patient data, physical examination, blood test results were collected, and all patients underwent dilated fundus examination. The prevalence of DR was calculated and Logistic regression was used to analyze DR risk factors.

RESULTS: The prevalence of diabetic retinopathy in patients with type 2 diabetes mellitus in the southern medical treatment combination of Chaoyang District, Beijing was 35.7%, among which the prevalence of mild, moderate and severe nonproliferative and proliferative diseases was 68.3%, 12.3%, 5.0% and 14.3%, respectively. Age, duration, insulin use, HbA1c and diabetic foot were independent risk factors for DR.

CONCLUSION: The prevalence of DR in patients with type 2 diabetes is higher in the area. When community doctors regularly follow up on diabetic patients, they should not only urge patients to strictly control blood sugar, regularly detect HbA1c, but also pay special attention to younger patients, patients with long course, patients with insulin use and patients with diabetic foot.

Abstract:AIM:To explore the efficacy of Qingre Huayu Recipe in the treatment of non-proliferative diabetic retinopathy(NPDR).

METHODS:We selected 84 cases of 84 eyes of NPDR patients diagnosed as “heat-blocking type” in the Department of Ophthalmology of our hospital during June 2016 to December 2017. According to the random number table method, 42 cases were divided into control group and experimental group respectively. On the basis of conventional hypoglycemic treatment, the control group was treated with calcium hydroxy benzene sulfonate capsules, and the observation group was treated with Qingre Huayu Recipe for 6wk. The improvement of visual acuity, fundus lesions and clinical efficacy before and after treatment were observed.

RESULTS:Before treatment, there was no significant difference in visual acuity between the two groups(P>0.05). After 6wk of treatment, the visual acuity of the experimental group(0.21±0.11)was significantly better than that of the control group(0.30±0.13), and the difference was statistically significant(P<0.05). After 6wk of treatment, the fundus improvement efficiency and clinical efficacy(78.6% and 71.4%)were higher in the experimental group than in the control group(45.2% and 40.5%). There were significant differences in the improvement of fundus and clinical efficacy between the two groups(P<0.05).

CONCLUSION:On the basis of traditional hypoglycemic treatment, Qingre Huayu Recipe has good curative effect on NPDR(heat-blocking type), which can improve the prognosis of patients. It is in line with syndrome differentiation and treatment, and provides ideas for Chinese medicine treatment of NPDR.

Abstract:AIM: To explore the risk factors of retinal artery stenosis and its relationship with urinary albumin/creatinine in patients with hypertension, so as to provide a basis for prevention of target organ damage.

METHODS: In this study, a cross-sectional study was conducted in 1 983 patients with hypertension. According to the fundus examination, 944 patients were divided into normal group and 1 039 patients were divided into abnormal group. Baseline data were collected and urine albumin/creatinine was measured. Analysis of risk factors for retinal artery stenosis and its relationship with urinary albumin/creatinine.

RESULTS: There were significant differences in age and diabetes between the two groups(P<0.05). Logistic regression showed that age(OR=1.013, P=0.011)and diabetes mellitus(OR=1.352, P=0.008)were risk factors for retinal artery stenosis. Hypertensive retinopathy(HR)detection rate was 95.56%. Grade I and grade II mild lesions were the major ones. The proportion of macroalbuminuria in retinal stenosis group was 65.59%, higher than that in microalbuminuria group(54.21%)and normal group(50.52%).

CONCLUSION: Age and diabetes are risk factors for retinal artery stenosis in hypertensive patients. Retinopathy is associated with urinary albumin/creatinine. The community should strengthen health education and early screening of retina and kidney to prevent the progress of the disease.

Abstract:AIM: To analyze the treatment of retinal arterial macroaneurysm(RAM)and its efficacy.

METHODS:A total of 26 diagnoses of retinal arterial microaneurysm made in the Fourth People's Hospital of Shenyang between June 2016 and June 2018 were reviewed. Various treatment strategies for different types, and complications, of RAM were utilized, with the clinical, anatomical, and functional outcomes being analyzed retrospectively.

RESULTS: Visual prognosis and its efficacy were due to the scope and location of exudation or heamorrhage, disease duration and treatments employed. Hemorrhagic RAM, edema or hemorrhage affecting the macular region and long disease duration associated with poor prognosis. Vitrectomy with subretinal air tamponade had strong functional and anatomical effects on submacular haemorrhages within 3wk.

CONCLUSION: A suitable, individually adapted treatment of retinal arterial macroaneurysm should be chosen to achieve better prognosis.

Abstract:AIM: To investigate the epidemiological character of white without pressure(WWOP)in the healthy adolescents by fundus examination and provide theoretical support for air force recruitment and health examination.

METHODS:A total of 461 middle school graduates and 71 junior middle school graduates, who participate in the air force cadets' medical selection, were selected as subjects. The ultra-wide-angle laser fundus scanning system, direct ophthalmoscopy and three-sided mirror were used to check the fundus. The χ² test was used to analyze the incidence and distribution of fundus abnormalities.

RESULTS: The prevalence of WWOP in healthy adolescents was as high as 2.63%. There was no significant difference in the prevalence of WWOP among junior middle school graduates(P>0.05). The lesion was more common in the temporal quadrant, especially the lower temporal quadrant. In the eyes with WWOP in high school graduates, the proportion of retinal degeneration was as high as 18.18%, which was significantly higher than that without WWOP.

CONCLUSION:WWOP is not uncommon in adolescents and is more common in the temporal quadrant. The proportion of retinal degeneration in eyes with WWOP is significantly higher. Thus, in order to avoid missed diagnosis, the surrounding retina should be carefully examined if WWOP was founded in aviation physical examination.

Abstract:AIM:To explore the clinical outcomes of RS lacrimal tube for lacrimal canaliculi rupture without nasal endoscope.

METHODS:A retrospective analysis from September 2017 to March 2018 were taken. According to admission time sequence. Totally 52 patients with lacrimal canaliculi rupture was divided into two groups. One group was treated with RS lacrimal tube, the other was treated with annular silicone tube. The treatment results were comparatively analyzed.

RESULTS:There were 15 eyes of nasal mucosa hemorrhage in annular silicone tube group. There was no eye with this in RS tube group, the difference between the two groups was significant(P<0.001). In RS tube group, 26 eyes were cured, 3 eyes improved, 3 eyes failed. The effective rate was 91%. In annular silicone tube group, 15 eyes were cured, 3 eyes improved, 2 eyes failed. The effective rate was 90%, the clinical efficacy was not significantly different between groups(P=0.877). There were 2 eyes in RS tube group occurred fall off in 2wk to 2mo after operations; 1 eye of lacrimal puncture were removed from the lacrimal puncture without 2wk, and was anastomosed again. The other eye was removed from the lacrimal puncture within 1-2mo after the operation, the lacrimal canal flushing was improved during follow-up. There were 3 eyes in annular silicone group occurred fall off without 2wk, and were not anastomosed again. The lacrimal duct flushing was improved during follow-up. No statistical significance was found in the two groups(P=0.361).

CONCLUSION:Lacrimal canaliculi rupture should be timely given surgical treatment. RS lacrimal tube can not only achieve good operation effect and reduce the probability of complications, but also has the advantages of simple surgical methods, good histocompatibility and no influence on the appearance of patients.

Abstract:AIM: To research the clinical effects of visual display terminal(VDT)syndrome after local treatment near the eyes in combination with systemic comprehensive treatment.

METHODS: Totally 62 patients(124 eyes)with VDT syndrome were randomly divided into a trial group and a control group, 31 cases(62 eyes)in each group. In the control group, artificial tears as eye drops were given. In addition to the above local treatment with artificial tears, the trial group was also treated with the auricular acupressure and tuina at the acupoints near orbits and the whole body. A health education was carried out in both of the two groups. The course of the treatment of the two groups was 2wk. The symptomatic scores, and the amplitude of accommodation, facility of accommodation, accommodative response, near point of convergence and the ratio of accommodative convergence to accommodation(AC/A)based on refractive error correction of all the patients were detected before and after the treatment. The parameters gained before and after the treatment were compared for evaluating efficacy.

RESULTS: After treatment, the symptomatic scores and facility of accommodation of the two groups were significantly improved compared with those before treatment(P<0.05). Amplitude of accommodation and near point of convergence in the trial group were significantly improved after treatment(P<0.05).

CONCLUSION: Local treatment near the eyes in combination with systemic comprehensive treatment can effectively improve the accommodative and convergent functions of patients with VDT syndrome, and relieve their symptoms of asthenopia and fatigue.

Abstract:AIM: To investigate the prevalence and clinical effects of the comprehensive treatment of demodex in eyelash follicles in patients with Meibomian gland dysfunction(MGD).

METHODS: This study was a prospective analysis.The MGD patients(experimental group, 264 eyes in 132 patients)and normal subjects(control group, 192 eyes in 96 patients)were collected from the He Eye Hospital from January 2016 to July 2017. Comprehensive treatment of patients in the experimental group. Eyelash sampling, demodex counting, tear film break up time(BUT), cornea fluorescein staining(FL)and Schirmer Ⅰ test(SⅠt)were measured for both groups. The symptom score of MGD patients was recorded.

RESULTS: For the experimental and control groups, the number of demodex before the treatment was 7(6, 9)and 2(1, 3), respectively(Z=5.264, P<0.01). The percentage of demodex infestation was 100% and 28.1%,respectively(χ²=35.957, P<0.01). The BUT was 4.06±1.38 and 12.00±2.82s. The FL was 3.06±1.57 and 0.46±0.63. The SⅠt was 6.93±2.08mm and 11.13±2.38mm/5min, respectively(t=-9.825, t=5.978, t=-4.776; all P<0.01). The symptom score of the MGD group before and after treatment was 6.57±2.93 and 3.27±1.89, respectively(t=5.443, P<0.01). After the treatment, the percentage of demodex infestation of the experimental group were 57.6%, the number of demodex were 3(0-5), had significant difference with the data before the treatment(Z=3.937, P<0.01). The BUT and FL were 6.53±3.27s and 1.67±0.54, and all had significant difference with the data before the treatment(t=5.152, 4.328; all P<0.01). The SⅠt of the experimental group after the treatment was 8.37±5.34mm/5min, with no significant difference with the data before the treatment(t=-0.285, P=0.748).

CONCLUSION: Demodex infection can cause Meibomian gland dysfunction and produce corresponding clinical symptoms. The comprehensive treatment can greatly diminishes the number of demodex mites and effectively relieve the symptoms of Meibomian gland dysfunction which is associated with demodex infestation.

Abstract:AIM: To observe the visual acuity changes within 24h after femtosecond laser small incision lenticule extraction(SMILE)and femtosecond laser in situ keratomileusis(FS-LASIK)for myopia.

METHODS: A retrospective analysis was made of 80 myopic patients(160 eyes)who underwent corneal refractive surgery in our hospital from August 2017 to March 2018. They were divided into two groups according to different surgical methods, 40 cases(80 eyes)in SMILE group and 40 cases(80 eyes)in FS-LASIK group. The visual acuity, intraocular pressure, corneal endothelial cells, intraoperative and postoperative complications were observed within 24h.

RESULTS: The operation was successfully completed in both groups. The uncorrected visual acuity(UCVA)of SMILE group and FS-LASIK group improved gradually at 2, 4, 6, 8, 12 and 24h after operation. At 2, 4, 6, 8, 12, 24h after operation, the UCVA of FS-LASIK group was better than that of SMILE group, and the difference was statistically significant(P<0.05). The UCVA of SMILE group was the best 12 and 24h after operation, and that of FS-LASIK group was the best 6 and 24h after operation. The results of intragroup comparison before and after operation showed that the intraocular pressure(IOP)of the two groups was lower than that before operation, the density of corneal endothelial cells, the coefficient of variation were significantly decreased, the area of corneal endothelial cells and the proportion of hexagonal cells were significantly increased; the difference was statistically significant(P<0.01). The results of comparison between groups after operation showed that there was no significant difference in intraocular pressure and corneal endothelial cell related indexes between the two groups(P>0.05). No serious complications occurred during and after operation in both groups.

CONCLUSION: Within 24h after SMILE and FS-LASIK, the visual acuity changed greatly, and good visual acuity was obtained.