Abstract:Since the end of 2019, the novel coronavirus pneumonia(COVID-19)has rapidly spread in Wuhan City, Hubei Province of China. This has aroused great concern of the Chinese government and the international community. There have been unconfirmed threads of COVID-19 patients with conjunctivitis as the first symptom. Therefore, the issue that whether and how the novel coronavirus strain SARS-CoV-2 infection is transmitted through the ocular surface has become a new concern. In the absence of clinical and experimental evidence of COVID-19 in ocular infection, we have conducted a retrospective literature analysis of viral pathogens that simultaneously trigger ocular lesions during the onset of epidemic diseases. The purpose of this paper is to provide some reference and suggestions for appropriately understanding of ocular protection in the prevention and control of the COVID-19.

Abstract:Age-related cataract is a blinding eye disease that affects vision due to opacity of intraocular lens, ranking first in the world. Under oxidative stress, the activation of apoptosis related signal transduction pathways in lens epithelial cells is the main mechanism mediating age-related cataract. There are many related signaling pathways for apoptosis, and it is a complex network system. The purpose of this literature review is to summarize different apoptotic cell signal transduction pathways that mediate age-related cataract, laying the foundation for further researching.

Abstract:AIM: To evaluate the changes in corneal epithelial thickness in corneal grafts following penetrating keratoplasty(PK)using anterior segment optical coherence tomography(AS-OCT), and to determine the role of epithelial thickness mapping in the early detection of graft rejection.

METHODS: This prospective comparative observational study included 20 patients(20 eyes)who underwent PK as study group and 16 patients(16 eyes)as control group. Corneal epithelial thickness mapping using AS-OCT was performed at 2wk, 1 and 3mo postoperatively. The parameters of epithelial thickness and distribution at the 3mo were compared to 16 patients(16 eyes)with allograft rejection following PK.

RESULTS: There was significant decline in the superior, inferior, maximum, and minimum epithelial thickness values of the study group at 1mo compared to 2wk(P=0.0004, 0.0001, 0.0001, 0.04 respectively)with no significant differences at 3mo compared to 1mo(P=0.4, 0.1, 0.8)respectively. Percentage of reduction in epithelial thickness was significantly higher than that of stromal thickness at 1mo compared to 2wk(P=0.04). The epithelial thickness maps showed a similar pattern of epithelial thickness distribution in the study group and in the rejection group showing considerable corneal edema. However, the allograft rejection group showed irregular pattern of epithelial thickness distribution in patients showing relatively higher central corneal thickness(CCT)as measured by pachymetry map.

CONCLUSION: Quantitative assessment of graft epithelial remodeling following PK shows early changes that contribute to significant corneal graft thickness changes. Changes in corneal epithelial thickness and pattern of distribution could be used as an indicator for corneal graft rejection.

Abstract:AIM: To find out the prevalence of inherited color vision deficiency(CVD)among Palestinian male-school children aged 14-18 and compare it with other eastern and western countries.

METHODS: Six hundred and thirty-four male subjects(n=634)aged 14-18 from Palestinian Governorate of Nablus were randomly selected and screened using Ishihara pseudoisochromatic plates. Subjects who failed Ishihara screening were tested further with computer software of Farnsworth-Munsell 100 Hue test.

RESULTS: Out of the 634 male participants, 597 were included in the study and 8.0% of them(48 males)demonstrated red-green CVD. 5.4%, 2.3% and 0.3% of the 48 males exhibited deutan, protan and total color vision deficiency(monochromacy), respectively.

CONCLUSION: The results show that the prevalence of red-green CVD among the male school children from Palestinian Governorate of Nablus is not significantly different from that of male populations in nearby and Western countries.

Abstract:AIM: To examine the morphological and biochemical alterations in the eyes of Thioltransferase knockout(TTase KO)mouse model as a function of age, and to explore the important function in redox homeostasis in the lens and in the age-related cataractogenesis.

METHODS: TTase KO model was established in this laboratory. TTase KO and WT mice were examined and the lens opacity was classified by using a slit lamp. Each lens was homogenized in lysis buffer and processed for measurement of glutathione(GSH)level. Examination of Protein-GSH mixed disulfides(PSSG)formation in the lens by Western blot analysis. Immunoprecipitation was used to identify the proteins formed PSSG. Dethiolation of lens proteins was carried out using purified recombinant human lens TTase(RHLT).

RESULTS: The slit lamp examination showed an age-dependent nuclear cataract development in both eyes of the WT and TTase KO mice. The onset of cataract was 4mo in the KO mice and 9mo in the WT mice. The GSH loss showed in both groups during aging and was prominent in the TTase KO mice after 9mo old. PSSG in the lenses of both groups showed progressive elevation, whereas the lenses of the KO group had a higher level of PSSG after 9mo. These GSH-conjugated proteins were confirmed as actin and glyceraldehyes 3-phosphate dehydrogenase(GAPDH)by immunoprecipitation and they could be eliminated when the homogenates were treated with RHLT.

CONCLUSION: The results showed that deletion of TTase gene in the mouse could lead to an early age-dependent cataract formation and the PSSG formation in these lenses appeared to link directly to lens opacity. The PSSG could be dethiolated by TTase. This data strengthens that TTase plays an essential role in maintaining lens clarity.

Abstract:AIM: To observe the effects of butterflybush flower eye drops at different concentrations on expression of inflammatory crtokines IL-1β, Mucin 5AC(MUC5AC)and P38MAPK in castrated male rabbits, and to explore the therapeutic effect of that drops on dry eyes.

METHODS: Thirty-six male rabbits were randomly divided into blank group(A), model group(B), low concentrations butterflybush flower eye drops group(C, 1mg/mL), the medium concentrations drops group(D, 1.5mg/mL), the high concentrations drops group(E, 3mg/mL), and testosterone group(F). In addition to group A, the testes and epididymis were removed from each group to establish a dry eye animal model. After successful modeling, groups A and B remain unchanged. Groups C, D, and E were given different concentrations of butterflybush flower eye drops, 3 times/d. In group F, testosterone propionate was injected into the muscles of the thigh at a dose of 0.5mL/kg once every 3d. Fluorescein staining, Schirmer I test(SⅠt)and tear film break time(BUT)were measured under general anesthesia in each group, eatment. After 4wk of treatment, the rabbits were sacrificed and the conjunctival tissues of the eyes were taken. The expression of IL-1β, mucin 5AC and P38MAPK in the conjunctiva was detected by immunohistochemical staining.

RESULTS: Among low concentrations butterflybush flower eye drops group, the medium concentrations drops group and the high concentrations drops group, the SⅠt value was significantly higher than that of model group, and BUT was significantly longer than model group. The positive staining of corneal fluorescein was significantly improved compared with model group, which was statistically significant(P<0.01). Among IL-1β and P38MAPK in the conjunctiva of high concentrations butterflybush flower eye drops group, the medium concentrations drops group and the low concentrations drops group, the positive expressions were lower than those in model group, and the expression of MUC5AC was higher than that in group model group(P<0.01). In addition, the high concentrations drops group was superior to the low and the medium concentrations drops group.

CONCLUSION: Butterflybush flower eye drops have androgen-like effect. For castrated dry eyes of male rabbits, they can down-regulate the expression of IL-1beta and P38MAPK in dry conjunctival tissue and increase the expression of MUC5AC, thus reducing inflammation infiltration in dry conjunctival tissue and maintaining tear film stability, but their effect is weaker than that of androgen. To the treatment of dry eyes, the middle and high concentration groups of the drops had stronger effects than the low one, and the high concentration group was better than the medium one.

Abstract:AIM: To investigate the therapeutic efficiency of Mulberry eye drops on dry eye in perimenopausal female rabbit model.

METHODS: Totally 36 female New Zealand white rabbits were selected and operated with bilateral ovariectomy and fed for 60d postoperatively to make perimenopausal female rabbit dry eye model(36 eyes, all right eyes). And 24 of them were randomly divided into control group and experimental group(12 for each): the control group used PBS, the experimental group used Mulberry eye drops, the other 12 did not use any eye drops. The Schirmer I tests(SⅠt)and corneal fluorescein(FL)were made, and the tear total protein content, amylase activity, lactoferrin and lysozyme contents and confocal scanning microscopy were performed in two groups before treatment and 2, 4, 6wk after treatment.

RESULTS: There was no significant difference in SⅠt,FL scores,total proteins,lysozyme,lactoferrin contents and amylase activity between two groups at pre-therapy(all P>0.05).After 2, 4 and 6wk of treatment, there were significant changes in SⅠt and FL scores in the two groups(P<0.05). There were no significant changes in lysozyme content, lactoferrin, amylase activity and total tear protein in the experimental group compared with those before treatment(all P>0.05), while there were significant changes in lysozyme content, lactoferrin, amylase activity and total tear protein in the control group(all P<0.05). At 2, 4 and 6wk after treatment, there were differences in the scores of SⅠt and FL, lysozyme content, lactoferrin, amylase activity and total protein content in tear between the two groups(P<0.05). At 6 wk after treatment, the mean number of corneal basal cells and inflammatory cells in control group were 4436±289mm² and 321±91mm²,respectively,which in experimental group were 3219±223mm² and 36±11mm², respectively,there were statistical differences between two groups( all P<0.05). After 6wk treatment, there were no change of corneal nerve bending and less density in control group while the nerve fiber bending and density decreased significantly in experimental group,there were statistical differences between two groups(all P<0.05).

CONCLUSION: Mulberry eye drops has significantly therapy effects on the dry eye induced by decreased androgen and it has a definite clinical application value.

Abstract:AIM: To investigate the protective effect of the antioxidant N-acetylcysteine(NAC)on retina in early diabetic rats.

METHODS: Thirty healthy adult male SD rats were randomly assigned to the normal control group(CON group, n=10)and the diabetes group(DM group, n=20). After fasting for 12h, the DM group was injected with 1% streptozotocin(STZ)solution, according to 60mg/kg disposable left lower abdominal injection. After 72h, blood was taken from the rat tail vein to detect blood glucose, diabetic model animals were defined as ≥16.7mmol/L. Model rats were randomly divided into diabetes control group(group D)and NAC treatment group(group N). After the model was established, N group of rats were injected with 4μL 1.6μg/μL NAC through the vitreous cavity every week. Rats in CON group and D group were injected with 4μL 0.01mmol/L phosphate buffer saline. All the rats no diet water, group feeding. Body mass and blood glucose were recorded weekly. After the diabetes was modeled, 2mo killed the experimental animals. The thickness of the inner layer of the retina of rats in each group was determined by HE staining. The number of retinal ganglion cells and the level of pigment epithelial derived factor in the retina were measured by immunofluorescence.

RESULTS: The thickness of retinal kernel layer increased in group N compared with group D(P<0.01), and there was no difference between group CON and group(P>0.05). Compared with CON group, the number of retinal ganglion cells decreased in group D(P<0.01), and decreased slightly in group N(P>0.05). Retinal ganglion cells decreased in group D compared with group N(P<0.01). Compared with CON group, PEDF expression decreased in group D(P<0.01), and decreased slightly in group N(P>0.05). The expression of PEDF in group D decreased compared with group N(P<0.01).

CONCLUSION: The protective effect of antioxidant NAC on retinal tissue in early diabetic rats may be due to the up-regulation of PEDF levels in the retina.

Abstract:AIM: To explore the relationship between HbA1c and the changes of retinal and choroidal structures in macular region, and between HbA1c and corrected distant visual acuity before and after cataract surgery in diabetic patients.

METHODS: It is a prospective randomized clinical trial. According to the patient's history, the subjects were divided into the non-diabetes group and the diabetic group. According to the level of HbA1c before operation, the diabetic group was divided into the high HbA1c group(HbA1c>7.0%)and the normal HbA1c group(HbA1c≤7.0%). All 87 eyes from 82 patients who met the criteria from October 2016 to December 2017 in the Department of Ophthalmology at Qingdao Municipal Hospital were enrolled in this study. There were 30 eyes from 28 patients in the non-diabetes group(4%≤HbA1c≤6.0%), 29 eyes from 28 patients in the high HbA1c group and 28 eyes from 26 patients in the normal HbA1c group. Spectral-domain optical coherence tomography(SD-OCT)was used to examine central subifield thickness(CST), central volume(CV)and subfoveal choroidal thickness(SFCT)at 1d before surgery, 1d after surgery, 1wk after surgery, 1mo after surgery and 3mo after surgery. The variance analysis and Pearson correlation analysis were used to analyze the changes and the correlation with HbA1c value. At the same time, the incidence of macular edema after surgery(PCME)was compared among the groups, and the relationship between HbA1c and postoperative corrected distance visual acuity(CDVA)in diabetes patients was also analyzed.

RESULTS: In non diabetic group, high HbA1c group and normal HbA1c group, CST was 239.03+11.55μm, 254.38+26.44μm, 247.07+19.51μm at 1wk after cataract surgery. Their CST was 241.00±11.15μm, 271.55±61.05μm, 248.64±38.28μm at 1mo after cataract surgery(F=3.001, P=0.048). Besides, there was a positive correlation between HbA1c and CST at 1wk and 1mo after operation in the two groups at P=0.01 level(r_1wk=0.338, r_1mo=0.297)(P<0.05). The postoperative macular cystoid edema in non-diabetic group, high HbA1c group and normal HbA1c group were 0, 5(5 eyes, 17%)and 1(1 eye, 4%)respectively. In non diabetic group, high HbA1c group and normal HbA1c group, CDVA was 0.07±0.06, 0.12±0.10, 0.09±0.08 at 1wk after cataract surgery. Their CDVA was 0.03±0.06, 0.11±0.15, 0.11±0.09 at 1mo after cataract surgery. Their CDVA was 0.02±0.04, 0.08±0.12, 0.06±0.06 at 3mo after cataract surgery(F=3.272, P=0.045). The differences among three groups in the CDVA were statistically significant at 1wk, 1mo and 3mo after surgery. There was no significant difference between the high HbA1c group and the normal HbA1c group(P>0.05). However, CDVA(LogMAR)of the two groups was positively correlated with HbA1c at P=0.01 level(r_1wk=0.425, r_1mo=0.235, r_3mo=0.332). There was no statistically significant difference in the changes of CV and SFCT among the three groups, and the trend of changes among these groups was approximately the same.

CONCLUSION: There is a close relationship between the microscopic structure of macula and HbA1c before phacoemulsification in diabetic patients. The risk of macular edema increased in patients with hba1c >7.0% before surgery. The best corrected visual acuity of diabetes patients after surgery was significantly related to the hba1c value before surgery. The higher the hba1c value before surgery, the poorer the improvement of vision after surgery. The level of HbA1c before surgery in diabetic patients is related to the anatomical structure of macular after cataract surgery. The risk of macular edema after surgery is increased in patients with high HbA1c(HbA1c>7.0%)before surgery. Meanwhile, the preoperative HbA1c of diabetic patients is closely related to CDVA after cataract surgery. The higher the preoperative HbA1c value, the worse the CDVA in diabetics after surgery.

Abstract:AIM: To analyze the correlation between tear film lipid layer thickness(LLT)and macular microvascular parameters in diabetic retinopathy.

METHODS: Totally 60 eyes of type 2 diabetes patients with non-proliferative stage(NPDR group)and 60 eyes of proliferative stage(PDR group)with diabetic retinopathy diagnosed in our hospital from 2018-01/12 were selected, and 60 eyes of healthy volunteers with appropriate age and gender were selected as the normal control group. The tear film lipid layer thickness(LLT)was examined by Lipiview eye surface interferometer, while the foveal avascular zone(FAZ), superficial capillary layer(SCL)vessel density and deep capillary layer(DCL)vessel density were measured by optical coherence tomography angiography(OCTA)in three groups. The differences and correlations between the parameters were compared.

RESULTS: LLT(69.87±11.401nm)in normal control group was higher than that in NPDR(54.87±7.453nm)and PDR group(42.67±5.246nm), and FAZ(0.312±0.021mm²)was lower than that in NDPR group(0.389±0.037mm²)and PDR group(0.437±0.032mm²). The vascular density of SCL(51.977%±4.164%)was significantly higher than that of NPDR(47.067%±4.757%)and PDR(41.865%±5.512%), and that of DCL(49.578%±2.619%)was higher than that of NPDR(46.032%±2.622%)and PDR(40.598%±2.671%)(all P<0.01). There was no correlation between LLT, FAZ, SCL and DCL in normal subjects. LLT was negatively correlated with FAZ in both NPDR group and PDR group(r=-0.922, r=-0.923, all P<0.01), positively correlated with SCL(r=0.798, r=0.902, all P<0.01), and had no correlation with DCL(r=0.140, r=0.073, P=0.285, P=0.581).

CONCLUSION: In diabetic retinopathy, the lipid layer of tear film is lower and the stability of tear film is decreased, and there is a correlation between diabetic dry eye and macular microvascular changes.

Abstract:AIM: To compare the efficacy and safety of intravitreal conbercept and ranibizumab in the treatment of macular edema secondary to retinal vein occlusion(RVO-ME)in order to provide basis for clinical guidance.

METHODS: The Cochrane Library, Embase, Web of Science, and CNKI, Wanfang data, and VIP database were comprehensively searched for studies comparing conbercept versus ranibizumab in patients with RVO-ME. Best-corrected visual acuity(BCVA), central macular thickness(CMT), intraocular pressure(IOP), mean number of intravitreal injections and adverse events were extracted from the final eligible studies. RevMan 5.3 software was used for relevant index data analysis. Random and fixed effect models were employed to evaluate heterogeneity and the publication bias.

RESULTS: A total of 14 randomized controlled trial(RCT)studies, involving 1 350 eyes. There was no significant difference in BCVA improved between the two groups after treatment 2wk, 2mo, 3mo and 6mo, but there was significant difference in BCVA improved after treatment 1wk [WMD=-0.03; 95% CI(-0.05, -0.02); P<0.0001] and 1mo [WMD=-0.03; 95% CI(-0.04, -0.01); P=0.001]. The conbercept treatment group had higher CMT reduction compared with ranibizumab treatment group after 6mo treatment, and there was a significant difference [WMD=-28.77; 95% CI(-54.23, -3.31); P=0.03], and there were no significant difference between two groups in others period of time. There were no significant difference in intraocular pressure(IOP)and adverse events between the two groups [OR=0.95; 95% CI(0.57, 1.57); P=0.84]. However, the use of conbercept had a fewer mean number of injections.

CONCLUSION: CMT and BCVA were improved significantly both in the conbercept and ranibizumab groups. Compared with ranibizumab, conbercept group did not have greater improved BCVA, but with a more CMT reduction after 6mo. The advantage of conbercept is fewer injections and maybe it is better for treatment of RVO-ME.

Abstract:A variety of therapeutic methods can be used to treat keratoconus. This article provides practical information for clinicians to make the most appropriate choices by reviewing the treatment of keratoconus. Search for keywords such as “keratoconus” “contact lenses” “corneal collagen cross-linking” “Intacs(corneal ring)” “keratoplasty” “gene therapy” “irregular astigmatism” through a database. According to the related literature, the treatment methods of keratoconus are reviewed. Glasses and contact lenses can be used for early keratoconus, while bowman layer transplantation, penetrating keratoplasty(PK), deep anterior lamellar keratoplasty(DALK), conductive keratoplasty and gene therapy can be used in advanced disease. In addition, cross-linking can prevent keratoconus progression, and intrastromal corneal ring segments(ICRS)reduce refractive error for therapeutic purposes by flattening the deformed cornea. In general, the development of ophthalmic diagnostic techniques and treatments can slow the progression of keratoconus, thereby reducing the need for corneal transplantation in patients with advanced keratoconus. Choosing the right keratoconus treatment can help patients with vision recover and prevent blindness.

Abstract:Aged-related macular degeneration(ARMD)is prone to occur in the people who aged 50a or older. The disease can lead to partial or even complete loss of sight in single or both eyes progressively. The pathogenesis of ARMD is still unclear, but the previous studies have shown that oxidative stress plays an important role. The mechanism of antioxidants on ARMD has gradually become a hotspot in recent years. In this paper, we briefly reviewed the mechanism of ARMD caused by oxidative stress and the application of antioxidants on ARMD.

Abstract:Microglia are the resident macrophages of the central nervous system(CNS). Microglia constantly monitor the pathological changes of the surrounding microenvironment. Activated microglia play key roles in tissue protection and injury under the stimulation of various injury factors. Abnormal activation of microglia mediates retinal inflammation and aggravates the original ophthalmic diseases. Our growing understanding of the mechanisms of the interaction between microglia and retinal cells is identifying potential cellular and molecular targets for therapeutic interventions that may be apply to optic nerve injury, diabetic retinopathy, glaucoma and other diseases in the future. In this review, potential links between ophthalmic diseases and microglial activity will be explored.

Abstract:Corneal collagen cross-linking(CXL)is a new treatment for corneal diseases such as primary or secondary keratoconus, infectious keratitis and bullous keratopathy. CXL is used to increase the biomechanical stability of the stromal tissue and prevent the progression of keratopathy based on Laws of Photochemistry, which is widely used in clinical practice at present. Currently, commonly used method in clinical practice is the traditional “epithelium-off” corneal cross-linking method(dresden protocol), but the classical method takes a long time, and there may be postoperative complications such as poor healing of the corneal epithelium and infection. In recent years, a number of studies have improved the classical method, such as the choice of riboflavin solution immersed in the cornea, increasing the energy of ultraviolet light to shorten the accelerated cross-linking time of irradiation and cross-epithelial CXL. Thus, this paper reviews clinical and basic researches of the current use of non-classical CXL in the treatment of keratoconus.

Abstract:Wet age-related macular degeneration is a severe and blinding disease with progressive central visual impairment, accounting for about 10%-15% of age-related macular degeneration. In recent years, with the deepening understanding of its pathogenesis, especially the discovery of anti-VEGF family, the clinical popularization of new drugs has brought benefits to patients. However, this treatment mode requires frequent intraocular injection, and many patients must continue to use it indefinitely to preserve their vision. Gene therapy can provide long-term stable anti-VEGF activity, which has become a new hotspot of research. Several methods of gene therapy are summarized as follows.

Abstract:Diabetic retinopathy(DR)is a chronic retinopathy secondary to diabetes that can cause permanent loss of vision in patients with type 1 and type 2 diabetes. The occurrence of DR is associated with retinal microvascular dysfunction, retinal tissue edema, bleeding, and secondary neovascular proliferation. Studies have shown that patients with diabetes have high expression of visfatin in adipose tissue, liver and kidney, and that the factor may be present in retinal tissue, which has a certain regulatory effect on the development of diabetic retinopathy. This review focuses on the relationship between visfatin and diabetic retinopathy.

Abstract:Currently, the main methods for treating diabetic retinopathy(DR): laser photocoagulation, medication, pars plana vitrectomy(PPV). The advantages of traditional laser photocoagulation are: relatively safe, long-lasting effect, but laser damages the visual quality of patients; PPV can save the vision of some patients, the risk and trauma of the surgery are greater. Although pharmacotherapy is applicable in the early stages of DR, glucocorticoids cannot be used as the main treatment because of their definite side effects; anti-vascular endothelial growth factor(VEGF)drug therapy can block diabetes from the pathogenesis. The occurrence and development of sexual retinopathy, however, the efficacy is relatively short, and the potential dangers and systemic side effects of repeated treatment still require further large-scale studies.

Abstract:Meibomian gland dysfunction(MGD)is a general term for various abnormal meibomian glands. Meibomian gland secretes meibomian ester to moisten the eye surface and maintain the stability of tear film. In this article, the etiology, pathology and related treatment of meibomian gland dysfunction were reviewed by referring to related literatures.

Abstract:Visual loss after non-ocular surgery(VLNOS)includes postoperative visual loss and perioperative visual loss after non-ocular surgery. The former accident consists of the blindness during a surgery or after a surgery, and the latter accident shows the acute visual loss in perioperative period. VLNOS can be appeared in a prone spinal surgery, cardiopulmonary bypass surgery, head and neck surgery, and facial micro-plastic injection treatment, which is a rare, extremely serious complication. VLNOS is divided into predictable and unpredictable condition. Doctors of related subjects have pay attention to VLNOS, and begin to study the possible reasons, and take positive precautions.

Abstract:Stereopsis is to perceive vision depth through the subtle three-dimensional differences between two eyes, and it is closely related to human working and living. There are different visual cortices in the cerebral cortex, which are involved in the formation of stereo vision, and process different visual information received. Clinical evaluation of stereo vision is needed to guide clinical decision-making. Traditional assessment is mainly based on static stereoscopic acuity, while binocular disparity appears dynamically with time in daily life. Nowadays 3D technology has been used to evaluate stereo vision. This paper mainly reviews the development mechanism and measurement methods of stereoscopic vision.

Abstract:AIM: To observe the changes of serum Adropin protein(AD)and neprilysin(NEP)levels in patients with diabetic retinopathy and to analyse the influencing factors.

METHODS: A total of 167 patients with type 2 diabetes were enrolled in this study. They were divided into simple type 2 diabetes group(DM group)with 59 cases and type 2 diabetic retinopathy group(DR group)with 108 cases. Furthermore, the DR group included patients in two periods of non-proliferation diabetic retinopathy(NPDR group)and proliferative diabetic retinopathy(PDR group). There were 45 patients in NPDR group and 63 patients in PDR group, meanwhile, another 57 healthy subjects were selected as the normal control group(NC group). Measuring the hight and weight and calculating body mass index(BMI). Indices of fasting plasma glucose(FPG), systolic blood pressure(SBP), diastolic blood pressure(DBP), total cholesterol(TC), triacylglycerol(TG), alanine aminotransferase(ALT), aspartate aminotransferase(AST)hemoglobin Alc(HbA1c)were be detected, while levels of serum adropin protein(AD)and neprilysin(NEP)were measured by enzyme-linked immunosorbent assay(ELISA). The correlation between AD, NEP and other indicators was analyzed by Pearson correlation analysis. The independent influence factors of both were analyzed by multiple linear regression.

RESULTS: Compared with the NC group, the AD level in the DM group, NPDR group, and PDR group decreased gradually, with the lowest level in the PDR group(P<0.05). The level of NEP in each group gradually increased, and the highest one was in the PDR group(P<0.05). Multiple linear regression analysis indicated that FPG, HbA1c and NEP were independently correlated with AD. BMI, FPG, HbA1c and AD were independently correlated with NEP.

CONCLUSION: In patients with diabetic retinopathy, AD level would be decreased with the progression of DR, and NEP level would be gradually increased, both of which may be involved in the development of DR.

Abstract:AIM: To discuss the correlation between fixation nature and macular thickness, in addition, to investigate the variations of macular thickness and other related factors in hyperopic ametropic amblyopic children ranged from 4 to 8 years old by measuring each area's macular thickness, fixation nature and length of optic axis.

METHODS: Prospective, non-randomized, contemporaneous controlled study trials. Totally 44 children with 57 eyes who admitted to the hospital for the first time without any amblyopia training before from September 2018 to December were included in this study.36 eyes from hyperopic ametropic amblyopic children were enrolled in hyperopia group and 21 eyes from children with normal vision were enrolled in healthy controls. The optical coherence tomography(OCT)was used to measure the macular retinal thickness in both. Meanwhile, the OCT was also used to measure the macular retinal thickness in 29 central fixation patients(32 eyes)and 15 eccentric fixation(25 eyes)which examined by direct ophthalmoscope, and the data were analyzed by SPSS19.0 statistical software.

RESULTS: The length of optic axis in hyperopic amblyopic eyes is shorter than it in normal eyes(P<0.05). The retinal thickness of central sector and nasal quadrant in inner ring of central fixation group was thinner than it of eccentric fixation which represents the statistical significance. However, there is no significance of two groups' retinal thickness differences between other sectors of the macular(P<0.05). Besides, hyperopia amblyopia group's retinal thickness of central sector or region and nasal, inferior quadrant in inner ring and superior quadrant in outer ring was thicker than it of normal control groups which reveals the statistical meaning(P<0.05). Otherwise, the data of two groups' retinal thickness in other sectors of the macular shows no significance(P>0.05)

CONCLUSION: The retinal thickness of central sector and nasal quadrant in inner ring of central fixation children was increase. Hyperopia amblyopia children's retinal thickness of central sector or region and nasal、inferior quadrant in inner ring and superior quadrant in outer ring was increase. The length of optic axis in hyperopic amblyopic children is decrease.

Abstract:AIM: To compare the postoperative outcomes after segmental scleral buckling(SSB)surgery with minimal in situ conjunctival incision(MCI)and conventional limbal conjunctival incision(LCI).

METHODS: Prospective randomized controlled study. Eighty eyes of 80 patients with rhegmatogenous retinal detachment(RRD)who received SSB surgeries in our hospital from August 2016 to November 2018 were recruited. They were randomly divided into two groups. Patients in control group were performed with conventional LCI, while patients in observation group received MCI. The length of the surgery, the retinal reattachment rate and the visual analogue scale(VAS)for evaluating the pain on the first postoperative day, questionnaire scoring method for evaluating the postoperative comfort level(including foreign body sensation and tearing)on the first, seventh, fourteenth, and thirtieth days were recorded.

RESULTS: The difference of surgery time between the control group and the observation group was statistically significant(t=2.057, P<0.05). There was no significance in retinal reattachment rate between two groups. At the first day after surgery, the postoperative pain of the observation group was significantly lower than the control group(P<0.05). At the first and seventh day after surgery, the observation group had higher postoperative comfort questionnaire score than the control group(P<0.01), however, at the fourteenth and thirtieth day after surgery, the score was similar between the two groups(P>0.05).

CONCLUSION: Using MCI in SSB operation could shorten the operation time and significantly reduced postoperative pain and discomfort level.

Abstract:AIM: To investigate the expression and significance of stromal cell-derived factor(SDF-1)and its receptor CXC chemokine receptor 4(CXCR4)in patients with pterygium of different ages.

METHODS: From January 2018 to October 2018, surgical specimens of 60 patients with primary pterygium and 60 eyes(including 30 eyes younger than 50 years old and 30 eyes older than 50 years old)were collected from the No.474 Hospital of Chinese PLA, at the same time collect age matched strabismus diorthosis and normal conjunctiva tissues of 30 patients with retinal detachment repairs(including 15 eyes younger than 50 years, older than 50 years of age 15 eyes).The expression and localization of SDF-1/CXCR4 in pterygium tissue specimens were detected by HE staining and immunohistochemistry, and the relationship between the expression of SDF-1/CXCR4 and the clinical characteristics of patients was analyzed. The mean optical density of SDF-1 /CXCR4 was measured by IPP 6.0 software.

RESULTS: SDF-1/CXCR4 showed slightly positive or no positive expression in normal conjunctival basal cells, but positive expression in both full-layer conjunctival epithelial cells and vascular endothelial cells in pterygium, with significant difference in expression level, and more obvious expression in basal cells, showing obvious polarity. The expression levels of SDF-1 and CXCR4 in pterygium tissues were higher than those in normal conjunctival tissues, and the difference was statistically significant(P<0.05). The expression of CXCR4 in patients younger than 50 years old was greater than that in patients older than 50 years old, and the difference was statistically significant(P<0.05).

CONCLUSION: SDF-1 and CXCR4 expression is up-regulated in pterygium, suggesting that SDF-1 and CXCR4 participates in the formation of pterygium and inhibits the SDF-1/CXCR4 signaling pathway, which may inhibit the occurrence of pterygium, and may also become a drug therapeutic target for pterygium, and become a new research direction. The higher expression of CXCR4 in young pterygium patients suggests that individualized drug administration may be realized in the future to reduce the waste of medical resources.

Abstract:AIM: To evaluate the application value of 3g/L sodium hyaluronate eye drops combined with corneal bandage contact lens in the early stage of pterygium excision surgery.

METHODS: In this double blind randomized controlled study, 90 eyes of 90 patients with unilateral primary nasal pterygium who underwent surgical treatment from March 2017 to March 2018 were sorted into three groups, named as group A, group B and group C. Group A was treated with +3g/L sodium hyaluronate eye dropsand corneal bandage contact lens; group B was treated with +1g/L sodium hyaluronate eye drops and corneal bandage contact lens; and group C with +3g/L sodium hyaluronate and patching. Ocular surface irritation symptom scores, corneal epithelial healing time and conjunctival graft edema subsidence time of the three groups were compared after treatment.

RESULTS: Ocular surface irritation symptom scores in group A were lower than those in group C at all observation time points postoperatively(all P<0.001); the corneal epithelial healing time(2.08±0.78d)and conjunctival graft edema subsidence time(4.62±1.17d)in group A were significantly shorter than those in group C with corneal epithelial healing time(5.13±2.34d)and conjunctival graft edema subsidence time(6.42±1.51d)(P=0.001, P=0.002). The corneal epithelial healing time was significantly shorterin group A when compared with group B(P=0.018), but there were no significant differences in ocular surface irritation symptom scores and conjunctival graft edema subsidence time between the two groups.

CONCLUSION: The combination of 3g/L sodium hyaluronate and corneal bandage contact lens has synergistic effect when applicated in the early stage after pterygium excision surgery, it can effectively shorten the corneal epithelial healing time as well as relieve irritation symptoms.

Abstract:AIM: To investigate the effect of surgical time on the development of visual refraction in children with congenital entropion and trichiasis.

METHODS: This was a prospective interventional study. Fifty nine eyes of 30 patients aged from 2 to 12 years old who suffered congenital lower eyelid entropion with trichiasis were divided into three groups according to the age. Improvement in binocular vision, refractive error, retinography astigmatism and cornea astigmatism by topography were analyzed. All patients were followed up for a period of 6 to 12mo.

RESULTS: There were no significant complications of overcorrection, undercorrection or eyelid deformity. The postoperative corneal astigmatism(CC)was significantly improved in three groups(P<0.05). retinography astigmatism(RC)and best corrected visual acuity(BCVA)were significantly improved in low-aged and middle-aged groups(P<0.05). The proportion of astigmatism with the rule and amblyopia was larger in middle-aged group. The postoperative CC, RC and BCVA was not statistically different in high-aged group(P>0.05).

CONCLUSIONS: Children with congenital entropion and trichiasis should be corrected surgically before 6 years old. The incidence of astigmatism with the rule and amblyopia is higher in 4 to 6 aged children and should be corrected earlier.

Abstract:AIM: To verify the accuracy of Van Herick method and slit-lamp anterior chamber depth examination in estimating angle closure.

METHODS: Totally 52 patients(100 eyes)over 40 years old were randomly selected from our outpatient department from June 2018 to January 2019.Their anterior chamber depth were examined by the methods of Van Herick method and the improved method to sort out peripheral anterior chamber depth are less than or equal to 1/3 CT and more than 1/4 CT and peripheral anterior chamber depth are less than or equal to 1/4 CT. Van Herick's anterior chamber depth inspection method and improved anterior chamber depth inspection method were checked for consistency, and then gonioscopic inspection and UBM inspection under darkroom were performed to check whether the peripheral angle was closed. In order to know whether there was any difference between gonioscopic and UBM inspection for angle closure, the consistency of the two verification results was checked.

RESULTS: Peripheral anterior chamber depth are less than or equal to 1/3 CT and more than 1/4 CT by the methods of Van Herick, the positive incidence of angle closure in angioscopy and ultrasound biomicroscopy are 39% and 43% respectively, Peripheral anterior chamber depth are less than or equal to 1/3 CT and more than 1/4 CT by the improved methods, the positive incidence of angle closure in angioscopy and ultrasound biomicroscopyare 46% and 42% respectively. In the patients whose peripheral anterior chamber depth checked by angioscopy and ultrasound biomicroscopy is less than or equal to 1/4 CT estimated by Van Herick method, the positive rate of angle closure was 67% and 89%, respectively. In the patients whose peripheral anterior chamber depth checked by angioscopy and ultrasound biomicroscopy is less than or equal to 1/4 CT estimated by the improved method, the positive rate of angle closure was 67% and 89%, respectively. The consistency test of the Van Herick method and the improved method showed good consistency(Kappa value: 0.85), when peripheral anterior chamber depth are less than or equal to 1/3 CT and more than 1/4 CT. peripheral anterior chamber depth(>1/4 CT), and good consistency(Kappa value: 0.83)when estimating peripheral anterior chamber depth ≤1/4 CT. According to the consistency test of the results of angioscopy and ultrasound biomicroscopy, when the Van Herick method estimated the depth of peripheral anterior chamber are less than or equal to 1/3 CT and more than 1/4 CT, the consistency was general(Kappa value: 0.73). When the Van Herick method estimated the depth of peripheral anterior chamber is less than or equal to 1/4 CT, the consistency was general(Kappa value: 0.40). According to the consistency test of the results of angioscopy and ultrasound biomicroscopy, when the improved method estimated the depth of peripheral anterior chamber are less than or equal to 1/3 CT and more than 1/4 CT, the consistency was good(Kappa value: 0.75). When the improved method estimated the depth of peripheral anterior chamber is less than or equal to 1/4 CT, the consistency was poor(Kappa value: 0).

CONCLUSION: The slit lamp anterior chamber depth examination has a certain false negative rate in estimating the angle closure in the population, but its accuracy is high, and it is still suitable for the preliminary examination of estimating the angle closure.

Abstract:AIM: To compare the macular subfoveal choroidal thickness(SFCT)and choroidal vascular index(CVI)between the patients with internal carotid artery stenosis(ICAS)but without ocular symptoms and controlled healthy people.

METHODS: This is a retrospective comparative study. Forty eyes(grouped as ICAS group)from 40 ICAS patients and 40 eyes(grouped as control group)from 20 matched healthy people were included in this study. All included eyes were received OCT scanning to measure the SFCT. And OCT images were binarized with Image J software to measure CVI values. These values were compared between the two groups.

RESULTS: SFCT of ICAS group and control group were 208±66μm and 234±77μm respectively, with no statistical difference between the two groups(P=0.27). The CVI of ICAS group(64.5%±1.7%)was significantly lower compared with that of control group's(66.1%±2.7%)(P=0.04). The area under the curve(AUC)of CVI in the ROC curve was 0.76 (P=0.005), while the AUC of SFCT was 0.58(P=0.41).

CONCLUSION: It is suggested that compared with the detection of SFCT, the detection of CVI is more helpful to the early discovering of the changes of choroidal circulation in this kind of patients.

Abstract:AIM: To investigate the clinical effect of non-invasive positive pressure ventilation in patients with nonischemic central retinal vein occlusion(RVO)combined with severe obstructive sleep apnea hypopnea syndrome.

METHODS: A retrospective analysis was performed on 66 patients(66 eyes)with nonischemic central retinal vein occlusion combined with severe obstructive sleep apnea hypopnea syndrome in our hospital from December 2017 to December 2018. 30 of the patients(30 eyes)received intraocular anti-vascular therapy with Lucentis and retinal laser irradiation therapy combined with noninvasive positive pressure ventilation(observation group). Totally 36 patients(36 eyes)only received intraocular anti-vascular therapy with Lucentis and retinal laser irradiation therapy(control group). The differences of the best corrected visual acuity(BCVA)and retinal thickness at lesion sites were compared and analyzed between two groups before treatment and at the 1mo, 3mo and 6mo after treatment.

RESULTS: There were statistically significant differences of both retinal thickness and BCVA between two groups at different time points(P<0.05). Both retinal thickness and BCVA of the observation group were lower than those of the control group at the 3 and 6mo after treatment(P<0.01). There was no significant difference between the retinal thickness of the 3mo after treatment and that of the 6mo after treatment in the control group(P>0.05), while there were significant differences of retinal thickness between two groups of the other time points in the control group or any two groups of the time points in the observation group(P<0.05); BCVAs of the 1, 3 and 6mo after treatment were significantly lower than that of before treatment in the observation group(P<0.05), while the BCVAs of the 3, 6mo after treatment were significantly higher than that of the 1mo after treatment in the control group(P<0.05), but no significant difference of BCVA was observed between any two group of the other time points in the observation group or control group(P>0.05).

CONCLUSION: Noninvasive positive pressure ventilation is beneficial for patients with nonischemic(RVO)combined with severe obstructive sleep apnea hypopnea syndrome to improve the therapeutic effect.

Abstract:AIM: To explore the effect of fundus laser combined with Qi Ming granule on diabetic retinopathy in stage Ⅲ.

METHODS: Fifty six patients with Ⅲ stage diabetic retinopathy who were treated in our hospital from December 2017 to June 2018 were divided into control group(28 cases)and observation group(28 cases)according to the treatment method. The control group was treated with panretinal photocoagulation. The observation group was treated with Qi Ming granule combined with retinal laser photocoagulation. The best-corrected visual acuity(BCVA), mean defect of visual field(MD), and central macular thickness(CMT)were examined before photocoagulation and 1mo, 3mo and 6mo after photocoagulation to compare the retinal function between the two groups.

RESULTS: The mean BCVA, MD and CMT values of the eyes in the PRP+ drug treatment group and the PRP treatment group were statistically significant(P<0.05)at 1, 3, and 6mo after treatment. The mean BCVA, MD and CMT values between the two groups were statistically significant(P<0.05)at 1 and 3mo after treatment. There was no significant difference at 6mo after treatment(P>0.05).

CONCLUSION: Qi Ming granule can alleviate the degree of laser photocoagulation damage to the retina, promote the rapid repair of laser damage, and reduce diabetic macular edema. It is worthy of popularization and application in the clinic.

Abstract:AIM: To investigate the efficacy of pars plana vitrectomy(PPV)with inner limiting membrane(ILMP)flap peeling and flute needle drawing in the treatment of idiopathic macular hole(IMH)without staining dye.

METHODS: A retrospective non-randomized case study on 76 patients(76 eyes)were diagnosed with IMH in our hospital from January 2018 to January 2019, 38 eyes were treated with PPV combined with ILMP and air tamponade without staining(group A), the remaining 38 eyes were treated with PPV combined with ILMP, needle drawing the Hole edge and air tamponde without staining(group B). The patients were followed up for more than 6mo, the macular hole closure, the best correct visual acuity(BCVA)and postoperative complication were analyzed in the two groups.

RESULTS: At 6mo after surgery, the closure rate of MH and BCVA improvement rate in group A were significantly lower than those in the group B(84% vs 100%, 76% vs 95%, P<0.05). With the passage of postoperative time after surgery, the BCVA of two groups of patients gradually improved, and the BCVA of group B was better than that of group A at 7, 14d, and 1, 3, 6mo after surgery(P<0.05). There were no postoperative complications in two groups.

CONCLUSION: PPV combined with ILM peeling without staining agent and flute needle drawing is effective in treating IMH, which is better than ILM-P group in both closure rate and BCVA improvement.

Abstract:AIM: To investigate the independent influencing factors of endoscopic dacryocystorhinostomy in the treatment of lacrimal duct diseases.

METHODS: Retrospectively analysis of the cases of 280 patients(316 eyes)with lacrimal duct diseases treated by endoscopic dacryocystorhinostomy in Hankou Eye Hospital of Wuhan Aier from Oct. 2015 to Mar. 2019, summarizd the efficacy and analyzed the independent factors of efficacy by using the ordered Logistic regression.

RESULTS: The total cure rate was 52.2%, the total improvement rate was 30.7%, and the total invalid rate was 17.1%. Rhinitis(OR=95.58), frequency of eye ointment injection after operation(OR=0.001), history of lacrimal duct catheterization(OR=0.0009), history of lacrimal laser(OR=94.73),packing material(OR=0.002)were the independent factor influencing the efficacy.

CONCLUSION: Rhinitis and history of lacrimal laser are the factors to reduce the curative effect of endoscopic dacryocystorhinostomy; regular injection of eye ointment after operation, history of lacrimal duct catheterization and filling of absorbable materials, which are beneficial to improve the curative effect of operation.

Abstract:AIM: To investigate the feasibility, effect and safety of endoscopic canaliculus opening operation with lacrimal drainage tube for proximal lacrimal duct obstruction.

METHODS: Totally 52 patients(61 eyes)with proximal lacrimal duct obstruction were examined in the Third Affiliated Hospital of Nanchang University from June 1 2016 to June 1 2018, and all were treated by endoscopic canaliculus opening operation with lacrimal drainage tube. Lacrimal drainage tube was removed after 2-3mo. All patients were followed up from 6-12(mean 7.3±2.2)mo. The operation effect and complications were observed.

RESULTS: All patients were treated by endoscopic canaliculus opening operation with lacrimal drainage tube successfully. The recovery rate was 85%, improvement rate was 8%, ineffective rate was 7%, effective rate was 93%. Without serious complications occurred after operation.

CONCLUSION: Endoscopic canaliculus opening operation with lacrimal drainage tube for treating the proximal lacrimal duct obstruction, could locate precisely and fully open the normal lacrimal duct with high success rate, safe and feasible.

Abstract:AIM: To compare the medical effects and economic benefits between spherical headed silicone intubation(SHSI)and endoscopic dacryocystorhinostomy(En-DCR), to further verify the therapeutic effect of modified SHSI under endoscope on NLDO.

METHODS: The 43 patients with 50 eyes of NLDO were randomly divided into SHSI group(21 cases and 25 eyes)and En-DCR group(22 cases and 25 eyes). Then to compared the intraoperative bleeding volume, monocularoperation time, surgical discomforta, nd hospitalization time between the two groups of patients. Followed-up to 12mo after surgery, the clinical efficacy was evaluated according to the situation of tear overflow and lacrimal lavage at the last follow-up, and the cost-effectiveness ratio(C/E)was used to evaluate the economic benefits.

RESULTS: The intraoperative blood loss and surgical discomfort visual analogue scores of patients in the SHSI group were significantly lower than those in the En-DCR group(4.96±1.989mL vs 27.60±14.950mL, 2.84±0.64 vs 4.88±0.84). Monocular surgery time and hospital stay were significantly shorter than those in the En-DCR group(13.40±6.007min vs 59.64±12.786min, 0.50±0.010h vs 137.280±23.085h)(All P<0.001). At the last follow-up, the clinical effectiveness rate of the two groups was no difference(88% vs 96%, P>0.05), but the C/E(13.57)of patients in SHSI group was far smaller than that of En-DCR(121.50).

CONCLUSION: Endoscopic SHSI and En-DCR are both effective surgical methods for nldo. But SHSI surgery is relatively lower difficult and has significant cost-effective advantages.

Abstract:AIM: To analyze the clinical imaging characteristics and surgical methods of intraorbitalorganic foreign bodies.

METHODS: The materials of 14 patients(14 eyes)with orbital organic foreign bodies from January 2010 to April 2019 in our hospital were retrospectively analyzed, then to summarize their clinical features and imaging characteristics and surgical methods.

RESULTS: It had been proved that all of foreign bodies removed from 14 patients's(14 eyes)were organisms. There were 9 patients's(9 eyes)foreign bodies were found with low density and inflammatory response in soft tissue around of 14 patients by orbital three-dimensional reconstruction computed tomography(CT). CT images showed different manifestations due to different properties of foreign bodies, and soft foreign bodies had no characteristic images. Drainage strips were placed after removed foreign bodies. After the operation, the incision healed in the first stage and scar formed.

CONCLUSION: Due to the complexity of orbital organic foreign bodies, it is important to make presurgical preparation sufficient and surgical plan individualized for remove the foreign body completely and reduce the difficulty of the surgery.

Abstract:AIM: To explore the risk factors of strabismus in preschool children.

METHODS: The clinical data of 1 926 preschool children who were hospitalized in Chongqing General Hospital of armed police from July 2009 to December 2015 were analyzed retrospectively. Among them, the children with strabismus were included in the strabismus group(n=186)and the children with normal vision were included in the normal group(n=1 740). The single factor and multi factor Logistic analysis were conducted on the clinical data of the two groups.

RESULTS: Birth weight, Apgar score and gestational age were independent risk factors for preschool children's strabismus(P<0.05), and Apgar score had the highest risk \〖OR(95% CI): 6.336(2.180-18.416)\〗.

CONCLUSION: Birth weight, Apgar score and gestational age are independent risk factors for preschool children's strabismus. Pregnant women should pay attention to prenatal care and try to give birth at full term to avoid the risk factors of children's strabismus. At the same time, regular visual screening of preschool children should be strengthened and appropriate interventions should be given.

Abstract:AIM: To observe the efficacy of two conbercept regimens in the treatment of polypoid choroidal angiopathy.

METHODS: Twenty-one patients with polypoidal choroidal vasculopathy who met the inclusion criteria and were treated in our hospital were randomly divided into two groups. The group A(9 patients and 9 eyes)was treated with 3+Q12W scheme, namely, 0.5mg conbercept ophthalmic injection was intravitreally injected every 4wk for 3 consecutive times, and then 1 time every 12wk. In the group B(12 patients and 12 eyes), 3+TAE scheme was carried out, that is 0.5mg conbercept ophthalmic injection was intravitreally injected every 4wks for 3 consecutive times. The time of next injection was determined according to the evaluation results of each visit. The interval to the next visit/treatment was ≥ 4wk and ≤ 12wk. The best corrected visual acuity(BCVA), central retinal thickness(CRT)and the frequency of injection were compared between the two groups at 12 and 48wk after treatment, respectively.

RESULTS: BCVA of the group A was 74.78±11.23 letters and 74.67±13.94 letters at 12 and 48wk after treatment, which increased by 7.00±4.21 letters and 6.89±4.48 letters at the baseline before treatment, respectively. BCVA in the group B was 77.83±5.46 letters and 77.58±8.59 letters respectively at 12 and 48wk after treatment, which were 8.75±7.54 letters and 8.50±5.60 letters higher than the baseline before treatment. At the 12 and 48wk after injection, the average CRT in the group A was 276.33±44.34μm and 240.56±40.11μm, respectively, which were 43.22±42.21μm and 79.00±53.64μm lower than the baseline before treatment. At the 12 and 48wk after injection, the average CRT in the group B was 271.58±63.08μm and 241.00±43.91 μm, which were 57.42±45.33μm and 88.00±61.16μm lower than the baseline before treatment, respectively. The average times of intravitreal injection of conbercept were 6.00±0.00 and 7.75±1.14 times in the 3+Q12W group and the 3+TAE group, respectively.

CONCLUSION: Two different regimens of conbercept could reduce the CRT and improve the visual acuity of the patients with polypoidal choroidal vasculopathy. And the times of intravitreal injection in the 3+Q12W administration group were less than those in the3+TAE administration group.

Abstract:AIM: To evaluate the efficacy of vitreous hemorrhage(VH)in patients with polypoidal choroidal vasculopathy(PCV), and to summarize the clinical characteristics of the cases.

METHODS: Retrospective case series. From Jan. 2014 to Dec. 2017, 14 patients(15 eyes)with PCV combined with VH were treated by microincision 25G vitrectomy in our hospital and were followed up for at least 6mo. Data of medical history and follow up observation were collected. The main outcome measures included visual acuity, intraocular pressure, ultrasonography, color fundus photography, fundus angiography, optical coherence tomography, and surgical complications. To analyze the difference of the best corrected visual acuity(BCVA, LogMAR)between pre-operation and postoperation, and to summarize the clinical characteristics and therapeutic effect of the cases.

RESULTS: Totally 11 cases had history of hypertension. 9 eyes were diagnosed with PCV before vitrectomy. The follow-up period was from 6-36mo. All 15 eyes were treated with microincision 25G vitrectomy. During the operation, 3 eyes were silicone oil tamponade in the vitreous cavity, 2 eyes were gas tamponade, and the remaining eyes were balanced saline solution tamponade. Postoperative complications included progressed cataract in 2 eyes, recurrent VH in 1 eye, high intraocular pressure in 1 eye, and recurrent retinal detachment in 0 eye. The BCVA before surgery was 2.78±0.46, and the last follow up BCVA after surgery was 1.15±0.50. Postoperative BCVA was significantly improved compared with the preoperation(t=11.14, P<0.01).

CONCLUSION: Microincision vitrectomy is a safe and effective way to treat PCV with VH, which can improve the visual acuity of patients with PCV companied with VH. The history of hypertension may be a risk factor for PCV with VH.

Abstract:AIM: To compare the effect of platelet-rich fibrin(PRF)grafts and conjunctival-limbal autografts in pterygium excision.

METHODS: Totally 62 cases(62 eyes)of primary pterygium were randomly divided into group 1(32 eyes)and group 2(30 eyes). After pterygium excision, conjunctival-limbal autografts was performed in group 1 and PRF grafts was performed in group 2. PRF was prepared by centrifugation and compression of venous blood from patients before the surgery. The follow-up period was 6mo. The surgery time, complications and recurrence rate were evaluated and compared between the two groups.

RESULTS: The operation time of group 1 and group 2 were 27.3±4.3min and 22.0±4.0min respectively. There was significant difference between the two groups(t=4.990, P<0.01). Conjunctival granuloma developed only in one eye in group 2 after the surgery, and there was no significant difference between group 1 and group 2(P=0.484). Pterygium recurred in one eye in group 1 and in one eye in group 2. There was also no significant difference in recurrence rate between group 1 and group 2(P=1.000). There was no significant difference in intraocular pressure between group 1 with 14.69±2.44mmHg and group 2 with 14.96±2.93mmHg before the surgery(t=0.399, P=0.691). As well, there was no significant difference in intraocular pressure between group 1 with 14.68±1.65mmHg and group 2 with 15.11±2.12mmHg after the surgery(t=0.888, P=0.378). The dissolution time of PRF membrane in PRF grafts group was 3.5±0.8d.

CONCLUSION: The use of PRF in pterygium surgery is safe, effective, easier and timesaving. It's a promising method for clinical application.

Abstract:The epidemic of the SARS-CoV-2 infection has presented as a critical period. Until February 14^th 2020, more than 55 000 cases of SARS-CoV-2 infection has been confirmed in China, which has a great impact on economy and society, and also seriously interfering with ordinary medical practice of ophthalmology. In order to protect ophthalmology medical staff from SARS-CoV-2 infection during the outbreak period, this paper suggests the necessary medical protective measures for ophthalmology outpatient and ward.