Abstract:AIM: To observe the intraocular pressure(IOP)control and bleb function after phacoemulsification in patients with previous history of successful/qualified success mitomycin-C augmented trabeculectomy.

METHODS: This was a retrospective cohort study. Data of patients who had undergone trabeculectomy between 1^st January 2013 to 31^st Dec 2015 with subsequent cataract surgery were extracted from server. All patients had previous either success/qualified success trabeculectomy done. They went through uncomplicated phacoemulsification via clear corneal incision. Postoperative follow-up, review of bleb and IOP readings using Goldmann tonometer were taken. Details that were investigated include postoperative IOP control, visual improvement, number of anti-glaucoma medications, as well as the timing from trabeculectomy to phacoemulsification. Comparison with control group was made.

RESULTS: Fifteen eyes from thirteen patients fulfilled the criteria for study and had undergone uncomplicated phacoemulsification on a post-trabeculectomy eye. Two of the eyes had secondary glaucoma while the other thirteen had primary glaucoma. All phacoemulsifications were done at least 6mo after trabeculectomy(mean 14.7±4.3mo). There was only 1 eye(6.7%)requiring anti-glaucoma medications before the cataract surgery. This number increased to 4(26.7%)at 1-year post-phacoemulsification. The number further increased to eight(53.3%)at 2y post-phacoemulsification. The number of anti-glaucoma drops needed after surgery at 2y ranged from 2-4. In all the 15 eyes, there was no statistically significant change in IOP control between pre-cataract surgery(mean 13.4±2.9 mmHg)compared to 1y(mean 14.1±3.2 mmHg, P=0.357)and 2y(mean 15.1±3.3 mmHg, P=0.212)post-phacoemulsification. Visual improvement after phacoemulsification however is significant, from a preoperative average visual acuity of LogMAR 1.52±1.00 to a postoperative average visual acuity of 0.53±0.54(P=0.000, paired t-test).

CONCLUSION: This analysis shows significant visual improvement following cataract surgery in post-trabeculectomy patients without compromising IOP control. However, a reduced bleb function is noted following the surgery evidenced by the increase in number of anti-glaucoma drops used after surgery especially two years after the cataract surgery. Patients should be counselled regarding the possibility of restarting on anti-glaucoma medications post-phacoemulsification. The timing and sequence of cataract and glaucoma surgery should be optimized for best outcome.

Abstract:AIM: To analyze the morphological changes of macular soft drusen and drusenoid pigmental epithulium detachment(DPED)after subthreshold micropulse laser treatment(SMLT).

METHODS: Fourteen patients(20 affected eyes)with soft drusen and DPED clinically confirmed from August 2016 to October 2018, were included in this study. 577 nm yellow laser of SMLT was applied for soft drusen and DPED. The changes of soft drusen and DPED in best corrected visual acuity(BCVA)(LogMAR)and height, diameter and cross-sessional area according to fundus autofluorescence and SD-OCT examinations were observed after SMLT.

RESULTS: BCVA was not significant difference after treatment of soft drusen(P=0.260), and the DPED(P=0.736)than that of the baseline. Compared with the baseline values, the height and cross-sessional area of soft drusen were reduced at the 6mo after treatment(P=0.008, P=0.034). Compared with the baseline values, the differences were not statistically significant in height, diameter and cross-sectional area of DPED after treatment.

CONCLUSION: BCVA was not reduced for drusen and DPED after SMLT, however, the height and cross-sessional area of soft drusen was reduced compared with those before treatment, and the differences were not statistically significant in height, diameter and cross-sectional area of DPED before and after treatment. The results indicated that SMLT was effective for soft drusen, but was not effective for short-term treatment of DPED. SMLT caused no damage to the visual acuity in treatment of soft drusen and DPED, but prospective, controlled, large sample and long-term follow-up studies should be required.

Abstract:AIM: To determine the status of non-strabismic binocular vision anomalies(NSBVA)among students of a Malaysian private university uses visual display units(VDU).

METHODS: A cross-sectional study was conducted among university students who use VDU 3h or more from January 2019 to May 2019. A convenient sampling method was utilized. All subjects had gone through primary eye-examinations to satisfy the inclusion criteria. Those who satisfy the inclusion criteria, further gone through the NSBVA assessment. The descriptive analysis was done to rule out the percentage of NSBVA and Chi-square test of independence was carried out to observe the association of NSBVA with age, gender and hours of VDU usage.

RESULTS: A total of 140 students including 88 females(62.9%)and 52 males(37.1%)participated in this study. The mean age of the participants was 22.54±1.48 years and the mean VDU usage hours were 5.76±2.49h. The percentage of NSBVA is 40% among the students those who use VDU. The occurrence of accommodative and vergence anomalies among the VDU users is 17.86% and 22.14% respectively. There was a moderate association between gender and NSBVA(P=0.010). However, there was no significant association observed for age(P=0.334)and hours of VDU usage(P=0.835)with NSBVA.

CONCLUSION: NSBVA is 40% among the students of a Malaysian private university uses VDU. Accommodation insufficiency(15%)and convergence insufficiency(10%)is more common among all NSBVA for VDU users.

Abstract:AIM: To analyze the function and mechanism of Apelin-13 in preventing the apoptosis of retinal Müller cells induced by hypoxia.

METHODS: In the research, the retinal Müller cells are regarded as research subjects, and the control group, hypoxia group and experiment group are set up. The cells of control group are cultivated in normal environment. The cells of hypoxia group are cultivated in hypoxia environment. The cells of experiment group are cultivated in hypoxia environment and are treated with the Apelin-13(1μmol/L). MTT method is used to monitor the changing of the cell viability, and the crystal violet staining method is adopted to observe the cell morphology. In addition, the immunofluorescence staining method is used to test the expression of GFAP and YAP and the TUNEL staining method is used to monitor the cell apoptosis situation and the apoptosis index is calculated. The protein staining method is used to observe the changing of the expression of p-LATS1, p-YAP, LATS1 and YAP protein.

RESULTS:The separated and extracted Müller cells grow on the wall and show elongation, polygon and circular shapes. The cytoplasm is plentiful and the cell nucleus show circular shape. The GFAP expression of the cell is positive. The treatment with 0.1, 1, 10μmol/L Apelin-13 can obviously prevent the Müller cell viability decreasing induced by hypoxia(P<0.05 or P<0.01). Compared with the control group, the cell apoptosis index of hypoxia group is obviously increased(P<0.01). However, compared with the hypoxia group, the cell apoptosis index of experiment group is obviously decreased(P<0.01). The p-LATS1 and p-YAP protein expression of the control group and hypoxia group does not have big difference. Compared with hypoxia group, the p-LATS1 and p-YAP protein expression of experiment group is obviously decreased(P<0.01). The YAP protein expression of cell nucleus of control group and hypoxia group does not have great difference. Compared with hypoxia group, the cell nucleus expression of YAP cell is gretaly increased(P<0.01).

CONCLUSION: Apelin-13 can be used to prevent the retinal Müller cells apoptosis caused by the hypoxia, which may be related to the regulation of YAP into the nucleus.

Abstract:AIM: To investigate the effects of intravitreal injection of triamcinolone acetonide(TA)on angiogenesis and Notch pathway in photochemistry induced branch retinal vein occlusion(BRVO)model in rats.

METHODS: BRVO model rats were induced by photochemistry induction and randomly divided into BRVO model group and TA(1, 7, 21)d groups; at the same time, blank control group was set for comparison. The intraocular pressure of rats was measured by ophthalmotonometer; the condition of rat fundus was observed fluorescein fundus color photography(FFA)and optical coherence tomography(OCT); retinal angiogenesis related factors vascular endothelial growth factor(VEGF)and vascular endothelial growth factor receptor 2(VEGFR2), the protein expressions of Notch pathway important factors Notch 1, Jagged 1 and DLL4 were detected in rat retina by Western blotting(WB).

RESULTS: In the normal control group, the fundus vessels were arranged neatly and in a clear state. In the BRVO model group, edema appeared in the fundus, the retina turned white, the arrangement of blood vessels was disordered, the optic disc pit was disappeared, retinal vessels were in the state of vasoconstriction. In TA 1, 7 and 21d groups, edema gradually decreased, blood vessels expansion and bending gradually slowed down, and the optic disc pit was restored. Compared with the blank control group, the intraocular pressure of BRVO model group increased, the thickness of the retina increased at the injured site and 250μm far from injured site, the protein expressions of VEGF, VEGFR2, Notch1 and Jagged1 increased, the protein expression of DLL4 protein was decreased(P<0.05). Compared with the BRVO model group, in TA 1d group, the retinal thickness decreased at 250μm far from injured site, the protein expressions of VEGFR2, Notch1 and Jagged1 decreased, the protein expression of DLL4 protein increased; in TA 7d group, the retinal thickness was decreased at the injured site and 250μm far from injured site, the protein expressions of VEGFR2, Notch1 and Jagged1 decreased, the protein expression of DLL4 protein increased; the intraocular pressure of TA 21d group decreased, the thickness of the retina decreased at the injured site and 250μm far from injured site, the protein expressions of VEGF, VEGF R2, Notch1 and Jagged1 decreased, the protein expression of DLL4 protein increased(P<0.05).

CONCLUSION: Vitreous injection of TA may inhibit angiogenesis by regulating Notch pathway to inhibit the activation of VEGF, thus achieving the retinal protection in BRVO rats.

Abstract:AIM: To assess the neuroprotective effect of bis(7)-tacrine in experimental Sprague-Dawley(SD)rat glaucoma.

METHODS: Totally 24 rats were randomly divided into control group, operated group, 0.5mg/kg bis(7)-tacrine group and 5mg/kg memantine group. Unilateral elevation of intraocular pressure(IOP)was produced by hypertonic saline injection into an episcleral vein. Animals were orally dosed daily with bis(7)-tacrine or memantine. IOP was measured in both eyes of animals per 3d, and the number of retinal ganglion cells and the thickness of nerve fiber layer axon bundle were measured at 5wk.

RESULTS: Elevated IOP were induced in 3 glaucoma groups. Compared with control group, the retinal ganglion cells decreased from 119.50±8.26 to 79.83±9.58 and the thickness of axon bundle come down from 13.40±0.60 μm to 6.64±0.50 μm in operated group. However the number of the retinal ganglion cells was 109.00±7.04 in bis(7)-tacrine group and 107.33±8.57 in memantine group individually. The thickness of axon bundle was 12.26±0.78μm in bis(7)-tacrine group and 10.13±1.19μm in memantine group individually.

CONCLUSION: Both bis(7)-tacrine and memantine inhibited retinal ganglion cells loss, but only bis(7)-tacrine decreased the thickness declining of axon bundle.

Abstract:AIM: To observe the clinical effect of compound trabeculectomy and air filtration injection in the anterior chamber in the treatment of chronic primary angle closure glaucoma, and to evaluate the safety and effectiveness of air filtration injection in the treatment of chronic primary chronic angle closure glaucoma.

METHODS: In a retrospective study, 129 patients(183 eyes)with chronic primary chronic angle closure glaucoma admitted to our hospital from September 2015 to June 2017 were divided into air injection group and control group. Patients in the air injection group(68 cases, 97 eyes)were treated with compound trabeculectomy and air filtration injection into the anterior chamber. Patients in the control group(61 cases, 86 eyes)were treated with compound trabeculectomy. The follow-up time was from 3 to 6mo with an average of 4.5mo.The visual acuity, intraocular pressure, bleb formation and complications were observed, and the unplanned reoperation, length of stay and total cost of stay were recorded.

RESULTS: The incidence of shallow anterior chamber, malignant glaucoma and unplanned reoperation in the air injection group was lower than that in the control group, the days of hospitalization in the air injection group were shorter than that in the control group, and the cost of hospitalization in the air injection group was lower than that in the control group(P<0.05). There was significant difference in intraocular pressure between different groups(F_group=42.394, P_group<0.001; F_time=7.373, P_time<0.001; F_time×group=23.903, P_time×group<0.001). Intraocular pressure at different time points was compared between groups. There was significant difference(P<0.001)in intraocular pressure of 1, 3d and no significant difference(P>0.05)in 3, 7d between the two groups. There was no significant difference(P>0.05)in the flash of anterior chamber of 1, 3, 7d and 1mo between the two groups. There was no significant difference(P>0.05)in the changes of vision and the formation of filtering blebs between the two groups in 3mo(P>0.05).

CONCLUSION:Combined trabeculectomy and air filtration in the anterior chamber for chronic primary angle closure glaucoma can reduce the incidence of shallow anterior chamber, malignant glaucoma and unplanned reoperation, not aggravate the inflammatory reaction in the anterior chamber, safely retain the residual visual function of patients, shorten the length of stay in hospital and the total cost of hospitalization, and have no effect on the formation of intraocular pressure, vision and filtering bleb obvious influence.

Abstract:AIM: To explore the clinical effect of leizhumab combined with 577nm multi-point scanning matrix laser photocoagulation in the treatment of diabetic macular edema(DME).

METHODS:Totally 127 eyes of 94 patients(January 2017-June 2018)with DME were selected. According to the different treatment methods, RA group was divided into two groups. RA group was only treated with razumab group: the patients in this group were treated with razumab injection; RL group: razumab combined with 577nm multi-point scanning matrix laser group: the patients in this group were treated with razumab combined with 577nm multi-point scanning matrix laser photocoagulation. To observe the treatment effect of RA group and RL group 1mo after three times of leizhumab injection; to check the visual improvement of RA group and RL group before treatment and 1mo, 3mo and 6mo after three times of leizhumab injection; to detect the macular fovea thickness(CMT)of RA group and RL group by optical coherence tomography(OCT); to detect the retinal neogenesis by FFA Vascular leakage area and postoperative complications.

RESULTS: The effective rate(100%)of the patients in the combined group was higher than that in the single group(97%), but the difference was not statistically significant(P>0.05). Before treatment, the BCVA of the two groups of patients were 0.57±0.20 and 0.56±0.18(P>0.05). After completing three injections of ranibizumab, the BCVA of the single group of patients at 1, 3, and 6mo were 0.39±0.05, 0.23±0.06,0.18±0.05, the BCVA of the combined group were 0.28±0.08,0.18±0.07, 0.12±0.06, the BCVA of the combined group was better than the control group(P<0.001). Before treatment, the CMT of the two groups of patients were 389±42.54 and 386±38.25, respectively(P>0.05).After completing three injections of ranibizumab, the CMT of the single group at 1, 3,and 6mo were 333.84±38.18, 297.12±27.10, 278.15±26.24μm, the CMT of the combined group were 315.04±39.07, 274.35±28.63, 253.65±25.91μm, the improvement of the CMT of the combined group was better than that of the single group(P<0.001). Before treatment, the leakage area of retinal neovascularization in the two groups was 22.31±3.26 and 21.98±3.18mm²(P>0.05). After the injection of ranibizumab was completed 3 and 6mo, the single group leaked The areas were 18.34±2.19, 7.81±1.28mm², and the leakage area of the combined group were 14.92±1.98, 5.39±1.42mm², respectively(P<0.001). Complications occurred in 3 eyes of a single group of patients and complications in 4 eyes of a combined group(P>0.05).

CONCLUSION: Leizhumab and 577nm multi-point scanning matrix laser photocoagulation are effective and safe in the treatment of DME patients, but the long-term effect of leizhumab combined with 577nm multi-point scanning matrix laser group is better than that of single line intravitreal injection of leizhumab.

Abstract:Retinitis pigmentosa is an inherited eye disease. The inheritance methods include autosomal dominant inheritance, autosomal recessive inheritance, and sex-linked recessive inheritance. Currently, there are more than 3,000 mutation sites, which makes clinical treatment of this disease difficult. Ophthalmologists are committed to exploring the treatment of retinitis pigmentosa, and have conducted a large number of experimental studies, mainly including drug treatment, cell transplantation, gene therapy, etc. Drug therapy includes traditional Chinese medicine, antioxidants, anti-apoptotic agents, neurotrophic factors, etc. Compared with other treatment methods, it is non-invasive and convenient and cheap, but its mechanism of action needs further research. Cell transplantation is considered an effective method for the treatment of retinitis pigmentosa, but it may cause preretinal membrane and macular folds. Although gene therapy has certain limitations, with the development of gene editing technology and new gene delivery vectors, it will become one of the most promising treatments for retinitis pigmentosa in the future. This article reviews and prospects the recent experimental research on retinitis pigmentosa.

Abstract:Retinal neovascularization is a pathological feature of many retinal diseases, such as retinopathy of prematurity and diabetic retinopathy, which can lead to severe vision loss or even blindness. Inhibition of retinal neovascularization is a therapeutic strategy for the treatment of these retinal diseases. At present, there are several therapeutic strategies for inhibiting retinal neovascularization, including laser blocking, inhibition of vascular endothelial growth factor(VEGF), and transplantation of stem cells. With the deepening of stem cell research, people find that although stem cell therapy has great potential, there are also technical obstacles such as low viability of transplanted cells and congenital heterogeneity. Current studies have found exosomes derived from mesenchymal stem cells(MSCs). They have similar functions as MSCs, and their sizes are small and easy to pass through biofilm, which provides a new idea for cell therapy. This paper reviews the recent progress of exosomes on retinal neovascular diseases.

Abstract:Meibomian gland dysfunction(MGD)is mainly characterized by terminal duct obstruction and/or qualitative/quantitative changes in the glandular secretion, resulting in the alteration of tear film and ocular surface diseases. It covers several meibomian gland diseases ranging from congenital to acquire. With the progress of clinical research, recent studies indicate there are many risk factors related to MGD, including ophthalmic diseases, systemic diseases, therapeutic approaches(topical/systemic medication, surgery)and even environmental factors. Thus, a proper understanding of the various risk factors acting on MGD will be helpful to the clinical diagnosis and treatment of MGD.

Abstract:The molecular basis of schnyder crystalline corneal dystrophy(SCCD)is UBIAD1 gene mutation. The pathogenesis of SCCD includes conformational change of UBIAD1 protein which leads to loss of combination with GGpp compounds. UBIAD1-HMG CoA reductase complexes can't be separated, and the rate-limiting enzyme can't dissociate from endoplasmic reticulum to cytoplasm, which results in loss of recognition and degradation by the proteasome. The direct consequence is the gradual accumulation and biosynthesis of cholesterol and non-sterol isoprenoids compounds in the cell. This paper reviews the clinical manifestation, molecular basis, pathogenesis of SCCD and the function of UBIAD1 which provide guidance for molecular diagnosis and treatment of SCCD and pave the way for elucidating the function of UBIAD1 in vivo.

Abstract:Neovascular glaucoma(NVG)is a common refractory glaucoma in ophthalmology, which is usually secondary to central retinal vein occlusion(CRVO), diabetic retinopathy(DR), long-standing retinal detachment, ocular tumors, etc. Previous treatments mainly included panretinal photocoagulation(PRP), drugs, anti-glaucoma surgery or ciliary destruction, but the therapeutic effect was unsatisfactory. With the continuous development and application of anti-vascular endothelial growth factor(VEGF)drugs, combination therapy of anti-vascular endothelial growth factor(VEGF)drugs has been proposed gradually, and the success rate of NVG surgery has been increased significantly, and NVG can be controlled. The treatment progress of NVG in recent years will be described in detail.

Abstract:Advanced glycation end products(AGEs)accumulate in various tissues in the body, and induce a series of biological responses by regulating the expression of related factors and activating signal pathways, causing age-related diseases and neurodegenerative diseases, such as Alzheimer's disease, Parkinson's disease and Atherosclerosis. Glaucoma, which is the leading cause of vision loss after cataract worldwide, is a degenerative disease of the optic nerve that ultimately leads to irreversible visual field loss. The accumulation of excessive AGE sin the retina and other eye tissues of glaucoma patients activates signal pathways and triggers biological responses, causing damage to the structure and function of tissues and cells, and participating in the pathogenesis of glaucoma. This article mainly describes the latest progress of AGEs in glaucoma pathogenesis, treatment, screening and other related research, and provides new ideas and research methods for the prevention and treatment of glaucoma.

Abstract:Age-related macular degeneration is a macular disease which incidence increases with age. Currently, it is believed that its pathogenic factors are related to patients' age, heredity, smoking, oxidative stress, immune inflammatory response, RPE cell aging and metabolic abnormalities. Complement system plays an important role in the body's defense against infection, immune regulation and inflammatory response. Immune inflammation caused by abnormal activation of complement system is considered to be an important cause of ARMD in recent years. Autophagy also plays a role in ARMD. Normal autophagy is an important way for cells' self-protection and maintenance of homeostasis. When autophagy is blocked, oxidative stress can be aggravated, which will lead to the development of ARMD. The balance regulation between complement activation and autophagy is an important method to control the development of ARMD.

Abstract:miRNA-15a(miR-15a)is a non-coding small molecule RNA located on 13q14 gene. It affects the growth, development, differentiation and apoptosis of all organs and cells of the whole body. As the study progressively deepened, it was found that the role of miR-15a in different tissues and cells was not entirely consistent. Sometimes it plays a role in suppressing cancer, and sometimes it promotes cancer. The signal pathways it affects are complex and diverse. With the deepening of biological research into cell signaling pathways, miRNA-15a has become a miRNA more extensively studied. But in the ophthalmology, the corresponding research is not much. In this article, we mainly focus on the mechanism of miR-15a and its current research situation in ophthalmic diseases, so as to provide a reference for further study and their treatment.

Abstract:With the continuous development of economic globalization, the relationship between artificial intelligence and medical decision-making has become more and more close, and it has shown it's unique advantages in the field of ophthalmology. At present, artificial intelligence is more widely used for diseases of the retina(diabetic retinopathy, age-related macular degeneration, retinal vein occlusion, premature retinopathy)and front section disease(cataract, glaucoma, anterior segment)in the diagnosis and treatment. The purpose of this review is to understand the application progress of artificial intelligence in ophthalmology, and to point out the potential challenges and prospects of artificial intelligence, so as to provide more information for the further development of artificial intelligence in ophthalmology.

Abstract:Alzheimer's disease(AD)is a neurological degenerative disease that is insidious onset. The main pathological features are deposition of amyloid β(Aβ)and intracellular hyperphosphorylated tau protein. In recent years, studies have found that the manifestations of AD exist not only in the brain but also in the eyes, such as impaired visual function, changes in the pupil, Aβ deposition in the lens, changes in the retina and choroid, and so on. These ocular manifestations provide clues to the early diagnosis of AD and have positive clinical and social significance. Therefore, this article reviews the ocular manifestations of AD and their use as biomarkers for diagnosis and progression.

Abstract:AIM: To systematically review the difference between the efficacy of 577nm subthreshold micropulse diode laser and conventional laser in the treatment of diabetic macular edema(DME).

METHODS:Retrieved from PubMed, Embase, Cochrane Library, Web of Science, CBM, CNKI, CQVIP, and CECDB databases, randomized controlled trials(RCT)and retrospective clinical control trials(CCT)about the difference between the efficacy of 577nm subthreshold micropulse diode laser and conventional laser in the treatment of diabetic macular edema were collected. The search time was from the establishment of the library until August 2019. Meta-analysis was performed by using RevMan 5.3/Stata 14.0 software after screening the literature, extracting the data, and evaluating the quality of the literature by two researchers.

RESULTS: A total of 7 studies, 6 RCTs and 1 CCT involving 401 patients and 545 eyes were included. The results of Meta-analysis showed that the best corrected visual acuity(BCVA)measured values in the 577nm subthreshold micropulse diode laser group were higher than the conventional laser group \〖95% CI(0.02, 0.08), P=0.002\〗. The macular retinal thicken measured values in the 577nm subthreshold micropulse diode laser group was significantly lower the conventional laser group \〖95% CI(-26.96 to -10.88), P<0.00001\〗. The mean sensitivity within macular 10° examination measured values in the 577nm subthreshold micropulse diode laser group was significantly higher than that conventional laser group \〖95% CI(1.56 to 2.39), P<0.00001\〗.

CONCLUSION: 577nm subthreshold micropulse diode laser can not only better improve the visual function of patients with DME, but also have a higher safety in treatment. 577nm subthreshold micropulse diode laser has good research value for the treatment of DME, it's worthy of application and promotion in clinical practice.

Abstract:AIM:To systematically evaluate the effect of trypan blue capsule staining on corneal endothelial cells in phacoemulsification.

METHODS: RCTs on the use of trypan blue for capsular staining in phacoemulsification were retrieved from China Knowledge Network(CNKI), Wanfang Database, Weipu Database, SinoMed, PubMed, SpringerLink, Clinicalkey, Medline, Cochrane Library, Web of Science, OVID, Embase. The search time was from the establishment of the databases to April 2019.The Meta-analysis of the included literature was made by Revman 5.3 and R 3.7.

RESULTS: Eight trials included 378 eyes were selected. Meta-analysis showed that the number of corneal endothelial cell loss between 0.02%, 0.06% or 0.1% trypan blue capsule staining group(193 eyes)and non-stained or placebo staining group(185 eyes)changed without statistical significance \〖Within 1mo after operation(WMD=-10.47, 95% CI=-26.44-5.61, P=0.20); 1mo after operation(WMD=-60.72, 95% CI=-170.92-49.49, P=0.28)\〗. The percentage of corneal endothelial hexagonal cell loss at 1mo after operation changed without statistical significance(WMD=0.50, 95% CI=-2.09-3.09, P=0.71). The central corneal thickness(CCT)at 1mo after operation changed without statistical significance(WMD=3.10, 95% CI=-5.77-11.98, P=0.49). The coefficient of variation(CV)changed without statistical significance(WMD=-1.00, 95% CI=-2.86-0.86, P=0.29).

CONCLUSION: 0.02%, 0.06% or 0.1% trypan blue capsule staining in phacoemulsification have no significant effect on the number and function of corneal endothelial cells.

Abstract:AIM: To study the differences of binocular vessel density and retinal thickness in patients with anisometropia, including refractive index, axial length, vessel density in 3 mm×3 mm macular area and peripapillary area, nerve fiber thickness of 3mm×3mm macular area. And to study the relationship between axial length and vessel density, as well as retinal thickness, analyze its clinical significance in the occurrence and development of anisometropia.

METHODS: A retrospective analysis was performed on 27 patients with anisometropia in our hospital. All the patients received the examinations including binocular diopter, intraocular pressure, axial length, vessel density in 3mm×3mm macular area and peripapillary area, retinal thickness in macular area. SPSS 23.0 and paired t-test was used to analyze and compare the differences.

RESULTS: In all 27 patients, the refractive index and axial length of the one with a higher degree were greater than that of the low eye(t=-3.559, 3.083, P<0.05). There were no statistically significant differences in superficial vessel density, deep vessel density, and retinal thickness in the macular area(1mm and 3mm)(P>0.05). In the all patients, the vessel density with a higher degree in the optic disc was higher(t=2.36, P=0.022).The vessel density of eyes with a higher degree in the superior nasal square(SN)was lower(t=-2.154, P=0.036). Refractive state, superficial and deep vessel density of foveal, deep parafoveal vessel density, retinal thinkness of foveal and parafoveal were correlated with the optic axis(r=-0.897, 0.458, 0.446, -0.328, 0.301, -0.397, P<0.05).

CONCLUSION: There was no difference in the superficial and deep vessel density in 3mm×3mm macular area of the Patients with ametropia as well as retinal thickness. The binocular vessel density in the optic disc and the SN square were difference, and there was nodegree eye of refractive error difference in the residual papillary area. The axial length is related to the refractive state, the vessel density in the superficial and deep fovea of the macula, the vessel density in the deep parafovea of the macula, the retinal thickness in the fovea and the parafovea of the macula.

Abstract:AIM:To study azelastine hydrochloride combined with praprofen for the treatment of allergic conjunctivitis in children.

METHODS: Totally 80 children with allergic conjunctivitis who were admitted to our hospital from May 2016 to June 2018, they were randomly divided into the control group and the observation group, 40 cases in each group. The control group was given pranoprofen eye drops, on the basis of the control group, the observation group was combined with azelastine hydrochloride eye drops for adjuvant treatment. The two groups children were treated continuously for 1wk. The clinical efficacy, the changes of the clinical symptoms, tear film stability, inflammatory factors and adverse reactions were compared between the two groups.

RESULTS: After 1wk of treatment, the clinical efficacy of the observation group was 95.0%, higher than that of the control group, 85.0%(P=0.035); the itching, tearing, foreign body sensation and photophobia scores in the observation group were lower than that of the control group \〖(1.13±0.36)vs (2.28±0.41)scores,(1.05±0.33)vs (2.14±0.49)scores,(1.17±0.46)vs (2.28±0.59)scores(1.29±0.37)vs (1.84±0.55)scores\〗(P<0.05); the tear film rupture time(BUT)in the observation group was significantly higher than that of the control group, and the corneal fluorescein staining test(FL)was significantly lower than that of the control group \〖(11.96±1.14)vs (5.85±0.92)s,(2.85±0.33)vs (6.21±0.68)scores\〗(P<0.05); the tears histamine(HA), eosinophilic cationic protein(ECP)and immunoglobulin E(IgE)in the observation group were lower than that of the control group \〖(31.62±4.51)vs (65.03±6.48)μg/L,(2.20±0.28)vs (7.26±0.72)μg/L,(0.06±0.01)vs (0.18±0.04)mg/L\〗(P<0.05); there was no significant difference in the overall incidence of adverse reactions between the two groups during treatment(χχ²=1.897, P=0.168).

CONCLUSION: The clinical efficacy of azelastine hydrochloride combined with pranoprofen in the treatment of allergic conjunctivitis in children is significant, which can effectively improve the level of inflammatory factors, promote the tear film stability recovery, and have good safety, the clinical value is high.

Abstract:AIM: To analyze the efficacy of sodium hyaluronate and cyclosporine A eye drops in treating patients with mixed dry eye disease.

METHODS: Among patients diagnosed with dry eye who presented to our hospital between February 2018 to February 2019, 60(120 eyes)cases were divided into 30(60 eyes)in each control and treatment group by random number table method. Both groups received routine treatment with the methods of eyelid hot compress cleaning and meibomian gland massage. The treatment group received combined application of sodium hyaluronate eye drop(0.3%)and cyclosporine A eye drop(1%), while control group received carbomer eye drops used alone at four times daily. And dry eye symptom score, Schirmer I test(SⅠt), tear film break-up time(BUT)and corneal fluorescein staining(CFS)results were obtained before treatment, at the 1 and 3mo after initiation of treatment.

RESULTS: No statistically differences were observed in any of the indexes between the control group(dry eye symptom score: 13.52±2.15, SⅠt: 5.22±2.23, BUT: 5.02±1.58, CFS:2.82±0.81)and the treatment group(dry eye symptom score: 13.75+3.05, SⅠt: 5.54+2.89, BUT: 5.14+1.84, CFS: 2.73±0.45)before initiating treatment. One month later, the dry eye symptom score of the control group(12.22±2.64)and the treatment group(11.42±2.06)improved after treatment; the SⅠt of the control group(7.94±2.15)and the treatment group(8.63±2.78)also improved after treatment, and result of the treatment group was better than that of the control group, and the difference was statistically significant; the BUT of the control group(5.32±1.34)and the treatment group(5.46±1.45)were better after treatment, but the difference was not statistically significant. After 3mo treatment, the dry eye symptom score, SⅠt, BUT and CFS of the control group were 11.57±2.98, 8.44±2.35, 5.92±1.75, 1.92±0.44, respectively, and the dry eye symptom score, SⅠt, BUT and CFS of the control group were 9.23±2.34, 10.45±2.65, 5.92±1.75, 8.69±1.78, 1.59±0.79, respectively(P<0.05).

CONCLUSIONS: Combination therapy of sodium hyaluronate eye drop and cyclosporine A eye drops treatments are effective for the treatment of mixed dry eye syndrome.

Abstract:AIM: To evaluate the early objective visual quality and vision related quality of life after implantation of posterior chamber phakic implantable collamer lens with a central hole(ICL V4c)for high myopia by applying the double-pass optical quality analysis system Ⅱ(OQAS Ⅱ)and life quality questionnaire.

METHODS: Totally 26 patients(44 eyes)with high myopia were enrolled in this research. The patients were all recieved ICL V4c implantation by the same surgeon in our hospital. The evaluation items included uncorrected visual acuity(UCVA), best corrected visual acuity(BCVA), intraocular pressure, corneal endothelial cell density(ECD), vault, objective scattering index(OSI), modulation transfer function cut off frequency(MTF cut off), Strehl ratio(SR), predicted visual acuity values(OV 100%, OV 20%, OV 9%)at contrasts of 100%, 20%and 9% and vision related quality of life questionnaire. All measurements were performed preoperative and 1wk, 1mo, 3mo postoperatively.

RESULTS: Compared with preoperative BCVA, for the high myopia patients, the 1wk, 1mo and 3mo UCVA postoperative were better at all time points, and the differences were statistically significant(P<0.001). Postoperative 1wk intraocular pressure was higher than that in preoperative and postoperative 1mo and 3mo(P<0.05). Postoperative corneal endothelial cell counts at all time points were lower than that in preoperative(P<0.05), but all within the normal range. No significant difference was found in vault(P=0.790). Compared with preoperative OSI, MTF cut off, SR, OV 100%, OV 20% and OV 9%, the situation improved at postoperative 1wk, 1mo and 3mo, with statistical significance(P<0.001). The vision related quality of life questionnaire showed that all patients had high satisfaction in the good subjective visual acuity after operation.

CONCLUSION: ICL V4c implantation is safe and effective in correcting high myopia. The objective visual quality and vision related quality of life of patients with high myopia was significantly improved after ICL V4c implantation in the early stage. The research laid a foundation for the establishment of “the comprehensive evaluation system of subjective and objective combination” of ICL in the application of high myopia.

Abstract:AIM: To observe the changes of binocular eye accommodation function in correcting anisometropia by monocular orthokeratology in anisometropic children, and to explore the mechanism of regulation in the progression of myopia control by orthokeratology.

METHODS: It was a prospective self-control study. A total of 22 anisometropic children(44 eyes), aged 8-13 years, who wore an orthokeratology lens in only one eye were enrolled in the outpatient clinic of Hainan Provincial Eye Hospital from September 2016 to September 2018. The eyes with an orthokeratology lens had a mean spherical equivalent refraction of -2.751±1.16 diopter(D), and fellow eyes without a lens had a refraction of -0.10±0.32D. The eyes wearing orthokeratology lens were used as the lens wearing group, and the fellow eyes without a lens were used as non-wearing lens group. During the follow-up period,we measured changes of diopter difference, monocular accommodative amplitude(MAA), monocular accommodative facility(MAF)and accommodative response(AR)before wearing the lens and wearing the lens for 12mo.

RESULTS: The monocular accommodative amplitude and monocular accommodative facility of the wearing group before wearing the lens were lower than those of the non-wear group(P<0.01), and the accommodative lag were higher than that of the non-wear group(P<0.05). The monocular accommodative amplitude 15.63±1.66D after wearing the lens for 12mo was higher than that before wearing the lens 11.25±3.15D(t=3.63, P<0.01), and the difference was not statistically significant(t=0.75, P=0.46)compared with the non-wearing group. The monocular accommodative facility 14.63±1.58 cyc/min after wearing the lens for 12mo was higher than that before wearing the lens 9.25±3.38cyc/min(t=2.83, P=0.01), and the difference was not statistically significant(t=0.38, P=0.71)compared with the non-wearing group. The accommodative lag 0.62±0.29D of the wearing group after 12mo was reduced compared with that before wearing the lens 1.35±0.26D(t=2.57, P=0.02),and compared with the non-wearing group, the difference was not statistical significance(t=0.61, P=0.55). The mean equivalent diopter of the non-lens group was -0.75±0.35D after 12mo, and the number of diopter group increased by -0.65±0.39D(t=4.24, P<0.01). The diopter of the wearing group increased by -0.15±0.22D(t=2.90, P<0.001), there was a statistically significant difference in the change of diopter between the two groups(t=5.30, P<0.01). There was no statistically significant difference in the change of the accommodation before and after 12mo in the non-wear group(P>0.05).

CONCLUSION: The accommodation function of anisometropic children in correcting anisometropia by monocular orthokeratology was significantly improved compared with that before wearing the lens and was consistent with the contralateral eyes without lens group. The refractive state of the group wearing orthokeratology lens was more stable, and the contralateral eyes without lens gradually showed mild myopia refractive state, but the accommodation did not change significantly.

Abstract:AIM: To observe the efficacy and safety of low-dose atropine eye drops combined with orthokeratology in the treatment of low and moderate myopia in adolescents.

METHODS: Totally 126 cases of low and moderate myopia in adolescents(all right eye data, 126 eyes)who all wore orthokeratology lens for 1mo were selected from May 2016 to Aug 2018. Then they were randomly divided into the experimental group and the control group. The experimental group(63 eyes)was combined with low-dose(0.01%)atropine eye drops once a night, and the control group(63 eyes)was combined with polyethyleneglycol eye drops once a night. Their AL,SE, BCNVA,PD,AMP,BUT and IOP were observed.

RESULTS: After 1y of treatment, the AL in the low myopia experimental group increased(0.13±0.03mm), while the low myopia control group increased(0.22±0.05mm). The AL in the moderate myopia experimental group increased(0.12±0.03mm),while the moderate myopia control group increased(0.20±0.05mm). The SE in the low myopia experimental group increased(0.16±0.07D), while the low myopia control group increased(0.21±0.08D). The SE in the moderate myopia experimental group increased(0.16±0.05D), while the moderate myopia control group increased(0.20±0.09D). There was statistical difference in AL and SE between the two groups(P<0.05). After 1a of treatment, there was no statistical difference in BCNVA(LogMAR), BUT and IOP between the experimental group and the control group(P>0.05). But the pupil diameter of the experimental group was significantly larger than that of the control group. The accommodation amplitude of the experimental group was lower than that of the control group(P<0.05).

CONCLUSION: 0.01% atropine eye drops combined with orthokeratology can control the progression of myopia in adolescents more effectively, which is safe and effective.

Abstract:AIM: To evaluate the therapeutic effect of the PVEP-CD comprehensive therapy \〖a multimedia visual training system uses the individualized PVEP(pattern visual evoked potential)sensitive spatial frequency parameters\〗 in children with amblyopia by comparing the differences in visual acuity and stereo acuity enhancement between the PVEP-CD comprehensive therapy and traditional therapy.

METHODS: A total of 38 children(54 eyes)with amblyopia who were treated in our hospital from April 2018 to January 2019 were randomly divided into two groups. Traditional therapy group(19 cases, 27 eyes; therapeutic methods contain refractive correction, patching/optical or drug suppress and precision eyesight training); PVEP-CD comprehensive therapy group(19 cases, 27 eyes; therapeutic methods contain refractive correction, patching/optical or drug suppress and a multimedia visual training using the individualized P-VEP sensitive spatial frequency parameters). To study the clinic therapeutic effect, the best distance corrected visual acuity(BCVA)and near stereo acuity were measured at the enrollment visit and the final visit after 6mo treatment.

RESULTS: After 6mo treatment, both groups had an apparent BCVA improvement(both therapy effective rate≥85%). PVEP-CD comprehensive therapy group were significantly better than traditional therapy group in BCVA lines improvement \〖3(2, 3)lines\〗, near stereo acuity therapy effective rate(89%)and near stereo acuity level improvement \〖2(1, 4)levels\〗(all P<0.05). In amblyopic children older than 6y, PVEP-CD comprehensive therapy group showed a significantly greater BCVA lines improvement(P=0.018). In mild amblyopia cases, PVEP-CD comprehensive therapy group showed a significantly better clinical efficacy in near stereo acuity(P=0.048)and greater improvement in near stereo acuity level(P=0.029). In moderate amblyopia cases,the BCVA lines improvement(P=0.003)was significantly greater in PVEP-CD comprehensive therapy group.

CONCLUSION:Both PVEP-CD comprehensive and traditional therapy can improve the BCVA in children with amblyopia and have a good clinical efficacy. Furthermore, the PVEP-CD comprehensive therapy could improve the BCVA and near stereo acuity level more obviously and help amblyopic children get a better binocular vision.

Abstract:AIM:To analyze the visual status and prevalence of myopia in adolescent and children's cohort in Gaoping, Shanxi Province, and further discuss influencing factors of myopia.

METHODS:The data was from November 2018 to January 2019 in Gaoping, Shanxi Province. A multi-stage sampling method was used to select 181 big class children from kindergarten, 948 primary school students, 432 middle school students and 244 high school students. The questionnaires were distributed to those students, vision and diopter tests were conducted. Based on that information, the study analyzes the occurrence of myopia and its influencing factors in adolescent and children's cohort in this area.

RESULTLS: Totally 1805 students were selected in this study. The detection rate of poor eyesight was 78.28%(1413/1805). The prevalence of myopia was 64.38%(1162/1805), and the rate of wearing glasses was 51.46%(598/1162)in the myopic population. With the development of learning stage and age, the prevalence of myopia increased. The prevalence of myopia in girls(66.81%)was higher than that in boys(61.73%), and the prevalence of myopia in urban areas(66.54%)was higher than that in rural areas(61.52%). Regression analysis results show that learning distance is a protective factor for the occurrence of myopia, while daily learning time, sweet food, time of first vision decrease, and interval between time of first vision decrease and time of wearing glasses are risk factors for myopia.

CONCLUSION: The prevalence of myopia among adolescents and children in Gaoping, Shanxi Province is relatively high. Using eyes at close range for a long time, unreasonable diet, and lagging prevention and intervention measures are all factors that can cause myopia.

Abstract:AIM: To evaluate visual field of the unilateral visually impaired applicants by a custom program test of Humphrey perimeter, which was indispensable for car driving.

METHODS: A retrospective study was performed. The process of a custom defined Humphrey ‘1 EYE Screening' program was set covers field region from temporal 90° to nasal 60°, and over 30° vertically away from the horizontal line. The candidates were qualified eligibility by range of visual field and reliability of the results. This study conducted statistics on the applicants who fulfilled the test from July 1^st, 2016 to June 30^th, 2017, and compared the impact factors of the pass rate.

RESULTS: After excluding repeated measurement reports, this study included 618 subjects, the most common causes of these eyes impaired were ocular trauma(49.7%)and unhealed amblyopia(29.3%). A total of 497 candidates(80.4%)passed the test. 85 of the 121 failure cases(70.2%)were due to a limitation of the nasal visual field(less than 60°), and 12 cases were failed by fixation loss because of nystagmus or poor cooperation. Compared with the test failure group, the subjects in the passing group are older, the average correct response points is more, and the average test time is shorter, all with statistically significant differences(P<0.05). In the passing group, the proportion of subjects with equivalent spherical mirror <0.5D was 77.5%, which was significantly higher than 62.8% in the failure group(χ²=7.264, P=0.007).

CONCLUSION: The custom program ‘1 EYE Screening' of Humphrey perimetry can be used to qualify eligibility of driving for unilateral visual impaired applicants. In order to prevent peripheral interfering from eye frames, corneal contact lenses were recommended for applicants with refractive errors.

Abstract:AIM:To research the visual function of femtosecond laser assisted phacoemulsification in patients with cataract with high myopia.

METHODS:Ninety seven patients(97 eyes)of cataract with high myopia underwent standard femtosecond laser assisted phacoemulsification and intraocular lens implantation. The best correct visual acuity(BCVA), accommodative function(negative/positive accommodation, accommodative acuity), convergence function(near point of convergence, convergence scope), accommodative convergence/accommodation(AC/A), visual stereoacuity, were observed preoperatively and postoperatively.

RESULTS: BCVA: Compared with preoperative date, the postoperative BCVA were improved significantly(P<0.05). There were no significant difference between the 1d, 1wk, 1mo, 3mo, 6mo, 12mo postoperative CVA(P>0.05). Accommodative function: There were no significant difference between preoperative and postoperative negative accommodation(P>0.05). Positive accommodation: Compared with preoperative date, the 1d, 1wk, 1mo postoperative positive accommodation were no significantly different(P>0.05), but the 3mo, 6mo, 12mo postoperative positive accommodation were significantly different(P<0.05). Convergence function: Near point of convergence: Compared with preoperative date, the 1d,1wk postoperative near point of convergence were significantly different(P<0.05), the 6mo, 12mo were no significantly different(P>0.05). Significant difference was observed among other near point of convergence(P<0.05). Convergence scope: Compared with preoperative date, the 1d, 1wk, 1mo postoperative convergence scope were no significantly different(P>0.05), the 3mo, 6mo, 12mo were significantly different(P<0.05). AC/A: Compared with preoperative date, the 1d, 1wk postoperative date decreased significantly(P<0.05). There was no significantly difference between the 6mo and 1a postoperative date(P>0.05). Significant difference was observed among other AC/A(P<0.05). Visual stereoacuity: Compared with preoperative date, the 1d, 1wk, 1mo postoperative visual steroacuity were no significantly different(P>0.05), the 3mo, 6mo, 1a were significantly different(P<0.05).

CONCLUSION: The BCVA of patients of cataract with high myopia which underwent standard femtosecond laser assisted phacoemulsification and intraocular lens implantation improved obviously and early, but the visual function improved slowly.

Abstract:AIM: To analyze the clinical characteristics of retinopathy of prematurity(ROP)in preterm infants with very low birth weight.

METHODS: A retrospective analysis was made of 3 121 premature infants who were admitted to the ophthalmic clinic and neonatal department of our hospital from December 2009 to June 2018 and underwent fundus examination. There were 1 862 males and 1 259 females. Among them, there were 400 premature infants with very low birth mass whose body mass was less than 1 500g. 191 males and 209 females. To compare the detection rate of ROP, gestational age, gender ratio, diagnosis time of ROP, severity of ROP and prevalence of other eye diseases, among different birth quality groups in preterm infants with extremely low birth mass.

RESULTS: In this study, 3 121 premature infants were screened, and the ROP detection rate was 8.2%(255/3 121). There were 400 premature infants with very low birth mass with a body mass less than 1 500g, ROP detection rate was 23.8%(95/400), stage 1-2 lesions that do not require treatment were 93.7%(89/95), pre-threshold and threshold lesions were 3.2%(3/95), stage 4-5 lesions were 3.2%(3/95). ROP detection rates of birth weight(g)<1 000, 1 000-1 499, ≥1 500, were: 25.0%, 23.7%, 5.9%, respectively. There were statistically significant differences in gestational age, ROP diagnostic time, between different birth weight groups(P<0.001). There were significant differences in the severity of ROP among the groups with birth weight <1 000g, 1 000-1 499g and ≥ 1 500g. But, there was no significant difference in the severity of ROP between the group with birth weight 1 000-1 499g and the group with birth weight ≥1 500g(P>0.05). There was no statistical difference in the incidence of other eye diseases in different birth weight groups(P>0.05).

CONCLUSION: The lower of birth weight, with the higher of incidence of ROP. The severity of ROP in preterm infants with birth weight <1 000g was significantly higher than that of preterm infants with birth weight≥1 000g. Ophthalmology should combine obstetrics and neonatology to reduce the incidence of very low birth weight premature infants, and improve the compliance of screening and follow-up of retinopathy of very low birth weight premature infants, which is an important way to reduce the blindness caused by ROP.

Abstract:AIM: To observe the changes of selected area of choroidal neovascularization(CSA)and flow area of choroidal neovascularization(CFA)before and after the treatment of anti-vascular endothelial growth factor(VEGF)by optical coherence tomography angiography(OCTA), and to explore the advantages of OCTA in the treatment and prognosis of wet age-related macular degeneration(wAMD).

METHODS: A retrospective analysis was performed on 22 patients(27 eyes)who were diagnosed with wARMD and received the first anti-VEGF drug treatment and subsequent treatment in the Department of Ophthalmology of our hospital from 2018-02 to 2019-07. All patients were treated with anti-VEGF drugs according to the 3+prn regimen. The best corrected visual acuity(BCVA),macular foveal retinal thickness(CMT), CSA, and CFA were compared before and after treatment. We analyzed the correlation between BCVA(LogMAR)and CMT, CSA, CFA by Pearson correlation analysis.

RESULTS: After 3mo of the treatment, the mean LogMAR BCVA(0.512±0.367), CMT(223.271±17.795μm),CSA(0.085±0.113mm²)and CFA(0.015±0.008mm²)were significantly lower than those before treatment(P<0.05). The results of correlation analysis showed that the post- BCVA was positively correlated with pre-CMT, post-CMT, pre-CSA, post-CSA, pre-CFA and post-CFA(P<0.05).

CONCLUSION: OCTA can directly display and quantify the changes of CSA and CFA before and after anti-VEGF treatment of wAMD, and provide a reference for the evaluation of wAMD treatment effects.

Abstract:AIM:To observe the clinical effects of YAG laser ablation in patients with physiological vitreous floaters by A/B ultrasound combined with autofluorescence(AF)of angiography.

METHODS: Screening of 30 patients(30 eyes)with physiological vitreous floaters from August 2018 to January 2019 in Hankou Aier Eye Hospital, we used A/B ultrasound to measure the distance from the wall of the ball and the back surface of the lens before operations. Check the patient's best corrected visual acuity, non-contact intraocular pressure, scanning laser fundus photography, A/B ultrasound and autofluorescence(AF)of angiography before treatment, laser ablation was performed by the same skilled doctor using ELLEX YAG laser ablation machine. After treatment, the patients were followed up at the point of 1d, 1wk, and 1mo. The same examination was performed after operation. The Image-J software was used to measure the vitreous opacity in the autofluorescence of angiography pictures before and after treatment.

RESULTS:There was no significant difference in the best corrected visual acuity and non-contact intraocular pressure before and after treatment(P>0.05). Of the 30 eyes, 28 eyes underwent laser ablation treatment once, and 2 eyes underwent laser ablation treatment twice. The average number of treatments was 1.06. After treatment, the autofluorescence of angiography showed that the vitreous opacity was obviously reduced or disappeared, and the difference was statistically significant before and after treatment(P<0.01). No complications occurred during or after surgery.

CONCLUSION: A/B ultrasound combined with autofluorescence confirmed that Nd:YAG laser is safe and effective in the treatment of physiological vitreous floaters.

Abstract:AIM: To observe the effects of Qi Jing Mingmu decoction combined with artificial tears on the clinical results and cell aging of conjunctivochalasis.

METHODS: Forty cases(80 eyes)of grade II-Ⅳ CCH with liver-kidney Yin deficiency were randomly divided into two groups: combined treatment group and artificial tears group, which were treated with Qi Jing Mingmu decoction combined with artificial tears and simple artificial tears respectively. The international ocular surface disease index(OSDI), tear break-up time(BUT)and Schirmer Ⅰ test(SⅠt)were observed and the clinical effects were compared after 3mo treatment. For CCH patients with grade III or above, followed up for 3mo or more and willing to operate, the loose conjunctival tissue was removed and the cell aging related β-gal staining was performed on frozen sections. The results were statistically analyzed.

RESULTS: The OSDI score(14.53±2.68), BUT 9.25±3.02s and SⅠt(8.95±3.57mm/5min)of combined treatment group were significantly better than those of artificial tears group after 3mo treatment(all P<0.05). After drug treatment, 7 cases(7 eyes)in artificial tears group and 4 cases(4 eyes)in combined treatment group of CCH patients were treated by operation. The positive rate of aging cells in combined treatment group was significantly lower than that in artificial tears group(16.00±7.84 vs 39.00±14.09, P=0.013).

CONCLUSION: Qi Jing Mingmu decoction combined with artificial tears to treat CCH is more effective than simple artificial tears in relieving ocular symptoms, improving tear film and promoting tear secretion. Combined treatment can also reduce the cell aging in CCH, which can be used as a safe and effective treatment method in addition to surgical operation.

Abstract:AIM: To analyze the curative effect and safety of modified dacryocystorhinostomy with simple anterior flap anastomosis in the treatment of chronic dacryocystitis.

METHODS: A total of 99 patients(113 affected eyes)with chronic dacryocystitis who underwent dacryocystorhinostomy in the hospital between March 2016 and July 2018 were enrolled in the retrospective study. They were divided into the traditional group(traditional dacryocystorhinostomy, 46 cases, 52 affected eyes)and the modified group(modified surgery with simple anterior flap anastomosis, 53 cases, 61 affected eyes)according to the surgical procedures. The surgical results, rates of granulation tissue formation around the anastomotic stoma at different time after surgery, rates of nasal mucosal epithelialization, size of the anastomotic stoma, the occurrence of surgical complications and the recurrence rate during 1a of follow-up were compared between the two groups.

RESULTS: The grade of curative effect in the modified group was better than the traditional group(75.0% vs 95.1%)during 6mo of follow-up(P<0.05). The total cure rate was higher than that of the traditional group(P<0.005). The rates of granulation tissue formation(3.8%, 5.7%, 9.4%)in the modified group at 1mo, 3mo and 6mo after surgery were lower than those in the traditional group(64.2% vs 39.1%, P<0.001). The rate of nasal mucosal epithelialization in the modified group was higher than that in the traditional group(25.63±4.76 vs 11.34±3.52mm², P<0.01)at 1mo after surgery. The area of anastomotic stoma in the modified group was larger than that in the traditional group(25.63±4.76 vs 11.34±3.52mm²,P<0.01)at 6mo after surgery. The incidence rates of postoperative hemorrhage and complication in the modified group and the recurrence rate in 1y of follow-up were lower than those in the traditional group(P<0.05).

CONCLUSION: The cure rate of patients undergoing modified dacryocystorhinostomy with simple anterior flap anastomosis is higher than those undergoing traditional surgery. The former can promote nasal mucosal epithelialization, maintain the size of anastomotic stoma and prevent the formation of surrounding granulation tissue. It is safe and effective, with few complications and low recurrence rate.

Abstract:AIM: To explore the value of Lund-Mackay score in the surgical treatment of chronic dacryocystitis with chronic sinusitis.

METHODS: Totally 92 cases(92 eyes)of chronic sinusitis with chronic dacryocystitis in our hospital from May 2016 to March 2019 were included in the prospective, single-blind study. According to Lund-Mackay score, the patients were divided into three groups: mild(22 cases), moderate(34 cases)and serious(36 cases). Each group was randomly divided into simultaneous operation group and phased operation group. We compared the operative effect and complications of simultaneous and phased operations.

RESULTS: In patients with mild and moderate chronic sinusitis combined with chronic dacryocystitis, there was no statistical difference in the efficiency and complications between simultaneous and phased operations(P>0.05). In patients with severe chronic sinusitis combined with chronic dacryocystitis, the efficiency of phased operations was higher than that of the simultaneous surgery(94% vs 61%, P<0.05), and the complications were lower than that of the simultaneous surgery(P<0.05).

CONCLUSION: According to Lund-Mackay score, patients with mild to moderate chronic sinusitis and chronic dacryocystitis are advised to undergo simultaneous surgery, while patients with severe rhinosinusitis are advised to undergo phased surgery.

Abstract:AIM: To compare the measurement of intraocular pressure(IOP)through a bandage contact lens with the “native” measurement by rebound tonometry and non-contact tonometry in patients after pterygium excision.

METHODS: Fifty consecutive patients(50 eyes)undergone pterygium excision(unilateral nasal, primary pterygium, horizontal length <4mm), and conjunctival autografting were included in this prospective study. IOP measurements were obtained by Rebound tonometry and non-contact tonometry in random order with(lens measurement)and without(native measurement)a bandage contact lens half a month after operation. We compared the mean values(validity parameter)and standard deviation(precision parameter)of the two individual measurements in each case using the paired t-test 14d after surgery.

RESULTS: With the rebound tonometry we detected statistically significant higher values in the contact lens measurements(18.20±3.19 vs 15.17±3.80mmHg in the native measurements; P<0.001), a good correlation with r=0.884 and mean difference was 3.04±1.79mmHg; With the non-contact tonometry we detected statistically significant higher values in the contact lens measurements(15.74±3.23 vs 13.19±3.89mmHg in the native measurements; P<0.001), a good correlation with r=0.876 and mean difference was 2.55±1.88mmHg. In the contact lens measurements and native measurements, we detected statistically significant higher values by Rebound tonometry than that by non-contact tonometry(P<0.001), and mean difference was 2.46±1.45mmHg, 1.98±1.67mmHg.

CONCLUSION: The use of rebound tonometry and non-contact tonometry shows good consistency between lens measurement and native measurement. However, it should be noted that the average of the measurements over contact lens by rebound tonometry and non-contact tonometry were found to be higher than that in native measurement, and the average of the measurements with and without lens by rebound tonometer was found to be higher than what was measured by non-contact tonometry.

Abstract:AIM: To evaluate the repeatability and reproducibility of ocular biological measurements by a swept-source optical coherence tomography biometer IOL Master 700 in healthy eyes.

METHODS: A diagnostic test study of 103 healthy subjects was implemented. The right eyes were selected for measurements. Ocular biological parameters including axial length(AL), anterior chamber depth(ACD), anterior aqueous depth(AQD), keratometry readings(K), central corneal thickness(CCT), lens thickness(LT), white-to-white corneal diameter(WTW)and pupil diameter(PD)were measured using IOL Master 700 by two experienced examiners. One-way ANOVA was used to evaluate the repeatability and reproducibility for the measurements by IOL Master 700.

RESULTS: Regarding repeatability, the test-retest repeatability(TRT)for AL, mean K(K_m), K₁, K₂, ACD, AQD, LT, CCT, WTW and PD obtained by the two examiners were 0.018(0.017)mm, 0.215(0.270)D, 0.325(0.334)D, 0.303(0.366)D, 0.049(0.041)mm, 0.048(0.042)mm, 0.058(0.047)mm, 6.168(5.779)μm, 0.395(0.406)mm, and 1.097(1.099)mm, respectively; the relative coefficient of variation(CoV)for all measured parameters but the PD were ≤1.219%; the intraclass correlation coefficient(ICC)for all measured parameters were ≥0.815. Regarding reproducibility, the TRT for AL, K_m, K₁, K₂, ACD, AQD, LT, CCT, WTW, and PD obtained were 0.018 mm, 0.240 D, 0.329 D, 0.337 D, 0.048 mm, 0.048mm, 0.055mm, 6.396μm, 0.420mm, and 1.144mm, respectively; the ICC for all measured parameters was ≥0.900; the CoV for all measured parameters were ≤1.263% CoV, except for the PD(8.750%). In addition, the ICC of AL measurement for both repeatability and reproducibility were 1.000.

CONCLUSION: With the exception of pupil diameter, IOL Master 700 demonstrates excellent repeatability and reproducibility in ocular biological measurements for healthy eyes, especially in measurement of axial length.

Abstract:AIM: To obtain the healthcare-seeking intention of eye patients during COVID-19 outbreak in China.

METHODS: Questionnaire survey was conducted from 2020-02-10 to 2020-02-20, with the combination form of convenience sampling and “Link-tracking related sampling”. We designed the questionnaires, forwarded them to individuals or WeChat group chats, and had the participants fill out the questionnaires on mobile phones, to evaluate their healthcare seeking time and intention, as well as their sense of trust towards online consultation when they had ocular discomforts or trauma.

RESULTS: Totally 458 males(51.3%)and 435 females(48.7%)responded and a total of 893 questionnaires were included. Our data shows that 26.5%, 33.3%, and 40.2% of the respondents respectively from low, medium and high risk area chose online consultation during the COVID-19 outbreak, and the hospital visiting rates were 45.1%, 30.3%, 24.6% in corresponding area. We also demonstrated that gender, age, education level, regional economic development, and the region-level risk classifications have impacts on the consultation methods of the population. Compared to females(39.3%), more males(60.7%)intended to accept online medicine, and the participants from highly developed area preferentially chose virtual medical advisory service(68.2%),while the hospital visiting rates of less developed area(65.2%)was much higher than that in developed area(34.8%). Interestingly, geographic risk level had dramatic influence on the participants' sense of trust towards online consultation.

CONCLUSION: Virtual online consultations were more favorable among Chinese population during COVID-19 outbreak, and were potential to facilitate clinician-patient communication. However, a balance should be achieved between online consultations and face-to-face communication, to avoid human-to-human coronavirus transmission, and to resolve patients' problems.

Abstract:AIM: To investigate the risk factors about recrudescence of retinopathy of prematurity(ROP)after anti-VEGF treatment.

METHODS: A retrospective study about all the infants diagnosed with ROP and treated with anti-VEGF from June 2016 to October 2019 in our hospital. They were divided into recrudescence group(8 cases)and non- recrudescence group(48 cases). The relationship between various clinical risk factors and the recrudescence of ROP after anti-VEGF treatment were considered. Those risk factors included birth weight, gestational age, thrombocytosis, anemia, coagulation disorder, sepsis, bronchopulmonary dysplasia, neonatal respiratory distress syndrome, asphyxia, pneumonia, intracranial hemorrhage, patent foramen ovale, and patency ductus arteriosus.

RESULTS: According to single-factor analysis, birth weight and intracranial hemorrhage showed statistically significant differences between recrudescence group and non-recrudescence group. Logistic regression analysis showed low birth weight(OR=9.800, P=0.039)and intracranial hemorrhage(OR=17.571, P=0.002)had relationship with recrudescence of ROP after anti-VEGF.

CONCLUSION: Low birth weight(<1 000g)and intracranial hemorrhage are the risk factors about recrudescence of ROP after anti-VEGF.