Abstract:AIM:To investigate the dry eye symptoms and the stability changes of tear film after correction of myopia by laser-assisted in situ keratomileusis(LASIK)and laser epithelial keratomileusis(LASEK)with the use of 0.1% sodium hyaluronate(HA).

METHODS:A total of 230 myopia patients(460 eyes)were divided into LASIK group and LASEK group from February 2017 to December 2017. Each operation group was randomly assigned to 0.1% HA treatment subgroup and HA-free subgroup. Both subgroups were instructed to apply gatifloxacin(0.3%)and loteprednol(0.5%)after the corneal refractive surgery. The changes of dry eye symptom score, corneal perceptual reaction, corneal fluorescein staining(FL), basic Schirmer Ⅰ test(SⅠt)and tear film break-up time(BUT)were observed in different time points.

RESULTS:There were significant differences in FL, dry eye symptom score and corneal perceptual response between the 0.1% HA treatment group and HA-free group at 1wk, 1, 3 and 6mo after operation both in LASIK and LASEK patients(P<0.05). BUT after operation in each group was significantly deceased at 1wk compared with preoperative level. Other observation time points after surgery of BUT and each postoperative level of SⅠt were still within the normal range although lower than the preoperative levels. The subjective symptoms of dry eyes, tear film stability and corneal surface perception of LASEK patients were better than LASIK patients especially at 1wk, 1 and 3mo after surgery.

CONCLUSION:These two kinds of refractive surgery may cause different degrees of dry eye symptoms. These symptoms in the LASEK group were lighter than that in the LASIK group in the early postoperative period. The early adequate use of preservative-free 0.1% HA could effectively promote the corneal repair and be greatly helpful for postoperative dry eye symptoms.

Abstract:AIM: To investigate the refractive outcomes and changes of corneal astigmatism and higher-order aberrations(HOAs)after Toric implantable Collamer lens implantation(Toric ICL).

METHODS: Prospective nonrandomized clinical trial studies. This study included 102 eyes of 57 patients underwent Toric ICL for myopic astigmatism correction. Uncorrected visual acuity(UCVA), manifest refraction, best spectacle-corrected visual acuity(BSCVA), manifest refractive cylinder, the corneal astigmatism and HOAs were measured preoperatively and up to 6mo after surgery. The vectors were measured using corneal topography, the Pentacam HR system and Wavefront analyzer.

RESULTS:Postoperative, the percentage of eyes had a spherical equivalent refraction within -1.00 D were 93.80%. The percentage of eyes within -0.50 D of emmetropia were 85.30%. The percentage of eyes which postoperative UCVA ≥20/25 was 66.30% and the percentage of eyes which postoperative UCVA ≥20/20 was 65.50%. The corneal astigmatism and aberrations preoperatively showed no statistical significance compared with postoperative. The total eyes aberrations and coma resulted in slight changes and had no statistically significant.

CONCLUSION:The corneal incision of Toric ICL implantation caused no changes in astigmatism and higher-order wavefront aberrations of cornea.

Abstract:AIM: To explore the relationship between the protective effect of 17β-estradiol(E₂)on human lens epithelial cells and pyroptosis.

METHODS: Human lens epithelial cells were cultured in vitro and divided into blank control group, H₂O₂ treatment group, and 17β-estradiol+H₂O₂ treatment group. Scanning electron microscope to observe the cytological morphology; immunofluorescence technique to detect Gasdermin D(GSDMD)distribution and fluorescence intensity; CCK-8 to detect cell viability; TUNEL to detect cell pyroptosis; Western-blot to detect Cysteinylaspartate specific proteinase-1(Caspase-1), GSDMD, NOD-like receptor protein 3(NLRP3)protein expression level; ELISA to detect interleukin-1β(IL-1β)expression.

RESULTS: Compared with the control group, the cell viability of the H₂O₂ treatment group was significantly decreased, the expression of Caspase-1, GSDMD, and NLRP3 protein were significantly up-regulated, and the secretion of IL-1β was significantly increased. Compared with the H₂O₂ treatment group, the expression of Caspase-1, GSDMD, and NLRP3 protein in the 17β-estradiol+H₂O₂ treatment group were down-regulated, and the secretion of IL-1β decreased, and it showed a decreasing trend with the increase of estrogen concentration.

CONCLUSION: 17β-estradiol has a protective effect on human lens epithelial cells, and its protective mechanism is related to the inhibition of the pyroptosis process of human lens epithelial cells, and the classical pyroptosis pathway is involved.

Abstract:AIM: To investigate whether circular RNA(circRNA)circ_0000144 targets microRNA(miRNA)-502-5p to regulate the proliferation, apoptosis, migration and invasion of human retinoblastoma Y79 cells.

METHODS: Y79 cells were divided into si-NC group(transfected with si-NC), si-circ_0000144 group(transfected with si-circ_0000144), miR-NC group(transfected with miR-NC), miR-502-5p group(transfected with miR-502-5p mimic), pcDNA group(transfected with pcDNA), pcDNA-circ_0000144 group(transfected with pcDNA-circ_0000144), si-circ_0000144+anti-miR-NC group(transfected with si-circ_0000144+anti-miR-NC), si-circ_0000144+anti-miR-502-5p group(transfected with si-circ_0000144+anti-miR-502-5p). Quantitative real-time polymerase chain reaction(qRT-PCR)was used to detect the expression of circ_0000144 and miR-502-5p in retinoblastoma tissues and cells, thiazole blue tetrazolium bromide(MTT)detected cell proliferation, and western blot was employed to determine the expression of nuclear associated antigen Ki67(Ki-67), B cell lymphoma/lewkmia-2(Bcl-2), Bcl-2 associated X protein(Bax), matrix metalloprotease(MMP)-2, MMP-9 protein. Flow cytometry detected cell apoptosis, and Transwell measured cell migration and invasion. Bioinformatics prediction and dual luciferase report experiment analyzed whether circ_0000144 targets miR-502-5p.

RESULTS: The expression of circ_0000144 in 31 cases of retinoblastoma tissue was higher than that of adjacent tissues, and the expression of miR-502-5p was lower than that of adjacent tissues(P<0.05). Compared with the si-NC group, the circ_0000144 expression, OD value, expression of Ki-67, Bcl-2, MMP-2, MMP-9 protein, number of migration and invasion cells of the Y79 cells in the si-circ_0000144 group decreased, and the expression of Bax protein and apoptosis rate increased(P<0.05). circ_0000144 targets and negatively regulates the expression of miR-502-5p. Compared with miR-NC group, miR-502-5p group increased cell apoptosis rate and expression of Bax protein of the Y79 cells, while decreased OD value, number of migration and invasion cells, and the expression of Ki-67, Bcl-2, MMP-2 and MMP-9 protein(P<0.05). Compared with the si-circ_0000144+anti-miR-NC group, cell apoptosis rate and Bax protein expression of the Y79 cells in the si-circ_0000144+anti-miR-502-5p group decreased, but the OD value, number of migration and invasion cells, the protein expression of Ki-67, Bcl-2, MMP-2 and MMP-9 increased.

CONCLUSION: circ_0000144 was highly expressed in retinoblastoma tissue, and inhibiting circ_0000144 can reduce the proliferation, migration and invasion of retinoblastoma Y79 cells, and promote apoptosis through negative regulation of miR-502-5p.

Abstract:AIM: To investigate the effect of age on the expression of Na⁺-K⁺-ATPase and acute reversible lens opacification induced by chloral hydrate in mice.

METHODS: Acute reversible lens opacification was induced by intraperitoneal injection of 4% chloral hydrate(400mg/kg)in 3-month-old(young group)and 24-month-old(old group)C57BL/6 mice. The lens opacification was graded at 10, 20, 30, 45, 60, 90, 120 and 150min after chloral hydrate injection. The histopathological changes of lens were observed by hematoxylin eosin staining, and the expression of Na⁺-K⁺-ATPase in lens was detected by immunohistochemistry.

RESULTS: The development of lens opacity is similar in young and old mice after chloral hydrate injection. The lens opacification in the young group appeared earlier, thicker and lasted longer than the old group. HE staining showed that many vesicles appeared in the cortex below lens epithelial cells(LECs), and the structure of superficial lens fiber cells were disordered after chloral hydrate injection. Immunohistochemical staining showed that the expression of Na⁺-K⁺-ATPase was positive in LECs and fibers. The expression of Na⁺-K⁺-ATPase in LECs were weak before chloral hydrate injection and up-regulated 45min after chloral hydrate injection in young and old groups. The up-regulation of Na⁺-K⁺-ATPase was stronger in the old group than in the young group.

CONCLUSION: Age may play a role in the acute reversible lens opacification induced by chloral hydrate in mice. The expression of Na⁺-K⁺-ATPase is involved in lens opacity induced by chloral hydrate.

Abstract:AIM: To explore the postoperative refractive error and influence factors using the Optical Biometry(IOL Master)in patients with silicone oil filled eye complicated cataract after silicone oil removal combined with cataract surgery.

METHODS: From August 2020 to November 2020 in the Affiliated Eye Hospital of Nanchang University, 41 patients with silicone oil removal combined with cataract surgery were divided into 2 groups: 18 patients(18 eyes)in high myopia group and 23 patients(23 eyes)in non-high myopia group. Collected and recorded the patients' IOL Master measurement data. Statistical analysis was performed in SPSS20.0.

RESULTS: The mean spherical degree or astigmatism of the IOL Master measurement and refraction in high myopia and non-high myopia group performed by paired t-test(P>0.05). The mean axial difference ΔAL were -0.28±0.29 and 0.05±0.31mm between the two groups has no difference(P<0.05), while ΔK, mean absolute refractive error(MARE)and Δastigmatism(P>0.05). The preoperative and postoperative axial length(AL)in high myopia groups were 28.37±1.73 and 28.10±1.55mm(t=3.994, P<0.05), yet the non-high myopia group(P>0.05). Bivariate linear correlation analysis: in the high myopia group, there was a moderate positive correlation between preoperative AL and MARE(r=0.742, P<0.05), and a moderate negative correlation between ΔAL and MARE(r=-0.646, P<0.05), but in non-high myopia group, preoperative AL, ΔAL, preoperative K, ΔK had no correlation(P>0.05).

CONCLUSION: IOL Master performed the small biostatistical error and high measurement accuracy of the intraocular lens in patients with silicone oil filled eye complicated cataract. The longer preoperative AL, the more changes in the axial length after silicone oil removal, and the greater the refractive error of patients with high myopia silicone oil filled eye complicated cataract.

Abstract:AIM: To observe the visual quality after implantation of regional refractive multifocal intraocular lens(MIOL)SBL-3.

METHODS: A retrospective and controlled study. Fifty-seven cataract patients(68 eyes)in our hospital from September 2019 to July 2020 were enrolled. Totally 33 cases(36 eyes)received regional refractive MIOL SBL-3(SBL-3 group), while 24 cases(32 eyes)received aspheric single focal intraocular lens(SIOL)ZCB00(ZCB00 group). Uncorrected and corrected distance, middle and near visual acuity, defocus curve, OPDⅢ objective visual quality, the quality of vision(QoV)questionnaire, patient satisfaction and spectacle independence were evaluated 3mo postoperatively.

RESULTS: No significant differences were found between the SBL-3 group and the ZCB00 group in terms of LogMAR value of corrected and uncorrected distance visual acuity(UDVA)at 3mo after the operation(0.13±0.09 vs 0.10±0.08, 0.06±0.06 vs 0.08±0.08, all P>0.05)and the UDVA was significantly improved compared with that before the operation(P<0.05). Corrected and uncorrected intermediate and near visual acuity were significantly better for the SBL-3 group than the ZCB00 group(0.10±0.14 vs 0.27±0.10, 0.05±0.16 vs 0.35±0.17, 0.11±0.14 vs 0.26±0.11, 0.03±0.17 vs 0.35±0.17, all P<0.05). Concerning the comparison of contrast sensitivity, the ZCB00 group was better than SBL-3 group at any spatial frequency evaluated and the differences were significant(all P<0.05). Statistically significant differences between groups were observed in intraocular total aberrations, high-order aberrations, coma and Trefoil presenting significantly higher values in the eyes of the SBL-3 group than in the ZCB00 group(P<0.05). The average Strehl ratio value was smaller in the ZCB00 group and the difference was statistically significant(P<0.05). There were 1 patient who had glare, 1 patient reported halo, 4 patients complained distance blur in the SBL-3 group at 3mo after the surgery. 82% and 88% were completely satisfied in the SBL-3 group and ZCB00 group, respectively. There was no statistically significant difference in satisfaction between the groups. SBL-3 group had a higher percentage of spectacle independence and the difference was significant(94% vs 67%, P<0.05).

CONCLUSION:The regional refractive MIOL SBL-3 provided good range of vision for near, intermediate, and distance. Although few vision phenomena were reported, it resulted in an excellent level of overall patient satisfaction and freedom from spectacles.

Abstract:The Notch signaling pathway is an evolutionarily highly conserved signaling pathway that exists in a wide variety of tissue cells and plays an important role in embryonic development, cell proliferation, differentiation and apoptosis, as well as in the maintenance of multicellular biosynthesis, angiogenesis, and the development of various cancers. In recent years, it has been found that the Notch signaling pathway is abnormally activated in cataract, uveitis and other ophthalmic diseases, regulating the process of ocular disease development. This article provides a brief review of the regulatory role of the Notch signaling pathway in the development of ophthalmic diseases.

Abstract:Zebrafish has become a popular model for the study of ocular degenerative diseases due to its similarity with human visual system and its great potential of retinal regeneration. The degenerative diseases, especially retinal degeneration and optic nerve degeneration, can seriously affect visual acuity, also the regeneration and repair are very limited, which can lead to blindness in severe cases. In contrast to mammals, zebrafish can repair optic nerve axon damage and stimulate retinal Müller glial cells to differentiate into multifunctional progenitor cells, thereby, regenerating retinal neurons and nerve axons and restoring normal visual function. This review focuses on the application of zebrafish model in eye diseases and the key signaling pathways of zebrafish retinal neurons and Müller glial cells to initiate regeneration and repair in response to injury.

Abstract:Infantile nystagmus syndrome(INS)is a congenital pathological nystagmus characterized by binocular involuntary conjugative oscillation and reverse optokinetic nystagmus. This condition is often accompanied by amblyopia, strabismus, and torticollis, affecting the visual function of INS patients. As the cause of the disease is unclear and cannot be completely cured, early detection and appropriate intervention of INS should be carried out. Based on domestic and foreign researches of INS, in this paper, we summarize INS etiology and occurrence mechanism. Furthermore, to provide a reference for clinical application and future research directions of INS, we have systematically introduced the most recent INS examination and treatment methods, and highlight the problems in relevant clinical practice.

Abstract:High myopia is one of the major blinding diseases in China and even in the world, and high myopia with cataract is a kind of complex cataract with a high risk of blindness. At present, surgery is the only treatment. Because high myopia can lead to a series of complex changes in the eye, compared with the normal axial eye, it is easier to produce the refractive error and refractive drift after surgery. In this paper, the influencing factors of refractive error after cataract surgery for high myopia are reviewed, including the accuracy of preoperative biological measurement, the choice of intraocular lens calculation formula, and the change of effective intraocular lens position.

Abstract:Glaucoma is a group of diseases characterized by progressive optic nerve atrophy and visual field defects. Some evidence demonstrate that glaucoma's pathological damage affects the retina and optic nerve and involves the entire visual pathway. Recent studies have found that the nerve injury is not completely irreversible but has certain plasticity. Furthermore, studies have shown that neurons in the visual pathway of glaucoma can be repaired and remodeled under certain conditions to restore visual function, which offers a new way to treat glaucoma.

Abstract:Optical coherence tomography angiography(OCTA), as a new imaging technology that has emerged in recent years, is characterized by non-invasiveness, high speed and high resolution. Compared with traditional contrast examination, OCTA is faster, safer and avoids the side effects and risks of traditional contrast agents. Now, OCTA has been gradually applied in the diagnosis, treatment and follow-up of eye diseases. Through real-time imaging of retinal choroidal blood vessels, this article reviews the research progress of clinical application of OCTA in diabetic retinopathy.

Abstract:Age-related macular degeneration(ARMD)is an important cause of visual impairment in people over 65 years old in western countries. It is the third leading cause of blindness in China and mainly affects central visual acuity. Vascular endothelial growth factor(VEGF)plays an important role in the pathogenesis of ARMD. Currently, intravitreous injection of anti-VEGF agents has been considered as the first-line treatment for ARMD. However, some patients still need repeated injection, or response negatively to anti-VEGF agents. Therefore, it is necessary to explore novel therapy to improve clinical outcomes and provide insights for neovascular ARMD treatment.

Abstract:Macular hole is a retinal disease that seriously threatens vision. With the progress of science and technology and the improvement of examination methods, understanding this disease has been further clarified. This article reviews the latest advances in pathogenesis, diagnosis, classification, healing process, prognosis, closure mode, and treatment macular hole, in order to help ophthalmologists formulate surgery.

Abstract:Aflibercept is a recombinant human fusion protein that acts as a soluble decoy receptor for vascular endothelial growth factor(VEGF)family members. VEGF-A, VEGF-B and placental growth factor(PLGF)were included in VEGF family that could inhibit downstream signalling mediated by these ligands. Aflibercept binds to all isoforms of VEGF-A with high affinity, and presented a markedly higher affinity compared with ranibizumab or bevacizumab. Intravitreal injection aflibercept has been approved for the treatment of patients with age-related macular degeneration(ARMD). Numerous studies showed it could improve best corrected visual acuity(BCVA), reduce macular edema and with fewer complications that has been another choice for ARMD patients. However, studies of participation time with large sample are lacking, and relevant studies are limited in China. Contribution in clinical efficacy, advancement in selection and use of medicines, safety and limitations with aflibercept will be here summarized.

Abstract:In recent years, with the development of social economy, the progress of science and technology and the change of life style, the prevalence of myopia has increased year by year and has a younger trend, and with the outbreak of COVID-19, children and adolescents attending short-distance online classes for a long time has accelerated the occurrence and development of myopia. Visual impairment caused by myopia and serious complications caused by high myopia have seriously affected people's quality of life, study and work. Therefore, the World Health Organization, the International Association for the Prevention of Blindness and China's health departments have put the prevention and control of myopia among children and adolescents on the agenda. However, the etiology is complex, and now it is considered to be related to genetic, environmental and other factors, which is briefly discussed in this review.

Abstract:AIM:To systematically compare and evaluate the clinical efficacy of intraocular lens(IOL)incarceration and non-incarceration in pediatric cataract.

METHODS: Literatures were searched from domestic and foreign databases such as PubMed, Embase, Cochrane Library, Wanfang, and CNKI, and the paper editions of relevant journals were consulted as well. The retrieval period of literature was from January 2000 to January 2021. The screened literatures were evaluated and extracted by two experienced researchers. After performing the evaluation guidelines of Cochrane collaboration and the Newcastle-Ottawa Scale(NOS), the Rev Man 5.4 software was applicated to complete the Meta-analysis.

RESULTS:Seven references(328 eyes)were involved in this analysis. The results of the Meta-analysis showed that the two groups had statistically significant differences in best corrected visual acuity(BCVA)>0.5 eyes(RR=2.00, 95%CI: 1.18-3.37, P=0.01), IOL shift(RR=0.28, 95%CI: 0.17-0.46, P<0.00001)and mild or above opacification of the visual axis(RR=0.35, 95%CI: 0.19-0.65, P=0.0007)after surgery. However, there was no significant difference in the occurrence of posterior synechia(RR=0.67, 95%CI: 0.10-4.33, P=0.67)and very mild opacification of the visual axis(RR=1.05, 95%CI: 0.64-1.73, P=0.84).

CONCLUSION:IOL incarceration in the treatment of pediatric cataract can significantly improve postoperative BCVA, reduce occurrence of IOL shift and prevent mild or above opacification of the visual axis, which has more advantages in overall clinical efficacy. But more high quality prospective studies should be still required for further analysis.

Abstract:AIM:To evaluate the effect of higher-order aberrations(HOAs)after topography-guided and wavefront-optimized femtosecond laser-assisted in situ keratomileusis(FS-LASIK).

METHODS: We searched on PubMed, the Cochrane Library, Medline, CNKI, CBM, VIP and WanFang Data database for randomized controlled trials(RCTs)and comparative studies(CTs). The published languages were limited to Chinese and English. The risk bias tool provided by the Cochrane cooperation scale and Newcastle-Ottawa Scale were used to assess the risk bias of included studies of RCTs and CTs. The published biases of included studies were assessed by the Egger test. Meta-analysis was performed with Review Manager 5.4.

RESULTS: Two randomized controlled trials and six comparative studies with a total of 987 subjects were included(482 in the topography-guided FS-LASIK group, 505 in the wavefront optimized FS-LASIK group). The Meta-analysis showed that the topography-guided group has a better effect than the wavefront-optimized group in spherical equivalent, the difference between the two groups was statistically significant \〖WMD=0.11, 95%CI (0.07, 0.14), P<0.00001\〗. And the results also indicated that there was a significant difference between the two groups with HOAs \〖WMD= -0.09, 95%CI (-0.13,-0.05), P<0.0001\〗, spherical aberrations \〖WMD=-0.05, 95%CI (-0.09, -0.01), P=0.008\〗 and coma \〖WMD=-0.08, 95%CI (-0.12, -0.05), P<0.00001\〗.

CONCLUSION: Based on the available evidence, topography-guided FS-LASIK has higher diopter and lower HOAs, spherical aberrations and coma than wavefront-optimized FS-LASIK.

Abstract:AIM: To compare the accuracy of Barrett Universal Ⅱ, Haigis and modified Wang-Koch SRK/T formulas in calculating intraocular lens(IOL)power in eyes with long axial length(AL).

METHODS: Eyes were divided into three AL groups as follows: 26.0 to 28.0mm(group A), 28.0 to 30.0mm(group B), and 30.0mm or more(group C). All eyes underwent phacoemulsification cataract surgery. In the 3mo after operation, IOL powers that would have resulted in emmetropia were calculated according to results of subjective refraction. The predictive error(PE)and absolute error(AE)of each formulas were calculated and compared and the factors(AL, keratometry value, the anterior chamber depth)associated with PEs were analyzed.

RESULTS: The average PE of Barrett Universal Ⅱ, Haigis and modified Wang-Koch SRK/T formulas were 0.37±0.78D, 0.77±0.88D and 0.36±0.82D respectively. In groups A and B, the PEs and AEs of three formulas were not statistically significant(P>0.05). However, in group C, the PEs and AEs of Barrett Universal Ⅱ and modified Wang-Koch SRK/T formula were significantly less than Haigis formula(P<0.05). The PEs of Haigis formula in cataract eyes with long AL was affected by AL and keratometry value, whereas the PEs of Barrett Universal Ⅱ and modified Wang-Koch SRK/T formula was not affected by AL.

CONCLUSION: In eyes with an AL of 26.0 to 30.0mm, all three formulas are acceptable. In eyes with AL of 30.0mm or more, the accuracy of Barrett Universal Ⅱ and modified Wang-Koch SRK/T formula are better than Haigis formula.

Abstract:AIM: To observe the changes of macular microvascular parameters and their correlation with best corrected visual acuity(BCVA)in patients with branch retinal vein occlusion(BRVO)by using optical coherence tomography angiography(OCTA).

METHODS: The superficial retinal capillary layer in the posterior pole of 29 patients with BRVO was scanned by OCTA. Macular vascular density including vessel density(VD), perfusion density(PD), foveal avascular zone(FAZ), and morphological index were obtained at baseline, 1 and 6mo respectively.

RESULTS: The FAZ area in BRVO group was 0.32±0.08mm², significantly larger when compared to the fellow eyes(0.21±0.06mm²)(t=-6.958, P<0.001). The VD of full area of 3mm×3mm and 6mm×6mm was lower in BRVO eyes compared to fellow eyes(P<0.05). As for PD, a difference was found between the two groups in the central and inter area in the 3mm×3mm scan pattern(P<0.001), while a significant difference was found in central, the outer, and the full area in the 6mm×6mm scan pattern(P<0.05). The BCVA at baseline was significantly better than that at 6mo(t=2.43, P<0.05); BCVA(LogMAR)was positively correlated with VD and PD of centre area in 3mm×3mm mode, and PD of central and full area in 6mm×6mm model, but negatively correlated with PD in the outer area in 6mm×6mm mode.

CONCLUSION: As a non-invasive examination, quantitative OCTA measurements confirm vascular density changes in the superficial vascular networks in eyes with BRVO. Moreover, vascular density and FAZ area appear to correlate with visual function.

Abstract:AIM: To use spectral domain optical coherence tomography(SD-OCT)to measure macular subfoveal choroid thickness(SFCT)in patients with diabetic retinopathy(DR), observe the changes of SFCT, and to explore the relationship between SFCT and diabetes mellitus and diabetes retinopathy.

METHODS: A total of 152 patients with type 2 diabetes(T2DM)were collected and grouped according to their fundus conditions. There were 72 cases in the NDR group and 80 cases in the DR group. Eighty-five healthy subjects were used as the control group. Follow-up according to the clinical stage of DR, where the DR components were mild NPDR, moderate NPDR, severe NPDR and PDR. According to the United Nations World Health Organization, the age group was divided into three age groups: 18-44 years old(youth group), 45-59 years old(middle-aged group), and 60-75 years old(old group). Analyzed and compared the SFCT between each group.

RESULTS:There was no statistically significant difference in SFCT between the T2DM group and the control group(P>0.05). The SFCT of the all group was not significantly correlated with age and course of disease(P>0.05); the SFCT of the control group was negatively correlated with age(P<0.05), and the SFCT of the elderly group was thinner than that of the middle-aged group and the young group(P<0.05). There was no significant difference between young and middle-aged(P>0.05). The SFCT of the T2DM group was thinner than the control group(P<0.001), and the SFCT of the NDR group and the DR group were thinner than the control group(P<0.001); the difference in SFCT between DR staging was statistically significant(P<0.001).

CONCLUSION: Age is a related factor that affects SFCT. Diabetic SFCT becomes thinner than normal people, and SFCT thickens with the severity of DR lesions.

Abstract:AIM: To investigate the dynamic changes of corneal hysteresis(CH)and corneal resistance factor(CRF)before and after orthokeratology(OK)in children with different degrees of myopia.

METHODS: Totally 40 cases(80 eyes)of myopic children treated in our hospital from January 2019 to January 2020 were retrospectively analyzed. The subjects were divided into low-grade group and medium-grade group according to the spherical equivalent(SE)level. They were all treated with night wearing OK glasses. The LogMAR naked eye vision of the children was detected and recorded before and 1wk, 1, 6mo and 1a after wearing glasses. The levels of central corneal thickness(CCT)and axial length(AL)were monitored by ocular a-ultrasound, the SE level was measured by comprehensive optometry, the corneal curvature(K)was measured by corneal topography, the corneal compensated intraocular pressure(IOPcc)level was measured by ORA analyzer, and the values of CH and CRF were calculated at the same time.

RESULTS:The naked visual acuity of LogMAR at 1wk, 1, 6mo and 1a after wearing glasses was significantly lower than that before wearing glasses(all P<0.05), and the SE and corneal curvature were significantly lower than that before wearing glasses(all P<0.05). CH and CRF at 1wk, 1, 6mo, 1a after wearing glasses were significantly lower than those before wearing glasses(all P<0.05). Compared with 1wk after wearing glasses, CH was significantly increased at 1, 6mo and 1a after wearing glasses(t=6.010, 6.447, 6.556, all P<0.05), CRF was significantly increased(t=6.429, 6.786, 7.143, all P<0.05). One week after wearing glasses, CH and CRF were positively correlated with K and CCT(P<0.05); 1mo after wearing glasses, CH and CRF were positively correlated with K and CCT(P<0.05). At 1wk, 1, 6mo and 1a after wearing glasses, CH in low degree group was significantly lower than that before wearing glasses(t=8.330, 3.922, 3.432 and 3.334, all P<0.05), and CH in moderate degree group was significantly lower than that before wearing glasses(t=13.276, 4.964, 4.052 and 4.387, all P<0.05). Compared with 1wk after wearing glasses, CH in low-grade group was significantly higher(t=4.413, 4.903, 5.001, all P<0.05)and in moderate group was significantly higher(t=8.312, 8.773, 8.889, all P<0.05)at 1, 6mo and 1a after wearing glasses. One week after wearing glasses, the CH level of moderate group was significantly lower than that of low group(t=2.089, P<0.05). CRF in low-grade group was significantly lower than that before wearing glasses(t=8.684, 3.928, 3.618, 3.308, all P<0.05), CRF in moderate group was significantly lower than that before wearing glasses(t=15.432, 5.576, 5.057, 4.668, all P<0.05), CRF in low-grade group was significantly higher than that after wearing glasses(t=4.755, 5.065, 5.376, all P<0.05), and CRF in moderate group was significantly higher than that after wearing glasses(t=9.856, 10.374, 10.764, all P<0.05). One week after wearing glasses, the CRF level of moderate group was significantly lower than that of low group(t=2.610, P<0.05).

CONCLUSION: The levels of CH and CRF were decreased after wearing OK lens, which reached the lowest level 1wk after wearing OK lens and returned to a stable state 1mo after wearing OK lens. With the increase of myopia, the levels of CH and CRF will decrease to achieve the best correction effect.

Abstract:AIM: To explore the effect of different energy parameters of femtosecond laser small incision lenticule extraction(SMILE)on stage Ⅰ opaque bubble layer(OBL)and visual quality.

METHODS: A retrospective analysis of the clinical data of 216 patients(432 eyes)who came to our hospital for SMILE surgery from July 2018 to December 2019. According to whether stage Ⅰ OBL occurred, they were divided into OBL group(42 eyes)and non-OBL group(390 eyes). The age, visual acuity parameters, corneal parameters, microlens parameters and energy parameters were compared between the two groups, and multivariate regression analysis was used to analyze the relationship between the difference in energy settings and the OBL of stage Ⅰ. The uncorrected visual acuity(UCVA), best corrected visual acuity(BCVA), and modulation transfer function cut-off spatial frequency(MTF_cut-off), Strehl Ratio(SR)and Objective Scattering Index(OSI)with energy parameters of 130, 135, 140, 145, and 150 nJ before and 1mo after surgery were compared. The correlation between energy parameters and stage Ⅰ OBL, UCVA, BCVA, MTF_cut-off, SR, OSI were analyzed.

RESULTS: Multivariate regression analysis showed that the energy setting with a difference of 5nJ did not show an association with stage Ⅰ OBL. In the different energy parameter groups, LogMAR UCVA, MTF_cut-off, and OSI at 1mo after surgery were improved compared with preoperatively(P<0.05), and the difference between the groups were statistically significant(F=75.712, 15.304, 26.293, all P<0.05). SMILE intraoperative energy parameters were negatively correlated with UCVA(r=-0.272), MTF_cut-off(r=-0.132), and OSI(r=-0.151)1mo after surgery(P<0.05).

CONCLUSION: When using a 4.5μm dot pitch, in the usual energy range, the lower the energy, the better the postoperative visual quality, but it does not significantly affect the incidence of stage Ⅰ OBL during SMILE surgery.

Abstract:AIM: To compare the differences and agreement in axial length(AL), anterior chamber depth(ACD)flat axial corneal curvature(K1)and steep axial corneal curvature(K2)measured by SW-9000 and IOL Master 500.

METHODS: Totally 258 eyes of 129 patients with ametropia were measured with SW-9000 and IOL Master 500. Among them, 159 eyes were low to moderate myopia(-0.75D≤ spherical equivalent <-6D)and 99 eyes were high myopia(spherical equivalent ≥-6D). Comparison between two devices were performed for AL, ACD, K1, and K2. The difference between two instruments were evaluated with a paired samples t-test. The correlation between the measurements was evaluated using Pearson correlation coefficients. The agreement between the devices was evaluated with Bland-Altman plots.

RESULTS: There was significant difference between SW-9000 and IOL Master 500 in measuring AL and ACD(all P<0.01), but there was no significant difference between K1 and K2 in patients with low to moderate myopia. There was no significant difference in AL, ACD and K1 between SW-9000 and IOL Master 500(all P>0.05), but there was significant difference in K2(P<0.05)in patients with high myopia. Pearson correlation analysis showed that AL, ACD, K1 and K2 of patients with low to moderate and high myopia were highly correlated(all P<0.01). Bland-Altman consistency analysis showed that the two methods had good consistency in measuring AL in patients with low to moderate and high myopia, but poor consistency in measuring ACD, K1 and K2.

CONCLUSION: SW-9000 and IOL Master 500 have good consistency in measuring the AL of people with ametropia. The measurement of ACD and corneal curvature has poor consistency, and should be carefully selected in combination with clinical practice.

Abstract:AIM:To compare the difference, correlation and consistency of corneal biological parameters measured by IOL Master 700 and Pentacam before cataract extraction and intraocular lens implantation in different age groups.

METHODS: Cross-sectional study. A total of 87 cataract patients(162 eyes)in Weifang Eye Hospital from February to September 2020 were collected, including 44 males(80 eyes)and 43 females(82 eyes)(age 61.2±9.87 years). The patients were divided into four groups: group A \〖17 cases(32 eyes), 40-50 years old\〗, group B \〖25 cases(47 eyes), 51-60 years old\〗, group C \〖28 cases(53 eyes), 61-70 years old\〗, and group D \〖17 cases(30 eyes), 71-80 years old\〗. The preoperative corneal biological parameters of cataract patients were measured by IOL Master 700 and Pentacam, and the flat axis corneal curvature(K1), steep axis corneal curvature(K2), mean corneal curvature(Km), corneal astigmatism, anterior chamber depth(ACD)and central corneal thickness(CCT)were recorded. The difference and correlation of measurement results between two kinds of biometric instruments in different age groups were analyzed.

RESULTS: Except for the corneal astigmatism in group C and K1 and corneal astigmatism in group D, there were significant differences between the two instruments(t=2.746, -2.582, 2.637, all P<0.05), but there was no significant difference in other parameters among the four groups. Pearson correlation analysis showed that there was a good correlation between the two instruments in measuring the parameters of the four groups of patients. The results of Bland-Altman analysis showed that there was a good consistency between IOL Master 700 and Pentacam in measuring K1, K2, Km, corneal astigmatism, ACD and CCT in the four groups.

CONCLUSION:There was no significant difference between IOL Master 700 and Pentacam in the measurement of corneal biological parameters in cataract patients aged 40-60 years, but there was significant difference in astigmatism between 61-70 years old, astigmatism and K1 value in 71-80 years old patients. Pearson correlation analysis showed that there was a good correlation between the two instruments. Generally speaking, the consistency of the two kinds of examination equipment is good, and the corneal astigmatism and corneal curvature should be selected by comprehensive analysis of the data.

Abstract:AIM: To observe the effect of pars plana vitrectomy(PPV)internal limiting membrane(ILM)insertion and nerve growth factor(NGF)injection in the treatment of large idiopathic macular hole(IMH).

METHODS: This was a retrospective clinical study which included 16 patients(16 eyes)with large IMH diagnosed in the Affiliated Eye Hospital of Nanjing Medical University from May 2018 to May 2020. All patients were treated with PPV combined with ILM insertion and NGF injection and the follow-up period was at least 6mo. Macular hole closure rates, best-corrected visual acuity(BCVA)(LogMAR), and optical coherence tomography(OCT)findings including ellipsoid zone(EZ)and external limiting membrane(ELM)were analyzed, the complications were also observed postoperatively.

RESULTS: The BCVA was 1.15±0.21 before operation, and the follow-up of BCVA was 1.02±0.19 and 0.87±0.24 respectively at 3 and 6mo after operation(F=34.966, P<0.01); The BCVA was improved 3 and 6mo after operation(P<0.01), and the BCVA at 6mo after operation was better than that at 3mo(P<0.01). The closure rate of the MH was 100% and 11 eyes showed U-shaped closure in OCT(69%), 3 eyes were V-shaped closure(19%)and 2 eyes were irregular closure(13%). The BCVA of U-shaped closure group, V-shaped closure group and irregular closure group were 0.75±0.18, 1.1±0.19, and 1.20±0.00 respectively(F=6.937, P<0.01). The recovery of BCVA in U-shaped closure group was significantly better than that in V-shaped closure group and irregular closure group(P=0.027, 0.007). Six months after operation, 10 eyes(91%)of ELM and 7 eyes(64%)of ellipsoid zone resumed continuity in U-shaped closure group, 2 eyes(67%)of ELM and 1 eye(33%)of resumed continuity in V-shaped closure group. ELM and ellipsoidal zone were not recovered continuously in irregular closure group(P<0.05). During the follow-up period, we found no ocular or systemic complications.

CONCLUSION: PPV combined with ILM insertion and NGF injection is safe and effective in treating large IMH. The synergetic effect of NGF and ILM can obviously promote the closure of IMH, which is beneficial to the recovery of photoreceptor layer integrity and the improvement of visual function after operation.

Abstract:AIM: To analyze the gene mutation spectrum of autosomal recessive retinitis pigmentosa(ARRP)pedigrees and cone-rod dystrophy(CORD)pedigrees in Ningxia region of China.

METHODS:Totally 35 ARRP pedigrees and 18 CORD pedigrees were included in Ningxia Eye Hospital from September 2016 to February 2020. Peripheral venous blood samples of the proband were collected for targeted capture enrichment and high-throughput sequencing using a genetic retinal disease capture chip that contain 232 pathogenic genes. Online analysis software was used to predict the pathogenicity of suspicious gene variation, and Sanger sequencing was used to analyze the co-segregation of the family members.

RESULTS: Totally 16 pathogenic genes were confirmed in 35 ARRP pedigrees, the mutations rate of RP1 gene was the highest, accounting for 14%(5/35), following were ABCA4, CRB1 and EYS gene, accounted for 11%(4/35); 18 CORD pedigrees carried 10 pathogenic genes. The mutation rate of ABCA4 gene was the highest, accounting for 28%(5/18), followed by ALMS1, PROM1, RPE65, USH2A gene, accounting for 11%(2/18). There were 5 co-exist disease-causing genes in ARRP and CORD pedigrees, which were ABCA4, CLN3, CRB1, PROM1, NRL, accounting for 42%(22/53).

CONCLUSION: There are similarities and crossover in the phenotype of ARRP and CORD. The pathogenic genes were overlaped. The most common overlaping gene between the two diseases is ABCA4.

Abstract:AIM:To evaluate the clinical effect of 25G pars plana vitrectomy(PPV)combined with intraocular lens(IOL)ciliary sulcus suture fixation and replacement of IOL capsular bag complex.

METHODS: A retrospective analysis of 21 patients(21 eyes)in our hospital who applied 25G PPV combined with IOL ciliary sulcus suture and fixation replacement in our hospital from January 2015 to January 2020 to treat the IOL capsular complex completely detached from the clinical data.

RESULTS: All the cases were successfully removed the dislocated IOL complex during the operation. There was no iatrogenic retinal damage. During the operation, 4 cases(4 eyes)were found to have the retina hole, 2 cases(2 eyes)were found to be retinal lattice degeneration area, which were treated with laser photocoagulation of the retina. Follow-up for 6-18mo, best corrected visual acuity(BCVA)(LogMAR)increased from 0.40±0.30 before operation to 0.33±0.25 after operation(P=0.040). The BCVA at the last follow-up of all cases reached the BCVA before surgery. The absolute value of the difference between the postoperative spherical equivalent power and the preoperative IOL refractive power prediction value is less than or equal to 0.75D. At the last follow-up, the position of the intraocular lenses in all cases was good, and there were no complications such as retinal detachment.

CONCLUSION: The technique of 25G PPV and the exchange of IOL ciliary sulcus fixation with intraocular IOL capsule complex is a safe and effective procedure for dislocation of IOL-capsular bag complex entirely into the vitreous cavity.

Abstract:AIM: To analyze the diagnostic value of Pentacam anterior segment analyzer examination parameters on early keratoconus.

METHODS: Retrospective control study. Totally 100 patients(124 eyes)with keratoconus who were treated in the hospital between January 2019 and January 2020 were selected as study group. According to the severity of Amsler-Krumeich classification, patients with keratoconus were divided into mild group(51 eyes), moderate group(43 eyes)and severe group(30 eyes), and another 30 normal people with past history of myopia and astigmatism(30 eyes)were selected as control group. The Pentacam anterior segment analyzer parameters \〖horizontal central curvature of 3mm diameter range(K1), vertical central curvature of 3mm diameter range(K2), maximum refractive power of corneal anterior surface(Kmax), corneal astigmatism(Cyl), corneal thickness at the thinnest(thinnest local), ROC curve was used to analyze the sensitive indicators in the diagnosis of early keratoconus.

RESULTS:The K1, K2, Kmax, Cyl, ISV, IVA, KI and ACD in study group were significantly higher than those in control group(P<0.05)while the thinnest local and ACV were significantly lower than those in control group(P<0.05). There were statistically significant differences in the K1, K2, Kmax, Cyl, thinnest local, ISV, IVA, KI, ACV and ACD among patients with different degrees of keratoconus(P<0.05), and the K1, K2, Kmax, Cyl, ISV, IVA, KI and ACD in moderate group and severe group were significantly higher than those in mild group(P<0.05)while the thinnest local and ACV were significantly lower than those in mild group(P<0.05), and there were significant differences in the parameters between moderate group and severe group(P<0.05). ROC diagnostic curve results showed that Kmax, thinnest local, ISV, IVA and KI were sensitive indicators for diagnosing keratoconus(AUC>0.85), of which ISV had the highest diagnostic value.

CONCLUSION: Pentacam anterior segment analyzer can effectively measure the keratoconus parameters. There are differences in the parameters among patients with different degrees of keratoconus. Kmax, thinnest local, ISV, IVA and KI are sensitive indicators for diagnosing early keratoconus, and Pentacam anterior segment analyzer examination parameters have a higher diagnostic value on early keratoconus.

Abstract:AIM: To investigate the relationship between platelet parameters and macular edema(ME)in retinal vein occlusion(RVO)patients with different OCT types.

METHODS: Retrospective study. A total of 126 eyes in 126 patients with RVO were enrolled in the ophthalmology department of the Fifth Affiliated Hospital of Zhengzhou University from December 2016 to February 2021, among whom, 51 eyes with central retinal vein occlusion(CRVO)were included, branch retinal vein occlusion(BRVO)included 75 eyes, 31 eyes without ME(non-ME)and 95 eyes with ME. According to the morphology of OCT, ME was divided into 26 eyes of diffuse retinal thickening(DRT), 30 eyes of cystoid macular edema(CME)and 39 eyes of serous retinal detachment(SRD), the platelet parameters of patients with different groups including platelet count(PLT), mean platelet volume(MPV), plateletcrit(PCT)and platelet distribution width(PDW)were collected and statistical analysis were performed.

RESULTS:The MPV value and CMT value of ME group was higher than that of Non-ME group(all P<0.001), the MPV value of SRD group was higher than that of DRT group and CME group(all P<0.001), but there was no statistically significant difference in MPV between DRT group and CME group(P=0.526), CMT in SRD group was significantly higher than that in DRT group and CME group(P<0.001), and there was no significant difference in CMT between DRT group and CME group(P=0.190).

CONCLUSION:MPV has differences in patients with RVO ME with different OCT classifications, activated platelets may be closely related to the occurrence and development of SRD.

Abstract:AIM: To evaluate the efficacy of pars plana vitrectomy combined with internal limiting membrane(ILM)insertion for the treatment of refractory macular holes(MH)by spectral-domain optical coherence tomography(SD-OCT).

METHODS: Retrospective analysis was conducted in 17 patients(17 eyes)with refractory MH from July 2019 to December 2020. All patients were treated with pars plana vitrectomy combined with ILM insertion. Preoperative and postoperative best corrected visual acuity(BCVA)were compared. Quantified evaluation of the postoperative macular restoration was performed by SD-OCT.

RESULTS: The widths of ellipsoid zone disruption were 839.00-1577.50μm, with an average of 1182.90±226.68μm. During the follow-up period(3-12mo), 17 cases achieved successful closure(100%), and no recurrence was seen. Postoperative BCVA was significantly improved compared with preoperative(P<0.01). The widths of external limiting membrane disruption and ellipsoid zone disruption were smaller gradually at 1wk and 3mo after surgery compared with preoperative(all P<0.01). But the continuity was still not restored. The thickness of the central fovea of macula(within 1mm diameter range)at 1wk and 3mo after surgery decreased significantly compared with preoperative(all P<0.01).

CONCLUSION: Pars plana vitrectomy combined with ILM insertion proves to be effective to achieve anatomical and functional improvement in the treatment of refractory MH. SD-OCT has important clinical value in the diagnosis and postoperative follow-up evaluation of refractory MH.

Abstract:AIM:To compare the effect of self-crosslinking sodium hyaluronic gel, Nasopore, and gelatin sponge in endonasal endoscopic dacryocystorhinostomy(En-DCR).

METHODS:Totally 72 patients(90 eyes)of chronic dacryocystitis admitted to our hospital from June 2019 to June 2020, and randomly divide them into three groups. Self-crosslinking sodium hyaluronic gel(group A), Nasopore(group B), and gelfoam(group C)were used during the En-DCR. Comfort level, bleeding, complication and epiphora, lacrimal situation were observed 2wk, 1, 2, 3, 6mo after surgery. Comparison of cure rate and effective rate.

RESULTS: The patients were followed up for 6mo after operation. The cure rate of lacrimal system reconstruction was 97% in group A, 89% in group B and 94% in group C. There was no meaningful statistical difference among the three groups(P>0.05). The effective rate of lacrimal system reconstruction was 91% in group A, 56% in group B and 87% in group C(P<0.05). There was significant statistical difference between groups A and B or between groups B and C(P<0.0167), however, there was no meaningful statistical difference between groups A and C(P>0.0167). Postoperative comfort level was better and bleeding was more severe in the group of A than in group B(P<0.0167). In terms of complications, there was less scar proliferation in group A than in group B(P<0.0167), the rate of synechiae in groups A and B was higher than in group C(P<0.0167).

CONCLUSION:Intraoperative application of self-crosslinking sodium hyaluronic gel to packing the anastomotic stoma makes the procedure simple and can effectively inhibit scar proliferation and conducive to the epithelialization of the anastomotic stoma, improve the cure rate of En-DCR. In addition, with more comfort. It is a simple, safe, comfortable and efficient absorbable anastomotic stoma packing material.

Abstract:AIM: To explore the related factors that affect the subfoveal choroidal thickness(SFCT)of children with low to moderate myopia.

METHODS: A cross-sectional study. We selected children aged 6-12 who were diagnosed as myopia in the Department of Ophthalmology of the Affiliated Xuzhou Municipal Hospital of Xuzhou Medical University from October to December 2020, according to the spherical equivalent refraction(SER), 60 patients(60 eyes)with low myopia of -0.75 to -3.00D and 50 patients(50 eyes)with moderate myopia of -3.25 to -6.00D, which was obtained by cycloplegic refraction. All participants conducted ophthalmic examination, including measurements of SFCT, subfoveal retinal thickness(SFRT), axial length(AL), and parameters of ocular accommodation. Children's age, sex, parental myopia, height and weight were collected. The relationship between SFCT and various factors was investigated.

RESULTS: The average SFCT of the low and moderate myopia were 273.30±44.93 and 237.16±48.56μm(P<0.01), respectively. Pearson's correlation analysis showed that SFCT was statistically related to SER, AL and height(r=0.35, -0.45, -0.19, all P<0.05), and no statistical correlation with other factors(all P>0.05). Multiple linear regression showed that SFCT became thinner as AL became longer(B= -19.87, P<0.01).

CONCLUSION:SFCT in children with low to moderate myopia was statistically related to SER, AL and height, but it was not notably related to other factors. AL was the most significant factor affecting SFCT.

Abstract:AIM: To investigate the current situation of myopia among pupils in Baotou and analyze the factors related to myopia, so as to provide data support and theoretical basis for myopia prevention and control in education and health departments.

METHODS: A random cluster sampling method was adopted to investigate the vision situation of students aged 7-14 in 26 primary schools in the urban and pastoral areas of Baotou from January to November 2019, 2000 questionnaires on myopia-related factors were distributed, and 1630 valid questionnaires were finally formed, and a myopia database was established for statistical analysis.

RESULTS: There were 14 845 myopia among the 31 080 students surveyed, and the myopia rate was 47.8%(14845/31080). Among them, the myopia rate of boys was 44.3%(6912/15609), and that of girls was 51.3%(7933/15471). The myopia rate in urban areas was 50.4%(9310/18489)and in pastoral were as was 44.0%(5535/12591). The myopia rate of Han nationality was 48.0%(13185/27442), and of Mongolian nationality was 44.6%(1149/2576), the other ethnic groups was 48.1%(511/1062)(P<0.05). The prevalence of myopia of 11, 12, 13,and 14-year-old urban pupils were: 51.9%(1333/2568), 62.8%(1671/2662), 72.0%(3415/4740), 45.4%(704/1551),and the pastoral areas of the same age group were 46.5%(938/2019), 58.0%(1089/1877), 68.3%(1557/2279), 36.2%(338/934). The myopia rate of urban pupils in 11-14 age group was higher than that in pastoral areas(P<0.05). Among them, doing eye exercises and eating fruits and vegetables were protective factors. Area, grade, tummy reading, reading and writing under low light, or using electronic products, parents' myopia, and father's education were risk factors for myopia.

CONCLUSION: The prevalence of myopia in Baotou primary school students is at a relatively high level. With the increase of age, the prevalence of myopia increases. Many factors are related to myopia in primary school students. Parents and education departments should carry out relevant interventions.