Abstract:AIM: To study the clinical characteristics of vitreous hemorrhage associated with retinal tears, so as to provide suggestions for early intervention and improving the prognosis of patients.METHODS: This was a retrospective study. Totally 105 patients(105 eyes)with vitreous haemorrhage associated with retinal tears treated at our hospital from December 2016 to December 2018 including 54 males and 51 females, of who the clinical characters, therapeutic effcet and prognostic facors were retrospectively analyzed.RESULTS: Among the 105 eyes(151 retinal tears), 82 tears were located in the superotemporal area(54.3%), 28 tears were located in the superonasal area(18.5%), 27 tears were located in the inferior temporal area(17.9%), and 14 tears were located in the inferior nasal area(9.3%). The shape of the retinal tears was mostly horseshoe(77.5%). The diameter of the tear was between 1/8-4 papillary diameter(PD), most commonly is 1 PD. Seventy-six patients(72.4%)had visual acuity better than or equal to their preoperative vision. There was no significant difference in corrected visual acuity pre-and postoperative(P>0.05), and there was no statistically significant improvement in visual acuity between the buckling procedure group and the vitrectomy group(P>0.05).CONCLUSION: Retinal tear is an important cause of vitreous haemorrhage. Retinal tears were mostly located in the superotemporal area with horseshoe shape. A comprehensive understanding of the clinical characteristics of rhegmatogenous vitreous haemorrhage helps to detect tears early and avoid serious complications.Patients had preoperative best corrected visual acuity(BCVA)(LogMAR)less than 1.6 and light perception less than 1 m, have poor postoperative vision, as do patients with retinal detachment involving the macula especially along with proliferative vitreoretinopathy(PVR).

Abstract:AIM: To analyze the efficacy of iris-claw intraocular lens(ICIOL)and scleral-fixator intraocular lens(SFIOL)in terms of visual outcomes, surgical time, and postoperative complications in the aphakic patients.METHODS: This study was a prospective study with 60 aphakic eyes of 60 patients who attended our outpatient department from October 2018 to February 2020. These patients were divided into two groups and each with 30 patients. Patients in Group I were underwent ICIOL whereas patients in Group II underwent SFIOL implantation. Patients with pre-existing ocular pathologies, previous history of retinal surgery of the eye were excluded. The preoperative and postoperative evaluation was done for the follow up period of 9mo.RESULTS: Twenty-six(87%)patients in the ICIOL group and 24(80%)patients in SFIOL group had best corrected visual acuity(BCVA,LogMAR)with 0.50-0.00 after 9mo follow up. The mean of BCVA(LogMAR)was comparable in both the groups. The surgical time in ICIOL was significantly less than the SFIOL group(P<0.01). Complications related to sutures were significantly more in the SFIOL group. Complications found in the ICIOL group were very mild and harmless. CONCLUSION: The visual outcome was comparable in both groups. ICIOL with fewer complications and requiring less surgical time was found to be a better alternative to SFIOL in the correction of aphakia.

Abstract:AIM: To isolate the retinal ganglion cells(RGCs)of neonatal Sprague-Dawley(SD)rats in vitro, and to establish the RGCs primary culture method and high glucose model of neonatal SD rats.METHODS: The retinal tissues of SD rats from 1-3d as the materials were taken, from which the RGCs were isolated and purified for primary culture. Toluidine blue and immunofluorescence staining methods were adopted to identify the cultured cells. After 48-72h of continuous culture, RGCs were randomly divided into 6 groups and cultured in different glucose concentrations of 5.5mmol/L(normal control group), 20mmol/L, 25mmol/L, 30mmol/L, 35mmol/L and 40mmol/L for 24, 48 and 72h, respectively. Finally, the CCK8 method and TUNEL method were adopted to determine the cell survival rate and apoptosis rate. RESULTS: The primary RGCs purified and cultured in vitro represented typical cell morphology and grew well, the cells were confluent and aggregated in small lamellar manner, while the axons crisscrossed into a network, in addition, cell halo could be seen around the cell body. Nissl bodies with clear structure were found in the cytoplasm of toluidine blue stained cells, the percentage of neurons was more than 95%. RGCs specific antibodies Thy-1 and Brn-3a were employed to identify the purified cells in vitro, and the positive rate reached more than 90%. The CCK8 results showed that the survival rate of cells decreased(OD value decreased)with the increase of culture time and glucose concentration. When the cells were treated with different glucose concentrations for 24h, the OD values of each group were lower than those of the normal control group, but there was no significant difference between the OD values of each group and the normal control group(all P>0.05). With the extension of culture time, the OD values of 35mmol/L and 40mmol/L glucose concentration intervention RGCs 48h, 30mmol/L, 35mmol/L, 40mmol/L intervention RGCs 72h were significantly lower than those of the normal control group, the difference was statistically significant compared with the normal control group(all P<0.05). TUNEL results revealed that the apoptosis rate of RGCs increased with the increase of glucose concentration and time, among them, the apoptosis rate of RGCs cultured in glucose concentration of 30mmol/L, 35mmol/L and 40mmol/L for 48h and 72h was significantly statistical different from that of normal control group(all P<0.05). CONCLUSION: The RGCs primary culture method established in this study is capable of separating typical RGCs with high purity. With the increase of glucose concentration in the medium, the survival rate of RGCs have been decreased while the apoptosis rate increased. Notably, the 35mmol/L glucose intervention for 48h can be employed as the optimal intervention concentration and time to effectively induce RGCs to establish the high glucose model.

Abstract:AIM: To investigate the effect of miRNA-147 targeted regulation of vascular endothelial growth factor(VEGF)on the proliferation, apoptosis and migration of human retinal pigment epithelial cells, and to explore its molecular mechanism. METHODS: Human retinal pigment epithelial(ARPE-19)cells were selected and divided into 7 groups: blank control group(untreated), nonsense miRNA group(transfected with mimic NC), miRNA-147 simulant group(transfected with miRNA-147 mimic), inhibitor negative control group(transfected with shRNA NC), VEGF inhibitor group(transfected with shRNA VEGF), miRNA-147 simulant+empty viral vector group(transfected with miRNA-147 mimic and pcDNA3.1)and miRNA-147 simulant+VEGF overexpression group(transfected with miRNA-147 mimic and pcDNA3.1 VEGF). RT-qPCR was used to detect the expression of miRNA-147 and VEGF mRNA. Dual luciferase experiments were used to verify the targeting relationship between miRNA-147 and VEGF. Western blot was used to detect the expression of VEGF protein. MTT method was used to detect the proliferation. Flow cytometry to detect the apoptosis level and cell cycle changes. Cell scratch test to detect the level of cell migration. RESULTS: Compared with the blank control group and the nonsense miRNA group, the expression level of miRNA-147 in miRNA-147 simulant group was significantly increased, while the expression levels of VEGF mRNA and protein were significantly reduced(P<0.05). Compared with the inhibitor negative control group, the expression levels of VEGF mRNA and protein in the VEGF inhibitor group were significantly reduced(P<0.05). Compared with the miRNA-147 simulant+empty viral vector group, the expression level of VEGF mRNA in the miRNA-147 simulant+VEGF overexpression group was significantly increased(P<0.05). The dual luciferase report shows that VEGF is the target gene of miRNA-147. Transfection of miRNA-147 mimic and shRNA VEGF can reduce the proliferation and migration of ARPE-19 cells and promote apoptosis can reduce the proliferation and migration of ARPE-19 cells and promote apoptosis(P<0.05). Transfection VEGF overexpression reverses the effect of miRNA-147 mimics on proliferation, migration and apoptosis of ARPE-19 cells(P<0.05). CONCLUSION: miRNA-147 can inhibit ARPE-19 cell proliferation, migration and promote cell apoptosis by targeting VEGF.

Abstract:AIM:To investigate the effect of growth hormone releasing peptide(ghrelin)on diabetic retinopathy in rats and study its protective effect.METHODS: Eighteen male SD rats were divided into control group, model group and ghrelin group. HE staining was used to observe the morphology of retina, TUNEL staining was used to observe apoptosis, transmission electron microscope was used to observe the ultrastructure of retinal pigment epithelium, immunohistochemistry was used to detect oxidative stress index, and ELISA was used to detect the content of inflammatory factors. RESULTS:Morphological observation showed that ghrelin could reduce the degree of retinal tissue damage and the apoptosis of retinal tissue in diabetic rats. The results of immunohistochemistry showed that the activities of SOD(superoxide dismutase)and glutathione peroxidase(GSH-Px)in retina tissue of ghrelin group were increased, and the content of malondialdehyde(MDA)was decreased, compared with model group(P<0.05). ELISA results showed that intercellular cell adhesion molecule-1(ICAM-1), tumor necrosis factor-a,(TNF-a)and interleukin-1β(IL-1β)in model group were significantly higher than those in control group(P<0.05). After ghrelin intervention, the expression of inflammatory factors decreased, compared with model group(P<0.05).CONCLUSION:Ghrelin could effectively retard the progression of diabetic retinopathy in diabetic rats, and its mechanism was related to lowering the level of oxidative stress and inhibiting inflammation.

Abstract:AIM: To investigate the impact of intravitreal conbercept injection on the aqueous humor levels of vascular endothelial growth factor(VEGF), interleukin-6(IL-6)and interleukin-8(IL-8)in patients diagnosed with neovascular glaucoma(NVG), and to evaluate the efficacy of conbercept in combination with different surgical modalities.METHODS: This study was conducted as a retrospective, case series investigation. A total of 102 patients(102 eyes)diagnosed with NVG from Jan. 2019 to Feb. 2020 were enrolled and randomized to trabeculectomy group(50 eyes of 50 cases)or EX-PRESS drain implantation group(52 eyes of 52 cases)3-5d after conbercept injections. The concentrations of VEGF, IL-6 and IL-8 in aqueous humor were determined by enzyme-linked immunosorbent assay(ELISA). The therapeutic efficacies of different surgical modalities were evaluated and compared by status of iris neovascularization, changes in postoperative intraocular pressure(IOP), improvement of visual acuity and incidence of complications.RESULTS:Decreases in aqueous humor concentrations of VEGF, IL-6 and IL-8 were observed at 3-5d after treatment of conbercept(all P<0.05). At 1, 3d, 1, 3, 6 and 12mo after surgery, the IOP levels of patients in both groups were significantly reduced compared to those before surgery(all P<0.05), and there was a statistically significant difference in IOP between the two groups at 3, 6, and 12mo postoperatively(all P<0.05). At 6 and 12mo after surgery, patients treated with EX-PRESS drain implantation showed better visual acuity compared to patients treated with trabeculectomy(all P<0.05). There was no statistically significant difference in types and dosages of anti-glaucoma drugs administered to patients in different groups. At 12mo follow-up, success rate of surgery in the EX-PRESS drain implantation group(86.5%)was higher than that in the trabeculectomy group(70.0%), along with remarkably lower incidence rate of complications compared to that of the trabeculectomy group(P<0.05).CONCLUSION: The intravitreal injection of conbercept could down-regulate aqueous humor concentrations of VEGF, IL-6 and IL-8. Both of trabeculectomy and EX-PRESS drain implantation could reduce IOP in NVG patients, but the latter procedure had fewer incidence of complications and was more advantageous in improving visual acuity.

Abstract:AIM: To observe the control effects of low concentration atropines, orthokeratology, and spectacles on children with myopia in Baotou, and to analyze change rules of myopia-related regulatory parameters for providing bases for myopia preventions and controls.METHODS: We selected 120 children with myopia aged 8-14 years old(240 eyes), treated in Ophthalmology Clinic of the First Affiliated Hospital of Baotou Medical College from June 2018 to December 2018. They were divided into three groups as follows: low concentration atropine group, orthokeratology group, and spectacles group. The accommodative lag, positive relative accommodation, negative relative accommodation, and diopter were followed up at 1, 3, 6, 12mo.RESULTS:During the follow ups of 3, 6, and 12mo. We observed a statistically significant difference in the accommodative lag between the orthokeratology group and low concentration atropine group spectacles group(P<0.05). At the 6, 12mo follow up, there was a statistical difference in the accommodative lag between the orthokeratology group and the spectacles group(P<0.05). During the follow ups of 3, 6, and 12mo, there was a statistically significant difference in negative relative accommodations among the low concentration atropine group, orthokeratology group, and spectacles group(P<0.05). The difference in positive relative accommodations was statistically significant among the orthokeratology group, low concentration atropine group, and spectacles group at each time point during the follow ups(P<0.05). During the follow ups of 6, 12mo,the difference of equivalent spherical lens was statistically significant among the low concentration atropine group and spectacles group(P<0.05). At the follow up 12mo, the difference between the equivalent spherical lens of the orthokeratology group and the spectacles group was statistically significant(P<0.05).CONCLUSION: The effects of three commonly used methods of controlling myopia on the accommodation parameters of myopic children are as follows: orthokeratology can not only solve the problem of hyperopia defocus by reducing accommodation lags but also improve positive relative accommodations, while it should be worn for a prolonged period. Low concentration atropine can improve the negative relative accommodations. However, there may be other ways to control myopia development. Compared to other groups, the spectacles group exerted fewer effects on each adjustment index, and did not demonstrate a significant effect on myopia control.

Abstract:Various ocular injuries can induce corneal neovascularization, which promote the development of diseases, causing corneal edema, impaired vision and even blindness. Therefore, with very important clinical significance, inhibiting corneal neovascularization can help to delay the progression of diseases and reduce corneal damage. This article will make the latest systematic discussion on the cells and molecules involved in corneal neovascularization, and analyze the possible inhibitory targets, hoping to provide references for scientific research and clinical practice.

Abstract:Dry eye is a complex disease caused by multiple factors which pathogenesis is complex and diverse. At present, the tear film instability, the increase of tear osmotic pressure, ocular surface inflammation and neurological abnormalities are recognized as the pathogenesis of dry eye. Particularly, inflammation has been confirmed as the key mechanism for the pathogenesis of the dry eye. In this case, this study focuses on discussing the role of critical factors and cell mediators related to dry eye and the anti-inflammatory treatments for it to understand the inflammatory cascade of the dry eye more comprehensively.

Abstract:Exosomes, which are 30-200nm nano-sized vesicles, can be released by many cell types into the extracellular environment. Various biological active substances have been identified in the exosomal lumen, including proteins, mRNA, and microRNA(miRNA). miRNA is small non-coding RNA involved in post-transcriptional generegulation, participating in many biological activities. They can be selectively packed into exosomes, delivered to neighboring or distant cells, and regulate the functions of recipient cells. Accumulating evidence showed that exosome-derived miRNA play important roles in initiation, progression, and prognosis of diverse ocular diseases. Thus, exosome-derived miRNA are considered as potential biomarkers for diagnosis and prognosis. This review summarizes the basic characteristics of exosome-derived miRNA and their research progresses in different ocular diseases.

Abstract:Posterior capsular opacification is the most common complication after cataract extraction, which seriously influences the quality of life of patients. At present, there is no effective measure to prevent posterior capsular opacification. Surgery or Nd:YAG laser is often used in clinical, and a new treatment is urgently needed. Hippo signaling pathway is involved in the steady-state regulation of many mammalian cells and organs. Recent studies have shown that Hippo signaling pathway can regulate the proliferation, apoptosis, differentiation and other behaviors of lens epithelial cells. Hippo signaling pathway may provide a new target in the treatment of posterior capsular opacification. This article reviews the composition, regulatory mechanism of Hippo signaling pathway and its application in posterior capsular opacification. In order to provide a broader idea for the prevention and treatment of posterior capsular opacification.

Abstract:Glaucoma is a common irreversible blinding eye disease, pathological elevated intraocular pressure is the main clinical feature. The formation of intraocular pressure, related to aqueous circulation, will be pathologically elevated when the aqueous cycle is abnormal. Trabecular network, which plays a key role in maintaining normal intraocular pressure, is the main component of aqueous outflow channel. Imbalance of oxidative stress manifested as oxidation and antioxidant effects is a direct risk factor for elevated intraocular pressure in glaucoma. When it comes to the trabecular meshwork cells, a series of changes such as deposition and degeneration of extracellular matrix, autophagy and aging will eventually occur, and finally the dysfunction of trabecular meshwork cells and increased aqueous outflow resistance, causing intraocular pressure pathological elevated. In this paper, we reviewed the research progress on the relationship between oxidative stress in trabecular meshwork cells and the pathogenesis of glaucoma, in order to provide evidence for further research and reference for exploring the pathogenesis, prevention and treatment of glaucoma.

Abstract:With the development of perinatal medicine technology, the survival rate of premature infants has been greatly improved. The birth gestational age and birth weight of viable premature infants have also been continuously reduced. However, the incidence of retinopathy of prematurity(ROP)and anemia in premature infants has also been increased accordingly. Currently, recombinant human erythropoietin(rhEPO)can be used to treat anemia in premature infants. In addition to promoting bone marrow red blood cell production, erythropoietin(EPO)can also regulate angiogenesis and inhibit apoptosis of neural cells and so on. Therefore, when rhEPO is clinically used to treat anemia in premature infants, it may affect ROP on the other hand. The impact of EPO on ROP may be two-fold, which means it can not only protect but also aggravates ROP. This review summarizes the basic research and clinical research on the relationship between EPO and ROP and analyzes the effects of endogenous EPO, exogenous EPO and different initial time and dosage of EPO on ROP.

Abstract:The retinal disease is one of the most important challenges in the field of ophthalmology. Its pathogenesis is complex and has a great damage to visual functional. It is the main cause of severe human vision. In recent years, the development of artificial intelligence(AI)is a powerful tool for analytics of retinal diseases. The application of AI to common retinal diseases mainly includes early screening, diagnostic grading, efficacy determination, treatment suggestions and prognostic development. However, any technology clinical application has its limitations. This article will be reviewed for the application of AI in retinal diseases.

Abstract:The epithelial ingrowth under corneal flap is one of the complications after keratorefractive surgery, of which the incidence has declined dramatically with the improvement of relevant facilities and surgical techniques. However, epithelial ingrowth results from traumatic flap displacement has been describing in the literatures from time to time. If the prompt and efficient treatment cannot be taken, the severe complications of epithelial ingrowth will occur such as the alternation of refraction and cornea keratolysis. In this article, we reviewed the research progress of epithelial ingrowth after keratorefractive surgery.

Abstract:Corneal refractive surgery is a method of correcting refractive errors such as myopia, hyperopia and astigmatism through corneal surgery. Refractive regression can often be seen in clinical practice, that is, refractive errors occur again after surgery. Refractive regression and the consequent poor visual quality often trouble patients. So far, different types and methods of corneal refractive surgery have the problem of refractive regression. It is believed that refractive regression is mainly related with epithelium thickening and change of corneal biomechanics. Refractive regression could be predicted and avoided by preoperative risk factors such as preoperative conditions and operative parameters, and can also be prevented by selecting appropriate refractive surgery and using medicine. Non-operative and enhancement surgery can be used to treat refractive regression that has occurred.

Abstract:Optical coherence tomography angiography(OCTA)is a new noninvasive imaging method in ophthalmology. Based on optical coherence tomography(OCT), it has been gradually developed and applied in clinical practice. By scanning the red blood cells, OCTA can display the blood flow density and the structure and morphology of the fundus tissue, which has a high value in the diagnosis, treatment and efficacy of ophthalmological diseases(especially fundus lesions). With the advantages of high resolution, easy operation, rapid scanning and 3D imaging, OCTA has been applied in the evaluation and diagnosis of ophthalmic diseases(such as choroidal neovascularization, diabetic retinopathy, corneal and iris-related diseases, amblyopia, glaucoma etc.). This review is about the application of OCTA in ophthalmic diseases.

Abstract:AIM:To investigate the application value of fluorescent staining technique in the detection of amoebic pathogens in corneal tissue biopsy, and to apply fluorescent staining technique in the histopathological diagnosis of Acanthamoeba keratitis(AK), comparing the results with those of hemotoxyiln-eosin staining(HE staining)and periodic acid-schiff staining(PAS staining), and analyzing the sensitivity and specificity of these three staining methods.METHODS:Specimens of infected corneal tissue were collected from 74 cases(75 eyes), and then they were divided into an AK group and a non-Acanthamoeba keratitis(NAK)group based on the results of corneal scraping, culture and histopathological diagnosis. The tissues of consecutive sections were stained with HE staining, PAS staining and fluorescence respectively, and the sensitivity and specificity of the three staining methods for the diagnosis of AK were analyzed. Area under the curve(AUC)was calculated using the receiver operating characteristic(ROC)curve. Further analysis was performed to count the number of Acanthamoeba pathogens found by the three staining methods under the same magnification field of view at the same site, and to clarify the diagnostic value of fluorescent staining technique for AK.RESULTS: The sensitivity of HE staining was 69%(27/39)with a specificity of 92%; the sensitivity of PAS staining was 62%(24/39)with a specificity of 97%, and the sensitivity of fluorescent staining was 95%(37/39)with a specificity of 97%. There were differences in the sensitivity of the three staining methods for the diagnosis of AK(χ2=19.857, P<0.001), and pairwise comparison revealed that the differences between HE staining and fluorescent staining, PAS staining and fluorescent staining for the diagnosis of AK were statistically significant(P=0.003,<0.001), while the difference in sensitivity between HE staining and PAS staining for the diagnosis of AK was not statistically significant(P=0.978). The maximum AUC was 0.960 for fluorescence staining, followed by 0.804 for HE staining and 0.794 for PAS staining, respectively. The median number of amoeba cysts detected by HE staining, PAS staining and fluorescent staining at the same site under the same magnification field of view was 4(0, 11), 2(0, 9)and 12(3, 33), respectively(χ2=56.561, P<0.001). Pairwise comparison revealed that the differences in the number of amoeba cysts found by HE staining and fluorescence staining, PAS staining and fluorescence staining were statistically significant(P<0.001), while the difference in the number of amoeba cysts found by HE staining and PAS staining was not statistically significant(P=0.210). Fluorescently stained histopathological sections make it easier to identify amoebic pathogens.CONCLUSION:Fluorescent staining technique is more sensitive to histopathological diagnosis of AK than HE staining and PAS staining, which can significantly improve the positive rate of detection of amoebic pathogens.

Abstract:AIM: To study the relationship between the changes of blood vessel density in optic disc area of normal tension glaucoma(NTG)and visual field index(VFI)of glaucoma and morphological staging of visual field defect. METHODS: Totally 106 patients(106 eyes)with NTG and 79 patients(79 eyes)with primary open angle glaucoma(POAG)in the hospital between December 2018 and December 2020 were selected for cross-sectional study. Among them, 1 eye of binocular disease was selected as the sample by the random number table method, and another 92 healthy subjects with physical examination in the hospital were selected as control group. All three groups completed the optic disc blood vessel density, VFI detection and visual field defect morphological staging, and the relationship between optic disc blood vessel density and VFI and visual field defect morphological staging were analyzed.RESULTS: The intraocular pressure in POAG group was significantly higher than that in NTG group and control group(P<0.05). The whole optic disc area blood vessel density, large vessel density and capillary density of NTG group and POAG group were significantly lower than those of control group(P<0.05)while the density of avascular area was significantly higher than that of control group(P<0.05), and there were differences in various indicators between NTG group and POAG group(P<0.05). The VFI of NTG group and POAG group was significantly lower than that of control group(P<0.05)while the mean visual field defect(MD)was significantly higher than that of control group(P<0.05), and there were no statistical differences in VFI and MD between NTG group and POAG group(P>0.05). With the increase in visual field defect morphology staging, the whole optic disc area blood vessel density and capillary density of patients with NTG showed a significant decrease(P<0.05). The whole optic disc area blood vessel density and capillary density of patients with NTG were positively correlated with VFI and negatively correlated with visual field defect staging, and avascular area density was negatively correlated with VFI and positively correlated with visual field defect staging(all P<0.05). CONCLUSION:Optic disc blood vessel density of patients with NTG is significantly lower than that of patients with POAG and normal people, and it is significantly correlated with VFI and visual field defect morphological staging. Among them, capillary density has the highest correlation. It can be seen that OCTA has important clinical significance for NTG diagnosis, treatment and follow-up.

Abstract:AIM: To detect the expression of erythropoietin(EPO)and hypoxia-inducible factor-1α(HIF-1α)in serum and aqueous humor of patients with acute anterior uveitis(AAU), and to explore their clinical significance. METHODS: From January 2018 to December 2020, 60 patients with AAU in our hospital were prospectively selected as the research objects, and 60 patients with proliferative vitreoretinopathy in the same period were taken as control(control group). The serum and aqueous humor of two groups were collected, enzyme-linked immunosorbent assay(ELISA)was used to detect the levels of EPO and HIF-1α in serum and aqueous humor; the self-rating anxiety scale(SAS)and the self-rating depression scale(SDS)were used to evaluate the AAU patients, and the severity of the disease was scored; Pearson method was used to analyze the correlation between SAS score, SDS score and levels of EPO and HIF-1α in serum and aqueous humor, and the correlation between levels of EPO and HIF-1α in the serum and aqueous humor. Spearman was used to analyze the correlation between the disease severity score of AAU patients and the levels of EPO and HIF-1α in serum and aqueous humor. RESULTS: Compared with the control group, the levels of EPO and HIF-1α in the serum and aqueous humor of the study group were higher(P<0.01). Among AAU patients, 23 were negative of SAS score and 37 were positive, and 29 were negative of SDS score and 31 were positive. Compared with patients with negative SAS score, the level of HIF-1α in serum and the level of EPO in the aqueous humor were higher in patients with positive SAS score(P<0.05); compared with patients with negative SDS score, the level of EPO in serum and the levels of EPO and HIF-1α in aqueous humor were higher in patients with positive SDS score(P<0.01). There were 26 mild patients and 34 severe patients with AAU. Compared with mild patients with AAU, the levels of EPO and HIF-1α in serum and aqueous humor were increased in severe patients(P<0.01). Pearson analysis showed that the SAS and SDS scores of AAU patients were not significantly correlated with the levels of EPO and HIF-1α in serum and aqueous humor(P>0.05), there was a positive correlation between EPO and HIF-1α in serum(P<0.05), and between EPO and HIF-1α in aqueous humor(P<0.05). Spearman analysis showed that the disease severity score of AAU patients was positively correlated with the levels of EPO and HIF-1α in serum and aqueous humor(P<0.05). CONCLUSION: EPO and HIF-1α are highly expressed in serum and aqueous humor of AAU patients, and they are closely related. The two are closely related to the disease severity score, and should be paid attention to clinically.

Abstract:AIM:To investigate the efficacy and safety of different fillers combined with vitrectomy and internal limiting membrane stripping in the treatment of idiopathic macular hole(IMH).METHODS: This retrospective study included 117 patients(117 eyes)with IMH who were admitted to the department of ophthalmology in the hospital between July 2018 and March 2020. Both groups were treated with vitrectomy combined with internal limiting membrane stripping. Sixty-five patients(65 eyes)receiving air filling were included in the air group, while 52 cases(52 eyes)receiving C3F8 filling were included in the C3F8 group. Re-examination was performed before operation and at 1, 2, and 3mo after operation. The rate of hole closure, closed shape, visual acuity, central macular thickness(CRT), exterior limiting membrane(ELM)defect diameter, ellipsoid band defect diameter, intraocular pressure, and the incidence of postoperative complications at the last follow-up were counted. RESULTS: The postoperative air absorption time of air group and C3F8 group was 8.55±2.17d and 25.74±7.41d, respectively(P<0.05). The macular hole closure rates in air group and C3F8 group were 95.4% and 98.1%, respectively(P>0.05). There were no significant differences in the proportions of different shapes of closed holes between the two groups(P>0.05). Visual acuity of the two groups was significantly improved at 3mo after operation(P<0.001). There were no significant differences in LogMAR visual acuity and visual acuity changes between air group and C3F8 group(P>0.05). The CRT was increased significantly after operation(P<0.001), and the diameters of ELM defect and ellipsoid band defect were reduced(P<0.001). There were no significant differences in above indicators between the two groups(P>0.05). There was no significant difference in intraocular pressure between the two groups before and after treatment(P>0.05). No serious complications were observed in the two groups. CONCLUSION: Vitrectomy and internal limiting membrane stripping combined with air filling and C3F8 filling are effective and safe in the treatment of IMH. Clinically, the operation mode can be selected according to the actual situation.

Abstract:AIM:To compare the changes of macular microcirculation in eyes with idiopathic and diabetic macular epiretinal membrane(ERM)before and after pars plana vitrectomy(PPV), and to evaluate the prognosis of the two types of ERM.METHODS:We conducted a retrospective study on 24 patients(24 eyes), 12 patients(12 eyes)with idiopathic macular epiretinal membrane(iERM)and 12 patients(12 eyes)with diabetic macular epiretinal membrane(dERM)who underwent PPV combined with ERM and internal limiting membrane(ILM)peeling from April 2020 to July 2020. In addition, 16 contralateral healthy eyes of iERM patients who underwent PPV combined with ERM and ILM removal from September 2019 to July 2020 were selected as the normal control group. All patients were followed up for more than 3mo. The area of foveal avascular zone(FAZ)and the macular vascular density(MVD), including superficial macular vascular density(SVD)and deep macular vascular density(DVD)were compared before and after surgery. And the prognosis was also analysed.RESULTS: The area of FAZ in the iERM group and dERM group before surgery were significantly smaller than that in the control group(P<0.05); The total SVD in the iERM and dERM groups were lower than that in the control group, and the dERM group was lower than that in the iERM group, but no statistically significant difference was found. The total DVD in the iERM and dERM groups was significantly lower than that in the control group(P<0.05). The foveal SVD in the iERM was significantly higher than that in the dERM and control groups, and the foveal DVD in the iERM was significantly higher than that in the control group(P<0.05). The parafoveal SVD in the iERM and dERM groups were lower than that in the control group, but only the difference was obvious between the dERM and the control group(P<0.05). The parafoveal DVD in the iERM and dERM groups were significantly lower than that in the control group(P<0.05). Postoperative visual acuity was significantly improved in the iERM group and dERM group(P<0.05), but the SVD was barely changed. The total and parafoveal DVD in the iERM group were statistically higher than those before surgery(P<0.05). DVD in the dERM group was higher than it was before surgery, but with no statistically difference. There were no differences in the visual acuity, SVD and DVD between the iERM and dERM groups after operation.CONCLUSION: The changes of macular microcirculation in dERM were more obvious than those in iERM. DVD in the iERM patients was improved at the early stage after operation, while the improvement was not obvious in the dERM patients.

Abstract:AIM: To observe and quantitatively analyze the thickness of macular ganglion cell inner plexiform layer(GCIPL)and the characteristics of superficial retinal capillaries vessel density in different stages of diabetic retinopathy(DR)by optical coherence tomography(OCT)and optical coherence tomography angiography(OCTA).METHODS: A retrospective case-control study. Thirty-three patients with diabetic(54 eyes)were selected as the DR group from December 2019 to May 2020. Among them, six patients(8 eyes)as non-diabetic retinopathy(NDR)group, eighteen patients(28 eyes)as non-proliferative diabetic retinopathy(NPDR)group and nine patients(18 eyes)as proliferative diabetic retinopathy(PDR)group according to fundus conditions. Eighteen healthy volunteers(26 eyes)without eye disease were selected as the normal group. The macular GCIPL thickness and the values of vascular linear density(vascular density, VD)and density of vascular perfusion(perfusion density, PD)in the superficial retinal capillaries vessels in each quadrant of macular region were observed and quantitatively analyzed in DR patients with different stages. RESULTS: The VD, PD and minimum thickness of GCIPL in each quadrant of DR group was lower than that of the healthy control group(P<0.05). The minimum thickness of GCIPL in macular area and the VD of superficial retinal capillaries in each quadrant decreased significantly in patients with different stages of diabetic retinopathy(P<0.01). The inferior VD of superficial retinal capillaries vessels had the highest diagnostic value for DR(AUC=0.807, optimal diagnostic threshold value of 18.60 mm-1, sensitivity of 0.923, specificity of 0.648). The minimum thickness of GCIPL in macular area of DR patients was positively correlated with VD of superficial retinal capillaries vessels in each quadrant(r=0.342, 0.480, 0.384, 0.342, all P<0.05). CONCLUSION: OCT combined with OCTA can provide repeatable and quantifiable detection methods and monitoring indicators for early assessment and regular follow-up of DR progress.

Abstract:AIM:To explore the serum retinol binding protein 4(RBP4), inflammatory index neutrophil to lymphocyte ratio(NLR), platelet to lymphocyte ratio(PLR)in patients with type 2 diabetes mellitus(T2DM)after diabetic retinopathy(DR)levels and factors affecting the occurrence of DR in patients. METHODS: The clinical data of 142 patients with T2DM who reached the standard of blood glucose control in our hospital from February 2017 to February 2020 were analyzed retrospectively. According to the results of fundus angiography, the patients were divided into Normal group(n=74), NPDR group(n=36)and PDR group(n=32). Compared the general data and blood test indexes of the three groups, and analyzed the factors affecting the occurrence of DR by multivariate Logistic regression analysis. Constructed a line chart prediction model to predict the occurrence of DR and evaluated its predictive efficiency. RESULTS: The course of DM, serum GH, IGF-I, LDL-C, UA, RBP4, NLR and PLR in PDR group were significantly higher than those in Normal group and NPDR group, while C-P and 2h C-P were significantly lower than those in Normal group and NPDR group. The course of disease >12a, IGF-I >145μg/L, C-P <0.75ng/mL, UA >245ng/mL, RBP4 >54mg/L, NLR >1.8 and PLR >110 were independent risk factors for DR. The line chart model has high degree of differentiation and calibration, and has good prediction efficiency. CONCLUSION: In addition to the common risk factors such as the course of DM, IGF-I, C-P and UA, the increase of RBP4, NLR and PLR is also related to DR, which may be involved in the occurrence and development of DR.

Abstract:AIM:To observe the long-term effect of Ultra Q:YAG vitreous ablation in the treatment of floaters, and to evaluate the advantages of Ultra Q:YAG over traditional Nd:YAG laser. METHODS: Retrospective study. Totally 112 patients(130 eyes)were diagnosed with vitreous opacity were included and treated with laser vitreous ablation in our hospital from May 2018 to January 2020. All patients were performed the laser treatment for vitreous ablation and divided into groups A and B by different laser types. Group A(60 patients, 70 eyes)underwent Ultra Q:YAG vitreous ablation, and group B(52 patients, 60 eyes)underwent traditional Nd:YAG laser treatment. Then, we divided subgroups by the morphology of vitreous floaters. Subgroup A1(45 patients, 52 eyes)and subgroup B1(30 patients, 38 eyes)both with the morphology of Weiss ring, floccule and dense membrane; Subgroup A2(15 patients, 18 eyes)and subgroup B2(22 patients, 22 eyes)with the morphology of filiform and mesh. We observed the difference of frequency and visual improvement by patients compared to baseline.RESULTS: BCVA: There was no significant difference between groups A1 and A2, groups B1 and B2, group A and group B at baseline(P>0.05). After treatment, there were statistically significant differences in BCVA between group A and group B at 2wk and 1mo. There were statistically significant differences between group A1 and group A2 at 1, 6 and 12mo(P=0.019, 0.042, <0.001). The effect of the laser treatment was significantly different between the two groups, group A was better than group B(P=0.006), group A1 was significantly better than that in group A2(P<0.001). Compared to traditional Nd:YAG laser, Ultra Q:YAG laser requires less frequency of laser treatment(P<0.001), and had no significant relationship with vitreous opacity(P>0.05). CONCLUSION: Ultra Q:YAG is easier to operate, safer and has better subjective symptom improvement than traditional Nd:YAG laser treatment of vitreous floaters, especially for the patients with Weiss ring, floccule and dense membrane.

Abstract:AIM: To investigate the expression of different kinds of transforming growth factors beta- 1(TGF- β1)and changes of activin receptor-like kinase(ALK)in pterygium and normal conjunctiva tissues. METHODS: A total of 40 cases(40 eyes)of pterygium patients who underwent surgical treatment in our hospital were selected. In the same period, 40 cases(40 eyes)of normal conjunctiva tissues removed from the eye due to cataract surgery were selected. The expression of TGF-β1 receptors(ALK1/ALK5)in pterygium and normal conjunctiva tissues was detected by immunohistochemistry, with the proportion of positive staining cells counted. The expression of ALK1 and ALK5 mRNA and their proteins were quantified by reverse transcription polymerase chain reaction(RT-PCR)and Western Blot, respectively.RESULTS: According to immunohistochemistry results, the ALK1 expression level was increased more distinct in pterygium group, compared to the normal conjunctiva group, and it was detected throughout the full-thickness pterygium epithelial cells, while only in the basal layer of epithelial cells in normal conjunctiva tissues; the ALK5 was detected in the basal layer of epithelial cells in both groups, while its level was decreased in the pterygium group compared to normal conjunctiva group. There was significant difference in the proportion of ALK1 and ALK5 positive cells between the two groups(all P<0.05). The expression of the ALK1 mRNA and its protein in the pterygium tissues were significantly elevated, while the ALK5 mRNA level and its protein was significantly decreased, compared with the normal conjunctival group(P<0.05).CONCLUSION: Compared with the normal conjunctiva tissues, the expression of ALK1 and ALK5 in pterygium tissues was increased and decreased, respectively. This indicated different activation status of TGF-β signaling pathway, providing experimental evidence for further study on the pathogenesis of pterygium.

Abstract:AIM: To explore the changes and influencing factors of effective optical zone(EOZ)after femtosecond laser small incision lenticule extraction(SMILE)in patients with different degrees of myopia.METHODS:Retrospective study. From October 2019 to October 2020, fifty patients(92 eyes)with myopia who underwent SMILE surgery in the Affiliated Eye Hospital of Nanchang University and whose preoperative optical zone diameter was designed to be 6.5mm were selected. According to the preoperative equivalent spherical diopter, the patients were divided into three groups: low myopia group(-0.50D to -3.00D, 18 cases, 34 eyes), moderate myopia group(>-3.00D to -6.00D, 20 cases, 36 eyes)and high myopia group(>-6.00D, 12 cases, 22 eyes). The uncorrected visual acuity, best corrected visual acuity, manifest refraction spherical equivalent, optical zone diameter, corneal Q-value and high-order aberrations(HOA)were collected before and 3mo after operation.RESULTS:The postoperative 3mo EOZ of patients with low, moderate and high myopia were 5.07±0.69, 5.08±0.43 and 4.50±0.58 mm, respectively, and the corneal Q-values were 0.22±0.17, 0.57±0.34 and 0.63±0.73, there were significant differences among the three groups(all P<0.05). The diameter of effective optical zones after operation in all three groups was lower than that predicted by 6.5mm before operation(P<0.001). There were significant differences in postoperative total HOA, spherical aberration(Z40)and vertical coma(Z3-1)among the three groups(P<0.05). The diameter of effective optical zone after SMILE was positively correlated with preoperative manifest refraction spherical equivalent and residual corneal thickness(r=0.357, 0.275,all P<0.05), and negatively correlated with central corneal ablation depth and postoperative corneal Q-value(r= -0.316, -0.353, all P<0.05). After operation, ΔZ40 was negatively correlated with ΔEOZ(r= -0.336, P<0.05).CONCLUSION:The EOZ after SMILE was lower than that expected before operation, and the higher the myopia was, the smaller the optical area was and the more the postoperative corneal spherical aberration increased. In addition, the depth of corneal ablation, residual corneal thickness and aspheric changes of cornea can affect the size of EOZ after operation.

Abstract:AIM: To compare the difference between the actual cutting amount and the preoperative predicted amount of corneal stroma after the small incision lenticule extraction(SMILE), and evaluate the predictability and accuracy of SMILE for corneal stroma. METHODS: Prospective study. A total of 113 myopic patients(220 eyes)who had taken SMILE in the Affiliated Hospital of Yunnan University were selected, and routine examinations were carried out before and 1,3mo after operation, including visual acuity, non-contact tonometer(NCT), spherical equivalents(SE), mean corneal curvature, spherical coefficient of anterior corneal surface and Pentacam anterior segment analysis. All the 102 eyes in the research objects were randomly selected to measure the central corneal thickness(CCT)with the A-supersonic cornea thickness gauge before and 3mo after operation. The actual cutting amount after operation is the difference between the thickness of the thinnest spot of the cornea before and after operation, and the error amount is the difference between the predicted cutting amount before operation and the actual cutting amount after operation. The cutting error amount was observed and its correlation with physiological parameters before operation was analyzed. RESULTS: SMILE had a good performance and the corneal morphology and visual acuity were relatively stable 1 and 3mo after operation. The consistency was good between the data measured by the A-supersonic cornea thickness gauge and the data of the thinnest spot of the cornea in the Pentacam anterior segment analysis, where the difference had no statistical significance(t= -1.877, P=0.063). The difference between the predicted cutting amount before operation(101.36±18.91)μm, and the actual cutting amount 1mo after operation(88.89±18.69)μm and 3mo after operation(84.95±18.64)μm(F=334.65, P<0.01)had statistical significance; There was statistical difference between the cutting amount 1 and 3mo after operation, and the predicted errors before operation [(12.59±9.78)μm and(16.50±9.21)μm]. The cutting amount errors were only correlated with the preoperative equivalent diopter(r=0.299, P<0.01)and(r=0.305, P<0.01). The equivalent diopter at 1 and 3mo after operation was correlated with the cutting amount error at the same time(r=-0.275, P<0.01)(r= -0.306, P<0.01). With the increase of the cutting amount error, the postoperative spherical equivalent shifted to negative.CONCLUSION: The actual cutting amount of corneal stroma after SMILE is smaller than the predicted preoperative cutting amount, and the predicted cutting amount error increases with the increase of preoperative diopter. As the cutting amount error increases, postoperative diopter gradually shifted to negative. The error, however, does not influence the target's visual acuity in the early postoperative period.

Abstract:AIM: To analyze the risk factors of corneal edema after phacoemulsification and intraocular lens implantation in patients with cataract. METHODS: The clinical data of 623 patients with cataract(957 eyes)who underwent phacoemulsification and intraocular lens implantation in our hospital between March 2018 and September 2020 were retrospectively analyzed. Patients with corneal edema observed at any time within the first three days after surgery were included in corneal edema group(82 cases, 82 eyes), and patients without corneal edema were enrolled as non-corneal edema group(541 cases, 875 eyes). The preoperative, intraoperative and postoperative related indexes of the two groups were collected and included in Logistic regression model to screen the high-risk factors. RESULTS: Logistics regression analysis showed that age(OR=1.162), Emery lens nuclear hardness grading(OR=1.301)and perfusion time(OR=1.172)were independent risk factors for corneal edema after phacoemulsification and intraocular lens implantation, and the anterior chamber depth(OR=0.651)were independent protective factors avoiding occurrence(P<0.05).CONCLUSION:The factors involved in corneal edema after phacoemulsification and intraocular lens implantation are complicated in patients with cataract. It is necessary to be vigilant for high-risk patients in clinical practice and take preventive measures during perioperative period so as to promote rapid recovery of prognosis and visual function.

Abstract:AIM: To investigate the efficacy of dexamethasone implant injection in the treatment of persistent diabetic macular edema(DME).METHODS: The clinical data of 30 DME patients(30 eyes)after anti-vascular endothelial growth factor(anti-VEGF)agents from June 2019 to January 2020 were retrospectively analyzed. All patients had underwent intravitreal injection of DEX. Best corrected visual acuity(BCVA), intraocular pressure(IOP), central macular thickness(CMT)and adverse events were recorded.RESULTS:BCVA(LogMAR)was significantly improved from(0.86±0.47)to(0.57±0.53, 0.42±0.48, 0.43±0.26, 0.45±0.66 and 0.51±0.37)at 1, 2, 3, 4 and 6mo after treatment. CMT improved significantly from baseline(495.64±107.23)μm to(412.57±74.55, 370.21±23.83, 371.53±52.66, 373.28±68.49, 389.35±95.61)μm 1, 2, 3, 4 and 6mo post-injection. The drug reached its peak efficacy 2mo after administration. 4 eyes were given repeated injection at 3mo, 5 eyes were given at 5mo and 2 eyes were given at 6mo following the primary injection. Cataract progression was showed in 1 case. 4 patients demonstrated IOP levels above 22mmHg and were mostly controllable by IOP-lowering medications. None of patients showed any adverse events at 6mo of follow-up.CONCLUSION: Dexamethasone implant injection showed significant BCVA and CMT improvement. DEX injection may be utilized as an effective DME therapy for patients who are persistent after anti-VEGF treatment.

Abstract:AIM: To investigate the optimal height of anastomotic in endoscopic dacryocystorhinostomy.METHODS: This was a prospective randomized controlled study. Totally 229 patients(255 eyes)who were treated with endoscopic dacryocystostomy in Hankou Eye Hospital of Wuhan Aier from January 2019 to August 2020 were selected as the research objects. Including three types of patients: acute dacryocystitis, chronic dacryocystitis and nasolacrimal duct obstruction. Each type of patients were randomly divided into four groups: A, B, C and D. The No.7 lacrimal passage probe was inserted from the upper lacrimal puncta into the bone hole of lacrimal passage stoma. The probe head was close to the upper end of the bone hole, and the angle between the probe and the horizontal line of inner and outer canthus was measured α. Group A α1: -15°to +15°; Group B α2: +16°to +30°; Group C α3: +31°to +45°; Group D α4: +46°to +75°. All patients were followed up to 3mo postoperative. The amount of intraoperative blood loss, operation time and postoperative efficacy were recorded.RESULTS: At 3mo postoperative, the intraoperative blood loss in Group A was more than that in Groups B, C and D, and the operation time was the longest. The operation time of Group D was shorter than that of Groups A, B and C(all P<0.05), but there was no significant difference between Groups B and C(P>0.05). The curative effect of Group B was the best and the Group D was the worst(all P<0.05), and there was no significant difference between Group A and Group C(P>0.05).CONCLUSION: The probe angle from +16°to +30°was the optimal height of anastomotic in endoscopic dacryocystorhinostomy.

Abstract:AIM: To observe the nerve morphological changes in cornea of fluorometholone eye drops combined with sodium hyaluronate eye drops in the treatment of dry eye of Sj&#xF6;gren's syndrome by in vivo confocal microscopy(IVCM).METHODS: From January 2017 to July 2020, totally 52 dry eye patients(104 eyes)of Sj&#xF6;gren's syndrome in our hospital were enrolled and were randomly divided into two groups: 26 patients(52 eyes)in the experimental group were treated with 0.1% fluorometholone eye drops and sodium hyaluronate eye drops, while 26 patients(52 eyes)in the control group were treated with sodium hyaluronate eye drops alone. The diameter of central corneal nerve fibers, the number of nerve beads, the score of nerve tortuosity, tear film break-up time(BUT), Schirmer I test(S I t)and non-contact intraocular pressure were measured before treatment and 2, 4 and 12wk after treatment.RESULTS: There were no significant differences in the results of the diameter of central corneal nerve fibers, the number of nerve beads, the score of nerve tortuosity, BUT, S I t and non-contact intraocular pressure between the two groups before treatment(P>0.05). At 2, 4 and 12wk after treatment, the BUT prolonged in the experimental group compared with the control group(P<0.05); At 12wk after treatment, the diameter of corneal nerve fibers increased, the number of nerve beads and the nerve tortuosity score decreased, the S I t increased in the experimental group compared with the control group(all P<0.05), and there were no significant difference in non-contact intraocular pressure(P>0.05).CONCLUSION: Fluorometholone eye drops combined with sodium hyaluronate eye drops is safe and effective in the treatment of Sj&#xF6;gren's syndrome related dry eye, and contribute to corneal nerve recovery.

Abstract:AIM: To investigate the effect of rigid contact lenses with multifocal design on binocular visual function in myopic patients. METHODS: A self-control study before and after. Fifteen myopic students of North Sichuan Medical College were recruited as test persons between July and August 2020. The subjects first wore framed glasses for binocular visual function examination, then wore single vision and multifocal rigid contact lenses(1wk apart), and binocular visual function examination was performed after wearing each lens for 2wk. One-way analysis of variance was used to compare the binocular visual function of multifocal rigid contact lens, single vision rigid contact lens and frame glasses.RESULTS: There were no significant differences among the three lenses in stereopsis, far horizontal phoria, far positive fusional vergence, far negative fusional vergence, near negative fusional vergence, convergence and dispersion flexibility, convergence near point, adjustment magnitude, adjustment flexibility and negative relative adjustment(P>0.05). Compared with frame glasses, multifocal rigid contact lenses had significant difference in near horizontal phoria, near positive fusional vergence, accommodation lag, positive relative accommodation increased and AC/A decreased(P=0.023,0.048,0.001,0.013,0.046); Compared with single vision rigid contact lenses, multifocal rigid contact lenses had significant difference in near horizontal phoria, accommodation lag, positive relative accommodation increased and AC/A decreased(P=0.014,<0.001,0.001,0.009).CONCLUSION:Wearing multifocal rigid contact lenses can lead to near horizontal phoria, accommodation lag, positive relative accommodation increase and AC/A decrease, which may have some influence on proximal use of eyes. These expected changes should be considered in clinical application in order to evaluate and manage patients correctly.

Abstract:AIM:To determine the incidence of myopia and related risk factors among Chinese school-age children in Suqian city.METHODS: The data were collected from 42 primary schools in Suqian, Jiangsu Province with a stratified cluster sampling method. According to the physical examination information in 2019 and 2020, a total of 12 452 school-age children were included. Based on their two-year information of visual acuity, diopter, height and weight, this study analyzed the incidence of myopia under different demographic factors and related risk factors among school-age children.RESULTS: It was found that the overall incidence rate of myopia among school-age children was 24.63% in Suqian(all P<0.01). Higher incidence rates of myopia occurred in the urban children than rural children(26.24% vs 21.31%), in females than males(27.05% vs 22.91%)and in overweight children than normal ones(25.82% vs 23.92%). The incidence also showed an increasing trend with age(χ2trend=236.421,P<0.01). For the growth and development, the annual increases of height and weight in incident myopia were greater than that in persistent non-myopes(allP<0.01). The Logistic regression analysis confirmed that urban children(OR=1.541), females(OR=1.325), elder-ages(OR=2.827)and overweight children(OR=1.191)were at higher risk of myopia onset(all P<0.01).CONCLUSION: The incidence of myopia among school-age children from Suqian City in 2020 was alarming. And urban children, females, elder and overweight school-age children were at relatively higher risk of myopia onset. Additionally, the rapid increase of height and weight over a period of time may be one of the warning signals for myopia onset. The factors impacting on the myopia onset among children warrants further studies.

Abstract:AIM:To evaluate the effect of stereoscopic 3D/4D technology as a visual training system combined with refractive correction and masking therapy for adult amblyopia.METHODS: A retrospective study. From July 2018 to October 2020, totally 41 cases(57 eyes)adult amblyopia in our hospital were divided into severe, moderate, mild group, effect of stereoscopic 3D/4D technology training were analyzed after 6mo, including the best corrected visual acuity, visual evoked potentials, stereoscopic function.RESULTS: After treatment, best corrected visual acuity of the patients were significantly improved, the effective rate of severe, moderate, mild amblyopia group were 69%, 88%, 75%, the total effective rate was 79%. The stereoscopic function of the patients were significantly improved, the effective rate of severe, moderate, mild amblyopia group were 62%, 75%, 80%, the total effective rate was 74%. The P100 wave latency periods of the visual evoked potentials were shortened after 6mo treatment, and the P100 wave amplitudes were increased(P<0.05). CONCLUSION:Stereoscopic 3D/4D technology training combined with refractive correction and masking therapy can effectively treat the adult amblyopic.

Abstract:AIM: To analyze the clinical efficacy of neonatal dacryocystitis treated by the lacrimal passage probing(LPB)in ambulatory surgery mode during the prevalence of the COVID-19, and to provide a theoretical basis for the development and promotion of daytime operation mode of LPB in neonatal dacryocystitis.METHODS: The information of 215 cases with neonatal dacryocystitis treated by LPB with ambulatory surgery mode was analyzed retrospectively, including the cure rate, the incidence of complications and adverse reactions, as well as the reasons for not arriving at the hospital after appointment.RESULTS: All patients accomplish LPB surgery and daytime operation management successfully. The success rate of LPB for neonatal dacryocystitis with ambulatory surgery mode was 99.6%, with few postoperative complications and adverse reactions. The reason why the children did not arrive at the hospital after appointment was mainly due to the sickness being catching a cold, pneumonia, diarrhea and other diseases, otherwise, they had to cancel or postponed the appointment.CONCLUSION: In the course of the prevalence of the COVID-19, LPB in the treatment of neonatal dacryocystitis in ambulatory surgery mode is safe, effective and feasible. It can reduce hospitalization expenses, shorten hospitalization time, and is more conducive to the prevention and control of COVID-19, which is worthy of popularization and application.

Abstract:AIM:To investigate the main clinical features, pathogen distribution and drug sensitivity of lacrimal angiitis, and to provide evidence for clinical diagnosis and treatment.METHODS:Retrospective study. A total of 45 patients(45 eyes)diagnosed with lacrimal angiitis in Hebei Eye Hospital from December 2016 to October 2020 were selected to analyze the general information, clinical manifestations and previous treatment history, bacterial culture results, and drug sensitivity test results.RESULTS:All 45 patients had monocular disease, including 21 eyes with tears, increased secretion, conjunctival congestion in inner canthus, 14 eyes with red and swollen inner canthus, 6 eyes similar to eyelid cyst, and 4 eyes were found and diagnosed during routine preoperative examination. 27 eyes were previously diagnosed with other eye diseases, and the misdiagnosis rate was 60.0%. The positive rate of bacterial culture was 80.0%(36/45), Staphylococcus epidermidis was the most common, followed by Streptococcus; 52.8%(19/36)of the patients were infected with multidrug-resistant bacteria. The sensitivity rate of bacteria to fluoroquinolones(82.9%, 97/117)was higher than that of aminoglycosides(70.1%, 68/97)and cephalosporins(68.1%, 111/163). Except vancomycin, rifampicin, levofloxacin and chloramphenicol were highly sensitive to Gram-positive bacteria.CONCLUSION: Staphylococcus epidermidis is the most common pathogen of dacryocystitis, followed by Streptococcus. Levofloxacin and rifampicin can be the first choice antibiotics for local anti-infection. Rational drug use can reduce the formation of multidrug-resistant bacteria. The cure rate can be improved by complete removal of stones by incision and plasty of lacrimal canaliculus.

Abstract:AIM: To discuss the efficacy of fresnel prism in different types of binocular diplopia patients.METHODS: This retrospective study reviewed 20 patients who received fresnel prism treatment between June 2018 and November 2020 in Jiangmen Central Hospital. Eight of them were diagnosed as acute acquired comitant esotropia, five patients were thyroid-associated ophthalmopathy, and seven patients were eye misalignment caused by cranial nerve palsies. The outcome measures were deviation, near stereoacuity, asthenopia and driving ability at pre-treatment and post-treatment.RESULTS: The deviations were decreased after treatment. There were significant differences between pre-treatment and post-treatment(P<0.05). The patients with acute acquired comitant esotropia or eye misalignment caused by cranial nerve palsies recovered near stereoacuity meanwhile significant difference between before and after treatment(P<0.05). There were no significant differences between before and after treatment in patients with thyroid-associated ophthalmopathy(P>0.05). Thirteen patients recovered in the driving ability while fifteen patients were cured of asthenopia. There were significant differences between before and after treatment(all P<0.05).CONCLUSION: Fresnel prism treatment could decrease deviations in binocular diplopia patients, improved near stereoacuity and quality of life.