Abstract:AIM: To determine the ocular biometric measurements and central corneal thickness(CCT)in Nigerian children so as to have a reference database.METHODS:A hospital-based observational study of a cross-section of children seen consecutively between November 2017 and January 2018. The socio-demographic data of patients, visual acuity(VA)was assessed with LogMAR charts and Lea charts according to age group. Examination under anesthesia(EUA)was carried out for children eight years and below. Anterior and posterior segments examination through dilated pupil were done. Corneal diameters(CD)were assessed using calipers. Intraocular pressures(IOP)were examined using hand held tonometer, CCT and axial length(AL)were measured using the ultrasonic pachymeter. Cycloplegic refraction was carried out after clinical examination. Data were entered into and analysed using SPSS version 17 to generate results through descriptive statistics. Frequencies and cross tabulations of variables were done(P<0.05).RESULTS:Sixty-six children with 132 eyes, of ages between 3-16(mean: 9.13±3.70)years were studied. Male with female ratio was 1:1.7. The modal age group range was 6-10 years(42.4%). Most of them were primary school students 36(54.5%). The predominant parents' occupation was traders/unskilled workers(51.6%)and the professionals/civil servants(30.3%). The mean right and left VA were 0.45±0.46 and 0.45±0.44(LogMAR)respectively. The mean right and left horizontal corneal diameters(HCD)were 10.5±1.6 mm and 10.37±1.45 mm respectively. The mean right and left vertical corneal diameters(VCD)were 9.7±1.2 mm and 9.7±1.3 mm respectively. The mean right and left CCT were 556.71±2.61 μm and 556.47±45.53 μm respectively. Myopia 23(34.8%), myopic astigmatism 18(27.3%)and simple astigmatism 16(24.2%)were the commonest types refractive error. No significant associations were observed between CCT and HCD(P=0.739), VA(P=0.058)and refractive error(P=0.199). However, CCT slightly significantly correlated with the age groups(P=0.055).CONCLUSION: Mean values for CCT, IOP and CD are known for the first time in Nigerian children. No significant association was seen between CCT and VA, CD and refractive errors. Further studies are required to ascertain findings.

Abstract:AIM: To compare the clinical effects of two brands of Toric intraocular lens(IOL)used in surgical correction of cataract with corneal astigmatism.METHODS: Totally 35 patients(50 eyes)with corneal astigmatism who underwent ophthalmic surgery from April 2019 to July 2019 were retrospectively analyzed. Among them, 25 eyes of 20 patients were implanted with Rayner 623T, while 25 eyes of 15 patients with Alcon AcrySof Toric IOL. Three months after surgery, the uncorrected distance visual acuity(UCDVA), best corrected distance visual acuity(BCDVA), residual astigmatism, rotational degree of intraocular lens, contrast sensitivity, objective visual quality and the National Eye Institute 25-Item Visual Function Questionnaire(NEI VFQ-25)scale score were compared. Vector analysis was performed using the Alpins method.RESULTS: The mean postoperative UCDVA(LogMAR)and BCDVA(LogMAR)in the Rayner group were 0.17±0.20 and 0.08±0.15, respectively(P>0.05), while those in the Alcon group were 0.21±0.16 and 0.10±0.11, respectively(P>0.05). The mean residual astigmatism in the Rayner group was(-0.57±0.24)D while that in the Alcon group was(-0.50±0.28)D(P>0.05). There was no statistically significant difference between the two groups in IOL rotational stability, vector analysis parameters, contrast sensitivity and objective visual quality(P>0.05). The NEI VFQ-25 scale score was 85.16±5.91 in the Rayner group while it was 82.08±6.16 in the Alcon group(P>0.05).CONCLUSION: The two brands of Toric IOL-Rayner 623T and Alcon AcrySof Toric showed no significant difference in their clinical outcomes.

Abstract:AIM: To quantitatively assess choroid vascular sublayers in women with pre-eclampsia(PE)compared to healthy pregnant women.METHODS: This cross-sectional observational study enrolled 100 subjects, including 40 healthy non-pregnant women, 23 healthy pregnant women, and 37 women with PE. Spectral-domain optical coherence tomography(SD-OCT)was used to measure the choroidal thickness(CT)at the fovea and four additional sites that were 750 μm nasal/temporal or 1 500 μm nasal/temporal to the fovea, and designated as subfoveal choroidal thickness(SFCT), N750, T750, N1500, and T1500, respectively. The thickness of two choroidal vessel layers, Sattler's and Haller's layers, also were quantitatively assessed. RESULTS: No significant differences in mean age or spherical equivalent were observed among the three groups(P=0.240, 0.338). No difference was observed in gestational ages between the healthy pregnant women and PE patients(P=0.783). Significant differences were observed in large choroidal vessel thickness(LCVT), medium choroidal vessel thickness(MCVT), and SFCT at the five sites among the three groups(P<0.05). Compared with normal non-pregnant women, a significant increase in LCVT, MCVT, and SFCT was detected at the five sites in healthy pregnant women(P<0.05). LCVT and SFCT in PE patients were significantly greater at the five sites compared to normal pregnant women(P<0.05), while MCVT was not different(P=0.709).CONCLUSION: This study demonstrated that the vascular sublayer thickness of the choroid was significantly increased in pregnancy and PE. Moreover, the increase in CT thickness might be due to the thickening of Haller's layer. We also observed that the nasal CT increased more than the temporal CT in PE patients and normal pregnant women. We suggest that parasympathetic and sympathetic mediated regulation and nonvascular smooth muscle cells might play a role in the choroidal vascular sublayer thickness variations observed in pregnancy and PE.

Abstract:AIM: To detect the visual dysfunction, and investigate the changes of Tau and its phosphorylated Ser396/Ser404 forms in retinas and optic nerves in traumatic optic neuropathy(TON)model rats by using FVEP technique.METHODS: Totally 30 SD rats were conducted FVEP electrode implantation. One week later, all rates were implemented TON operation with the optic nerve of left eye crushed and the optic nerve of right eye exposed(sham-operated). FVEP detections were performed respectively in these TON model rats at 1, 3, 7, 14, and 28d post crush, with 5 rats tested at each time point. After FVEP tests were taken, rats were sacrificed and then retinas and optic nerves of left eyes were separated for detecting the expression levels of Tau and pTau-Ser396/404 by Western Blot.RESULTS: Typical FVEP waves were observed in the sham-operated eyes. Compared to the sham group, the N2 waves were significantly delayed and the amplitude of N2-P2 were greatly reduced at each time point in the operation eyes. However, the differences of N2 wave and the amplitude reduction of N2-P2 were not significant at each time point after crush. The contents of total Tau protein in retinas of TON rats sharply decreased at 1d post crush, briefly recovered at 7d post crush, and remained a slightly lower level than normal condition till 28d. The changes of pTau-Ser396/404 were consistent with the changes of total Tau in retains and the Ser396 was the main phosphorylation site. However, the total Tau contents in optic nerves of TON rats increased gradually, and peaked at the 14d post crush and remained till 28d. The changes of pTau-Ser396/404 were similar to the changes of total Tau in optic nerves, which peaked at 7d post crush. However, Ser404 was the main phosphorylation site of Tau in optic nerves.CONCLUSION: The related indexes of N2 and P2 waves in FVEP can be used to detect the visual dysfunction in TON rats. After TON, the content changes of total Tau in retinas and optic nerves were much different while the changes of pTau-Ser396/404 followed the alterations of total Tau in the two locations. However, the main phosphorylation site of Tau was differnet according to the locations.

Abstract:AIM: To explore the effects of heat shock protein 47(HSP47)siRNA on biological behaviors of human Tenon capsule fibroblasts(HTCF)cells cultured in vitro and the expression level of transforming growth factor-β1(TGF-β1).METHODS: HTCF were cultured in vitro and divided into blank control group, empty vector group and transfection group. In transfection group, interfering siRNA sequences were designed and synthesized based on the HSP47 gene sequences, vectors were constructed and introduced into HTCF. The empty vector group was introduced with empty vectors. The expressions of HSP47 mRNA and protein in cells were detected by RT-PCR and Western blot. The proliferation, apoptosis, invasion and migration of cells were detected by clone formation assay, flow cytometry, Transwell method and scratch test. The expressions of proliferation, apoptosis, invasion and migration proteins, and TGF-β1 were detected by Western blot.RESULTS: Compared with empty vector group, expression of HSP47 mRNA and protein, clone formation rate, cell healing rate, number of invasive cells, relative expression levels of Ki67, N-cadherin and TGF-β1 were significantly decreased in transfection group(P<0.05), relative expression level of E-cadherin protein was significantly increased(P<0.05), but there was no difference in apoptosis rate, and relative expression levels of Bcl-2 and Bax(P>0.05).CONCLUSION: HSP47 siRNA can reduce proliferation, invasion and migration abilities of HTCF cells by inhibiting the expression of TGF-β1 protein, without significant effects on the apoptosis of HTCF cells.

Abstract:AIM: To explore the differentiation of bone marrow-derived mesenchymal stem cells from peripheral blood to the retina and the expression of ciliary neurotrophic factor(CNTF). We also investigate the mechanism by which Bu Shen Yi Jing Fang could treat dry age-related macular degeneration(ARMD). METHODS:C57BL/6 mice were administered with sodium iodate(NaIO3)by tail intravenous injection. One day after modeling, 3×106 green fluorescent protein labeled bone marrow-derived mesenchymal stem cells(GFP-BMSCs)were injected into the tail vein. The injected mice were randomly divided into distilled water group and Bu Shen Yi Jing Fang group according to random number table, and 12 mice in each group. The mice were intragastrical administrated with either Bu Shen Yi Jing Fang solution or distilled water every day. Twelve healthy C57BL/6 mice were fed regularly as the normal group. At 14d after the treatment, the differentiation of GFP-BMSCs in retina was determined by immunofluorescence, and the expression of CNTF in the retina was detected by immunofluorescence and quantitative real-time PCR.RESULTS: Immunofluorescence staining showed that there were more glial fibrillary acidic protein(GFAP)and GFP double-stained positive cells in the Bu Shen Yi Jing Fang group than in the distilled water group(P<0.01), and the positive rate of retinal pigment epithelium 65(RPE65)was not significantly different between two groups(P>0.05). There were no Rhodopsin and GFP double-stained positive cells in the two groups. Immunofluorescence and quantitative real-time PCR showed that the expression of CNTF in the Bu Shen Yi Jing Fang group was higher than which in the distilled water group(P<0.05). CONCLUSION: Bu Shen Yi Jing Fang facilitated the differentiation of peripheral blood stem cells into glial cells in the retina and the expression of CNTF, which might be one of the mechanisms of Bu Shen Yi Jing Fang in the treatment of dry ARMD.

Abstract:AIM: To compare the effectiveness of diode transscleral cyclophotocoagulation(CPC)and transscleral cyclocryotherapy(CCT)for the intraocular pressure(IOP)control and postoperative complications of absolute glaucoma. METHODS: This was a prospective case observation study. Totally 85 cases with absolute glaucoma which were admitted by Tianjin Eye Hospital were randomly assigned in 2 groups to receive either CPC or CCT. IOP, the numbers of anti-glaucoma medication, inflammatory reaction of anterior segment and postoperative ocular pain which was evaluated by Visual Analogue Scale(VAS)in two groups were recorded at eight points in time: the day before surgery and 1d, 3d, 1wk, 2wk, 1mo, 3mo and 6mo after surgery. The generalized estimated equation was used to compare all the indexes before and after operation and the difference of success rate between the two surgical methods. RESULTS: Compared with CPC group, IOP of CCT group decreased less than that before surgery at 1, 3d, 1, 2wk, 1mo after surgery, VAS score decreased less than that before surgery at 3d, 1, 2wk, 1mo after surgery, and the number of anti-glaucoma drugs decreased less than that before surgery at 1, 3d, 1, 2wk after surgery(P<0.05). Compared with CPC group, the complete success rate of CCT group was higher than that at 1d after surgery at 3d, 1, 2wk, 1, 3, 6mo after operation, but only the difference of 3, 6mo after surgery was statistically significant(P<0.05). Compared with CPC group, anterior chamber flash grade of CCT group increased more than that before surgery at 3d, 1, 2wk, 1mo after surgery, conjunctival congestion grade increased more than that before surgery at 1, 3d, 1, 2wk after surgery, corneal edema grade increased more than that before surgery at 3d, 1, 2wk, 1mo after surgery(P<0.05).CONCLUSION: Compared with CPC, the rate of IOP reduction after CCT was slower, the inflammatory reaction of anterior segment and discomfort of eyeball were more severe and lasted longer. Therefore, the duration of anti-inflammatory drugs and anti-glaucoma medications should be extended after the surgery.

Abstract:AIM: To explore the value of frequency threshold optical coherence tomography(OCT)in the diagnosis of primary open angle glaucoma optic nerve injury. METHODS: Eighty patients with early primary glaucoma who were admitted to the hospital between January 2018 and March 2020 and 100 healthy subjects were selected as the study subjects. Patients with primary open angle glaucoma were divided into early group, middle group and late group. OCT was used to measure the thicknesses of upper, lower, nasal, bitemporal peri-papillary retinal nerve fiber layer(pRNFL)and upper and lower macular ganglion cell complex(mGCC)in each group. The mean deviation(MD)of visual field was determined through perimetry. The OCT parameters and perimetry parameters were compared among groups. Spearman correlation analysis was performed to analyze the correlation between OCT parameters and visual field defects, and the receiver operating characteristic(ROC)curve was used to calculate the value of OCT parameters in diagnosing primary open angle glaucoma. RESULTS: There were 24 cases, 39 cases and 17 cases in the early group, middle group and late group, respectively. There were statistically significant differences in pRNFL and mGCC among 3 groups(P<0.05).The upper, lower, average pRNEL and the upper, lower, and average mGCC of patients in the early group of a third-class hospital were significantly lower than those of the control group, and the parameters of pRNFL and mGCC in each position of the mid-stage and late group were significantly lower than those of the control group. The upper, lower, nasal pRNFL, average pRNFL, upper, lower and average mGCC of the late group of glaucoma patients were significantly lower than those of the early group and the middle group. The indicators of the middle group were significantly lower than those of the early group(P<0.05). Spearman correlation analysis showed that pRNFL and mGCC parameters were negatively correlated with glaucoma severity(P<0.05)ROC curve analysis showed that the areas under the curves of the upper, lower, nasal, bitamporal and average pRNFL for diagnosis of primary open angle glaucoma optic nerve injury were 0.693, 0.846, 0.676, 0.579 and 0.844, respectively. The areas under the curves of upper, lower and average mGCC for diagnosis of primary open angle glaucoma optic nerve injury were 0.542, 0.677 and 0.676 respectively. The area under the curve of average pRNFL combined with average mGCC for the diagnosis of primary open angle glaucoma optic nerve injury was 0.883. CONCLUSION:The pRNFL and mGCC measured by OCT are closely related to the degree of primary open angle glaucoma optic nerve injury. Both have high diagnostic value for glaucoma and can be used clinically for diagnosis and condition assessment.

Abstract:AIM: To explore the effect of corneal limbal trapezoid conjunctival flap incision and modified Parks incision on tear film function and postoperative complications in patients with strabismus.METHODS: A prospective study was conducted in patients with strabismus who had been treated with surgery in the First Affiliated Hospital of Nanyang Medical College between January 2017 and October 2019. The subjects were divided into conjunctival flap incision group(60 cases with 82 affected eyes treated with strabismus surgery via corneal limbal trapezoid conjunctival flap incision)and modified Parks group(62 cases with 83 affected eyes treated with strabismus surgery via modified Parks incision). Therapeutic effects on strabismus were evaluated, and dry eye symptoms were scored before and after surgery. Schirmer I test(SⅠt), tear film break up time(BUT)and cornea fluorescein staining score(FL score)were recorded. Comprehensive ocular surface examination was performed to determine tear river height(TMH)and noninvasive keratograph tear breakup time(NIKBUT). Satisfaction with surgery was surveyed, and adverse reactions were statistically analyzed.RESULTS: Both groups of patients completed the surgery. Totally 80 eyes and 79 eyes of the conjunctival flap incision group and the modified Parks group were basically in normal position(within±10PD), and there was no statistically significant difference in cure rate between the two groups(P>0.05). S I t and BUT of the modified Parks group were significantly higher than those of the conjunctival flap incision group at 7 and 14d after surgery, and the FL score was significantly lower than that of the conjunctival flap incision group at 7d after surgery(P<0.05). TMH of the modified Parks group was significantly higher than that of the conjunctival flap incision group at 14d after surgery, and NIKBUT was significantly longer than that of the conjunctival flap incision group at 7d and 14d after surgery(P<0.05). The overall incidence rates of complications in the conjunctival flap incision group and the modified Parks group were 7.3% and 2.4%, respectively(P>0.05). The overall satisfaction rates of the conjunctival flap incision group and the modified Parks group were 83.3% and 95.2%, respectively(P<0.05).CONCLUSION:Surgeries with corneal limbal trapezoid conjunctival flap incision or modified Parks incision can achieve good correction effects on strabismus, but surgery with modified Parks incision has less effect on tear film stability, with higher surgical satisfaction and better clinical application effect.

Abstract:Diabetes mellitus(DM)is a chronic metabolic disease characterized by sustained hyperglycemia, which can cause systemic macrovascular, microvascular and nervous system complications. The eye is one of the main organs affected by this disease. The ocular complications of DM include DR, however, non-retinal complications are also contained. This review provides an overview of the non-retinal eye diseases associated with DM, including diabetic keratopathy, dry eye, iridocyclitis, glaucoma, cataract, refractive error, optic neuropathy, iridocyclitis, asteroid hyalosis and so on. These ocular diseases may also lead to vision loss and should be taken seriously in diabetic patients.

Abstract:Diabetic retinopathy caused by diabetes is one of the main causes of blindness and one of the most serious complications of diabetes. Recently, many scholars have foundthat in the early stage of diabetes before serious ocular complications, chronic injuries can still occur to anterior ocular tissues such as cornea, conjunctiva, meibomian glands etc. We review the impact of diabetes on the anterior segment of the patient with existing ophthalmologic examination techniques, which can help clinicians identify patients with early diabetes and then intervene and refer them, thus reducing the risk of long-term serious complications of diabetes.

Abstract:Mucin is the key factor to determine the stability of tear film and is crucial to maintain ocular surface homeostasis. Goblet cells can alter the secretion of mucin in corneal and conjunctival epithelial cells, contributing to dry eye disease and ocular surface inflammation. Based on the understanding of mucin biology, this review makes a summary on the potential relationship between mucin dysfunction and ocular surface diseases, and we hope to deepen the understanding of the importance of mucin and select the most appropriate treatment plan on the basis of ocular surface diseases.

Abstract:In modern society, children and adolescents are experiencing an increasing incidence of myopia, resulting from the combined influence of genetic factor and environmental factor. Despite the influence of genetic factor, a great number of researches indicate that environmental factor has been playing a crucial role. Outdoor activity proves to be a major protective factor to reduce the incidence of children's myopia. Sunlight is one of the important ones among various factors of outdoor activity. The intensity, wavelength and rhythm of sunlight may all affect eyeball's refraction development. Varied sunlight environment may have different influences on eyeball's refraction development. The paper has summarized clinical and trial and animal experiment research results on how sunlight affects eyeball's refraction development, and it has offered references to further study on refractive error development mechanism and prevention strategy.

Abstract:The occurrence and development of ophthalmic diseases are closely related to the abnormality of cellular regulation and ocular tissue function, in which the relevant signaling pathways play an important role in the regulation of physiological functions. The Rho/ROCK signaling pathway is involved in a variety of cellular events, including cytoskeletal reorganization, cell adhesion, cell proliferation and angiogenesis, and also plays a significant role in cell cycle progression, cell differentiation and apoptosis. Studies have shown that the Rho/ROCK signaling pathway is widely distributed in ocular tissues, and its aberrant activation can affect the normal physiological function of ocular tissues, demonstrating it is closely related to the occurrence and development of ophthalmic diseases. This paper briefly reviews the role of Rho/ROCK signaling pathway in the occurrence and development of ophthalmic diseases, providing new insights into the clinical treatment of ophthalmic diseases.

Abstract:Hirudo is highly effective in promoting blood circulation and removing blood stasis, a vital medicine for breaking blood and removing blood stasis in ophthalmopathy. Presently, Hirudo is commonly used in ophthalmology for age-related macular degeneration, diabetic retinopathy, cataract, retinal vein occlusion and other ophthalmic diseases, with the mechanism thereof possibly being related to anti-VEGF, improvement of microcirculation and anti-apoptosis. Further, although new functions have been found in Hirudo extract, such as transdifferentiation and inhibition of WERI-RB-1, these studies remain in the basic exploratory stage, and the specific molecular mechanism requires further verification. This paper concisely describes the application and research status of Hirudo and the extract thereof in ophthalmic diseases, so as to provide a new direction for further research on the treatment of ophthalmopathy using Hirudo and the extract thereof.

Abstract:Optical coherence tomography angiography(OCTA)is a quick, non-invasive imaging technology which can both qualitatively and quantitatively analyze retinal blood perfusion that is now more widely used in clinical practice. Choroidal neovascularization(CNV)is the main cause of loss of vision in the elderly and is caused by neovascular age-related macular degeneration(nARMD). Therefore, the detection of CNV in nARMD is of extreme importance. In this paper, the research progress of OCTA in diagnosing and treating nARMD was reviewed by analyzing the diagnosis, morphology, area and blood perfusion of CNV.

Abstract:Familial exudative vitreoretinopathy(FEVR)is an inherited vitreoretinopathy characterized by vascular dysplasia of periphery retina. Typical fundus findings consist of avascular periphery retina, increasing branching and abnormal anastomosis of retinal vessels. Having diversified clinical phenotypes, FEVR patients can be asymptomatic, which can often be missed, or with severe complications including retinal detachment, retinal folds, vitreous hemorrhage, causing vision loss. While FEVR had been thought to be rare in previous studies, the incidence was found to reach up to 1% in recent studies of fundus screening in the newborn. Diagnosis is usually based on clinical features, fundus fluorescein angiography, and detection of pathogenic genes. Ultra-wide-field imaging is a noninvasive and convenient way for the screening and diagnosis of FEVR. In this review,clinical features and diagnostic approaches of FEVR are concluded, and application value of ultra-wide-field imaging in its screening is discussed.

Abstract:Tears are secreted by lacrimal and accessory lacrimal glands, mainly through eyelid and blink movement to form the watery layer of tear film. Tear proteomics is a difficult and hot topic whose main purpose is to detect high sensitive and specific biomarkers representing eye diseases or even systemic diseases so as to facilitate diseases diagnosis and assessment, as well as to achieve personalized treatment, improve prognosis, and design targeted follow-up experiments to understand the molecular mechanisms of the disease. It may have wider application prospects in eye diseases and some systemic diseases compared to existing routine fluid examinations such as blood, urine, and cerebrospinal fluid tests. Numerous studies have shown that many diseases have changes in the composition of tears. In this paper, we will review the progress of proteomics used to investigate the changes of the protein components of tears in different eye diseases.

Abstract:Selenium is an essential microelement required as a nutrient by human organism to perform important biological functions, mainly in the form of selenocysteine. It plays an important role in improving human immunity and the myocardial nutritional blood flow, and preventing oxidative stress. Various ocular diseases are closely associated with selenium and selenoprotein due to the presence of high concentration of selenium. This article mainly aims to review the present research advance of biological functions of selenium and selenoprotein in ocular diseases, and provide some valuable reference for deeper study of selenium in human eyes.

Abstract:AIM:To evaluate the clinical efficacy of different interventions of traditional Chinese medicine in the treatment of traumatic optic neuropathy by means of mesh Meta-analysis.METHODS:The Computer searched of Chinese databases(CNKI, VIP, WanFang, SinoMed)and English databases(PubMed, Embase, Cochrane Library). Search time was limited from their inception to March 2020. Randomized controlled clinical trials of traditional Chinese medicine for treatment of traumatic optic neuropathy were subjected to Meta-analysis. Cochrane evaluation tool was used to evaluate the quality of the included studies and Stata 14.2 software was used to conduct network Meta-analysis.RESULTS: Twenty-one RCT studies involving 1 297 patients were included and 7 interventions were involved. Among them, Chinese medicine, Chinese medicine+hormone drugs, acupuncture+Chinese medicine+neurotrophic drugs were better than those with neurotrophic drugs alone. Chinese medicine+hormone drugs, acupuncture+Chinese medicine+neurotrophic drugs, acupuncture+Chinese medicine+hormone drugs were better than that of hormone drugs alone(P<0.05), and the intervention measures ranked first in terms of effective treatment rate is acupuncture+Chinese medicine+neurotrophic drugs.CONCLUSION: Chinese medicine has advantages in the treatment of traumatic optic neuropathy. Among them, acupuncture+ Chinese medicine+neurotrophic drugs is most likely to be the best choice.

Abstract:AIM:To evaluate the visual quality of different types of cataracts by double-pass optical quality analysis system(OQAS).METHODS: A cross-sectional study was conducted. Totally 30 age-related cataract patients(30 eyes), which were aged group, with an average age of 71.69±3.79 years, thirty patients(30 eyes)with complicated cataract were in the complicated group with an average age of 61.00±4.56 years and 30 normal patients(30 eyes)were in the normal group, with an average age of 65.34±4.06 years old, both of which with naked eye vision(UCVA)≤0.5, and from June 2019 to June 2020 in the eye Center of Renmin Hospital of Wuhan University were collected. The ocular surface and optical quality examination on the patient's visual quality, including anterior chamber depth(ACD), ocular axis(AL), IOP, corneal curvature(K), objective scattering index(OSI), MTF cut off frequency(MTF cut off), Sterl ratio(SR), contrast sensitivity VA100%, VA20%, VA9% and other visual quality were operated by the same doctor. RESULTS: Compared with glaucomatous cataract, the MTF cut off of uveitis cataract was lower(P=0.025), but higher than that of fundus cataract(P=0.013), and diabetic cataract(P=0.001). The MTF cutoff value of glaucomatous cataract was higher than that of fundus cataract(P=0.013), and diabetic cataract(P=0.007); the MTF cutoff of fundus cataract was higher than that of diabetic cataract and there was significant difference(P=0.010).CONCLUSION: There are some differences in the ocular surface and visual quality parameters of each subtype of complicated cataract, especially MTF cut off, so we should paid attention to the cataract types before surgery.

Abstract:AIM: To analyze the effectiveness of transepithelial-corneal collagen cross-linking for 1a after the treatment of progressive keratoconus and discuss its clinical significance. METHODS:A total of 45 cases(48 eyes)of progressive keratoconus who underwent accelerated transepithelial-corneal collagen cross-linking in our hospital from Jan. 2017 to Dec. 2018 were collected. After 1a of postoperative follow-up, the changes of visual acuity, corneal thinnest point thickness, corneal endothelial cell count, corneal cross-linking line depth, Km of anterior corneal curvature and corneal biomechanical parameters before and after surgery were analyzed.RESULTS:Compared with preoperative, the uncorrected visual acuity(UCVA)was improved obviously postoperative in this group patients(P<0.05), but the best-corrected visual acuity(BCVA), corneal thinnest point thickness and corneal endothelial cell counts were no significant change(P>0.05). At 6mo and 1a postoperative, Km of anterior corneal curvature(48.54±2.57, 48.77±2.29D)are decreased significantly, the first flatten width of corneal biomechanical parameters(1.52±0.21, 1.57±0.22mm)were significantly lower(P<0.05). The absolute value of the second flattening velocity(0.82±0.09, 0.82±0.18m/s)was significantly increased(all P<0.05).CONCLUSION:Accelerated transepithelial-corneal collagen cross-linking surgery for progressive keratoconus can significantly improve the UCVA and corneal biomechanics postoperative, but the BCVA was not significantly improved.

Abstract:AIM: To analyze the effectiveness and influencing factors of phacoemulsification combined with intraocular lens(IOL)implantation in the treatment of primary angle-closure glaucoma(PACG). METHODS: Clinical data of 75 patients(75 eyes)with PACG who received phacoemulsification and IOL implantation in our hospital from January 2017 to December 2018 were retrospectively analyzed. Postoperative intraocular pressure(IOP), best-corrected visual acuity(BCVA), changes of anterior segment and incidence of complications were counted. The patients were grouped by efficacy, and multivariate Logistic regression analysis was performed to analyze the risk factors influencing the effectiveness of phacoemulsification and IOL implantation in patients with PACG. RESULTS: Postoperative IOP of patients with PACG was decreased while BCVA was increased, and there were statistically significant differences compared with those before operation(P<0.05). Central anterior chamber depth(ACD), angle opening distance(AOD500), trabecular iris angle(TIA500)and angle recess area(ARA)were increased significantly compared with those before operation(P<0.05). Multivariate Logistic regression analysis showed that chronic PACG and preoperative IOP were independent risk factors for efficacy of phacoemulsification and IOL implantation in patients with PACG(P<0.05). CONCLUSION: Phacoemulsification combined with IOL implantation has good efficacy and safety in the treatment of PACG. However, it is necessary to pay attention to preoperative IOP control. What's more, it should be carefully considered whether this operation is necessary for patients with chronic PACG.

Abstract:AIM: To analyze the effect of Yiqi Yangyin Huoxue Decoction combined with Conbercept on diabetic macular edema(DME), and the influence on TCM syndromes and serum vascular endothelial growth factor(VEGF)expression. METHODS: Between January 2017 and June 2019, 60 patients admitted to the ophthalmology department at Henan Province Hospital of Traditional Chinese Medicine were perspective enrolled in the study. They were divided into observation group and control group by random number table method, 30 cases with 30 eyes in each group. The control group were treated with intravitreal injection of Conbercept, while the observation group were treated with Yiqi Yangyin Huoxue Decoction combined with intravitreal injection of Conbercept. Changes in TCM symptom scores, the best corrected visual acuity(BCVA), central macular thickness(CMT), retinal neovascularization(RNV)fluorescein leakage area under fundus fluorescein angiography(FFA)and VEGF expression were compared between the two groups, and complications were recorded.RESULTS: Three months after treatment, the observation group had lower scores for blurred version, dry eyes, fatigue, soreness and weakness of waist and knees, and thirst than the control group(P<0.05). There were statistically significant differences in BCVA between the 2 groups before and after treatment(all P<0.01). The observation group had higher BCVA than the control group at 1mo, 3mo and 6mo(P<0.05). Differences in CMT between the 2 groups before and after treatment were statistically significant(all P<0.01). Besides, the observation group had smaller CMT than the control group at 7d, 14d, 1mo, 3mo and 6mo(P<0.05). There were statistically significant differences in RNV between the two groups before and after treatment(all P<0.01), and the observation group had smaller RNV than the control group at 7d, 14d, 1mo, 3mo and 6mo(P<0.05). Difference in VEGF between the 2 groups before and after treatment were statistically significant(all P<0.01). The VEGF expression level was lower in the observation group than in the control group at 7d, 14d, 1mo, 3mo and 6mo(P<0.05). No statistically significant difference was found in the incidence of complications between the two groups(7% vs 10%, P>0.05).CONCLUSION: Yiqi Yangyin Huoxue Decoction combined with intravitreal injection of Conbercept is more effective than Conbercept alone in the treatment of DME. The former can significantly improve the patient's vision and CMT, reduce leakage area, down regulate the expression of VEGF, and promote the absorption of retinal edema, with good safety.

Abstract:AIM: To study the clinical efficacy, complications and visual related quality of life(VRQoL)of Ozurdex in the treatment of macular edema secondary to retinal vein occlusion(RVO-ME). METHODS: Totally 30 patients with ME, which had developed secondary to either CRVO(13 eyes)or BRVO(17 eyes), were monitored for 6mo after treatment with Ozurdex in the Department of Ophthalmology of our Hospital. We measured the best corrected visual acuity(BCVA), intraocular pressure(IOP), central macular thickness(CMT)at different time after treatment(1wk, 1mo, 2mo, 3mo, 4mo, 5mo, and 6mo after treatment), and we also measured the Chinese version vision related quality of life questionnaire-25(CVRQoL-25)at 3mo after treatment and compared them separately with the ones measured before treatment to evaluate the efficacy, adverse reactions and the visual related quality of life. RESULTS: Generalized estimation equation results showed that BCVA, CMT and IOP all had differences at different time points(P<0.001). A BCVA increase was achieved and CMT decreased in all patients at any time point after the onset of treatment(P<0.001). The changes of BCVA and CMT were the largest in the 2mo compared to the baseline(P<0.001). The score of CVRQol-25 at 3mo after treatment was significantly higher than that before treatment and then the central retinal thickness decreased and a BCVA increased compared to the baseline level(P<0.01). The score of CVRQoL-25 at 3mo was negatively correlated both with the LogMAR BCVA evaluated before treatment and at 3mo after treatment(rs= -0.717, -0.746, all P<0.001); Meanwhile, the score of CVRQoL-25 was also negatively correlated with CMT at 3mo after treatment(rs= -0.862, P=0.001). In 19 eyes(63%)of the patients with RVO-ME,a relapse was observed after a follow-up time of 1-3mo and the average recurrence time was(2.8±0.5)mo. In follow-up of 6mo, about(2.3±0.4)intravitreal Ozurdex injections per eye was observed. The increase in IOP was observed at 1wk, 1, 2, 3mo after pretherapy(P<0.05). The mean IOP values reached a peak at 2mo after injection, which rose(7.85±0.32)mmHg above the baseline level(P<0.05)and decreased to normal at 4mo after treatment. 10% of patients had an elevation in IOP above 25mmHg, which could be medically controlled and 4 eyes(13%)of patients had cataract formation, two of which needed to surgery. CONCLUSION: Ozurdex proved to be efficacious with increase in visual acuity and reduction of central retinal thickness and improve the visual function-related quality of life of RVO-ME patients. After single injection of Ozurdex, visual acuity benefited for 2-3mo. 63% of the patients relapsed at about 3mo after treatment. Adverse reactions associated to the use of Ozurdex include the formation of cataracts and an increase in IOP.

Abstract:AIM: To investigate the clinical efficacy of intravenous immunoglobulin(IVIG)in the treatment of neuromyelitis optica related optic neuritis(NMO-ON)patients with recurrent and glucocorticoid resistance. METHODS: A total of 79 NMO-ON patients with recurrent and glucocorticoid resistance admitted to the ophthalmic inpatient department of our hospital from January 2016 to January 2018 were retrospectively selected and divided into two groups according to the treatment mode. Forty-two patients(57 eyes)in the IVIG group were treated with IVIG, and 37 patients(43 eyes)in the PE group were treated with plasmapheresis. The differences in efficacy, adverse reactions and recurrence rates between the two groups were compared, as well as the changes and differences in uncorrected visual acuity, aquaporin-4 immunoglobulin G antibody(AQP4-IgG), and myelin oligodendrocyte glycoprotein antibody(MOG-IgG)antibody before and after treatment. RESULTS: The effective rates of IVIG group and PE group were 91% and 91% respectively(P>0.05). After treatment, the uncorrected visual acuity, photosensitive sense and number finger of the 2 groups were significantly improved(P<0.01), and the proportions of AQP4-IgG(+)and MOG-IgG(+)were significantly decreased(P<0.001)compared with those before treatment, while the proportions of visual acuity, photosensitive sense and number finger, AQP4-IgG(+)and MOG-IgG(+)in the 2 groups showed no statistical difference(P>0.05). The patients in the two groups were followed up for a median of 40(29-50)mo. By the last follow-up, the recurrence rates in IVIG group and PE group were 10% and 9%, respectively(P>0.05). The incidence of adverse reactions in IVIG group was lower than that in PE group(P<0.05). CONCLUSION: Both PE and IVIG can improve the vision and symptoms of patients with NMO-ON patients with recurrent and glucocorticoid resistance, clear the pathogenic antibodies, and reduce the recurrence. The clinical efficacy of two methods is significant, but IVIG is relatively safe.

Abstract:AIM: To investigate the influence of orthokeratology combined with 0.01% Atropine Sulfate Eye Gel on the recovery of myopia in children and the factors influencing the curative effect of children. METHODS: Totally 200 children with myopia admitted to our hospital in 2017-03/2019-03 were selected. According to the requirements of children and guardians, the observation group(orthokeratology combined with 0.01% Atropine Sulfate Eye Gel)and the control group(only wearing orthokeratology)were selected. Totally 108 cases in the observation group were included in the study, 8 cases were abandoned after 6mo, and 100 cases were finally included to complete the follow-up. 92 cases in the control group were included in the study, 5 cases abandoned after 6mo, and 87 cases completed the follow-up. The patients' best corrected far vision, best corrected near vision, naked eye vision, intraocular pressure, pupil diameter and adjustment amplitude and discomfort symptoms after treatment were collected before and after 6mo.RESULTS: The uncorrected visual acuity of the observation group after treatment was 0.12±0.05, and that of the control group was 0.19±0.07, which were significantly higher than those before treatment(P<0.05), and the observation group was significantly higher than that of the control group(P<0.05). After treatment, the intraocular pressure of the two groups had no significant change(P>0.05); the pupil diameter of the observation group after treatment was(7.01±0.66)mm, which was significantly higher than(6.09±0.69)mm before treatment(P<0.05); the adjustment amplitude was(14.06±4.03)D, which was significantly lower than(15.31±4.40)D before treatment(P<0.05); there were no significant changes in the pupil diameter and adjustment amplitude of the control group after treatment(P>0.05). Pearson correlation analysis showed that good myopia control was negatively correlated with age, uncorrected visual acuity and astigmatism before treatment(P<0.05). Multivariate Logistic regression analysis showed that myopia control was negatively correlated with age and uncorrected visual acuity before treatment(P<0.05).CONCLUSION: Orthokeratology combined with 0.01% Atropine Sulfate Eye Gel is helpful for the control of myopia in children. The effect of treatment is influenced by the age of children and the visual acuity before treatment.

Abstract:AIM: To compare the measurement results of anterior chamber depth(ACD)by Pentacam, IOL Master and Contact Ultrasonic A-scan, and analyze the difference, correlation, consistency and influencing factors of the three measurement methods.METHODS: In this study of 307 eyes of 250 cataract patients with preoperative, ACD estimation was done by Pentacam, IOL Master and Contact Ultrasonic A-scan. The independent sample t-test, Analysis of Variance(ANOVA), Pearson's correlation test and multiple linear regressions were used to analyze the results.RESULTS: The mean of ACD measured by Pentacam(ACDp), IOL Master(ACDi)and A-scan(ACDa)were 2.42±0.45mm, 2.96±0.43mm, 2.58±0.36mm, the difference was statistically significant(F=136.694, P<0.05). The three methods were sequentially compared in pairs, and the differences within the groups were statistically significant(P<0.05). Pearson's correlation test was performed on the three methods in pairs, and there was a linear positive correlation within each group. When the ACDp and the central corneal thickness(CCT)were added, the sum(ACDp2)was no statistically significant compared with the ACDi(P=0.93). When the ACDp was less than 1.85mm(ACDi was about 2.40mm), the ACDa increases significantly and the fluctuation increases. Among the many possible influencing factors, axial length, lens thickness and age have the highest relative importance for ACD measurement.ACD was positively correlated with axial length(rPentacam=0.602, rIOL Master=0.603, rA-scan=0.483), and negatively correlated with the lens thickness(rPentacam= -0.382, rIOL Master= -0.350, rA-scan= -0.582), negatively correlated with age(rPentacam= -0.328, rIOL Master= -0.414, rA-scan= -0.265). Three factors were included in the multiple linear regression model, and the age factor of Contact Ultrasonic A-scan was eliminated due to the low influence weight.CONCLUSION: ACDp2 and ACDi may be closer to the true value of the anterior chamber depth. The Contact Ultrasonic A-scan may increase the measurement error when measuring shallow anterior chamber. Axial length, lens thickness and age have the greatest influence on ACD measurement, which are the influencing factors of Pentacam and IOL Master, but age is not the influencing factor of Contact Ultrasonic A-scan.

Abstract:AIM: To discuss the clinical effects of pars plana vitrectomy(PPV)combined with interal limiting membrane peeling(ILMP)for macular hole(MH)in pathological myopic eyes.METHODS: This is a retrospective case study. Eighteen patients(19 eyes)with high myopic MH diagnosed in our hospital from January 2017 to January 2019 were enrolled in this study. All eyes were grouped for pathological myopia(9 patients 10 eyes)and non-pathological myopia groups(9 patients 9 eyes). All eyes were treated with PPV combined with ILMP surgery. Postoperative follow up was 3-23mo, the efficacy was determined at the final follow up, including BCVA, visual deformation symptoms and macular hole closure.RESULTS: During the final follow up, BCVA was improved in 6 eyes,stable in 2 eyes, more severe in 2 eyes in pathological myopia group, and MH was fully closed in 7 eyes(70%), bareness-closed in 2 eyes(20%)and not closed in 1 eye(10%). In non-pathological myopia group, BCVA was improved in 6 eyes,stable in 2 eyes, more severe in 1 eyes, and MH was fully closed in 8 eyes(88%), not closed in 1 eye(11%). There were significant differences in the axial length between the two groups before surgery, axial length was negatively correlated with the macular hole closure rate at the last follow up(rs= -0.477, P=0.039).CONCLUSION: PPV combined with ILMP for the treatment of MH in high myopia can effectively improve BCVA. However, the hiatal closure rate of pathological myopia patients was lower than that of non-pathological myopia patients.

Abstract:AIM: To use optical coherence tomography angiography(OCTA)in measuring the macular vascular density, foveal avascular zone(FAZ)area and the macular retinal thickness in patients with retinal vein occlusion(RVO).METHODS: Totally 30 patients(30 eyes)with unilateral RVO were enrolled. Fifteen patients with central retinal vein occlusion(CRVO)and 15 patients with branch retinal vein occlusion(BRVO), OCTA was performed on both eyes. Macular vascular density in the 3mm×3mm range, FAZ area, foveal thickness and best-corrected visual acuity(BCVA)were measured. The changes of vascular density, FAZ area, foveal thickness and its correlation with BCVA were compared between the eyes and the fellow eyes.RESULTS: In eyes with CRVO the overall vascular density measured in the entire scan was lower compared to fellow eyes in both the superficial [SVN:(43.07±4.95)% vs (50.09±2.86)%; P<0.01)]and [DVN:(45.89±4.12)% vs(53.29±2.62)%; P<0.01]. And a negative correlation was found between the visual acuity and the overall density in superficial(rs= -0.6, P<0.05)and deep(rs= -0.5, P<0.05)networks. In eyes with BRVO the overall vascular density measured in the entire scan was lower compared to fellow eyes in both the superficial [(45.62±3.04)% vs(52.10±2.98)%; P<0.01] and deep [(49.21±3.80%)vs(55.52±3.33)%; P<0.01] networks. And a negative correlation was found between the visual acuity and the overall density in superficial(rs= -0.5, P<0.05)and deep(rs= -0.5, P<0.05)networks. In both networks, the density was lower in the affected BRVO sector compared to the unaffected sector in the same eye and in the fellow eye(P<0.01). And the vascular density in the affected BRVO sector correlated negatively with visual acuity in the deep network(rs= -0.6, P=0.01). In the deep network, the density was lower in the unaffected sector of the BRVO eye compared with the corresponding sector in the fellow eye [(56.86±1.95)% vs(58.15±2.24)%; P=0.02]. The mean FAZ area in CRVO and BRVO eyes was significantly lower at the superficial network when compared to the fellow eyes \ and correlated positively with visual acuity(CRVO: rs=0.6, P=0.01; BRVO: rs=0.5, P=0.01). The mean foveal thickness in CRVO and BRVO eyes was significantly thicker when compared to the fellow eyes \ and correlated positively with visual acuity(CRVO: rs=0.9, P=0.01; BRVO: rs=0.6, P=0.01).CONCLUSION: Quantitative OCTA can be used as an effective tool for measuring blood flow in macular areas and FAZ area of RVO patients.

Abstract:AIM: To investigate the secretion levels of serum tumor markers neuron specific enolase(NSE), glycoprotein antigen CA153 and CA199 in patients with retinoblastoma(RB).METHODS: Data of 42 RB patients who received chemotherapy at Shenzhen People's Hospital between October 2017 and October 2019 were collected. The RB group was regrouped according to early and mid-term/advanced stages, and single/double eye involvement, the levels of serum tumor markers were compared between these subgroups and different genders.RESULTS: The levels of tumor markers NSE, CA153 and CA199 in the advanced group were higher than those in the early and mid-term groups(49.69±18.45ng/mL vs 36.18±14.92ng/mL, 22.38±12.03U/mL vs 15.10±8.32U/mL, 46.44±18.76U/mL vs 30.21±24.03U/mL, P<0.05), but there was no statistically significant difference in expression between the groups of different genders and single and binocular involvement(P>0.05).CONCLUSION: Serum NSE, CA153 and CA199 are significantly increased in advanced group than early and mid-term group, and they are of great significance in the diagnosis and treatment of RB. The difference between NSE in single and double eyes is worthy of further study.

Abstract:AIM: To investigate effects of different corneal protective agents on ocular surface in vitrectomy in patients with diabetes.METHODS: Totally 90 patients(90 eyes)with diabetes who received vitrectomy were randomly divided into HPMC group(30 eyes), SHSCS group(30 eyes)and BSS group(30 eyes). Hydroxypropyl methyl cellulose(HPMC)and sodium hyaluronate sodium chondroitin sulfate(SHSCS)were used to cover the corneal surface to avoid the cornea drying in HPMC group and SHSCS group, respectively. Balanced salt solution(BSS)was continuously dripped on the cornea to keep the cornea moist in BSS group. Schirmer Ⅰ test(SⅠt), breaking up time(BUT)and central corneal thickness were performed before and after operation. Their changes were observed and compared.RESULTS: At 1wk and 1mo after operation, compared with HPMC group and SHSCS group, SⅠt was significantly increased and BUT was significantly shortened in BSS group(P<0.05). At 1wk after operation, BUT of HPMC group was significantly shortened compared with SHSCS group(P<0.05). At 3mo after operation: SⅠt and BUT of the three groups were no significant difference compared with before operation(P>0.05). At 1d after operation, the corneal thickness of BSS group was significantly increased compared with HPMC group and SHSCS group(P<0.05). At 1wk after operation, the corneal thickness of the three groups were no significant difference compared with before operation(P>0.05).CONCLUSION:The patients with diabetes use HPMC and SHSCS can protect the cornea and maintain the stability of tear film in vitrectomy. Different corneal protectors can be selected according to the clinical practice.

Abstract:AIM:To investigate the efficacy of 99Tcm-octreotide orbital imaging combined with magnetic resonance imaging(MRI)in stage diagnosis of thyroid associated ophthalmopathy(TAO). METHODS: Retrospective analysis of clinical data of 35 surgically treated TAO patients admitted to hospital from June 2017 to June 2018. 99Tcm-octreotide orbital imaging and MRI were performed, and the pathological observation and stages were performed. The result of pathological staging was statistically analyzed. The imaging findings and results of 99Tcm-octreotide orbital imaging combined with MRI were observed. The efficacy of 99Tcm-octreotide orbital imaging, MRI, 99Tcm-octreotide orbital imaging combined with MRI in the stage diagnosis of TAO was analyzed. RESULTS: Totally 58 eyes with TAO in 35 patients with pathological stages were 49 eyes in the active phases and 9 eyes and inactive phases. 99Tcm-octreotide orbital imaging and MRI diagnosis of TAO severity staging have typical imaging findings, and the sensitivity, specificity, accuracy of 99Tcm-octreotide orbital imaging combined with MRI in the diagnosis of active TAO was higher than that of 99Tcm-octreotide orbital imaging and MRI alone. The ROC results showed that the AUC of the active phase of 99Tcm-octreotide orbital imaging combined with MRI diagnosis was 0.893, which was higher than that of 99Tcm-octreotide orbital imaging or MRI alone. CONCLUSION:It is recommended to use 99Tcm-octreotide orbital imaging and MRI imaging in combination with TAO stage diagnosis. The imaging findings are typical, and the combined application has higher diagnostic efficiency.

Abstract:AIM: To investigate the related-factors analysis of extra-ocular muscle paralysis in pediatric ocular myasthenia gravis(OMG). METHODS: A retrospective, observational cohort study was performed of 203 pediatric patients diagnosed with OMG between Nov.2011 and May 2020 at Wuhan Children's Hospital. Data on clinical features and laboratory indicators of children with OMG were statistically analyzed between extra-ocular muscle paralysis group and non-extra-ocular muscle paralysis group, which were classified by pediatric ophthalmologists based on ocular manifestations. The Logistic regression analysis was performed immediately after that to determine the independent factors. RESULTS: Totally 203 pediatric OMG, 97(47.8%)had extra-ocular muscle paralysis with various clinical features including strabismus(n=69, 71.1%), torticollis(n=18, 18.6%). Among the 97 children, 79(81.4%)patients were presented with monocular involvement, of which 53(54.6%)had single extra-ocular muscle paralysis. The most common was medial rectus muscle(n=19, 35.8%). Between extra-ocular muscle paralysis group and non-extra-ocular muscle paralysis group, there were statistically significant difference(P<0.05)in age, serum immunoglobulin M(IgM), serum free triiodothyronine(FT3), serum thyroglobulin, and glucocorticoid combination pyridostigmine bromide therapy(72.2% vs 38.7%). Furthermore, the level of FT3(OR=2.006, 95%CI: 1.233-3.263)and glucocorticoid combined treatment(OR=4.328, 95%CI: 1.936-9.677)were the related-factors affecting the extra-ocular muscle paralysis of children with ocular myasthenia gravis. CONCLUSION: Extra-ocular muscle paralysis was the common ocular manifestation in pediatric OMG. Monocular involvement was more common than binocular involvement especially the medial rectus muscle, while diplopia was rare. The level of FT3 can be considered as an important immune indicator to evaluate extra-ocular muscle paralysis in children with ocular myasthenia gravis.

Abstract:AIM:To investigate the monocular and binocular accommodative difference between wearing orthokeratology lens and frame lens in low myopic anisometropia children.METHODS: Totally 47 children(94 eyes)with low degree myopic anisometropia(1.0D≤binocular equivalent spherical lens difference <2.5D)were involved between November 2019 and April 2020 in the retrospective clinical study. Twenty-seven cases(54 eyes)wore frame lens were used as group A and 20 cases(40 eyes)wore orthokeratology lens were used as group B. The corrected visual acuity and the accommodative parameters [the accommodative response(AR), the accommodative facility(AF), the accommodative amplitude(AMP)] at 1mo after treatment were recorded and compared. RESULTS:In two groups the results of AR were positive, and it meant accommodative lag(AL). AL of the higher myopic eyes was higher than the lower eyes in group A(0.63±0.21D vs 0.25±0.34D, P<0.001), but there was no significant difference of AL in group B(P=0.104). Between two eyes, the difference of the corrected visual acuity and the monocular AMP in two groups were no significant(P>0.05). The binocular AR difference in group A was significantly higher than group B(0.38±0.36D vs 0.10±0.26D, P=0.005), and the binocular AF was lower(8.22±1.15c/min vs 9.95±0.89c/min, P<0.001). There was no statistical difference in binocular AMP(P=0.280).CONCLUSION: Low myopic anisometropia children with orthokeratology lens can obtain higher binocular AF and lower binocular AR difference than that with frame lens, so as to maintain more coordinated binocular accommodation.

Abstract:AIM: To observe the changes of relative peripheral refraction(RPR)after wearing orthokeratology(OK)lens, and to explore the relationship between the changes of RPR and the axial length(AL).METHODS: Totally 104 cases of adolescent myopia(-1.00D to -6.00D)were selected from May 2016 to Nov. 2018. Then they were randomly divided into the experimental group and the control group. The experimental group wore OK lens, and the control group wore frame glasses. Their AL, RPR(N30°-T30°)were observed for 1a.RESULTS:The RPR of the experimental group showed myopic drift at each time point after wearing OK lens(P<0.05), and the change was most obvious in 1mo(P<0.05). After 1mo, the RPR basically tended to be stable(P>0.05). The RPR of the control group showed an increase in hyperopia. One year later, there were statistical differences in the changes of AL and RPR between the two groups(P<0.001). There was a positive correlation between the changes of AL and RPR in the experimental group(P<0.001).CONCLUSION: After wearing OK lens, the AL growth slowed down, while the RPR showed myopic drift and it was most obvious in 1mo. There was a correlation between the changes of AL and RPR.

Abstract:AIM: To investigate the correlation of myopia severity(SE)with axial length(AL), intraocular pressure(IOP), central corneal thickness(CCT), anterior chamber depth(ACD), and mean keratometry(Km)in young myopia patients.METHODS: In the retrospective study, we selected myopic patients who were diagnosed in Lanzhou Huaxia Eye Hospital from Mar. 2017 to Jul. 2019. They were divided into four myopia groups, A(mild), B(moderate), C(high), and D(hyper)based on the SE. We then measured and analyzed the correlation of the degree of myopia with AL, IOP, CCT, ACD, and Km. Differences between groups were analyzed by one-way analysis of variance. Relationships between the relevant factors were analyzed by Pearson correlation analysis.RESULTS: The SE were(-2.38±0.49)D,(-4.60±0.82)D,(-7.40±1.08)D and(-11.58±1.23)D in the mild, moderate, high and hyper myopia groups respectively. The AL were(24.55±0.72)mm,(25.68±0.77)mm,(26.75±0.64)mm and(28.00±0.56)mm in the respective myopia groups. The IOP were(14.68±3.18)mmHg,(14.78±2.81)mmHg,(15.19±2.66)mmHg,(15.70±2.68)mmHg in the respective myopia groups. The ACD were(3.41±0.24)mm,(3.34±0.25)mm,(3.32±0.25)mm and(3.24±0.27)mm in the respective myopia groups. The Km were(42.96±1.22)D,(43.02±1.43)D,(43.29±1.47)D and(43.56±1.47)D in the respective myopia groups. There were no significant differences for CCT among the different groups. SE was significantly positive correlated to AL(r=0.851, P<0.001), IOP(r=0.104, P<0.001), CCT(r=0.066, P<0.001)and Km(r=0.157, P<0.001); SE was negative correlated to ACD(r=-0.129, P<0.001).CONCLUSION: In our study, there is a positive correlation between the progression of myopia and the increase in AL, IOP, CCT, and Km. There is a negative correlation between myopia and ACD.

Abstract:AIM: To study the visual efficiency and characteristics of Top-down perceptual pathway in children.METHODS: Totally 26 children volunteers in the outpatient department from January to June 2020 were selected. We adopted the photos of children's self-face as the Top-down perceptive fixation point pictures. The N75 time, P100 peak time, P100 amplitude and P100 repolarization time were recorded by graphic visual evoked potential(PVEP)examination.RESULTS: Different visual perception pathway had no significant effect on the latency of N75, while different spatial frequencies have a significant effect on the N75 time. The latency of N75 was prolonged under high frequency spatial stimulation. The interaction between visual perceptual processing path and spatial frequency has a significant effect on the peak time of P100.Under Top-down condition, the peak time of P100 was significantly shortened under high-frequency spatial stimulus. Different visual perception paths and spatial frequencies had significant effects on P100 amplitude, and Top-down perceptual processing and spatial frequencies had significant effects on the time of P100 wave repolarization, while the interaction between processing paths and spatial frequencies had no significant effects.CONCLUSION:Under Top-down visual perceptual, the visual conduction velocity and visual condition efficiency are improved in children's visual process.