Abstract:AIM: To investigate for any detectable change in sub-foveal choroidal thickness following intravitreal injections of Ranibizumab or Aflibercept in patients with central involving diabetic macula edema(DME), evidenced by optical coherence tomography(OCT).

METHODS: Totally 17 patients with central involving DME who required and agreed to intravitreal anti-VEGF injection were invited to be the subject of this study. These injection-naive subjects were undergone three loading doses of monthly intravitreal anti-VEGF(Ranibizumab 0.5 mg/0.05 mL for 9 patients or Aflibercept 2 mg/0.05 mL for 8 patients)injection, and a clinic review appointment 1mo after the third injection. The changes of foveal choroidal thickness, visual acuity and central retinal thickness at 1mo were observed before and after treatment in 2 groups by enhanced depth image-optical coherence tomography(EDI-OCT).

RESULTS: We recorded a significant sub-foveal choroidal thinning and vision improvement after three loading doses of anti-VEGF(all P<0.05). The thinning effect between Ranibizumab and Aflibercept group was insignificant(all P>0.05). There was no significant correlation between pre-treatment sub-foveal choroidal thickness and vision improvement(r_s=-0.269, P=0.296). There was also no significant correlation between choroidal thickness changes with vision improvement, central retinal thickness change and age of subjects(all P >0.05).

CONCLUSION: Intravitreal Ranibizumab and Aflibercept injections both leads to significant sub-foveal choroidal thinning in DME subjects. It was accompanied with significant vision improvement with no evidence of immediate detrimental effect of choroidal thinning. Future research with a longer study duration would help in establishing the duration and long term effect of choroidal thinning.

Abstract:AIM: To provide a scientific basis for the development of children's eye health measures in Binhu District of Wuxi City by understanding the visual development status of children aged 0-6 years old in the region.

METHODS: A total of 3 695 children of 0-6 years old from preschool children in Binhu District received quickly check of eye's refractive status by using the SureSight automatic screening refractor, and determine the results by referring to the refractive screening referral standard norm for each age groups offered by the US Welch Allyn company. All participating preschool children have completed a vision screening and a comprehensive eye examination.

RESULTS: The total of abnormal rate was 9.76%, suspicious rate was 5.40% in vision screened children, along with the age increase, the abnormal and suspicious detection rates had a tendency to rise, differences in vision screening results of each age group were statistically significant(χ²=15.913, P=0.014), and differences between boys and girls had no statistical significance(χ²=7.200, P=0.066). The highest proportion of abnormal vision was astigmatism(13.89%, 17.96%, 17.62%, 11.50%), followed by hyperopia(0.35%, 1.91%, 3.60%, 8.86%)and anisometropia(0.69%, 0.67%, 1.64%, 2.07%)in different age groups. Hyperopia(4.38%), myopia(0.82%), astigmatism(15.65%), anisometropia(1.42%)and any refractive(0.466%), these five types in the distribution of various age groups. The prevalence of astigmatism in preschool children in 0-3 years old were 6.94%(95%CI: 4.90%-9.00%)and the 3-4 years old were 8.98%(95%CI: 7.80%-10.20%), the 4-5 years old were 8.81%(95%CI: 7.70%-9.90%), the 5-6 years old were 5.75%(95%CI: 4.80%-6.70%). The prevalence of astigmatism in different age groups had no statistical difference(χ²=0.872, P=0.929).

CONCLUSION: Astigmatism was the most common type of ametropia in preschool children, followed by hyperopia and anisometropia. Although no myopia was found, it confirmed the previous research that myopia was not formed at early age. Preschool children vision screening and eye care should be implemented regularly.

Abstract:AIM:To investigate changes in the normal intraocular pressure(IOP)fluctuation range after the small incision lenticule extraction(SMILE)in patients with low, moderate and high myopia and to explore new methods for postoperative IOP(IOP_post)correction.

METHODS: In this prospective case series study, 79 patients(158 eyes)who underwent SMILE at the Affiliated Hospital of Qingdao University from March 2018 to September 2019 were involved, and they were divided into low myopia(A), moderate myopia(B), and high myopia(C)groups. The 24-hour IOP was measured by the non-contact tonometer(NCT)and Goldmann applanation tonometer(GAT). Spherical equivalent(SE), central corneal thickness(CCT), the horizontal corneal diameter(WTW), corneal curvature, corneal volume(CV), ratio of the central 3-mm diameter CV(CCV_3mm)to the total CV, and the ratio of the cutting CV(ΔCV)to the CV were measured 3d preoperatively and 6mo postoperatively. The correlation between the postoperative NCT measurements(NCT_post)and various factors was statistically analysed, and the IOP_post expression model was established by phased multiple linear regression analysis.

RESULTS:The differences in IOP measured by NCT and GAT were not statistically significant(P>0.05), but the differences in IOP of the three groups were statistically significant(P<0.05). The IOP_post range by NCT were 8-17 mmHg in group A, 7-16.3 mmHg in group B, and 7.7-14.3 mmHg in group C. The IOP_post range by GAT were 8-17 mmHg. The IOP_post fluctuation was <6 mmHg. The IOP_post difference between the right eye and left eye was 0-4 mmHg. A staged multivariate regression model was established: NCT_{post corrected(A)}= 0.349 × NCT_post + 4.137 × CCV_pre3mm - 1.533; NCT_{post corrected(B)}= 0.477 × NCT_post + 3.643 × CCV_post3mm -1.125; NCT_{post corrected(C)}= 0.638 × NCT_post + 3.426 × CCV_post3mm -0.716.

CONCLUSION:The IOP measured by NCT and GAT after SMILE was lower than that measured before surgery. For different patients, the greater the rate of change in CV before and after surgery, the lower the IOP_post. CCV_post3mm is an important index for evaluating IOP after SMILE and thus guide postoperative medication administration.

Abstract:AIM:To establish the model of pseudomonas aeruginosa and staphylococcus aureus keratitis infection in tree shrews. To determine the expression of IL-17 in the bacterial infection process of tree shrews cornea, and the mechanism of IL-17 in bacterial keratitis of tree shrews is discussed.

METHODS: The tree shrew bacterial keratitis models were established by the contact lens-assisted corneal scratching method. After establishing models successfully, the infection symptoms of the model were evaluated by using anterior segment photography and in vivo confocal microscopy on 1, 4, 7 and 14d after performing inoculation, and pathological sections were made to observe histopathological changes in the cornea. Samples were collected at the corresponding time points above, and the expression of IL-17 mRNA in the corneal tissues of tree shrews was detected by real-time quantitative PCR, and the expression of IL-17 protein was detected by ELISA.

RESULTS:The success rate of modeling the tree shrew pseudomonas aeruginosa and staphylococcus aureus keratitis models was 96% and 100%.The clinical manifestations and inflammatory cell infiltration of the tree shrew keratitis was consistent with the changing rules of the cornea in histopathological. IL-17 gene and protein expression profiles in tree shrew corneas were consistent with the severity of corneal inflammation basically.

CONCLUSION:The use of contact lens-assisted corneal scratching method can successfully establish animal models of pseudomonas aeruginosa and staphylococcus aureus keratitis in tree shrews that more closely resemble the natural course of human bacterial keratitis infection. IL-17 participated in the occurrence and development of bacterial keratitis in tree shrews.

Abstract:AIM: To observe the protective effect of Qishen recipe on corneal epithelial cells induced by hypertonic fluid, and elucidated its mechanism of action in the treatment of dry eye base on JNK1 / AQP5 pathway.

METHODS: Human corneal epithelial cells(HCECs)model was created by osmotic pressure at a concentration of 500mOsm/L for 24h. Serum of rats containing drugs in the blank group, model group, Western medicine group, and Qishen recipe low-dose, medium-dose and high-dose groups were treated on the modeled DE HCECs, and the effects of different drug stimulation on the survival rate of HCECs were tested by CCK-8 method. The expressions of inflammatory factors TNF-α, IL-6 in extracellular fluid were explored by ELISA. The expression of apoptosis factors caspase 1 and AQP5 were detected by immunocytochemistry(ICC). The expressions of AQP5, JNK1, p-JNK1 of HCECs after intervention with different drug concentrations were found by Western blotting.

RESULTS: Compared with the blank group, the survival rate of HCECs in each group was significantly reduced(P<0.01). The extracellular fluid inflammatory factors TNF-α, IL-6 and caspase-1, p-JNK1, AQP5 protein expression levels increased significantly in each group(all P<0.01); In comparison to the model group, the survival rate of HCECs in each medication group increased significantly(all P<0.01). The expression levels of TNF-α, IL-6 in the extracellular fluid of each drug group, AQP 5 and p-JNK1 protein expression in HCECs, and the expression of caspase-1 and AQP5 protein in the western medicine group and the Qishen recipe high and medium dose group were all reduced(all P<0.05). Compared with the western medicine group, the survival rate of HCECs in the Qishen prescription high-dose group was significantly increased(P<0.01). The expression levels of TNF-α and IL-6 in each dose group of Qishen recipe were reduced(all P<0.05), while the expression levels of caspase-1 in the high-dose Qishen recipe group and the AQP5 protein expression levels of the high and medium-dose Qishen recipe group saw a decrease(all P<0.05). However, there was no statistically significant difference in the JNK1 protein expression of HCECs of all the groups detected by Western blotting method(P>0.05).

CONCLUSION: Qishen recipe can not only reduce the JNK1 phosphorylation and AQP5 protein expression of HCECs induced by hypertonicity, but also reduce the expression of inflammatory factors TNF-α, IL-6 and the apoptotic factor caspase-1 of HCECs in the extracellular fluid, thus effectively Inhibit inflammation and apoptosis.

Abstract:AIM: To explore the changes and significance in JIA-U and to detect the levels of CDld^(hi)CD5⁺CD19⁺ regulatory B cells(Breg)in the peripheral blood of children with juvenile idiopathic arthritis-associated uveitis(JIA-U).

METHODS: From April 2018 to May 2020, 95 children with JIA-U were selected as JIA-U group; 70 children with juvenile idiopathic arthritis(JIA)were selected as JIA group, and all of them were diagnosed and treated in our hospital; another 75 healthy children in the same period were selected as the control group. The ratio of CDld^(hi)CD5⁺CD19⁺Breg in peripheral blood was detected by flow cytometry; the level of IL-10 in peripheral blood was detected by ELISA; the correlation between CDld^(hi)CD5⁺CD19⁺Breg ratio and the expression of IL-10, the severity of JIA-U patients was analyzed by Pearson correlation coefficient method; the influencing factors of JIA-U were analyzed by Logistic regression.

RESULTS: Compared with the control group, the proportion of CDld^(hi)CD5⁺CD19⁺Breg in peripheral blood of children in JIA group and JIA-U group was significantly lower(all P<0.01), while the level of IL-10 was significantly higher(all P<0.01); compared with JIA group, the proportion of CDld^(hi)CD5⁺CD19^+Breg in JIA-U group was significantly lower(P<0.01), while the level of IL-10 was significantly higher(P<0.01); compared with the stationary phase, the ratio of CD1d^(hi)CD5⁺CD19⁺Breg in the active phase of JIA and JIA-U patients was significantly reduced(all P<0.01), and the IL-10 level was significantly increased(all P<0.01); the ratio of CDld^(hi)CD5⁺CD19⁺Breg was negatively correlated with the expression of IL-10 and the severity of JIA-U; multivariate analysis showed that low proportion of CDld^(hi)CD5⁺CD19⁺Breg, less-joint JIA subtype, duration of arthritis < 4a, high levels of IL-10 were risk factors for JIA-U.

CONCLUSION: The proportion of CDld^(hi)CD5⁺CD19⁺Breg in peripheral blood of children with JIA-U is significantly decreased, which may be involved in the occurrence and development of JIA-U, and has the potential to be used as an index to judge the severity of JIA-U.

Abstract:AIM: To observe and analyze the efficacy of Conbercept combined with 577nm yellow subliminal micropulse laser photocoagulation in the treatment of macular edema(ME)secondary to ischemic branch retinal vein occlusion(BRVO).

METHODS: Totally 71 patients(71 eyes)diagnosed as ME secondary to ischemic BRVO during the period from March 2016 to March 2019 were retrospectively included, and they were divided into laser group(n=33, 33 eyes)and combined group(n=38, 38 eyes)according to the different treatment methods. The patients in the laser group all received 577nm yellow subliminal micropulse laser photocoagulation, and the patients in the combined group all received Conbercept combined with 577nm yellow subliminal micropulse laser photocoagulation. The best corrected visual acuity(BCVA), central macular thickness(CMT)and total macular volume(TMV)were compared between the two groups before treatment and at 1, 2, 3, 6, 9 and 12mo after surgery, and the therapeutic efficacy was observed and the occurrence of complications were recorded.

RESULTS:There were statistically significant differences in the BCVA, CMT and TMV between the two groups before and after treatment(P<0.05), and the BCVA, CMT and TMV in the two groups at 1, 2, 3, 6, 9 and 12mo after treatment were significantly lower than those before treatment(P<0.05), and the differences between the two groups were statistically significant(P<0.05). During follow-up, there were 30 eyes with once laser photocoagulation, 7 eyes with twice and 1 eye with 3 times in combined group, and there were 16 eyes with once laser photocoagulation, 14 eyes with twice and 3 eyes with 3 times in laser group(Z=2.670, P<0.05). There were 3 eyes of corneal epithelial exfoliation on the 1d after vitreous injection in combined group, and the symptoms disappeared after symptomatic treatment. All patients did not have serious complications such as persistent intraocular pressure increase, retinal detachment and intraocular inflammation.

CONCLUSION: Conbercept combined with 577nm yellow subliminal micropulse laser photocoagulation has a significant efficacy in the treatment of ME secondary to ischemic BRVO, and it can effectively improve the visual acuity and promote the macular edema absorption, and it is safe and reliable.

Abstract:Vision loss can occur when the cornea loses transparency or changes shape. The most effective treatment to restore vision is to use full or partial layers of donor cornea for corneal transplantation. However, there is a severe shortage of donor corneas worldwide, with more than 98.5% of patients with corneal blindness waiting for donor corneas. In addition, there exist some problems such as the possibility of infection, allotransplantation immunologic rejection, and other problems after corneal transplantation. Therefore, tissue-engineering corneas have been widely studied over the years as a viable alternative to donor corneas, with different materials and methods. And in nearly ten years, the research has had breakthrough progress. The ultimate goal of the research is to construct a full or partial tissue-engineering graft with good transparency, biocompatibility, and appropriate mechanical strength to repair, regenerate, or replace diseased corneas. This review discusses the research progress and existing problems about the most frequently studied natural biomaterials in recent years. These biomaterials include amniotic membrane, acellular cornea, collagen, and silk. In addition to the future research directions, other challenges related to the biomaterials discussed in this field are illustrated.

Abstract:Diabetic retinopathy(DR)is one of the chronic microvascular complications of diabetes mellitus in the eye, leading to an increasing incidence of visual quality loss and even blindness in diabetic patients. However, so far, the mechanism of pathological changes leading to DR is very complex and not completely elucidated, and clinical treatment is mostly based on different stages of DR with symptomatic treatment, such as retinal laser photocoagulation, anti-vascular endothelial factor treatment, vitreous excision and membrane peeling surgery, etc. There is still a lack of safe and effective treatment methods, and it is therefore necessary to find new targets for diagnosis and treatment. With the development of molecular biology analysis technology, circular RNA(circRNA)has become one of the important research hotspots at present. It is reported that under the stimulation of various factors, the regulated expression of genes-circRNA regulates the development of DR by regulating the functions of retinal microvascular pericytes, retinal microvascular endothelial cells, and retinal pigment epithelial cells, which are involved in the pathological processes such as retinal basement membrane thickening, vascular leakage, apoptosis, inflammatory response and neovascularization. Therefore, this paper focuses on the research progress of cyclic RNA, competitive endogenous RNA and microRNA in the molecular mechanism of DR pathological alterations and therapeutic prospects, in order to provide some reference for clinical and basic research.

Abstract:Microglial activation is one of the main pathogenic factors to cause retinal neuroinflammation. Recently, with the advancement of retinal imaging technologies, hyperreflective foci(HRF), as a novel biomarker in optical coherence tomography(OCT)imaging, have received more attention in retinal neuroinflammation. Current research demonstrated that HRF are the aggregates mainly derived from the activated microglia in retina or mononuclear phagocyte-macrophage from the blood. HRF were defined as discrete and well-circumscribed hyperreflective dot-shaped lesions with the maximum diameter between 20-50μm in retina and choroid imaged with OCT. Under pathological conditions, the number of HRF increases significantly. Under pathological condations, the number of HRF was obviously increased, which might be related to the severity of some retinal diseases. However, the research on the source and function of HRF is still in its infancy. This review is aimed to describe the basic characteristics of HRF and their roles in both retinal inflammatory diseases and neurodegenerative diseases of the central nervous system. HRF are expected to be a potential and novel biomarker of inflammation for early diagnosis and prognosis of neuroinflammation in both retinal and central nervous system diseases.

Abstract:Ocular cicatricial pemphigoid(OCP)is a special manifestation of mucosal pemphigoid(mucous membrane pemphigoid, MMP), and the pathogenesis is not clear at present. It can be caused by variety factors such as antigen-antibody reaction, inflammation cell infiltration, the action of various cytokines, elevated calcium ion levels and susceptibility genes. In the early period of diseases, conjunctival present chronic progressive fibrotic inflammation, later the corneal opacity and the neovascularization will eventually lose vision. Therefore, it is particularly important to carry out clinical standardized treatment for OCP patients in a timely manner. To use medicine to control the inflammation and delay the progression of the disease, for example, dapsone, intravenous immunoglobulin(IVIG), rituximab(RTX), tumor necrosis factor antagonists and adrenocorticoids. Surgical treatment can be considered appropriately when OCP patients are complicated by severe trichiasis, corneal disease and cataract.

Abstract:Netrin-1 is a neuronal axon guidance factor, a soluble protein secreted by the cell floor, and is among the most widely studied members of the Netrins family.Netrin-1 has the diversity of receptors, and its binding to different receptors can activate different biological effects, resulting in multiple functions. Recent studies have revealed that Netrin-1 is closely associated with neural axon guidance, inflammatory responses, neovascularization, apoptosis, and other responses. It can act not only in the central nervous system, but also in many systemic diseases such as those of the respiratory and cardiovascular systems, making it an important target for the treatment of these diseases. In the field of ophthalmology, Netrin-1 is closely associated with optic nerve hypoplasia(ONH), corneal disease, diabetic retinopathy(DR), age-related macular degeneration(ARMD), and retinoblastoma(RB), and has very promising applications in the prevention and treatment of these diseases. In this review, we will explore the association of Netrin-1 with ocular diseases and its role.

Abstract:Proliferative vitreoretinopathy(PVR)is a eye disease characterized by the formation of epiretinal membranes(ERM)composed of extracellular matrix(ECM)and various types of cells in the vitreous and/or the surface of the retina through the wound repair and fibrotic process. ERM shrinks to form retinal folds and stretches the retina to cause retinal detachment(RD). Epithelial-mesenchymal transition(EMT)of retinal pigment epithelial(RPE)cells and accumulation of ECM are considered to be the main pathological mechanisms for the formation of ERM. RPE cells undergo a process named EMT induced by transforming growth factor-β(TGF-β), by which differentiated epithelial cells go through epithelial phenotypic loss, the weakness of cell-cell contact and mesenchymal phenotype expression. Fibroblast-like cells differentiated from mesenchymal cells produce ECM and other components, which forms ERM together with glial cells and fibroblasts, etc. Recent studies indicated a lot of cytokines/growth factors, transcriptional factors, and microRNA(miRNA)regulate the development of EMT in RPE cells, in which miRNA is a novel and powerful regulatory gene and plays a critical regulatory role in the EMT process of PVR. This review focuses on the current understandings of the mechanism and the interventional treatments of miRNA in PVR.

Abstract:Proliferative vitreoretinopathy(PVR)is a common complication of perforation injury and surgery for rhegmatogenous retinal detachment. The pathogenesis of this disease is still unclear. However, studies have shown that retina pigment epithelium(RPE)cells have the ability to secrete cytokines, and many growth factors are overexpressed in vitreous or subretinal fluid in PVR patients. These growth factors and their receptors play an important role in the occurrence and development of PVR. When the blood-retinal barrier is broken, the physiological balance of growth factors disappears, and RPE cells are stimulated by growth factors to undergo epithelial-mesenchymal transformation(EMT), migration and proliferation, this leads to the formation of the preretinal membrane, which pulls on the retina and causes retinal detachment. In recent years, scholars have done a lot of researches on the signaling pathways, EMT process and cell proliferation involved in the formation of PVR with growth factors. This article will summarize the function of growth factors involved in the formation of PVR and the therapeutic effects of antagonistic growth factors in the development of PVR.

Abstract:Pachydrusen is found in pachychoroid diseases such as polypoid choroidal vasculopathy disease, central serous chorioretinopathy, pachychoroid pigment epitheliopathy and pachychoroid neovasculopathy. The typical choroidal changes of the spectrum are abnormally dilated pachyvessels, choroidal thickening with overlying retinal pigmentary epithelium changes. In this paper, we summarized the clinical manifestations, epidemiology, genetics, and histopathology of the newly named type of drusen, in order to provide the direction for diagnosis and treatment in clinical ophthalmic diseases.

Abstract:Neovascular eye disease, which is characterized by pathological neovascular formation, is a major disease threatening visual health. In recent years, neovascular eye disease has become a serious public health problem and attracted widespread attention, with the incidence increasing year by year. Pathological neovascularization is formed under the mutual inclusion and interaction of a variety of cellular components and pathological factors. It is often difficult to achieve ideal therapeutic effect if we intervene only one of the factors. Therefore, it is in an urgent need to conduct a more in-depth study in the pathological process of neovascularization and explore new factors that regulate neovascularization in order to find more effective treatments of neovascular eye diseases. In recent years, pericyte has been proved to play important roles in the occurrence and development of various neovascular eye diseases and interventions for pericytes will affect the pathological process of these diseases. This article will review the specific roles of pericytes in some common neovascular eye diseases and the factors regulating pericytes in these diseases, which would provide new ideas in the treatment of neovascular eye diseases.

Abstract:The incidence of dry eye is increasing year by year, and it has become one of the most common ophthalmic diseases. The main symptoms of dry eye disease are dry, foreign body sensation, burning in eyes, itchy and viscous secretion. These discomforts affect the daily life, efficiency of work and study, mental health and physical function of patients with dry eye. Dry eye is a multifactorial disease of the ocular surface characterized by a loss of homeostasis of the tear film, and accompanied by ocular symptoms, in which tear film instability and hyperosmolarity, ocular surface inflammation and damage, and neurosensory abnormalities play etiological roles. Meanwhile, there are changes in the tissue structure and ocular surface microenvironment of the eyes of patients with dry eye. In view of the fact that dry eye is an important public health problem, which seriously affects people's visual quality and life quality, studying the pathophysiology of dry eye is of great significance for efficient diagnosis, more targeted treatment and reduction of adverse events. This paper reviewed the research progress in the pathophysiology of dry eye in recent years.

Abstract:AIM: To investigate the therapeutic effect of femtosecond laser-assisted cataract surgery(FLACS)in eyes with shallow anterior chamber depth.

METHODS: Totally 60 eyes of 55 cataract patients with shallow anterior chamber who received cataract phacoemulsification in Tangshan eye hospital from November 2020 to February 2021 were selected, and divided into two groups according to the surgical methods on patient's subjective willingness: Patients who received FLACS were assigned to the FLACS group(28 patients, 30 eyes), and patients who received conventional Phaco(27 patients, 30 eyes)were assigned to the Phaco group. Preoperative general conditions, cumulative dissipated energy(CDE), effective phacoemulsification time(EPT), postoperative best corrected visual acuity(BCVA), uncorrected visual acuity(UCVA), endothelial cell loss rate(ECL), central macular thickness(CMT)and complications were compared and analyzed.

RESULTS:There was no significant difference in preoperative general data between the two groups(P>0.05). In both groups, UCVA at 1d, 1wk and 1mo after surgery and BCVA at 1wk and 1mo after surgery were better than those before surgery, and at 1d after surgery, UCVA in FLACS group was better than that in Phaco group, the difference was statistically significant(P<0.05). In the FLACS group, CDE, EPT, ECL at 1wk and 1mo after surgery, and the incidence of corneal edema at 1d and 1wk after surgery were all lower than those in the Phaco group(all P<0.05). There was no significant change in CMT in either the intragroup comparison or the intergroup comparison(P>0.05).

CONCLUSION:FLACS is safe and effective in patients with shallow anterior chamber cataract, which can significantly reduce the rate of endothelial cell loss, quickly restore vision, reduce the incidence of complications, and has no significant effect on macula.

Abstract:AIM: To observe the changes of visual acuity, intraocular pressure(IOP)and anterior chamber structure after phacoemulsification intraocular lens(IOL)implantation and goniosynechialysis in acute angle-closure glaucoma with cataract.

METHODS: A prospective study. Totally 80 eyes with acute primary angle-closure glaucoma(APACG)and cataract were selected in our hospital from August 2019 to February 2021. All study underwent phacoemulsification IOL implantation and goniosynechialysis. Visual acuity, IOP, anterior chamber distance(ACD), trabecular iris angle(TIA)and angle opening distance(AOD500)were measured before and 1wk, 1, 3 and 6mo after surgery. Four quadrant angle classifications of upper, lower, nasal and temporal were determined by Scheie classification method and the measured values were statistically analyzed.

RESULTS: The postoperative corrected visual acuity in 1wk, 1, 3 and 6mo were improved than preoperative, there were no statistically significant differences between each postoperative period(P>0.05). The IOP in postoperative 1wk, 1, 3 and 6mo were reduced than preoperative, there were not significantly different between each postoperative period(P>0.05). The ACD in postoperative 1wk, 1, 3 and 6mo were deepen than preoperative, there were not significantly different between each postoperative period(P>0.05). The TIA in postoperative 1wk, 1, 3 and 6mo were widened than preoperative, there were not significantly different between each postoperative period(P>0.05). The AOD500 in postoperative 1wk, 1, 3 and 6mo were increased than preoperative, there were not significantly different between each postoperative period(P>0.05). The depth of anterior chamber angle in four quadrants were deepened combined with the depth in postoperative 1wk, 1, 3 and 6mo(P<0.05).

CONCLUSION: Phacoemulsification IOL implantation and goniosynechialysis in the treatment of acute angle-closure glaucoma with cataract can significantly improve visual acuity, increase the depth of central anterior chamber, open angle, reduce IOP. It is an effective and stable surgical method.

Abstract:AIM: To investigate the difference of the optic vessel density in early primary open angle glaucoma(POAG), ocular high tension subjects and healthy subjects.

METHODS: A cross-sectional study. From January 2019 to April 2021, patients were selected in the Department of Glaucoma in Fuzhou Southeast Eye Hospital. There were 45 patients(70 eyes)of early POAG group, including 32 males(49 eyes)and 13 females(21 eyes)with age of 48.50(26.75, 64.50)years. There were 37 patients(65 eyes)of ocular high tension group, including 17 males(29 eyes)and 20 females(36 eyes)with age of 37.00(27.00, 47.00)years. There were 51 patients(94 eyes)of healthy group, including 23 males(39 eyes)and 28 females(55 eyes)with age of 46.00(34.50, 56.50)years. Ophthalmic examinations including best-corrected visual acuity(BCVA), intraocular pressure, central corneal thickness(CCT), mean deviations(MD), retinal nerve fiber layers thickness(RNFL)were measured in three groups. The center area, the inner circle area, the outer circle area, and the whole area of the optic vessel density in three groups were measured via optical coherence tomography angiography(OCTA)device.

RESULTS: The difference of the intraocular pressure in early POAG group-ocular high tension group was not significant(H=146.876,P<0.001), while significantly in early POAG group-healthy group and ocular high tension group-healthy group(all P<0.01). Significant differences in BCVA, MD, and RNFL were observed in early POAG group-ocular high tension group(P=0.005, P=0.01, P<0.01)and early POAG group-healthy group(P=0.013, P<0.01, P<0.01), while the difference was not found in ocular high tension group-healthy group(P=1.000, P=0.660, P=1.000). There was no difference of CCT in early POAG group-healthy group(P=0.074), and significant differences were observed in early POAG group-ocular high tension group and ocular high tension group-healthy group(P=0.006, P<0.01). The optic vessel density comparison in the center area, the inner circle area, and the whole area were significantly different in early POAG group-ocular high tension group(all P<0.01)and in early POAG group-healthy group(all P<0.01), which indicated that the optic vessel density was obviously less in the early POAG group than the other two groups. The optic vessel density had no significant difference in ocular high tension group-healthy group in these areas(all P=1.000). In the outer circle area, there were no significant differences of the optic vessel density in early POAG group-ocular high tension group and early POAG group-healthy group(P=0.067, P=0.877), while significant difference was observed in early POAG group-healthy group(P=0.001).

CONCLUSION: The optic vessel density was decreased in early POAG comparing with ocular high tension subjects and healthy subjects, which was agree with the changes of MD, RNFL. The optic vessel density decreased firstly from the center area and the inner circle area for early POAG.

Abstract:AIM: To observe the efficacy of addition and subtraction of Buyang Huanwu decoction in the adjuvant treatment of non-proliferative diabetic retinopathy of Qi-Yin deficiency and blood stasis and its effects on traditional Chinese medicine(TCM)syndromes and visual function level.

METHODS: A total of 110 patients with non-proliferative diabetic retinopathy of Qi-Yin deficiency and blood stasis in our hospital between January 2017 and December 2019 were selected and divided into observation group(55 cases, 110 eyes)and control group(55 cases, 110 eyes). Patients in control group received conventional treatment according to the condition of patients with reference to relevant guidelines, and patients in observation group were combined with addition and subtraction of Buyang Huanwu decoction adjuvant therapy on this basis. The clinical efficacy after 3mo of treatment, and TCM syndromes scores, clinical indicators(macular edema score, macular retinal volume, macular foveal retinal thickness), visual function(best corrected visual acuity, average visual field sensitivity)and serum biochemical indicators \〖vascular endothelial growth factor(VEGF), hypoxia-inducible factor-1(HIF-1)\〗 before treatment and 3mo after treatment were compared between the two groups.

RESULTS: After 3mo of treatment, the total effective rate of treatment in observation group was significantly higher than that in control group(P<0.05). After 3mo of treatment, the TCM syndromes scores in the two groups were decreased compared with those before treatment, and the scores in observation group were lower than those in control group(P<0.05). After 3mo of treatment, the macular edema score, macular retinal volume and macular foveal retinal thickness in the two groups were reduced compared with those before treatment, and the indexes in observation group were smaller than those in control group(P<0.05). After 3mo of treatment, the best corrected visual acuity and average visual field sensitivity in the two groups were improved compared with those before treatment, and the indexes in observation group were higher than those in control group(P<0.05). After 3mo of treatment, the levels of serum VEGF and HIF-1 in the two groups were decreased compared with those before treatment, and the levels in observation group were lower than those in control group(P<0.05).

CONCLUSION: Addition and subtraction of Buyang Huanwu decoction has an exact efficacy in the adjuvant treatment of non-proliferative diabetic retinopathy of Qi-Yin deficiency and blood stasis, and it can improve symptoms and promote visual function recovery by reducing the expressions of VEGF and HIF-1.

Abstract:AIM: To analyze the effectiveness and safety of different concentrations of tea tree essential oil in the treatment of Demodex blepharitis.

METHODS: The clinical data of 120 patients(240 eyes)with blepharitis caused by Demodex infection in our hospital from June 2017 to June 2019 were retrospectively analyzed. According to the use of tea tree essential oil concentrations of 10%, 15%, 20% and 25%, patients were divided into 4 groups(group A, group B, group C, group D), each group with 30 people. All patients were given meibomian gland massage, eyelid margin cleaning, and then scrubbed with different concentrations of tea tree oil to clean the eyelid margin. The number of demodex mites, clinical symptom score, clinical sign score, tear film break-up time(BUT), corneal fluorescein staining(FL)and SchirmerⅠtest(SⅠt)were compared before and 2, 4wk after treatment.

RESULTS: The number of Demodex mites, clinical symptom score, clinical sign score, BUT, FL and SⅠt were not statistically significant in the four groups before treatment(P>0.05). After treatment, the number of Dmodex mites, clinical symptom score, and clinical sign score in each group were lower than those before treatment, and the number of Demodex mites, clinical symptom score, and clinical sign score after 4wk of treatment in each group were lower than those after 2wk of treatment(all P<0.008). After 2 and 4wk of treatment, the number, clinical symptom score and clinical signs score of Demodex mites in group A were the highest, while those in group D were the lowest(all P<0.008). After treatment, the BUT of each group was higher than before treatment, and reached the peak in the 4wk. After 2 and 4wk of treatment, BUT among groups was highest in group D and lowest in group A(all P<0.008). After treatment, FL and S I t of each group were lower than before treatment, and reached the lowest value in the 4wk. After 2 and 4wk of treatment, FL among the groups was the lowest in group D and the highest in group A(all P<0.008).

CONCLUSION: Compared with 10% tea tree essential oil, 15% tea tree essential oil can effectively repel mites, relieve clinical symptoms and eye signs in patients with Demodex blepharitis, and is safer than 20% and 25% tea tree essential oils. As the preferred concentration of tea tree essential oil against Demodex blepharitis.

Abstract:AIM:To investigate the application of multi-mode teaching steered by “HOPE” in the clinical teaching of contact lens.

METHODS: Prospective study. Two classes(totally 80 students)of 2018 grade major in optometry, Nanjing Medical University, were randomly selected as experimental group(40 students, 18 males, 22 females)using multi-mode teaching(including problem-based learning, case-based learning and flipped classroom),and control group(40 students, 19 males, 21 females)using traditional teaching mode. At the end of the course, the teaching effects were evaluated by usual performance, network examination, theory test, operation test and questionnaire.

RESULTS: The assessment result at ordinary times: the points of experiment group(16.46±2.19)points was higher than the control group(13.81±2.95)points(t=6.36, P<0.01); Network examination result: the points of experiment group(9.37±1.57)points was higher than the control group(7.21±1.46)points(t=4.39, P=0.01); Theory of the assessment result: the points of experiment group(40.41±3.48)points was higher than the control group(36.29±3.34)points(t=9.25, P<0.01); The assessment result of operation: the points of experiment group(18.22±2.69)was higher than the control group(16.28±2.52)(t=3.25, P=0.02); Total grade: the points of experiment group(84.46±5.26)was higher than the control group(73.69±6.35)(t=11.26,P<0.01). Contact lens teaching effect feedback questionnaire results showed that: students based on the concept of “HOPE” teaching mode were more satisfied than control group, and they think it had more advantages than traditional teaching group in learning initiative and improving teaching efficiency, cultivating clinical thinking ability, improving the communication power of expression(all P<0.05).

CONCLUSION: Multi-mode teaching(PBL, CBL and flipped classroom)steered by “HOPE” in the clinical teaching of contact lens can stimulate students'interest in learning, improve the quality of teaching and achieve better teaching effect.

Abstract:AIM: To evaluate efficacy, safety and complications of 25G vitrectomy, phacoemulsification combined with intrascleral fixated intraocular lens(IOL)implantation for treatment of lens luxation.

METHODS: Totally 20 patients(20 eyes)with complete lens luxation and the hardness of lens nucleus was grade 3 or above who underwent 25G vitrectomy, phacoemulsification combined with intrascleral fixated IOL implantation between May 2018 and December 2020 were analyzed retrospectively. The uncorrected visual acuity, best corrected visual acuity, intraocular pressure, the count of corneal endothelium cell, central corneal thickness and complications were observed.

RESULTS: The uncorrected visual acuity and best corrected visual acuity after operation were improved than those before treatment(P<0.05). The number of corneal endothelial cells in the central part of cornea after operation was lower than that before operation(P >0.05). There was no significant difference in central corneal thickness 2wk after operation compared with that before operation(P >0.05). There were 3 cases of low intraocular pressure and 2 cases of high intraocular pressure, but they all returned to normal at the end of follow-up. The IOL were all centered and there were no obvious eccentricity and inclination. No other complications such as vitreous hemorrhage and retinal detachment occurred.

CONCLUSION: 25G vitrectomy, phacoemulsification combined with intrascleral fixated IOL implantation is a fast, safe and simple method for the treatment of complete lens luxation.

Abstract:AIM: To observe the clinical effect of femtosecond laser-assisted phacoemulsification combined with goniosynechialysis in the management of acute angle-closure glaucoma with cataract.

METHODS:Retrospective study. From March 2019 to April 2021, 34 eyes of 29 acute angle-closure glaucoma with cataract patients were performed femtosecond laser-assisted phacoemulsification combined with goniosynechialysis. Best corrected visual acuity(BCVA), intraocular pressure(IOP), grading of chamber angle, central anterior chamber depth, corneal endothelial cell count and central corneal thickness were mesaured and analyzed preoperatively and at 1d, 1wk, 1mo.The postoperative complications were analyzed.

RESULTS: There was a statistically significant difference between preoperative and postoperative BCVA at 1mo(Z= -5.126, P<0.01). IOP at 1d, 1wk and 1mo were 16.72±2.12mmHg, 13.73±1.68mmHg and 12.87±3.54mmHg respectively, which were different from 28.67±4.13mmHg before surgery(all P<0.01). The range of atrial angle adhesion at 1mo after the surgery was significantly reduced compared with preoperative(t=21.32, P<0.01). The depth of central anterior chamber, the open distance of atrial angle and the included angle of trabecular iris at 1mo after the surgery were significantly greater than preoperative(t= -3.37,-3.68, -5.61, all P<0.01). There were no significant differences in corneal endothelial cell count and central corneal thickness(P>0.05). Postoperative satisfaction was high without serious complications.

CONCLUSION:Femtosecond laser-assisted phacoemulsification combined with goniosynechialysis may be an effective treatment option for acute angle-closure glaucoma complicated with cataract, is safe, effective and has fewer complications.

Abstract:AIM: To explore the effects of different intensity aerobic exercises on macular retinal vascular density in patients with primary open angle glaucoma(POAG).

METHODS: Prospective case-control study, 88 eyes of 48 patients with POAG diagnosed in our hospital from January 2019 to April 2021 were included(POAG group), 43 cases(86 eyes)were included in the normal control group(control group). The fundus photographic examination without mydriasis was performed with a mydriatic fundus camera, and the operation and film reading were carried out by a special ophthalmologist. Macular vascular density was measured by macular vascular segmentation method. According to macular vascular density, 48 patients with POAG were divided into low vascular density group and high vascular density group, with 24 cases in each group. 48 patients with POAG were instructed to perform treadmill load exercise to compare the vascular density levels in macular area of patients with high intensity(76%-87% HRmax), moderate intensity(64%-75% HRmax)and low intensity(52%-63% HRmax).

RESULTS: The vascular density in macular area of control group was significantly higher than that of POAG group; Compared with the high vascular density group, the age and systolic blood pressure were significantly higher in the low vascular density group, and the body weight was significantly lower; In both low and high vascular density groups, the retinal vascular density of macular area under moderate intensity aerobic exercise was significantly higher than that of low intensity and high intensity aerobic exercise; Systolic blood pressure and aerobic exercise were the influencing factors of vascular density in macular area; the above results showed statistically significant differences(P<0.05).

CONCLUSION: Systolic blood pressure and aerobic exercise are factors affecting macular vascular density, and moderate intensity aerobic exercise can significantly increase macular vascular density.

Abstract:AIM: To explore the effects of ranibizumab and conbercept combined with photodynamic therapy(PDT)on vision and hemorheology of polypoid choroidal vascular(PCV)lesions.

METHODS: Prospective research. A total of 120(120 eyes)PCV patients who were admitted to our hospital from 2017-02/2020-06 were enrolled and divided into 61 cases(61 eyes)in the ranibizumab combined with PDT treatment group according to the random number table. Conbercept combined with PDT treatment group of 59 patients(59 eyes), compared the intraocular pressure, best corrected visual acuity(BCVA), central retinal thickness(CRT), blood flow, and the incidence of complications within 3mo of follow-up between the two groups before and after treatment.

RESULTS: There was no difference in intraocular pressure, CRT, and BCVA at 1 and 3mo after treatment between the two groups(all P>0.05). The whole blood high shear viscosity and whole blood of the ranibizumab combined with PDT treatment group were 1 and 3mo after treatment. The low-shear viscosity was lower than the conbercept combined with PDT treatment group(all P<0.05). At the same time, the complication rate in the ranibizumab combined with PDT treatment group during the follow-up period of 3mo was lower than that in the conbercept combined with PDT treatment group(3.3% vs 16.9%, P<0.05).

CONCLUSION: The treatment of ranibizumab combined with PDT for patients with PCV disease is more conducive to hemorheological stability and reduces the incidence of complications.

Abstract:AIM: To evaluate the visual function and visual quality of patients with diabetic macular edema treated with conbercept injection.

METHODS: The average change of contrast sensitivity(CS), best corrected visual acuity(BCVA), central retinal thickness(CRT)and NEIVFQ-25 score were observed for 3mo after intravitreal injection of conbercept in 43 eyes of 38 patients with diabetic macular edema.

RESULTS: The mean CS increased from(1.060±0.14)units to(1.47±0.31)units at 12wk after intravitreal injection of conbercept(P<0.05). The average LogMAR BCVA decreased significantly from 0.535±3.32 to 0.333±0.11 at 12wk(P<0.05), and the average CRT decreased significantly from 369.45±36.42μm to 226.53±39.48μm at 12wk(P<0.05). There is not a correlation between the changes in CRT and BCVA and the improvement of CS. The NEIVFQ-25 score improved in 30 cases(79%)from baseline to 12wk. 6 cases(16%)had no change in the NEIVFQ-25 score, and 2 cases(5%)declined in the NEIVFQ-25 score.

CONCLUSION: The treatment of conbercept injection for diabetic retinal macular edema can significantly improve the visual function and the quality of life.

Abstract:AIM: To observe the therapeutic effects of different dosage regimens of conbercept on clinical significant diabetic macular edema(CSME).

METHODS: Totally 65 patients with diabetes and CSME who were admitted to the Ophthalmology Department at Ganzhou People's Hospital between January 2019 and January 2020 were selected as the research subjects, and divided into observation group(n=33, conbercept 5+PRN regimen)and control group(n=32, conbercept 3+PRN regimen)using random number table method. Visual acuity test and optical coherence tomography(OCT)were carried out at 1, 2, 3, 6, 9, 12mo after treatment. Changes in the best corrected visual acuity(BCVA,LogMAR)and central macular thickness(CMT)were compared between the two groups. The mean injection times and complications in the two groups were recorded.

RESULTS: The BCVA was improved and CMT thinned in the two groups at 1, 2, 3, 6, 9, 12mo after treatment(P<0.05). There was no statistically significant difference in BCVA and CMT between the two groups before treatment, and at 1, 2, 3, 6, 9, 12mo after treatment(P>0.05). The mean injection times in observation group was more than that in the control group \〖(5.81±0.54)times vs (4.19±0.41)times\〗(P<0.05). In the early stage of postoperative follow-up, there were 30 times(23%)and 15 times(22%)of subconjunctival hemorrhage in observation group and control group, respectively(P>0.05). No other severe complications were observed in the two groups.

CONCLUSION:Both conbercept 3+PRN and conbercept 5+PRN are effective in the treatment of patients with diabetes and CSME. Both can significantly improve the patients' visual acuity and reduce CMT, with equivalent effect. The latter may increase the injection times but its adverse reactions are tolerable. In addition, it is safe and reliable.

Abstract:AIM: To investigate the correlation between lipid metabolism disorder and retinopathy of prematurity(ROP)of premature infants.

METHODS: A retrospective analysis was performed on the medical data of 48 premature infants mothers who were hospitalized and diagnosed with ROP in the Department of Neonatology, Children's Hospital of Soochow University from January 2017 to December 2018. Forty-eight hospitalized no-rop premature infants mothers were enrolled as the control group during the same period. The two groups were compared in terms of blood lipids and adiponectin level in the third trimester. Pearson correlation and Logistic regression analysis were used to analyze the correlation between adiponectin and blood lipids and risk factors of retinopathy in premature infants.

RESULTS: The total cholesterol, triglyceride, low-density lipoprotein and apolipoprotein B level in the observation group were all higher than those in the control group, while high-density lipoprotein, adiponectin and apolipoprotein A1 level were lower than those in the control group. In addition, Pearson correlation analysis showed correlation between adiponectin and blood lipid levels, while Logistic regression analysis showed increased of total cholesterol, triglycerides, low-density lipoprotein, and apolipoprotein B and decreased of high-density lipoprotein, and apolipoprotein A1 were risk factors for ROP.

CONCLUSION: Pearson test indicated positive correlation between lipid disorders of third trimester and retinopathy of premature infants, which may be related to adiponectin. In clinical work, we should focus on strengthening the guidance of maternal nutrition to reduce the incidence of ROP.

Abstract:AIM: To compare the optic disc microvessel density(MVD)with different degrees of myopia and to evaluate the association of MVD with axial length(AL)and retinal nerve fibre layer thickness(RNFL)by using optical coherence tomography angiography(OCTA).

METHODS: Prospective and pathological control study. A total of 94 eyes \〖31 eyes with mild myopia(SE: +0.50D to -0.50D), 32 eyes with low and moderate myopia(-0.75D≤SE<-6.00D), and 31 eyes with high myopia(SE≥-6.00D)\〗 underwent optical coherence tomography angiography imaging. OCTA was used to image 4.5mm×4.5mm scanning area centered on the subject's optic disc, and to automatically and quantitatively measure the MVD and RNFL thickness in different partitions of the optic disc in order to carry out relevant discussions.

RESULTS: Among ISNT partition, temporal RNFL thickness was positively correlated with AL(r=0.343, P<0.05). RNFL thickness in the nasal, inferior and superior quadrants was negatively correlated with AL(r=-0.341, -0.289, -0.269, all P<0.05). In Garway Heath partition, temporal superior RNFL thickness was positively correlated with AL(r=0.382, P<0.05). Negative correlations were found in the thickness of RNFL with AL at the nasal superior, nasal inferior and inferior nasal quadrant(r=-0.226, -0.211, -0.369, -0.316, -0.304, -0.241, all P<0.05). The overall MVD in optic disc increased with the increase of AL(r=0.376, P<0.05), while the overall MVD around optic disc was negatively correlated with AL(r=-0.361, P<0.05).

CONCLUSION: The change of MVD and RNFL thickness of optic disc are closely related to AL. With the increase of AL, the thickness of RNFL and MVD in the nasal superior, nasal inferior and inferior nasal quadratons decreased, the overall MVD in optic disc decreased, and the MVD in optic disc and the temporal superior quadratons increased, especially in high myopia.

Abstract:AIM:To evaluate the effect of Yangxue Runmu formula combined with sodium hyaluronate on dry eye after cataract surgery by ocular surface analyzer.

METHODS: Totally 80 patients with dry eye after cataract surgery in our hospital from June 2019 to December 2020 were selected and divided into control group and observation group by random number table method, 40 cases in each group. The control group was treated with sodium hyaluronate eye drops, and the observation group was treated with Yangxue Runmu formula combined with sodium hyaluronate eye drops. The index levels of ocular surface analyzer and fluorescein staining(FL)score were compared between the two groups.

RESULTS: After treatment, the wet length of tear film, first non-invasive tear break-up time(NIBUTf), average non-invasive tear break-up time(NIBUTav)and tear meniscus height(LTMH)in the two groups were markedly higher than those before treatment(all P<0.01), and the observation group were markedly higher than those in the control group(P<0.05); after treatment, the conjunctival hyperemia score, meibomian gland loss score, FL score in the two groups were markedly lower than those before treatment(all P<0.01), and the observation group were markedly lower than those in the control group(all P<0.01); there were no obvious adverse reactions in the two groups.

CONCLUSION: Through the evaluation and analysis of ocular surface analyzer, Yangxue Runmu formula combined with sodium hyaluronate can effectively improve the ocular surface function of patients after cataract surgery, and has good safety.

Abstract:AIM: To observe the epidemiological characteristics of myopia among primary school students in Xindu District of Chengdu before and after COVID-19 home isolation period(from Jan.-May 2020).

METHODS:Cross-sectional study. A total of 10 153 primary school students from grade 1-6(age 6-13, three classes per grade)were selected from four primary schools in Xindu District of Chengdu for three consecutive years(2018-2020), by using a random stratified cluster sampling method. All students' visual acuity and spherical equivalent refraction(SE)were measured, a further cycloplegia optometry was conducted for those whose visual acuity was less than 5.0. The SE was recorded and the prevalence of myopia was calculated. Chi-square test was used to compare the difference of prevalence of myopia between different years. One-way Anova was used to compare the difference of SE among different years.

RESULTS: There was statistical difference in prevalence of myopia between the three years(2018: 35.98%, 2019: 36.29%, 2020: 42.52%; χ²=39.374, P<0.001). The prevalence of myopia among 6-9 years old students increased significantly in 2020(P<0.01). They were 2.20 times(6 years old), 2.08 times(7 years old), 1.36 times(8 years old)and 1.24 times(9 years old)of the previous year. Students aged 6-9 years showed an obvious myopic shift in SE in 2020(P<0.05). The increases were -0.34±0.76D(6 years old), -0.28±0.84D(7 years old), -0.29±1.41D(8 years old)and -0.18±1.35D(9 years old)than the previous year. The prevalence of myopia and SE remained stable among 10-13 years old students in 2018-2020(P>0.05).

CONCLUSION: After the COVID-19 home isolation period, there was a significant myopic shift among students aged 6-9 years old. We should pay more attention to the window period for myopia prevention and control of 6-9 years old.

Abstract:AIM: To investigate the current quality of life in children with amblyopia and its influencing factors.

METHODS: Cross-sectional study. Using random sampling method, 178 children with amblyopia were selected as the research objects, and the Chinese version of the Universal Core Scale of Children's Quality of Life was used to investigate the research objects. The impact of amblyopia on children's quality of life was analyzed.

RESULTS:The quality of life score of children with amblyopia was(77.23±15.52)points. The results of multiple linear regression showed that parental education, left eye best-corrected visual acuity, right eye corrected visual acuity, coverage, premature delivery, hypoxia at birth and delivery way were the main factors affecting the quality of life of amblyopic children. It can explain 38.6% of the variance in the quality of life of children with amblyopia(F=15.242, P<0.001).

CONCLUSION:The current quality of life in children with amblyopia is at a low-to-moderate level. Amblyopia may have a greater negative impact on children's daily life, learning, psychology and social interactions. It is necessary to implement health plans and psychological guidance for children with amblyopia and their parents, improve treatment compliance, improve vision, strengthen health guidance for women of child bearing age, and provide reference for further improving the quality of life of children with amblyopia.

Abstract:AIM: To examine the clinicopathological characteristics of adult orbital xanthogranulomatous disease(AOXGD).

METHODS: From January 2015 to January 2021, the researchers collected postoperative pathological diagnoses cases of AOXGD from Xi'an People's Hospital(Xi'an Fourth Hospital), retrospectively analyzed clinical pathological data, and reviewed related literature.

RESULTS: A total of five AOXGD cases were collected, including three cases of adult-onset xanthogranuloma(AOX), one case of necrobiotic xanthogranuloma(NBX), and one case of Erdheim-Chester disease(ECD). The five patients were composed of middle-aged and elderly patients with local orbital lesions were treated. Microscopic examination revealed that the orbital skin and subcutaneous tissue had foam-like non-Langerhans histiocytes that exhibited diffused or nested infiltration. Immunohistochemistry revealed that the cells were positive for CD68, CD163, FXⅢa, lysozyme, negative for S100, CD1a, Langerin, HMB-45, MDM2. One ECD patient had orbital lesions as the first symptom and exhibited a combination of retroperitoneal lesions, right atrium pseudotumor, and long bones, heart, kidney lesions. The diagnosis of AOXGD depends on clinical manifestations and pathological features. The treatment was based on subtypes and clinical manifestations to select corresponding strategies, which mainly include the administration of glucocorticoids, immunosuppressants, and surgical treatment.

CONCLUSION: AOXGD is relatively rare in clinical practice. AOXGD can manifest as a local orbital disease or an orbital disease combined with a systemic disease. In the clinical and pathological work of ophthalmology, the understanding and identification of this group of diseases should be strengthened, and correct diagnosis and standard treatment should be promoted.

Abstract:AIM: To analyze the role of preoperative telephone interview in the cancellation rate for ophthalmic daytime surgery.

METHODS: A prospective, single center study was conducted to compare and analyze the cancellation of daytime surgery in two time periods. The control group was from June 2018 to June 2019, only routine nursing and health education were implemented. The patient in the intervention group were from October 2019 to October 2020, add the telephone interview of the day before operation was added by the nurses in the ophthalmic operating room.

RESULTS: The main reasons for canceling the operation included upper respiratory tract infection, abnormal blood glucose, abnormal blood pressure and physiological period, abnormal preoperative examination results, and patients didn't follow the doctor's advice to use preoperative eye drops. In the control group, there were 16 974 cases scheduled for daytime operation, 16 332 cases actually operated, and the cancellation rate of operation was 3.78%(642 cases cancelled). In the intervention group, 17 694 cases were scheduled for daytime operation, and 17 296 cases were actually operated, with the cancellation rate of 2.25%(398 cases cancelled). The disease distribution and cancellation reasons of the two groups were statistically significant(P<0.05).

CONCLUSION: Telephone interview can effectively reduce the cancellation rate of ophthalmic daytime operation, provide targeted and personalized pre-hospital guidance for patients, improve the compliance of patients and their families to complete preoperative preparation, reduce the psychological anxiety of patients before operation, and improve the medical experience of patients.

Abstract:AIM:To describe the clinical characteristics of 20 patients with acute acquired comitant esotropia(AACE).

METHODS: This retrospective, observational case series study enrolled patients with AACE examined from June 2018 to May 2021 in Guangdong Jiangmen Central Hospital. The age when attacked, the duration of excessive near work before illness, symptom, refraction, AC/A, deviation and near stereopsis were analyzed. All 20 patients had unremarkable neurological finding by imageological test.

RESULTS: Most patients whose mean age was 24.25±5.78 years immersed in near work for more than 6h a day before illness. All patients seeked for medical help because diplopia with normal ocular motility in all directions of gaze and meaningless finding in routine ophthalmologic examinations. They were all nearsightedness whose mean spherical equivalent was -5.73±5.09D, while mean AC/A was 2.65±1.16 within the upper limit. There was no different between the distant and near deviations(P>0.05). Deviations might be correlated with near stereopsis(P<0.05), however the duration from onset to treatment was irrelevant(P>0.05).

CONCLUSION: The clinical features of AACE in older children and adults who immersed excessive near work are medium myopia, diplopia, normal ocular motility, no neurological finding and limited AC/A. Moreover, it is approximate between distant and near deviations. The deviations affect near stereopsisd more, while the influence of duration from onset to treatment may be less.