Abstract:AIM: To evaluate the efficacy of mycophenolate mofetil(MMF)on the prevention of relapse and visual prognosis of patients in neuromyelitis optica spectrum disorders(NMOSD)with AQP4 antibody positive optic neuritis.

METHODS: We retrospectively reviewed 11 patients with initial diagnosis of NMOSD and AQP4 antibody positive optic neuritis from January 2017 to December 2019. Among the 11 patients, 3 were male and 8 were female. The unique core clinical manifestation of NMOSD was optic neuritis. The onset age was 36.3±6.0(27-47)years old. Duration of the disease was 3.4±1.4(2.2-6.8)a. MMF was added in the relieving period of NMOSD for 1a or over 1a. Annualized relapsing rate(ARR), best corrected vision activity(BCVA)and adverse reactions of MMF were recorded.

RESULTS: The median time of MMF treatment was 18(12, 36)mo. The ARR was 0.66/a at baseline and 0.16/a after the treatment. There were 91% of the patients had decreased ARR and 82% of them had no clinical relapse. The patients had significant improvement on ARR after MMF treatment(P<0.05 ). In total, there was no significant difference between the mean BCVA after treatment and that at baseline(P>0.05). Of the 11 patients, 3 patients had side effects(27%), including 1 patient with elevated liver transaminase(9%), and 2 patients with mild gastrointestinal reaction(18%)during follow-up period. None of them discontinued MMF due to adverse events.

CONCLUSION: MMF treatment for AQP4 antibody positive NMOSD can reduce the ARR of optic neuritis to a certain extent and protect the visual function of patients.

Abstract:AIM: To investigate the prevalence and risk factors of dry eye(DE)among middle school students in Nantong.

METHODS: A cross-sectional study was conducted among 1 939 middle school students in January 2021. The minimum sample size was calculated by cluster random sampling. A dry eye questionnaire was used to assess the prevalence and risk factors of DE in middle school students. DE was defined as often or all the time presence of one or more DE symptoms(i.e. “eye dryness” “grittiness” “burning sensation” “redness” “crusting of lashes” “eyelids getting stuck”). The risk factors associated with DE were evaluated by Logistics regression analysis.

RESULTS: The prevalence of DE was 19.55%. The most reported dry eye symptom was “eyelids getting stuck”, accounting for 60.95%. Female(OR: 1.287, 95%CI: 1.018-1.626, P=0.035), the daily time of electrical appliances use at near distance >2h(OR: 1.927, 95%CI: 1.260-2.947, P=0.002), the daily time of reading and writing after class >3h(OR: 1.588, 95%CI: 1.214-2.079, P=0.001), frequent use of eye drops(OR: 1.908, 95%CI: 1.359-2.680, P<0.001), use of systemic anti-allergic drugs(OR: 1.787, 95%CI: 1.220-2.618, P=0.003)and joint pain(OR: 1.688, 95%CI: 1.128-2.524, P=0.011)were independent risk factors for DE among middle school students. Sufficient sleep(>6-8h, OR: 0.627, 95%CI: 0.477-0.823, P=0.001; >8h, OR: 0.511, 95%CI: 0.283-0.922, P=0.026)was an independent protective factor for the disease.

CONCLUSION: The prevalence of DE among middle school students is high and should not be ignored. Preventive measures against risk factors may help to reduce the prevalence of DE and have a positive impact on the health of students.

Abstract:AIM: To study the protective effect of astragalus-containing serum on cobalt chloride(CoCl₂)-induced hypoxia injury of human retinal pigment epithelial cells(ARPE-19), so as to explore whether astragalus can improve diabetic retinopathy(DR)by anti-oxidative stress.

METHODS: The ARPE-19 hypoxia model induced by CoCl₂ was established and divided into the following 5 groups: normal group(cells were cultured normally without any treatment), hypoxia model group(200μmol/L CoCl₂), blank serum group(200μmol/L CoCl₂+blank serum), low-dose drug-containing serum group(200μmol/L CoCl₂+10% medicated serum)and high-dose drug-containing serum group(200μmol/L CoCl₂+20% medicated serum); CCK-8 detects cell viability; Detect the levels of reduced glutathione(GSH)and malondialdehyde(MDA)in the cell supernatant with a kit; ELISA was used to detect the content of hypoxia-inducible factor-1α(HIF-1α)and vascular endothelial growth factor(VEGF)in cell culture medium; Real-time quantitative PCR(qPCR)to detect the mRNA levels of VEGF, HIF-1α and Prolyl hydroxylase-2(PHD-2); The expressions of VEGF, HIF-1α and PHD-2 were detected by Western Blot.

RESULTS: Hypoxia model of ARPE-19 can successfully establish by CoCl₂ at 200μmol/L. Low-dose and high-dose astragalus-containing serum could inhibit hypoxia-induced ARPE-19 proliferation(P<0.05), increase the GSH level and reduce the MDA content in ARPE-19 with hypoxic injury(P<0.05). Low-dose and high-dose astragalus-containing serum could inhibit the expression of HIF-1α and VEGF in ARPE-19 hypoxic injury supernatant(P<0.05), as well as the mRNA and protein expressions of VEGF, HIF-1α and PHD-2 in ARPE-19(P<0.05).

CONCLUSION: Low-dose and high-dose astragalus-containing serum alleviates the hypoxia injury of ARPE-19 induced by CoCl₂ through anti-oxidant effect.

Abstract:AIM: To explore the effect of silencing LncRNA DLGAP1-AS2 on the proliferation, migration and invasion of human retinoblastoma HXO-Rb44 and its possible mechanism.

METHODS: Twenty-five cases of retinoblastoma tissue specimens with complete clinical data and pathologically diagnosed were collected. At the same time, 9 cases of normal retinal tissue from which the eyeball was removed due to trauma were selected as controls. The qRT-PCR method was used to detect the expression of DLGAP1-AS2 and miR-1193 in normal retinal tissue, retinoblastoma tissue, human normal retinal vascular endothelial cell ACBRI-181, and retinoblastoma cell HXO-Rb44. The si-NC, si-DLGAP1-AS2, miR-NC, miR-1193 mimic, si-DLGAP1-AS2 and miR-1193 inhibitor(co-transfected)were transfected into HXO-Rb44 cells. The dual luciferase reporter experiment was used to detect the targeting relationship between DLGAP1-AS2 and miR-1193. The CCK-8 method, plate clone formation experiment and Transwell experiment were used to detect cell proliferation, colony formation, migration and invasion. Western blot method was used to detect the expression of E-cadherin and N-cadherin protein.

RESULTS: The expression of DLGAP1-AS2 in retinoblastoma tissue was higher than that of normal retinal tissue(P<0.05), while the expression of miR-1193 was lower than that of normal retinal tissue(P<0.05). The expression of DLGAP1-AS2 in HXO-Rb44 cells was higher than that of ACBRI-181 cells(P<0.05), and the expression of miR-1193 was lower than that of ACBRI-181 cells(P<0.05). DLGAP1-AS2 could target the expression of miR-1193. Transfection of si-DLGAP1-AS2 or miR-1193 mimic could inhibit the proliferation, migration and invasion of HXO-Rb44 cells. Co-transfection of si-DLGAP1-AS2 and miR-1193 inhibitor could reduce the effect of transfection of si-DLGAP1-AS2 on the proliferation, migration and invasion of HXO-Rb44 cells.

CONCLUSION: Silencing DLGAP1-AS2 could inhibit the proliferation, migration and invasion of retinoblastoma cells through targeted regulation of miR-1193 expression.

Abstract:AIM: To investigate the protective effect and mechanism of ghrelin on human retinal vascular endothelial cells under high glucose.

METHODS: A hyperglycemic injury model as a research object was established on human retinal vascular endothelial cells. CCK-8 kit was used to detect the effects of ghrelin with different concentrations on cell proliferation under high glucose, so as to screen the optimal concentration of ghrelin. The cells were then divided into normal control group(NC), ghrelin group(ghrelin), high glucose group(HG)and ghrelin+ high glucose group(ghrelin+HG). Cell proliferation was detected by CCK-8 kit, apoptosis was detected by Annexin-APC/7-AAD kit, and the expressions of NLRP3, Caspase-1, IL-1β and IL-18 proteins were detected by western blotting.

RESULTS: Compared with NC group(100.00%±0.00%), the cell proliferation rate of HG group(69.87%±0.68%, P<0.05)was significantly decreased. Compared with HG group, the cell proliferation rate of ghrelin + HG group was significantly increased(92.31%±3.62%, P<0.05). Compared with NC group(4.94%±0.15%), the cellular apoptosis rate of HG group(28.33%±1.37%, P<0.05)was significantly increased. Compared with HG group, the cellular apoptosis rate of ghrelin+HG group(14.24%±0.32%, P<0.05)was significantly decreased. Compared with NC group, the expressions of NLRP3, Caspase-1, IL-1β and IL-18 proteins were all significantly increased(all P<0.05). Compared with HG group, the expressions of NLRP3, Caspase-1, IL-1β and IL-18 proteins in ghrelin + HG group were all significantly decreased(all P<0.05).

CONCLUSION: Ghrelin can protect retinal vascular endothelial cells damaged by high glucose, it may function by inhibiting NLRP3 inflammasome signaling pathway.

Abstract:AIM: To investigate the expression changes of Toll like recepter 9(TLR-9)and myeloid differentiation factor 88(MyD88)in retina of mice following optic nerve injury(ONI).

METHODS: There were 36 male 8-week-old C57BL/6J mice randomly divided into 6 groups: blank control(no treatment), ONI 1d group(materials were taken at 1d after optic nerve injury), ONI 3d group(materials were taken at 3d after optic nerve injury), ONI 5d group(materials were taken at 5d after optic nerve injury), ONI 7d group(materials were taken at 7d after optic nerve injury), ONI 14d group(materials were taken at 14d after optic nerve injury). The mice optic nerve model was made by optic nerve gripping, and the mRNA and protein levels of Toll like recepter 9 and myeloid differentiation factor 88 in each retinal were measured by RT-qPCR and Western-blot.

RESULTS: The mRNA and protein levels of Toll like recepter 9 and myeloid differentiation factor 88 in the retina of ONI 1d group were not significantly different from those of the blank control group(P>0.05), the mRNA and protein levels of TLR-9 and MyD88 in the retina of ONI 3d group, ONI 5d group, ONI 7d group and ONI 14d group were significantly increased compared with the blank control group, and the differences were statistically significant(P<0.01). Compared with the blank control group, the mRNA and protein levels of TLR-9 and MyD88 in the retina of mice began to increase at ONI 3d(P<0.01), peaked at ONI 5d(P<0.001), and gradually decreased at ONI 7d(P<0.01).

CONCLUSION: Optic nerve injury can activate the expression of TLR-9 and MyD88 in mice retina. TLR-9 and MyD88 may play an essential role in the process of optic nerve injury.

Abstract:AIM: To investigate the effect of triamcinolone acetonide(TA), artesunate(ART), and luteolin(LU)on the prevention and treatment of traumatic proliferative vitreoretinopathy(TPVR).

METHODS: Forty-eight cyanotic blue rabbits were selected to prepare TPVR animal models by making a penetrating eye injury and intravitreal injection of 0.3mL platelet-rich plasma, and were randomly divided into four groups(n=12), in which the vitreous cavity of the control group was injected with 0.1mL saline; The vitreous cavity of the TA group was injected with 0.1mL(1mg/mL)triamcinolone acetonide; The vitreous cavity of the ART group was injected with 0.1mL(20μg/mL)artesunate; 0.1mL(10μg/mL)luteolin was injected into the vitreous cavity of the LU group. The vitreous and retinal proliferation were observed by fundus photography and ocular ultrasound at 1, 2, 3 and 4wk postoperatively. The expression levels of α-SMA and VIM protein in the vitreous fluid of each group of rabbit eyes were detected by Western Blot at 28d postoperatively, and the retinal tissue structure of each group was observed by retinal HE staining.

RESULTS: At 28d postoperatively, the TPVR grading of rabbit eyes in the TA, ART and LU groups were significantly lower than that in the control group(P<0.05), and the TPVR grading of rabbit eyes in the TA group was significantly lower than that in the ART and LU groups(P<0.05). The expression levels of α-SMA and VIM proteins in the vitreous fluid of the rabbit eyes in the TA, ART and LU groups were significantly lower than those in the control group at 28d after surgery(P<0.01). The results of HE staining showed that the arrangement of retinal layers in rabbit eyesin the control group were disordered, severely distorted or locally broken, the structure of each layer were unclear, the anterior membrane was obviously thickened, and the retina was obviously detached; The arrangement of retinal layersin rabbit eyes in the LU group were slightly distorted, inflammatory exudation was visible in front of the retina, and the retina was superficially detached; The structure of retina in rabbit eyes in the ART group were clear, with mild edema and superficial detachment; The structure of retinal layers in rabbit eyes in the TA group were clear, the arrangement was still neat, the retinal folds were locally visible, and there was no retinal detachment.

CONCLUSION: Intravitreal injection of triamcinolone acetonide, artesunate and luteolin were all effective in preventing and treating traumatic TPVR, among which triamcinolone acetonide has the most obvious effect.

Abstract:AIM: To observe the macular retinal microvascular density and thickness of each retinal layer in children with monocular myopia by optical coherence tomography angiography(OCTA). Meanwhile, the correlation with the above-mentioned retinal parameters and axial length(AL)were analyzed.

METHODS: A cross-sectional study. A total of 32 children(64 eyes)with monocular myopia who were treated at the Affiliated Eye Hospital of Nanjing Medical University from November 2020 to April 2021 were selected,with an average age of 10.88±2.34 years old. According to the spherical equivalent refraction(SER)of the children, SER≤-0.75D was included in the myopia group, with an average SER of -2.15±1.10D; The contralateral healthy eye was included in the non-myopia group, with an average SER of 0.01±0.48D. All participants underwent general ophthalmic examination and OCTA was performed to measure the blood flow density of superficial retinal capillaries(SCP), deep retinal capillaries(DCP)blood flow density and the thickness of each retinal layer in the macular region.

RESULTS: The uncorrected visual acuity(UCVA)of the myopia group was lower than that of the non-myopia group, the SER and AL were higher than those of the non-myopia group(all P<0.01), and there was no difference in intraocular pressure and corneal flatness K value(all P>0.05). The blood flow density of SCP above the macular area and the DCP blood flow density of the fovea in the myopia group were significantly higher than those in the non-myopia group(P=0.029, 0.010), and there was no difference in the blood flow density of retinal capillaries in other regions(all P>0.05). Except for the fovea, the whole retinal thickness of myopia group in temporal, superior, nasal and inferior regions was significantly lower than those in the control group(all P<0.01). The temporal inner retinal thickness of the macular region in the myopia group was slightly lower than that in the non-myopia group(P=0.043). The macular fovea and the outer retinal thickness of the temporal, superior, nasal and inferior macular areas in the myopia group were significantly smaller than those in the non-myopia group(all P<0.05). Pearson correlation analysis showed that foveal SCP and DCP blood flow density were positively correlated with AL(r=0.432, 0.541, all P<0.01). AL was significantly positive correlated with inner retinal thickness in macular central, temporal, superior, nasal and inferior regions(r=0.452, 0.389, 0.313, 0.401,0.445, all P<0.05). AL was negative correlated with outer retinal thickness in superior, nasal and inferior regions(r=-0.308, -0.309, -0.330, all P<0.05).

CONCLUSION: There was a compensated increase of blood flow density in superior SCP and macular central DCP of the myopic eyes in unilateral myopic children. The full-thickness retinal thickness was significantly reduced in the macular region, except for the fovea. The AL elongation was related to the thickening of the inner retina, as well as the thinning in the superior, nasal, and inferior regions of outer retina.

Abstract:AIM: To explore the effect of SiWuWuZi decoction combined with intravitreal injection of conbercept on patients with wet age-related macular degeneration(ARMD)and its effects on serum vascular endothelial growth factors(VEGF), transforming growth factor-β1(TGF-β1)and inflammatory factors.

METHODS: A retrospective study. A total of 60 cases(60 eyes)wet ARMD patients admitted to the ophthalmology department of our hospital from May 2019 to November 2020 were divided into 30 cases(30 eyes)of the control group were treated with intravitreal injection of conbercept, while observation group 30 cases(30 eyes)was added with SiWuWuZi decoction on the basis of treatment for control group. The best corrected visual acuity(BCVA), the neovascular area were not be vanished fundus hemorrhage, exudation, choriocapillario-Bruch's membrane-retinal pigment epithelium complex(CBRC), and retinal neuroepithelial layer(RNL), serum VEGF, TGF-β1, interleukin-6(IL-6)and interleukin-13(IL-13)levels and overall efficacy after 3mo were compared.

RESULTS: After 3mo treatment, BCVA, fundus hemorrhage, exudation, CBRC and RNL thickness in 2 groups were improved compared with before treatment(P<0.05), and the observation group was better than the control group(P<0.05). Compared with before treatment, serum VEGF, TGF-β1, IL-6 and IL-13 in 2 groups after 3mo treatment were decreased(P<0.001), and serum VEGF, TGF-β1, IL-6 and IL-13 levels in observation group were significantly lower than those in control group(P<0.05). The overall effect of observation group was significantly better than control group(P=0.037).

CONCLUSION: SiWuWuZi decoction combined with intravitreal injection of conbercept can gradually vanish fundus neovascularization in patients with wet ARMD, serum levels of VEGF, TGF-β1 and inflammatory factors, improve ocular microcirculation and promote vision recovery in patients with wet ARMD.

Abstract:Retinal vascular diseases such as retinopathy of prematurity, diabetic retinopathy, and retinal vein occlusion, and other retinal vascular diseases, with abnormal proliferation of retinal neovascularization as the main pathological manifestation. Exosomes derived from bone marrow mesenchymal stem cells transmit biologically active molecules through paracrine action to mediate the exchange of materials and information between cells. Among them, miRNA and other contents play key roles in transmitting information to regulate the proliferation of endothelial cells, the formation of the lumen, and new blood vessels in an ischemic and hypoxic environment. And it can cross the blood-retinal barrier without causing immune and inflammatory reactions and has great potential in the treatment of ophthalmic diseases. This article summarizes the role and possible mechanism of miRNA in bone marrow mesenchymal stem cell-derived exosomes in retinal neovascularization, with a view to broadening new ideas for the application of exosomes in the diagnosis and treatment of ophthalmic diseases.

Abstract:Retina and optic nerve both originate in brain, therefore they have the similar structure and functional characteristics of the brain. Exploring the performance of the central optic nervous disorder on the retina will be beneficial to uncovering the interaction mechanism between brain and eye. As an extension of the central nervous system, the retina contains ganglion cell, a special neuron, whose axon form the optic nerve and has access into the central nervous system. Therefore, the retina can be used as a mirror reflecting neurodegenerative diseases structurally and functionally. With the development of imaging technology, optical coherence tomography(angiography)has become the mainstream tool for ophthalmological clinical diagnosis due to its easy operation and low cost. In recent years, discovering biomarkers of neurodegenerative diseases, especially Alzheimer's disease, Parkinson's disease, multiple sclerosis and so on, in the retinal optical coherence tomography images has gradually become an emerging research direction. In this review, we summarized the research progress of neurodegenerative diseases analysis based on the retinal images in the past decade, and provide a prospect to inspire further research as far as possible.

Abstract:Specific pro-resolving mediators(SPM)are a class of lipid mediators that trigger and orchestrate the resolution of inflammation, which formed in cells by the metabolism of polyunsaturated fatty acids. SPM pathway and receptors are highly expressed inocular surface, and constitute endogenous SPM networks which are important for maintaining ocular surface health and immune homeostasis. Recent evidence indicates that SPM and their analogs are essential mediators in promoting corneal wound healing, corneal nerve regeneration, and inhibiting the immune inflammatory response of corneal transplant rejection, allergic conjunctivitis and microbial keratitis. In addition, they are potential therapeutic drug targets of dry eye disease, and provide novel insight on the research and treatment of ocular surface diseases. Here, we will review and discuss evidence for SPM as important endogenous regulators of ocular surface health and disease and their therapeutic potential.

Abstract:Amblyopia is a common eye disease in children. In recent years, people have been exploring new treatments for amblyopia patients with poor results of the traditional treatment. In the field of visual cognition, some computer programs and video games are widely used to improve the functions of the visual system. Based on the perceptual learning, new methods such as video games, dichotomous stimulation, and stereo vision training are proposed to treat amblyopia. This article combines domestic and foreign research on perceptual learning and other emerging methods. The application of therapies in the treatment of amblyopia was reviewed, the effects of different methods in the treatment of amblyopia were analyzed. Combined with the existing problems, the future development of this field was further discussed.

Abstract:Persistent corneal epithelial defect(PED)can occur after corneal herpes simplex virus infection, corneal transplantation, and intraocular surgery in diabetic patients. Although the incidence is not high, it can cause serious consequences if not properly managed, such as corneal infection or exacerbation, stromal ulcers, perforation, scarring, and even loss of vision. The pathogenic causes of PED are diverse and can be mediated by multiple mechanisms. In clinical practice, even with aggressive treatment, the corneal epithelium in PED eyes is difficult to heal and presents a challenge for treatment. At present, the standard treatment for PED management mainly includes the use of bandage soft contact lenses and artificial tears, aiming at the barrier protection for the corneal epithelium. The new treatment mainly focuses on epithelial regeneration and corneal nerve re-innervation. In addition, several drugs and methods with potential therapeutic value have emerged in recent years. In this review, we talk about how are the PEDs spread, what causes them, how are they diagnosed and how are they treated. We also talk about some new therapies and research process.

Abstract:Ultrasound cycloplasty(UCP)procedure using high intensity focused ultrasound(HIFU)is a new non-invasive glaucoma treatment based on miniaturized transducers. In recent years, the safety and efficacy of UCP on various types of glaucoma have been well verified, and it has shown broad application prospects in the treatment of glaucoma. This article collects and reviews the relevant literature on glaucoma treatment by UCP, and summarizes the information on the development of equipment, composition and operation, treatment mechanisms, indications, efficacy and safety, with the purpose to provide relevant basis for clinical applications and future research.

Abstract:Age-related macular degeneration(ARMD)is the most common eye disease that can cause irreversible loss of central vision in the elderly population. Since the complexity of the pathogenesis in ARMD, the underlying mechanism remains uncovered,and treatment limited. Conventional bulk transcriptome sequencing strategies can only provide the average gene profile in the dominant cells, while single-cell RNA-sequencing(scRNA-seq)is able to reveal the mRNA transcriptome at a single-cell level. The ScRNA-seq has been applied to discover novel cell subtypes, reveal intercellular heterogeneity, and unveil the process of cell differentiation.In this paper, we reviewed the technical principle of scRNA-seq and its application in retinal,choroid development and ARMD research, raised the defection of scRNA-seq and trended in emerging technologies,provided the new insights and perspectives for the in-depth study of retinal and choroid physiology, pathophysiology, and pathogenesis of ARMD diseases. It is hoped to provide theoretical foundation for the targeted therapy of ARMD.

Abstract:Proliferative vitreoretinopathy(PVR)is a serious complication that occurs in the natural history of rhegmatogenous retinal detachment(RRD)or after retinal detachment surgery, often resulting in vision loss. Currently, there has no effective treatment. The pathological characteristics of PVR are the excessive inflammatory response and abnormal proliferation of various cells under the action of cytokines, which eventually form a layer of proliferative membrane around the retinal surface, and further lead to traction retinal detachment(TRD). In-depth studies on the pathogenesis of PVR will help to find promising molecular targets for its treatment. Recent studies have found that vascular endothelial growth factor(VEGF)and the epithelial-mesenchymal transition(EMT)of retinal pigment epithelium(RPE)cells play an important role in the pathogenesis of PVR. This article summarizes the roles of VEGF and RPE cell EMT in the pathogenesis of PVR and the interaction mechanism between them, with the aim to provide new ideas for the treatment and clinical research of PVR.

Abstract:Migraine is acommon chronic neurovascular disorder, its pathophysiological mechanisms are not fully understood. There are various clinical phenotypes of migraine, among which visual migraine may present as visual aura. Retinal migraine and ophthalmoplegic migraine also belong to the category of visual migraine. Optical coherence tomography(OCT)and optical coherence tomography angiography(OCTA)can be used to detect the circulation of retinal nerve fiber layer, ganglion cell layer, optic papilla, retina and choroid qualitatively and quantitatively. Based on above two imaging findings, studies have addressed that during visual migraine pathogenesis, the transitory and recurrent constriction of the retinal and ciliary arteries, which may cause ischemic damage to the optic nerve, retina and choroid in patients with migraine, with the subsequent reduction in thickness of retinal nerve fiber layer, ganglion cell layer, and retinal microvasculature decrement. The fundus imaging examinations are helpful to improve our understanding on pathophysiological mechanisms of visual migraine, these imaging findings based on OCT and OCTA may serve as indicators to evaluate course and severity of visual migraine.

Abstract:As the prevalence of myopia continues to increase, our society shows increasing interest in the visual impairment associated with myopia and methods for myopia control. Current methods for myopia control include atropine, orthokeratology, dual-focus contact lenses, multifocal contact lenses, and functional frame glasses, etc. Low-concentration atropine(0.01%, 0.05%)became the first-line medication which has been administrated and shown to be effective in controlling the occurrence and progression of myopia. Meanwhile, low-concentration atropine shows longer-lasting effects, less frequent adverse effects and higher patients' acceptance than high-concentration atropine. This article reviews the efficacy, safety, time-to-treatment, and effects when combined with other treatments to provide evidence for the clinical application of low-concentration atropine on myopia control.

Abstract:AIM: To determine the relationship between interleukin-8(IL-8)levels in aqueous ocular samples and diabetic retinopathy(DR)through systematic evaluation and Meta-analysis.

METHODS: The PubMed, Embase and Web of Science database were searched from January 2010 to June 2021. A random effects model was used to combine the results, and the sensitivity analysis was performed to determine the stability and reliability of the arithmetic results, and subgroup analysis was used to identify possible sources of heterogeneity.

RESULTS: A total of 25 case-control studies were included. IL-8 levels in patients with DR were significantly higher than those in patients without DR(SMD: 1.57, 95%CI: 1.19-1.95, P<0.01). Sensitivity analysis shows that the calculation results of random effects are stable and reliable. Subgroup analysis based on test method, region, sample source, and type of DR showed that the choice of these factors greatly influenced the relationship between IL-8 levels and patients with DR. Among them, the samples from Bead-based multivariate analysis(I ²=18%, P=0.27), Europe(I ²=38%, P=0.17)and nonproliferative diabetic retinopathy(NPDR)(I ²=0%, P=0.49)showed good consistency. ELISA, American, Asian, vitreous fluid, proliferative diabetic retinopathy(PDR)and other factors may increase the effect size.

CONCLUSION: Elevated IL-8 levels in aqueous eye solution are associated with the risk of DR, and IL-8 may serve as a potential predictor or therapeutic target for DR.

Abstract:AIM: To explore the changes of retinal optical coherence tomography angiography(OCTA)vessel density in Patients with Alzheimer's disease(AD)by Meta-analysis, and to explore the value of OCTA in early diagnosis of AD patients.

METHODS: Embase, PubMed and Cochrane Library data were searched from January 2016 to September 2021 for relevant studies on vessel density in macular area of AD patients. Two researchers independently screened the literature, extracted the data, and evaluated the risk of inclusion bias using Newcastle-Ottawa Scale(NOS). Meta-analysis was performed using RevMan 5.3 software.

RESULTS: A total of 740 cases(eyes)were included in 10 literatures, including 321 cases from the AD group and 419 cases from the control group(age-matched people with normal cognitive abilities). The results of the Meta-analysis showed that the superficial vessel density in macular area of AD patients was lower than that in control group(MD=-1.58, 95%CI -2.60- -0.55, P=0.003). The deep vessel density in macular area of AD patients was lower than that in control group(MD=-2.72, 95%CI -4.36- -1.07, P=0.001). The parafoveal vessel density in AD patients was lower than that in control group(MD=-1.44, 95%CI -1.94- -0.94, P<0.00001). The avascular area in the fovea of AD patients was slightly larger than that of the control group(MD=0.05, 95%CI -0.01-0.11, P=0.13).

CONCLUSION: The vessel density of each layer in macular area of AD patients were lower than that of control groups the difference was statistically significant. OCTA can assist in the early diagnosis of AD.

Abstract:AIM: To observe the clinical therapeutic efficacy of Ahmed glaucoma valve(AGV)implantation with intravitreal injection of aflibercept or ranibizumab in patients with neovascular glaucoma(NVG).

METHODS: A retrospective study. The clinical data of 33 cases(33 eyes)with NVG angle-closure glaucoma who were received intravitreal injection of aflibercept or ranibizumab with AGV implantation from January 2018 to August 2020 in our hospital were involved in this study. There were 18 eyes in the aflibercept group and 15 eyes in the ranibizumab group. All patients were followed-up for 6mo. The best-corrected visual acuity(BCVA), intraocular pressure, neovascularization, and postoperative complications were recorded and evaluated.

RESULTS: Before the first intravitreal injection and 1wk after intravitreal injection, the differences of intraocular pressure and BCVA in two groups were not statistically significant(P>0.05); The changes of intraocular pressure and BCVA before the first intravitreal injection and after AGV implant 1wk, 1, 3, 6mo were statistically significant in two groups(P<0.01), but there were no statistically significant differences intraocular pressure and BCVA between the two groups at each follow-up time point(P>0.05). There were no significant differences in average number of injections between aflibercept group(1.61±0.98)and ranibizumab group(1.80±0.86)(P>0.05). The differences of neovascular recurrence rate, incidence of early and late complications and surgical success rates were not statistically significant(P>0.05).

CONCLUSION: Intravitreal aflibercept or ranibizumab injection combined with AGV implantation is an effective treatment for NVG. The clinical efficacy of aflibercept and ranibizumab were similar.

Abstract:AIM: To investigate the anxiety, depression and sleep status of patients with primary angle-closure glaucoma(PACG)and primary open angle glaucoma(POAG).

METHODS: Retrospective clinical study. The Anxiety Self-Rating Scale(SAS), Depression Self-Rating Scale(SDS)and Pittsburgh Sleep Quality Index(PSQI)were used to evaluate 60 patients with primary glaucoma(30 PACG, 30 POAG)diagnosed in the department of ophthalmology in our hospital during the period from June 2019 to December 2020 and 30 healthy adults from the physical examination department of our hospital as a control group. The scores of anxiety, depression and sleep quality in the three groups were compared.

RESULTS: The scores of SAS, SDS and PSQI in PACG and POAG groups(48.40±9.302, 53.40±8.625, 9.57±2.861; 42.57±9.684, 48.80±10.320, 7.23±2.223)were significantly higher than those in control group(37.03±6.805, 38.63±7.881, 4.87±2.688)(P<0.05). The scores of SAS and PSQI in PACG group were higher than those in POAG group(all P<0.05). With SAS≥45, SDS≥50 and PSQI>7, the positive rates of anxiety, depression and insomnia in the PACG group(77%, 73%, 70%)were higher than those in the POAG group(43%, 40%, 37%)and the control group(13%, 10%, 20%)(P<0.05).

CONCLUSION: Patients with PACG has more severe anxiety, depression and insomnia than POAG, so necessary psychological intervention should be given.

Abstract:AIM: To compare the efficacy of intravitreal conbercept or ranibizumab for myopic choroidal neovascularization(CNV).

METHODS: A retrospective cohort study. This study included 46 patients(46 eyes)with myopic CNV who were treated with conbercept(conbercept group, 20 cases, 20 eyes)or ranibizumab(ranibizumab group, 26 cases, 26 eyes)from March 2015 to August 2019. Central macular thickness(CMT), the number of injections and complications measured by best-corrected visual acuity(BCVA)and optical coherence tomography(OCT)were compared between the two groups before treatment and 1, 3, 6mo after treatment.

RESULTS: Before treatment, the BCVA(LogMAR)of conbercept and ranibizumab groups were 0.81±0.51, 0.83±0.66(P=0.900). After treatment, the BCVA(LogMAR)in the conbercept group at 1, 3 and 6mo were 0.59±0.33, 0.49±0.34, 0.44±0.32, in the ranibizumab group were 0.53±0.54, 0.47±0.47, 0.40±0.43. The BCVA was significantly improved in both groups after treatment(all P<0.001). Before treatment, the CMT of conbercept and ranibizumab groups were 242.30±73.27, 233.38±66.63μm(P=0.669). After treatment, the CMT in the conbercept group at 1, 3, and 6mo were 217.00±54.78, 208.65±55.38, 206.00±45.34μm, in the ranibizumab group were 197.42±50.47, 198.38±55.19, 192.15±51.97μm. The CMT was significantly decreased in both groups after treatment(all P<0.05). There were no significant differences in the number of injections, BCVA and CMT at each follow-up time points between conbercept and ranibizumab groups(all P>0.05). Systemic adverse reactions and serious ocular complications were not found during the treatment period.

CONCLUSION: Intravitreal conbercept or ranibizumab provide similar efficacy to improve the BCVA and reduce the CMT in the patients with myopic CNV. Both conbercept and ranibizumab could be a choice of treatment for myopic CNV.

Abstract:AIM: To analyze the funding status of cataract research funded by National Natural Science Foundation of China from 2010 to 2019, and discuss the development focus on basic cataract research in the near future, so as to provide reference information for researchers in the field of cataract to understand the progress of basic research and apply for funding.

METHODS: The cataract research projects funded by the National Natural Science Foundation of China from 2010 to 2019 were counted. The categories of funded projects, project title, fund amount, applicant unit and region, approved year and key words were statistically analyzed.

RESULTS: In the past ten years, the number of cataract research projects and the amount of funding accounted for 9.35% and 9.72% of the total amount of the whole ophthalmology area respectively. The number of projects in ophthalmology and cataract research and the amount of aid received generally showed a wavy upward trend. The key words in the project setup are gradually increasing, and more and more inclined to mechanism research. With the development of computer aided technology, TALEN technology and total exon sequencing technology, cataract research presents a trend of integration of medicine and other disciplines. East China, especially Shanghai, ranks first in terms of the number of projects and funds received. Among the categories of projects, the number and funding are the largest among the general projects. In recent years, the number of the Youth Science Foundation projects has risen strongly, and even exceeds the general projects in some areas.

CONCLUSION: The focus of cataract research from 2010 to 2019 tends to be diversified. The integration of multi-disciplines and the application of new techniques and methods are prominent features. The fund amount and the level of research are unbalanced in regional development.

Abstract:AIM: To study the precise segmentation of pterygium lesions using the convolutional neural networks from artificial intelligence.

METHODS: The network structure of Phase-fusion PSPNet for the segmentation of pterygium lesions is proposed based on the PSPNet model structure. In our network, the up-sampling module is connected behind the pyramid pooling module, which gradually increase the sampling based on the principle of phased increase. Therefore, the information loss is reduced, it is suitable for segmentation tasks with fuzzy edges. The experiments conducted on the dataset provided by the Affiliated Eye Hospital of Nanjing Medical University, which includes 517 ocular surface photographic images of pterygium were divided into training set(330 images), validation set(37 images)and test set(150 images), which the training set and the validation set images are used for training, and the test set images are only used for testing. Comparing results of intelligent segmentation and expert annotation of pterygium lesions.

RESULTS: Phase-fusion PSPNet network structure for pterygium mean intersection over union(MIOU)and mean average precision(MPA)were 86.31% and 91.91%, respectively, and pterygium intersection over union(IOU)and average precision(PA)were 77.64% and 86.10%, respectively.

CONCLUSION: Convolutional neural networks can segment pterygium lesions with high precision, which is helpful to provide an important reference for doctors' further diagnosis of disease and surgical recommendations, and can also visualize the pterygium intelligent diagnosis.

Abstract:Artificial intelligence is described as the“fourth industrial revolution”. Driven by the development of the Internet and big data, ophthalmology has become a frontier discipline in this wave, showing a good prospect of vigorous development. Artificial intelligence has been applied to the auxiliary screening, diagnosis and treatment of a variety of eye diseases, and assisted in the completion of corneal, refractive, cataract and other related operations; Help realize graded diagnosis and treatment, telemedicine and improve the training mode of ophthalmic talents, and participate in eye health management and ophthalmic education. While artificial intelligence brings benefits to mankind, it also brings a number of ethical problems, among which the contradictions related to medical ethics, such as the division of responsibility for diagnosis and treatment errors, the protection of patient information privacy, humanistic care and its fairness, the contradiction between the growing artificial intelligence and imperfect ethics and laws are particularly prominent. Artificial intelligence must be guided by the correct value and abide by the corresponding ethical norms to continue to mature and improve in clinical practice. This paper summarizes the development status and ethical dilemma of ophthalmology under the background of artificial intelligence to provide reference for promoting its healthy development in the field of ophthalmology.

Abstract:AIM: To compare the efficacy of conbercept and ranibizumab on neovascular age-related macular degeneration(nARMD)of type 1 macular neovascularization(MNV)with fibrovascular pigment epithelial detachment(fPED).

METHODS: Retrospective clinical study. From January 2019 to December 2020, 48 patients(48 eyes)of nARMD type 1 MNV patients with fPED diagnosed in our hospital were included and divided into conbercept group with 26 patients(26 eyes)and ranibizumab group with 22 patients(22 eyes)according to the drugs they received. All patients received treatment of 3+PRN. Followed up for 12mo, the best corrected visual acuity(BCVA)of the two groups was observed, and optical coherence tomography(OCT)was used to measure the macula foveal thickness(CFT)and the regression degree(height, area, volume)of retinal pigment epithelial detachment(PED).

RESULTS: There was no significant difference between two groups in BCVA, CFT and PED height, area and volume before treatment(P >0.05). The PED height of the two groups was significantly improved at 3, 6 and 12mo after the first intravitreal injection treatment compared with those before treatment(P<0.05). But the PED area and volume were not significantly improved(P>0.05). There was no significant improvement in BCVA between the two groups after treatment compared with those before treatment(P>0.05). The CFT of the conbercept group was significantly improved at 3, 6 and 12mo after treatment compared with those before treatment(P<0.05), and the ranibizumab group improved significantly only 3mo after treatment(P<0.05). There were no significant differences in BCVA, CFT, and PED height, area and volume between the two groups at 3, 6 and 12mo after treatment(P >0.05).

CONCLUSION: The conbercept and ranibizumab have good effects on type 1 MNV with fPED in nARMD, which can reduce the PED height and CFT, and stabilize the visual acuity, PED area and volume. However, conbercept can achieve longer reduction of macular edema.

Abstract:AIM: To observe the dynamic changes of lens parameters of adolescents with hyperopia and myopia, analyze the difference to investigate the characteristics of lens changes under different accommodation stimuli.

METHODS: A random selection of 50 cases(86 eyes)of adolescents with refractive errors aged 7-15 years old who visited our clinic from January to October 2019 were divided into in myopia group(29 cases, 46 eyes, mean equivalent spherical lens was -2.17±1.41D)and hyperopia group(21 cases, 40 eyes, mean equivalent spherical lens was 1.92±1.49D). The axial length(AL)was measured by optical biometer(IOL Master). By using anterior swept source optical coherence tomography(SS-OCT), the dynamic changes of lens parameters including lens thickness(LT), anterior crystalline lens radius of curvature(ALRC)and posterior crystalline lens radius of curvature(PLRC)were observed under different accommodation stimuli(0, -3, -6D).

RESULTS: In the state of relaxed accommodation(0D), the LT of the myopia group was significantly lower than that of the hyperopia group, both ALRC and PLRC were greater than those of the hyperopia group(all P<0.01). The AL of the hyperopia group was significantly shorter than that of the myopia group(22.49±1.12mm vs 24.48±0.82mm, P<0.01). With the increase of the accommodation stimulus amplitudes(-3, -6D), the LT of the two groups increased significantly, the ALRC and PLRC both decreased significantly(all P<0.01). Under the condition of -3D and -6D, the change rate of ALRC was higher than that of PLRC in both groups(P<0.01). However, the change rate of LT and PLRC were not significantly different between the two groups(P>0.05). Furthermore, the change rate of ALRC in the hyperopia group was significantly higher than that of the myopia group when the -6D accommodation was completed(P<0.05).

CONCLUSION: During accommodation stimulation, the thickness of the lens in adolescents with refractive errors increased, the shape of the lens became convex, and the degree of change of the anterior surface was significantly greater than that of the posterior surface.

Abstract:AIM: To investigate the difference and consistency among iTrace, IOL Master 700 and Pentacam HR in measuring corneal astigmatism before cataract surgery.

METHODS: Across-sectional study. From May 2020 to May 2021, a total of 149 cataract patients(181 eyes)were collected in our hospital. Presurgery, steep keratometry(Ks), flat keratometry(Kf), mean keratometry(Km), astigmatism magnitude(Cyl), and steep astigmatic axis values measured by the three instruments of the iTrace, IOL Master 700 and the Pentacam HR. The difference and consistency of the measurement indexes of the three instruments were analyzed.

RESULTS: Statistical differences existed in Ks, Kf, Km among the three instruments(F=4.912, 3.514, 4.873, all P<0.05)and there was no difference in Cyl and Axis(F=0.523, 0.128, all P>0.05). Bland-Altman analysis showed the outcomes revealed that the Ks and Kf measured by iTrace and the other two instruments have poor consistency, and the consistency of Cyl and Axis was good. But the difference of Axis is not clinically acceptable. There were no statistically differences between the iTrace and the other two devices among the low astigmatism(50 eyes), moderate astigmatism(34 eyes)and high astigmatism(18 eyes)groups(all P>0.05).

CONCLUSION: In the preoperative measurement of cataract patients except for the good consistency of astigmatism, the iTrace, IOL Master 700 and Pentacam HR showed different Ks and Kf, and the Axis difference exceeded the clinically acceptable range, especially in the highly astigmatism group. The measurement of corneal astigmatism before cataract surgery should be evaluated by multiple measurement methods and make comprehensive planning for the surgical plan.

Abstract:AIM: To investigate the changes and clinical significance of corneal parameters and tear film stability after cataract combined with pterygium surgery.

METHODS: The clinical data of 80 patients with cataract and pterygium admitted to our hospital from January to December 2020 were retrospectively studied. All patients underwent pterygium excision + phacoemulsification + intraocular lens implantation + limbal stem cell transplantation. The changes of visual acuity, corneal Pentacam parameters, corneal astigmatism, corneal curvature and tear film stability before and after operation were compared, and the degree deviation of intraocular lens(IOL)was calculated.

RESULTS: At 3mo after operation, the average corneal refractive index and average corneal refractive index of the patients in this group were significantly higher than those before operation. The index of surface variance(ISV)of corneal surface and astigmatism of anterior corneal surface were significantly lower than those before operation, and the indexes of tear film stability were significantly improved compared with those before operation(all P<0.01). At 6mo after operation, the visual acuity of the patients in this group was significantly improved compared with that before operation, and the corneal astigmatism was significantly decreased compared with that before operation, but the corneal curvature was significantly higher than that before operation(all P<0.001). The IOL degree deviation of the patients in this group was -5.5 - +3.5D.

CONCLUSION: Cataract combined with pterygium surgery can effectively improve the visual acuity of patients and improve the stability of tear film, but there may be corneal astigmatism. Therefore, the contralateral corneal refractive power should be used to calculate the IOL degree after pterygium excision. When the corneal refractive state is stable, cataract phacoemulsification is performed to ensure its prognosis.

Abstract:AIM: To compare and modify the accuracy of the Haigis formula calculates for intraocular lens(IOL)refraction after myopic excimer laser surgery.

METHODS: The clinical records of 31 patients(31 eyes)who firstly accepted myopic corneal refractive surgery(LASIK/PRK)and then underwent phacomulsification was combined with IOL implantation in Tianjin Eye Hospital between February 2014 and March 2019 were finally enrolled in this study. Postoperative refraction was performed at least 6mo after cataract surgery. To compare the accuracy of equivalent keratometry readings(EKR)of different corneal radius(2.0, 3.0, 4.0, 4.5, 5.0mm)combined with the Haigis formula to calculate the IOL diopter after myopia, obtain the modified Haigis formula, and then compare the modified Haigis formula with the accuracy of Barrett true K, Haigis-L and Shammas-PL formulas for calculating IOL diopter after myopia.

RESULTS: The median absolute error(MedAE)and mean absolute error(MAE)of 4.0mm EKR Haigis formula was significantly lower than that of 4.5mm and 5.0mm EKR(all P<0.01). And the refractive prediction error(PE)also had a higher percentage of eyes in ±0.50D, ±1.00D and ±2.00D than that of 4.5mm EKR and 5.0mm EKR(all P<0.05). Thus, 4.0mm EKR Haigis formula was considered as the modified Haigis formula. The Postoperative MedAE of modified Haigis, Barrett true K, Haigis-L and Shammas-PL were 0.58(0.27, 1.12), 0.51(0.30, 1.15), 1.26(0.67, 1.72), 0.77(0.36, 1.45)D respectively. Moreover, the percentages of eyes with postoperative PE in ±0.50D and ±1.00D of the above formulae were 42% and 74%, 52% and 71%, 22% and 42%, 32% and 61% respectively. In eyes with axial length(AL)<27mm and 27mm≤AL≤30mm, the postoperative PE value of Haigis-L formula was higher than that of modified Haigis(P=0.019, 0.0142)and Barrett true K formula(P=0.002, <0.001 ). In patients with 27mm≤AL≤30mm, the postoperative PE value of Haigis-L formula was higher than that of Shammas-PL formula(P=0.003), and there was no significant difference among the other groups(P>0.05).

CONCLUSION: Haigis formula combined with the 4.0mm EKR can be used to calculate the IOL power in eyes after myopic LASIK/PRK, and its accuracy is comparable to the Barrett true K formula. However, the longer the AL is, the higher the possibility of hyperopic drift postoperatively might occur with the modified Haigis.

Abstract:AIM: To evaluate the accuracy of the single measurement of intraocular pressure in 24h and to explore the differences of intraocular pressure in different body positions at night.

METHODS: A prospective study. A handheld tonometer(iCare-PRO rebound tonometer)was used to measure the intraocular pressure for 24h with 24 patients(48 eyes)who were measured for 48h at 7:00, 10:00, 14:00, 18:00, 22:00, 02:00, 05:00 from July to August in 2019 in the department of Ophthalmology, Jiaxing Hospital of Traditional Chinese Medicine, Intraocular pressure measurements in sitting and lying positions were performed at 22:00, 2:00, and 5:00. Intraocular pressure measurements in lying positions were measured at first. Then the patients were required to remain the sitting position for 10min, and measured the intraocular pressure in sitting positions again. Repeated measurements were used in the intraclass correlation coefficient(ICC)within-group to analyze consistency. The intraocular pressure of different body positions at night was analyzed and compared with the paired t test.

RESULTS: The ICC value at each time point fluctuates between 0.79-0.94, most of which are around 0.90 and both eyes are basically the same. The ICC values in the night time decubitus position fluctuated from 0.73 - 0.91, mostly above 0.86. The ICC value at each time point was above 0.75, most of which was around 0.90 which shows the consistency of repeated intraocular pressure measurements at each time point is good. However, the ICC results of intraocular pressure fluctuations were poor. The ICC value of the right eye was 0.49 and the left eye was 0.55. The ICC value of the right eye in lying positions was 0.40 and the left eye was 0.43. The consistency of the right eye was poor. The intraocular pressures in lying positions at night were higher than that in the sitting position, which was a difference at all time points.

CONCLUSION: A single 24h intraocular pressure measurement may not be highly reproducible, especially for intraocular pressure fluctuations. The reliability of the results of one measurement needs to be studied. The intraocular pressure measurement in the sitting position at night may not represent the actual intraocular pressure during sleep at night.

Abstract:AIM: To evaluate the effect and safety of conbercept combined with trabeculectomy and retinal photocoagulation in the treatment of nevoascular glaucoma.

METHODS: A retrospectively analysis study. The clinical data of 47 patients(47 eyes)with neovascular glaucoma admitted to Shaanxi Eye hospital from January 2018 to December 2020. The patients were followed up for 6mo to observe the changes of visual acuity and intraocular pressure and the occurrence of complications before and after treatment.

RESULTS: At 6mo after compound trabeculectomy, the visual acuity of this group of patients improved in 25 eyes(53%), among which 8 eyes without light perception before operation, visual acuity increased to 0.2 and 0.02 respectively, to hand motion/30cm in 2 eyes,restoring light perception from no light perception 2 eyes; The visual acuity remained unchanged in 19 eyes(40%)and decreased in 3 eyes(6%). 40 eyes of 40 cases did not use any intraocular pressure lowering drugs, the intraocular pressure <21mmHg and the complete success rate was 85% at the 6mo follow up post-operatively. The intraocular pressures were 15.6±6.2, 12.8±5.9, 14.7±5.3, 17.1±6.9, 18.3±6.7mmHg at 1, 7d, 1, 3 and 6mo after compound trabeculectomy, which were different from the intraocular pressure at admission(46.0±11.9mmHg)and intravitreal intraocular pressure(39.9±12.5mmHg)after 3d of intravitreal injection of conbercept were significantly different(F=106.65, P<0.001). Hyphema occurred in 3 eyes after compound trabeculectomy, and completely absorbed within 3-7d after conservative drug treatment.

CONCLUSION: Intravitreal injection of conbercept combined with compound trabeculectomy and retinal photocoagulation is safe and effective in the treatment of neovascular glaucoma.

Abstract:AIM: To compare and observe the efficacy of 25G+ and 27G+ minimally invasive vitrectomy(MIVS)in the treatment of vitreoretinal diseases.

METHODS: A retrospective case-control study, 76 patients(76 eyes)with various vitreoretinal diseases treated in our hospital from December 2018 to January 2020 were selected and randomly divided into 25G+ group and 27G+ group underwent vitrectomy, and the operation time of the two groups of patients, as well as the changes of ETDRS visual acuity, intraocular pressure, and conjunctival edema 1d before surgery, 1d after surgery, and 1, 4, 12, and 24wk after surgery were compared and analyzed.

RESULTS: Compared with the 25G+ group, the 27G+ group had a longer vitrectomy time(27.17±5.95 vs 26.71±5.93min)and the total operation time was shorter than that of the 25G+ group(28.26±6.88 vs 30.37±6.68 min), but there was no significant difference between the two groups(t=0.322, P=0.748; t=-1.353, P=0.180). After vitrectomy, the visual acuity of the two groups was significantly improved compared with that before operation, but there was no significant difference between the two groups(P>0.05). Compared with the 25G+ group, the intraocular pressure fluctuation range of the 27G+ group at 1d(12.58±2.44 vs 10.56±3.21mmHg, t=2.943, P=0.004)and 1wk(13.48±2.85 vs 12.89±2.01mmHg, t=1.460, P=0.031)after the operation was low. Within 1wk after the operation, 7 eyes of transient hypotony occurred in the 25G+ group, but no hypotony occurred in the 27G+ group, indicating that the 27G+ MIVS can better stabilize postoperative intraocular pressure.

CONCLUSION: 27G+ MIVS and 25G+ MIVS are safe and effective in the treatment of vitreoretinal diseases. Compared with 25G+ MIVS, 27G+ MIVS can better stabilize intraocular pressure and reduce the occurrence of complications caused by postoperative hypotony.

Abstract:AIM: To observe the characteristics of the dominant eye in the progression of myopia in the proportion and gender distribution of the left eye and the right eye in the dominant eye, the difference in the degree and growth rate of myopia between the dominant eye and the non-dominant eye during the progression of myopia in adolescents.

METHODS: In this prospective study, we selected 235 cases of 7-17 years old adolescents with myopia who were treated in our hospital from February to May 2020. The ocular structure was examined to exclude various eye diseases, and the dominant eye(card hole method)was determined and cycloplegic optometry was performed. They were all corrected by wearing monofocal glasses, and the dominant eye(card hole method)and cycloplegic optometry were retested after 1a.

RESULTS: Among the subjects, 159 cases were right eyes, accounting for 67.7%, and 76 cases were left eyes, accounting for 32.3%; There was no significant difference in gender distribution between dominant eyes and non-dominant eyes(P>0.05); There was no significant difference in spherical equivalent degree between dominant and non-dominant eyes(P>0.05); There was no significant difference in the degree of myopia growth between dominant and non-dominant eyes(P>0.05); There was no significant difference in the increase of myopia and the increase of myopia between the two eyes whether the right eye was dominant or the left eye was non-dominant(P>0.05); There was a significant correlation between the degree of myopia growth in the dominant eye and in both eyes(P<0.01).

CONCLUSION: In myopic adolescents, most of the dominant eyes were right eye, and there was no difference between dominant eye and gender; Dominant eyes showed no specificity in the degree and growth of myopia, the dominant eye type do not affect the degree of myopia growth and the degree of anisometropia, but the degree of dominant myopia growth may affect the degree of anisometropia in both eyes.

Abstract:AIM: To analyze the clinical application of calculated and gradient accommodative convergence/accommodation ratio(AC/A)in different eye positions.

METHODS: A total of 127 myopes in ophthalmology were included. The calculated AC/A was obtained by near/distance phoria and the gradient AC/A was obtained by near addition +1.00D. The differences of eye positions of the calculated and gradient AC/A were compared.

RESULTS:The calculated AC/A value was higher than the near +1.00D gradient AC/C(P<0.01); Comparing the same method in different eye positions revealed that the calculated AC/A and gradient AC/A were significantly different, which has the highest AC/A in the esophoria group and the lowest AC/A in the exophoria group; Comparing the two methods in the same group revealed that the calculated AC/A in the esophoria group and the normal group was higher than the gradient AC/A(P<0.01), and there was no significant difference in the AC/A measured by the two methods in the exophoria group(P>0.05).

CONCLUSION: The calculated AC/A is higher than the gradient AC/A, especially in patients with esophoria and emmetropia, it is easy to obtain high AC/A values by using the calculation method, resulting in erroneous diagnosis. The gradient method is more recommended.