Abstract:AIM: To compare the visual quality in patients after implantation of extended-range-of-vision(Tecnis Symfony)intraocular lens(IOL)and zonal refractive(Lentis Comfort LS-313 MF15)IOL.

METHODS: A prospective clinical study. Collecting 267 cataract patients(305 eyes)who underwent phacoemulsification combined with IOL implantation surgery in our hospital from January 2021 to December 2021,they were divided into the Symfony group(group A, 160 eyes)and MF15 group(group B, 145 eyes)according to the types of implanted IOL. Postoperative visual acuity were observed at 3mo and included uncorrected distance visual acuity(UDVA, 5m), uncorrected intermediate visual acuity(UIVA, 80 cm), uncorrected near visual acuity(UNVA, 40cm), defocus curve, modulation transfer function(MTF)and high-order aberrations(HOAs), including coma, spherical aberration and trefoil aberration, and conducted the Quality of Vision(QoV)questionnaire.

RESULTS: There were no significant differences in the preoperative parameters in both groups(P>0.05). There was no significant difference between the UDVA and UNVA in groups A and B(P>0.05); The UIVA was higher in group A than in group B(P<0.05); The MTF value in group A was higher than group B at all spatial frequency, and the difference was statistical significant(P<0.05); The HOAs in group A was lower than that in group B(P<0.05); Defocus curves were plotted 3mo after the operation suggest that the visual acuity of the two groups was similar at 0D, and the visual acuity of the groups A was better than group B from -0.5D to -2.5D, and there was a statistically significant difference at -1.0D and -2.0D(P<0.05). The QoV score in group A was significantly higher than that in group B(P<0.05). The frequency of bad visual interference such as halo and starburst was higher in group A than in group B.

CONCLUSION: Both the MF15 and Symfony can provide stable distance and near visual acuity. Compared with MF15, Symfony had better intermediate visual acuity, higher contrast sensitivity and lower HOAs. Compared with Symfony, MF15 IOL had less postoperative bad visual interference symptoms(halo, starburst, etc).

Abstract:AIM:To investigate whether ceramide kinase-like protein(CERKL)alleviates oxidative stress injury of retinal pigment epithelial(RPE)cells induced by blue light via activating the silent information regulator 1(SIRT1)/E2F transcription factor 1(E2F1)axis.

METHODS:Cultured human retinal pigment epithelial-19(ARPE-19)cells were irradiated with blue light to observe the morphological changes, and the expression of CERKL was detected by PCR and Western blot. ARPE-19 cells were transfected with siRNA-CERKL and pcDNA3.1-CERKL respectively. After exposure to blue light, cell viability was determined by MTT assay, apoptosis was detected by TUNEL assay, content of oxidative stress markers and the expression of SIRT1/E2F1 axis was analyzed. Then siRNA-SIRT1 was transfected into ARPE-19 cells, and the oxidative stress damage of ARPE-19 cells under blue light irradiation was detected again.

RESULTS:ARPE-19 cells gradually contracted into spheres and appeared vacuoles after exposure to blue light. Blue light irradiation led to the increase of CERKL expression level(P<0.05), meanwhile, the rate of cell viability was decreased(P<0.05), the rate of the apoptosis was increased(P<0.05), contents of reactive oxygen species, malondialdehyde and 8-hydroxydeoxyguanosine were increased(P<0.05). Silence of CERKL aggravated this phenomenon, while up-regulation of CERKL could alleviate this change(P<0.05). Up-regulation of CERKL also activated the expression of SIRT1 and promoted the deacetylation of E2F1(P<0.05). Silencing SIRT1 could reverse the alleviating effect of up-regulating CERKL on oxidative stress injury of ARPE-19 cells induced by blue light(P<0.05).

CONCLUSION: CERKL can reduce oxidative stress damage of ARPE-19 cells induced by blue light via activating SIRT1 expression and promoting the deacetylation of E2F1.

Abstract:AIM: To investigate the effect and mechanism of matrix metalloproteinase(MMPs)inhibitor AG3340 on the migration and invasion ability of retinal pigment epithelial cells-19(ARPE-19)cultured in high glucose(CHG).

METHODS: ARPE-19 cells cultured in vitro were divided into four groups: Control group, the glucose at the concentration of 5.6mmol/L in DMEM/F12 medium; HG group, the glucose at the concentration of 30mmol/L was cultured with DMEM/F12 medium; HG+AG3340 group, the cells were pretreated with AG3340 for 12h, and then cultured in DMEM/F12 medium containing 30mmol/L glucose; The mannitol(MA)group, cultured with DMEM/F12 medium of 5.6mmol/L glucose and 24.4mmol/L mannitol, which used as hypertonic control group. The migration ability of cells was detected by wound healing assay, the invasion ability of cells was detected by Transwell assay, and the relative expression levels of MMP-9, MMP-2, fibronectin and collagen Ⅳ were detected by Western blot.

RESULTS: The results of wound healing assay showed that compared with the Control group, the cell migration rate of scratching after 24h and 48h in the HG group was significantly increased(all P<0.001).After pretreated by AG3340, the cell migration rate was significantly lower than that in the HG group(all P<0.01).Transwell assay showed that compared with the Control group, the number of cell invasion in the HG group was significantly higher than that in the Control group(all P<0.001). After pretreated by AG3340, the number of cell invasion was decreased than the HG group(all P<0.01). Western blot results showed that compared with the Control group, the relative expression levels of MMP-9 and MMP-2 of the cells in the HG group were increased, and the relative expression levels of Fibronectin and Collagen Ⅳ were decreased(all P<0.001). Compared with the HG group, the relative expression levels of MMP-9 and MMP-2 protein in AG3340 pretreatment group were decreased, and the relative expression levels of Fibronectin and Collagen Ⅳ were increased(all P<0.05).

CONCLUSION: High glucose induced ARPE-19 cells with enhanced migration and invasion ability, and AG3340 partially reversed this effect, which was related to the inhibition of MMP-9 and MMP-2 expression and the stability of extra-cellular matrix components.

Abstract:AIM:To investigate the effect of epigallocatechin gallate(EGCG)on the apoptosis of human retinal pigment epithelium(ARPE-19)cells and its mechanism.

METHODS:The ARPE-19 cells were cultured in vitro and treated with 0,40,80 and 160 μg/mL EGCG, respectively. At the proposed time of treatment the morphological changes were detected by hoechst 33258 staining. The apoptosis rate was detected by flow cytometry. The expression of apoptosis-related factors B lymphocytoma-2 gene(bcl-2), BCL2-Associated X protein(Bax),caspase-3 and p53 were detected by quantitative RT-PCR and Western blotting.

RESULTS: Hoechst 33258 staining showed that the ARPE-19 cells with the increase of EGCG drug concentration, the number of apoptotic cells gradually increased and the apoptotic bodies were observed. Flow cytometry showed that the apoptosis rate increased gradually with the increase of EGCG drug concentration. The apoptosis rates at 40, 80 and 160 μg/mL were 4.95%±0.071%, 11.75%±0.075% and 21.25%±0.919% respectively, which was significantly different compared with the control group(2.8%±1.556%)(P<0.01), presented with a drug concentration-dependent. The results of quantitative PCR and Western blotting showed that EGCG could significantly up-regulate the expression of apoptosis-promoting factors Bax, caspase-3 and the mRNA and protein expression of p53, and down-regulate the apoptosis-inhibiting factor bcl-2, all of these showed concentration-dependent effects.

CONCLUSION:EGCG can obviously induce the apoptosis of ARPE-19 cells. The mechanism is related with the inhibition of bcl-2 and increase the expression of Bax, caspase-3 and p53.

Abstract:AIM: The clinical outcomes of unilateral single-focal intraocular len(SIOL), contralateral implanted multifocal IOL(MIOL)and the SIOL was implanted in binoculus were compared.

METHODS: There were 60 cases with 120 eyes age-related cataract patients in January 2019 to January 2021 underwent phacoemulsification and IOL implantation in Chengdu Aier Eye Hospital. The SIOL has been implanted in the dominant eyes, all patients were divided into three groups according to the types of IOL implanted in the contralateral non-dominant eyes, among them, there were 36 eyes of 18 cases in group A with non-dominant eyes implanted MIOL(SBL-3); 38 eyes of 19 cases in group B were implanted MIOL(SN6AD1)in non-dominant eyes. SIOL was implanted in all 46 eyes of 23 cases of control group. After operation at 3mo,the results of binocular vision and visual quality of the three groups were evaluated and compared.

RESULTS: After operationat 3mo, there was no difference in the uncorrected distance vision and corrected distance vision, uncorrected medium vision and corrected near vision among the three groups(P<0.05).The uncorrected near visual acuity and corrected intermediate visual acuity of both eyes in groups A and B were significantly improved in both groups compared with the control group(P<0.05). The scores of Catquest 9SF-CN scale showed that the quality of life of patients in group A and group B(11.11±1.323, 11.89±1.883 scores)was better than that in the control group(14.65±1.722 scores, both P<0.05). The rate of lens removal in group A, B and control group were 88.9%, 84.2% and 39.1%, respectively, and the rate of lens removal in group A was significantly higher than that in the control group(P<0.0167).

CONCLUSION: Dominant eye implantation of SIOL in patients with cataract and contralateral non-dominant eye implantation of MIOL(SBL-3/SN6AD1)can obtain better full-range visual acuity than binoculus, less postoperative adverse visual symptoms, and higher patient disengagement rate and satisfaction.

Abstract:AIM: To investigate the changes of morphology and function of meibomian glands in patients with type 2 diabetes mellitus and its influence on the tear film.

METHODS: A total of 52 patients(104 eyes)with type 2 diabetes mellitus who came to our hospital from January 2018 to January 2020 were selected. Then they were divided into non-diabetic retinopathy group(NDR group, 31 cases with 62 eyes)and diabetic retinopathy group(DR group, 21 cases with 42 eyes)according to the fundus changes. While 38 cases(76 eyes)of diabetic-free cataract patients who treated at the same time were selected as the control group. The differences of three groups were compared with the morphology and the scores of the function of lid edge and meibomian glands, the scores of fluorescence staining of cornea, break-up time(BUT)of tear film, lipid layer thickness(LLT), blink times(BT)and partial blink rate(PBR).

RESULTS: The morphology and the scores of function of lid edge and meibomian glands, the scores of fluorescence staining of cornea were significantly higher than the control group, and the DR group was significantly higher than the NDR group(all P<0.05). The BUT in the DR group and NDR group was significantly lower than that in the control group, and the DR group was significantly lower than that in the NDR group(all P<0.05). There were differences in LLT, BT and PBR among the three groups(P<0.05). The LLT and BT in the DR group and NDR group were significantly lower than those in the control group, and PBR was significantly higher than that in control group(all P<0.05), but there was no significant difference between the DR group and the NDR group(all P>0.05). Type 2 diabetes mellitus patients with morphology abnormalities of meibomian gland have a higher incidence of abnormal tear film function.

CONCLUSION: Patients with type 2 diabetes mellitus are prone to shortening and loss of meibomian glands, which is easy to cause the dysfunction of the meibomian gland and decrease the stability of the tear film. While the patients with DR, the morphology abnormalities and dysfunction of the meibomian glands are more pronounced, and the stability of the tear film is worse.

Abstract:AIM: To observe the clinical effect of 3% diquafosol sodium eye drops in treatment of meibomian gland dysfunction-related dry eye.

METHODS: The study involved 280 patients totally with meibomian gland dysfunction-related dry eye in the ophthalmology department, Hangzhou Hospital of Traditional Chinese Medicine from May 2020 to May 2021. Patients were divided into the treatment group(160 cases with 320 eyes)and the control group(120 cases with 240 eyes)according to the randomized number table method. The control group was treated with YangXueRunMu formula combined with 0.3% sodium hyaluronate eye drops, the treatment group was treated with YangXueRunMu formula combined with 3% diquafosol sodium eye drops. Both groups were administered for 4wk. The following indicators were measured before and after treatment at 2 and 4wk, respectively: the ocular surface disease index(OSDI)score, Schirmer I test( SⅠt), comprehensive analysis of tear meniscus height(TMH), non-invasive tear film break-up time(NITBUT), meibomian gland lipid secretion of smooth degree scoring and meibomian gland loss rate score, the determination of interleukin-6(IL-6)in tears and the level of tumor necrosis factor-alpha(TNF-α). The efficacy of these tests results was evaluated among these indicators.

RESULTS: The overall effective rates of the treatment group and the control group were 95.6% and 81.7% respectively(P<0.05). After 2, 4wk of treatment, the ocular surface disease index(OSDI), NITBUT, meibomian gland lipid secretion scoring, meibomian gland loss rate score and the levels of IL-6 and TNF-α in tears of two groups were significantly different than before treatment(P<0.05). and the treatment group was better than the control group; there was no difference between the SⅠt and TMH groups before and after treatment in the two groups(P>0.05).

CONCLUSION: The 3% diquafosol sodium eye drops can promote the normal secretion of meibomian gland by prolonging the homeostasis of the tear membrane, and it can also inhibit the release of inflammatory factors in tears in the treatment of blebomian gland dysfunction-related dry eye.

Abstract:Diabetic macular edema(DME)has become the leading cause of vision loss in patients with diabetes. Currently, intravitreal injection of anti-vascular endothelial growth factor(VEGF)therapy is the first-line treatment for DME. However, the economic burden and related complications brought by frequent injections should not be ignored. Therefore, the drugs with longer-lasting effects and longer injection intervals must be explored. Brolucizumab is a single-chain antibody fragment(scFv)with a high affinity for VEGF. Compared with other available anti-VEGFs, it has the characteristics of smaller molecular weight, higher tissue permeability and durable therapeutic effect. Clinical studies and real-world evidences showed that Brolucizumab is non-inferior to aflibercept in improving visual acuity in patients with DME. And Brolucizumab is more effective in regressing intra-retinal fluid and reducing central foveal thickness(CSFT)with longer injection interval. At the same time, Brolucizumab has a low incidence of adverse events and favourable safety after intraocular injection. This article reviews the latest progress of Brolucizumab in the treatment of DME.

Abstract:Diabetic retinopathy is the leading cause of blindness in the working-age population, in which diabetic macular edema(DME)is the most common reason resulting in the vision impairment. Studies showed that inflammation factors play an important role in the pathogenesis and development of DME. Chronic hyperglycemia activates several biochemical pathways, leading to retinal hypoxia, oxidative stress and chronic inflammation. Intraretinal inflammation-related cells, such as microglia, monocytes/macrophages, Müller cells and retinal pigment epithelial cells, become activated and release a large number of inflammation-related factors and mediators, including the complement system, vascular endothelial growth factor(VEGF), placental growth factor(PlGF), tumor necrosis factor-α(TNF-α), interleukin-1β(IL-1β), IL-6 and IL-8, etc., resulting in the breakdown of the blood-retinal barrier and neuronal degeneration. In addition, up-regulatethe expression of intercellular adhesion molecule-1(ICAM-1)and vascular cell adhesion molecule-1(VCAM-1)by retinal vascular endothelial cells increased the adhesion of leukocyte and leukostasis, further aggravating retinal hypoxia and breakdown of the blood-retinal barrier, leading to the increased retinal vascular leakage and macular edema. Therefore, early treatment with anti-VEGF and anti-inflammatory are pivotal for the treatment of DME. In this review, we will discuss the role of inflammation factors in the pathogenesis of DME and the research status of the targeted drugs targeting inflammation, so as to provide reference for the treatment of DME.

Abstract:Thyroid-associated ophthalmopathy(TAO)is an autoimmune disease that is closely related to thyroid dysfunction. It is one of the most common orbital diseases in adults with complex clinical manifestations. As the disease progresses, it may manifest as proptosis, diplopia, exposure keratitis, corneal ulceration and compressive optic neuropathy, leading to irreversible visual impairment or even blindness. The treatment is lack of specificity and only focuses on clinical symptomatic treatment, the efficacy is uncertain. It is currently a problematic area of ophthalmology. Clinical first-line drug treatment is based on glucocorticoids. Second-line treatments, such as immunosuppressants and radiotherapy, all them have certain limitations. With the in-depth and comprehensive understanding of the disease, a variety of new targeted drugs represented by teprotumumab and rituximab have been developed for the pathogenesis of TAO. Their excellent roles in relieving inflammation and controlling the disease are the future research direction. In this paper, the current status and research progress of conservative treatment of TAO will be reviewed.

Abstract:Uveitis is a group of inflammation diseases involving the iris, ciliary body, choroid, vitreous body, retina and retinal vessels, which can lead to visual deterioration and even visual loss. The pathogenesis of uveitis is complex and diverse, including infection, autoimmunity, trauma, physical and chemical injury, immune genetic mechanism and so on. Recent studies have shown that the activation of complement system is one of the pathogenesis of uveitis. Various complement proteins, including CFH, CFB, CFI, MAC, CD59 and so on, regulate host tissue damage through a rigorous mechanism mediated by the complement system. And studies have found that those complement proteins are involved in the occurrence and development of uveitis at the gene level and biological function. In addition, complement components like C2, C3, C4 and C5 can affect the pathogenesis of uveitis in terms of copy number variation, gene polymorphism and the regulation of T-cell-mediated autoimmune response. Therefore, complement inhibition therapy and related gene therapy provide new ideas and targets for the treatment of uveitis.

Abstract:Epiretinal membrane(ERM)is a retinal disease characterized by a fibrocell membranes that can develop on the inner surface of the retina. The existing clinical guidelines and literature have reached a consensus on the diagnosis and treatment of ERM, but the explanation of their mechanism is still controversial. Transforming growth factor-β(TGF-β)is a highly pleiotropic cytokine that plays an important role in wound healing, angiogenesis, immune regulation, cancer, inflammation and fibrosis diseases. Studies have increasingly shown that ERM is a kind of pathological changes in fibrosis that caused by the posterior vitreous detachment(PVD)and lead to the retinal inflammatory damage and epithelial to mesenchymal transition(EMT)of retinal pigment epithelial cells. A variety of cytokines regulate TGF-β-mediated EMT process by participating in the non-classical TGF-β-Snail pathway and the classical TGF-β-Smad pathway. At present, some drugs targeting cytokines related to the above pathway have entered the development stage, which is of great significance to provide new ideas for clinical treatment and prevention of ERM. This review reviews the progress of TGF-β related cytokines in ERM formation.

Abstract:Diabetic retinopathy(DR)is one of the common and severe ocular complications of diabetes mellitus, representing a leading cause of blindness among working-age people. Currently, the pathogenesis of DR is not been explained, and the treatment effect is quite limited in advanced stage. In recent years, it has been revealed in some studies that DR could produce a particularly remarkable performance in genomics, transcriptomics, epigenomics, proteomics and metabolomics. With the rapid development of high-throughput sequencing and detection technology, different omics techniques can explore the occurrence and development mechanism of DR from different omics levels. This paper introduces the research progress of DR in different omics techniques,as well as the new direction of integration analysis in multiomics with DR, and finally discusses the current existing problems and future prospects of omics technology. Therefore, the application of different omics techniques to explore the occurrence and development of DR on different levels contributes a novel idea to unraveling the pathophysiological mechanism of DR and identifying new biomarkers and therapeutic targets.

Abstract:Diabetic retinopathy(DR), one of the common complications of diabetes, is a major cause of blindness. Traditionally, DR has been considered primarily a microvascular disease, and as research has progressed, it is now believed that disruption of the neuro-glia-vascular unit(NVU)and imbalance in its coupling mechanisms(coupling)play a key role in the early onset of DR. Understanding the cellular and molecular basis of NVU and how diabetes alters normal cellular communication and disrupts the cellular environment is important for the early prevention and treatment of DR. This paper summarizes the retinal NVU and its involvement in the molecular mechanism of DR pathogenesis, DR treatment based on retinal NVU repair, and discusses the future prospects and problems of DR.

Abstract:The dry eye is a common ocular surface disease caused by multiple factors with multiple pathogenesis. With the increasing morbidity of dry eye in our country year by year, dry eye has gradually attracted people's attention. The pathogenesis of dry eye is more complicated whose critical influencing factors include inflammation, corneal and conjunctival epithelial cell changes, tear film composition changes, corneal nerve changes, and meibomian gland dysfunction and so on. The tear film hypertonicity leads to the hypertonicity of the ocular surface epithelial cells, stimulating the cascade of inflammation, which is the most critical part among the pathogenesis of dry eye. A variety of inflammatory mediators and immune cells are involved in this process, and more and more people have reached a consensus that the dry eye is an antigen-specific autoimmune inflammatory disease and they are closely correlated with each. In clinical treatment, various anti-inflammatory drugs and drugs promoting tear secretion mark the rapid development of drug therapy for dry eye to some extent, but dry eye treatment is not only to improve symptoms, but to carry out treatment according to specific etiology. Recently, researches on the immune mechanism of dry eye have been increasing. This article reviewed on the immune progress of dry eye to realize the clinical significance and systematically understand the role of which in the occurrence and development of dry eye.

Abstract:Myopic anisometropia is a special type of refractive error. As the prevalence of myopia has rapidly increased worldwide in recent years, the prevalence of myopic anisometropia is also growing year by year. Anisometropia can cause aniseikonia of the retinal and fusion impairment, leading the problems such as asthenopia, monocular suppression, amblyopia, and stereopsis disorder, which results in negative effects on patients' work and life. Therefore, it is crucial for children to discover myopic anisometropia in early stage and take effective measures in time to delay the progression of it. At present, a wide range of research has been conducted to study the methods that control the progression of myopia among children. It has been found that orthokeratology lens(OK lens)can effectively slow the progression of myopic anisometropia. This article mainly reviews the mechanism of how orthokeratology control myopic anisometropia, its effect on delaying the progression of myopic anisometropia, and its impact on stereopsis among children with myopic anisometropia, aiming to provide a theoretical basis for the prevention and control of myopic anisometropia in the future.

Abstract:AIM: To compare the analysis of conjunctival autograft(CAG)or limbal conjunctival autograft(LCAG)for treating pterygium.

METHODS: Systematic search of the National Library of America Medical Literature Search System(PubMed), the Excerpta Medica Database(EMBASE), the Cochrane Library and the US Clinical Trial Registry which all literatures established of the database from September 2021. The rate of recurrence, corneal epithelial healing time, the change in Schirmer Ⅰ test(SⅠt)and the change in tear break-up time(BUT)were analyzed. Statistical analysis was performed using Review Manager 5.3, count data were expressed as relative ratio(RR),measurement data were expressed as standardized mean difference(SMD)with 95%CI.

RESULTS: There were 15 studies included with a total number of 1 883 surgical eyes,among them, there were 897 eyes experienced LCAG while 986 eyes underwent CAG. For the rate of recurrence, LCAG group was lower than CAG group(RR=0.33, 95%CI: 0.15-0.71, P=0.004). For corneal epithelial healing time, LCAG group seemed to behave better than CAG group(SMD=-0.87, 95%CI: -1.64 to -0.11, P = 0.02). No statistical significance was found for SⅠt(SMD = 0.03, 95% CI, -0.33-0.40, P=0.86)and as for BUT, LACG group showed longer times against CAG group(SMD=0.40, 95%CI: 0.09-0.70, P=0.01).

CONCLUSIONS: Pterygium resection combined with LCAG was with lower recurrence rate, faster corneal epithelial healing and more stable tear film rather than CAG.

Abstract:AIM: To compare the effectiveness of unilateral lateral rectus recession-medial rectus resection(RR))and lateral rectus recession-medial rectus plication(RP)in the treatment of exotropia.

METHODS: Evidence-based medicine research. A systematic database search was conducted Medline, Embase, Web of Science, the Cochrane Register of Controlled Trials and so on from August 2011 to August 2021. Related studies meeting the inclusion criteria were included in our study. The main outcome measures were as follows: success rate and postoperative deviation. Mean difference(MD)and odds ratio(OR)with 95% confidence interval(CI)were statistical analyzed as measurement data and continuous variables statistics.

RESULTS: A total of two randomized controlled studies and five retrospective studies were included. The Meta-analysis results showed that the success rate of surgery was similar for RP group compared with RR group(OR=0.65, 95%CI:0.39-1.07, P=0.09). There was no difference in the incidence of poor postoperative prognosis of the two groups(the undercorrection and overcorrection rates)(OR=1.59; 95%CI: 0.92-2.74, P=0.10; OR=4.43; 95%CI: 0.69-28.18, P=0.12). There were no significant differences in postoperative deviation and the amount of external oblique drift(MD=0.75, 95%CI: -0.27-1.76, P=0.15; MD=-0.34, 95%CI: -1.30-0.63, P=0.50).

CONCLUSION: The success rate of RP and RR surgery is close to the incidence of poor postoperative prognosis, moreover, there was no significant difference between the deviation and the amount of external oblique drift after the two surgeries, RP is an effective surgical procedure for the treatment of exotropia.

Abstract:AIM:To analyze the correlation between optical coherence tomography(OCT)parameters and central retinal vein occlusion of macular edema secondary(CRVO-ME), and compare the clinical efficacy of ranibizumab combined with laser photocoagulation and ranibizumab alone in the treatment of CRVO-ME.

METHODS:There were 43 case with 43 eyes of patients in CRVO-ME diagnosed in our hospital from January 2020 to December 2020 included in the present study and divided into two groups, namely A and B. Patients in group A were treated with ranibizumab combined with laser photocoagulation, while patients in group B were treated with ranibizumab alone. The structure of outer retina and “SAVE” scores were observed and estimated using OCT and fluorescein angiography(FFA)examination before and after the treatment at 1, 3, 6, 12mo, and then analyzed their correlation with best corrected visual acuity(BCVA, LogMAR). The BCVA, central macular thickness(CMT), intraocular pressure and average number of drug injections were also compared between the two groups before and after treatment.

RESULTS:At 12mo after treatment, the BCVA in the OCT baseline external limiting membrane(ELM)intact group and baseline ellipsoid zone(EZ)intact group before and after treatment were significantly improved than those of the fracture group(0.47±0.16 vs 0.21±0.15, P=0.013; 0.44±0.20 vs 0.25±0.17, P=0.008). There was no statistically significant difference in BCVA changes between baseline RPE fracture group and RPE intact group(P>0.05). The number of patients with “S” and “A” at 1 score decreased significantly at 12mo after treatment in both groups, the BCVA of patients with “V” and “E” at 0 score before treatment was significantly improved than those patients at 1 score(all P<0.05). The BCVA and CMT of patients after treatment in groups A and B were both significant improved compared with before treatment(P<0.05). There were no significant differences in the BCVA and CMT in the number of drug injections between the two groups(P>0.05). In addition, there were no severe complications such as secondary glaucoma and endophthalmitis in both groups.

CONCLUSION: Baseline status of ELM and EZ, presence or absence of vitreoretinal abnormalities(V), and focal leakage(E)could suggest the treatment efficacy of CRVO-ME. Ranibizumab in the treatment of CRVO-ME demonstrates prominent efficacy and great safety, and there was no better effect was observed when combined with laser photocoagulation.

Abstract:AIM: To evaluate the effect of 0.02% mitomycin-C(MMC)on the corneal density after transepithelial photorefractive keratectomy(Trans-PRK).

METHODS: Retrospective case analysis. Selected 28 patients with 56 eyes in moderate myopia who underwent Trans-PRK surgery from January 2021 to June 2021 in our hospital. They were divided into MMC group in 28 eyes with a combination of 0.02% MMC 20s during the surgery and the control group in 28 eyes was not use MMC during the surgery. The Pentacam anterior segment analyzer was used to measured the corneal density in different diameter ranges and different thickness layers before and after surgery at 14d, and after surgery at 1 and 3mo.

RESULTS: The total corneal density value of MMC group was 16.60(15.70,17.10 )before the surgery, after the surgery at 14d was 16.63(15.90,17.50 ), at 1mo was 16.57(15.10,16.70 ), at 3mo was 16.04(14.60,16.60 ). The total corneal density value of control group was 16.30(15.50,17.30 )before the surgery, after the surgery at 14d was 16.20(15.20,17.10 ), at 1mo was 16.08(14.90,16.40 )and at 3mo was 15.60(14.60,16.40 ). In the zone of 0-2mm diameter was centered on the corneal vertex, the corneal density of the two groups at 14d after the surgery was higher than those before surgery(P<0.001 ). In the zone of 2-6mm diameter, the corneal density of the two groups at 1mo and 3mo after surgery was higher than those before the surgery(P<0.001). In the zone of 6-10mm, the corneal density of the two groups at 14d, 1 and 3mo after surgery was higher than those before the surgery(P<0.001). In the layer of anterior 120 μm, the corneal density of the two groups at 1mo and 3mo after the surgery was decreased than that before surgery(P<0.01). In the middle layer, the corneal density of the two groups at 1mo after the surgery was decreased than those before surgery(P<0.01).

CONCLUSION:The use of 0.02% MMC during the operation can reduce the corneal density and increase the corneal light transmittance in the early postoperative period. The occurrence and prognosis of haze can be effectively quantified by observing the changes of corneal optical density in different ranges in different time periods after operation.

Abstract:AIM:To explore the changes and influencing factors of macular retinal blood flow density in patients with proliferative diabetic retinopathy(PDR)after vitrectomy, and establish a predictive model.

METHODS: The clinical data of 173 patients with 173 eyes in PDR who underwent vitrectomy in our hospital from June 2019 to June 2021 were analyzed retrospectively. According to the changes of macular retinal blood flow density after operation, the patients were divided into normal group(118 cases with 118 eyes)and descending group(55 cases with 55 eyes). The general data, preoperative laboratory examination index and intraoperative condition of the two groups were compared. Multivariate Logistic regression was used to analyze the factors affecting the changes of retinal blood flow density in macular area after operation. Construct the line chart prediction model and evaluate its prediction efficiency.

RESULTS: The course of diabetes, proportion of patients with complicated maculopathy, serum TC, TG, LDL-C, HbA1c, vascular occlusion and hyperplastic retinal traction in the decreasing group were significantly higher than those in the normal group, while HDL-C was significantly lower than that in the normal group(P<0.05). Multivariate Logistic regression analysis showed that course of diabetes > 17a(OR=4.526), complicated maculopathy(OR=4.983), HbA1c > 6.25%(OR=4.283), vascular occlusion(OR=5.216)and hyperplastic retinal traction(OR=4.765)were all risk factors of the decrease of macular retinal blood flow density after operation(P<0.05). The line chart prediction model has good differentiation and accuracy, and has high prediction value.

CONCLUSION: Course of diabetes, complicated maculopathy, HbA1c, vascular occlusion and proliferative retinal traction are all related to the decrease of macular retinal blood flow density after vitrectomy with PDR. Understanding the risk factors is beneficial to surgical decision-making.

Abstract:AIM:To discuss the efficacy and safety of orthokeratology with reducing back optic zone diameter(5mm-BOZD)compared with conventional back optic zone diameter(6mm-BOZD)in the treatment of adolescent myopia.

METHODS: A prospective randomized controlled trial was performed. There were 100 cases with 100 eyes of adolescent myopia(all right eye data were taken)selected from April 2016 to January 2019, the spherical degree was -1.00--5.00D. Then they were randomly divided into the two groups. The experimental group wore 5mm-BOZD orthokeratology, and the control group wore 6mm-BOZD orthokeratology. Their axis length(AL), spherical equivalent(SE), relative peripheral refraction(RPR), best corrected visual acuity(BCVA), uncorrected near visual acuity(NVA), Efron grading was applied to record the anterior segment of the eyes, corneal hysteresis(CH), corneal resistance factor(CRF), corneal-compensated intraocular pressure(IOPcc), average noninvasive Keratograph tear breakup time(NIKBUTav)and higher order aberration(RMS_h) were compared between the two groups during the 1a treatment period.

RESULTS: After 1a of treatment, the AL in experimental group increased 0.05±0.05mm,while it increased 0.15±0.05mm(t=-8.949, P<0.001)in control group. The SE in experimental group increased -0.18±0.27D,while it increased-0.42±0.35D(t=3.609, P=0.001)in control group. There were statistical differences in RPR changes at N30°, N20° and T30°sites between the two groups(P<0.05). There were no statistical differences in BCVA,NVA,Efron grade,CH,CRF,IOPcc,NIKBUTav and RMS_h between the two groups(P>0.05).

CONCLUSION:Reducing back optic zone diameter orthokeratology can correct adolescent myopia safely and more effectively during the observation period.

Abstract:Conbercept is a novel anti-vascular endothelial growth factor drug independently developed by China. Since it was approved for clinical application by the State Food and Drug Administration of China in 2013, conbercept has shown reliable safety and efficacy in the treatment of ocular neovascular diseases such as wet age-related macular degeneration, choroidal neovascularization and macular edema. For different diseases, the treatment strategies of conbercept are different. This article mainly reviews the application progress of conbercept in ocular neovascularization related diseases including wet age-related macular degeneration, diabetic macular edema, pathologic myopia choroidal neovascularization, neovascular glaucoma, retinopathy of prematurity and corneal neovascularization, and summarizes and explores the indications, administration scheme and therapeutic effect of conbercept. It is expected that the indications of conbercept will be wider and the administration scheme will be more given, and the usage of conbercept will bring new ideas for the treatment of ocular neovascular diseases.

Abstract:AIM:To evaluate the application effect of artificial intelligence(AI)assisted diagnosis system in screening diabetic retinopathy(DR)in Yinchuan Community, Ningxia Hui Autonomous Region.

METHODS:From July 2020 to July 2021, fundus photograph of 2 707 eyes from 1 358 diabetic patients with type 2 diabetes in two communities of Ningxia and Yinchuan were included in this study. The Eye Wisdom AI assisted screening and diagnosis system was used to analyze automatically and detect the characteristic changes of DR, such as hemorrhage, microaneurysms and retinal microvascular abnormalities. The results of fundus photograph were automatically graded according to the standard of DR international stage standard. The manual analysis group gave feedback after image interpretation, analyzed the sensitivity, specificity, misdiagnosis rate and missed diagnosis rate of the AI-assisted screening system for DR diagnosis, and compared the consistency between AI and manual analysis. Kappa consistency test was performed for the results of AI screening system and manual analysis.

RESULTS:Compared with manual analysis, the sensitivity, specificity, missed diagnosis rate and misdiagnosis rate of AI were 91.84%, 99.06%, 8.16% and 0.94% respectively. The Kappa value of consistency analysis of the two diagnosis results was 0.817(P<0.001). Compared with manual analysis, the sensitivity and specificity of AI group to diagnose non-DR were 99.06% and 91.84% respectively. The sensitivity and specificity of mild NPDR were 85.36% and 98.52% respectively. The sensitivity and specificity of moderate NPDR were 81.53% and 98.55% respectively. The sensitivity and specificity of severe NPDR were 70% and 99.51% respectively. The sensitivity and specificity of PDR were 86.67% and 99.63% respectively. The Kappa value of the consistency analysis of DR staging diagnosis was 0.878(P<0.01).

CONCLUSION: The AI remote screening system adopted in this study showed good consistency with the results of manual analysis, which can meet the needs of DR screening and provide a new effective prevention and treatment mode for DR patients in the community.

Abstract:AIM:To evaluate the accuracy of A-ultrasound combined with corneal topography measurement in clinical application by analyzing the ocular-related biometric parameters and refractive error and comparing with those of IOL Master 700 in cataract patients.

METHODS: A prospective study. Clinical data were collected from 113 patients(122 eyes)who underwent phacoemulsification in the First Affiliated Hospital of Soochow University from July 2020 to July 2021. The axial length(AL), anterior chamber depth(ACD), lens thickness(LT)and corneal curvature(Km)were measured respectively by IOL Master 700 and A-ultrasound combined with corneal topography measurement and the 3mo after the surgery of the refractive error was analyzed.

RESULTS: There were differences in AL(24.09±1.65, 23.81±1.62mm), ACD(3.11±0.42, 2.97±0.43mm)and Km(44.12±1.59, 44.06±1.54D)measured by IOL Master 700 and A-ultrasound combined with corneal topography(P<0.05), while there was no difference in LT(4.34±0.46, 4.30±0.59mm)(P>0.05). The postoperative mean absolute refractive error(MAE)of intraocular lens(IOL)diopter calculation formulas with different measurement methods was significantly different(P<0.001). The Barrett Universal II formula MAE of the IOL Master 700 measuring instrument was different from the Holladay I, Haigis and SRK/T formulas(P<0.01), at the same time, compared with the A-ultrasound combined with corneal topography calculation formula SRK/T and Barrett Universal II formula, they were also different(P<0.01). However, there was no difference among the Holladay Ⅰ, Haigis, SRK/T formula MAE which come from the IOL Master 700 measuring instrument and the A-ultrasound combined with corneal topography calculation formula SRK/T formula(P>0.05). In addition, the Barrett Universal II formula of the IOL Master 700 measuring instrument has the smallest median absolute refractive error(MedAE)(0.260D), and the A-ultrasound combined with corneal topography calculation formula Barrett Universal II formula MedAE is the largest(0.765D).

CONCLUSION: The values of AL, ACD and Km measured by A-ultrasound combined with corneal topography were smaller than those of IOL Master 700. When the SRK/T formula was used to calculate the IOL diopter, the results of the two group were similar. However, when using the Barrett Universal Ⅱ formula, the refractive error of the A-ultrasound combined with corneal topography group was large, resulting in hyperopia drift.

Abstract:AIM: To analyze the infection characteristics and clinical treatment outcome of patients with fungal keratitis(FK)in Jingzhou area, so as to provide basis for clinical diagnosis and treatment of FK.

METHODS: The data of 176 patients with FK diagnosed by etiology in Jingzhou Central Hospital from January 2015 to July 2020 were collected, and the epidemiological characteristics, identification results of fungal strains, drug sensitivity and clinical treatment outcome of the patients were analyzed.

RESULTS:Among the 176 patients with FK, 118 were male and 58 were female, and the ratio of male to female is 2.03:1. The age of onset was the largest number of patients in 50-59 years old and 60-69 years old. The peak seasons of onset were April to June and October to December. Risk factors include trauma and possible history of trauma, ocular surface diseases, post ophthalmic surgery, wearing corneal contact lenses and long-term local drug use. The main pathogens were Fusarium(39.8%), aspergillus(30.7%), alternaria(15.9%)and candida(5.1%). The results of drug sensitivity showed that voriconazole and amphotericin B were sensitive, while the drug resistance rate of fluconazole was very high. There were 125 eyes improved or cured after conservative treatment, 12 eyes were injected into corneal stroma, 15 eyes were covered with conjunctival flap or amniotic membrane transplantation, and 21 eyes were treated with corneal transplantation. Enucleation of ocular contents was performed in 8 eyes, including 5 eyes with severe endophthalmitis after conjunctival flap covering.

CONCLUSION:The incidence of FK in Jingzhou area is mostly middle-aged and elderly men, mostly caused by corneal trauma in the process of agricultural labor. The main pathogens were fusarium and aspergillus. It is very important to select reasonable antifungal drugs and treatment methods according to the drug sensitivity results.

Abstract:AIM:To observe the clinical effect of ranibizumab combined with 577nm micropulse laser in the treatment of severe diabetic macular edema(DME).

METHODS:There were 52 eyes of 52 patients diagnosed with severe DME who admitted to the People's Hospital of Guangxi Zhuang Autonomous Region from June 2016 to September 2019. The patients were randomly divided into the observation group(26 patients with 26 eyes, treated with ranibizumab combined with 577nm micropulse laser)and the control group(26 patients with 26 eyes, treated with ranibizumab alone). Patients in both groups received intravitreal injection of ranibizumab with “3+PRN” regimen. Followed up at 9mo after treatment to observe the central macular thickness(CMT), the best corrected visual acuity(BCVA)and the times of intravitreal injection of ranibizumab in the two groups.

RESULTS:Compared with before treatment, the CMT and BCVA of the two groups were significantly improved at each time point after treatment(all P<0.001), but there was no difference between the two groups(P>0.05). During the follow-up period, the times of vitreous injection of ranibizumabin the observation group was significantly less than that in the control group(5.88±1.24 times vs 7.12±1.24 times, P=0.001).

CONCLUSION:Both ranibizumab combined with 577nm micropulse laser and ranibizumab alone are effective in reducing edema and improving vision in patients with severe DME, but the combination therapy reduces the times of injection.

Abstract:AIM:To evaluate the macular microstructural changes in patients with rhegmatogenous retinal detachment(RRD)after silicone oil tamponade by spectral-domain optical coherence tomography(SD-OCT).

METHODS:From November 2019 to July 2021, 27 patients with 27 eyes in RRD who underwent vitrectomy combined with silicone oil tamponade in Cangzhou Aier Eye Hospital were enrolled in this study as the observation group, other 30 healthy volunteers with 30 eyes were included in the control group. The best corrected visual acuity(BCVA)of patients before and after operation were observed, and quantified evaluation of the postoperative macular microstructural changes were performed by SD-OCT.

RESULTS: The BCVA(LogMAR)of the observation group at 1wk and 3mo after operation(0.61±0.23, 0.69±0.34)were improved compared with those before operation(1.43±0.77)(all P<0.01). The cube volume and average cube thickness in the macular area at 3mo after operation in the observation group were lower than those at 1wk and 1mo after operation in the control group(all P<0.05). There were no differences in the average ganglion cell-inner plexiform layer(GCIPL)thickness, minimum GCIPL thickness, average macular retinal nerve fiber layer(mRNFL)thickness and minimum mRNFL thickness at 1wk, 1 and 3mo after operation in the observation group, but all decreased compared with the control group(all P<0.01). There were 9 eyes with subretinal fluid(SRF)in the observation group during postoperative follow-up, SRF had a tendency to be gradually absorbed, but 1 eye had a secondary macular hole; 3 eyes had ellipsoid zone disruption, which had a tendency to be gradually repaired; 2 eyes had submacular perfluorocarbon liquid; 2 eyes had macular edema.

CONCLUSION: SD-OCT can show the microstructure and morphological changes very well in macular area in patients with RRD after silicone oil tamponade, and has important clinical value for the preoperative and postoperative follow-up evaluation of RRD.

Abstract:AIM: To investigate the validity of triglyceride glucose(TyG)index to identily diabetic retinopathy(DR)in type 2 diabetic patients.

METHODS: A cross-sectional study. A total of 1061 type 2 diabetic patients in Shanghai who underwent health checkup in our hospital in 2021, all the subjects underwent questionnaire survey, physical examination, blood biochemical index detection and fundus examination. According to the fundus photos, they were divided into DR group(275 cases)and no DR group(786 cases). Risk factors for DR were evaluated by univariate and multivariate Logistic regression analyses, receiver operating characteristic(ROC)curve was used to analyse the predicted values of TyG with DR.

RESULT: Elevated TyG index was an high risk factor for development of DR in type 2 diabetic patients. After adjusting for multiple confounding factors(gender, age, smoking history, the course of diabetes, glycosylated hemoglobin, systolic blood pressure, diastolic blood pressure, body mass index and serum uric), the OR value of the DR in the TyG index Q4 group relative to the Q1 group was 2.57(95%CI: 1.56-4.05), P<0.001. ROC curve analysis: the optimal cutoff value of TyG index was 6.1762, with a sensitivity of 66.92% and a specificity 63.27%, the AUC was 0.6952 and 95%CI was 0.6575-0.7329.TyG index had better predictive abilities than fasting blood glucose(AUC=0.6697), glycosylated hemoglobin(AUC=0.6864)and triglycerides(AUC=0.6521).

CONCLUSION: The TyG index correlates well with the onset risk of DR and potentially is a useful predictive factors, especially in the early stages of DR in patients with type 2 diabetes.

Abstract:AIM: To evaluate the imaging characteristics of dense automatic real time B-scan optical coherence tomography angiography(DART-OCTA)in macular-involved branch retinal vein occlusion(BRVO)and the diagnostic value of capillary perfusion imaging in the macular area.

METHODS: From June 2020 to December 2020, there were 51 cases of 51 eyes with BRVO diagnosed in Eye Hospital, Wenzhou Medical University. Imaging characteristics of the BRVO macular area were observed by fluorescein angiography(FA), optical coherence tomography angiography(OCTA)and DART-OCTA examination, respectively. According to the retinal capillary perfusion status, the included patients were divided into capillary and non-imaging groups, comparing the results of capillary perfusion imaging in the BRVO macular area among the three examination methods.Furthermore, quantitative analysis of capillary perfusion density in the lesion involved area and the lesion non-involved area was performed in DART-OCTA images.

RESULTS: Patients with 51 eyes were included in this study, FA identified 10 eyes of capillary perfusion imaging, OCTA identified 14 eyes of capillary perfusion imaging, DART-OCTA identified 34 eyes of the capillary perfusion imaging.Comparison of the three test methods for capillary perfusion imaging findings in the BRVO macular area showed that DART-OCTA was more sensitive compared to FA and OCTA for capillary perfusion imaging in the ischemic area. In DART-OCTA examination, retinal capillary blood flow density was lower in the lesion-involved areas in both the capillary perfusion imaging group and the non-imaging groups(0.65±0.20/mm vs 1.16±0.31/mm,0.41±0.16/mm vs 1.06±0.38/mm, all P<0.0001).

CONCLUSION: DART-OCTA can provide clearer tomographic imaging of retinal capillary perfusion. And the imaging with its observation of BRVO involving the macular area is least affected by macular hemorrhage and it is an important complementary method for BRVO patients with significant retinal hemorrhage.

Abstract:AIM: To compare the consistency and feasibility of objective ocular torsion measured with GMPE module-based optical coherence tomography(OCT)and fundus color photography(FCP).

METHODS: Patients were enrolled in our strabismus clinic from December 2020 to March 2021, and the objective ocular torsion of the eyes was measured by both GMPE module-based OCT and FCP on the same day. FCP was used to measure the fovea-disc angle(FDA)manually by using the Adobe Photoshop software, while the GMPE module-based OCT software positioned automatically the macula and the center of the optic disc to measure the FDA.

RESULTS: Fifty-five patients were included, the FDA measured by OCT was -6.6°±4.5° in the right eye and -8.8°±4.7° in the left eye, respectively; The FDA measured by FCP was -6.6°±4.7° in the right eye and -8.4°±4.1° in the left eye, respectively, with no statistically significant difference between the results of the two methods(P_{right eye}=0.90, P_{left eye}=0.08). In patients with exotropia, the FDA measured by OCT was -5.8°±4.9° in the right eye and -9.1°±4.5° in the left eye, respectively, the FDA measured by FCP was -5.7°±5.0° in the right eye and -8.6°±4.3° in the left eye, respectively,(P_{right eye}=0.75, P_{left eye}=0.15). Similarly, the patients with esotropia, the FDA measured by OCT was -9.0°±7.3° in the right eye and -11.3°±3.5° in the left eye, respectively, while the FDA measured by FCP was -10.0°±7.0° in the right and -10.1°±2.8° in the left eye(P_{right eye}=0.21, P_{left eye}=0.10), respectively. There were no significant differences between the two methods in patients with esotropia or exotropia(P>0.05). The results of both Pearson test and Bland-Altman analysis were highly correlated(r_{right eye}=0.93, r_{left eye}=0.94, P<0.01).

CONCLUSION: GMPE module-based OCT can be used for objective ocular torsion measurement with high reliability and reproducibility, and is a promising clinical alternative to the fundus color photographic method.

Abstract:AIM:To investigate the factors affecting patients with post traumatic infectious endophthalmitis(PTIE)relieving from blindness.

METHODS: A retrospective study was conducted on 169 patients(169 eyes)with PTIE from January 2010 to December 2020 in the department of ophthalmology, the Affiliated Hospital of Nantong University. After treatment of intravitreal injection of antibiotics(IVIA)and/or pars plana vitrectomy(PPV), the patients were divided into the getting rid of blindness group(103 eyes)and unilateral blindness group(66 eyes)according to the last follow-up of best correct visual acuity(BCVA)≥0.05. The factors affecting the patients to get rid of blindness were analyzed.

RESULTS: The rate of relieving from blindness was 53.5%. Univariate analysis showed that BCVA before treatment ≥ hand movement, no retinal detachment, fundus grade of endophthalmitis < grade 3 and no strong virulence of infected microorganisms were beneficial for patients to get rid of blindness(P<0.05). Multivariate Logistic regression analysis identified that BCVA before treatment ≥ hand movement(OR=0.253, 95%CI: 0.108-0.592)and no retinal detachment(OR=0.241, 95%CI: 0.103-0.564)were favorable factors for patient to get rid of blindness.

CONCLUSION: Better BCVA before treatment, no retinal detachment, endophthalmitis fundus grade < 3, and no strong virulence of infected microorganisms are favorable factors for patients with PTIE to get rid of blindness finally.

Abstract:AIM: To analyze the correlation of changes in non-contact intraocular pressure(IOP_NCT)and the surgical parameters after femtosecond laser small incision lenticule extraction(SMILE)for high myopia.

MOTHODS:A retrospective analysis, the clinical data of 98 patients(196 eyes)with high myopia were operated SMILE in the optometric center of Gansu Provincial Hospital from January 2018 to July 2019 were analyzed. The change of IOP_NCT before and after operation was observed, and recorded the optical zone(OZ), lenticule thickness(LT), cap thickness(CT)and residual stromal thickness(RST)and the correlation with the change value of IOP_NCT(△IOP_NCT, △IOP_NCT=IOP_preoperative-IOP _{postoperative at 6mo}).

RESULTS:After operation at 1d, 1wk, 1,3 and 6mo, the group of patients with IOP_NCT(10.84±2.14,11.00±2.19,10.65±2.43,10.45±2.04,10.61±1.39mmHg)and the preoperative(16.79±1.65mmHg)comparison have a difference(P<0.001).The optical zone and lenticule thickness were positively correlated with △IOP_NCT respectively(r=0.1537, 0.8161, all P<0.05). The cap thickness and residual stromal thickness were negatively correlated with △IOP_NCT respectively(r=-0.8362, -0.3351, all P<0.0001). Introduce the above related factors into a multiple linear regression analysis model. The regression coefficients of variables are statistical significane. The regression equation was Y=16.189+0.227X₁+0.032X₂-0.083X₃-0.007X₄(Y=△IOP_NCT, X₁=OZ, X₂=LT, X₃=CT, X₄=RST). The equation was statistically significant(F=195.704, P<0.001), and the regression model coefficient of determination R²=0.901.

CONCLUSION:The intraocular pressure changes after SMILE with high myopic were correlated with optical zone, lenticule thickness, cap thickness and residual stromal thickness. The regression equation would provide reference to evaluation the real intraocular pressure after SMILE in clinic.

Abstract:AIM: To understand the status of poor vision and analyze the main influencing factors among primary and secondary school students in a division of the Xinjiang Production and Construction Corps, and provide a scientific basis for prevention and control of poor vision.

METHODS: A total of 12 primary and secondary schools in a divisional urban district and regiment field of the Xinjiang Production and Construction Corps were chosen using stratified cluster random sampling from August to October 2020. A total of 2 982 primary and secondary school students were selected for visual inspections and questionnaires. Logistic regression analysis was used to explore the influencing factors of poor vision.

RESULTS: The rate of poor vision was 65.66% among 2 982 primary and secondary school students in the division of the Xinjiang Production and Construction Corps, with the majority severe poor vision. Furthermore, the rates of poor vision were higher in girls(70.17%)than that in boys(61.47%)(χ²=4.993, P<0.001)and the urban area(70.03%)were higher than the rural area(58.96%)(χ²=38.680, P<0.001)and the Han nationality students(66.83%)were higher than Uyghur students(52.82%)(χ²=19.772, P<0.001). The risk of poor vision increased with age(χ²_trend =300.144, P<0.001), and by the age group ≥18 years old, the rate of poor vision reached 80.47%. The results of the multivariate analysis showed that the women, the age≥13 years old, writing and reading duration every day ≥2h, cram school on weekends and presence of myopia in parents increases the risk of poor vision, increase the outdoor exercise time, sleep time ≥8h, and do eye exercises every day can reduce the occurrence of poor vision.

CONCLUSION: Poor vision rate of primary and secondary school students in the division of the Xinjiang Production and Construction Corps is higher than that of many regions in the country. Girls with the age(≥13 years old)whose parents are myopic should receive special attention. Increasing outdoor exercise time, doing eye exercises every day, and keeping your eyes more than one foot away from books when reading and writing is effective in preventing poor vision.