Abstract:AIM: To describe the prevalence of age-related macular degeneration(AMD)in aged 50 years and older population in Shunqing District of Nanchong and to investigate the associated risk factors of AMD.

METHODS:Population-based cross-sectional of epidemiological investigation. Persons aged 50 years and older, recruited between May to October 2013, from Shunqing District of Nanchong, Sichuan province, China. Totally 2242 eligible residents who aged 50 years and older were selected using a stratified, clustered, and random sampling technique. All participants underwent a standardized interview concerning general data, physical examinations, laboratory examinations, and comprehensive eye examinations. The diagnostic criteria was followed the international clinical classification systems. The survey data were analyzed by statistical software SPSS 13.0.

RESULTS: Totally 2242 participates, whole examination were finished for 2097 persons, with the examination rate of 93.53%. There were 207 patients(283 eyes)were diagnosed as AMD, with the total prevalence rates of 9.87% and the standardized prevalence rates of 9.73%. Early and late AMD prevalence rates were 9.25% and 0.62%, respectively, among participants, in which the prevalence of exudative AMD were 0.14%. The prevalences of AMD in the age groups of 50-59, 60-69, 70-79 and no less than 80 years were 6.38%, 9.27%, 14.69% and 17.39%, respectively. The visual acuity of late AMD was significantly worse than early AMD. The prevalence of bilateral blindness and low vision were 0.48% and 1.45% of the AMD patients. There were eight factors associated with AMD: age, systolic blood pressure, smoking, sun exposure, history of diabetes, cataract surgery and serum total cholesterol were the risk factors of AMD, while the level of education was a protective factor.

CONCLUSION: The prevalence of AMD in Shunqing District of Nanchong was 9.87%. With the age increasing, the prevalence rate of AMD was significantly increased. The late AMD affected vision seriously. The risk factors of AMD included age, systolic blood pressure, smoking, sun exposure, history of diabetes, cataract surgery and serum total cholesterol, and the protective factor was the level of education.

Abstract:AIM: To investigate the expression and significance of B-cell lymphoma factor(Bcl-2), Bcl2-Associated X protein(BAX)and vascular endothelial growth factor(VEGF)in the retina of early diabetic rats.

METHODS: An early diabetic retinopathy model was made in rat by intraperitoneal injection of streptozotocin(60mg/kg). The model rats were sacrificed at 4,8,12wk after the establishment of the model, and the eyeballs were removed to make paraffin section and retina sheets were prepared. HE staining was used to detected the retinal morphology and vascularity. Immunohistochemistry(IHC)was employed to examine the expression of Bcl-2, Bax and VEGF in the retina. ADP enzyme staining were conducted to evaluate the retinal vascular morphologic change. Nikon-A1 laser confocal microscopy was used to detect the morphology, fluorescence intensity and distribution of Ca²⁺ in retinal cells.

RESULTS: In the diabetic group, the number of endothelial cells in the inner limiting membrane increased 12wk later. In diabetes mellitus group, there was no vascular area in the middle and peripheral retina, and no vascular area was significantly more than that in the blank control group(P<0.05). There were significant differences in the values of VEGF, Bcl-2 and Bax between diabetic rats and control group(P<0.05). Compared with diabetic rats at 4, 8, 12wk, the fluorescence concentration of calcium ions in RGCs increased gradually, and the ratio of fluorescence staining intensity increased significantly(P<0.05).

CONCLUSION: The expressions of Bcl-2 and Bax were significantly increased, which upgraded the expression of VEGF in the retinas of early diabetic rats. Bcl-2, Bax and VEGF might play an important role in the neovascularization of the retinas in early diabetic rats.

Abstract:AIM: To study the effects of Shuangdan Mingmu capsule on the expressions of vascular endothelial growth factor-a(VEGF-a), VEGF-b, VEGF-c in the retina of a diabetic rat model.

METHODS: Forty male SD rats were divided into Group A(normal group), Group B(model group), Group C(Shuangdan Mingmu group)and Group D(positive control group)10 rats(20 eyes)in each group. A rat model of diabetic retinopathy was established by one-time tail vein injection with STZ(50mg/kg). After modeling for 1wk, the rats were given medicine by gavage. After gavage for 4wk rats were sacrificed, and the expressions of VEGF-a, VEGF-b, VEGF-c in the retina tissues were detected by immunohistochemical method.

RESULTS: After gavage for 4wk the average gray values of VEGF-a, VEGF-b and VEGF-c protein in the retina of model group, Shuangdan Mingmu group and positive control group were lower than those of the normal group, and the average optical density were higher than those of the normal group. There was a significant difference between the model group and the normal group(P<0.01). The average gray values of VEGF-a, VEGF-b and VEGF-c expression in Shuangdan Mingmu group and positive control group were higher than those in the model group(P<0.05)and the average optical density value were lower than those in the model group.(P<0.01).

CONCLUSION: Shuangdan Mingmu capsule could significantly reduce the expressions of VEGF-a, VEGF-b,VEGF-c in the retina and had a certain protective effect on the retina of rats in the diabetic retinopathy model.

Abstract:AIM: To observe the efficacy of fundus photocoagulation combined with triamcinolone acetonide(TA)in the treatment of diabetic retinopathy(DR).

METHODS: The clinical data of 94 patients(112 eyes)in our hospital from September 2016 to September 2017 were analyzed retrospectively. According to the treatment regimen, the patients were divided into fundus photocoagulation with TA group(study group, 54 cases 64 eyes)and fundus photocoagulation group(control group, 40 cases 48 eyes). The treatment conditions \〖best corrected visual acuity(BCVA), macular retinal thickness\〗 were monitored before treatment(T1)and after 7d, 1, 3 and 6mo of treatment(T2, T3, T4, T5), and the efficacy was assessed at T5, and the improvement times of clinical manifestations(fundus hemorrhage, exudation, retinal edema)were recorded, and the serological markers \〖intercellular adhesion molecule(ICAM-1)and vascular endothelial growth factor(VEGF)\〗 were measured at T1 and T5.

RESULTS: At T1 to T5, there were statistically significant differences in the between-group effects, time-point effects and interaction effects of between-group and time-point of BCVA and macular retinal thickness(P<0.05). At T2 to T5, the BCVA was improved in the two groups with time while the macular retinal thickness was decreased with time(P<0.05). The efficacy in study group was better than that in control group, and the improvement times of fundus hemorrhage, exudation and retinal edema were less than those in control group(P<0.05). At T5, the serum levels of ICAM-1 and VEGF in the two groups were lower than those at T1, and the levels were lower in study group than those in control group(P<0.05).

CONCLUSION: Fundus photocoagulation combined with TA can effectively improve the visual acuity and retinal edema in patients with DR, and it has significant efficacy, and it can help promote the recovery of clinical symptoms, reduce the vascular endothelial injury, and inhibit the neovascularization.

Abstract:AIM: To explore the correlation between eccentricity in the optical treatment area and tear film function and corneal morphology after orthokeratology.

METHODS:Eighty patients(80 eyes)with myopia who were treated with orthokeratology were selected as subjects. The eccentric distance, tear film function and corneal morphology of the patient's optical treatment area were detected at different time points before and after wearing the lens. According to the median eccentric distance, the patients were divided into low eccentricity group and high eccentricity group. The differences of tear film function and corneal morphology at different time points before and after wearing were compared between the two groups. Pearson correlation coefficient was used to analyze the correlation between total eccentricity and tear film function and corneal morphological parameters at 12mo after wearing glasses.

RESULTS:Compared with before wearing lenses, the corneal surface asymmetry index and corneal surface regularity index of the two groups were significantly increased at 1wk, 3, 6 and 12mo after wearing lenses(P<0.05). Patients in the high eccentric group were more significantly elevated than in the lower eccentric group, and the differences were statistically significant(P<0.05). The time of tear film rupture, corneal curvature, basic tear secretion, and central corneal thickness were significantly lower, and the differences were statistically significant(P<0.05). Compared with the patients with lower eccentricity, the patients with high eccentricity group had more significant reduction in tear film rupture time and basic tear secretion, and the difference was statistically significant(P<0.05), however, the degree of corneal curvature and central corneal thickness decreased less(P<0.05). There was no significant difference in corneal endothelial cell density between 1wk after wearing lenses and 3mo after wearing lenses(P>0.05). The difference was statistically significant at 6mo and 12mo after wearing lenses(P<0.05). At 12mo after wearing the lens, the total eccentric distance was positively correlated with the asymmetry index of the corneal surface and the regularity index of the corneal surface(r=0.869, 0.815; P<0.05). At 12mo after wearing the lens, the total eccentric distance was negatively correlated with tear film rupture time, corneal curvature, basic tear secretion, and central corneal thickness(r=-0.865, -0.745, -0.912, -0.713; all P<0.05), and there was no significant correlation with corneal endothelial cell density(r=0.185, P=0.199).

CONCLUSION:The eccentricity of the optical treatment area occurs at the beginning of wearing lenses. And the total eccentric distance has a significant correlation with the changes of tear film function and corneal morphology after keratoplasty.

Abstract:AIM:To compare the results of computer optometry and manifest refraction after mydriasis and prescription for refractive error in juveniles and explore the emphasis and notes of juvenile optometry.

METHODS: Totally 334 ametropic eyes of juveniles(including 212 myopic eyes and 122 hypermetropic eyes)were examined with computer optometry and manifest refraction after mydriasis. The manifest refraction was done again after the pupil recovered to obtain the prescription for refractive error. The results of computer optometry and manifest refraction after mydriasis and prescriptions for refractive error were compared and analyzed retrospectively.

RESULTS: When comparing computer optometry and manifest refraction after mydriasis, the differences of spherical power and cylindrical axis in general group, the differences of spherical power, cylindrical power and axis in myopia group and cylindrical axis in hyperopia group were all statistically significant(P<0.05). The differences of spherical power and cylindrical axis between computer optometry and manifest refraction after mydriasis and prescriptions in general and hyperopia group were statistically significant(P<0.05). The spherical power of computer optometry and manifest refraction after mydriasis in hyperopia group was greater than that of prescription and there was statistically significant difference in cylindrical power between manifest refraction after mydriasis and prescription(P<0.05). In myopia group the differences in spherical power, cylindrical power and axis between computer optometry after mydriasis and prescription were statistically significant(P<0.05)and the differences in cylindrical power and axis between manifest refraction after mydriasis and prescription were statistically significant(P<0.05). The Bland-Altman analysis in three groups showed the good consistency of spherical and cylindrical power between computer optometry and manifest refraction after mydriasis and that the differences between them were acceptable clinically. It also showed the poor consistency of cylindrical axis between them. The Bland-Altman analysis in general and hyperopia groups showed the poor consistency of spherical power and cylindrical axis and the good consistency of cylindrical power between computer optometry and manifest refraction after mydriasis and prescription. In myopia group the spherical and cylindrical power between computer optometry and manifest refraction after mydriasis and prescription revealed good consistency and the cylindrical axis presented poor consistency.

CONCLUSION: The results of computer optometry and manifest refraction after mydriasis cannot be used as prescription. There was statistically significant difference between computer optometry and manifest refraction after mydriasis, but the spherical and cylindrical power between them revealed good consistency clinically. The cylindrical axis between computer optometry and manifest refraction after mydriasis presented poor consistency and so did the cylindrical axis between them and prescription. In conclusion, the cylindrical axis should be paid much attention to in optometry and glasses taking.

Abstract:Familial exudative vitreoretinopathy(FEVR)is a rare inherited disorder of retinal angiogenesis. It is characterized by avascular peripheral retina. Mutations in FZD4, NDP, LRP5, TSPAN12, ZNF408, KIF11 have been found the causation genes of FEVR. The phenotypic features are variable, when some patients are asymptomatic while some may suffer from neovascularization, exudation, hemorrhage, retinal folds and retinal detachment. The use of FFA can help to identify the disease in the earlier stage, enabling timely treatment. The current treatments include laser photocoagulation, scleral buckling, vitrectomy and intravitreal anti-VEGF injections as an adjunctive therapy before surgery. With the development of genome research on this disease, the more effective diagnosis and treatments would be available.

Abstract:As one of the most common diseases, dry eye in adults has been extensively investigated in the past decades. However, research on dry eye in children are very limited, leading to missed diagnosis or poor treatment in clinical work. Understanding the etiology and related factors of dry eye in children is of great significance for improving clinicians' attention in the diagnosis and the treatment. Herein, the current progress of dry eye in children are reviewed.

Abstract:Exposure keratitis refers to corneal inflammation caused by corneal dryness, epithelial exfoliation and secondary infection when the cornea loses the protection of the eyelid and is exposed to air. It is a potentially vision-threatening disease and is not uncommon in clinical work, so the treatment and prevention of exposure keratitis remain important. This article reviews the treatment and research progress of exposure keratitis.

Abstract:Risk factors including short axial length, shallow anterior chamber, narrow angles, spherical lens and other characters such as gender, age and family history are well known to be related to the attack of primary angle-closure glaucoma(PACG). In recent years, with the development of advanced techniques such as the anterior segment optical coherence tomography(AS-OCT)and ultrasound biomicroscope(UBM), the technical supports for the measurement of anterior segment parameters were largely provided, which made it possible to quantify risk factors of PACG precisely. In this paper, the relevant research progresses of commonly used anatomic parameters and their significances in pathogenesis of PACG were reviewed.

Abstract:Macular hole retinal detachment(MHRD)mainly occurs in high myopic eyes with posterior scleral staphyloma and always causes severe visual impairment. The pathogenesis of MHRD in high myopic eyes is still unclear. It is generally believed that it involves various complex traction. A variety of surgical methods have been tried to remove retina tractionin order to achieve retina reattachment and macular hole closure. This article reviews the current surgical methods and progress of MHRD in high myopic eyes.

Abstract:Idiopathic macular epiretinal membrane(IMEM)is a common macular area disease associated with age and characterized by symptoms of decreased visual acuity and metamorphopsia. With the acceleration of aging population, the incidence of IMEM is also increasing year by year. At present, its exact pathogenesis is not clear, and there is no effective drug therapy. Vitrectomy is an effective treatment, but the improvement of postoperative visual function is very different. This article reviews the pathogenesis and factors related to prognosis in patients with IMEM, in order to adopt more accurate and effective preventive and therapeutic measures.

Abstract:Silicone oil, as a temporary vitreous substitute, has been widely applied to the treatment of various complex vitreoretinal disease. However, silicone oil tamponade also causes a variety of postoperative complications, the most common of which is temporary or permanent elevated intraocular pressure(IOP). A number of studies have shown that intraocular pressure after silicone oil filling is affected by a variety of factors. In this paper, the progress on the risk factors and pathogenesis of secondary high intraocular pressure after silicone oil tamponade are reviewed, which might provide a reference for the timely and effective control of IOP.

Abstract:Ocular rosacea is a chronic inflammatory disease that affects the ocular surface. The clinical manifestations are blepharitis and Meibomian gland dysfunction, severe corneal involvement and visual impairment. The study of the pathogenesis in recent years is believed to be the result of a combination of risk factors. Its clinical manifestations lack specificity, but early diagnosis and standard treatment can significantly improve symptoms and restore vision. This review focuses on the latest research progress in ocular rosacea.

Abstract:AIM: To explore the efficacy and safety of vitrectomy combine with internal limiting membrane peeling and epiretinal membranes peeling in the treatment of idiopathic epiretinal membrane(IERM).

METHODS: In this retrospective study, 53 patients(53 eyes)who underwent vitrectomy for IERM from January 2015 to December 2015 were evaluated, with 24-month follow-up. Only removal of the epiretinal membrane(ERM group)was performed in 21 patients, while 32 had removal of the epiretinal membrane associated with internal limiting membrane peeling(ERM+ILM group). The best corrected visual acuity(BCVA), central macular thickness(CMT)and the complications were observed and analyzed before operation, 1, 3, 12, 24mo after operation.

RESULTS: Both groups showed significant improvement of BCVA when compared to preoperative BCVA(P<0.05). In ERM group the BCVA before and 1, 3, 12 and 24mo after operation were 0.676±0.137,0.576±0.099, 0.551±0.085, 0.514±0.077, 0.506±0.032, and in ERM+ILM group were 0.659±0.132, 0.582±0.111, 0.578±0.101, 0.523±0.062, 0.511±0.081. The comparison between the two groups at 1, 3,12 and 24mo after surgery were no significant differences(P>0.05). After operation, statistically significant CMT reduction occurred in both groups(P<0.05). In ERM group the preoperative and postoperative CMT were 461.14±13.477μm, 402.36±11.346μm, 368.52±13.216μm, 325.24±8.246μm, 273.29±8.973μm, and in ERM+ILM group were 462.47±14.287μm, 414.72±9.237μm, 373.44±8.328μm, 328.94±6.923μm, 274.28±8.340μm. There were no significant difference between the two groups at 1, 3, 12 and 24 after operation(P>0.05). There were 3 cases(3 eyes)had retinal punctate hemorrhage after operation, of which 1(5%)was from the ERM group and 2(6%)were from the ERM+ILM group. No significant difference was observed between the groups(P=1.000). At the end of follow-up, 4 cases(19%)presented with recurrence of the epiretinal membrane all from the ERM group, and there no recurrence was found in ERM+ILM group, and the difference was statistically significant(P=0.020).

CONCLUSION: Vitrectomy with ILM peeling and epiretinal membranes peeling for the treatment of epiretinal membrane is the efficacy and safety, and it may reduce the recurrence.

Abstract:AIM: To study the consistency of pre-operative and postoperative wave-front aberration between SCHWIND and SIRIUS eye anterior segment analysis system.

METHODS: Prospective control study. A total of 360 eyes of 180 patients with refractive errors in West China Hospital of Sichuan University were selected. The data, including the degree and the direction of the flat axis and the steep axis, Kappa angle and a variety of high order wave-front aberrations, were measured by SCHWIND and SIRIUS anterior segment analyzers. The average value of each parameter was taken 5 times, and paired sample t test was used and the data was analyzed by SPSS22.0 software.

RESULTS: Flat axis degree and direction, steep axis degree and direction, coma, and trefoil were measured preoperatively and 1mo postoperatively by SCHWIND and by SIRIUS eye anterior segment analysis systems, and there were no statistically significant differences between the two machines(P>0.05). Kappa angle was measured 1mo postoperatively and there was no statistically significant differences(P>0.05). There was statistically significant difference(P<0.01)preoperatively between two machines of high-order aberrations and spherical aberration(SpAb); values measured by SCHWIND were higher than those measured by SIRIUS. There was no statistically significant difference(P>0.05)between two machines of high-order aberrations or SpAb in 1mo postoperatively.

CONCLUSION: SCHWIND and SIRIUS anterior segment eye analysis system have a good consistency of wave-front aberration measurement before and after refractive surgery.

Abstract:AIM: To explore the effects of double-incision phacoemulsification combined with trabeculectomy on visual acuity, intraocular pressure and complications in patients with glaucoma complicated with cataract.

METHODS: The clinical data of each 68 patients(68 eyes)with glaucoma and cataract who were given double-incision(observation group)and single-incision(control group)phacoemulsification combined with trabeculectomy from April 2016 to October 2017 were retrospectively analyzed. The visual acuity and corneal endothelial cell status(density, area)before operation and at 1mo after operation, and occurrence of complications(hyphema, corneal endothelial edema, anterior chamber fibrinous exudation, filtering bleb scarring)within 1mo after operation were recorded in the two groups. And the differences of intraocular pressure and astigmatism degree were compared between the two groups before operation and at 1 and 6mo after operation.

RESULTS:At 1mo after operation, the visual acuity in the two groups was better than that before operation(P<0.05). However, there was no significant difference between the two groups(P>0.05). At 1mo after operation, the area of corneal endothelial cell in the two groups was larger than that before operation(P<0.05)while the density of corneal endothelial cell was lower than that before operation(P<0.05), and the changes in control group were greater than those in observation group(P<0.05). The total incidence rate of postoperative complications in observation group was significantly lower than that in control group(P<0.05). The intraocular pressure in the two groups after operation was lower than that before operation(P<0.05), but there was no significant difference between at 1mo after operation and at 6mo after operation(P>0.05). And there was no statistically significant difference between the two groups(P>0.05). The postoperative astigmatism degree in the two groups was higher than that before operation(P<0.05), and the index at 1mo after operation was higher than that at 6mo after operation(P<0.05), and the index in control group was higher than that in observation group(P<0.05).

CONCLUSION:Double-incision phacoemulsification combined with trabeculectomy has significant effects on patients with glaucoma and cataract. Although double-incision surgery and single-incision surgery have similar effects in improving visual acuity and intraocular pressure, double-incision surgery has less damage to the operative area, and it can reduce the postoperative corneal endothelial injury and the postoperative astigmatism degree, and it can also reduce the postoperative complications, and has a positive significance in promoting the disease outcomes.

Abstract:AIM: To study the effect of two kinds of phacoemulsification combined with goniosynechialysis for primary angle-closure glaucoma with cataract.

METHODS: Phacoemulsification combined with goniosynechialysis was performed in 60 patients 62 eyes for primary angle-closure glaucoma with cataract. They were randomly divided into two groups, 31 eyes underwent phacoemulsification with goniosynechialysis combined with I/A catheterization were performed in Group A; in Group B, 31 eyes were performed phacoemulsification with goniosynechialysis combined with viscoelastics. Best corrected visual acuity, the intraocular pressure, anterior chamber depth, anterior chamber angle width and pupil size were measured before the operation, and 3mo after the operation.

RESULTS: Intraocular pressure of all cases were reduced obviously after the operation(P<0.05). Visual acuity of the 62 eyes were improved in different extent; the anterior chamber depth and anterior chamber angle width after 3mo of the operation were deeper and wider than those before the operation(P<0.05). There were no different in the intraocular pressure, best corrected visual acuity and anterior chamber depth between the two groups(P>0.05), but, Group A was superior to Group B in anterior chamber angle width(P<0.05). At 3mo after operation, there were 8 eyes in Group A with more than 1mm lessen pupil size, two eyes in Group B had the same.

CONCLUSION: Two kinds of goniosynechialysis combined with phacoemulsification in the treatment of primary acute angle-closure glaucoma with cataract are effective. Among them, the goniosynechialysis with I/A was more effective to increase the anterior chamber angle width.

Abstract:AIM: To observe the clinical effect of combined anterior and posterior segment surgery in the treatment of vitreoretinal diseases with cataract and the influence on visual acuity recovery and complications after surgery.

METHODS: The clinical data of 94 patients(94 eyes)with vitreoretinal diseases complicated with cataract treated in the hospital during the period from January 2016 to December 2017 were collected retrospectively. Fifty of them treated by vitrectomy combined with phacoemulsification were included in Group A, and the other 44 cases treated by one-stage vitrectomy and two-stage phacoemulsification were included in Group B. The improvement rate of visual acuity, best corrected visual acuity(BCVA), changes of intraocular pressure(IOP)and incidence of complications after surgery were compared between the two groups.

RESULTS: There was no significant difference in the improvement rate of visual acuity between Group A and Group B(P>0.05). The logMAR BCVA of Group B at the last follow-up was significantly better than that of Group A(0.59±0.17 vs 0.78±0.28, P<0.05), but there was no significant difference in IOP between the two groups before and after surgery(P>0.05). The incidence of anterior chamber inflammatory response in Group A was significantly higher than that in Group B(52% vs 20%, P<0.05), but there was no significant difference between the two groups in other complications, such as transient high IOP or rubeosis iridis(P>0.05).

CONCLUSION: Both concurrent anterior and posterior segment surgery and stage surgery are safe and effective in the treatment of vitreoretinal diseases with cataract. The surgical field of the former is clearer and it is easier to operate while the latter can alleviate the anterior chamber inflammatory response, with certain advantages in improvement of postoperative visual acuity. The appropriate surgical method should be chosen according to the patient's condition.

Abstract:AIM: To investigate the changes and significance of retinal nerve fiber layer(RNFL)thickness in patients with acute and chronic angle-closure glaucoma.

METHODS: Totally 37 patients(40 eyes)with acute angle-closure glaucoma and 35 cases(38 eyes)patients with chronic angle-closure glaucoma in our hospital from January 2016 to January 2018 were studied, and 30 cases with normal check-up in our hospital were compared. All the objects were scanned by optical coherence tomography(OCT). All subjects underwent visual field examination and OCT examination. According to the visual field examination results, the patients were divided into 2 subgroups of visual field defect and normal visual field. To study the relationship between RNFL thickness and visual field defect.

RESULTS: The superior, inferior, nasal side and average RNFL thickness of the acute group were obviously higher than that in the normal group(160.41±39.87μm vs 124.50±14.86μm, 155.38±31.79μm vs 127.75±20.08μm, 96.12±32.01μm vs 75. 79±13.10μm, 121.49±21.46μm vs 101.79±10.34μm), and the average RNFL thickness of the chronic group was lower than that in the normal group(superior: 91.57±30.22μm, inferior: 96.23±30.68μm, nasal side: 65.46±16.94μm, temporal side: 63.28±16.94μm, average: 80.58±22.18μm; P<0.05). The RNFL thickness of the superior and inferior part of normal visual field in the acute group was lower than that of the same group with visual field defect(159.68±27.49μm vs 163.32±37.76μm; 152.31±21.86μm vs 161.27±32.09μm; P<0.05); however, there was no significant difference on nasal side, temporal side and average RNFL thickness between the two subgroups(P>0.05). And the RNFL thickness of the subjects in chronic group with visual field defect was significantly lower than that in normal visual field(120.83±13.19μm vs 88.82±25.18μm, 124.83±17.01μm vs 85.89±30.91μm, 76.06±11.79μm vs 62.03±12.13μm, 75.17±9.99μm vs 63.09±8.24μm; P<0.05).

CONCLUSION: The RNFL thickening of acute PACG is mainly caused by optic nerve edema, while chronic PACG's RNFL thinning is due to the damage of ganglion cells and the loss of nerve fibers, different reasons cause different PACG thickness.

Abstract:AIM: To observe the changes of choroidal thickness(CT)in diabetic patients with different stages of non-proliferative diabetic retinopathy(NPDR)and then investigate the relationship between CT and diabetic retinopathy(DR), to assess the value of enhanced depth imaging optical coherence tomography(EDI-OCT)in the diagnosis of choroidopathy in early-stage DR.

METHODS: A total of 85 eyes of 55 patients with type 2 diabetes mellitus(DM)were included in this study. The patients were divided into three groups according to China Clinical Guidelines of DR in 2014, including non-diabetic retinopathy(NDR)group(28 eyes), mild and moderate NPDR group(27 eyes), and severe NPDR group(30 eyes). The control group included 24 normal subjects(35 eyes). The best corrected visual acuity(BCVA)and CT among normal eyes, and eyes with NDR, mild/moderate NPDR and severe NPDR were compared. Data were analyzed using SPSS 18.0.

RESULTS: Visual changes: The median LogMAR BCVA visions were 0.00 in control group, 0.10 in NDR group, 0.15 in mild and moderate NPDR group and 0.30 in severe NPDR group, the difference between each group was statistically significant(P<0.01). The changes of CT in diabetic patients with different stages of NPDR: CT in the subfoveal area and T1, T3, N1, N3, S1, S3, I1 and I3 sites in the four groups were statistically significant(F=3.975, 3.365, 3.991, 4.290, 6.208, 5.079, 3.234, 2.907, 3.843, P<0.05). CT in the mild and moderate NPDR group decreased and were thinner than the control group, but CT in the severe NPDR group increased significantly.

CONCLUSION: CT in the mild and moderate NPDR group decreased, but it increased significantly in the severe NPDR group, suggesting DM affected not only retina but choroids as well. The study hypothesizes that the changes of CT may played an important role in the progression of DR and the changes of CT had been initiated before DR. This provides significance in the early diagnosis of diabetic choroidopathy.

Abstract:AIM: To analyze the effect of pan-retinal photocoagulation(PRP)surgery on retinal arteriovenous circulation time and hemodynamics in patients with diabetic retinopathy(DR), and provide reference for clinical treatment.

METHODS: Eighty patients with DR who underwent PRP treatment in our hospital during May 2013 to February 2018 were selected for 80 eyes. The fundus fluorescein angiography system was used to record laminar flow time and total filling time(V1 and V2), retinal artery branch trunk development time and total filling time(A1 and A2), respectively, before and after treatment. Retinal arteriovenous passage time(V2-A1), retinal artery transit time(A2-A1), retinal vein transit time(V2-V1)and retinal capillary passage time(V1-A2)were recorded; we used automatic biochemical analyzer to detect red blood cells aggregation index, hematocrit, plasma viscosity, whole blood viscosity, high shear and low shear viscosity of whole blood; color Doppler ultrasound was used to record ophthalmic artery resistance index(the RI), peak systolic velocity(PSV)and diastolic the end of the flow velocity(EDV).

RESULTS: At 3mo after treatment, the V1-A2 time of this group was significantly longer than that before treatment. The red blood cell aggregation index, hematocrit, plasma viscosity, high blood viscosity and low blood viscosity were significantly lower than before treatment. RI was significantly lower than before treatment. EDV and PSV were significantly higher than before treatment, and the difference was statistically significant(P<0.05).

CONCLUSION: PRP surgery has a certain effect on the retinal arteriovenous circulation time and hemodynamics in patients with DR, and has a significant effect on the transit time of retinal capillaries.

Abstract:AIM: To analyzed the species of bacteria and antibiotic susceptibility in the conjunctival sac of non- diabetic patients and diabetic patients, to decrease the rate of postoperative endophthalmitis through the proper use of antibiotic drop and preoperative disinfection.

METHODS: Totally 124 patients(124 eyes)underwent cataract operation in Yangsi Hospital during November 2013 to January 2017 were divided into two groups: diabetic group(37 patients 37 eyes)and control group(87 patients 87 eyes). Bacterial culture in the conjunctival sac and antibiotic susceptibility test was operated in three time-points: before preoperative disinfection(T0), after preoperative disinfection(T1)and after operation(T2).

RESULTS: The bacterial culture rate in the conjunctival sac of diabetic patients was significantly higher than that in non-diabetic patients. Most of strains of bacteria were sensitive to vancomycin, levofloxacin and tobramycin. For penicillin, azithromycin and tetracycline, the rate of antibiotic resistance was much higher than other antibiotic.

CONCLUSION: Due to the change of the microenvironment of ocular surface, the bacterial culture rate of the conjunctival sac was significantly increased in diabetic patients. The main cultured bacteria in conjunctival sac were staphylococcus epidermidis and acnes propionate. Most of cultured bacteria in conjunctival sac were sensitive to levofloxacin and tobramycin. Levofloxacin and tobramycin can be used as preoperative antibiotic eye drop.

Abstract:AIM: To summarize and analyze the clinical data of patients with ocular injuries during Spring Festival in the past five years, and analyze the effect of injury on the patient and visual outcome.

METHODS: The clinical data of 155 cases of ocular trauma admitted during the Spring Festival from 2013 to 2017 were collected, including their age, sex, place, course, causes, nature of trauma, etc. The clinical features and the trends of ocular traumas in each year were summarized, and analysis the impact of injury on the vision prognosis, probe the relationship between ocular trauma sore and hospitalization days and costs.

RESULTS: A total of 155 ocular trauma patients(158 eyes)were enrolled in this study. The ratio of male to female was 6.05: 1, the mean age was 34.8±20.0 years old, and the proportion of 30-44 years old was higher. There were more rural residents than urban residents, showing differences on the course of injury(Z=-3.232, P<0.01). The general trend was that the number of people injured in the Spring Festival holidays increased. Fireworks were the main cause of injury, accounting for 41.9%, followed by toy gun injuries(16.1%), and the latter was the main cause of child injury. Closed globe injury accounted for a large proportion(76.6%)). Conservative treatment were needed for 71 eyes(44.9%), the majority patients still for surgery intervention. Open globe injury of ocular trauma sore was lower than closed globe injury(Z=-5.249, P<0.01), and the blindness rate of the former was higher. The visual acuity on discharge was significantly higher than admission(Z=-7.487, P<0.01). Hospitalization expenses increased with the number of hospitalization days, and both were positively correlated(r_s=0.755, P<0.01). The average ocular trauma sore was about 77.41±16.96, which was negatively correlated with hospitalization costs(r_s=-0.474, P<0.01)and negative correlation with hospitalization days(r_s=-0.359, P<0.01).

CONCLUSION: During the Spring Festival, ocular trauma occurred in middle-aged men and rural population. Fireworks were the main cause of injury. The eyeball shape and visual function was damaged after ocular trauma. Timely diagnosis and treatment could save the visual function of some patients. The heavier the injury, the higher the hospital days and hospitalization costs, which increased the personal and social burden.

Abstract:AIM:To compare dry eye symptoms and signs before and after three kinds surgery, femtosecond laser-assisted laser in situ keratomileusis(FS-LASIK), transepithelial photorefractive keratectomy(T-PRK), small incision lenticule extraction(SMILE)using ocular surface analyzer(Oculus Keratograph).

METHODS:Totally 98 patients(196 eyes)undergoing corneal refractive surgery from January 2017 to May 2017 were recruited. They were divided into three groups, namely, FS-LASIK group, T-PRK group and SMILE group. All patients underwent observation and assessment in the following order: ocular surface disease index(OSDI), tear meniscus height(TMH), measure using the infrared pattern of Oculus Keratograph. The first tear film break-up time(FBUT)and average tear break-up time(ABUT)measure using the infrared pattern of Oculus Keratograph, corneal fluorescein staining(FL), Schirmer Ⅰ test(SⅠt).

RESULTS:1)OSDI index: There was statistically significant difference between the three groups(F_groups=2.799, P_groups<0.05). However, the difference in the OSDI values of different time points in each group was statistically significant(F_time=85.942, P_time<0.001). The OSDI index were significantly increased at 1wk, 1 and 3mo after operation in each group. All groups recovered to the preoperative level at 6mo after operation. After 3mo, there was an inter-group difference in the OSDI values(P=0.019), and the OSDI values of the T-PRK group were higher than those of the other two groups. 2)TMH: There was statistically significant difference among the three groups postoperatively(F_groups=1.720, P_groups<0.05). The TMH values of different time points in each group were significantly different(F_time=11.202, P_time<0.001). The TMH values of each group were significantly reduced after 1wk and 1mo and were restored to preoperative levels after 3 and 6mo. After 3mo, there was a difference TMH among the three groups(P=0.004), and the inferior TMH in the SMILE group was higher than that of the other two groups. 3)FBUT: There was statistically significant difference among the three groups after surgery(F_groups=1.428, P_groups=0.245). The difference in FBUT values between different time points in each group was statistically significant(F_time=4.511, P_time=0.001). The FBUT values of each group were significantly reduced after 1wk and 1mo, and recovered to preoperative levels after 3mo and 6mo. There was no significant difference in FBUT between different groups at each time points(P>0.05). 4)ABUT: There was statistically significant difference in ABUT among the three groups after surgery(F_groups=1.290, P_groups<0.05). However, the difference in ABUT values between different time points in each group was statistically significant(F_time=10.294, P_time<0.001). The ABUT values of each group were significantly reduced after 1wk and 1mo, and recovered to preoperative levels after 3mo and 6mo. There was a statistical difference in ABUT values between different groups after 1mo(P=0.008); among them, the ABUT value of the SMILE group was higher than that of the T-PRK group and the FS-LASIK group. 5)FL: There was no statistical difference in the FL score between the three groups(F_groups=0.816, P_groups=0.445). The differences in the FL scores at different points in each group were statistically significant(F_time=5.539, P_time=0.004). The FL score of each group was significantly higher than before surgery at 1wk and 1mo, and recovered to preoperative levels at 3mo and 6mo after surgery. There was no statistical difference in the FLs between different groups at different points in time(P>0.05). 6)SⅠt: There was no statistically significant difference in SⅠt values among the three groups after surgery(F_groups=0.225, P_groups=0.799). The difference in SⅠt values between different time points in each group was statistically significant(F_time=4.604, P_time=0.003). The SⅠt values of each group were slightly higher than the preoperative values afyer 1wk and 3mo, but they were all within normal values. There was no significant difference between the SⅠt values of 1mo or 6mo after operation and the preoperative level. There was no statistical difference in SⅠt values between different groups at each points in time(P>0.05).

CONCLUSION:The three types of corneal refractive surgery FS-LASIK, T-PRK, and SMILE all cause different degrees of dry eyes within a certain period of time after surgery, but they can gradually recover later. After SMILE surgery, the stability of the tear film recovered faster, while the symptoms after T-PRK surgery improved the least.

Abstract:AIM:To evaluate the clinical efficacy of treatment via disinhibition and visual function training in children patients with anisometropic amblyopia.

METHODS: Eighty-three children patients with anisometropic amblyopia were enrolled in the prospective case control study. All patients were monocular amblyopia, which were randomly classified into 2 groups as a training group(44 cases)and a control group(39 cases). All patients had routine glasses and quantitative coverage, and were treated by the combination of both family and clinic training. Patients in both control and training groups were treated by amblyopia training instrument(light brush, red flash, grating, etc.)and fine stimulation training via computer software. Additionally, patients in the training group, whose corrected vision improved more than 0.6, were also exposed to other treatments including monocular adjustment function training, disinhibition training, binocular adjustment function training, binocular integration and fusion function training. Visual acuity and outcomes were statistically analyzed after 6mo.

RESULTS: No significant difference in the total effective rate of vision improvement between the two groups. However, the overall visual acuity difference between the two groups was statistically significant(P<0.05). After disinhibition and visual function training, the number of patients with improvement in both far and near stereopsis in the training group was significantly greater than that in the control group(P<0.05).

CONCLUSION: Combinational treatment with disinhibition and binocular visual function training enhances the competitiveness of amblyopic eyes and eliminate inhibition, which is accompanied by improved visual acuity and ameliorated visual function in children patients with anisometropic amblyopia.

Abstract:AIM:To study the therapeutic effect of visual occlusion combined with levodopa and benserazide hydrochloride tables on children with amblyopia.

METHODS: Totally 90 cases(140 eyes)of children diagnosed with amblyopia in our hospital were selected from January 2016 to January 2017. They were randomly divided into the monotherapy group and the combined treatment group, and 35 healthy children(70 eyes)were selected as the normal group for comparison. Patients in the monotherapy group were treated with visual cover, while patients in the combined treatment group were treated with oral administration of levodopa and benserazide tablets on the basis of visual cover. Tears were extracted from both groups of children before and after treatment, and the protein levels of CREB and PKA in tears of 140 eyes and 70 eyes of children in the normal group were detected by enzyme-linked immunosorbent assay. The index levels of the two groups and the normal group were compared, as well as the therapeutic efficiency of different age groups and the total therapeutic efficiency of different methods.

RESULTS: After treatment, the levels of IL-1β, IL-6 and IL-9 in the combined treatment group were significantly lower than those in the single treatment group after treatment(P<0.05).After treatment, the levels of CREB and PKA in the combined treatment group were significantly lower than those in the single treatment group(P<0.05).The total effective rate of children at the age of 3-6 in the combined treatment group and the single treatment group was significantly higher than those at the age of 7-9 and 10-12 in each group(P<0.05). The total therapeutic efficiency of the combined treatment group was significantly higher than that of the single treatment group, and the difference was statistically significant(P<0.05).

CONCLUSION: Combined with the traditional masking method, levodopa and benserazide hydrochloride tables can improve the treatment of children's amblyopia. The earlier the treatment time, the better and the higher efficiency is.

Abstract:AIM: To study the clinical effects of ganciclovir eye gel combined with spleen ammonia peptide oral freeze-dried powder in the treatment of epithelial herpes simplex keratitis(HSK).

METHODS: Totally 70 cases(70 eyes)with HSK diagnosed in Ophthalmology Department of our hospital from January 2015 to June 2016 were enrolled. All the patients were divided into control group and experimental group randomly. Control group was treated by ganciclovir eye gel, 6 times per day; while experimental group was treated by ganciclovir eye gel combined with spleen ammonia peptide oral freeze-dried powder, administered by cool white boiling water at daily bedtime, 2 milligram of every time. All patients were treated for 30d. Then the therapeutic effects of two groups, including the cure rate, time of corneal ulcer healing, pain relief, photophobia disappeared, vision improvement and recurrence rate were compared and analyzed.

RESULTS: The therapeutic effects of experimental group was better than the control group. The cure rate was 80% for experimental group and 51% for control group. The clinical cure rate in experimental group was significantly higher than that of the control group(P<0.05). The time for corneal ulcer healing and pain relief and photophobia disappeared in experimental group was significantly shorter than that for the control group(P<0.05). The recurrence rate in the 1-year follow-up was 14% for experimental group and 67% for control group. The clinical recurrence rate in experimental group was significantly lower than that of the control group(P<0.05).

CONCLUSION: The application of ganciclovir eye gel combined with spleen ammonia peptide oral freeze-dried powder in epithelial herpes simplex keratitis, which improves visual acuity, the cure rate and shortens the course of disease and reduces the recurrence rate, is the ideal treatment of epithelial herpes simplex keratitis at present.

Abstract:AIM: To investigate the causes and effective diagnosis and treatment of Descemet's membrane detachment in the patients received phacoemulsification combined with intraocular lens implantation and extracapsular cataract extraction combined with intraocular lens implantation.

METHODS: A retrospective analysis was applied for 2 069 eyes in 2006 patients which had received one of above-mentioned surgeries from January 2015 to December 2017. The treatment and prognosis of 26 patients(26 eyes)who had the complication of Descemet's membrane detachment during or after the surgery were observed.

RESULTS:After the appropriate treatment, no corneal endothelial decompensation happened in the 26 patients, and the visual acuity was improved to different extent. UBM confirmed that the Descemet's membrane was reset.

CONCLUSION: Early detection and appropriate treatment of Descemet's membrane detachment is important for the visual acuity recovery.

Abstract:AIM: To observe the effect of built-in type OASIS iris expander in phacoemulsification surgery for cataract with small pupil.

METHODS: Totally 44 cataract patients with small pupil were treated in our hospital from January 2016 to October 2017 were randomly divided into the control group(22 cases, 31 eyes)and the observation group(22 cases, 30 eyes). The patients in control group was treated by conventional phacoemulsification surgery, within surgery the small pupils were dilated by cleavage and lens position hook; the patients in observation group use OASIS iris expander within surgery. The best corrected visual acuity(BCVA), corneal endothelial cell counts, pupil size, intraocular pressure(IOP)of two groups before and after surgery were compared and analyzed, and the application effect of built-in type OASIS iris expander was evaluated.

RESULTS: At 1mo after operation, the BCVA of the two groups were significantly improved, and the BCVA of the observation group(0.09±0.04)was significantly better than that of the control group(0.20±0.03), the difference was statistically significant(P<0.05). At 1mo after operation, the corneal endothelial cell counts of the two groups were significantly decreased, but the corneal endothelial cell counts of the observation group(2455.77±52.98/mm²)were significantly higher than those of the control group(2298.94±49.12/mm²), the difference was statistically significant(P<0.05). At 1mo after operation, the pupil diameter of the two groups was enlarged(P<0.05), and the pupil diameter of the observation group(3.52±1.14mm)was larger than that of the control group(3.15±1.02mm, P>0.05). At 6mo after operation, the pupil diameter of the two groups was significantly enlarged(P<0.05), but there was no significant difference in the pupil diameter between the two groups(P>0.05). At 1mo after operation, intraocular pressure in both groups was lower than that before operation(P<0.05), and the intraocular pressure in observation group(13.40±1.73mmHg)was lower than that in control group(13.93±1.98mmHg, P>0.05). At 6mo after operation, intraocular pressure in both groups was lower than that before operation and 1mo after operation(P<0.05), but there was no significant difference in intraocular pressure between the two groups at 6mo after operation(P>0.05).

CONCLUSION: The OASIS built-in iris dilator can improve the best corrected visual acuity, reduce intraocular pressure and expand pupil diameter in small pupil phacoemulsification.

Abstract:AIM: To compare the postoperative quality of life between patients who underwent binocular and unilateral Symfony continuous-vision intraocular lens(IOL)implantation.

METHODS: A population-based cross-sectional study was performed. The visual function-related quality of life(QoL)was evaluated with the National Eye Institute Visual Functioning Questionnaire-25(NEI VFQ-25)which was developed by the National Eye Institute. Thirty patients(60 eyes)who underwent phacoemulsification combined with IOL implantation from March 2017 to March 2018 were divided into two groups according to the type of implanted IOL. For bilateral group(36 eyes in 18 cases), patients accepted TECNIS Symfony(ZXR00, AMO)in both eyes. For unilateral group(24 eyes in 12 cases), patients accepted TECNIS Symfony(ZXR00, AMO)in one eye and an aspherical monofocal IOL(PCB00,AMO)in the other eye. Follow-up was performed 3-6mo after surgery. Postoperative binocular uncorrected distant, intermediate and near visual acuity(bUCDVA, bUCIVA and bUCNVA)were compared and the quality of life was evaluated for every patient.

RESULTS:There were no statistical differences in bUCDVA, bUCIVA and bUCNVA between two groups(P>0.05). There was no significant difference in composite scores of the NEI VFQ-25 questionnaire between bilateral group and unilateral group(88.95±4.01 vs 88.99±4.22, t=-0.025, P=0.980). A comparison of the 12 scales acquired from the questionnaire showed that there were no statistical differences in visual function-related quality of life in the two groups(P>0.05).

CONCLUSION:Compared with bilateral implantation of ZXR00, the patients with the implantation of ZXR00 in one eye and PCB00 in the other eye share the excellent binocular uncorrected distant, intermediate and near visual acuity and postoperative quality of life. For patients who have undergone monofocal IOL implantation in one eye or whose one eye is not suitable for multifocal IOLs, unilateral implantation of Symfony continuous-vision IOL is feasible to meet patients' need for spectacle independency.

Abstract:AIM:To assess the efficacy and safety of improved glaucoma drainage valve implantation in the treatment of refractory glaucoma after vitrectomy.

METHODS: The improved procedure: the surgeon used a crescent knife to make a scleral sleeve with a width of about 2mm and a length of about 3mm behind the limbus 5mm to 7mm; maked a length of about 1.5mm scleral tunnel at a distance of 3.5mm from the limbus; piercing the posterior chamber by a one-time spear knife through the scleral tunnel; the drainage tube was trimmed to the proper length, then placed between the iris and intraocular lens in the posterior chamber through the scleral sleeve and scleral tunnel. Reduce the pupil, we could see the drainage tube port in the pupil margin, drainage tube mouth beveled toward the pupil edge. All patients underwent modified surgical glaucoma drainage valve implantation. Patients incorporated into the study who had secondary glaucoma after vitrectomy and intraocular lens implantation admitted to our hospital from March 2016 to August 2017. Follow-up time: 1, 3d, 1wk, 1 and 6mo, followed up every 6mo. The intraocular pressure, intraoperative and postoperative complications and related treatment methods were analyzed before and after surgery. Intraocular pressure(IOP)at different time points before and after surgery was compared using repeated measures of variance analysis.

RESULTS: A total of 26 patients were enrolled in the study. The average IOP was 42.5±8.1 mmHg preoperatively, 12.1±11.2mmHg on the first day after surgery, 14.3±5.9mmHg in the last follow-up. There was a statistically significant difference between preoperative IOP and that on the first postoperative day(P<0.001). There was no significant difference in intraocular pressure between the first day after surgery and the last follow-up(P=0.89). There were 8 eyes with IOP less than 6mmHg on the first postoperative day. There were 6 eyes with IOP higher than 6mmHg on the first postoperative day, then dropped below 6mmHg on the third postoperative day. The rate of early postoperative low intraocular pressure was 54%. IOP returned to normal after intravitreal injection of air, injection of drug(triamcinolone acetonide), or injection of viscoelastic into the anterior chamber. During the follow-up no corneal endothelial decompensation, drainage tube exposure, explosive choroidal hemorrhage, endophthalmitis and other serious complications.

CONCLUSION: Improved glaucoma drainage valve implantation is a safe, effective and less-complicated surgical procedure for the treatment of refractory glaucoma. Anterior chamber injection of viscoelastic, vitreous cavity gas injection is a simple, effective, repeatable, and easy-to-use method for the treatment of early hypotony after glaucoma valve implantation.

Abstract:AIM: To investigate the relationship between the glycosylated hemoglobin(HbA1c)and retinal nerve fiber layer(RNFL)thickness in patients at early stage of type 2 diabetes.

METHODS: Totally 58 patients at early stage of type 2 diabetes(average disease course was 3.25±2.32a)and 18 healthy subjects were recruited for this study. Optical coherence tomography(OCT)was used to measure retinal nerve fiber layer(RNFL)thickness of all subjects.

RESULTS: The difference of the superior, inferior and nasal RNFL thickness between two groups was significant(P<0.05), and the superior, inferior and nasal RNFL thickness was negatively related to the HbA1c and disease course(P<0.05). No significant difference of temporal RNFL thickness existed between two groups(P>0.05), and temporal RNFL thickness was not related to HbA1c and disease course(P>0.05).

CONCLUSION: RNFL thickness are thinner in diabetes patients than that in healthy subjects, and HbA1c and RNFL thickness are correlated in diabetes patients. Clinically, RNFL changes of patients can be evaluated according to HbA1c level, and the severity of DR can be predicted, thus guiding the clinical diagnosis and treatment.

Abstract:AIM: To investigate the expression of copeptin and midkine(MK)in patients with diabetic retinopathy and their clinical significance.

METHODS: Totally 180 patients with type 2 diabetes mellitus(T2DM)admitted to our hospital from June 2016 to October 2017 were divided into three groups according to the criteria of diabetic retinopathy staging. Among them, there were no retinopathy group(68 cases), non-proliferative retinopathy group(72 cases), proliferative retinopathy group(40 cases)and 90 healthy subjects in the same period as the control group. The copeptin level was detected by double antibody immunosorbent assay and the MK level by ELISA. The glycosylated hemoglobin(HbA1c)was detected by TOSOH automatic glycosylated hemoglobin analyzer and the whole blood hs-CRP was detected by using blood routine instrument. Fasting plasma glucose(FPG), triglyceride(TG), cholesterol(TC), low density lipoprotein(LDL-C)and high density lipoprotein(HDL-C)were detected by automatic biochemical analyzer and the systolic blood pressure(SBP)and diastolic blood pressure(DBP)of each group were recorded. The relationship between copeptin and MK levels and blood lipid, blood pressure, biochemical parameters and the course of diabetes mellitus were also analyzed.

RESULTS: The levels of copeptin and MK in patients with diabetic retinopathy were significantly higher than those in controls, and the levels of copeptin and MK were gradually increased with the progress of disease(P<0.05). The levels of copeptin and MK were correlated with the levels of HbA1c, hs-CRP and course of T2DM(P<0.05), but no significant correlation with plasma lipids, blood pressure and FPG(all P>0.05).

CONCLUSION: The copeptin and MK levels are closely related to the course of diabetic retinopathy and the severity of the disease, both of which may be involved in the development of diabetic retinopathy.

Abstract:AIM:Analysis of visual prognosis and correlative factors in patients with branch retinal artery occlusion(BRAO).

METHODS: Retrospective medical record review of 68 eyes of 68 patients with BRAO seen at Fushun Ophthalmology Hospital from June 2015 and June 2017. Demographic and clinical characteristics were recorded, including gender, age, race, eye involved, and best-corrected visual acuity(BCVA), spectral domain optical coherence tomography(SD-OCT)and optical coherence tomography angiography(OCTA, OptoVue). The OCTA retinal blood flow imaging scan mode was performed, the scanning region in the macular area were 3mm×3mm. the patients were followed up for 6mo.

RESULTS: On presentation, 69% of eyes with BRAO had BCVA of 0.5 or better, 24% of moderate visual impairment(0.1-0.4)and 7% of severe visual impairment(<0.1). At the 6-month visit, the percentage of eyes with slight, moderate and severe visual impairment was 75%, 19% and 6% respectively. The presenting BCVA(r=0.776, P<0.001), the integrity of superficial foveal capillary arcade(r=-0.003, P<0.001), the integrity of deep foveal capillary arcade(r=-0.003, P<0.001), the density of superficial retinal capillary plexuses(r=-0.034, P=0.029)and the density of deep retinal capillary plexuses(r=-0.014, P=0.012)were found to be statistically significant with regard to visual outcome. Male, age, duration of symptoms, macular retinal thickness, area of macular involvement(superior or inferior)and presence or absence of emboli were not found to be statistically significant with regard to follow-up BCVA(r=0.273, 0.01, 0, 0.082, 0.41, 0.109, all P>0.05).

CONCLUSION: The integrity of foveal capillary arcade, the density of retinal capillary plexuses and the presenting BCVA are dosely associated with visual outcome of patients with branch retinal artery occlusion.

Abstract:AIM: To investigate the correlations between aqueous concentrations of bone morphogenetic protein 6(BMP-6), interleukin 6(IL-6), and vascular endothelial growth factor(VEGF)and the parameters of macular edema acquired by optical coherence tomography(OCT)in patients with neovascular age-related macular degeneration(nARMD).

METHODS: Totally 35 eyes from 34 patients with nARMD were studied. Twenty eyes from 20 patients with no retinal pathology who underwent cataract surgery served as controls. The central subfield macular thickness(CSMT)of nARMD within 1 mm was measured with OCT. Aqueous humor samples were collected just before intravitreal ranibizumab injection in 35 eyes with nARMD and before cataract surgery in 20 control eyes. Concentration of BMP-6 were determined by ELISA. IL-6, VEGF were measured by cytometric bead array(CBA).

RESULTS: The level of BMP-6 in aqueous humor of patients with nARMD(35.29±4.27pg/mL)was significantly lower than that of control eyes(62.04±2.78pg/mL, P<0.05), while VEGF level was 93.13±47.25pg/mL, significantly higher than that of the control group 69.21±13.40pg/mL(P<0.05). The level of IL-6 was not significantly different between the two groups. BMP-6 was negatively correlated with CSMT(r=-0.409, P=0.015).

CONCLUSION: Aqueous humor concentrations of BMP-6 are decreased in eyes with nARMD. Aqueous humor concentrations of VEGF are elevated in eyes with nARMD. BMP-6 could be associated with the pathogenesis of nARMD.

Abstract:AIM: To observe the multimodal imaging characteristics of adult-onset foveomacular vitelliform dystrophy(AFVD).

METHODS: Retrospective study. Six cases(11 eyes)of AFVD in Zhengzhou Second People Hospital from January 2015 to April 2018 were included. Amongst all of them, there were 2 men 3 eyes, 4 women 8 eyes, aged from 43-67 years(average 52.5±1.7 years). No abnormality was found in the anterior segment, intraocular pressure and electroretinogram(ERG). There was no family history. Best corrected visual acuity(BCVA)was from 0.08-0.8, EOG was normal in 9 eyes, slightly decreased in 2 eyes. Fundus color photography, optical coherence tomography angiography(OCTA), fundus fluorescein angiography(FFA)and indolecyanine green angiography(ICGA)of the patients were examined and analyzed.

RESULTS: The fundi of all patients showed less than 1PD vitelliform lesions, showing hypofluorescence in FFA and ICGA. In the late phase of FFA,fluorescence accumulated in the lesion in some patients. In B-scan of OCTA, there was vitelliform substance which deposited between the photoreceptor and retinal pigment epithelium(RPE )layer. As the disease continues to progress, photoreceptor layer became thinner, RPE-Bruch layer became thinner or disappeared. In OCTA there was dark spot with strong reflection around it in choriocapillary layer. There was dark spot in En-face image.

CONCLUSION: Multimodal imaging assist in diagnosing AFVD, reducing missed diagnosed and misdiagnosis, better understanding the pathogenesis, developing the treatment plan, judging prognosis.

Abstract:AIM:To evaluate the effect of soft contact lens on the comfort of postoperative patients with recurrent pterygium.

METHODS: For 100 eyes of 98 patients after recurrent pterygium excision, the conjunctival implant with limbal stem cells from the upper part of the cornea was used, and the scleral surface of the operation area was transferred and covered. Fifty eyes were treated with corneal bandage lens for 5d(Group A)and 50 eyes were conventionally ensheathed(Group B). The time of corneal wound healing and various symptoms and signs were observed after operation.

RESULTS: Compared with Group B, 1d after pterygium, the symptoms and signs of corneal irritation in Group A were significantly less(P<0.05), and the corneal epithelial healing was significantly faster and better(P<0.05).

CONCLUSION: The corneal contact lens can obviously improve the early postoperative corneal irritation in patients with pterygium, promote corneal wound healing and relieve postoperative discomfort.

Abstract:AIM: To evaluate the clinical effect of wearing bandage lens after pterygium excision combined with corneal stem cell transplantation.

METHODS: This study was a prospective analysis. Totally 110 cases 110 eyes of pterygium excision combined with corneal stem cell transplantation admitted to our hospital from August 2015 to February 2018 were randomly divided into control group and observation group with 55 cases in each group. Patients in observation group wore bandage lens after operation. Visual analogue scale(VAS)was used to evaluated the pain 1, 3d and 1wk after operation. Fluorescein staining(FL)was used to evaluate the corneal epithelial healing and the incidence of complications.

RESULTS: The VAS score and corneal epithelial healing score of the observation group were significantly lower than those of the control group at 1, 3d and 1wk after operation(P<0.05). There was no difference in the incidence of complications between the two groups(P>0.05).

CONCLUSION: It is safe and effective to wear bandage lens after pterygium excision combined with corneal stem cell transplantation. It can relieve pain and promote epithelial healing after pterygium operation.

Abstract:AIM: To investigate the importance between several edge points repair through enophthalmos study after orbital wall fracture repair surgery.

METHODS: The date of 23 eyes of 23 cases with medial-inferior orbital wall fracture with enophthalmos were collected and analyzed retrospectively. All cases underwent orbital fracture surgery, the follow-up time was 3mo. After surgery, the degree of enophthalmos was within 2mm. The repair of bony buttress, exterior margin of inferior orbital wall, and superior margin of medial orbital wall after surgery were analyzed.

RESULTS: In these well-recoverd patients, repair rate between bony buttress(100%), exterior margin of inferior orbital wall(43%)and superior margin of medial orbital wall(83%)were different.

CONCLUSION: The repair of bony buttress was most important for surgery. Analysis between surgical efficacy and edge points repair is valuable for surgical operation and risk control.

Abstract:AIM: To investigate the changes in constituent ratio and operation of the inpatients with ophthalmology from a key hospital in province.

METHODS: A retrospective analysis was conducted including the data of medical record first sheet of patients from January 1 2015 to December 31 2017 using the hospital medical statistical analysis system. All cases were classified by clinical specialties, and the surgery quantity was counted according to the first operation method. The database was established and analyzed with Excel 2007 and SPSS 17.0.

RESULTS: Total of 43 307 patients were research studied, including 21 063 males(48.64%)and 22 244 females(51.36%)with an average age of(55.0±20.4)years. The proportion of patients over 60 years old accounted for 49.92% of the total number, and this value tended to increase year by year while that decrease among patients aged 0 to 19 years. These included 31.49% of diseases of the lens, 20.61% of retino-choroidal diseases, 10.29% of glaucoma, 8.70% of strabism, 8.49% of ocular trauma, 7.44% of vitreous body disease, 6.51% of eyelid-conjunctiva and lacrimal apparatus disease, 2.69% of eye neoplasm, 1.06% of optic-nerve disease, 0.89% of sclera, corneal, iris or ciliary body disease, 1.82% of other eye disease. There was 89.40% of cases underwent an ophthalmic surgery(38 718 cases), 16 590 were operation on lens(42.85% of cases), 4 697 were intravitreal injection(12.13% of cases), 3 491 were strabismus surgery(9.02% of cases), 2 597 were glaucoma operation(6.66% of cases).

CONCLUSION: Lens disease, retino-choroid disease, glaucoma, strabismus and ocular trauma were constituted the top five diseases. At present, treatment of cataract is still the main work of prevention and treatment of blindness, while retino-choroid disease is increasing rapidly and becoming the focus of prevention and treatment.

Abstract:AIM: To explore whether there was a difference in clinical efficacy of toric design orthokeratology and regular spherical orthokeratology in myopia patients with high difference in corneal surface.

METHODS: A retrospective analysis of 48 moderate myopia patients(94 eyes), who went to the optometry center of Ruikang Hospital Affiliated to Guangxi University of Chinese Medical form July 2016 to December 2017. The height difference between the horizontal axis and the vertical axis away from the central cornea at 4mm was ≥30μm calculated in all patients with corneal topography. In Group A, 25 cases(48 eyes)with toric design orthokeratology, Group B(23 cases, 46 eyes)with regular spherical. After wearing orthokeratology 1wk, 1, 3mo, the uncorrected visual acuity(UCVA), the changes of corneal astigmatism in 3mm corneal center, the eccentricity of corneal treatment area were observed.

RESULTS: The UCVA was improved of both groups after operation, while was not significantly different between the two groups(P>0.05). The corneal regular astigmatism in 3mm corneal center were decreased after wearing orthokeratology 1wk, 1, 3mo, the changes were more obvious in Group A than Group B(P<0.05). the eccentricity of corneal treatment area in Group A were less than Group B(P<0.05).

CONCLUSION: For myopic patients with height difference between the horizontal axis and the vertical axis from the central cornea, the toric design orthokeratology is superior to regular spherical design orthokeratology in reducing astigmatism and stability of treatment area.

Abstract:AIM: To compare the difference of biomechanical stability after a femtosecond laser-assisted in situ keratomileusis(FS-LASIK)and laser-assisted subepithelial keratomileusis(LASEK)by ocular response analyzer(ORA).

METHODS: This prospective study was conducted at the First Affiliated Hospital of Harbin Medical University, and myopic patients with the equivalent sphere between -2.00 and -5.00 diopters from January 2016 and December 2017 were enrolled. All the subjects were divided into FS-LASIK and LASEK group respectively according to different surgical methods. There were 64 patients(100 eyes)participated in the FS-LASIK group while 53 patients(100 eyes)in the LASEK surgery group. Corneal hysteresis value(CH)and corneal resistance factor value(CRF)were measured pre-, 1mo and 3mo postoperation of all the subjects. And the variance analysis of two groups was repeated to compare the overall difference between the two modes of operation from pre-operation to post operation.

RESULTS: The CH and CRF value of the two groups were different before and after operation(P<0.05). The comparison results of repeated measurements showed that the CH value and CRF value of the surgical methods were reduced in 1 and 3mo after operation, respectively, and there was significance(P<0.05). The CH and CRF of FS-LASIK group was lower than LASEK group only in 1mo after the operation(P<0.05).

CONCLUSION: Both surgeries could affect the biomechanical stability of cornea. From the point of view of biomechanical stability, LASEK operation is safer than FS-LASIK operation and reduces the possibility of postoperative refractive regression.