Abstract:AIM: To compare the visual results and postoperative complications of polymethylmethacrylate(PMMA)and hydrophobic acrylic intraocular lenses(IOLs)in children who underwent cataract extraction with primary IOL implantation.

METHODS:This retrospective study included 117 eyes of 63 children with bilateral pediatric cataract undergoing cataract surgery and primary IOL implantation. The patients were divided into two groups, Group I included 58 eyes of 30 patients with PMMA IOLs; Group II included 59 eyes of 33 patients with hydrophobic acrylic IOLs. The clinical features, refraction errors, best corrected visual acuity(BCVA)and surgical complications were compared between two groups.

RESULTS:The mean age at the time of surgery was 5.8(2-12)y and mean follow up period was 40.5(6-196)mo. Postoperatively, BCVA was ≥0.5 in 80 eyes(68.4%)and this was comparable in two groups. Visual axis opacification was seen in 28 eyes(48.3%)in Group I and 16 eyes(27.1%)in Group II and this difference was statistically significant(P=0.018). Postoperative IOL dislocation and posterior synechia formation were also noted. When all postoperative complications were considered, there were significantly less complications in the acrylic IOL group than PMMA IOL group(P=0.020).

CONCLUSION: Pediatric cataract surgery with primary IOL implantation is a safe procedure. Hydrophobic acrylic IOLs may lead to less postoperative complications compared to PMMA IOLs.

Abstract:AIM: To assess the changes in anterior chamber parameters and examine the factors associated with changes in the intraocular pressure(IOP)in individuals who have undergone phacoemulsification surgery.

METHODS: It was a longitudinal analysis of secondary clinical data collected from 105 non-glaucomatous eyes(of 82 patients)undergoing a cataract surgery. We studied the association between anterior chamber parameters, grade of cataract, demographics, and changes in the IOP over a period of 3wk. We also evaluated the association between the pressure-depth(PD)ratio and changes in the IOP during this time.

RESULTS: The mean age [standard deviation(SD)] of the 82 patients was 60.1(7.8)years. The mean SD IOP was 15.06(3.36)mmHg pre-operatively; it increased to 15.75(4.21)mmHg on day one(P=0.20). In the multifactorial models, the mean IOP was -1.715 \〖95% confidence intervals(CI): -2.795, -0.636\〗 mmHg on day 21(±5)compared with the pre-operative values. The anterior chamber depth(ACD), axial length, age, sex, and grade of cataract were not significantly associated with changes in the IOP. Each unit increase in the PD ratio was associated with an increase in the mean IOP by 1.289 mmHg(95% CI: 0.906, 1.671). After adjusting for pre-operative PD ratio, none of the other variables(ACD, axial length, temporal angle)were significantly associated with changes in mean IOP.

CONCLUSION: The PD ratio was the single most important factor associated with the changes in post-operative IOP over 3wk post surgery.

Abstract:AIM: To identify a link between optical coherence tomography(OCT), length of multiple sclerosis(MS)and the expanded disability status scale(EDSS).

METHODS: In a prospective double blind study, 29 patients with a diagnosis of MS were compared with 29 healthy patients, matched by age and sex. All participants underwent an OCT study and neurological EDSS test on the same day.

RESULTS: The mean EDSS score was 3.2 in the MS group vs 0.03 in the control group, and the duration of MS was 11.7y. The mean retinal nerve fiber layer(RNFL)thickness was significantly thinner in those with MS (P<0.001). Correlation was found between duration of MS and RNFL thinning. EDSS and thinning of RNFL showed a tendency to correlate but without statistical significance.

CONCLUSION: RNFL is thinner in MS patients than in the general population. MS duration has a direct statistically significant effect on RNFL thickness. There seems to be a tendency of a relationship between RNFL thinning and EDSS. OCT is suggested as a monitoring and evaluation tool of MS patients.

Abstract:AIM: To investigate the expression of protease-activated receptor 2(PAR2)in uveal melanoma(UM), and the effects of silencing the expression of PAR2 gene on proliferation and invasion of human UM cell line M23.

METHODS: A total of 45 patients(45 eyes)with UM who underwent surgical treatment with complete information in our hospital were selected from February 2012 to December 2017. In the same period, 30 patients(30 eyes)who underwent eyeball removal due to ocular trauma and most of the uvea were normal were selected. Real-time quantitative PCR was used to detect the expressions of PAR2 gene in UM and normal choroidal tissues. M23 cells were cultured and divided into PAR2 interference group, negative control sequence group and blank group. Real-time quantitative PCR was used to detect the expression of PAR2 gene in cells. MTT assay was used to detect cell proliferation, and transwell assay was used to detect cell migration and invasion.

RESULTS: The relative expression level of PAR2 mRNA was 1.73±0.13 in UM tissues, and 1.06±0.10 in normal choroid tissues(t=23.732, P<0.001). The relative expression level of PAR2 mRNA in UM tissues was associated with pathological type, scleral invasion, optic disc involvement and extraocular growth(P<0.05). The relative expression level of PAR2 mRNA in PAR2 interference group was lower than that in negative control sequence group and blank group(P<0.05). The absorbance A values at 24h, 48h, 72h and 96h in the PAR2 interference group cells were lower than those in negative control sequence group and blank group(P<0.05). The number of migrated cells and the number of invasive cells in PAR2 interference group were lower than those in negative control sequence group and blank group(P<0.05).

CONCLUSION: PAR2 was highly expressed in UM tissues and was associated with high risk of tumor metastasis. Specific silencing of PAR2 gene expression in M23 cells could effectively inhibit cell proliferation, migration and invasion.

Abstract:AIM: To explore the effect of hydrogen sulfide(H₂S)on oxidative stress in diabetic cataract rats and its mechanism.

METHODS:SD rats were randomly divided into control group, diabetic group, low-dosage NaHS-treated group, high-dosage NaHS-treated group, and NaHS treated alone group. NaHS was used as a donor of H₂S. The diabetic model was established by a single intraperitoneally administrating streptozotocin(STZ, 65mg/kg). BQ900 slit lamp was used to recorded the changes of lenses. At the end of experiment, the level of superoxide dismutase(SOD)was measured by xanthine oxidase test, the activity of malondialdehyde(MDA)was detected by thiobarbituric acid test, and glutathione(GSH-Px)were detected by corresponding assay kits. Western blotting was applied to detect the expression of SIRT1.

RESULTS:The lenses of diabetic group showed different levels of turbidity, which demonstrated that diabetic cataract model was successfully established. Low-dosage NaHS and high-dosage NaHS treatment dramatically alleviated turbidity levels of lenses in diabetic rats, respectively. Compared to diabetic group, low-dosage NaHS and high-dosage NaHS treatment obviously decreased the levels of MDA and increased the levels of SOD and GSH-Px. Furthermore, the SIRT1 expression in lens of diabetic rats was downregulated, and low-dosage NaHS as well as high-dosage NaHS treatment significantly reversed this change.

CONCLUSION:H₂S protects against oxidative stress in STZ-induced diabetic rats involving upregulation of SIRT1.

Abstract:AIM: To study the effects of FOXO4 on oxidative stress and apoptosis of retinal vascular endothelial cells under high glucose environmental conditions.

METHODS: Human retinal vascular endothelial cells were cultured with high glucose medium. Real-time PCR and Western blot were used to detect the expressions of FOXO4 within cells; meanwhile, both FOXO4 RNAi lentivirus and control vector lentivirus were infected the retinal vascular endothelial cells cultured in high sugar culture medium. Real-time PCR and Western blot techniques were used to detect the interference efficiency. After collection of supernatant and cells treated with various interferences, the SOD activity, MDA content in the supernatants and ROS level within cells were detected. Flow cytometry was used to determine the changes of cell apoptosis. Western blot was used to detect the expressions of apoptotic protein cleaved Caspase-3 and cleaved Caspase-9 within cells.

RESULTS: The expression of FOXO4 was increased in retinal vascular endothelial cells after treatment with high glucose medium. FOXO4 RNAi lentivirus infection reduced the expression level of FOXO4 in retinal vascular endothelial cells under high glucose environmental conditions. By contrast, control vector lentivirus had no effect on FOXO4 expression in cells. High glucose induced elevated levels of ROS in retinal vascular endothelial cells, reduced the activity of SOD in cell culture medium, increased the content of MDA, elevated the rate of apoptosis, and promoted the expressions of cleaved Caspase-3 and cleaved Caspase-9 proteins in cells. After down-regulation of FOXO4 expression, retinal endothelial cells were induced by high glucose, the activity of SOD in the cell culture medium increased, the levels of MDA, ROS, apoptosis, and the levels of cleaved Caspase-3 and cleaved Caspase-9 proteins decreased in cells as compared with those of retinal vascular endothelial cells. Moreover, compared with those did not interfere with FOXO4 expression, there was statistically significant differences(P<0.05).

CONCLUSION: High glucose induces the expression of FOXO4 in retinal vascular endothelial cells. Knocking-down of FOXO4 expression reduces oxidative stress and apoptosis induced by high glucose medium.

Abstract:AIM: To evaluate the clinical effect of Conbercept combined with vitrectomy in the treatment of proliferative vitreoretinopathy(PVR)after choroidal detachment.

METHODS: From January 2015 to January 2018, 66 eyes of 64 patients with PVR were treated in our hospital. All the patients were randomly divided into control group(32 cases, 34 eyes)and observation group(32 cases, 32 eyes). The control group was treated with routine vitreoretinal surgery. The observation group was treated with routine vitreoretinal surgery combined with intravitreal injection of conbercept. The clinical efficacy, operative duration, intraoperative bleeding, incidence of iatrogenic holes and the best corrected visual acuity(BCVA), subfoveal choroidal thickness before and after treatment were compared between the two groups.

RESULTS: After 3-6mo follow-up, the total effective rate in the observation group(94%)was significantly higher than that in the control group(74%), and the difference was statistically significant(P<0.05). The duration of operation in the observation group was significantly shorter than that in the control group, and the incidence of intraoperative hemorrhage and iatrogenic hiatus were significantly lower in the observation group than in the control group(P<0.05). Before treatment, there was no significant difference in serum VEGF level and bFGF content between the two groups(P>0.05). After treatment, the above indexes were lower than those before treatment. The levels of serum VEGF and bFGF in the observation group were significantly lower than those in the control group(P<0.05). Before treatment, there was no significant difference in the thickness of subfoveal choroid and BCVA between the two groups(P>0.05). The BCVA of the two groups was significantly higher than that before treatment. The thickness of subfoveal choroid in the observation group was significantly lower than that before surgery(P<0.05), and the thickness of the subfoveal choroid in the observation group was significantly lower than that in the control group(P<0.05).

CONCLUSION: Vitrectomy combined with intravitreal injection of conbercept in the treatment of PVR after choroidal detachment has a good effect. It can effectively shorten the operation time, reduce the incidence of intraoperative hemorrhage and iatrogenic hole, and reduce the level of serum VEGF and bFGF content. Improve the visual acuity and reduce the thickness of choroid.

Abstract:AIM: To explore the application effect of fenofibrate combined with 23G minimally invasive vitrectomy in patients with diabetic retinopathy(DR).

METHODS: Totally 102 DR patients(102 patients)treated in our hospital from October 2015 to November 2017 were selected and divided into observation group and control group according to random number table, 51 cases in each group. The 23G minimally invasive vitrectomy was performed in all patients. From the 1^st day after operation, the two groups were treated with related treatment, and the control group was given conventional hypoglycemic, antihypertensive and improved microcirculation treatment. On the basis of the above, the observation group was treated with fenofibrate treatment. Both groups were treated for 3mo. The operation and postoperative basic conditions(operative time, intraoperative blood loss, complication rate, length of stay), the level of blood lipid \〖total cholesterol(TC), triglyceride(TG), low density lipoprotein cholesterol(LDL-C), high density lipoprotein cholesterol(HDL-C)\〗, and the serum levels of related factors \〖lipoprotein associated phospholipase A2(Lp-PLA2), vascular endothelial growth factor(VEGF)\〗 before and after 3mo of operation of two groups were compared. Following up for 6mo after operation, the recurrence rate of two groups of retinopathy was statistically compared.

RESULTS: There was no significant difference in operative time, intraoperative blood loss, incidence of complications and length of stay between the two groups(P>0.05). There was no significant difference in the levels of TC, TG, LDL-C and HDL-C between the two groups before operation(P>0.05). After 3mo, the levels of TC, TG and LDL-C in the observation group were lower than those in the control group, and the level of HDL-C was higher than that in the control group, and the difference was statistically significant(P<0.05). There was no significant difference in serum levels of Lp-PLA2 and VEGF between the two groups before operation(P>0.05). The serum levels of Lp-PLA2 and VEGF in the observation group were lower than those in the control group 3mo after operation, and the difference was statistically significant(P<0.05). There was insignificant difference in visual function and quality of life, sensory adjustment, psychological and social scores and total scores between the two groups before surgery(P>0.05). At 3mo after operation, the scores of visual function and life quality in the observation group were lower than those in the control group, and the difference was statistically significant(P<0.05). After follow-up for 6mo, no recurrence occurred in the observation group. The recurrence rate in the control group was 5.9%(3/51), and there was no significant difference between the two groups(P>0.05).

CONCLUSION: The combination of fenofibrate and 23G minimally invasive vitrectomy for the treatment of DR can effectively correct the disorder of lipid metabolism, reduce the level of serum Lp-PLA2 and VEGF, so it is beneficial to improve the visual function and quality of life of the patients, but there is no effective data support for reducing the postoperative recurrence rate.

Abstract:Epithelial-mesenchymal transition(EMT)of retinal pigment epithelial cells(RPE)plays a key role in proliferative vitreoretinopathy(PVR), and also decreases the therapeutic effect of anti-vascular endothelial growth factor(anti-VEGF)to choroidal neovascularization(CNV). In addition, cells transplantation has been becoming a potential therapeutic method to treat age-related macular degeneration(AMD), and some cells sources like human embryonic stem cells(hESC)or induced pluripotent stem cell(iPSC)induced RPE cells, and fetal RPE cells have been attempted. However, EMT, as a common problem, decreases cells proliferation and differentiation efficiency, and it will reduce therapeutic effect and the number of therapeutic populations. So, in this article, we reviewed some possible methods to inhibit EMT.

Abstract:Amblyopia is one of the common ophthalmic diseases in children's visual development, and its pathogenesis is rather complicated. This paper summarizes the current literatures on the pathogenesis of amblyopia, and analyzes the molecular biological mechanism of visual development and amblyopia pathogenesis from the visual neurotransmitters and their receptors, cell factors, related genes and proteins, as well as the expression of regulatory kinase. In order to provide a reference for the study of visual plasticity, amblyopia pathogenesis and treatment.

Abstract:Posterior chamber intraocular lens implantation was effective for correcting refractive errors. More scientific studies about subjective visual quality(visual acuity, contrast sensitivity)and objective visual quality(wave front aberration, point spread function, Strehl ratio, modulmion transfer function)had showed that the improvement of subjective visual acuity was accompanied with the improvement of objective visual acuity after phakic intraocular lens implantation. However, the complications, such as anterior subcapsular cataract, glaucoma and decomposition of corneal endothelium needed to be long-term followed up. This article summarized the visual quality research after posterior chamber phakic intraocular lens implantation.

Abstract:Neovascular glaucoma(NVG)is a kind of glaucoma secondary to other ocular or systemic diseases, which has characteristics such as uncontrollable intraocular pressure, sharp decline in vision, and eye pain. There are many researches on neovascular glaucoma at home and abroad about different treatments and new methods are being explored, but the surgery is the ultimate treatment at present. The way of combining anti- vascular endothelial growth factor(VEGF)drugs and surgical methods is a hot topic in recent years. This article will review the different treatments and efficacy evaluations described in the article about NVG.

Abstract:Myopia, a deteriorated and still unsolved eye problem in China, shows the character of early onset, rapid progress and increased proportion of high myopia. Because of the serious complication caused by high myopia, such as retinal detachment, glaucoma, cataract and macular disorders, it can even lead to the irreversible loss of vision. The prevention and effective control of myopia turn to be an urgent social problem. In this review, causes and the progress of treatment in myopia are described.

Abstract:AIM: To explore the effects of overnight orthokeratology lens and conventional frame glasses on the myopic diopter, uncorrected visual acuity and ocular parameters of myopia adolescent.

METHODS: Totally 102 cases of(204 eyes)of adolescent myopia patients were randomly divided into observation group and control group with 51 cases(102 eyes)in each group during April 2014 to April 2017. Control group was only given conventional frame glasses, and observation group was given overnight orthokeratology lens. The myopic diopter and uncorrected visual acuity(UCVA)before wearing glasses and at 1wk, 1, 3, 6mo and 1a of wearing glasses, and the ocular parameters before wearing glasses and at 1a after wearing glasses were observed in the two groups, and the occurrence of complications was compared between the two groups.

RESULTS: After 1wk to 1a of wearing glasses, the myopic diopter in observation group was gradually decreased(P<0.05), and there was no significant difference in control group(P>0.05), but there was statistically significant difference between-groups at different time points(P<0.05). After 1wk to 1a of wearing glasses, the UCVA in observation group showed a increasing tendency(P<0.05), and the UCVA in observation group after 6mo to 1a of wearing glasses was significantly higher than that in control group(P<0.05). At 1a after wearing glasses, the axial length, corneal endothelial cell density, central anterior chamber depth, and intraocular pressure in observation group were not significantly different from those before wearing glasses(P>0.05), and the axial length in control group was significantly longer than that before wearing glasses and that in observation group(P<0.05). The total incidence rates of complications in observation group and control group were 10.8% and 6.9% respectively(P>0.05).

CONCLUSION: Overnight orthokeratology lens for adolescent myopia can effectively correct the myopic diopter, and improve the uncorrected visual acuity. It is less harmful to the eyes and less complications, and it is safe and reliable in clinical application.

Abstract:AIM: To discuss the curative effect of different chopping techniques on hard nuclear during the phacoemulsification in age-related cataract.

METHODS: Totally 200 elderly patients(264 eyes)with age-related cataract were selected from January 2015 and January 2018 in our Hospital, according to the random digital table method, they were divided into the interceptor group(100 patients 130 eyes)and the hook group(100 patients 134 eyes). Interceptor group was given interceptor chopping techniques to complete phacoemulsification; the hook group was given hook pre-chopping techniques to complete phacoemulsification. The actual phacoemulsification time(US/TIME), the cumulative release energy(CDE), the best corrected visual acuity, the corneal edema degree, the complication were compared in the two groups.

RESULTS: The US/TIME and CDE in the hook group were significantly lower than those in the interceptor group, the difference was statistically significant(P<0.05). The 1 and 3d postoperative best corrected visual acuity in the hook group were significantly higher than those in the interceptor group, the 1 and 3d postoperative corneal edema degree in the hook group were significantly lower than those in the interceptor group, the difference was statistically significant(P<0.05). The comparison of the 7d postoperative best corrected visual acuity and corneal edema degree in the interceptor group and the hook group, there was no statistically significant difference(P>0.05). The complication rate in the hook group was significantly lower than that in the interceptor group, the difference was statistically significant(P<0.05).

CONCLUSION: Compared with the interceptor chopping techniques, the hook pre-chopping techniques can effectively reduce the US/TIME and CDE of phacoemulsification in the age-related cataract patients, it is beneficial to improve the best corrected visual acuity and the corneal edema degree as soon as possible, and it can effectively reduce the complications.

Abstract:AIM: To observe the efficacy of 23G minimally invasive system combined with phacoemulsification in the treatment of cataract complicated with vitreoretinopathy.

METHODS: Totally 96 cases(103 eyes)of patients with cataract and vitreoretinopathy were divided into observation group(48 cases 51 eyes)and control group(48 cases 52 eyes)by computer random number method. Observation group was given 23G minimally invasive system combined with phacoemulsification and vitrectomy, and control group was given conventional phacoemulsification and vitrectomy. The changes of best corrected visual acuity(LogMAR visual acuity), intraocular pressure and corneal astigmatism degree were observed before operation and at 1, 3 and 6mo after operation, and the complications were observed as well.

RESULTS:At 1, 3 and 6mo after operation, the LogMAR visual acuity in the two groups were lower than those before operation, and they were gradually decreased(P<0.05), and the LogMAR visual acuity in observation group at the same time point were lower than those in control group(P<0.05). The intraocular pressure in the two groups was lower than that before operation, and it was with a gradual decrease trend(P<0.05), and the intraocular pressure in observation group was lower than that in control group at the same time(P<0.05). Compared with before operation, the corneal astigmatism degree was increased significantly in the two groups at 1mo after operation(P<0.05), and was decreased gradually to preoperative level at 6mo after operation and the corneal astigmatism degree at 1mo and 3mo after operation in observation group was lower than that in control group(P<0.05). The incidence rate of postoperative complications in observation group was lower than that in control group(P<0.05).

CONCLUSION: The 23G minimally invasive system combined with phacoemulsification has better efficacy than conventional surgery in the treatment of cataract complicated with vitreoretinopathy, and it is beneficial to the restoration of visual acuity, intraocular pressure, and corneal astigmatism degree, and it can reduce postoperative complications.

Abstract:AIM: To investigate the protective effect of nerve growth factor(NGF)combined with mecobalamine on optic nerve and the influence on matrix metalloproteinase-2(MMP-2), tissue inhibitor of matrix metalloprotease-2(TIMP-2).

METHODS: Totally 54 patients(73 eyes)with acute angle closure glaucoma undergoing trabeculectomy was included in the study, and the patients were divided into the control group(30 cases, 35 eyes)and combination group(24 cases, 38 eyes)according to the digital table method. The patients in the control group were treated with mecobalamine, and the patients in combination group were treated with NGF combined with mecobalamine. Visual acuity, intraocular pressure, mean light sensitivity(MS), visual field mean defect(MD), retinal nerve fibre layer(RNFL)thickness, the nipple cup/disc ratio, P100 wave incubation period and amplitude of P100 wave, neuron-specific enolase(NSE), nitric oxide(NO), nitric oxide synthase(NOS), matrix metalloproteinase-2(MMP-2), metalloproteinases tissue inhibiting factor-2(TIMP-2)before and after treatment were observed in the two groups. The adverse reactions during medication were supervised.

RESULTS: Compared with those before treatment, visual acuity, MS, and P100 wave amplitudes increased, MD and P100 wave latency decreased(P<0.05)after treatment, the change ranges in combination group were greater than those in control group(P<0.05). There was no significant change in intraocular pressure, RNFL, the nipple cup/disc ratio before and after treatment in the two groups(P>0.05). Compared with those before treatment, serum NO, NOS, MMP-2 levels in the two groups increased, and the levels of NES, TIMP-2, TIMP-2/MMP-2 decreased(P<0.05), but the change degrees in combination group were greater than those in control group(P<0.05).

CONCLUSION: NGF combined with mecobalamine can improve postoperative visual function of glaucoma, which has certain regulatory effects on MMP-2 and TIMP-2.

Abstract:AIM: To investigate the effects of par plana vitrectomy(PPV)+ inner limiting membrane(ILM)flat covering + vitreous cavity disinfected air filling and PPV + ILM stripping + vitreous cavity disinfected air filling on giant idiopathic macular hole(IMH)and high myopia macular hole(MH).

METHODS: The clinical data of giant IMH 40 eyes and giant high myopia MH 40 eyes were compared. Twenty patients with giant IMH underwent traditional ILM removal(Group A1), the remaining 20 underwent ILM flat transplantation(Group A2); 20 underwent traditional ILM removal(Group B1)for giant high myopic MH, and the remaining 20 underwent ILM flat transplantation(Group B2). The closure rate of MH and the improvement of best corrected visual acuity(BCVA)before and after operation were compared and analyzed.

RESULTS: There were significant differences in BCVA before and after operation in Group A(F=96.193, P<0.001), between A1 and A2(F=4.971, P=0.03), and the interaction between different time points and groups after operation(F=18.772, P<0.001). The results showed that there were significant differences of the two groups between any two time point(P<0.05). The t-test results between the two groups at different time showed that there was no difference in preoperative vision between A1 and A2(P>0.05). There were significant differences in preoperative visual acuity between the two groups at 1, 3 and 6mo after operation(P<0.05). There were significant differences in different time points before and after BCVA in Group B(F=136.150, P<0.001), B1 and B2(F=5.179, P=0.029), and the interaction between different time points and groups after BCVA(F=7.079, P=0.001). The results showed that there were significant differences of the two groups between any two time point(P<0.05). The results of t-test between the two groups at different time showed that there was no difference in preoperative visual acuity between B1 and B2(P>0.05), but there was significant difference in 1, 3 and 6mo after operation(P<0.05). After 6-month follow-up, the closure rate of Group A1 was 80%, attached rate was 20%, closure rate of Group A2 was 100%. There was no significant difference in closure rate between Group A1 and Group A2(P=0.053). The closure rate of Group B1 was 70%, attached rate was 30%, closure rate of Group B2 was 90%, attached rate was 10%. There was no significant difference in closure rate between Group B1 and Group B2(P=0.118). There was significant difference in closure rate between retinal initial membrane stripping group and plaster group(75% vs 95%, χ²=4.057, P<0.05).

CONCLUSION: For giant IMH and giant high myopia MH, there was significant difference in closure rate and BCVA improvement between ILM stripping group and covering group, on which the former is better.

Abstract:AIM: To investigate the correlation between macular morphology and visual acuity and visual deformation in acute central serous chorioretinopathy(CSC).

METHODS: A cross-sectional clinical case-control study was conducted in which 38 patients with acute monocular CSC(CSC group)and 38 normal eyes(control group)were included. The best corrected visual acuity(BCVA), slit lamp microscope, indirect ophthalmoscope, frequency domain optical coherence tomography(OCT), color fundus photography and M-charts were performed in all subjects. The BCVA was converted to the minimum resolution angle LogMAR record when doing statistical. The mean LogMAR, macular retinal thickness(CFT), subretinal fluid thickness(SRF), transverse diameter length of subretinal fluid in macular area and visual deformation(M value)were significantly different between the two groups. The correlation between CFT and SRF, transverse diameter length of subretinal fluid in macular area and M value was analyzed.

RESULTS: The mean BCVA in acute CSC group was 0.15±0.15(LogMAR), that in control group was 0.12±0.12(LogMAR); CFT was 418.89 ±134.74μm in CSC group and SRF was 286.95±136.77μm in CSC group. The length of subretinal fluid transverse diameter in macular area was 2926.37±1109.66μm. CFT in control group was 217.58±12.49μm, SRF was 0, and the transverse diameter of subretinal fluid in macular area was 0. The M value of CSC group was 0.86±0.40, MH and MV were 0.99±0.38, 0.73±0.43, respectively. Compared with MV, MH was obviously aggravated, the difference was statistically significant(t=4.564, P<0.01). There was no correlation between BCVA and the degree of visual deformation in CSC group(r=-0.124, P>0.05). In CSC group, BCVA had no correlation with SRF or the length of subretinal fluid transverse diameter in macular area(r=-0.059, -0.12; P=0.73, 0.48; respectively.)There was a positive correlation between CFT and M value in CSC group(r=0.91, P<0.01). The value of MV was positively correlated with the length of transverse diameter of subretinal fluid in macular area(r=0.934, P<0.01), and the value of MH was positively correlated with SRF(r=0.949, P<0.01).

CONCLUSION: In acute CSC group, BCVA had no correlation with CFT, SRF, macular subretinal fluid transverse length and visual deformability, and visual deformability was positively correlated with CFT, SRF and macular subretinal fluid transverse length; MV was positively correlated with subretinal fluid transverse length, and MH was positively correlated with SRF.

Abstract:AIM:To explore the photodynamic therapy(PDT)combined with intravitreal injection of Ranibizumab(IVR)on visual acuity, central macular thickness(CMT)and postoperative complications in the treatment of polypoidal choroidal vasculopathy(PCV)complicated with vitreous hemorrhage(VH).

METHODS: Totally 71 cases of patients(71 eyes)with PCV complicated with VH were divided into two groups according to the treatment methods. And observation group(n=43)was given PDT with IVR after vitrectomy, and control group(n=28)was only given IVR adjuvant treatment. The best corrected visual acuity(BCVA), CMT and postoperative complications were followed up at the 1^st, 3^rd and 6^th month after treatment.

RESULTS: After treatment, the BCVA in the two groups was gradually improved while the CMT was gradually decreased with time, and the difference within-groups at different times was statistically significant(P<0.05), and there were statistically significant differences in BCVA and CMT between the two groups at the same time after treatment(P<0.05). After treatment, the closure of CNV lesion in observation group was significantly better than that in control group(P<0.05), and the complete closure rate was higher than that in control group(χ²=4.508, P<0.05). There was 6 cases(14%)of related complications in observation group after treatment and 5 cases(18%)in control group, and there was no statistically significant difference between the two groups(P>0.05).

CONCLUSION: PDT combined with IVR for patients with PCV and VH after vitrectomy is beneficial to promote the absorption of vascular exudate and the elimination of polypoid lesions, thus reducing macular edema, improving the visual acuity and reducing postoperative complications. And its clinical efficacy and safety are worthy of recognition.

Abstract:AIM: To probe into the related influencing factors of serum lipoprotein associated phospholipase A2(Lp-PLA2)level in patients with diabetic retinopathy.

METHODS: Totally 174 cases of patients with type 2 diabetes mellitus and who treated in Department of Endocrinology from September 2015 to September 2017 were selected as the research objects, and were divided into the non-diabetic retinopathy group(NDR), non-proliferative diabetic retinopathy group(NPDR)and proliferative diabetic retinopathy group(PDR)according to the results of fundus examination. Then, the age, sex, body mass index(BMI), blood pressure, blood glucose, blood lipids, vascular endothelial growth factor(VEGF), C-reactive protein(CRP), and Lp-PLA2 levels and other clinical data of three groups of patients were collected and compared.

RESULTS: There was significant differences in the duration of diabetes, fasting blood glucose(FBP), 2h postprandial blood glucose(2hBP), HbA1c, triacylglycerol(TG), total cholesterol(TC), high density lipoprotein cholesterol(HDL-C), low density lipoprotein cholesterol(LDL-C), VEGF, CRP, Lp-PLA2 between the three groups of patients(P<0.05). There was no significant difference in serum TG, TC, HDL-C and CRP levels between NPDR group and NDR group(P>0.05). While there was significant difference in biochemical indexes of patients between PDR group and NDR group(P<0.05). The VEGF, CRP and Lp-PLA2 in the PDR group were significantly higher than those in the NPDR group, and the difference was statistically significant(P<0.05). Pearson correlation analysis found that the serum Lp-PLA2 was positively correlated with age, course of disease, 2hBG, TG, VEGF and CRP(P<0.05). Multiple linear regression analysis showed that serum Lp-PLA2 was positively correlated with the course of diabetes mellitus and serum level of VEGF(P<0.05).

CONCLUSION: The level of serum Lp-PLA2 in patients with diabetic retinopathy are significantly increased, which the level is positively correlated with the duration of diabetes and serum VEGF level, thus it can be used as diagnostic index for diabetic retinopathy.

Abstract:AIM: To investigate the correlation between symptoms and sign of drug users with dry eye.

METHODS: Eighty-seven patients(87 eyes)with dry eye syndrome who were abstained from a compulsory rehabilitation center in Yangpu District of Shanghai from October 2017 to February 2018 were selected as test group. And 90 eyes of 90 patients with non-dry eye syndrome who were abstained from the same center during the same period were selected as control group. All subjects were selected for the right eye. All the patients were analyzed including dry eye questionnaire-5, ocular surface disease index(OSDI)questionnaire survey, symptoms, tear height test, break-up time test, sodium fluorescein staining test, tear osmotic pressure, Schirmer Ⅰ test and Meibomian gland function tests. Pearson and Spearman correlations were used to analyze the relationship between symptoms and signs of drug users with dry eye.

RESULTS: Both the DEQ-5 questionnaire and the OSDI questionnaire scores were negatively correlated with BUT values(r=-0.791, -0.849, P<0.01), and were also positively correlated with corneal fluorescein sodium staining(DEQ-5: r=0.652, P<0.01; OSDI: r=0.571, P<0.05). The scores of DEQ-5 questionnaire and OSDI questionnaire were not significantly correlated with tear height, tear osmotic pressure, Schirmer Ⅰ test, and Meibomian gland functional score. Fatigue, dryness, and visual acuity were the three most common symptoms(69.0%, 63.2%, 55.2%, respectively). The negative correlation was shown between photophobia and tear height(r=-0.218, P=0.023). Dryness, fatigue, pain/sting, visual acuity were also negatively correlated with BUT(r=-0.057,-0.197, -0.053, -0.068, P<0.05). The positive correlation was shown between dryness, fatigue, visual acuity and FL(r=0.169, 0.201, 0.226, P<0.05), tearing and tear osmotic pressure(r=0.315, P=0.013), dryness and Schiemer Ⅰ(r=0.324, P=0.043). Visual acuity was positively correlated with meibomian gland function(r=0.227, P=0.011). The difference in tear height, corneal fluorescein sodium staining, and tear osmotic pressure were statistically significant between dry eye patients and normal group(P<0.05). The differences in BUT, Schirmer Ⅰ test and meibomian gland function were not statistically significant(P>0.05).

CONCLUSION: The clinical symptoms of dry eye in drug users are not obvious, and their correlation with the test results is poor. Clinicians should pay attention to the medical history inquiry, physical examination, and the refinement and individualization of diagnosis.

Abstract:AIM:To study effect of intermittent exotropia operation in children of different ages.

METHODS: Totally 300 cases of children who underwent intermittent exotropia surgery in our hospital from March 2015 to April 2017 were selected as the study subjects. According to the age of children, there were 110 cases in Group A, aged from 3 to 5 years. Group B: 100 cases, ages 6 to 8 years. There were 90 cases in Group C, aged from 9 to 12 years. All three groups of children underwent intermittent exotropia surgery. The clinical efficacy, strabismus before and after operation, fusion function and stereoscopic acuity were compared.

RESULTS: After 6wk, the total effective rate of clinical efficacy in Group A was 92.7%, significantly higher than that in Group B(67.0%)and Group C(68.9%,P<0.05). Before surgery, no statistically significant differences were found in the levels of strabismus, fusion, and stereoscopic acuity between the three groups(P>0.05). At 6wk postoperatively, the children in the three groups had decreased levels of strabismus, and the stereoscopic acuity and fusion function were significantly improved. In addition, the strabismus and stereoscopic acuity of the children in Group A were significantly lower than those in Group B and Group C, and the fusion function was significantly higher than that in Group B and Group C, with statistically significant differences(P<0.05).

CONCLUSION: The age of the children with intermittent exotropia is closely related to the recovery and reconstruction of binocular vision.

Abstract:AIM: To explore the teaching effect of problem-based learning(PBL)on cultivating students' clinical thinking in clinical practice teaching of ophthalmology.

METHODS: A total of 141 clinical undergraduate students were selected to attend the ophthalmology course in the first semester of the 2017-2018 academic year, students were randomly assigned to the traditional lecture based learning(LBL)teaching group of 69 and the PBL model teaching group of 72 in the clinical practice class. The two groups of students studied the same courses at the early stage, and there was no statistically significant difference in college entrance examination scores, gender, age, and practice time of ophthalmology(P>0.05). At the end of the internship, the teaching effects of the two teaching methods were compared and analyzed by means of students' curriculum assessment questionnaire survey and the clinical examination results.

RESULTS: The evaluation of students' satisfaction with the training of various abilities of the course showed that the satisfaction of each ability of the PBL teaching group was higher than that of the traditional teaching group(LBL). Among these abilities, there were statistically significant differences in learning interest improvement, knowledge expansion ability, problem-solving ability and doctor-patient communication ability(P<0.05). The PBL group was higher than LBL group in terms of case analysis and skill operation in clinical assessment, and the difference was statistically significant(P<0.05).

CONCLUSION: PBL teaching method is more effective in clinical practice teaching of ophthalmology, which is beneficial to train clinical thinking and improve teaching quality.

Abstract:AIM: To observe the effects of different duration of diabetes on dry eye and ocular surface before cataract surgery.

METHODS: The patients with diabetes and cataract were included from March to August in 2018. According to the duration of diabetes, the patients were divided into three groups(<5a, 5-15a, >15a). Age, sex, break-up time(BUT), Schirmer Ⅰ test, corneal fluorescein cornea staining(FL), palpebral margin staining score, meibomian glands secretion function score, and ocular surface disease score(OSDI)were compared between the three groups.

RESULTS: There were no significant differences in age and sex between the three groups. There were no significant difference in BUT and Schirmer Ⅰ test and OSDI score among the three groups, but the more duration of diabetes was, the more OSDI score was. FL and the secretion of tarsal gland were significantly different between groups(χ²=8.372, 9.346, P=0.015, 0.009, respectively). There was no significant difference in the shape of palpebral margin(χ²= 0.353, P=0.838).

CONCLUSION: The more duration of diabetes is, more serious the ocular surface and dry eye diseases may be. For the patient with long-term diabetic, more attention should be paid to the eye surface health and perioperative recovery.

Abstract:AIM: To investigate the condition of visual acuity and macular edema after cataract surgery in diabetes mellitus(DM)patients with fundus lesions.

METHODS: Totally 97 eyes of 97 patients with cataract and DM fundus lesion treated in our hospital from January 2016 to September 2017 were selected, and were divided into the observation group A, 43 cases 43 eyes(DM duration <5a), observation group B, 54 cases 54 eyes(DM duration ≥5a). Besides, 60 eyes of 60 patients with simple cataract were selected as the control group. The best corrected visual acuity(BCVA)and macular retinal thickness(foveal area, inner ring area, outer ring area), and the retinal mean sensitivity(MS)were observed before and after the treatment.

RESULTS: BCVA in control group and observation Group A was better than that in observation Group B(0.24±0.09)at 1mo after operation, and the difference was statistically significant(P<0.05). The thickness of fovea, inner ring and outer ring in Group B were 283.30±17.06μm, 335.51±20.26μm and 297.28±20.22μm, which were significantly higher than those in Group A and control group, and the difference was statistically significant(P<0.05). The MS in Group B(11.54±1.89dB)were obviously lower than the observation Group A and the control group, the difference was statistically significant(P<0.05). After 3mo, the total leakage rate of Group B(55.6%)was significantly higher than that of Group A and control group(P<0.0167).

CONCLUSION: Compared with simple cataract patients, the retinal thickness of patients with DM fundus disease is significantly increased, which is easy to has macular edema, and affects postoperative visual acuity recovery, in the patients with longer DM course which are especially obvious.

Abstract:AIM: To investigate the clinical efficacy and safety of EX-PRESS glaucoma drainage combined with phacoemulsification in the treatment of patients with acute angle-closure glaucoma and ocular hypertension with cataract.

METHODS: Patients with acute angle-closure glaucoma and cataract sustained high intraocular pressure who were admitted to our hospital from January 2016 to January 2017 were enrolled in this study. All patients were treated with EX-PRESS glaucoma drainage device combined with phacoemulsification. The anterior chamber depth before and after operation, intraocular pressure, corrected visual acuity at 1, 4, 8, 12, 24, and 48wk after surgery were performed. The success rate of surgery and intraoperative and postoperative complications were recorded.

RESULTS: The anterior chamber depth of the preoperative patients was 1.974±0.182mm, and that after operation was 2.961±0.175mm. The difference was statistically significant(P<0.01). At 1, 4, 8, 12, 24, and 48wk, the intraocular pressure was significantly lower than that before surgery(P<0.05). The proportion of successful patients at 12, 24, and 48wk after surgery gradually decreased, but the total success rate was 100%. The corrected visual acuity of the patients was significantly improved compared with the preoperative 48wk after operation, and the difference was statistically significant(P<0.05). There were no serious intraoperative and postoperative complications in this group of patients.

CONCLUSION: EX-PRESS glaucoma drainage combined with phacoemulsification is safe and effective in cataract patients with acute angle-closure glaucoma with high intraocular pressure.

Abstract:AIM: To study and analyze the clinical effect of phacoemulsification with intraocular lens(IOL)implantation in patients with acute angle-closure glaucoma complicated with cataract.

METHODS: From June 2016 to January 2018, 80 patients with acute angle-closure glaucoma and cataract admitted to our hospital were enrolled in this study. They were divided into two groups according to random number table. They were divided into observation group and control group, respectively. The patients in the control group were treated by phacoemulsification and IOL implantation. The observation group were treated with combined surgery for glaucoma and cataract. The difference between the two groups was compared.

RESULTS: After operation, the visual acuity, intraocular pressure and complications of the observation group were better than those of the control group(P<0.05).

CONCLUSION: The clinical effect of phacoemulsification with IOL implantation in the treatment of acute angle-closure glaucoma with cataract is of great clinical value.

Abstract:AIM: To determine the medium term efficacy of intravitreal ranibizumab injection combined with subsequent trabeculectomy and panretinal photocoagulation(PRP)for the treatment of neovascular glaucoma(NVG).

METHODS: In this retrospective study, 21 neovascular glaucoma patients(21 eyes)were enrolled between January 2015 and March 2017 in the department. All cases received combination therapy with intravitreal injection(IVR)of ranibizumab, subsequent 5-fluorouracil(5-FU)padding trabeculectomy and then pan-retinal photocoagulation(PRP). Intraocular pressure(IOP), visual function, the status of neovascularization of the iris and the anterior chamber angle, the use of anti-glaucoma medications and the surgical complication were recorded during the complete follow-up period of 6mo before and after treatment.

RESULTS: Of the 21 patients, all completed the 6-month follow-up, and 3 completed the 2a follow-up(mean 7.8mo). The IOP of all 21 eyes were well controlled after the combination therapy. The post-operative IOP in the 6mo after treatment was 18.50±3.51mmHg, which was significantly lower compared with the pre-operative IOP(53.17±10.52mmHg, P=0.001). Visual acuity improved after treatment, to some extent. Anterior chamber hemorrhage and vitreous hemorrhage occurred in three surgical eyes, which were absorbed after conservative treatment. Neovascularization of the iris and angle had clearly regressed in all of the patients after completion of the treatment process.

CONCLUSION: The medium outcomes reveals that intravitreal ranibizumab injection combined with subsequent 5-fluorouracil padding trabeculectomy and PRP is a possible new method for NVG.

Abstract:AIM:To investigate the effect of intravitreal injection of anti-vascular endothelial growth factor(VEGF)on choroidal thickness and posterior ciliary artery blood flow in patients with wet age-related macular degeneration(ARMD).

METHODS:A total of 93 wet ARMD patients enrolled into the ophthalmology department in our hospital from September 2014 to December 2016 were selected into our study. The patients were treated with anti-VEGF vitreous injection for 3mo. The central retinal thickness(CRT), subfoveal choroidal thickness(SFCT), best corrected visual acuity(BCVA, LogMAR), choroidal neovascularization(CNV)and parameters of ciliary arterial blood flow \〖systolic peak flow velocity(PSV), end-diastolic blood flow velocity(EDV)and mean blood velocity(mV), resistance index(RI)/pulse index(PI)\〗 before treatment(T0), 1mo after treated(T1), 2mo after treated(T2), 3mo after treated(T3)were recorded and compared. All patients had been followed for 18mo, and side-effect were recorded.

RESULTS: All wet ARMD patients had successfully completed intravitreal anti-VEGF injection. Compared with before treatment, BCVA, CRT, SFCT, and CNV had gradually decreased(F=72.738, 32.333, 7.305 and 957.450, P<0.05)after treatment. BCVA, CRT, SFCT and CNV: T3P<0.05). There had no significant difference in PSV, EDV and mV before and after treatment(F=2.619, 1.942, 0.820, P>0.05). Compared with before treatment, RI index had gradually decreased(F=25.451, P<0.05)and PI index had gradually increased(F=8.660, P<0.05)after treatment. PI: T3>T2≈T1>T0; RI: T3≈T2CONCLUSION: Intravitreal injection of anti-VEGF can effectively reduce choroidal thickness and increase ciliary posterior arterial perfusion, with a good long-term effect and less risk.

Abstract:AIM: To analyze the characteristics of choroidal neovascularization(CNV)in neovascular age-related macular degeneration(nARMD)patients and the outcome of intravitreal anti-vascular endothelial growth factor(VEGF)treatment by using optical coherence tomography angiography(OCTA).

METHODS: A prospective cohort study was carried out, which included 37 eyes of 29 patients with nARMD in West China Hospital during May to December 2017. OCTA scans was conducted to all patients before treatment, 1d, 1wk, 1mo and 3-6mo after treatment. The analysis was performed to evaluate the morphological characteristics, lesion area, parafoveal superficial vessel density and perfusion area of CNV before and after treatment.

RESULTS: Among all the subjects, immature structure, small branches, and capillaries responded well to anti-VEGF treatment. Compared with the mean lesion area in nARMD patients before treatment(1.27±1.88mm²), there was significant reduction(1.13±1.79 mm²)1d after treatment, which meant CNV lesion decreased 1d after treatment, and stabilized 1mo later(P=0.001). Obvious decrease was observed both in parafoveal superficial vessel density(P=0.003)and perfusion area(P=0.015)3mo after treatment in nARMD patients.

CONCLUSION: OCTA, a non-invasive diagnostic examination, clearly identified tiny structures of CNV, quantified the lesion area and displayed specific vasculature in nARMD patients. Furthermore, retinal microcirculation can be detected using OCTA, which provides an effective approach of monitoring the progression and treatment effect of nARMD.

Abstract:AIM: To observe the changes of chemokine macrophage inflammatory protein(MIP-1α)and MIP-1β in peripheral blood of patients with diabetic retinopathy and to analyze its clinical significance.

METHODS: The patients with diabetic retinopathy(DM group), monproli fertive diabetic retinopathy(NPDR group)and proliferative diabetic retinopathy(PDR group)were selected in Foshan Fifth People's Hospital and the Fourth People's Hospital of Nanhai District, Foshan. There were 50 patients were treated in each group, and 50 healthy persons(control group)were selected for the same period. The differences in the levels of chemokine MIP-1 alpha, MIP-1 beta, blood glucose and cytokines in peripheral blood of patients with different groups were observed. The correlation between the levels of chemokine MIP-1α and MIP-1β of peripheral blood in patients with diabetic retinopathy and the level of blood glucose and cytokines was analyzed by Pearson correlation analysis.

RESULTS: The levels of MIP-1α, MIP-1β and mean blood glucose(MBG)in the DM group were higher than those in the control group(t=6.306, 2.954, 3.617; P<0.05). The levels of insulin like growth factor-1(IGF-1), fibroblast growth factor-21(FGF-21)and vascular endothelial growth factor(VEGF)in DM group were higher than those in control group(t=27.216, 7.778, 3.214; P<0.05). The levels of MIP-1α, MIP-1β and MBG in PDR group were higher than those in NPDR group(t=6.620, 3.461, 3.378; P<0.05). The levels of IGF-1, FGF-21 and VEGF in PDR group were higher than those in NPDR group(t=10.260, 12.611, 4.108; P<0.05). The level of MIP-1α and MIP-1β in patients with diabetic retinopathy is positively correlated with the levels of MBG, IGF-1, FGF-21 and VEGF.

CONCLUSION: The levels of MIP-1α and MIP-1β in patients with PDR are relatively high, and are positively correlated with blood glucose and cytokines levels.

Abstract:AIM: To observe the treatment effect and discuss availability of spherical retinal detachment by 23G intra-infusion-assisted scleral buckling.

METHODS: Twenty-one eyes were randomly selected from in-patients with rhegmatogenous retinal detachment with much subretinal fluid and spherical appearance between February 2017 and February 2018, which were suitable for scleral buckling. The 23G intra-infusion was placed in the pars plana of ciliary body before the surgery. Retinal hole was not solidified during operation. Laser photocoagulation was performed around the retinal hole after surgery. Retinal reattachment state and the complications were evaluated by 3 to 10mo follow up.

RESULTS: All patients have undergone operations smoothly. Subretinal fluid was drainage, chroidal bleeding and retinal incarceration did not appear during the operation. Eighteen eyes achieved retinal reattachment on the first postoperative day; Subretinal fluid of two eyes was asorbed fully; One eyes achieved retinal reattachment after the adjustment by the external pressure block. One eyes with recurrence achieved retinal reattachment after vitreoretinal surgery. One eye developed complication with subretinal hemorrhage and the range of bleeding was less than 1PD, which was absorbed after 3mo. There were no eyes found abnormal intraocular pressure, anterior segment ischemia or other sever complications.

CONCLUSION: The 23G intra-infusion was pre-placed before relieving fluid in the scleral buckling of retinal detachment, which can effective keep intraocular pressure stably and reduce the possibilities of explosive suprachoroidal hemorrhage and postoperative choroidal amotio triggered by fast decrease of intraocular pressure. The retina is flat basically and the hole location is relatively accurate, which improve the success of the surgery.

Abstract:AIM:To explore the therapeutic effect and safety evaluation of Qiming Granule on non-proliferative diabetic retinopathy(NPDR).

METHODS: Totally 94 cases(120 eyes)of NPDR patients treated in endocrinology department of our hospital from January 2016 to November 2017 were selected and randomly divided into the control group(n=47, 60 eyes)and the experimental group(n=47, 60 eyes). The control group was treated with calcium dobesilate, and the experimental group was treated with Qiming granule. The clinical efficacy, central macular thickness, retinal circulation time, best corrected visual acuity and adverse reactions between two groups were evaluated and compared after 6-month treatment.

RESULTS: Before treatment, there were no significant difference in central macular thickness, retinal circulation time, and best corrected visual acuity between two groups(P>0.05). After treatment, comparing with the control group, the retinal circulation time were not significantly different, the improvement of macular edema and the recovery of visual acuity were significantly better in the experimental group. The total effective rate of the experimental group was 97%, which was significantly higher than that of the control group(57%), and the incidence of adverse reactions was significantly decreased. The difference was statistically significant(P<0.05).

CONCLUSION: The therapeutic effect of Qiming Granule on NPDR is better than that of calcium dobesilate. Qiming Granule can improve visual acuity, macular edema, the retinal circulation time with less adverse reactions.

Abstract:AIM: To evaluate the safety and efficacy by short-term following up of choroidal neovascularization(CNV)in high myopia treated with intravitreal Conbercept.

METHODS: Totally 19 eyes from 19 high myopia patients with CNV were reviewed after intravitreal Conbercept therapy. They were all diagnosed in the Ophthalmology Department of our hospital between April 2016 and February 2018. They were between 35 to 73 years old and the average age was 55.40±11.75 years old, 8 male and 11 female. The spherical equivalent refractive error of the 19 eyes was ranged from -19.00D to -7.50D whose mean value was -12.70D±3.23D. All these patients received intravitreal conbercept 0.5mg/0.05mL once per month for 3mo. The clinical features like age, gender, systemic disease, best corrected visual acuity(BCVA)and intraocular pressure(IOP), exudation of CNV by fundus fluorescein angiography(FFA)and central macular thickness(CMT)by optical coherence tomography(OCT)were evaluated before the treatment. The BCVA and IOP were observed after 1d, 1wk, 1mo of each treatment, and the CMT was recorded by OCT after 1wk, 1mo of each treatment, also the variety of CNV that present in FFA was observed after 1mo of the last treatment. These data was compared to the basal data that before intravitreal injection of conbercept to evaluate the clinical efficacy, and the adverse drug reaction was noticed as well. SPSS was used to analysis the change of parameters after treatment for CNV secondary to high myopia.

RESULTS: The pre-injection mean BCVA(LogMAR)at baseline was 0.98±0.29. At the last follow-up visit, the mean post-injection LogMAR BCVA was 0.64±0.16. CMT improved from 324.9±55.6μm to 248.7±17.7μm. The mean post-injection LogMAR BCVA and CMT after each time treatment were both improved than before treatment(P<0.05). However, the data observed after injection was not improved between each other(P>0.05). In these 19 patients, elevated IOP did not occur, besides individual patients had conjunctival hemorrhage, no other significant ocular or systemic injection complications or drug-related side effects were observed.

CONCLUSION: The outcomes of this small case series suggest intravitreal Conbercept to be a safe and promising treatment method for CNV secondary to high myopia with both visual and anatomic improvements and the effect is obvious at the first time injection.

Abstract:AIM: To evaluate the efficacy of pseudo-ginseng power for post-vitrectomy vitreous hemorrhage in diabetic patients and provide new insight into the treatment options.

METHODS: Totally 32 eyes of 32 patients with post-vitrectomy hemorrhaged secondary to proliferative diabetic retinopathy were included. Patients were prescribed with pseudo-ginseng powered, 1.5g, twice a day, for 3 consecutive sections(21d). The visual acuity, optical coherence topography image quality and degree of vitreous hemorrhage was assessed before and after the treatment were analyzed to evaluate the efficacy of pseudo-ginseng powder.

RESULTS: No adverse reaction was seen in all subjects after 21d of treatment. And 88% of the patients had improved visual acuity. The mean best corrected visual acuity(LogMAR)was 1.93±0.46 and 1.42±0.5, before and after treatment, respectively. For the patients with visual acuity no worse than 0.02, finger counting to less than 0.02 and light perception, the improvement rate was 100%. For patients with visual acuity from hand motion, the improvement rate was 60%. The improvement rate for optical coherence tomography image quality was 94%, and 94% for degree of vitreous hemorrhage.

CONCLUSION: Pseudo-ginseng power is effective in patients with postvitrectomy hemorrhaged secondary to proliferative diabetic retinopathy. It accelerated the elimination of vitreous hemorrhage and improved the visual acuity as well as decreased the likelihood of re-cooperation.

Abstract:AIM:To investigate the prevalence of demodex folliculorum in eyelashes of elderly patients with Meibomian gland dysfunction(MGD)and to find the correlation between the presence of demodex folliculorum and MGD.

METHODS: The study involved elderly patients(age≥40)who visited Department of Ophthalmology in Fujian Provincial Hospital for the Elderly between September 2017 and March 2018. Patients were divided into MGD group(137 patients 137 eyes)and non-MGD group(96 patients 96 eyes). The patients underwent eyelid examinations by slit lamp, lipid secretion of the Meibomian gland, fluorescein corneal staining(FL), tear film breakup time(BUT). At the same time underwent epilation of eyelashes, and the number of Demodex was counted. The positive rate of demodex was compared between the two groups, the relation of number of demodex with eyelid margin score, lipid secretion of the meibomian gland, FL score and BUT were evaluated.

RESULTS: The positive rate of demodex in MGD group was 89.1%, significantly higher than that of group non-MGD 74.0%(P<0.05). The number of demodex showed significant positive correlations with the eyelid margin(r=0.89, P<0.05), lipid secretion of the meibomian gland(r=0.67, P<0.05), FL(r=0.35, P<0.05)and BUT(r=-0.37, P<0.05). The mild infection rate of demodex mites in non-MGD(60.6%)was higher than MGD(37.7%, P<0.05).

CONCLUSION: There is a strong correlation between ocular moderate or severe demodex mites infection and MGD, suggesting that demodex folliculorum may play a pathogenic role in elderly patients with MGD.

Abstract:AIM: To explore the application effect of mitomycin C in lacrimal duct obstruction during anterograde lacrimal drainage tube implantation.

METHODS:Totally 78 cases of lacrimal duct obstruction(82 eyes)were randomly divided into the observation group(39 cases, 42 eyes)and the control group(39 cases, 40 eyes), and the control group was treated with lacrimal drainage tube implantation. The observation group was based on this combined mitomycin C treatment and compared the effect of two groups.

RESULTS: The total effective rate of the observation group was 81%, which was significantly higher than that of the control group(62%), and the difference between the two groups was statistically significant(P<0.05). The eye surface change score(26.25±1.67)and tear SP content(256.32±10.07pg/mL)were lower than that of the control group after treatment. The tear film rupture time(8.85±0.89s)was shorter than that of the control group(9.58±0.92s), and the two groups were statistically significant(P<0.05).

CONCLUSION: Mitomycin C can improve the efficacy of anterograde lacrimal drainage tube implantation for the treatment of lacrimal duct obstruction and improve prognosis.

Abstract:AIM: To analyze ocular surface changes and risk factors in patients with type 2 diabetes mellitus(T2DM).

METHODS: Totally 118 cases of T2DM patients(236 eyes)admitted from May 2017 to May 2018 were selected as T2DM group, and 100 non-T2DM patients(200 eyes)were selected as control group. The patients were given routine ophthalmic testing, Schirmer Ⅰ test(SⅠt), tear film break-up test(BUT), corneal fluorescein staining test(FL)and conjunctive impression cytology. The cases data were collected for univariate and multivariate Logistic regression analysis so as to analyze the independent risk factors for ocular surface changes in T2DM patients.

RESULTS: The incidence rate of ocular surface changes in T2DM group was significantly higher than that in control group(22.5% vs 7.5%, P<0.05). The SⅠt, BUT and conjunctival goblet cell count in T2DM group were significantly lower than those in control group while the FL and conjunctival squamous metaplasia degree were significantly higher than those in control group(P<0.05). Univariate analysis results suggested that there were significantly differences between T2DM patients with ocular surface changes and T2DM patients without ocular surface changes in terms of age, disease duration, fasting plasma glucose(FPG), plasma total cholesterol(TC), triglycerides(TG), low-density lipoprotein cholesterol(LDL-C), glycosylated hemoglobin(HbA1c), urea, creatinine(Cr), glomerular filtration rate(GFR)and 24h urinary protein(24h UP)(P<0.05). Multivariate Logistic regression analysis showed age, disease duration, TC, TG, LDL-C, HbA1c and Cr were independent risk factors for ocular surface changes in T2DM patients.

CONCLUSION: Ocular surface changes of T2DM patients are more obvious than those of normal people, and T2DM patients have high incidence of ocular surface changes, thus it is necessary to actively correct lipid metabolism disorder and given early prevention for T2DM patients so as to reduce the risk of ocular surface changes.

Abstract:AIM: To investigate the clinical effect of intracameral cefuroxime injection on prevention of endophthalmitis following phacoemulsification.

METHODS: This was a retrospective clinical study. The clinical records were reviewed for 3112 patients(4210 eyes)with cataract phacoemulsification in our hospital from January 2015 to June 2018; 1810 patients(2250 eyes)without intracameral cefuroxime injection were treated as control group from January 2015 to April 2017; 1302 cases(1960 eyes)with intracameral cefuroxime injection were treated as experimental group from May 2017 to July 2018. Patients in both groups were treated with phacoemulsification and intraocular lens implantation. The follow-up period was 1-8mo and the visual acuity and the infectious endophthalmitis were observed and compared.

RESULTS:There were 1 344 eyes with best corrected visual acuity >1.0, 696 eyes with 0.5-0.9, 151 eyes with 0.1-0.4, 59 eyes with <0.1 in control group within 6mo after operation; those in experimental group were 1 136 eyes, 624 eyes, 146 eyes, 54 eyes. No postoperative endophthalmitis case occurred in experimental group. Three postoperative endophthalmitis cases(3 eyes)occurred in control group, 0.13%(3/2250). There was no significant difference between the two groups(P=0.15). All the cases with endophthalmitis were cured. No sever complication was reported with intracameral cefuroxime, corneal endothelium decompensation, retinal toxicity.

CONCLUSION: Intracameral cefuroxime injection is safe and effective in prevention of endophthalmitis following phacoemulsification.

Abstract:AIM: To observe the binocular motion parameters of children and adolescents with myopia anisometropia, and to investigate the influence of myopia anisometropia in children and adolescents on binocular motion parameters.

METHODS: A case-control study was conducted. From September 2014 to May 2016, 82 cases of children aged 7 to 14 who were admitted to the University-Town Hospital of Chongqing Medical University were involved. There were 47 emmetropic children as the control group and 35 myopic anisometropic children as the experimental group. We measured the diopter, separated lateral phoria at distance(5m)and near(40cm), gradient and computational AC/A ratios, accommodative function, as well as accommodative function,including fused cross cylinder(FCC), negative relative accommodation/ positive relative accommodation(NRA/PRA), AMP and accommodation facility(AF).

RESULTS: The separated lateral phoria at distance(5m)and near(40cm), FCC, PRA, gradient and computational AC/A ratios had significant different between two groups(P<0.05). Between two groups, AF, NRA had no significant difference found, the same as difference between the detected AMP and minimum normal AMP(P>0.05).

CONCLUSION: Myopia anisometropia in children and adolescents had a significant effect on separated lateral phoria at distance(5m)and near(40cm), FCC, PRA, gradient and computational AC/A ratios.

Abstract:AIM: To compare and analyze the changes of the anterior corneal surface, posterior surface and total corneal high-order aberration between femtosecond small incision lenticule extraction(SMILE)and implantable collamer lens(ICL)in the correction of moderate and low myopia.

METHODS: Retrospective Study. Patients underwent SMILE surgery(n=35)or ICL surgery(n=35)with moderate or low myopia were selected in the refractive center of the Xi'an Aier Eye Hospital from November 2017 to February 2018. Before and 1, 3 and 6mo after surgery, the Scheimpflug phase formation based on Ray Tracing technology was applied to evaluate the anterior corneal surface, posterior surface and total corneal high-order aberration with a diameter of 6mm. Repeated measurement ANOVA was used to analyze the mean square root of corneal coma, spherical aberration and total high-order aberration at different time points.

RESULTS: The post-surgery uncorrected visual acuity of both the SMILE group and the ICL group at 1, 3, and 6mo reached or exceeded the pre-surgery best corrected visual acuity, and the pre-surgery corneal aberrations of the two groups were not statistically significant(P>0.05). One month after surgery, the precorneal high-order aberration of the SMILE group was significantly increased(P<0.05), while the precorneal high-order aberration of the ICL group was unchanged(P>0.05). Post-corneal aberration of the two groups was not statistically significant(P>0.05). After surgery, and the differences of coma, spherical aberration and total high-order aberration between the two groups were not significantly(P>0.05).

CONCLUSION: Compared with SMILE surgery, precorneal high-order aberration induced by ICL is less for moderate and low myopia in the short term.

Abstract:AIM: To evaluate the effect of astigmatism on optical quality in young myopic patients by a double-pass system.

METHODS: Retrospective series of case studies, 258 young myopia patients(479 eyes)were selected and divided into four groups according to the degree of astigmatism: -1D< astigmatism ≤0 for Group L, -2D< astigmatism ≤-1D for Group M, -3D< stigmatism ≤-2D for Group H, -4D≤ astigmatism ≤-3D for Group S. Optical Quality Analysis System(OQASTM II)based on double-pass system was used to examine the patient's optical quality, the following parameters were analyzed: MTF cutoff, OSI, SR, OV100%, OV20%, and OV9%.

RESULTS: As the degree of astigmatism incresaes, MTF cutoff, SR, OV100%, OV20% and OV9% gradually decrease and OSI increases; Except for Group L and the Group M(P>0.05), the difference of MTF cutoff and OSI between the other groups were statistically significant(P<0.05). In this study, there were no significant correlation between MTF cutoff and SR in age, and negative correlation with the degree of astigmatism. OSI had no significant correlation with age and was positively correlated with the degree of astigmatism.

CONCLUSION: The degree of astigmatism has a significant influence on the objective optical quality of low-to-moderate myopia in young people. As the degree of astigmatism increases, the optical quality gradually decreases.

Abstract:AIM: To investigate the incidence of amblyopia in preschool children and correlation factors in Bao'an District of Shenzhen so that to provide possible basis for the prevention of regional amblyopia.

METHODS: Totally 818 preschoolers with visual acuity screening were selected and studied from June 2017 to February 2018 in our Hospital. The incidence of amblyopia in children was recorded with the amblyopia diagnostic criteria and they were treated as observation groups. The others were treated as controls. The single factor and multivariate Logistic regression analysis were performed for the two groups.

RESULTS:The incidence of amblyopia in preschool children in Bao'an District of Shenzhen was 5.7%(47/818). Among them, ametropic amblyopia was the most common(63.8%), the second was anisometropic amblyopia(21.3%), the third was strabismic amblyopia(12.8%)and in the end was form deprivation amblyopia(2.1%). By single factor analysis: there were statistically significant differences between two groups for the correlation factors of gestational age, gravidity and parity history, gestational weeks and nearsightedness(amblyopia)family history(P<0.05). By multivariate Logistic regression analysis: the older gestational age, more gravidity and parity, shorter gestational weeks and positive nearsightedness(amblyopia)family history were the highest risk factor for children with amblyopia(P<0.05).

CONCLUSION: The incidence of amblyopia in preschool children in Bao'an District of Shenzhen is high and it should be taken seriously. In the meantime, there are many influencing factors. But comprehensive preschool vision screening is an effective method for early discovery, early diagnosis and early treatment.

Abstract:AIM: To investigate the clinical efficacy of visual function training in the late stage of ametropic amblyopia treatment.

METHODS: One hundred and twenty two children patients and 244 eyes with ametropic amblyopia, which were ranged from January 2016 to December 2016, were enrolled in the prospective case control study. Patient inclusion criteria: spherical power≤ ±3.00D, absolute value of astigmatism(hereinafter referred to as the degree of astigmatism)≥2.00D, binocular spherical lens difference ≤1.50D, binocular cylinder difference ≤1.00D. All patients received preliminary treatment. After routine optometry and amblyopia treatment, visual acuity in amblyopic eyes improved to more than 0.6 and visual acuity difference between two eyes should be less than 2 lines in visual chart testing. Enrolled patients were randomly assigned into a training group(62 cases 124 eyes)and a control group(60 cases 120 eyes). All patients had routine glasses with a combination of both family and clinic training. Treatments in the control group included: amblyopia training instrument(light brush, red flash and grating etc.)and fine stimulation training through computer software. In addition to similar treatments in control group, patients in training group also received following treatments including monocular adjustment function training, binocular adjustment function training, binocular integration and fusion function training. After 6mo, visual acuity, near stereopsis, adjustment amplitude, adjustment sensitivity and adjustment response tests were compared and statistically analyzed in patients of both control and training groups.

RESULTS: Our data demonstrated that the overall visual acuity was significantly improved in training group(P<0.05). Additionally, results of near stereopsis function, adjustment amplitude, adjustment sensitivity and adjustment response examination, also displayed significant difference between the two groups(P<0.05).

CONCLUSION: Binocular visual function training has a certain effect in the improvement of successful cure rate, shortening treatment course and establishing a sound stereo vision function in the late stage of children patients receiving a comprehensive therapy.