Abstract:Diabetic retinal disease(DRD)is a disease with a sharp increase in the proportion of retinal disease(RD). Diabetic macular edema is the leading cause of vision loss. The treatment of diabetic macular edema has always been a hot topic in medicine. The diagnosis and treatment of diabetic macular edema is the latest treatment guideline for diabetic macular edema published by the European Association of Retinal Experts. It is considered to be the most representative guide at present. Detailed interpretation in this article will help the majority of ophthalmologists have a new understanding of the diagnosis and treatment of diabetic macular edema.

Abstract:AIM:To evaluate the effects of reduced glutathione(GSH)and niacin combination on protein oxidative stress, endoplasmic reticulum(ER)stress, glycation, and aggregation of the αβ crystalline in human lens epithelial(HLE)cells treated with high glucose levels.

METHODS:HLE cells were cultured and exposed to 25 mmol/L glucose to promote high glucose conditions. Groups of cells were co-treated with three different combinations of dosages: 10 μmol/L GSH+2 μmol/L niacin, 30 μmol/L GSH+25 μmol/L niacin, and 100 μmol/L GSH+25 μmol/L niacin. After 72h incubation, protein carbonyl content(PCC)and glucose reactive protein(GRP78)content were assessed using ELISA examinations. After two-week incubation, advanced glycation end products(AGEs)were also assessed and the expression of αβ crystalline was measured using Western Blot examination. The SPSS 18.0 statistical package was used for all data analyses.

RESULTS:PCC and GRP78 levels in the co-treated groups were not significantly reduced compared to control(P>0.05). In contrast, there was a significant decrease of the AGEs levels in all groups co-treated with GSH and niacin when compared with the control group(P<0.05). In addition, the αβ crystalline expression increased after high dose glucose administration, but decreased in all groups co-treated with GSH and combinations of GSH and niacin.

CONCLUSION:The results suggest that combinations of GSH and niacin inhibit the aggregation of proteins and prevent glycation in hyperglycemic human lens epithelial cells. This study shows that this combination may play an active role in preventing diabetic cataract mainly from the AGEs pathway.

Abstract:AIM: To explore whether low myopia would affect cerebral visual functions by comparing perceptual eye position(PEP), fixation stability and stereoacuity tests between low myopic and normal adolescents.

METHODS: Totally 120 adolescents matched in age and gender participated in our study. Subjects were divided into three groups according to their refractive states. The cerebral visual functions tested in our study included perceptual eye position(PEP), fixation stability and stereoacuity. Stereoacuity tests involved in our study could be categorized into two parts. The first part was classical stereo tests including Titmus and synoptophore stereo test. The second part was 3D random-dot test for zero-order stereoacuity(hereinafter as zero-order test)at different viewing distances(0.8 m and 1.5 m).

RESULTS:1)PEP: the deviation of horizontal PEP was significantly larger in non-anisometropia when compared to control group. Both horizontal and vertical PEP bias pixels were significantly larger in anisometropia group. 2)χ² test showed that both non-anisometropia group and anisometropia group had more trouble in holding their fixation stable. Moreover, anisometropia group had more abnormal results than other two groups. And in zero-order test at 1.5 m, both non-anisometropia and anisometropia had more abnormal results in stereoacuity than control group. The correlation between fixation stability and near stereoacuity(Titmus and zero-order stereoacuity at 0.8 m)was weak and positive.

CONCLUSION:Low myopic adolescents still have certain defects in cerebral visual functions; Examinations used in our study were useful in assessing cerebral visual functions. They could provide better follow-up evaluation and solid ground for further specific treatments in treating defects of cerebral visual functions. So far, local retinal environment has been the focus on the development in myopia. Our results suggested that researchers might pay more attention on visual cortex in studying the mechanisms of myopia in the near future.

Abstract:AIM: To investigate the role of bone marrow mesenchymal stem cells(BMSCs)under hypoxia on vascular endothelial cell migration and lumen formation.

METHODS: Three kinds of conditioned media(CM)were prepared which including control group(vascular endothelial cells conditioned medium, VCM), normoxic BMSCs-CM group(NCM), and hypoxic BMSCs-CM group(HCM). Then the migration and lumen formation of human umbilical vein endothelial cells(HUVECs)and monkey choroid-retinal vascular endothelial cells(RF/6A)were detected after cultured with the above three kinds of CM respectively for 6-24h.

RESULTS: The numbers of cells migration and the tubes formation(including the total length of the tubes and the numbers of branches)in the hypoxic group(HCM)were increased significantly compared with the control group and the normoxic group(P<0.05). The numbers of migrated RF/6A cells were 19.00±3.61, 32.33±3.06, and 114.00±11.53, respectively in control group(VCM), normoxic group(NCM)and hypoxic group(HCM)after treated for 24h(F=153.3, P<0.001). And the numbers of migrated HUVECs were 76.00±9.54, 122.00±18.68, and 307.70±25.97, respectively in three groups(F=121.5, P<0.001). After incubation of RF/6A cells with three different CM for 6h, the numbers of tubes formation were 12.00±3.00, 37.00±4.58, and 51.00±3.61, respectively(F=81.7, P<0.0001). The results of lumen formation of HUVECs in three groups were similar with that of RF/6A.

CONCLUSION: BMSCs can promote the migration and lumen formation of vascular endothelial cells under hypoxia. This mechanism may play a role in retinal neovascularization.

Abstract:AIM: To investigate the effect of berberine on proliferation of in vitro pterygium fibroblasts and its possible mechanism.

METHODS: Pterygium fibroblast obtained from cultured pterygium tissue after surgical excision. Pterygium fibroblasts cells apoptosis level, mitochondrial membrane potential and apoptosis-related factors mRNA and protein expression levels were detected after the induction of berberine with different final concentrations(0, 20, 40, 80μmol/L).

RESULTS: Berberine increased the mitochondrial depolarization level, apoptosis rate, expression level of pro-apoptotic gene Bax, Bad mRNA and protein, and decreased the expression level of Bcl-2 gene mRNA and protein in vitro pterygium fibroblasts cells in a dose-dependent manner.

CONCLUSION: Berberine may induce in vitro cultured pterygium cell apoptosis by increasing mitochondrial depolarization.

Abstract:AIM: To observe changes in the flash electroretinogram(ERG)and retinal microcirculation in mice suspended by their tails, an animal model that simulates cephalad movement of bodily fluids under conditions of microgravity.

METHODS: Thirty-six adult male C57BL/6J mice(36 eyes)were randomly divided into three experimental groups and three control groups. Mice in the experimental groups were tail-suspended for 15d(Group one), tail-suspended for 30d(Group two), or tail-suspended followed by returning to normal position for 30d(Group three). Three control groups were similarly fixed with a harness but kept in the normal position for corresponding periods of 15, 30, and 60d. The mice were immediately examined using scotopic ERG(including oscillatory potentials \〖OPs\〗)and fundus fluorescein angiography(FFA)in vivo, and subsequently sacrificed to analyze the retinal histology(methods including immunohistochemistry and TUNEL staining)in vitro. Independent sample t-test was used for data comparison between the same time-point groups.

RESULTS: Following 15-days' tail-suspension, scotopic ERG showed a decline in OPs, but not in the b-wave; the second OP(O₂)showed an amplitude of 197±33μV, which was about 60% of the control level(t=-5.938, P<0.001). Following 30-days' tail-suspension, ERG recovered, with O₂ showing an average value of 264±39μV; when compared to the corresponding control group(308±41μV), no significant difference was observed(t=-1.887, P>0.05). Morphologically, only the 15-days' tail-suspended mice showed FFA with microvascular dilation and tortuosity. Rhodopsin and cone-opsin were almost normal and no apoptotic-positive signals were detected in the retinas of the three tail-suspended groups.

CONCLUSION: Simulating cephalad shifting of bodily fluids as under microgravity, using short-term tail-suspension can affect rodent ERG and retinal microcirculation; however, the change is reversible with no obvious permanent injury observed in the retinas.

Abstract:AIM: To investigate the survival time and distribution of rabbit corneal stromal cells(CSCs)after transplantation of rabbit corneal in vitro.

METHODS: Primary rabbit CSCs was cultured in vitro and identified by immunohistochemical staining. using lentivirus(LV)with marker gene enhanced green fluorescent protein(EGFP)transfection rabbit CSCs, the growth status and fluorescence intensity of the transfected cells were observed under an inverted fluorescence microscope. The in vitro animal experiments were randomly divided into 2 groups. experimental group lines of LV-EGFP tag of rabbit CSCs suspension stromal injection, control group amount of normal saline injection corneal stroma, Frozen sections were taken 1wk and 1mo after surgery to observe the fluorescence of transplanted CSCs, and hematoxylin-eosin(HE)was used to observe the tissue morphology of paraffin sections.

RESULTS: LV-EGFP transfected rabbit CSCs showed a small amount of fluorescence after 24h under an inverted fluorescence microscope, with the strongest at 96h and 110h. There was no significant difference in the morphology of the transfected CSCs and normal CSCs. Green fluorescence can be seen in the stromal layer of the cornea in the experimental group at 1wk and 1mo, while there is no green fluorescence in the control group. Paraffin section for 1wk showed obvious epithelial cell hyperplasia and slight corneal edema in the experimental group, and a small amount of inflammatory cell infiltration. 1mo after surgery, the epithelial cell hyperplasia was weakened in the experimental group, and no corneal layer edema was observed. No obvious abnormality was found in the control group for 1wk and 1mo.

CONCLUSION: Extracorporeal corneal stroma transplantation of LV-EGFP labeled rabbit CSCs can survive at least 1mo in the corneal and is compatible with adjacent tissues.

Abstract:AIM: To compare the visual quality of bifocal(AT LISA 809MP)and trifocal(AT LISA tri 839MP)IOLs after implantation.

METHODS: Retrospective study. A total of 49 eyes of 28 patients with cataract who underwent phacoemulsification combined with multifocal IOL implantation from March 2018 to February 2019 were collected. There were 30 eyes of 18 patients in the bifocal group, aged 40-85(mean 67.08±10.80)years. The trifocal group consisted of 19 eyes of 10 patients, aged 38-79(mean 62.21±14.50)years. All patients underwent visual quality analysis system(OQAS), defocus curve and other examinations.

RESULTS: The near BCVA of the two focus groups was better than that of the three focus groups, and the medium UCVA and far BCVA of the three focus groups were better than those of the two focus groups(all P<0.05). The trifocal group had better visual acuity at +1.5, -1.0, -1.5, -2, -2.5D and -3.0D defocus than the bifocal group. OQAS visual quality parameters were better in the two-focus group than in the three-focus group in OV 20%, OV 9%, and SR(all P<0.05).

CONCLUSION: Both bifocal and trifocal IOL implantation can achieve good uncorrected and near visual acuity and high visual quality, while trifocal IOL can achieve better intermediate visual acuity.

Abstract:AIM: To study the efficacy of laser combined with ranibizumab in the treatment of proliferative diabetic retinopathy(PDR)and its effects on levels of plasminogen activator inhibitor(PAI), tissue plasminogen activator(t-PA)and vascular endothelial growth factor(VEGF)in aqueous humor.

METHODS: Totally 76 cases of patients(76 eyes)with PDR were divided into observation group(n=41)and control group(n=35)according to the use of ranibizumab or not. Control group was given routine laser surgery, and observation group was added with ranibizumab for adjuvant treatment. The laser energy and density used in treatment, and the best corrected visual acuity(BCVA), central macular thickness(CMT)and levels of PAI, t-PA and VEGF in aqueous humor after treatment, postoperative complications and prognosis were compared between the two groups.

RESULTS: The sunfleck quantity, laser energy and energy density in observation group were lower than those in control group(P<0.05). After treatment, the BCVA in the two groups was gradually increased while the CMT was gradually decreased, and the difference within-groups at different times was statistically significant(P<0.05), and the BCVA in observation group was higher than that in control group at the same time while the CMT was lower than that in control group(P<0.05). After treatment, the levels of VEGF, t-PA and PAI in aqueous humor were gradually increased, and were significantly lower than preoperative levels(P<0.05), and there was a statistically significant difference at different time points within-groups(P<0.05), and the levels of VEGF, t-PA and PAI in aqueous humor in observation group were lower than those in control group at the same time(P<0.05). The incidence rates of postoperative macular edema in the two groups were 17% and 37% respectively(P<0.05). The PDR recurrence rates at 1a after operation were 6% and 16% respectively(P>0.05).

CONCLUSION: Laser combined with ranibizumab for PDR can significantly reduce the expression levels of serum VEGF, t-PA and PAI in aqueous humor, decrease the CMT, and improve the BCVA. And combined therapy is beneficial to reduce the sunfleck quantity, laser energy and energy density during treatment, and lower the laser damage towards the retina.

Abstract:Endotoxin-induced uveitis(EIU)has been established as a common model of a special kind of human uveitis, which has been linked to the infection of Gram-negative bacilli. Despite the florid ocular inflammation, there are no significant histopathological abnormalities in other organs or tissues of rats during EIU induced by systemic injection of endotoxin. The phenomenon that rats' ocular tissues are electively affected by endotoxin may reveal some unknown particular sensitivity of rat's ocular tissues. This article would review published papers on the reason for the particular sensitivity of rats' ocular tissues to endotoxin, which might help to provide new ideas for clinical treatment of human uveitis.

Abstract:Fibrotic disease can disrupt the normally transparent ocular tissues resulting in irreversible loss of vision. A common feature in fibrotic eye disease is the transdifferentiation of cells into myofibroblasts that can occur through a process known as epithelial-mesenchymal transition. Transforming growth factor β has a central role in fibrogenesis by modulating the fibroblast function, inducing myofibroblast transdifferentiation and promoting extracellular matrix accumulation. It has been implicated in numerous fibrotic eye diseases. This article aims to introduce the new progression on TGFβ and fibrotic ocular diseases and its clinical significance for providing the reference in clinical practices.

Abstract:Corneal avascularity is critical for its immune privilege and optical transparency. It remains avascular in spite of being surrounded by vessel-enriched conjunctiva. The endogenous angiogenesis inhibitors are responsible to the cornea's avascularity.MicroRNAs(miRs)are a class of endogenous small non-coding RNAs. Some miRs, such as miR-184, 204, and 21, are involved in the process of corneal neovascularization. In this article, we summarized the studies of miRs related to corneal neovascularization in order to provide a useful guidance for future therapy and research.

Abstract:Diabetic keratopathy is one of the common complications of diabetes in the eye, the main clinical manifestations include dry eye diseases, punctate keratitis, slow regeneration of cornea epithelial, recurrent epiththelial erosions, degeneration of corneal sensitivity and corneal edema. The main pathogenesis is AGES, polyol pathway, the changes of proteinases, etc. This article mainly reviews the pathogenesis of its main clinical manifestations,expect to provide new ideas for clinical treatment.

Abstract:Non-infectious corneal ulceration after uneventful phacoemulsification cataract surgery is a rare complication after cataract surgery. It may be associated with autoimmune conditions and neurotrophic corneal epitheliopathy in patients. Rheumatoid disease, arthritis, Sjogren's syndrome, Crohn's disease, tuberculosis and using non-steroidal anti-inflammatory drugs are all high-risk factors for corneal ulceration after cataract surgery. This article reviews the cases report and clinical manifestations, mechanism of occurrence, prevention and treatment of corneal non-infectious ulceration after cataract surgery.

Abstract:Age-related macular degeneration(ARMD)is a multifactorial disease, genetic factors play important roles in the pathogenesis of the disease. To date, intraocular injection of anti-vascular endothelial growth factor drugs is the first choice for the treatment of wet ARMD, but the response is variable. This review summarizes vascular endothelial growth factor(VEGF)gene, complement factor H(CFH)gene, age-related maculopathy susceptibility 2(ARMS2)gene and high-temperature requirement A-1(HTRA1)gene single-nucleotide polymorphisms(SNP)in the study of pharmacological genetics of wet ARMD. It is still worthy of further investigations that the genetic mechanism of the disease, so that we can provide individualized treatment sequences and predict the response to anti-VEGF therapy.

Abstract:Age-related macular degeneration(ARMD)is one of the main causes which lead to irreversible blindness. Wet ARMD, which is featured by choroidal neovascularization(CNV), takes up 90% in ARMD related blind patients. With the increasing population of aged people in China, wet ARMD has become a severe social and medical issues. Currently, management aiming at wet ARMD is the applications of anti-VEGF agents. Anti-VEGF drugs not only postpone the development of CNV, but also preserve the visual function, improve the prognosis, and reduce the incidence of blindness. However, we still need to focus on the non-response during treatment, long-term maintenance, drug resistance, adverse reactions, and economic effectiveness. Here we review the recent clinical medications on wet ARMD.

Abstract:Central serous chorioretinopathy(CSC)is a disease that associated with multifactors. The specific pathogenesis is not yet clear. Except for subthreshold micropulse laser treatment and reduced dose photodynamic therapy(PDT), drugs based on etiology of CSC, such as anti-vascular endothelial growth factor(VEGF), methotrexate, eplerenone, anti-helicobacter pylori, have been applied to experimental treatment. The purpose of this article is to review the literature in the treatment of CSC, and to provide reference for clinical treatment of CSC.

Abstract:The most severe form of rapidly progressing posterior retinopathy of prematurity(ROP)is aggressive posterior retinopathy of prematurity(AP-ROP). It is a rare disease, usually progresses to stage 5 without through the classic stage 1-3, eventually leading to irreversible loss of vision. The therapeutic approaches mainly include laser photocoagulation, intravitreal injection of anti-vascular endothelial growth factor(VEGF)drugs and vitrectomy. In this article, we reviewed the above advances of AP-ROP treatment.

Abstract:Surgery is the most effective treatment of rhegmatogenous retinal detachment(RRD)which is the most common type of retinal detachment. Nowdays, the postoperative retinal anatomic reattachment is evaluated by indirect ophthalmoscope, optical coherence tomography(OCT), ocular ultrasonography and etc. which are also helping ophthalmologist in diagnosis of RRD. Postoperative visual function is mainly confirmed by the best corrective visual acuity(BCVA), which is mostly chosen by ophthalmologist in prognosis evaluation. However, there were patients with terrific postoperative retinal anatomic reattachment, who should have achieved the BCVA. The factors and the probable mechanism which affect the postoperative visual function of RRD would be summarized in this paper.

Abstract:Subthreshold micropulse laser(SML)consists of short repetitive pulses of laser. This kind of treatment is safe and cheap, and contrary to conventional laser photocoagulation(LPC), SML doesn't involve destruction of retinal cells and leave no scars. The possible mechanism of SML is to stimulate retinal pigment epithelium(RPE)cells for the production of heat shock proteins(HSPs)and regulate its metabolism and improve its function. The clinical indication of SML includes central serous chorioretinopathy(CSC), diabetic retinopathy edema(DME), nonproliferative diabetic retinopathy(NPDR)and proliferative diabetic retinopathy(PDR)and macular edema(ME)secondary to retinal vein occlusion(RVO). This article discussed the mechanism and safety of SML and reviewed the updates of its application.

Abstract:AIM: To systematically evaluate the effectiveness and safety of Qiju Dihuang Pill on xerophthalmia.

METHODS: PubMed, EMbase, Web of Science. The Cochrane Library, CBM, CNKI, VIP and WanFang Data databases were electronically searched to identify randomized controlled trials(RCTs)of Qiju Dihuang Pill on xerophthalmia from the inception of the databases to June 2019. Two reviewers independently screened literatures, extracted data and assessed risk of bias of the included trials. The Meta-analysis was conducted with RevMan 5.3 and Stata 12.0 software.

RESULTS: Totally 17 RCTs with 1 662 patients were included. The results of the Meta-analysis showed that, compared with the control group, the Qiju Dihuang Pill group had statistical difference in BUT(MD=4.32, 95% CI 3.15 to 5.49, P<0.00001), SⅠt(SMD =1.07, 95% CI 0.71 to 1.42, P<0.00001), FL(MD= -1.01, 95% CI -1.61 to -0.40, P=0.001), efficiency(OR=7.22, 95% CI 4.36 to 11.93, P<0.00001). There were no serious adverse reactions in either group. The results of GRADE showed that the level of evidence of BUT, SⅠt, efficiency was low, and the level of evidence of FL was very low.

CONCLUSION: The current evidence indicated that Qiju Dihuang Pill had a better therapeutic effect on xerophthalmia than conventional treatment, and no serious adverse reactions were reported in the study. Considering the limitations of the quality and quantity of the included studies,more well-designed randomized controlled trials are required to verify the above conclusions.

Abstract:AIM: To compare the visual quality and visual related quality of life in cataract patients after implantation of diffractive aspheric bifocal IOL and single focus aspheric IOL.

METHODS: Retrospective non-randomized study was implemented. In clinical application 110 patients(176 eyes)underwent phacoemulsification combined with IOL from October 2016 to December 2017. In details, 56 cases(82 eyes)with diffractive aspheric bifocal IOL(ZEISS AT LISE 809M)and 54 cases(94 eyes)with single focus aspheric IOL(ZEISS CTA 603P), respectively. Three months after surgeries, the main evaluation indices were successively collected, which included visual, the optical quality analysis system(OQAS)of the MTF cutoff, the Strehl ratio, the OSI, the 100% visual acuity(VA), the 20% VA and the 9% VA, as well as the visual function related quality of life scale(NEI-VFQ-25).

RESULTS: 1)VA: there was no significant difference in the corrected distance visual acuity(CDVA)between the two groups(P>0.05). However, there existed significant difference in the near vision(P<0.05); 2)Objective quality visual analysis(OQAS): there was significant difference in the OSI. Regarding the visual acuity of simulated contrast sensitivity between two groups, the 20% VA and 9% VA expressed significant difference(P<0.01); 3)NEI-VFQ-25 questionnaire: there were no significant differences in overall health, general vision, eye pain, distant vision, peripheral vision, social function, color vision, dependence and mental health between the two groups(P=0.88, 0.08, 0.60, 0.36, 0.80, 0.18, 0.41, 0.07, 0.95). But there was significant difference in near vision and social role limitation between the two groups(P<0.05).

CONCLUSION: The 809M intraocular lenses and the 603P intraocular lenses can improve the optical quality of patients after the surgeries. The former one can provide better near vision, but the OSI was higher than the latter one, which may cause some visual interference. There was no significant difference in visual related quality of life after the surgeries generally.

Abstract:AIM: To study the effects of phacoemulsification(Phaco)combined with different types of intraocular lens implantation(IOL)on age-related cataract.

METHODS: A retrospective study was performed on 105 elderly patients with age-related cataract who were treated with surgery in our hospital, and they were divided into group A(35 cases, 51 affected eyes), group B(35 cases, 49 affected eyes)and group C(35 cases, 52 affected eyes). All subjects were treated by IOL+Phaco, and types of IOL in the three groups were three-piece and single-piece Natural and Rayner. The preoperative and postoperative biological measurement indexes and postoperative complications were compared among the three groups.

RESULTS: At 3mo after surgery, the intraocular pressure(IOP)in three groups was significantly decreased(P<0.05)while the angle opening distance(AOD500), trabecular iris angle(TIA500), central anterior chamber depth(ACD), trabecular-ciliary processes distance(TCPD), each quadrant angle, uncorrected visual acuity and best corrected visual acuity(BCVA)were significantly increased(P<0.05). The ACD and TIA500 in group A were significantly higher than those in groups B and C(P<0.05),and there were no significant differences in the uncorrected visual acuity, BCVA and other biological measurement indexes among the three groups(P>0.05). There were significant differences in vertical shift and horizontal shift of intraocular lens among the three groups at 1mo and 3mo after surgery(P<0.05), and the vertical shift and horizontal shift of intraocular lens at 1mo and 3mo after surgery in group A were lower than those in groups B and C(P<0.05), and there were no significant differences in vertical shift and horizontal shift between group B and group C(P>0.05).The incidence rate of posterior capsule wrinkle in group A after surgery was obviously higher than that in group B and group C(P<0.05).

CONCLUSION: The intraocular stability and safety of Phaco+single-piece IOL are better than those of Phaco+ three-piece IOL, but Phaco+ three-piece IOL has deeper ACD after surgery and can prevent the forward shift of IOL, and they have their own advantages and disadvantages.

Abstract:AIM:To investigate the effects of 1.8mm coaxial micro-incision phacoemulsification in cataract patients with diabetic.

METHODS: Totally 130 eyes in 130 patients with type 2 diabetes mellitus were underwent phacoemulsification from January 2017 to December 2018, and they were randomly divided into observation group of 63 cases(63 eyes)and control group of 67 cases(67 eyes). The best corrected visual acuity(BCVA)of the two groups were compared. Average phacoemulsification energy(AVE), effective phacoemulsification time(EPT)were recorded of two groups. Corneal endothelial cell counts, corneal astigmatism and complications of two groups were compared preoperatively and 1wk, 1mo and 3mo postoperatively.

RESULTS: The BCVA in observation and control groups were improved after 7d, 1, 3mo operation(P<0.05). The differences of AVE(t=3.89, P<0.05)in observation and control groups were significant, while EPT(t=0.773, P=0.221)between them were not. The corneal endothelial cell counts between the two groups was not significantly different before surgery(t=1.21, P=0.114), while it reduced a lot postoperatively in both groups. The surgically induced corneal astigmatism of the observation group was much smaller than that of the control group, and the differences were statistically significant. The main complication was corneal edema.

CONCLUSION: The 1.8mm coaxial micro-incision phacoemulsification is helpful to reduce surgically induced astigmatism and has less effect on corneal endothelial cell of patients with type 2 diabetic comparing to normal 3.0mm incision phacoemulsification.

Abstract:AIM: To evaluate the efficacy of phacoemulsification and intraocular lens implantation combined with goniosynechialysis in the treatment of chronic angle-closure glaucoma.

METHODS: Thirty-three patients(35 eyes)with primary chronic angle-closure glaucoma and cataract were enrolled in the Department of Ophthalmology, Xi'an First Hospital from May 2018 to November 2018. The best corrected visual acuity, intraocular pressure, central anterior chamber depth, angle-opening distance at 500μm from the scleral spur, trabecular iris angle, angle closure or adhesion were compared between preoperative and postoperative 6mo.

RESULTS: The best corrected visual acuity of 34 eyes(97%)was improved after operation. 27 eyes(77%)did not need any intraocular pressure lowering drugs after operation, and the intraocular pressure was kept below 21mmHg. The average value of anterior chamber depth, angle-opening distance at 500μm from the scleral spur and trabecular iris angle(2.04±0.31mm, 0.132±0.033μm, 15.44°±3.10°)before operation were significantly lower than the postoperative mean values(3.26±0.29mm, 0.407±0.038μm, 34.26°±3.60°). The range of angle closure or adhesion decreased after operation, and the difference was statistically significant.

CONCLUSION: Phacoemulsification with intraocular lens implantation and goniosynechialysis is an effective way to treat primary chronic angle-closure glaucoma.

Abstract:AIM: The changes of optic disc and macular blood flow in POAG patients with different symptom types of traditional chinese medicine(TCM)were detected by OCTA, and the correlation between them and optic nerve damage was analyzed.

METHODS: Totally 103 eyes of 103 POAG patients were classified according to the different symptom types of TCM. The vascular density of optic disc, the vascular density of macular area, the thickness of peripapillary retinal nerve fiber layer(pRNFL), and the thickness of ganglia cell complex(GCC)were collected by OCTA, and then the differences among them were analyzed. The correlation between the blood flow parameters and visual field of mean deviation(MD)was also analyzed.

RESULTS: There were significant differences in best corrected visual acuity(BCVA), intraocular pressure(IOP)and course of disease among the three groups of POAG patients(F=29.671, 13.05, 108.60; all P<0.01). The differences in macular GCC thickness, pRNFL thickness, optic disc vascular density and macular vascular density in different regions among the three groups were significant(P<0.01). Linear positive correlation were found between optic disc vascular density, macular vascular density and visual field MD(r=0.591, 0.402, all P<0.001).

CONCLUSION: OCTA can be used as an evaluation index for POAG patients with different symptom types, and it can provide a strong objective theoretical basis for the treatment of POAG.

Abstract:AIM:To compare the clinical effects of removing or reserving the epithelial flap in high myopia correction by laser subepithelial keratomileusis(LASEK).

METHODS: Retrospective analysis of 58 patients(115 eyes)with high myopia received LASEK were selected and divided into reserving the epithelial flap group(30 patients, 59 eyes)and removing epithelial flap group(28 patients, 56 eyes)according to the order of the alternating vists. The changes of corneal irritation, epithelial healing time,uncorrected visual acuity and the occurrence of haze after surgery were observed.

RESULTS:Postoperative 1d, 2d, 3d, respectively, the pain score of the two groups were 1.64±0.64, 1.57±0.57; 0.83±0.49, 0.84±0.56; 0.36±0.48, 0.34±0.47, respectively, the differences were not significant(P>0.05). Postoperative 1wk, 1mo, 3mo, respectively, the uncorrected visual acuity of two group was 0.15±0.06, 0.12±0.05; 0.032±0.004, 0.041±0.003; 0.018±0.004, 0.022±0.005, and the differences were not significant(P>0.05). After 1mo, 3mo of surgery, the differences of the haze less than grade one of the two group, respectively, and were not significant(P>0.05), the differences of the haze of grade two of the two groups, respectively, and the differences were significant(P<0.05). The epithelial healing time of the two groups were 4.22±0.30d, 3.89±0.32d(P<0.05). The number of epithelial delayed healing of two groups was 0 eye and 10 eyes(P<0.05).

CONCLUSION:It was similar both the changes of corneal irritation and uncorrected visual acuity of two groups,the rate of level two haze was higher in removing epithelial flap group. The time of healing of epithelium was quick than reserving the epithelial flap group,but the rate of delayed healing and poor healing of epithelium was higher than reserving the epithelial flap group. Therefore, for high myopia, it is worthy of clinical application of reserving the epithelial flap by LASEK.

Abstract:AIM: To investigate the changes of visual function and multifocal visual evoked potential in children with strabismus after intermittent exotropia operation.

METHODS: Totally 91 children with intermittent exotropia from January 2014 to December 2017 were enrolled in the study. All children were treated with surgery. The changes of visual function before and after operation were observed, and the level of multifocal visual evoked potential before and after operation were detected.

RESULTS: The total effective rate was 88% at one week after operation, 86% at 6mo after operation, the mean preoperative strabismus was-38.12^△, and the mean postoperative strabismus was-5.8^△. At 6mo after operation, the number of children with simultaneous vision, fusion and distant stereopsis decreased significantly as compared with that before operation(P<0.01). The orthopedic rate was 68% at 6mo after operation, and the majority of the patients with all or only one or two grade visual function before the operation were positive, which was significantly higher than that of the patients who lost it after operation(P<0.05). From before operation to 6mo after operation, the amplitude response density of the characteristic peak and the latency of the nasal and temporal retinas in the fourth and sixth rings of the children were significantly increased, while the latent period of the inferior retina was significantly decreased(P<0.05).

CONCLUSION: Intermittent exotropia operation can effectively improve the visual function of children and promote the recovery of eye position in children, and the level of multifocal visual evoked potential in children after operation is also improved to some extent. The clinical effect is outstanding, and it is worth popularizing and applying.

Abstract:AIM: To evaluate effects of Qing Mang Yi Hao in the treatment of toxic optic atrophy.

METHODS: A retrospective analysis of 7 patients(13 eyes)suffered from toxic optic atrophy in Department of Ophthalmology, Dongfang Hospital Beijing University of Chinese Medicine, who were diagnosed as liver stagnation and blood deficiency and treated with Qing Mang Yi Hao formula. The formula treatments patients received were varying from 1 to 12 courses, and the clinical follow-up unequally lasted from 6-24mo. Then the formula clinical efficacy was comprehensively evaluated by comparing their visual acuity, visual field, visual evoked potential(VEP)and retinal nerve fiber layer(RNFL)thickness before and after treatment.

RESULTS: Seven cases(13 eyes)consisted of 5 ethambutol-induced optic neuropathy cases(10 eyes), 1 alcohol toxic neuropathy case(1 eye)and 1 rabies vaccine toxic neuropathy case(2 eyes). OCT showed the RNFL thicknesses on nasal and temporal quadrants were significantly thin at their first visits and the tendency of decreasing was noticed on each quadrant of RNFL thickness at the last follow-up. However, the visual acuity of 7 cases(13 eyes)had varying improvements: ≥0.1 4 eyes(31%), 0.06-<0.1 2 eyes(15%), 0.04-<0.06 1 eyes(8%), 0.01-<0.04 4 eyes(31%), no improvements 2 eyes(15%). The total efficacy rate of Qing Mang Yi Hao formula was 64%(27% significant).

CONCLUSION: Qing Mang Yi Hao could improve visual function, delay the progressive optic atrophy of TON, thus plays a significant role in optic neuroprotection.

Abstract:AIM: To observe the clinical effect of modified continuous single straight needle suture in the treatment of early traumatic ciliary body detachment.

METHODS: Totally 25 patients with cyclodialysis associated with macular edema were retrospectively analyzed during 2017-2018. The range of cycloidalysis was determined by ultrasound biomicroscopy(UBM)and the level of macular edema was observed by optical coherence tomography(OCT)before surgery. In the closed state of the eyeball, the modified continuous single-straight needle suture method was used for suture repair, and mydriasis and corticosteroid drugs were applied to control inflammation. Visual acuity and intraocular pressure were observed after operation. Ciliary body reduction was observed by UBM, OCT was used to observe the recovery of macular edema.

RESULTS: Three months after the operation, all the ciliary body detachment of 25 patients were restored, the intraocular pressure returned to normal, the vision was improved, and the macular edema disappeared.

CONCLUSION:It is a minimally invasive, safe and effective operation method to suture ciliary body detachment with single straight needle under the closed state of vitreous body cavity and anterior chamber.

Abstract:AIM: To explore the effect of phacoemulsification and intraocular lens implantation on corneal endothelial cells(CECs)in patients with glaucoma and cataract.

METHODS: The clinical data of 107 patients(113 affected eyes)with glaucoma and cataract who were treated in the hospital during the period from October 2016 to October 2018 were retrospectively analyzed. Patients treated with trabeculectomy or phacoemulsification combined with intraocular lens implantation were included in the control group(n=52, 54 affected eyes)and the study group(n=55, 59 affected eyes). The changes in visual acuity, anterior chamber depth and intraocular pressure before and after surgery, CECs related indexes and incidence of postoperative complications were compared between the two groups.

RESULTS: There was no significant difference in visual acuity between the two groups before surgery(P>0.05). The visual acuity of both groups were significantly improved after surgery(P<0.05), and the improvement in study group was better than that in control group(P<0.05).The anterior chamber depth in both groups increased, while intraocular pressure decreased after surgery(P<0.05). After surgery, anterior chamber depth in study group was significantly larger than that in control group(P<0.05), but there was no significant difference in intraocular pressure between the two groups(P>0.05). The cell area variation coefficient, hexagonal cell ratio, average cell area and corneal center thickness in control group increased significantly, while CECs density decreased significantly after surgery(P<0.05). However, there was no significant difference in CECs related indexes in study group before and after surgery(P>0.05). After surgery, changes levels of CECs related indexes in study group were significantly lower than those in control group(P<0.05). The incidence rates of postoperative complications in study group and control group were 5.1% and 20.4%, respectively(P<0.05).

CONCLUSION: The application of phacoemulsification and intraocular lens implantation in the treatment of glaucoma with cataract can improve the visual acuity and intraocular pressure of patients, maintain structural integrity of CECs, with safety.

Abstract:AIM: To investigate the effect of modified Ahmed drainage valve implantation combined conbercept in the treatment of neovascular glaucoma.

METHODS: Neovascular glaucoma patients(59 cases, 60 eyes)were separated into experiment group(20 cases, 21 eyes)and control group(39 cases, 39 eyes)in our hospital from 2015 to 2018. Patients in the experiment group received Ahmed drainage valve implantation and intravitreal conbercept injection while patients in the control group were treated with ciliarybody photocoagulation. The visual acuity, intraocular pressure and iris neovessels were observed in 3mo after operation.

RESULTS: There was no significantly difference in the preoperative data between the two groups and both of them can decrease intraocular pressure(P<0.05). The intraocular pressure of experiment group was significantly lower than that of control group in 1wk, 1mo and 3mo after treatment(all P<0.05). The iris neovessels disappeared in experiment group, which was significantly different from that in control group(Z=2.74,P<0.05).

CONCLUSION: Modified Ahmed drainage valve implantation combined with intravitreal conbercept injection can effectively decrease the intraocular pressure for a long time and make the iris neovessels vanish.

Abstract:AIM: To analyze the difference of macular retinal thickness between diabetic patients without apparent visual loss and normal subjects.

METHODS: Totally 40 cases(79 eyes)with type 2 diabetes without significant decrease of visual acuity(best corrected visual acuity, BCVA ≥0.8)in our hospital from April, 2018 to June, 2019 were enrolled as observation group and 64 cases(119 eyes)normal persons were enrolled as control group. The average retinal thickness in nine areas of macula, central retinal thickness(CRT), average retinal thickness(ART)and total volume(TV)of all patients were determined by optical coherence tomography(OCT), and the difference of average retinal thickness in nine areas of macula, CRT, ART and TV among them were compared.

RESULTS: The CRT, ART and TV(193.99±14.58μm, 291.07±12.24μm, 8.22±0.35mm³)in the observation group were significantly higher than those in the control group(187.38±12.24μm, 280.54±8.71μm, 7.92±0.25mm³), and the average retinal thickness in nine areas of macula in the observation group was significantly higher than that in the control group(P<0.05).

CONCLUSION: Compared with normal persons, macular retinal thickness and TV are significantly thickened in early stage of type 2 diabetes.

Abstract:AIM: To evaluate the clinical effecacy of the RS-1 silicone tube and the conventional silicone tube in the management of pediatric canalicular lacerations.

METHODS: We retrospectively reviewed the medical records of 48 pediatric patients(48 eyes)with canalicular lacerations admitted for primary repair in the Department of Ocular Trauma of Hebei Eye Hospital from January 2015 to June 2018. The patients were divided into two groups according to the treatment of method: Group A(25 patients, the conventional silicone tube), Group B(23 patients, the RS-1 silicone tube). The management of pediatric canalicular lacerations were performed under general anesthesia. The silicone tube was removed about 3mo after surgery. The surgical time, clinical efficacy and complications were compared.

RESULTS: The mean surgical time between the two groups was 44.92±14.45min in Group A and 31.78±7.40min in Group B, which was statistically significant difference(t=4.02, P<0.01). The clinical efficacy of the two groups was compared. Group A: 20 patients were cured(80%), 2 patients were improved(8%), 3 patients were failed(12%), and the functional success rate was 88%. Group B: 19 patients were cured(82%), 2 patients were improved(9%), 2 patients were failed(9%), the functional success rate was 91%, which was not statistically significant difference(χ²=0.14, P>0.05). The incidence of complications(32% vs 9%)including lower lacrimal point and mild eyelid eversion(1 patient 4% vs 1 patient 4%), slit canaliculus(2 patients 8% vs 1 patient 4%), early tube extrusion(3 patients 12% vs 0%), and nasal mucosal injury(3 patients 12% vs 0%)in Groups A and B, respectively, were comparable. There was statistically significant difference in the incidence of complications between the groups(χ²=3.94, P<0.05).

CONCLUSION: There is no statistically significant difference with the two different types of silicone tube, which have good clinical efficacy, in the management of pediatric canalicular lacerations. But the RS-1 silicone tube is easier to operate, shorter surgical time, less complications and easier to removed.

Abstract:AIM:To study the distribution, drug resistance and epidemic characteristics of pathogenic bacteria in neonatal eye infection in Cangnan County, Zhejiang Province from 2014 to 2018, and to provide the basis for the prevention, diagnosis and treatment of clinical conditions.

METHODS: Totally 108 strains of pathogenic bacteria isolated from 294 eyes specimens from neonatal clinic from January 2014 to December 2018 were identified, common drug sensitivity test and epidemiological characteristics were summarized and analyzed.

RESULTS: The detection rate of pathogenic bacteria in 294 ocular secretions was 36.7%(108/294). The main flora included 48 strains of Staphylococcus epidermidis(44.4%), 16 strains of Staphylococcus aureus(14.8%), 24 cases of Escherichia coli(22.2%), 12 strains of Neisseria gonorrhoeae(11.1%), 5 strains of Corynebacterium diphtheria(4.6%), 2 strains of Enterococcus(1.9%)and 1 case of Streptococcus (0.9%). The main pathogens are highly sensitive to amikacin and netilmicin, and are highly sensitive to jellithromycin and netilmicin. The activity of gentamicin is poor. It has good activity against quinolones.

CONCLUSION:Staphylococcus is the main pathogen of neonatal eye infection, and eye antibiotics commonly used in clinic have good antibacterial activity against all kinds of pathogenic bacteria.

Abstract:AIM: To investigate the Demodex infection in patients with recurrent chalazion and the possible related factors for Demodex infection.

METHODS: Patients diagnosed with "chalazion" in our ocular surface and cornea department from January 2019 to May 2019 were collected. 32 eyes in group A were patients with recurrent chalazion, 30 eyes in group B were patients with primary chalazion, and 35 eyes in group C were patients without eye disease. The positive infection rate of the roots of Demodex lashes was observed by biological optical microscopy. The infection of Demodex in the roots of the eyelashes and the opening of the meibomian glands was observed by vivo laser scanning confocal microscopy.

RESULTS: Observations by biological optical microscope: the detection rate of Demodex in the eyelashes of group A was 78%, which was significantly higher than that of group B(57%)and group C(34%). Observations by confocal microscopy: the detection rate of Demodex in the eyelashes of group A was 88%, which was significantly higher than that of group B(67%)and group C(37%). The detection rate of Demodex in the meibomian gland opening of group A was 69%, which was significantly higher than that of group B(23%)and group C(14%).

CONCLUSION: The rate of Demodex infection in patients with recurrent chalazion is obviously higher. Demodex infection may be one of the pathogenic reasons for recurrent chalazion.

Abstract:AIM: To analyze the correlation and agreement of corneal horizontal diameter(WTW)measured with caliper, IOL Master and Oculyzer anterior segment analysis system.

METHODS: Totally 41 patients with 80 eyes who underwent ICL V4c implantation in our hospital from July 2018 to January 2019 were enrolled. Compare the correlation and agreement of preoperative WTW measured with caliper, IOL Master and Oculyzer anterior segment analysis system respectively.

RESULTS: The mean WTW value measured with caliper, IOL Master and Oculyzer anterior segment analysis system were: 11.73±0.40, 12.03±0.46, 11.54±0.39mm respectively, the value of caliper and IOL Master, caliper and Oculyzer, IOL Master and Oculyzer were highly correlated(r=0.809, 0.826, 0.785, all P<0.01), and the 95% LoA of Bland-Altman analysis were(-0.84, 0.22),(-0.27, 0.64),(-0.07, 1.05)mm respectively.

CONCLUSION: Among the three measuring instruments, IOL Master has the largest measurement value and Oculyzer is the smallest. The three measurement methods have poor consistency and cannot be replaced in clinical application. Whereas, their measurements are highly correlated. In clinical application, the measurements of IOL Master and Oculyzer can be corrected based on the difference with caliper.

Abstract:AIM: To evaluate the therapeutical effects of modified reposition surgery in the treatment of traumatic cyclodialysis, and to explore a better surgical method for traumatic cyclodialysis.

METHODS: Totally 33 cases diagnosed of traumatic cyclodialysis were brought into observation. After accurately dialysis location of ciliary body through ultrasonic biological microscope, all cases received modified ciliary body reposition surgery. The period of follow-up was three to six months after surgery. The observation items included ciliary body status, intraocular pressure, visual acuity and complications and so on.

RESULTS:Among them, 30 cases were completely reposition during 1wk after surgery, 3 cases were found partial cyclodialysis, and then after half a month the three cases above got desirable outcome. Twenty cases were observed high intraocular pressure after surgery, 17 cases of which had high intraocular pressure returned to normal in 3d, 1 case of which had high intraocular pressure returned to normal in 1wk. 2 cases of which had high intraocular pressure were out of control through medicine, finally received anti-glaucoma surgery in 1 case, and the other one case underwent ciliary body laser photocoagulation and the high intraocular pressure was effectively controlled. Postoperative visual acuity was improved to some extent. There was no anterior segment ischemia or corneal macro astigmatism in all cases.

CONCLUSION:The modified reposition surgery in treating traumatic cyclodialysis is a simple, safe, effective, less iatrogenic injuries and fewer complications. It is worthy of clinical application.

Abstract:AIM: To explore the effect of anastomosis surgery for lacrimal canaliculi laceration combined with circular tube implantation.

METHODS: A retrospective study was conducted on 59 cases(59 eyes)from June 2018 to December 2018 with lower lacrimal canalicular laceration. The nasal cut end of lacerated lacrimal canaliculi was found under the microscope, the circular tube was implanted as a support. The tube was removed 3mo after the surgery. All the patients were followed additional 3mo. The therapeutic effect and complications were observed.

RESULTS: All patients were successfully operated. 46 cases(46 eyes)were cured, 5 cases(5 eyes)were improved, 8 cases(8 eyes)had no effect. The overall successful rate was 86%(51/59). No serious complications and eyelid deformity were found.

CONCLUSION: The anastomosis surgery combined with circular tube implantation is an effective treatment for the lacrimal canaliculi laceration.

Abstract:AIM: To evaluate the efficacy and utility of computer navigation technique in the treatment of complex orbital fracture.

METHODS: A retrospective review of 19 patients with complex orbital fractures were conducted. They underwent the reconstructive surgery assisted by image-data-based computer navigation. The pre- and postoperative data of enophthalmos, eyeball movement, diplopia, infraorbital numbness, and orbit CT image were recorded and analyzed.

RESULTS: The processes of pre-operation planning and intraoperative navigation were successful. During the 6 to 18mo postoperative follow-up, enophthalmos was completely corrected in 14 cases, while 5 patients had slight residual enophthalmos. Eyeball movement restriction was completely corrected in 7 cases, and was also improved in 3 cases. Diplopia was disappeared in 10 patients and improved in 2 patients, but still maintained in 1 patient postoperatively. Infraobital numbness was found in 4 cases, and dissappeared in 6mo postoperatively. No serious complications such as optic nerve lesion and vision loss were observed. Postoperative CT scans demonstrated that the fractures were corrected in all cases. The accuracies of the surgeries were satisfying.

CONCLUSION: Computer navigation system is a safe and effictive technique in assisting diorthosis in complex orbital fracture.

Abstract:AIM: To evaluate the clinical application of resorbable implants in orbital fracture repair surgery.

METHODS: A retrospective analysis of 48 eyes in 48 cases of orbital fracture, all patients were treated with resorbable implants for orbital fracture repair. During operations we exposed fully fracture defect range and returned the tissues that entered the paranasal sinus. A resorbable implant was trimmed to proper sizes according to the fracture defect range and fixed with 2 absorbable screws. The accuracy of plate positioning of the reconstructed orbit and the practicability of clinical use of resorbable implant were judged by the ophthalmic examination and computed tomography(CT)scan before and after operation.

RESULTS: All the patients completed the operation successfully and had no serious complications during or after surgery. All the patients had a good anatomical restoration by the postoperative CT scan. One year re-examination after operation, among 18 eyes with limitation of extraocular muscle movement(EOM)before operation 1 eye(6%)with limitation of EOM improved after surgery,17 eyes(94%)with limitation of EOM got cured. Among 30 cases with diplopia before operation 12 cases(40%)with diplopia improved after surgery, 18 cases(60%)with diplopia got cured. Among 32 eyes with enophthalmos before operation 10 eyes(31%)with enophthalmos improved after surgery, 22 eyes(69%)with enophthalmos get cured. Among 40 eyes with suborbital skin numbness before operation 33 eyes(82%)with suborbital skin numbness improved after surgery, 7 eyes(18%)with suborbital skin numbness got cured. Only one eye got lower eyelid entropion after surgery and was resolved by the second correction of entropion.

CONCLUSION: The resorbable implant can repair the fractures of orbital wall well. It is a better material of orbital fracture repairment.

Abstract:AIM: To investigate the effect of silencing SIAH1 gene on H₂O₂-induced apoptosis of human lens epithelial cells.

METHODS: The human lens epithelial cell line HLE-B3 was cultured and divided into normal group, H₂O₂ group(cultured with medium containing 400μmol/L H₂O₂)and H₂O₂+siR-SIAH1 group(transfected with SIAH1 interference sequence, followed by cultured with medium containing 400μmol/L H₂O₂)and siR-NC group(transfected with negative control sequence, followed by cultured with medium containing 400μmol/L H₂O₂). The expression of SIAH1 gene in cells was detected by real-time fluorescent quantitative PCR. The apoptosis rate was detected by flow cytometry. The expressions of p38 MAPK, p-p38 MAPK, Bcl-2 and Bax proteins were detected by Western blot.

RESULTS: The relative expression levels of SIAH1 mRNA in the H₂O₂ group, siR-NC group and H₂O₂+siR-SIAH1 group were higher than that in the normal group(P<0.05). The relative expression level of SIAH1 mRNA in H₂O₂+siR-SIAH1 group was lower than those in the H₂O₂ group and siR-NC group(P<0.05). The apoptosis rates in the H₂O₂ group, siR-NC group and H₂O₂+siR-SIAH1 group were higher than that in the normal group(P<0.05). The apoptosis rate in the H₂O₂+siR-SIAH1 group was lower than those in the H₂O₂ group and siR-NC group(P<0.05). The expression levels of p38 MAPK and Bcl-2 proteins in the H₂O₂ group, siR-NC group and H₂O₂+siR-SIAH1 group were lower than those in the normal group, while the expression levels of p-p38 MAPK and Bax proteins were higher than those in the normal group(P<0.05). The expression levels of p38 MAPK and Bcl-2 proteins in the H₂O₂+siR-SIAH1 group were higher than those in the H₂O₂ group and siR-NC group, while the expression levels of p-p38 MAPK and Bax proteins were lower than those in the H₂O₂ group and siR-NC group(P<0.05).

CONCLUSION: Down-regulation the expression of SIAH1 gene could inhibit H₂O₂-induced apoptosis of human lens epithelial cell line HLE-B3, which might be related to inhibition of p38 MAPK signaling pathway activation.

Abstract:AIM: To analyze both the effects of different risk factors on incidence of retinal vein occlusion and the comparison of difference between risk factors of RVO subgroups.

METHODS:Retrospective case control study. 79 cases of patients treated were collected as RVO group. These cases were further classified into high CRT group(26 cases)and low CRT group(53 cases)according to the CRT whether it is greater than 369μm. In the same time, 59 cases of patients who were conducted surgery of ophthalmology ward in our hospital were also collected. Statistical analysis of risk factors.

RESULTS: After a comparison between these factors and control group, it turns out that there are statistical differences on high blood, carotid artery plaque and HHCY in RVO group(P<0.05). The analysis conducted on two CRT groups revealed that difference exist in obstruction site and smoking(P<0.05).

CONCLUSION: Hypertension, carotid plaque and HHCY are risk factors of RVO. In the two CRT groups, the factors that may affect CRT are obstruction site and smoking.

Abstract:AIM: To observe the changes of retinal nerve fiber layer(RNFL)thickness and visual field loss in patients with severe non proliferative diabetic retinopathy(NPDR)treated by panretinal photocoagulation(PRP).

METHODS: This was a prospective clinical study. From January 2017 to March 2018, 35 patients(52 eyes)with severe NPDR diagnosed in our hospital were selected as photocoagulation group(conventional therapy combined with PRP)and 35 patients(52 eyes)with severe NPDR matched with age and gender in the same period were selected as the control group(conventional therapy, use difrarel, ginkgo leaves tablets, mecobalamin and other drugs to protect blood vessels, improve microcirculation and nourish nerves). The best corrected visual acuity(BCVA), RNFL thickness and visual field of the two groups were compared after 1a after treatment.

RESULTS: There was no significant difference in BCVA before and after treatment in the photocoagulation group(P>0.05), but the BCVA of the control group decreased(P<0.05). There was no significant difference in temporal RNFL thickness(74.5±13.7μm vs 70.8±11.3μm, P>0.05)in the photocoagulation group, and the thickness of RNFL in the other quadrants and the mean RNFL were thinner than those before treatment(P<0.05); there was no significant change in the MS of the corresponding field of vision of the temporal nerve fiber(22.5±8.7dB vs 20.8±7.2dB, P>0.05), the other quadrants and the mean MS were lower than those before treatment(P<0.05). Before and after treatment, the change of RNFL thickness of the patients in the photocoagulation group showed weak positive correlation or no correlation with the change of visual field MS corresponding to the RNFL at nasal, nasal superior, temporal superior, temporal, temporal superior, temporal inferior and average RNFL.

CONCLUSION: PRP can effectively control the further development of severe NPDR and maintain the visual acuity of patients, but the damage of PRP to RNFL and visual field cannot be ignored.