Abstract:Sunlight consists of lights of continuous spectra. Ultraviolet light and blue light in the sunlight have higher energy. High dose exposure to sunlight can cause direct cellular damage. In the eye, sunlight is known to cause pathological changes in various eye structures. We reviewed the studies on the role of sunlight in corneal diseases, cataracts, glaucoma, and age-related macular degeneration in recent years. Possible sunlight-triggered signaling pathways and mechanisms in the eye are summarized. Excessive exposure to sunlight may lead to increased DNA damage, aberrant protein modification and aggregation, and oxidative stress of ocular tissues, and thus results in the development of ocular diseases. Accordingly, physical protection, topical and/or oral antioxidants and small molecules blocking sunlight-activated signal pathways could be used independently or combinedly to prevent and reduce sunlight-induced ocular damages.

Abstract:AIM: To analyze the impacts of the shape of uveal melanoma on retinal structure.

METHODS: Histopathological sections and clinical data from patients with uveal melanoma were retrospectively observed and analyzed, and key indicators including the tumor's shape, size, height-to-base ratio, retinal thinning and retinal invasion were analyzed.

RESULTS: The study included 102 patients(102 eyes)with a mean age of 45.6±12.4 years, with 76(75%)uveal melanomas showing the spindle cell type, 6(6%)showing the epitheloid cell type, 16(16%)showing the mixed cell type and 4(4%)showing predominantly other cell types. Differentiated by tumor locations: 3 cases of ciliary body melanoma(2.9%), 28 cases of ciliary body and choroid melanoma(27.5%), 71 cases of choroid melanoma(69.6%). Retinal thinning was detected in 43(43%)eyes and retinal invasion by the tumor cells in 86(84%)eyes. Maximal tumor height ranged between 1.2 and 15.6(mean: 8.3±3.6)mm, and mean maximal tumor base diameter was 17.3±6.5(range: 4.8-31.2)mm. Mean R-value as ratio of tumor peak height to maximal tumor base diameter was 0.53±0.32. Mean R-value was significantly higher in the group with retinal thinning(n=43)than in the group without retinal thinning(n=59)(0.69±0.31 vs 0.42±0.27; P<0.01). R-value was slightly, however statistically not significantly higher in the group with retinal tumor invasion(n=86)than without retinal tumor invasion(n=16)(0.56±0.33 vs 0.41±0.25; P=0.09).

CONCLUSION: A high R-value indicating a prominent tumor is associated with tissue thinning in the adjacent retina, and marginally significantly with intra-retinal tumor cell invasion. Shape of uveal melanomas's corss section is of importance for the secondary involvement of the adjacent retina.

Abstract:AIM: To investigate whether the curcumin reduce retinal inflammation in animal model and human retinal pigment epithelium(ARPE)-19 cells.

METHODS: In vivo, male C57/B6 mice received intraperitoneal injections of curcumin for 3d before intraperitoneal injection of lipopolysaccharide(LPS; 10mg/kg)to induce retinal inflammation. 24h after LPS application, the mRNA levels of pro-inflammatory cytokines were detected by real-time PCR(RT-PCR). Concanavalin A lectin perfusion-labeling technique evaluated leukocyte adhesion to the retinal vasculature. The protein concentration in the anterior chamber was measured with a protein quantification kit. In vitro, ARPE-19 cells were cultured. The optimum concentration of curcumin was detected by cell counting kit-8(CCK-8)assay. Before stimulated with 5 μg/mL LPS, ARPE-19 cells were incubated with or without curcumin for 1h. Pro-inflammatory cytokines were measured by RT-PCR and ELISA. PI3K/Akt expression was analyzed by Western Blotting.

RESULTS: Curcumin pre-treatment led to significant inhibition of EIU-associated leukocyte adhesion to retinal blood vessels and anterior-chamber protein leakage. The mRNA expression level of inflammatory cytokines was also significantly reduced with application of curcumin in vivo, such as IL-1β, IL-6 and TNF-α. Meanwhile, Curcumin significantly attenuated the expression of IL-6, IL-8 and MCP-1 at both mRNA and protein levels in ARPE-19 cells. Curcumin suppressed PI3K/Akt phosphorylation as well as NF-κB activation in LPS-activated ARPE-19 cells.

CONCLUSION: Curcumin plays a preventive effect on LPS-induced retinal inflammation. The beneficial effect appears associated with inhibiting of the PI3k/Akt signaling pathway.

Abstract:AIM:To compare the results of corneal cross-linking(CXL)with isotonic(IR)and hypotonic riboflavin(HR)in patients with keratoconus.

METHODS: Retrospective study of 29 eyes/keratoconus patients submitted to CXL, 15 eyes with application of IR(IR group)and 14 eyes with application of HR(HR group). The parameters analysed included(1-year follow-up): best corrected visual acuity(BCVA), sphere and cylinder, central and finer pachymetry, mean and maximum keratometry(Km and Kmax respectively), complications and progression.

RESULTS: An increase on the BCVA scale(LogMAR, logarithm of the minimal angle of resolution)was observed in the two groups: 0.26±0.57(IR)and 0.47±0.72(HR)before treatment, and 0.13±0.79(IR)and 0.29±1.52(HR)at the 1y. Only at 1y, the difference was statistically significant(P=0.018, group IR with higher BCVA). The central pachymetry(μm)decreased at 1mo in both groups, and increased in the following months: 497±28 μm(IR)and 432±14 μm(HR)before treatment, and 480±31 μm(IR)and 424±15 μm(HR)to the 1y. The thinner pachymetry(μm)presented the same evolution: 487±29 μm(IR)and 410±20 μm(HR)before treatment, and 468±33 μm(IR)and 413±13μm(HR)at 1y. Km and Kmax decreased in both groups(P>0.05). 6 eyes from each group presented transitory haze. No eye progressed to the 1y.

CONCLUSION:The use of hypotonic riboflavin seems to be a valid alternative for performing the traditional corneal cross-linking technique in eyes with a central corneal thickness of <400 μm.

Abstract:AIM: To explore the effect of low expression of senescence marker protein 30(SMP30)on proliferation and oxidative stress of human lens epithelial cells(LECs)line SRA01/04 under high calcium conditions.

METHODS: Three RNAi sequences were designed to knock down SMP30 target gene RGN expression(KD1-3), and the blank-load sequence was used as the negative control group(NCKD), all of which were used to construct lentiviral vectors to infect SRA01/04 cells. Meanwhile, the uninfected SRA01/04 cells was used as the blank control group(CON). After transfecting SRA01/04 cells, the lentiviral vector with the highest knockdown efficiency was selected by RT-PCR for subsequent experiments. Cells were treated with 15mmol/L CaCl₂ for 24h to simulate a high calcium conditions. BrdU-Elisa assay was used to measure cell proliferation, superoxide dismutase(SOD)assay kit and oxidized glutathione/total glutathione(GSSG/T-GSH)assay kit were used to detect the level of intracellular oxidative stress.

RESULTS: KD1-3 and NCKD lentiviral vectors were successfully constructed to infect SRA01/04 cells with an infection efficiency of about 80%. The knockdown efficiency of KD1-3 group was 93%, 60% and 74%, respectively, KD1 group was selected for follow-up experiment. Under the high calcium conditions, the activity of relative cell proliferation and SOD in KD1 group \〖(2.42±0.08)and(11.69±0.52U/mg)\〗 were significantly lower than that in NCKD group \〖(2.95±0.08)and(31.10±2.24U/mg)\〗 and CON group \〖(2.96±0.25)and(26.33±1.04U/mg)\〗, the ratio of GSSG/T-GSH in KD1 group(70.80±2.34)was significantly higher than that in NCKD group(15.93±3.47)and CON group(20.05±2.45)(P<0.05); there was no significant difference between NCKD group and CON group(P>0.05).

CONCLUSION: Under high calcium conditions, SRA01/04 cells(HLECs)with low expression of SMP30 mediated by shRNA lentivirus resulted in the decrease of the proliferation activity and antioxidant capacity, suggesting that SMP30 may play a protective role in regulating cell proliferation and anti-oxidative stress in HLECs.

Abstract:AIM: To investigate the effect and possible mechanism of enriched environment on regulating the plasticity of visual cortex in adult monocular deprivation amblyopia mice.

METHODS: In this experimental study, a total of 72 Kunming mice were randomly divided into control group(Nor), monocular deprivation+ standard environment group(MD+SE), monocular deprivation + enriched environment group(MD+EE)and monocular deprivation+ fluoxetine group(MD+FLX). MD model of mice were established at postpartum 21d, and then fed the mice under SE or EE for 4wk. For the mice in MD+FLX group, they were fed by water with fluoxetine. The visual acuity and flash visual evoked potential of mice in each group were detected. Ultrastructral modifications of synaptic junctions in each group were detected using the electronic microscope. We also applied the molecular biology to study the role of enriched environment in visual cortex of adult amblyopic mice whether through regulating the expression of IGF-1, IGF-1R and IGFBP5.

RESULTS: 1)Visual acuity examination: the successful rate of forepaw-reaching reflex in MD+SE group mice is lower than that in Nor group(P<0.001). Compared to MD+SE group, the successful rate of forepaw-reaching reflex improved in MD+EE group(P<0.001)and MD+FLX group(P<0.001). The difference is not significant between the MD+EE group and MD+FLX group(P=0.816); 2)Flash-visual evoked potential examination: compare to the Nor group, the P2 latency was prolonged(P<0.01), and the P2 amplitude was decreased(P<0.01)of flash-visual evoked potential(F-VEP)in the deprived eye in MD+SE group mice; After raring in enriched environment, the P2 latency was shortened(P=0.003)and P2 amplitude was increased(P=0.000)in the deprivated eye detected with F-VEP, which is not significant in P2 latency and amplitude when compare to MD+FLX group(P>0.05); 3)The structural modifications of synaptic junctions examined by electromicrographs: Compare to the Nor group, the synaptic clefts increased(P<0.01), the synaptic active zone shortened(P<0.01), and the thickness of PSD decreased(P<0.01)in MD+SE group mice. After raring in enriched environment, the synaptic clefts decreased(P=0.0035), the synaptic active zone prolonged(P=0.000)and the thickness of PSD increased(P=0.000)in the visual cortex contralateral to the deprived eye, which is not significant in all of the structural parameters of the synaptic junction in visual cortex when compare to MD+FLX group(P>0.05); 4)IGF-1, IGF-1R and IGFBP5 expression detected by Western-blot: Compare to the Nor group, the IGF-1 and IGF-1R expression in visual cortex contralateral to deprivated eye are both down-regulated in MD+SE group(P<0.01; P<0.01). After raring in enriched environment, the expression of IGF-1 and IGF-1R in MD+EE group was significantly higher than that in MD+SE group(P=0.016; P=0.041), but still lower than that in Nor group(P=0.001; P=0.001). The different expression of IGFBP5 in each group is not significant(P>0.05).

CONCLUSION: Environmental enrichment can improve the visual function through reactivating the plasticity of monocular deprivation amblyopia mice. The mechanism is presumed to be related to the expression of IGF-1 and IGF-1R.

Abstract:AIM: To investigate the effect of scutellarin on high glucose-induced human retina pigment epithelium(RPE)cells under high glucose.

METHODS: RPE cells were cultured and divided into control group(5.5mmol/L glucose), high glucose group(30mmol/L glucose), low concentration scutellarin group(30mmol/L glucose+1μmol/L scutellarin)and high concentration scutellarin group(30mmol/L glucose+10μmol/L scutellarin), cell scratch experiment observed RPE cells migration, cell survival rate were detected by CCK-8 colorimetry, flow cytometry was used to detect the level of ROS, Hoechst staining was used to observe the proportion of apoptotic cells, and Western blot was used to analyze the changes of Bcl-2 and Bax.

RESULTS: Cell scratch experiment results showed that RPE cells form in low concentration scutellarin group and high concentration scutellarin group were improved than that in high glucose group, cell mobility rate also increased; The CCK-8 results showed that RPE cells survival rate increased to 61.06%±5.59% and 79.81%±7.04% after treated with 1μmol/L and 10μmol/L scutellarin, the difference was statistically significant when compared with high glucose group(40.63%±4.72%, P<0.05); The H₂DCFDA fluorescent probe dying showed that scutellarin reduced ROS generation in RPE cells; Hoechst staining showed that the number of apoptosis RPE cells gradually decreased after treatment with 1μmol/L and 10μmol/L scutellarin; Western blot results showed that scutellarin enhanced the expression of Bcl-2 protein and reduced the expression of Bax protein.

CONCLUSION: Scutellarin could inhibit high glucose-induced oxidative damage and apoptosis in human RPE cells, which provides theoretical support for the research on the therapeutic targets of diabetic retinopathy.

Abstract:AIM:To observe the changes of retinal and choroid tissue structure in SD rats exposed to blue light from 455nm-470nm array, and to analyze the relationship between irradiation time and tissue structure changes.

METHODS: Totally 24 healthy SD male rats of 6wk were selected and randomly divided into normal control group(n=6)and experimental group(n=18). The normal control group was fed for 6wk without any intervention. The experimental group was divided into three groups, which were exposed to the array blue light emitting apparatus(455nm-470nm, 391Lx)for 3, 6 and 12h each day for 6wk.

RESULTS: The fundus tissue structure was intact and the cell morphology was normal in the control group. With the extension of blue light irradiation time, the choroid fiber connective tissue of rats in all experimental groups presented hyaline changes, local loose edema, proliferation of small blood vessels, thinning of pigment layer, thinning of cells, gradual reduction of the number of visual cells, and local disappearance. At 3h, the nucleus staining of the experimental group was clear, and no definite changes were observed in the bipolar cell layer and ganglion cell layer. In the 6h and 12h groups, nucleus pyknosis was observed, bipolar cell layer was mildly proliferated, and local cytoplasm was formed in the ganglion cell layer.

CONCLUSION: The photoreceptor cells of retina become thinner, atrophy and disappear with the extension of blue light irradiation time. There was no significant relationship between the injury of pigment epithelial cells and the prolonged exposure time of blue light.

Abstract:AIM: To investigate the correlation between retinal microstructural changes and visual function after scleral buckling and vitrectomy with rhegmatogenous retinal detachment.

METHODS: Prospective clinical study was conducted. With PVR grade B-C1, 75 patients with 75 eyes of aged 15-30 years who were macular-off retinal detachment were selected. PPV was performed for posterior equatorial retinal hiatus(35 eyes, PPV group), and SB was performed for anterior equatorial retinal hiatus(40 eyes, SB group).The patients in the two groups were followed up for 6mo to observe the changes in the best corrected visual acuity(BCVA)and retinal microstructures.

RESULTS: Compared with SB group, the probability of inner sensory layer/outer sensory layer and inner boundary membrane fracture after operation in PPV group was 2.812 times, with a statistically significant difference(P=0.020), and the probability of subretinal effusion was 0.115 times, with a statistically significant difference(P<0.001). There was no statistically significant difference(P=0.700)between the two groups. And with the extension of observation time, the possibility of inner sensory layer/outer sensory layer and inner boundary membrane, persistent subretinal fluid and interlayer effusion in the two groups of patients gradually decreased. After the operation, the thickness of the neurosensory retinal and outer nuclear layer in the two groups gradually increased, and BCVA gradually improved. With the prolonging of observation time, the thickness of the neurosensory retinal in SB group increased greatly, and BCVA recovered better.

CONCLUSION: The integrity of the inner sensory layer/outer sensory layer and inner boundary membrane, subretinal effusion, interlaminar effusion, and the thickness of the neurosensory retinal are the key factors affecting the recovery of visual function after SB or PPV.

Abstract:AIM: To observe the effects of combined anti-VEGF therapy on neovascular glaucoma.

METHODS: A total of 62 patients(68 eyes)with neovascular glaucoma admitted to our hospital from February 2012 to October 2018 were retrospectively analyzed. Group A were given intravitreal injection of anti-VEGF drug(conbercept ophthalmic injection)0.05mL, and complex trabeculectomy was performed 1wk after injection, and total retinal laser photocoagulation was performed 3wk after injection. Cyclocryosurgery was performed in group B. Intraocular pressure(IOP), best corrected visual acuity(BCVA), axial length and postoperative complications of patients in two groups were observed before treatment and 2wk, 1mo, 3mo and 6mo after treatment.

RESULTS: The regression degree of iris neocescularization in group A was significantly better than that in group B. IOP at 2wk, 1mo, 3mo and 6mo after surgery in the two groups showed statistical differences(P<0.05). There was a statistically significant difference in axial length 6mo after treatment(P<0.05). The total effective rate was 94% in anti-VEGF group(group A)and 78% in cyclocryosurgery group(group B), the difference was not statistically significant(P=0.073).

CONCLUSION: It is safe and effective for the combined treatment of anti-VEGF drug, combined trabeculectomy and total retinal laser photocoagulation in the treatment of neovascularization glaucoma.

Abstract:Endothelial dysfunctionis traditionally considered irreversible, and endothelial keratoplasty(EK)is almost the only treatment available. Recently, however, a surgery called descemetorhexis without endothelial keratoplasty(DWEK)can regenerate the central corneal endothelial cells in patients with Fuchs endothelial corneal dystrophy(FECD), and local Rho-associated kinase inhibitor can enhance its efficacy.

Abstract:In the progress of retinal angiogenesis, sprouting angiogenesis plays an important role in retinal normal development and neovascular diseases. The structural and functional integrities of vascular endothelial cells are essential condition of sprouting angiogenesis. Vascular endothelial cells possess various subtypes, each of which plays a different role in sprouting angiogenesis. Many mechanisms participate in the regulation of endothelial cells under physiological and pathological conditions, such as biological signaling pathway, metabolism, immune inflammation and non-coding RNA. In this review, we provided a brief overview of the role and the related regulatory mechanisms of vascular endothelial cells in retinal sprouting angiogenesis.

Abstract:Cataract is a kind of eye disease that causes lens metabolic disorder and protein degeneration and turbidity due to various reasons. Congenital cataract is especially serious. It is a common eye disease that affects the visual development of infants. It can inhibit the development of visual pathway and cause permanent blindness. About one-third of the cases are genetically related, of which autosomal dominant inheritance is the most common genetic mode. It's occurrence and development may be related to genes involved in lens development. Up to now, hundreds of mutation sites in more than 40 genes have been found to be associated with congenital cataract. This article will review the genetic research progress of congenital cataract.

Abstract:Macular edema(ME)is a typical non-specific complication of uveitis, one of the common causes of visual impairment in patients with non-infectious uveitis(NIU). The treatment of uveitis related ME is still challenging in clinic. Various agents, such as corticosteroids, anti-vascular endothelial growth factors, and immune-modulators, have been used for combating uveitis related ME. However, there is not enough evidence to support the efficacy of any of these agents. Intravitreal dexamethasone implant(IDI, Ozurdex^©; Allergan Inc, Irvine, CA)is a widely administered corticosteroid for the long-term management of uveitic ME in certain cases. Recent studies have demonstrated that IDI effectively improves uveitis related ME, and this effect could be sustained for at least six months with close monitoring and retreatment, as needed. Currently, we reviewed major clinical studies about IDI in eyes with NIU and briefly overviewed their results.

Abstract:Punctate inner choroidopathy(PIC)is an infrequent idiopathic chorioretinopathy, frequently affecting young myopic women. There are multiple, small, round, yellow-white or gray punctate lesions in the retinal pigment epithelium and the choroidal lining, in the absence of anterior ocular segment or the vitreous body inflammation. In general, most patients have good prognosis and a few patients will be caused severe vision loss if complicated by choroidal neovascularization(CNV)and subretinal fibrosis. This article reviews the etiology, pathogensis, clinical manifestations, diagnosis and differential diagnosis and treatment of PIC.

Abstract:Congenital hypertrophy of the retinal pigment epithelium(CHRPE)is a rare fundus lesion. It usually does not cause serious clinical symptoms. However, incorrect diagnosis and treatment frequently occurred clinically because most ophthalmologists have little knowledge about it. Thus, we conducted the current study to investigate the clinical characteristics and prognosis of CHRPE, to provide evidence for differential diagnosis clinically and further guideline for treatment and follow-up.

Abstract:Non-arteritic anterior ischemic optic neuropathy is an acute optic nerve disease that seriously impairs the visual function of middle-aged and elderly people. It is generally believed to be caused by ischemia of the short ciliary artery supplying the optic disc plate area and the posterior area of the sieve plate. The disease is associated with a variety of factors, such as diabetes that affects the systemic microcirculation, hypertension and respiratory sleep apnea syndrome that has been widely studied recently, and so on. Moreover, it was also found that genetic susceptibility, drugs, surgery and ocular diseases were all associated with the occurrence and development of the NAION. In this paper, the latest researches on these factors are reviewed.

Abstract:Myopia is one of the most common eye diseases in the world. MicroRNAs(miRNAs)are small, non-protein-coded single-stranded RNAs with a length of about 20-25 nucleotides,which are widely involved in the process of post-transcriptional regulation of many physiological and pathological processes of organisms. It has attracted extensive attention for the regulation role of miRNAs in the process of induction and development of myopia in recent years. This article reviews the regulatory role and related signal pathways of miRNAs in the development of myopia. It will provide highlights for the understanding of molecular mechanism of myopia and benefit for potential molecular diagnosis of myopia in the future.

Abstract:Myopic population of China is already nearly 600 million, the rate of teenager myopic occupies the first place in the world, myopia hsa already became one of the main diseases that endangers our adolescent's health. Dopamine is the main catecholamine in retina. Many studies have found that increasing the content of dopamine can effectively inhibit the development of myopia. Form-deprivation myopia is a classical method of myopia modeling. By observing the influence of dopamine and its receptors on the development of form-deprivation myopia, its role in the development of myopia can be reflected, and it is of great significance to guide and control the occurrence and development of myopia. In this paper, the effects of dopamine and its receptors on the development of form-deprivation myopia were reviewed in order to provide reference for the prevention and treatment of myopia.

Abstract:Anti-vascular endothelial growth factor(VEGF)drugs have been used to treat various ophthalmic diseases, especially in the treatment of vascular proliferative ophthalmopathy. Anti-VEGF drugs can significantly inhibit the formation of new blood vessels and reduce retinal edema, thereby improving the patient's vision. However, their long-term therapeutic effect and safety require longer-term follow-up and research. This article reviews the application and research progress of anti-VEGF drugs in ophthalmology and provides references for clinical application and further research.

Abstract:AIM: To study the effect of cyclosporine A combined with glucocorticoid in the treatment of corneal ulcer.

METHODS: From May 2015 to May 2018, 200 patients with corneal ulcer were selected and divided into combined group and glucocorticoid group according to different treatment methods, 100 cases each. In the combined group, cyclosporine A was given on the basis of the glucocorticoid group. C-reactive protein(CRP)and interleukin-6(IL-6)were measured to evaluate the quality of life, clinical symptoms, treatment efficiency, recurrence rate and incidence of adverse reactions.

RESULTS: After treatment, the levels of CRP and IL-6 in the two groups were lower than that before treatment, and the quality of life was higher than that before treatment(P<0.05). The level of CRP and IL-6 in the combined group was lower than that in the glucocorticoid group, and the quality of life was higher than that in the glucocorticoid group(P<0.05). The time of conjunctival hyperemia, ophthalmalgia and ulcer healing in the combined group were lower than those in the glucocorticoid group(P<0.05). The effective rate of combined group was higher than that of glucocorticoid group, and the recurrence rate of combined group was lower than that of glucocorticoid group(P<0.05).

CONCLUSION: Cyclosporine a combined with hormone is effective in the treatment of corneal ulcer, which can improve the clinical symptoms, reduce the inflammation, improve the quality of life and reduce the recurrence.

Abstract:AIM: To investigate the early corneal morphological changes and the possible influenced factors of small incision lenticule extraction(SMILE)combined with corneal collagen cross-linking(CXL)in the treatment of refractive error.

METHODS: This was a retrospective case study. The patients(76 eyes)with ametropia who had undergone SMILE surgery in our hospital from September 2018 to March 2019 were small age, high degree of severity, thin cornea or irregular shape. The patients were divided into the SMILE combined with CXL group with 17 patients(32 eyes)and the SMILE group with 22 patients(44 eyes). The corneal morphological parameters of the two groups were measured preoperatively and 1mo postoperatively.

RESULTS: There were significant statistically differences in the changes of K1, K2, Km, central corneal thickness, posterior corneal elevation, anterior corneal elevation parameters, posterior corneal elevation parameters, the D value and index of vertical asymmetry(IVA)between these two groups(P<0.05), while there were no significant statistically difference in the changes of index of highest decentration(IHD)(P>0.05). The changes of some parameters of the corneal anterior surface morphology of the two groups were correlated with the corneal cutting depth, spherical equivalent and optical zone diameter(P<0.05). While the changes of some parameters of the corneal posterior surface morphology were not correlated with the corneal cutting depth, spherical equivalent,and optical zone diameter(P>0.05). There was no apparent correlation between the changes of corneal surface morphology and the cross-linking depthin SMILE combined with CXL group(P>0.05).

CONCLUSION: SMILE combined with CXL was applied to the high-risk patients with small age, high degree of severity, thin cornea or irregular shape, which increased its safety and effectiveness. SMILE combined with CXL didn't make significant effects on the posterior surface morphology of the cornea, but it influenced the anterior surface morphology. The influenced factors may be related to the corneal cutting depth, the spherical equivalent and the optical zone diameter.

Abstract:AIM: To investigate the effect of LECs removal on the stability of lens capsule bag in patients with high myopia.

METHODS: From March 2018 to April 2019, 98 cases(120 eyes)of cataract patients with high myopia were treated in Cataract Department of Hebei Province Eye Hospital. They were divided into two groups according to whether the LECs were removed during the operation. In group A, the anterior and posterior capsule were polished in 50 cases(60 eyes), while in group B, 48 cases(60 eyes)were not polished. During the follow-up period we used anterior segment OCT to detect the change of effective intraocular lens position(ELP), the eccentricity of intraocular lens(IOL)and the reduction of anterior capsule opening in the two groups, and used slit lamp to observe the occurrence and degree of PCO.

RESULTS: We compared the changes of ELP(0.16±0.06mm vs 0.55±0.07mm)and the changes of contraction of anterior capsule(0.18 ± 0.16mm vs 0.92 ± 0.13mm)on the first day and three months after operation. Three months after operation, we compared the IOL eccentricity of the two groups(0.02±0.005mm vs 0.69±0.23mm). There were differences between the two groups(P<0.05). At 3mo after operation, the PCO of group A was observed by slit lamp: grade I 4 eyes, grade II 2 eyes, grade III 1 eye. The PCO of group B: grade I 16 eyes, grade II 8 eyes, grade III 4 eyes and grade IV 3 eyes. There was significant difference between the two groups(Z=-4.765, P<0.01).

CONCLUSION: The removal of LECs could reduce the contraction of anterior capsule, decrease the change of ELP and enhance the stability of bag IOL complex, which played a good role in reducing PCO.

Abstract:AIM:To investigate the clinical effect and influencing factors of phacoemulsification in cataract patients with high myopia.

METHODS:A retrospective analysis of 109 eyes of 90 patients with cataract combined with high myopia was performed on January 2016. According to the best corrected visual acuity, the curative effect was evaluated and divided into two groups: low vision group(best corrected visual acuity <0.3)and normal vision group(best corrected visual acuity ≥0.3). A Logistic regression analysis model was established to analyze the factors affecting the postoperative efficacy.

RESULTS:There were 22 cases(27 eyes)in the low vision group and 68 cases(82 eyes)in the normal vision group. During the follow-up period, 6 eyes of the posterior lens capsule became cloudy, all of which were mildly cloudy and improved after laser treatment. No complications such as secondary glaucoma, corneal decompensation, retinal detachment, and intraocular lens displacement were observed. Univariate analysis found that the axial length, corneal astigmatism, Emery classification, fundus lesion classification were the influential factors affecting the efficacy of the operation(P<0.05). Logistic regression analysis results showed that the axial length(OR=2.121), corneal astigmatism(OR=1.698), Emery classification(OR=1.901), and fundus lesion classification(OR=1.964)were independent factors affecting the postoperative efficacy(P<0.05).

CONCLUSION: Axial length, corneal astigmatism, Emery classification, and fundus lesion classification can affect cataract phacoemulsification surgery for cataract combined with high myopia, but patients have more influential factors for prognosis, and effective measures should be formulated according to influencing factors Intervention to improve the prognosis of patients.

Abstract:AIM: To explore the differentially expressed genes and crucial genes between epithelioid and mixed uveal melanoma(UM)based on bioinformatics analysis.

METHODS: Microarray datasets GSE22138 was extracted from gene expression omnibus database(GEO). The differentially expressed genes(DEGs)were screened out between epithelioid and mixed UM, and functional enrichment analysis were performed with DAVID database. STRING and cytoscape was applied to explore the protein-protein interaction(PPI)network and hub genes. Subsequently, cBioPortal was applied to explore the network of the hub genes, and GEPIA was adopted to study the survival analysis of hub genes.

RESULTS: Overall, 241 DEGs including 125 upregulated and 116 down regulated genes were identified. The DEGs mainly enriched in cell adhesion, response to drug and Positive regulation of endothelial cell proliferation. A total of 10 hub genes were identified. Survival analysis revealed the hub genes was associated with the prognosis of UM.

CONCLUSION: DEGs and hub genes identified by Bioinformatics analysis in the present study would be beneficial to understand mechanism and biological characteristics between epithelioid and mixed UM.

Abstract:AIM: To observe vascular density and foveal avascular zone(FAZ)in macular area for diabetic macular edema(DME)with optical coherence tomography angiography(OCTA)when before and after intravitreal injection of rainbizumab.

METHODS: For the 45 DME patients(52 eyes)whose diagnosis were confirmed by ophthalmic clinical examination, their sick eyes were examined by OCTA with macular area 3x3mm scanning range model when before and 1wk after intravitreal injection of rainbizumab, and obtain vascular density of superficial capillary plexus(SCP), deep capillary plexus(DCP), and the number of microaneurysm and the area, perimeter and the roundness index in FAZ, and do block matching t-test.

RESULTS: There was no statistical difference for the vascular density of SCP before and after treatment(t=1.635, P=0.10). Vascular density(46.59%±4.91%)of DCP after treatment were more than before treatment(42.47%±4.16%), and it was statistically significant difference(t=1.014, P=0.02). There was no statistical difference for the number of microaneurysm in SCP when before and after treatment(t=1.623, P=0.21); But the number of microaneurysm(6.10±0.67)in DCP after treatment decreased obviously than before treatment(8.21±0.41),and the difference was statistically significant(t=1.124, P=0.01). The area and perimeter of FAZ after treatment increased than before treatment, but there was no statistical difference(P>0.05); The roundness index of FAZ after treatment was lower than before treatment,and there was also no statistical difference(P>0.05).

CONCLUSION: The capillary circulation in DCP increased in short term for sick eyes of DME after intravitreal injection of rainbizumab, and the number of microaneurysm in DCP reduced, but the change in SCP is not obvious. At the same time, the area, perimeter and the roundness index of FAZ had no significant meaning of clinical observation for DME with injection of rainbizumab.

Abstract:AIM: To appraise the therapeutic effect of dual laser(micro-pulse laser and traditional laser)and single intravitreal injection with conberceptin on macular edema secondary to ischemic branch retinal vein occlusion.

METHODS: A prospective cohort study was conducted. 83 patients(83 eyes)participated in the study from November 2017 to November 2018. They were randomly divided into two groups. Group A(42 eyes)accepted the treatment of dual laser and single intravitreal injection with conbercept and group B(41 eyes)accepted only traditional laser treatment and single intravitreal injection with anti-VEGF, and the aim is to analysis the data including BCVA, CMT in follow-up visit after treatment 1, 3, 6mo.

RESULTS: After 1mo: in group A, BCVA improved from 0.88±0.11 to 0.43±0.19(P<0.01), CMT changed from 595.00±61.12 to 379.8±76.08μm(P<0.01). In group B, BCVA changed from 0.82±0.19 to 0.39±0.16(P<0.01)while CMT changed from 601.70±81.37 to 381.50±70.92 μm(P<0.01). There were no difference between two groups(P>0.05). After 3mo: in group A, BCVA raised to 0.13±0.07(P<0.01), CMT reduced to 282.80±31.93μm(P<0.01); in group B, BCVA hold on 0.41±0.09(P=1.00), CMT retained 395.80±34.53μm(P=0.99). The improvement of BCVA and CMT were better in group A(P<0.01). After 6mo: in group A, BCVA maintained 0.28±0.12(P<0.01), CMT keeped 335.60±33.98μm(P=0.02); in group B, BCVA rebounded to 0.77±0.15(P<0.01), CMT was 579.60±19.61μm(P<0.01). Both BCVA and CMT were better in group A than group B(P<0.01). No serious complications happened in all phases.

CONCLUSION: The treatment of dual laser and single intravitreal injection with conbercept for macular edema secondary to ischemic branch retinal vein occlusion can maintain good effect more than 3mo.

Abstract:AIM: To observe the efficacy and safety of 25-gauge vitrectomy combined with air tamponade for rhegmatogenous retinal detachment.

METHODS: The clinical data of 30 eyes with primary rhegmatogenous retinal detachment(RRD)from 30 patients who received vitrectomy with intraocular air tamponade in Zunyi First People's Hospital from August 2017 to December 2018 were retrospectively analyzed. The best corrected visual acuity(BCVA)(LogMAR), intraocular pressure were evamined before surgery, 1wk and 1mo after surgery, while the retinal reattachment rate, intraoperative and postoperative complications were recorded.

RESULTS: The mean BCVA was significant different among before surgery, 1wk and 1mo after surgery(F=3.74, P=0.047), and the BCVA at 1wk and 1mo after surgery was evidently improved in comparison with before surgery(0.64±0.36 vs 0.87±0.71; 0.37±0.22 vs 0.87±0.71). The mean IOP was(13.61±3.57),(15.74±4.84)and(14.05±2.88)mmHg before surgery, 1wk and 1mo after surgery, showing no significant difference in IOP before and after operation(F=4.13, P=0.051). The retinal reattachment rate of retinal hiatus was 97%(29/30)1wk after operation. Postoperative OCT monitored 1 eye of persistent subomental effusion, which was absorbed 3mo after operation.

CONCLUSION: Vitrectomy combined with air tamponade is effective in the treatment of rhegmatogenous retinal detachment. It can improve visual quality, reduce complications related to silicone oil and reduce the economic burden of patients.

Abstract:AIM: To study the serum lipids changes and lipid ratiosin patients with pterygium.

METHODS: Based on the retrospective study, 500 pterygium patients who were admitted to the department of ophthalmology and had finished physical examination in the physical examination center of Zhongnan Hospital of Wuhan University from January 2016 to February 2019 were included. As well as 500 people who underwent health examination and were matched in age and gender at the same time. The serum levels of triglycerides(TG), total cholesterol(TC), low density lipoprotein cholesterol(LDL-C), and high-density lipoprotein cholesterol(HDL-C), were measured by professionals in hospital. TG/HDL, TC/HDL, LDL/HDL were calculated and analyzed statistically between the two groups.

RESULTS: Among the 500 patients with pterygium, abnormal serum lipid content accounted for 68.2%(341/500). TG, TC, LDL-C level and TG/HDL, TC/HDL and LDL/HDL were higher in pterygium group than control, and with statistically significant differences(P<0.001). While serum HDL level was lower than that in control group and with no statistically significant differences(P>0.05). According to Logistic analysis, TG(OR=4.132), TC(OR=2.194), TG/HDL(OR=2.184)and TC/HDL(OR=2.007)were risk factors for pterygium(P<0.05).

CONCLUSION: Dyslipidemia is an important factor in the pathogenesis of pterygium. It is very necessary for the patients with pterygium to control the level of blood lipids because it has important clinical significance for the attack and treatment of them.

Abstract:AIM: To study the changes of myopic components in premature children aged 1-6 years, and to explore the relationship between the development of myopia and components.

METHODS: Totally 158 cases of 316 eyes of preterm infants with myopia were collected from the eye clinic of Hunan Children's Hospital from January 2016 to December 2018. As a non-myopia group of preterm infants. Corneal curvature(CR), anterior chamber depth(ACD), vitreous cavity depth(VITR), axial length(AL), lens thickness(LT)and other refractive parameters were detected and analyzed in two groups of subjects.

RESULTS: To 1-3 years old premature children,there was the steeper CR and the longer AL in myopia group than non-myopia group, but only longer AL in 4-6 years old premature children. To 1-3 years old premature children, there were significant differences in CR and AL between myopia group and non-myopia group, but VITR and AL in 4-6 years old.

CONCLUSION: The mismatch of optical components development may be one of causes in premature children myopia. The axis length played a major role in the occurrence of myopia, the steep corneal curvature in young premature children.

Abstract:AIM: To investigate the recovery of binocular vision in patients with intermittent exotropia of different age.

METHODS: Totally 172 patients with intermittent exotropia who underwent strabismus correction in our department from January 2016 to January 2018 were selected, including 95 males and 77 females, aged from 3 to 32 years, with an average age of 11.4±1.5 years. All patients with intermittent exotropia were basic type. According to the age of operation, the patients were divided into two groups: the group of less than 9 years old(90 cases)and the group of more than 9 years old(82 cases).The preoperative, 1d, 7d, 1mo and 3mo after operation were observed. The function of binocular vision was examined by synoptophore and myopia was examined by Titmus.

RESULTS: A comparison of simultaneous vision: at the same time, the visual function, fusion function, fusion range, far stereo, near stereo recovery effect of patients ≤9 years group was better than that of patients >9 years group. The difference was statistically significant(P<0.05).

CONCLUSION:Suggested surgical treatment of intermittent exotropia before 9 years old. Early operation is conducive to better improvement of binocular vision after surgery.

Abstract:AIM: To explore the correlation between corneal biomechanics and corneal densitometry.

METHODS: Prospective study. Patients who examined before corneal refractive surgery in the Second People's Hospital of Yunnan Province from March 2019 to June 2019 were selected as research objects. Pentacam HR system was used to evaluate corneal densitometry. The corneal was divided into three areas around the corneal apex with diameters of 0-2mm, >2-6mm, >6-10mm,and the corneal thickness was divided into anterior, middle and posterior layers. The thinnest point thickness of cornea in Pentacam HR was selected to be included in the study. Corvis ST was used to measure the biomechanical parameters, including the first applanation length(AP1L)and applanation velocity(AP1V),the second applanation length(AP2L)and applanation velocity(AP2V),the highest concavity peak distance(PD),highest concavity radius(HCR)and deformation amplitude(DA). Pentacam & Corvis ST comprehensive diagnostic platform software was used to comprehensively analyze the examination results and obtain comprehensive corneal biomechanical parameters(CBI), as well as other independent parameters including stiffness parameters(SP), integrated radius(IR), Ambrosio relational thickness-horizontal(ARTh)and deformation amplitude ratio(DAR). Variance analysis was used for the difference of corneal densitometry in each region, the correlation between corneal biomechanical parameters and corneal densitometry was analyzed by Pearson or Spearman.

RESULTS: The difference of optical density between different diameter ranges and different layers was statistically significant(F=35.101, P<0.01; F=1002.897, P<0.01), CBI was correlated with AP2L,AP2V,PD,DA,SP,IR,ARTh and DAR in the independent biomechanical parameters(r_s= -0.502, P<0.01; r_s=-0.457, P=0.001; r_s=0.428, P=0.002; r_s=0.539, P<0.01; r_s=-0.687, P<0.01; r_s=0.716, P<0.01; r_s=-0.728, P<0.01; r_s=0.750, P<0.01). CBI was positively correlated with optical density within the range of 0-2mm(r=0.343, P=0.015). The corneal densitometry within a range of 0-2mm is correlated with AP2L, IR, ARTH and DAR in independent biomechanical parameters(r_s=-0.298, P=0.035; r_s=0.368, P=0.009; r_s=-0.419, P=0.002; r_s=0.493, P<0.01).

CONCLUSION: There is a correlation between corneal biomechanics and corneal densitometry in the central region of cornea, which has a more significant correlation with the biomechanics.

Abstract:AIM: To investigate the repairment of wound by using soft contact lenses and rb-bFGF eye drops after deep foreign body removal.

METHODS: Patients with deep corneal foreign body(72 cases, 72 eyes)were randomly separated into three groups and received surgery to remove the foreign bodys. Patients in group C only accepted levofloxacin eye drops and ofloxacin eye ointment while patients in group A wore soft contact lenses and group B received rb-bFGF eye drops as an extra after operation. The corneal irritation and pain(1, 3, 5d), wound healing(1wk)and relevant factors in visual acuity impairment(1mo)were observed after deep foreign body removal.

RESULTS: Corneal irritation and pain scores in group A were significantly lower than that in the other two groups at 1, 3 and 5d after operation. Patients felt less painful in group B than group C at 3 and 5d. Corneal wound healing in groups A and B was significantly higher than group C at 1wk after surgery(P>0.05). The closer corneal foreign body was to the pupil area, the more vision was affected after 1mo operation(r_s=0.635, P<0.05).

CONCLUSION: Soft contact lenses can effectively alleviate eye irritation after deep corneal foreign body removal in early time. Both SCL and rb-bFGF eye drops can accelerate the recovery of corneal wounds. Visual acuity impairment was closely related to the location of foreign body in deep corneal.

Abstract:AIM: To analyze the risk factors of corneal epithelial dysfunction(CED)after pars plana vitrectomy(PPV).

METHODS: Clinical data of 235 patients with 235 eyes of PPV from July 2016 to June 2018 in our hospital were retrospectively analyzed. The age, sex and related medical history of the patients(such as ocular lesions and systemic diseases)were collected, and the intraocular fillers, operation time, postoperative intraocular pressure were recorded. Logistic regression was used to analyze the risk factors of CED after PPV.

RESULTS: The incidence of CED after PPV was 16.6%(39/235), and the incidence of persistent corneal epithelial lesion was 1.3%(3/235). Logistic regression showed that age, preoperative xerophthalmia, diabetes mellitus, Silicone oil filling, postoperative high intraocular pressure and operation time were risk factors for CED after PPV. The OR values were 1.270, 5.218, 18.598, 4.659, 10.799 and 1.104, respectively.

CONCLUSION: Age, preoperative xerophthalmia, diabetes mellitus, silicone oil filling, postoperative high intraocular pressure and operation time are risk factors for CED after PPV.

Abstract:AIM: To explore the effect of corneal suture tension on the accuracy of intraocular lens power calculation in traumatic cataract.

METHODS: In this prospective study, 57 patients who were waiting for secondary intraocular lens implantation surgery with sutured corneal penetrating injury and extracted traumatic cataract in our hospital from March 2017 to March 2019, were divided into observation group and control group. Corneal sutures were removed one week before operation in the observation group, while corneal sutures were removed during the operation in the control group. The corneal curvature, corneal astigmatism, anterior chamber depth, axial length and theoretical intraocular lens power in the observation group were compared before and after suture removal; the postoperative uncorrected visual acuity and corneal astigmatism were compared between the observation group and the control group.

RESULTS: There were significant changes in corneal curvature(43.15±1.32D vs 45.05±1.20D), corneal astigmatism(-5.23±2.52D vs -2.04±1.44D)and theoretical intraocular lens power(22.24±2.36D vs 20.40±1.46D)before and after suture removal(P<0.05), while there were no difference in anterior chamber depth and axis length in the observation group(P>0.05). The uncorrected visual acuity was better, and the corneal astigmatism was lower 1d, 1wk, 1mo and 3mo post-operative in the observation group than that in the control group(P<0.05).

CONCLUSION: Corneal suture tension has significant effect on corneal astigmatism, theoretical intraocular lens power calculation and postoperative refraction in traumatic cataract patients.

Abstract:AIM: To study the optical coherence tomography(OCT)treatment of optic fiber thickness in patients with high myopia combined with glaucoma.

METHODS: Totally 160 eyes of 80 patients with high myopia and glaucoma who were treated in our hospital during 2017-01/12 were selected as the observation group, and 60 healthy volunteers(120 eyes)who underwent physical examination in our hospital during the same period were selected as the control group. OCT was used to analyze the thickness of optic nerve fibers in both groups.

RESULTS: Subjects compared with control group, the observation group of patients with nasal side, temporal, under the nose, nasal, under the temporal and the week on the average thickness of the optic nerve fiber layer is reduced, and the temporal side nerve fiber layer thickness increased(P<0.05), and in the observation group diopter -10.00 to -11.00D in patients with nasal side, temporal, under the nose, nose, and the temporal and the week, on average, the optic nerve fiber layer thickness were significantly higher than that of diopter≥-12.00D patients(P<0.05). Spearman correlation analysis results showed that the absolute value of diopter was negatively correlated with the mean thickness of optic nerve fiber layer in the nasal side, upper temporal quadrant, lower nasal side, upper nasal side, lower temporal and the whole circumference, and positively correlated with the thickness of optic nerve fiber layer in the lateral temporal optic nerve.

CONCLUSION: In patients with high myopia combined with glaucoma, the optic nerve fibers in all quadrants except the temporal side become thinner.

Abstract:AIM: To observe the changes of retinal structure in macular region of wet age-related macular degeneration(wARMD)after treatment with conbercept by optical coherence tomography(OCT), and explore the effect of conbercept on wARMD.

METHODS: From May 2018 to October 2018, 21 patients(23 eyes)with wARMD were studied. All patients were treated by intravitreal injection of conbercept monthly for 3mo. During the six-month follow-up period after the last injection, the changes of best corrected visual acuity(BCVA)and intraocular pressure were observed, in the meantime, the macular fovea retinal thickness(CFT), macular fovea pararetinal thickness(PMT), choroidal neovascularization(CNV)area and subretinal fibrosis also were observed by OCT.

RESULTS:Six months after treatment, 21 eyes(91%)was effective, and 2 eyes(9%)was stable in all patients. 1mo, 3mo and 6mo after treatment, the BCVA of patients were significantly improved, the areas of CFT, PMT and CNV decreased significantly compared with those of before(P<0.05), while intraocular pressure did not change significantly before and after treatment(P>0.05). During the follow-up period, transient blurred vision occurred in 2 eyes(9%), intraocular pressure increased(>21mmHg)in 1 eye(4%)and subconjunctival hemorrhage in 1 eye(4%)of 23 eyes, and all recovered within 7d after the end of 3 conbercept treatments.

CONCLUSION: The application of conbercept in the treatment of wARMD can significantly improve the patients' vision and retinal structure in macular region. And it also shows good therapeutic effect, less side effects and high safety.

Abstract:AIM: To investigate the effects of intravitreal conbercept combined with peripheral laser photocoagulation for ischemic RVO-ME.

METHODS: A retrospective clinical study. Totally 39 patients(39 eyes)were included in this study since 2014-10 to 2018-11, who were diagnosed ischemic RVO-ME in Eye Hospital of Wenzhou Medical University. There were 14 CRVO and 25 BRVO. All patients were given intravitreal conbercept combined with peripheral laser photocoagulation. BCVA, OCT were examined before and after treatment.

RESULTS:BCVA of 1, 2, 3, 6mo(0.67±0.49, 0.56±0.41, 0.62±0.52, 0.47±0.40)after treatment was significantly improved compared to base line(0.99±0.57)(P<0.05). CMT of 1, 2, 3, 6mo(299.5±188.1, 254.8±127.6, 294.1±174.9, 228.8±64.45μm)after treatment was significantly decreased compared to base line(608.4±214.7μm)(P<0.05). BCVA of 6mo was positively correlated with base line BCVA(r=0.78, P<0.05),while there was no correlation with base line CMT(r=0.25, P=0.13).

CONCLUSION: Intravitreal conbercept combined with peripheral laser photocoagulation is a effective approach for ischemic RVO-ME, which can significantly improve BCVA and decrease CMT.

Abstract:AIM: To investigate the changes of serum cytokines in patients with polypoid chorioretinopathy and analyze its risk factors.

METHODS: Select 50 cases of PCV patients in our hospital from December 2018 to May 2019 served as observation group, 50 cases of senile cataract patients who want to undergo cataract surgery served as control group. The levels of inflammatory factors and angiogenic factors were compared between the two groups, and the general clinical data were analyzed by single factor and logistic regression.

RESULTS: The levels of IL-8, MCP-1, VEGF and PEDF in the observation group were significantly higher than those in the control group(P<0.01). The results of ANOVA showed that there was significant difference between smoking history and hypertension between the two groups(P<0.05); Logistic regression analysis showed that the increased levels of IL-8, MCP-1, VEGF, PEDF, smoking history and hypertension were independent risk factors for PCV.

CONCLUSION: The serum levels of IL-8, MCP-1, VEGF and PEDF in PCV patients were all increased abnormally, which was closely related to smoking history and hypertension.

Abstract:AIM: To investigate the effect of puerarin combined with lecithin complex iodine tablets on hemostasis in patients with fundus hemorrhage.

METHODS: Totally 66 patients with fundus hemorrhage who entered into our hospital from April 2016 to March 2017 were collected and randomly divided into 2 groups: group A and group B, 33 cases(50 eyes)in each group. Group A was treated with lecithin complex iodine tablets, and group B was treated with puerarin combined with lecithin complex iodine tablets. Plasma viscosity index, serum homocysteine(Hcy), total cholesterol(TC)and triglyceride(TG)were measured and compared within 2 groups. The therapeutic effects and adverse reactions were compared between 2 groups.

RESULTS: Before treatment, there were no significant differences in plasma viscosity, serum Hcy, TC and TG between 2 groups(P>0.05). After treatment, the high blood viscosity, low blood viscosity, low plasma viscosity, plasma viscosity, Hcy, TC and TG in 2 groups had decreased than before treatment(P<0.001). Compared with group A, the high blood viscosity, low blood viscosity, plasma viscosity, Hcy, TC and TG had decreased(P<0.05). The total effect of group B were better than group A(P<0.05). The adverse reaction like thyroid changes, gastrointestinal reactions, mental excitement and bloating happened in 2 groups. There was no significant difference in the adverse reaction rate between 2 groups(P>0.05).

CONCLUSION: The efficacy of puerarin combined with lecithin complex iodine tablets in the treatment of fundus hemorrhage is significant, which is related to improving plasma viscosity and decreasing serum Hcy, TC and TG.

Abstract:AIM: To evaluate the effectiveness and surgical timing for the treatment of lacrimal duct obstruction secondary to chemotherapy by bicanalicular stent intubation.

METHODS:A retrospective analysis was performed on 50 patients of 100 eyes who underwent bicanalicular stent intubation from July 2015 to April 2018 in our hospital, all the patients were suffered from lacrimal duct obstruction secondary to chemotherapy. They were divided into three groups according to the length of time between the date of surgery and the date of first chemotherapy. All patients were followed for at least 12mo post-operation. Ophthalmic physical examinations and lacrimal duct irrigations were recorded.

RESULTS: Evaluating the effectiveness 12mo after surgery. The efficiency of group 1, group 2 and group 3 were 83.3%, 61.1%, 30.0%, respectively. With the delay of surgical intervention, the efficiency decreased significantly, and the difference was statistically significant(χ²=18.322, P<0.01).

CONCLUSION: Early diagnosis and surgical intervention of lacrimal duct obstruction secondary to chemotherapy with 5-FU, S-1 or docetaxel in patients with malignant tumors are of great significance to improve the success rate of surgery.

Abstract:AIM: To investigate the prevalence of convergence insufficiency(CI)of primary school children in Nanchong and to analysis its relationship with age, gender and myopia in a school screening study.

METHODS: A cross-sectional screening study was used to select students in grades three, four, and five of three primary schools in the urban area of Nanchong from April to June in 2019. They were all performed relevant eye examinations, including slit lamp, fundus examination, vision acuity, refraction, distance and near heterophoria with alternate cover test, near point of convergence(NPC), and near positive and negative fusional vergences. A questionnaire of convergence insufficiency symptom survey(CISS-15)was performed for each participant, and a score of ≥21 was considered as a positive symptom.

RESULTS: Of the 4123 students, 2876 students participated in the study. And the data was analyzed using 2571 participants. The average age of the participants was 9.33±0.02(7 to 13)years. The prevalence of CI was 12.4%, and analysis of variance showed no gender difference(χ²=0.479, P=0.489). The CI prevalence among primary third, fourth, and fifth grade students were 12.4%, 11.3% and 13.5%, respectively, and there was no statistically significant difference in the prevalence of CI between grades(χ²=1.97, P=0.374). The prevalence of myopia among students in the third, fourth and fifth grades was 15.1%, 24.0% and 34.5%, respectively, and the difference in the prevalence of myopia between grades was statistically significant(χ²=86.47, P<0.01). Of the 641 myopic students, 240(37.4%)were diagnosed as CI, while the CI prevalence of non-myopic students was 4.15%. The difference between the two groups was statistically significant(χ²=489.54, P<0.01).

CONCLUSION: This study shows that the overall prevalence of convergence insufficiency of primary school students in Nanchong was 12.4%, which was higher than most previous studies. The prevalence of convergence insufficiency in myopic students was significantly higher than that in non-myopic students. There was no statistical difference in the prevalence of convergence insufficiency between different grades and genders.

Abstract:AIM: To investigate the corneal curvature and refractive changes after microscopically extraocular muscle surgery in adults.

METHODS: To observe 62 cases of 85 eyes underwent microscopic extraocular muscle surgery in the Second People's Hospital of Yunnan Province from December 2016 to May 2017, age 18 to 43, according to the surgical method, patients were divided into horizontal rectus surgery: Ⅰ group(simple migration group)32 eyes, Ⅱ group(rectus monocular migration combined with its antagonist muscle excision group)34 eyes, the oblique muscle group: Ⅲ group(single oblique muscle tendon broken group)10 eyes, Ⅳ group(oblique muscle transposition group)9 eyes; Subjective optometry was performed preoperatively and postoperatively at 1d, 1wk, 1mo, 3mo and 6mo, respectively, to obtain the refractive state changes and the curvature value of the anterior surface of the cornea(0-3mm, 5mm, 7mm)collected by corneal topography. The dynamic changes of the refractive state and corneal morphology of the patients in each group at different time points were compared. Anova and LSD-t test were used for comparison among time points and within each group.

RESULTS: Changes of corneal curvature in horizontal rectus muscle can be induced in a short period after the operation, which is limited to the central 5mm area of the cornea, and basically restored to the preoperative level 1mo after the operation. There was no significant effect on corneal curvature after inferior oblique operation. Astigmatism value increased in the early postoperative period of horizontal rectus muscle; Myopic drift occurred and recovered to preoperative level 1mo after surgery. After the operation of the inferior oblique muscle, there was no significant change in the spheroscopy and astigmatism.

CONCLUSION:Corneal curvature and refractive changes may occur after extraocular muscle in adults.

Abstract:AIM: To observe the effect of sub-bowman keratomileusis(SBK)on the posterior corneal curvature, posterior corneal elevation and anterior chamber parameters.

METHODS: Prospective self controlled study. Totally 49 patients(97 eyes)with myopia who had planned for SBK were included in this study, mean posterior corneal curvature, central posterior corneal elevation(PCE), anterior chamber volume(ACV), central and peripheral anterior chamber depth(ACD)were measured by Oculyzer before and 1wk, 1y, 3y after surgery. Repeated measure analysis of variance was adopted for data analysis.

RESULTS: There were no significant differences in mean posterior corneal curvature at any time point postoperatively compared with that preoperatively(P>0.05). However, central PCE, ACV and central ACD at 1wk, 1y and 3y postoperatively were all decreased(P<0.01). Except for the anterior peripheral ACD at 3y after SBK, other peripheral ACD at any time point postoperatively were all decreased(P<0.05).

CONCLUSION: The posterior corneal curvature remained stable after SBK, while the central PCE shifted slightly backward and the entire anterior chamber became shallow.

Abstract:AIM: To observe the changes of corneal curvature and astigmatism and anterior chamber depth after femtosecond laser-assisted LASIK for myopic astigmatism.

METHODS: One hundred and thirty-four cases(212 eyes)undergone femtosecond laser-assisted LASIK in our hospital were included. They were selected and divided into two groups based on astigmatism. The group A:astigmatism -2.00D to -5.00D, spherical equivalent -6.15±1.74D. The group B:astigmatism -0.25D to -1.00D, spherical equivalent-6.67±1.04D. Patients were examined 1wk, 1mo and 3mo. Visual acuity, intraocular pressure, refraction, corneal curvature and anterior chamber depth were recorded. The changes of corneal curvature and astigmatism and anterior chamber depth were compared. Spearman correlation analysis and independent t-test were used for statistical analysis.

RESULTS: No statistically significant difference was found in posterior corneal curvature and astigmatism and anterior chamber depth of the groups A and B at preoperative, postoperative 1wk, 1mo and 3mo(P>0.05). No statistically significant difference was found in anterior corneal curvature of the groups A and B at postoperation 1wk, 1mo and 3mo(P>0.05). One week postoperative, the anterior corneal astigmatism of the group A was statistically significant from that of 1mo and 3mo postoperative(P<0.05), there were no significant differences at 1mo, 3mo after operation(P>0.05). No statistically significant difference was found in anterior corneal astigmatism of the group Bat postoperation 1wk, 1mo and 3mo(P>0.05).

CONCLUSION: When correct high astigmatism, no significant changes of posterior corneal curvature and anterior chamber depth was found after femtosecond laser-assisted LASIK for correct myopic astigmatism. The anterior corneal curvature was stable from 1wk to 3mo.The astigmatism was stable from 1mo to 3mo.

Abstract:AIM: To evaluate the effect of red-green duochrome test in subjective refraction.

METHODS: A randomly-selected sample size of 60 new patients with myopia were measured twice using subjective refraction with and without the red-green duochrome test. Assessments on the effectiveness were made based on comprehensive optometry analysis, accommodation response, accommodation sensitivity, positive and negative relative accommodation.

RESULTS: Application of red-green duochrome test on the targeted population did not show any statistical significance to the subjective refraction results. No difference was observed on patients with dilated pupils(P=0.686)and non-dilated pupils(P=0.655). Bland-Altman analysis of displayed good consistency between both subjective refraction measurements on each patient. Multivariate linear regression analysis shows that the results of subjective refraction were independent of age, obliquity, regulation lag, positive relative adjustment, and negative relative adjustment effect(P>0.05).

CONCLUSION: The red-green duochrome test does not affect optometric results.

Abstract:AIM:To observe the post-operative outcomes, safety and complications of the sutureless-intrascleral fixation of posterior chamber intraocular lens(SF-PCIOL)by using the modified Yamane's technique.

METHODS:This study involved 5 patients who underwent SF-PCIOL with the modified Yamane's technique, from December 2017 to September 2018. The longest follow-up time was 12mo, and the primary outcomes included uncorrected visual acuity(UCVA, LogAMR)and bestcorrected visual acuity(BCVA, LogMAR), intraocular pressure and the location and stability of IOLs.

RESULTS: The BCVA of 3 patients were ranged from 0.0 to 0.1 by the time of following up 12mo postoperatively. The difference between the spherical equivalent refraction and the predicted spherical equivalent refraction was in a range of 0.11-0.62 diopters. In the other two cases, at 3mo after the surgery, the UCVA was 0.2 for one case, and the BCVA was the same as preoperative corrected visual acuity for another case, where the patient manifested corneal leucoma and macular edema prior to surgery. During the follow-up period, the flanges and the IOL haptics of all the recruited patients were maintained in an ideal position, the optics were located in center of the pupils, and no visible IOL decentration or tilt was observed. Neither hypotony nor other complications were discovered in all the cases.

CONCLUSION: For SF-PCIOL by using modified Yamane's technique, smaller incisions and shorter operation time are feasible, and the need for scleral flaps, sutures and fibrin glue is eliminated. The IOLs are well centered and fixed securely. A learning curve is necessary to master this surgery technique. As revealed by our initial observation, the surgery is capable of producing satisfactory and consistent postoperative outcomes for patients with fewer postoperative complications as long as the crucial points are fully understood.

Abstract:AIM: To study individualized treatment of malignant glaucoma.

METHODS: Totally 19 malignant glaucoma patients(19 eyes)admitted in Leshan Ophthalmological Center from January 2016 to October 2018 were retrospectively analyzed. Main outcomes of best corrected visual acuitv, intraocular pressure(IOP), anterior chamber depth and complications were closely observed.

RESULTS: IOP were recovered by drug treatments in 7 eyes to anterior chamber depth. 3 eyes were treated by peripheral iridectomy combined with posterior capsule of lens and anterior vitreous membrane excision with YAG laser. 5 eyes were treated by cataract phacoemulsification with foldable intraocular lens implantation combined with posterior capsule excision and anterior vitrectomy. 1 eye was treated by vitrectomy.1 eye developed to malignant glaucoma during operation was treated by trabeculectomy combined with cataract phacoemulsification after vitreous water-bag was punctured. The post-treatment IOP(14.43±3.46mmHg)significantly declined compared with pre-treatment IOP(31.25±5.19mmHg), the post-treatment anterior chamber depth(2.64±0.47mm)significantly deepened compared with that of pre-treatment(0.69±0.57mm). The best corrected visual acuity in LogMAR before treatment was 0.71±0.25, after the treatment of 0.34±0.19(P<0.05). There were no serious complications except 1 case with low intraocular pressure and choroidal detachment.

CONCLUSION: It is necessary to fully evaluate the specific conditions of patients after the occurrence of malignant glaucoma and adopt individualized treatments according to patient's condition.

Abstract:AIM:To report the residual and treatment of subretinal perfluorocarbon liquid after vitreoretinal surgeries.

METHODS: Six cases of subretinal PFCL residual cases were surgically removed. Before and after operation, we assessed best corrected visual acuity(BCVA)and optical coherence tomography angiography(OCTA)features of retina and choriocapillaris.

RESULTS: Subretinal PFCL in the range of more than 1/5PD in diameter and 2PD in the fovea were completely removed in all cases, macular was reattached and visual acuity was improved in varying degrees. The OCTA features of two patients showed that the changes of blood flow in the superficial retina of the PFCL were small, the deep inner retinal layers blood flow disappeared, and the choriocapillaris signal were different according to the quantity of PFCL bubble.

CONCLUSION: Large PFCL bubble can be removed surgically, and small PFCL outside the macula can be observed for a long time. OCTA is helpful to observe the size and morphology of retained subretinal PFCL, and to analyze the structure and function of the retina and choroid in the lesion.

Abstract:AIM: To investigate the diagnostic value of optical coherence tomography angiography(OCTA)in choroidal rupture and evaluate the imaging features.

METHODS: We selected 25 patients(25 eyes)whom were diagnosed as choroidal rupturein in this retrospective observational case. All patients underwent fundus photography, fundus fluorescein angiography(FFA), indocyannine green angiograph(ICGA), spectral domain optical coherence tomography(SD-OCT)and OCTA examinations.

RESULTS: All the patients showed the lesions were mostly located in the macular area or on the temporal side of the optic disc, with a yellow-white arc hyperreflexia with stripes shape, it can be accompanied by retinal choroidal edema and subretinal hemorrhage. In the early stage of FFA, it showed a curved shape window defect of choroidal rupture, and fluorescent staining in the late stage. When secondary to choroidal neovascularization(CNV), the active CNV showed a hyperfluorescence leakage. SD-OCT showed the reflex of outer retina and choroidal capillary layer were ruptured, the reflex of the surrounding tissue were reinforced, the subretinal small cluster hyperreflexia can be seen. The granulation tissue showed an arc hyperreflexia with “stripe shape” in the outer retinal and choroid capillary layer of OCTA angiogram image. On the B-scan, it showed an inwardly bulge or outwardly recess shap, with blood flow signal inside. When secondary to CNV, vascular morphology can be seen clearly, most of them were cluster shape, which is different from the granulation tissue.

CONCLUSION: Although the granulation tissue and CNV of choroid rupture showed cluster shap and blood flow signal on OCTA, there were significant differences in morphology and tissue composition between them. Through the display of OCTA stratification and the detailed observation of the lesion, the diagnosis rate of secondary CNV in choroidal rupture can be improved.