Abstract:AIM: To study the changes in choroidal thickness in central serous chorioretinopathy(CSCR)over a 3mo follow-up using spectral domain optical coherence tomography(SD-OCT).

METHODS: This prospective study included 60 eyes, both eyes of 20 patients(mean age: 33.65±5.24 years)with classic acute unilateral central serous chorioretinopathy and normal fellow eye and 20 eyes as healthy controls. Fluorescein angiography and OCT were done. The subfoveal choroidal thickness(SFCT), central macular thickness(CMT), 1000 μm temporal and nasal to the centre of the fovea and the subretinal fluid were measured.

RESULTS: There was a statistically significant difference in SFCT among the three groups at the three different locations. SFCT in eyes with CSCR(372.40±34.39 μm)was significantly greater than that in each of the unaffected fellow eyes(302.10±8.9 μm)and control eyes(279.80±14.49 μm)at the base line and after 3mo follow-up. The mean CMT in CSCR was 317±141.86 μm, with a statistically significant positive correlation between SFCT and CMT.

CONCLUSION: The increase in the choroidal thickness at different locations as well as hyper-dilated and hyper-permeable vessels known as “pachychoroid” seems to play an important role in a broad spectrum of diseases that includes central serous chorioretinopathy.

Abstract:AIM: To compare the non-invasive tear film break-up time(NIBUT), tear break up time(TBUT), basal tear secretion(BTS)and blink rate in four ethnic groups: Malay, Chinese, Indian and Nigerian.

METHODS: Totally 120 healthy(61 males and 59 females)subjects(without dry eye symptoms and ocular surface disorder)with the age 20 to 39 years were recruited; 30 were Malays, 30 were Chinese, 31 were Indians and 29 were Nigerians. Based on McMonnies questionnaire and clinical examination, normal subjects were selected. NIBUT, TBUT, BTS were assessed in only one eye(right)of each subject and blink rate was also assessed.

RESULTS: There was significant difference in the NIBUT, TBUT, BTS and blink rate among 4 different ethnic groups(P=0.018),(P=0.001),(P=0.011), and(P=0.004)respectively. No statistically significant difference of NIBUT, TBUT, BTS and blink rate was found between the genders among different ethnic groups. Indian had higher median for NIBUT(10±6s), TBUT(7±5s)and BTS(20±20 mm)than others races. Chinese had lower median for NIBUT(7.5±4s)and TBUT(4±2s)while Malay had low BTS(9.5±16 mm)among the groups. There was no significant correlation of blink rate with NIBUT, TBUT and BTS(r= -0.119, P=0.195),(r=-0.086, P=0.352),(r= -0.123, P=0.180)respectively.

CONCLUSION: This study showed the variability in tear-film measurements values in four ethnic groups.

Abstract:AIM: To investigate the feasibility of constructing corneal stromal scaffolds and the optimal preservation conditions of corneal stromal lenses obtained from the small incision lenticule extraction(Smile)surgery.

METHODS: Constructing a bilayer lens by adhering together two corneal stromal lenses with human fibrin sealant(FS). Human corneal fibroblasts were isolated and cultured from Smile derived corneal stromal lenses in vitro, and the toxicity of FS on human corneal fibroblasts was detected by MTT method. The bilayer lenses were then placed in anhydrous glycerin, sodium hyaluronate eye drops, a simulated wet room environment and fetal bovine serum groups respectively, and stored at 4℃ for 14d. The transparency, hardness and stability of the scaffolds were then compared. Afterwards, the bilayer lens scaffolds were stored in anhydrous glycerin at room temperature, 4℃ and -20℃. After 14d of preservation, the diverse effects of temperature on the transparency and hardness of the scaffolds were compared.

RESULTS: MTT results showed that the cells of the experimental group and the control group had similar proliferation trend within 0-72h. The cytotoxicity rating of the experimental group was 0 at 36-48h and 1 at 24h and 60-72h. The relative survival rate of the cells within 0-72h was over 90%. FS-bonded bilayer lens scaffold had a smooth surface, close bonding, good transparency and suitable hardness. After 14d of storage at 4℃, none of the nine bilayer lens scaffolds in the anhydrous glycerol group showed signs of cracking cracking after rehydration, and their transparency was good. In the sodium hyaluronate group, three of the nine scaffolds cracked and the remaining six were still intact. In the simulated wet room environment group, none of the 9 scaffolds cracked, but there were different degrees of shrinkage, their surface was rough and transparency was lower. In the fetal bovine serum group, all the 9 stents were cracked, and the single corneal stromal lens was soft and edema was serious. Out of the 15 bilayer lens scaffolds preserved in anhydrous glycerol at room temperature, 2 remained colourless and transparent, 5 slightly yellowed but still remained transparent, 8 yellowed substantially with a significant reduction in transparency. Out of the 15 bilayer lens scaffolds preserved in anhydrous glycerol at 4℃, 5 remained colourless and transparent, and 10 slightly yellowed while remaining transparent. Of the 15 bilayer lens scaffolds preserved in anhydrous glycerol at -20℃, none of the scaffolds yellowed, therefore, remaining colourless and transparent.

CONCLUSION: FS is a safe and non-toxic bio-gel. It can be used to glue Smile-derived corneal stromal lenses to construct corneal stromal scaffolds with good stability, high transparency and suitable hardness. Anhydrous glycerol at -20℃ is the best preservation condition for corneal stromal lens scaffolds.

Abstract:AIM: To investigate the temperary changes in the refraction, axial length, and choroidal thickness after a Chinese herb(Zhujing formula)feeding or injection of ranibizumab in a guinea pig myopia model.

METHODS: A Guinea pigs model of form-deprived(FD)myopia were randomly divided into 3 groups: Zhujing formula group, ranibizumab group and saline group(n=20 for each group). Zhujing formula group were fed daily with Zhujing formula solution 3.285g/(kg·d)(1.5mL/d)for 1wk. Ranibizumab group were treated with(intravitreal injections of 0.02mg)ranibizumab at the first day. Saline group were fed with 1.5mL 0.9% saline at the first day. The refraction(Diopter), axial length and choroidal thickness were measured before and at day 1, 3 and 7d postoperative.

RESULTS: The spherical equivalent(SE), axial length and choroidal thickness in ranibizumab group showed no significant trend after intravitreal injection(P>0.05). However, SE and axial length showed trendency to greater myopic shift in the Zhujing formula group and the saline group(P<0.05). The effect began to appear on the first day after administration, achieved the maximum effect after 3d, and faded completely until 7d. On the first day after administration, the diopter and the axial length in ranibizumab group showed the lowest among three groups(P<0.05), and choroid thickness showed the thickest among three groups(P<0.05). At 3d after administration, the diopter and the axial length in the saline group showed the lowest among three groups, and choroid thickness showed the thickest among three groups(P<0.05). There was no significant difference in the parameters among the three groups at 1wk after administration(P>0.05).

CONCLUSION: There is a temperary choroidal thickening of the form deprivation myopia recovery period. The ranibizumab inhibited the thickening of the choroid in the whole recovery period of form deprivation myopia, Zhujing formula slight inhibited the thickening at 3d, and the all change persisted only for 1wk.

Abstract:AIM: To compare the differences of CP-RNFL, optic nerve head(ONH)and macular parameters between ocular hypertension(OHT)patients with different central corneal thickness(CCT)and normal subjects using three dimensional optical coherence tomography(3D-OCT).

METHODS: This is a prospective study including 124 eyes of 77 OHT patients classified as group 1(CCT<555μm)including 38 eyes of 25 patients, group 2(CCT 555-590μm)including 44 eyes of 26 patients and group 3(CCT>590μm)including 42 eyes of 26 patients according to CCT. Totally 124 eyes of 77 normal healthy subjects, matching patients with age and gender, were divided into group four. The CP-RNFL thickness,optic nerve head and macular parameters were measured by 3D-OCT. There were no significant difference in gender, age between four groups and in intraocular pressure among three OHT patients groups.

RESULTS: The optic rim area was significantly smaller in group one than in other three groups, and the thickness of inferior CP-RNFL was significantly thinner than group two and group three, while the thickness of the temporal inner ring of macular was thinner than group three. All the thickness of the central fovea, macular center 1mm, the temporal inner ring of macular in OHT patients were significantly thinner than healthy subjects. The CCT and the rim area in OHT patients were significantly positively correlated.

CONCLUSION: The OHT patients are considered to be different from normal persons in optic nerve head and macular parameters though the parameters are still in normal range. CCT<555μm may be a risk factor of OHT patients converting to POAG, so we should pay more attention to following up these patients and intervention in time.

Abstract:AIM: To compare the clinical effects and safety of single subthreshold micropulse(STMP)yellow laser and combined ranibizumab intravitreal injection on the treatment of diabetic macular edema(DME).

METHODS: Totally 33 patients(58 eyes)with DME were divided into two groups. Group A(laser group)received STMP yellow laser, and group B(combined treatment group)received ranibizumab intravitreal injection combined with STMP yellow laser. The best corrected visual acuity(BCVA), intraocular pressure(IOP), central macular thickness(CMT), total macular volume(TMV), fluorescein fundus angiography(FFA), multifocal ERG(MERG), autofluorescence(AF)and macular pigment optical density(MPOD)were compared before and after the treatments. And treatment times were counted.

RESULTS:Compared with those before treatment, there were significant differences in BCVA and TMV 6, 9, 12mo after treatment in the laser group(P<0.05). And there were significant differences in BCVA and TMV 3, 6, 9, 12mo after treatment in the combined treatment group(P<0.05). For both groups, there were significant differences in CMT before and 3, 6, 9, 12mo after treatment(P<0.01). Compared with the P₁ amplitude of MEG, Max OD and Mean OD before treatment, there were significant differences for the two groups 12mo after treatment(P<0.01). And the differences were significant in TMV and P₁ amplitudes between the two groups after 12mo of treatment(P<0.01). During the follow-up period, the laser times was 3.32±1.09 in the laser group and 3.30±1.18 in the combined treatment group(P=0.943).

CONCLUSION:Both single STMP laser and combined with intravitreal injection of ranibizumab can effectively reduce macular edema, improve vision and safety in DME patients. And the combined treatment group has faster and better effect.

Abstract:AIM: To investigate the clinical effects of laser photocoagulation combined with anti-vascular endothelial growth factor(VEGF)drugs at different time in the treatment of diabetic retinopathy(DR).

METHODS: A prospective study was conducted. Totally 120 patients(191 diseased eyes)with DR who were admitted to the hospital between January 2018 and January 2019 were divided into group A(treated with simple laser photocoagulation, 30 cases, 44 diseased eyes), group B(treated with intravitreal injection of ranibizumab, 30 cases, 46 diseased eyes), group C(treated with intravitreal injection of ranibizumab after laser photocoagulation, 30 cases, 49 diseased eyes)and group D(treated with laser photocoagulation after intravitreal injection of ranibizumab, 30 cases, 52 diseased eyes). Patients in each group were followed up for 6mo after the end of treatment. The best corrected visual acuity(BCVA), intraocular pressure and central foveal thickness(CMT)of each group were compared before and after treatment. The situation of laser photocoagulation and anti-VEGF treatment, complications and recurrence of diabetic macular edema were observed.

RESULTS: There was no significant difference in BCVA or CMT among the four groups before treatment(P>0.05). The two indexes were improved at 1wk, 1mo, 3mo and 6mo after treatment(P<0.05). Besides, they were better in group C and group D than in group A and group B at different time after treatment(P<0.05). The BCVA and CMT in group D were better than those in group C at 1wk, 1mo and 3mo after surgery(P<0.05). There was no significant difference in intraocular pressure among the four groups before or after treatment(P>0.05). The laser parameters and frequency of laser treatment were lower or fewer in group C and group D than in group A, and lower in group D than in group C(P<0.05). The frequencies of intravitreal injection in group C and group D were fewer than that in group B(P<0.05). There was no significant difference in the frequency of laser treatment or drug injection between groups C and group D(P>0.05). There was no significant difference in the incidence of complications or the incidence of diabetic macular edema among the four groups during follow up(P>0.05).

CONCLUSION: The effect of laser photocoagulation after intravitreal injection of anti-VEGF drug is better than simple photocoagulation, simple intravitreal injection or intravitreal injection of ranibizumab after laser photocoagulation in the treatment of DR. It can improve the BCVA, relieve macular edema, reduce laser energy, frequency of laser treatment and injection frequency of anti-VEGF drug, with safety.

Abstract:With a new therapy of keratoconus in recent years-corneal cross-linking, the pediatric keratoconus have characterized by corneal dilatation, central thinning, protrusion and conical shape in the children' eyes. By analyzing the epidemiological characteristics of keratoconus and the current methods of treating pediatric keratcoconus, this paper discusses the role of different CXL protocols in the clinical application of pediatric keratcoconus, thus providing some help for the choice of clinical treatment methods.

Abstract:Optical coherence tomography angiography(OCTA)is a rapid and non-invasive imaging tool, which can provide real-time flow imaging of retina and choroid. Compared with traditional angiography, OCTA can produce more detailed and high-resolution vascular images without increasing the risk due to contrast medium. Age-related macular degeneration(ARMD)is one of the major senile blinding eye diseases in the world, OCTA can well display the image of choroidal neovascularization and provide the possibility for early diagnosis and intervention. This review summarizes the OCTA image characteristics and clinical diagnostic value in patients with ARMD.

Abstract:Retinitis pigmentosa(RP)was known as pigmentation retinitis even. RP is a group of hereditary eye diseases that cause irreversible visual impairment due to progressive loss of function of retinal pigment epithelial cells and progressive apoptosis of photoreceptors. Because of its heterogeneity in phenotype and heredity and complex pathogenesis, there is currently no single effective treatment. This article mainly elaborates on the progress in the treatment of retinitis pigmentosa in recent years.

Abstract:The uveitis is a clinical common involving the iris, ciliary body, vitreous body, choroid, retina and retinal blood vessels, a group of inflammatory disease causes complex, due to the pathogenesis of uveitis did not clarify clearly, looking for effective treatment of uveitis drugs has been the main direction of ophthalmic research, in addition to the traditional glucocorticoid, cycloplegia agent, nonsteroidal anti-inflammatory drugs(nsaids), immune inhibitor has a good curative effect on uveitis, along with the development of molecular biology, a new type of biological agents, gene therapy, could fairly claim a place in the history of Chinese medicine in the treatment of uveitis. This article aims to review the latest progress in the treatment of uveitis.

Abstract:Given the popularity of corneal refractive surgery and an aging population of patients who have undergone this procedure, those patients will likely require the diagnosis, follow-up, and management of glaucoma in the future. Since glaucoma examination metrics such as intraocular pressure depend largely on corneal properties, patients who plan to undergo corneal refractive surgery must also undergo a thorough glaucoma examination in order for the ophthalmologist to monitor the development and progress of glaucoma. This article presents an overview of related research on the diagnosis of glaucoma before and after corneal refractive surgery in order to provide reference for clinical work.

Abstract:Pterygium is a common conjunctival disease which is mainly attributed to chronic ultraviolet light exposure. Previous studies have focused primarily on the clinical characteristics, surgical management and the pathogenesis of pterygium, but the differences between primary pterygium and recurrent pterygium have been less frequently documented. This article reviews the differences in clinical manifestations, histopathological findings, and laboratory parameters between primary pterygium and recurrent pterygium and summarises the latest findings regarding these differences.

Abstract:Lacrimal drainage is the process of drainage tear from eye surface to nasal cavity and its mechanism is complex. It requires not only the coordination of gland and muscle system of eyelid, but also the joint participation of lacrimal secretion system and drainage system. For hundreds of years, the function and mechanism of lacrimal drainage system has been concerned by ophthalmologists. Many representative viewpoints have been put forward and great progress has been made. It has important clinical significance to improve the diagnosis and treatment of lacrimal passage diseases. This paper reviews the anatomical background, mechanism, problems and prospects of lacrimal drainage system.

Abstract:Nasolacrimal duct obstructive disease is a common ophthalmological disease with high clinical incidence. It is caused by inflammation or other reasons that nasolacrimal duct obstruction is partially or totally impassable. The main manifestation is epiphora. Secondary dacryocystitis can cause pyorrhea and secondary dacryocyst cyst can lead to enlargement of lacrimal sacand swelling of inner canthus. Opening obstructive nasolacrimal duct is the key to treat nasolacrimal duct obstructive disease. Tract-related anatomical parameters are very important in the diagnosis and treatment of nasolacrimal duct obstructive diseases. CT is one of the common methods of imaging examination of lacrimal duct, which is convenient for measuring the relevant anatomical parameters of nasolacrimal duct. This article reviews the research progress of CT measurement of nasolacrimal duct related anatomical parameters in nasolacrimal duct obstructive diseases in recent years, including the length and width, area, volume and angle of nasolacrimal duct and lacrimal sac, and summarizes the correlation between related anatomical parameters and nasolacrimal duct obstructive diseases in order to better guide clinical practice.

Abstract:Optical coherence tomography angiography(OCTA), as a new non-invasive and non-contact blood flow imaging technique, is becoming more and more popular in clinic. This technique does not need intravenous injection of contrast agent, only by detecting the normal movement of red blood cells in capillaries, it can realize the detection of flowing blood and the morphological evaluation of tissue, and has the advantages of high speed, non-invasive, three-dimensional imaging and so on. At present, OCTA is used in the evaluation and diagnosis of many diseases in ophthalmology. This paper reviews the clinical application of OCTA in ophthalmology.

Abstract:AIM: To compare the effectiveness and safety of femtosecond laser-assisted cataract surgery(FLACS)with traditional cataract surgery in cataract patients with different axial lengths.

METHODS: Patients with cataract surgery were divided into normal axis group(22mm≤AL<24mm group), medium and long axis group(24mm≤AL <26mm), and long axis group(26mm≤AL)according to the axial length. Each group had 100 eyes. The patients in each group were randomly divided into femtosecond laser group and traditional ultrasonography group. The postoperative changes of best-corrected visual acuity(BCVA), visual quality and corneal endothelial cells were analyzed.

RESULTS: The visual acuity of the patients in each group was improved(FLACS: t=8.29, 25.01, 19.23, all P<0.01; PHACO: t=19.61, 18.76, 18.23, all P<0.01). Visual acuity improvement after FLACS in different axial groups was better than that after PHACO, but there was no significant difference between the groups(P=0.24, 0.25, 0.19). The postoperative strehl ratio value increased after operation in all groups expect for PHACO medium and long axis group, but the increase was significant only in normal axis group(P=0.011, 0.007). The corneal endothelial counts in the FLACS group were significantly lower than those before the operation(P<0.01, 0.002, <0.01). The corneal endothelial counts in the PHACO group except for the medium and long axis group were significantly reduced after surgery(P<0.01); there was no significant difference in postoperative corneal endothelial count between the FLACS and PHACO groups(P>0.05).

CONCLUSION: Both traditional cataract surgery and femtosecond laser-assisted cataract surgery can effectively improve the BCVA in various types of axis. Both surgical methods will cause damage to the corneal endothelium, but the difference is not obvious.

Abstract:AIM: To explore the clinical efficacy of the T-hook pre-chopping combined with capsule fine treatment technology for patients with high myopia and cataract.

METHODS: From March 2016 to February 2019, 56 cases(80 eyes)of cataract patients with high myopia were treated in cataract department of Hebei Province Eye Hospital. They were randomly divided into A and B groups, 40 eyes in each group. Group A underwent T-hook pre-chopping combined with fine capsular treatment. Cataract phacoemulsification combined with intraocular lens implantation was purely performed in group B. We compared the cumulative release energy of ultrasound during operation between the two groups. We also observed the best corrected visual acuity(BCVA), the amount of contraction of the anterior capsule, the degree of posterior capsule opacification, intraocular lens neutrality and complications for more than 6mo.

RESULTS: The cumulative release energy of ultrasound in group A was less than that in group B(12.23±3.61 vs 20.46±4.61, P<0.01). The best corrected visual acuity of group A was better than that of group B at 6mo after operation(Z=5.328, P=0.002). The changes of anterior capsular contraction and intraocular lens decentration(0.18±0.14, 0.02±0.007mm)were less than those of group B(0.82±0.23, 0.65±0.240mm)(P<0.05). In group A, there were 3mm round holes in the center of the posterior capsule, and the optic axis area remained transparent, while in group B, 13 eyes(32%)had turbid central area of the posterior capsule. In group A, there was no intraoperative posterior capsule rupture or postoperative retinal detachment. In group B, there were 2 eyes(5%)with intraoperative posterior capsule rupture and 1 eye(2%)with postoperative retinal detachment.

CONCLUSION: We used T-hook pre-chopping combined with capsule fine treatment technology to treat cataract with high myopia, which could reduce the use of ultrasound energy during operation, reduce the risk of posterior capsule rupture, effectively avoid the occurrence of posterior cataract, and achieve satisfactory clinical effect.

Abstract:AIM: To discuss the effect of conbercept in the treatment of polypoid chorioretinopathy(PCV)and its influence on hemorheology.

METHODS: From January 2017 to April 2018, 62 patients with PCV were enrolled in our hospital. According to the difference of treatment, the patients were divided into two groups, 31 cases in each group. The control group was treated with rapunzumab and the observation group with conbercept. Intraocular pressure, BCVA, CMT, SFCT, hemorheology and complications were compared between the two groups.

RESULTS: There was no difference in intraocular pressure, BCVA, CMT and SFCT between the two groups before treatment(P>0.05). With the increase of time, BCVA increased, CMT and SFCT decreased in both groups(P<0.05). BCVA, CMT and SFCT were different between the two groups(P<0.05). There was no difference in intraocular pressure between the two groups before and after treatment(P>0.05). The whole blood high shear viscosity, whole blood low shear viscosity, plasma viscosity and RBC aggregation index in the observation group were lower than those before treatment and lower than those in the control group(P<0.05), and the RBC deformation index was higher than that before treatment and higher than that in the control group(P<0.05). There was no difference in the incidence of complications between the two groups(3% vs 6%, P>0.05).

CONCLUSION: The application of conbercept in PCV can improve the visual acuity, and have a good impact in the hemorheology, reduce the macular edema and other clinical symptoms, and it has high safety and no effect on intraocular pressure.

Abstract:AIM: To observe the clinical effect of 25G vitrectomy combined with inner limiting membrane(ILM)peeling in the treatment of severe proliferative diabetic retinopathy(PDR)with macular displacement.

METHODS: Clinical data of 36 cases(36 eyes), diagnosed as severe proliferative diabetic retinopathy with macular displacement in Jiangsu Province Hospital were collected. Eighteen cases admitted from January to December 2016 were included in the control group(18 eyes, treated by 25G vitrectomy), while 18 cases admitted from January to December 2017 were included in the combined group(18 eyes, treated by 25G vitrectomy with ILM peeling). Best corrected visual acuity(BCVA), intraocular pressure(IOP), complications, and the thickness of macular center area(CMT)were examined during follow-up at 7d, 1mo, 3mo and 6mo postoperative.

RESULTS: BCVA showed a significant improvement at postoperative 6mo compared with baseline in both groups (P<0.05). CMT of the combination group was thinner than that of the control group(P<0.001). Two eyes(11%)had intraocular hypertension,and 1 eye(6%)had macular edema in the combined group, while post-operative complications included intraocular hypertension(6%),macular membrane(6%)and vitreous hemorrhage(6%)in the control group. No statistical difference was found in the complication rates between the two groups(all P=1.000).

CONCLUSION: In the treatment of severe PDR with macular displacement, 25G vitrectomy combined with ILM peeling can effectively and safely improve visual acuity and reduce the thickness of macular center area.

Abstract:AIM:To evaluate the functional and structural changes of foveal macula after intravitreal ranibizumab injection in patients with macular edema secondary to branch retinal vein occlusion(BRVO-ME)and screen the factors that can predict the final visual acuity of the patients.

METHODS: Prospective, clinical study. In this prospective single-arm study, we observed 25 patients(25 eyes)diagnosed with BRVO-ME who were enrolled from 2018.6-2019.5 in the first central hospital of Baoding. All patients received monthly ranibizumab 0.5mg injections for 3 consecutive months. The best-corrected visual acuity(BCVA),the central macular thickness(CMT)and the vessel perfusion density(VPD), vessel length density(VLD)and fovea avascular zone(FAZ)of superficial capillary plexus(SCP)were evaluated detected by optical coherence tomography(OCT and OCTA)before and 1mo after the third injection. Mf-ERG was used to analyze the amplitude density of P1 wave and latency of P1, N1 wave from ring 1 and ring 2.

RESULTS: After treatment, BCVA(LogMAR)was improved significantly compared with that before(0.323±0.086 vs 0.773±0.304, P<0.05). CMT was lower than before(239.385±33.175μm vs 489.346±137.453μm, P<0.05), but there was no significant change in FAZ, VPD and VLD of SCP within 6mm×6mm of macular area before and after treatment(P>0.05). The latency of P1, N1 wave of ring 1 and ring 2 were significantly decresed from baseline, while the amplitude density of P1 wave was increased(P<0.05). Pearson correlation analysis shows that age, baseline BCVA, VLD, VPD, FAZ were significantly correlated with changes in visual acuity before and after treatment(P<0.05).

CONCLUSION: In patients with BRVO-ME, ranibizumab therapy can reduce CMT, improve BCVA and improve the structure and function of macular area. Age, BCVA before treatment and microstructure parameters of macular area can be used as predictors of vision improvement.

Abstract:AIM: To investigate the clinical analysis of dry eye and tear film stability in pterygium patients after autologous conjunctival flap transplantation.

METHODS: Totally 114 cases of 138 eyes with pterygium were selected and divided into 56 groups of 67 eyes in the traditional group and 58 eyes of 71 eyes in the experimental group. The SⅠt values and BUT values of the two groups were observed before, 1 and 3mo after the operation, FL value, eye surface temperature and dry eye score of the two groups after surgery.

RESULTS: The total effective rate of the traditional group was 83.6%, and the total effective rate of the experimental group was 95.8%. The difference between the two groups was statistically significant(χ²=5.207, P=0.022); there was no difference in the SⅠt value before surgery between the two groups(P>0.05 ), SⅠt values in the experimental group increased significantly at 1, 3mo after surgery compared with the traditional group(both P<0.05); there was no difference in BUT values before surgery in the traditional and experimental groups(P>0.05), and at 1 and 3mo after surgery the BUT value in the group was significantly increased compared with the traditional group(both P<0.05); there was no difference in the FL score between the traditional group and the experimental group before surgery(P>0.05).FL value was decreased in the experimental group campared to the traditional group 1, 3mo after surgery(All P<0.05); there was no difference in eye surface temperature between the traditional group and the experimental group(P>0.05), and the dry eye score test group was significantly lower than the traditional group(P<0.05).

CONCLUSION: Autologous conjunctival flap transplantation is superior to simple tendon resection, which can promote the recovery of tear film stability in patients with pterygium, and the dry eye symptoms of patients are significantly improved.

Abstract:AIM: To observe the effect of transepithelial photorefractive ketatectomy(TPRK)on corneal curvature, asphericity and aberrations.

METHODS: Twenty-nine patients(58 eyes)were enrolled. The 1mm-8mm zone curvature, target curvature and 3mm ring curvature, corneal asphericity(Q value)and corneal aberration was measured and analyzed before and 6mo after TPRK surgery.

RESULTS: In the 1mm-8mm zone, the corneal curvature all had significant decrease after TPRK surgery. The curvature 3mm ring after operation was 39.20±1.99D, and the curvature target was 39.51±1.99D. And both values had a significant correlation(r=0.98). The Q values before and after operation were -0.44 to -0.30, 0.34-0.66 respectively (P<0.05). The total high-order aberration, spherical aberration and vertical coma of cornea before and after operation were 0.41±0.10, 0.17±0.08, -0.07±0.23 and 0.72±0.23, 0.41±0.17, -0.24±0.32, respectively, and these differences were significant. The pre-and postoperative horizontal coma was -0.03±0.12, and -0.03±0.30 respectively(P>0.05).

CONCLUSION: After TPRK operation, corneal curvature decreased significantly, and the change in zone of 3mm was the largest. The Q value, total high-order aberration, spherical aberration and vertical coma increased significantly after TPRK operation.

Abstract:AIM: To analyze the differences of retinal structure, visual evoked potential and visual function in different types of amblyopia children.

METHODS: One hundred and twenty children with 136 eyes with moderate amblyopia treated in our hospital from May 2014 to May 2018 were enrolled as the observation group(31 cases with 31 eyes of anisometropy, 35 cases with 70 eyes of refractive ametropia, and 26 cases with 35 eyes of strabismus); meanwhile, 29 children with 58 eyes with normal vision in the eye examination from our hospital were selected as the control group. Optical coherence tomography(OCT)imager was used to detect the foveal thickness of the macula, the thickness of the retinal nerve fiber layer(RNFL)around the optic disc and the quadrants, and the changes in retinal function were detected using visual electroencephalography. The P100 amplitude and latency of visual evoked potentials were observed and stereoscopic inspection being performed.

RESULTS: The thickness of macular fovea, the thickness of the optic disc and the RNFL in the quadrants of children with anisometropy and ametropia were significantly higher than those in the control group and children with strabismic amblyopia(P<0.01). Compared with the control group, patients with refractive amblyopia had lower light peak potentials and longer light peak times. The dark valley potential of myopia children was higher in children with refractive amblyopia, and the Arden ratio and Gliern ratio were lower(All P<0.01). The P100 wave amplitudes of the visual evoked potentials of the three types of amblyopia children were significantly lower than those of the control group, and the 1° and 15' spatial frequency latency periods were significantly delayed(all P<0.01). The number of cross parallaxes, non-cross parallaxes, near-zero parallaxes, and far-sighted stereoscopic aberrations in the ametropic amblyopia group were significantly higher than those in the strabismic amblyopia group(P<0.05), but were no different from those in the ametropic amblyopia group in terms of each indicators.

CONCLUSION: Retinal structure of patients with ametropic amblyopia and ametropic amblyopia has obvious abnormalities, and the P100 wave latency is delayed; strabismic amblyopia has the largest effect on stereoscopic function, while refractive amblyopia has the least effect.

Abstract:AIM: To explore the effect of the improved four-stage teaching mode in the teaching process of optometry.

METHODS: Totally 109 students majoring in Ophthalmic Optics in our college in 2016 were selected as the subjects of study. Taking the mid-term results of optometry as the reference of baseline results. The control group adopted the traditional teaching mode, while the experimental group adopted the improved four-stage teaching model. Achievements in the final optometry examination, satisfaction of students with the teaching of optometry and self-evaluation were compared between the two groups.

RESULTS: There was no significant difference among the three final grades(basic theory of optometry, experimental skills and clinical case analysis)and the baseline scores in the control group(P>0.05). Compared with the baseline scores, the final scores of the three items in the experimental group were significantly improved, and the difference was statistically significant(P<0.05). The final scores of the two groups were compared(P<0.05). The satisfaction with the teaching process and results of optometry course and the improvement of self-evaluation ability of the two groups were significantly higher than those of the control group(P<0.05).

CONCLUSION: Four-stage teaching can effectively improve the effect of optometry teaching for students majoring in Ophthalmic Optics, which can make students adapt to clinical work faster and more effectively.

Abstract:AIM: To explore the effect of different intraocular irrigating solutions on lens opacity after pars plana vitrectomy(PPV)for proliferative diabetic retinopathy(PDR).

METHODS: Totally 48 subjects(48 eyes)patients with proliferative diabetic retinopathy from March 2018 to February 2019 were enrolled in this study, randomly divided into BSS intraocular irrigating solution group(23 cases and 23 eyes)and Shike intraocular irrigating solution group(25 cases and 25 eyes). LOCS grading system Ⅲ was applied to grade lens opacity. Pentacam occipital analyzer was applied to analyze the density and thickness of lens, and the results were compared and discussed.

RESULTS:Three months after PPV,NC, P score and the density of lens in LOCSIII grade in the two groups were significantly higher than those before surgery(P<0.05), but the C score was not different significantly(P>0.05). In addition, the thickness of the lens in BSS intraocular irrigating solution group was significantly higher than that before PPV(P<0.05), but there was no significant difference in the Shike intraocular irrigating solution group(P>0.05). NC, P score, the density and thickness of lens were significantly lower in Shike intraocular irrigating solution group than those in the BSS intraocular irrigating solution group. But the C score was not different significantly between the two groups(P>0.05).

CONCLUSION: Shike intraocular irrigating solution can delay the development of postoperative complicated cataract formation.

Abstract:AIM:To observe the correlation between the interleukin-1β(IL-1β)and interleukin-18(IL-18)in tears of patients with dry eye and symptoms and signs.

METHODS: A total of 131 patients(262 eyes)who were treated for dry eye in the ophthalmology clinic of the First Affiliated Hospital of Hunan University of Traditional Chinese Medicine were selected from September 2018 to December 12, and the patients were divided into dry eye classification standards according to the dry eye clinical consensus in 2013 No dry eye group, mild dry eye group, moderate dry eye group, severe dry eye group. All patients were examined for dry eye symptom score, break up time(BUT), and tear secretion test Schirmer I test(SⅠt), corneal fluorescein sodium staining(FL), ELISA method to detect the expression of IL-1β and IL-18 in tears, and to analyze the correlation between dry eye inflammatory factors and symptoms and signs.

RESULTS: There were significant differences in the expression of dry eye symptoms, BUT, SⅠt, FL and IL-1β and IL-18 in tears(P<0.001), inflammatory factors IL-1β, IL-18 and dry eye symptom scores. FL was positively correlated(P<0.05)and negatively correlated with BUT and SⅠt(P<0.05).

CONCLUSION:Inflammatory factors in tears of dry eye patients were correlation with dry eye symptom and signsa.

Abstract:AIM: To investigate the clinical and imaging data of proliferative diabetic retinopathy(PDR)treated by pars plana vitrectomy(PPV), and to further explore the risk factors associated with poor prognosis.

METHODS: Data of 90 eyes of 90 patients at Guangxi Zhuang Autonomous Region People's Hospital from January 2016 to December 2018 were retrospectively reviewed. According to the postoperative visual acuity, the patients were divided into favorable prognosis group(group A)and unfavorable prognosis group(group B). To explore the clinical and image risk factors and prognosis of disease outcome. Univariate analysis uses Chi-square analysis,while multivariate analysis takes Logistic regression analysis.

RESULTS: Univariate analysis showed that there was much more difference between good prognosis and those with poor prognosis: the preoperational PRP treatment experience(P=0.042), HbA1c(P=0.008), OCT-TRD(P=0.004), OCT-HRF(P=0.005). Multivariate logistic regression analysis showed that HbA1c(OR=1.439, P=0.009)and OCT-TRD(OR=4.007, P=0.040)were independent risk factors for poor prognosis after proliferative diabetic retinopathy.

CONCLUSION: HbA1c and OCT-TRD are independent predictors of poor prognosis in PDR patient.

Abstract:AIM: To investigate and analyze the influencing factors of diabetic retinopathy(DR)and the therapeutic effect of conbercept.

METHODS:Totally 157 patients with diabetes who were treated in our hospital from January 2018 to July 2019 were selected as the research objects to carry out ophthalmic examination. According to the results of the examinations, the prevalence of DR was counted and the patients were divided into DR group and non-DR group. The basic data and clinical data of the two groups were compared and analyzed. The risk factors of DR in diabetic patients were explored by univariate analysis and multivariate Logistic regression analysis. The patients in DR group were treated with conbercept, and the therapeutic effect of conbercept on DR patients was observed and evaluated.

RESULTS:According to the diagnosis survey, there are 44 DR patients in 157 diabetic patients, 63 eyes in total, the prevalence rate is 28.0%. Univariate analysis showed that there was no significant difference in gender, body mass index(BMI), smoking history, drinking history, education level, history of coronary heart disease and blood lipid history between DR group and non-DR group(P>0.05), while there was a significant difference between the two groups in the duration of diabetes, age, history of ophthalmic diseases, the use of hypoglycemic drugs, and the history of hypertension(P<0.05). Logistic multivariate analysis showed that age, long course of diabetes, history of ophthalmic diseases, history of hypertension, irregular use of hypoglycemic drugs were independent risk factors for DR in diabetic patients. The parafoveal macular thickness(PMT), vascular endothelial growth factor(VEGF), insulin-like growth factor-1(IGF-1)and best corrected visual acuity(BCVA-LogMAR)of DR patients were lower than those before treatment(P<0.05).

CONCLUSION: The incidence of DR in diabetes mellitus patients in our hospital is relatively high in recent years, and its disease induction is mainly affected by diabetes course(≥10 years), age(≥60 years old), history of ophthalmic diseases, taking of hypoglycemic drugs, history of hypertension and other risk factors. The treatment of DR patients with conbercept can achieve good therapeutic effect and promote the rapid recovery of vision.

Abstract:AIM: To compare the efficacy of air versus silicone oil tamponade for management of rhegmatogenous retinal detachment(RRD)following 25G pars plana vitrectomy(PPV).

METHODS: A prospective, randomized comparative study. 146 eyes from 146 patients who underwent 25G transconjunctival sutureless vitrectomy to repair rhegmatogenous retinal detachment were performed. Totally 60 eyes used air tamponade but 86 eyes used silicone oil tamponade. The follow-up time ranged from 6-12mo. The best corrected visual acuity(LogMAR), intraocular pressure, retinal reattachment rate, intraoperative and postoperative complications were compared.

RESULTS: One month after surgery, the mean BCVA was 0.45±0.5 in the air tamponade group and 0.78±0.65 in the silicone oil tamponade group, it were both evidently improved in comparison with before surgery, what's more, air tamponade had significantly better BCVA than those in the silicone oil tamponade(both P<0.05). 3mo after surgery, the reattachment rate of patients in air group was lower than that of silicone oil group(93.3% vs 97.7%), but had no significant differences between the two groups. 6mo after surgery, the anatomical success rate were 100% in both groups. The main intraoperative complication was iatrgenic retinal breaks in 10 eyes(6.8%). The main postoperative complication was high intraocular pressure, the intraocular pressure 1wk after surgery in the silicone oil tamponade group was evidently higher than that air tamponade group(P<0.001). No serious complication such as endophthalmitis and choroidal hemorrhage were observed in both groups.

CONCLUSION: For the simple early RRD, air tamponade had equivalent reattachment rate to silicone oil tamponade after 25G PPV. In the early postoperative, the visual acuity of air group was better comparing with silicone oil group, and was lower incidence of high intraocular pressure.

Abstract:AIM: To investigate the ability of Retcam3 in screening the retinopathy of prematurity(ROP)and its relationship with the change of intraocular pressure.

METHODS: A total of 80 premature infants who met the screening criteria admitted to our hospital from August 2017 to August 2019 were selected as subjects. They were screened by binocular indirect ophthalmoscope and Retcam3 system respectively. The former method was chosen as the gold standard, the sensitivity, specificity, positive and negative predictive values of Retcam3 system screening was calculated, the intraocular pressure changes before and after screening was compared.

RESULTS:A total of 37 children with ROP were examined by binocular indirect ophthalmoscopy. 35 infants with ROP were screened by Retcam3 system. The sensitivity of Retcam3 was 100%, the specificity was 95.8%, and the positive predictive value was 94.2%, the negative predictive value is 100%. The intraocular pressure of left eye and right eye after Retcam3 screening was higher than that before dilation, and the difference was statistically significant(P<0.05).

CONCLUSION: The Retcam3 system can accurately screen patients with ROP, while it can cause an increase in intraocular pressure after screening.

Abstract:AIM: To explore the clinical efficacy and prognosis of glucocorticoid combined with surgical method for TAO-related upper eyelid retraction.

METHODS: A total of 96 patients(146 eyes)with upper eyelid retraction who were admitted to the plastic surgery clinic and ward of our hospital from February 2014 to July 2018 were selected. According to different treatment methods, the patients were divided into GI group: 72 patients with TAO-related upper eyelid retraction treated with glucocorticoids; 72 patients with GS group: 48 patients with TAO-related upper eyelid retraction treated with glucocorticoid combined with conjunctival approach. After treatment, the upper eyelid muscle strength, the treatment effect, the height of the eyelid fissure, and the actual double eyelid width were compared between the two groups of patients.

RESULTS: After treatment, the patients in GI group had significant treatment effects in 32 people and 47 eyes, and the patients in the GS group had significant treatment effects in 16 and 25 eyes. The patients in the GS group had significant treatment effects in 46 cases and 71 eyes, and there were no significant treatment effects in 2 people and 3 eyes. Compared with the GS group, the treatment effect of the GS group was significantly higher than that of the GI group(P<0.05). There was no significant difference between GS group and GI group(P>0.05). According to the table, before treatment, the height of the eyelid fissures in the GI group and the GS group were 11.25±1.85 and 11.31±1.46mm, and the data in the two groups were similar(P>0.05). The height of the eyelid fissures was 10.14±1.23mm, 3mo after treatment was 8.52±1.01mm. Compared with the GI group, the recovery of blepharoplasty was better in the GS group than in the GI group(P<0.05). According to the table, before treatment, the upper eyelid muscle strength of the patients in the GI group and the GS group were 15.34±2.13 and 15.26±1.78mm, the data in the two groups were similar(P>0.05). Three months after treatment, the upper eyelid muscle strength was 15.64±1.34, 14.36±1.56mm. There was no significant difference in upper eyelid muscle between the GI group and the GS group(P>0.05). The results showed that before treatment, the patients with GI group and GS group actually had a double eyelid width of 5.12±1.64 and 5.16±1.48mm. The data in the two groups were similar(P>0.05). Three months after treatment, the double eyelid was actually The widths were 7.67±2.95 and 8.49±2.39mm, respectively. Compared with the GI group, the GI group had a better change in the double eyelid width than the GI group(P<0.05).

CONCLUSION: Glucocorticoid combined with conjunctival approach Müller myectomy is better for patients with upper eyelid retraction, which can significantly improve the height of the eyelid fissure and the width of the double eyelid.

Abstract:AIM: To analyze changes in objective visual quality before and after femtosecond laser in situ keratomileusis(FS-LASIK)and smart pulse technology-assisted transepithelial photorefractive keratectomy(SMART).

METHODS: Prospective study. We collected 50 cases(100 eyes)treated with FS-LASIK(FS-LASIK group)and another 50 cases(100 eyes)treated with SMART(SMART group)from the Ophthalmology Department of our hospital between October 2018 and December 2018 using Optical Quality Analysis System(OQAS)to measure objective scatter index(OSI), modulation transfer function cut off frequency(MTF cut off), strehl ratio(SR)before and after surgery.

RESULTS: In the FS-LASIK and SMART groups, the OSI values were higher in the 1 and 3mo after surgery, whereas the MTF cut off and SR were lower in the 1 and 3mo after surgery(P<0.05). There was no statistical difference between the two groups in the objective visual quality index before and after 1mo(P>0.05). However, after 3mo, the OSI value of the FS-LASIK group was higher than the SMART group(0.88±0.28 vs 0.70±0.27, P<0.001), whereas the SR was lower than SMART group(0.21±0.05 vs 0.24±0.05, P=0.002).

CONCLUSION: Both FS-LASIK and SMART caused an increase in the intraocular scattering index and a decrease in objective visual quality. However, the visual quality of the SMART group was generally better than that of the FS-LASIK group, and long-term visual quality was more dominant.

Abstract:At present, the new coronavirus(COVID-19)epidemic is spreading rapidly in Wuhan city Hubei province of China, and has aroused great attention of the international community. There have been clues that the conjunctiva may be one of the entries for the new coronavirus(SARS-CoV-2). In the absence of clinical evidence on ocular infection with SARS-CoV-2. Therefore, understanding the mechanism and cell receptors of coronavirus transmission through ocular surface and the transmission characteristics of homologous coronavirus can provide some suggestions for appropriately ocular protection and identify COVID-19 coexisting with ocular signs for ophthalmologists during this epidemic disease.

Abstract:SARS-CoV-2 has been spreading rapidly since its outbreak in December 2019.Understanding its epidemiological characteristics, especially cutting off transmission routes, is crucial to controlling the spread of the disease. In the study of transmission pathway, the issue of whether SARS-CoV-2 is transmitted through ocular surface tissue has also aroused concerns, but there are still no clinically confirmed cases and laboratory evidence of its infection through ocular surface tissue. New research suggests that the SARS-CoV-2 belongs to the same genus as SARS coronavirus(SARS-CoV), and that it enters cells in the same way as SARS-CoV. This paper reviews the research on SARS-CoV to investigate the possible mechanism of eye transmission of SARS-CoV-2.

Abstract:AIM: To investigate the clinical application value of anterior segment OCT(AS-OCT)in diagnosis and treatment of descemet's membrane detachment(DMD)after intraocular surgery.

METHODS: Totally 23 eyes of 21 patients with corneal edema after intraocular surgery in our hospital from June 2016 to April 2019 were analyzed retrospectively. The degree of corneal edema and the descemet's membrane detachment(DMD)were observed by AS-OCT. The patients with mild or above descemet's membrane detachment were treated with anterior chamber gas tamponade, the patients with other corneal edema were treated with drug conservative treatment, and the corneal edema and adhesion of descemet's membrane were observed.

RESULTS: In this study, 21 patients(23 eyes)had corneal edema of different degrees, 14 eyes with descemet's membrane detachment,11 eyes with mild or above descemet's membrane detachment were re-examined by AS-OCT one day after anterior chamber gas tamponade. 10 eyes had good adhesion, 1 eye had poor adhesion, and the adhesion was good after anterior chamber gas tamponade again. After 1mo follow-up, the cornea of all the patients recovered to be transparent and their vision recovered well.

CONCLUSION:AS-OCT can timely and accurately diagnose and evaluate descemet's membrane detachment and its therapeutic effect.

Abstract:AIM: To explore the influencing factors and coping strategies of adverse reaction after retinal laser photocoagulation.

METHODS: Retrospective analysis of 1 165 cases of adverse reactions in patients with retinal laser photocoagulation in our hospital.

RESULTS: The present study included 50 patients with adverse reactions in 1 165 patients(4.29%), including 13 patients with nausea and vomiting(1.12%), 21 patients with dizziness, chest tightness, cold sweat(1.80%), 4 cases with yawning and drowsiness(0.34%), 12 cases with syncope(1.03%), and no death. There was no difference in the incidence of adverse reactions between men and women(3.68% vs 5.14%, χ²=1.474, P=0.225); there was a difference in the incidence of adverse reactions among patients of different ages(χ²=48.817, P<0.05)and under 40. The incidence of adverse reactions was higher than that of patients aged 40 and older, and the incidence of adverse reactions in men under 40 was significantly lower than that in women(8.46% vs 18.60%, χ²=6.094, P=0.014). The adverse reactions of patients with different fundus diseases were different.

CONCLUSION: The incidence and degree of postoperative adverse reactions in patients with fundus diseases treated by retinal laser photocoagulation are different, so we should understand the history and mental state of the patients in detail before operation, and prepare the patients with high risk factors and possible serious reactions in time to ensure the safety of the patients.

Abstract:AIM: To investigate the clinical features of Axenfeld-Rieger syndrome associated with secondary glaucoma and its surgical treatment.

METHODS: It was a retrospective case series study. The general clinical data and related ocular manifestations in 15 patients(26 eyes)with Axenfeld-Rieger syndrome associated with secondary glaucoma in our hospital from January 2003 to January 2016 were collected and analyzed retrospectively.

RESULTS: Age of the patients ranged from 3-month to 43 years old, and the median age was 11 years old. There were of all 11 patients(73%)had bilateral glaucoma and 4(27%)had unilateral glaucoma. In the aspect of clinical features, hypoplasia or deficiency of the iris was found in 20 eyes(77%), peripheral iridocorneal adhesions was found in 17 eyes(65%)in various extent, and pupil distortion or multiple-pupil was found in 14 eyes(54%); Also posterior embryotoxon was found in 14 eyes(54%)as well; And 11 eyes(42%)had anomalies in corneal size. That root of iris is located at a more anterior position than that of a normal eye was found in all affected eyes by gonioscopy, coupled with different extent of angle synechiae-closure. According to the data, in 15 patients only two had a family history of ARS, while 5 had systematic abnormalities, eyes excepted, in dental, maxillary, cardiovascular, et al. Anti-glaucoma surgeries including trabeculotomy, trabeculectomy, glaucoma valve implantation were performed in 20 eyes. Nine patients(11 eyes)were followed up for 59mo on average. Intraocular pressure was significantly lower than pre-operation(t=2.4185, P=0.0362), and intraocular pressure in 7 followed-up eyes was controlled ≤21mmHg. The long-term success rate of surgery was 64%.

CONCLUSION: The clinical features of Axenfeld-Rieger syndrome associated with secondary glaucoma were diverse. The patients might concomitant with other systematic dysplasia. Although it was tough to treat, surgery for glaucoma could reduce the intraocular pressure effectively.