Abstract:AIM: To evaluate the diagnostic performance of the isolated-checked visual evoked potential(IC-VEP)in the detection of open angle glaucoma and compared it to the blue-yellow perimetry(B/YP)and optical coherent tomography(OCT).METHODS: In a retrospective analysis, IC-VEP, perimetry and OCT were performed on 101 subjects(n=35, normal; n=30, early glaucoma; n=36, moderate and advanced glaucoma)from China. The sensitivity of IC-VEP, perimetry and OCT for detection of glaucoma, as well as the agreement within these 3 methods, were calculated to evaluate their clinic performance.RESULTS: In the early primary open angle glaucoma(POAG)group the sensitivity of IC-VEP, blue-yellow perimetry and OCT were 70.00%, 70.00% and 63.33%, respectively. In the moderate advanced POAG group, the sensitivity of IC-VEP, OCT and blue-yellow perimetry were 86.11%, 88.89% and 91.67%, respectively. The specificity of IC-VEP was 91.43%. The results of IC-VEP were highly consistent with OCT and blue-yellow visual field tests(kappa: 0.721-1.000, P<0.05).CONCLUSION:As an objective examination of visual function, IC-VEP can be used for early diagnosis of glaucoma. It may be a useful tool for monitoring the function of RGCs in suspected glaucoma patients.

Abstract:AIM: To provide an insight to the common pathophysiology of both most frequent and neurodegenerative diseases by comparing thickness parameters of macula and retinal nerve fiber layer(RNFL)by using spectral domain optical coherence tomography(SD-OCT)in patients with early stage of Parkinson's disease(PD), and early stage of primary open angle glaucoma(POAG). METHODS A retrospective review was conducted of 48 patients with an early stage of POAG, 34 patients with an early stage of PD and 37 age- and gender-matched healthy eyes as a control group. The RNFL and macular thicknesses in the nine macular quadrants according to the ETDRS were measured with an SD-OCT and mean deviation(MD)values by a visual field analyzer. POAG patients were selected only MD smaller than -6 dB. Patients with MD values below -6 dB were considered as early stage glaucoma. PD severity was assessed using Hoehn and Yahr(H & Y)and Unified Parkinson's Disease Rating Scale(UPDRS). The PD group selected only H & Y Stage I-III patients. RESULTS:Statistically significant difference was determined between all groups RNFL measurements except temporal RNFL(P<0.05). Statistically significant difference was determined between all groups including fovea, mean macula thickness and macula outer quadrant thickness evaluations(P<0.05). There was not any significant difference between thickness evaluation of macula inner quadrant for POAG and PD groups(P>0.05). A weak negative correlation was determined between duration of disease and UPDRS score together with macula and RNFL thickness parameters in PD group.CONCLUSION:Similar thinning was detected by using SD-OCT for thickness parameters of macula and RNFL in early stage of POAG and early stage of PD group. However this thinning was more significant in early stage of POAG group. It can be declared that neurodegeneration on the macula which is caused by glaucoma is more destructive than PD. Thinning on foveal region is remarkable for PD patients.

Abstract:AIM: To systematically assess the effect of intravitreal injection of Aflibercept or Ranibizumab in the treatment of diabetic retinopathy(DR)by using Meta-analysis.METHODS: PubMed, MEDLINE, Web of Science, Cochrane, Nature Series, ScienceDirect, and ESI Databases were searched until May 2019. Ten studies included a total of 1 240 participants with DR had been administered in the Meta-analysis. Aflibercept or Ranibizumab via intravitreal injection. After selecting useful information, we used RevMan 5.3 to further analysis. Systematic review and Meta-analysis were used to design.RESULTS: The pooled results showed that central macular thickness(CMT)was significantly reduced(P<0.00001)in the intravitreous Aflibercept group(IVA); compared with the intravitreous Ranibizumab group(IVR), which did not greatly improve best corrected visual acuity(BCVA)and visual acuity(VA).CONCLUSION:This Meta-analysis suggests that both IVA and IVR are effective in the treatment of DR patients. Specifically, Aflibercept shows better improvements in CMT, while Ranibizumab is beneficial in increasing BCVA or VA.

Abstract:AIM: To investigate the effect of human umbilical mesenchymal stem cells(hUMSC)exosomes on the autophagy and expression of vascular endothelial growth factor(VEGF)of ARPE-19 cells under the condition of high glucose.METHODS: Tissue explants adherent culture was adopted to cultivate umbilical cord mesenehymal stem cells. The ultrastmcture of exosomes was observed under transmission electron microscope and the expression of surface specific marker proteins CD63 on exosomes were determined by Western blot. ARPE-19 cells were divided into the control group, high-glucose group and exosomes+high-glucose group. The cells in the exosomes+high-glucose group were pretreated with 75μg/mL exosomes. The ultrastructure of autophagosomes formed in all cells of the three groups was detected under transmission electron microscopy. The viability of ARPE-19 cells was measured by MTT assay. Western blot was applied to detect the expression of autophagy-associated proteins in different groups, including microtubule related protein 1 light chain 3B(LC3B), Beclin-1 and p62. The expression of VEGF in the cell supernatants was examined by ELISA assay. RESULTS: Transmission electron microscopy showed that the shape of hUMSC exosomes was spherical with membranous structure. The diameter of exosomes ranged from 30-100nm. Western blot indicated that the surface marker protein CD63 of exosomes showed positive expression. The number of autophagosomes in high glucose group was more than that in control group, while it was less in exosome+high-glucose group than in high glucose group. Compared with the high-glucose group, the cell proliferation rate of exosomes+high-glucose group was significantly increased(P<0.01). In the control group, high-glucose group and exosomes+high-glucose group, the LC3B-Ⅱ/LC3B-Ⅰ ratio in ARPE-19 cells was 0.214±0.019, 0.461±0.067 and 0.332±0.079, respectively; the relative expression of Beclin-1 protein in the cells was 0.186±0.029, 0.615±0.044 and 0.464±0.046, respectively; the relative expression of p62 protein in the cells was 0.771±0.051, 0.364±0.016 and 0.547±0.039, respectively. Compared with the control group and exosomes+high-glucose group, the ratio of LC3B-Ⅱ/LC3B-Ⅰ and the protein expression levels of Beclin-1 were significantly increased in the high-glucose group(all P<0.05). Compared with the control group and exosomes+high-glucose group, the protein expression level of p62 were significantly decreased in the high-glucose group(all P<0.01). Compared with the high-glucose group, the expression levels of VEGF were significantly decreased in the exosomes+high-glucose group(P<0.01). CONCLUSION: High glucose conditions activated autophagy of ARPE-19 cells and promoted the expression of VEGF. hUMSC exosomes could effectively inhibit the autophagy level of ARPE-19 cells and the expression of VEGF in high-glucose environments.

Abstract:AIM: To identify the related biomarkers, coding genes, transcription factors and biological pathways in diabetic retinopathy(DR)via analysis of the gene expression database of C57BL/KsJ-db/db mice.METHODS: We selected and obtained microarray datasets from the Gene Expression Omnibus database to identify different expressed genes in retinas with db/db mouse model. Integrated bioinformatic analysis was used to clarify biological functions of the identified genes, including Gene Ontology(GO), the construction of a protein-protein interaction network, transcription factor, and gene set enrichment analysis.RESULTS:Totally 38 genes were found upregulated accompanied by down-regulation of 28 genes in the retina of db/db mouse. GO analysis showed that the down-regulated genes were enriched in eye development whereas there was no significant KEGG pathway identified by the differentially expressed genes. The protein-protein interaction network revealed seven hub genes involved in DR. Moreover, GSEA showed 12 up-regulated pathways with 6 down-regulated pathways(P<0.1), predicting up-regulation of 5 transcription factors(TFs)and down-regulation of 8 TFs along with their binding sites. CONCLUSION: The pathways and genes discovered herewith are beneficial to clarify the mechanism of DR and the part of transcription factors identified during the study, such as Runx2, Ppara, MafA, Gata2 and Hoxa13, may provide promising targets for future noval treatment of DR.

Abstract:AIM:To investigate the association between single nucleotide polymorphisms(SNPs)of Lanosterol synthase(LSS)and 3-Hydroxy-3-methylglutaryl coenzyme A reductase(HMGCR)genes and age-related cataract(ARC)risks. METHODS: This was a case-control study. The SNPs of the genes were assayed with TaqMan RT-PCR genotyping. The qRT-PCR was used to detect the LSS mRNA levels of lens epithelial cells(LECs)in individuals. The Chi-square test was used to compare differences of each SNPs between ARCs and controls and to calculate the odds ratio. RESULTS: We found that LSS-rs2968 of ARCs was different from controls(P=0.018), but the significance was lost after Bonferroni correction(P=0.072). We then further performed stratification analysis and found that LSS-rs2968 A allele was associated with nuclear type of ARC risk in Chinese population(P=0.003), and the significances still existed after Bonferroni correction(P=0.012). Consequently, we found that the LSS mRNA levels was lower in LECs of all subtypes of ARC group than that of control group(P<0.05). CONCLUSION: LSS-rs2968 A allele might plays a role in the formation and development of nuclear type of ARC risk in Jiangsu population.

Abstract:AIM:To observe circumpapillary and macular vessel density(cpVD/MVD), and to evaluate correlations of cpVD/MVD with retinal nerve fiber layer(RNFL)in patients with acute primary angle-closure glaucoma(APACG).METHODS: Patients with monocular APACG(n=29)visited the Affiliated Hospital of Xuzhou Medical University from March 1, 2019 to December 31, 2019 were prospectively enrolled. Moreover, 29 eyes with APACG attack were included in the experimental group to be performed with combined trabeculectomy, and 29 contralateral eyes were served as the control group to receive preventive laser peripheral iridotomy. Changes in the MVD, the cpVD and the thickness of optic nerve fiber layer(RNFL)before operation and 1wk, 1mo, 3mo and 6mo after operation were observed by oraphyptical coherence tomography angiography(OCTA), respectively.RESULTS: Before operation, the experimental group showed lower cpVD in the superotemporal(ST)quadrant and the temporosuperior(TS)quadrant compared with the control group(all P<0.01). In addition, a brief rise was observed in each quadrant of the experimental group 1wk after operation, but with lower cpVD in the supero-nasal(SN)quadrant, the ST quadrant and the TS quadrant than the control group(all P<0.05). Furthermore, 1mo, 3mo and 6mo after operation, there was a steady downward trend in the cpVD and the MVD in each quadrant of the experimental group over time, and the RNFL thickness was increased at first within 6mo after operation, and then gradually thinned, but the RNFL thickness of the experimental group were thinner than those of the control group 6mo after operation. Correlation analysis showed that there was a positive correlation between the cpVD and the RNFL thickness in the SN, ST, temporoinferior(TI), IT, IN and nasoinferior(NI)quadrants in the experimental group 6mo after operation(all P<0.05). CONCLUSION: The RNFL was thickened in the affected eyes in the early stage after acute attack of APACG, and gradually thinned 3-6mo after operation. However, the cpVD was decreased continuously, and there was a correlation between the RNFL thickness and the cpVD 6mo after operation.

Abstract:AIM: To observe and compare the changes of macular vascular density and retinal thickness in children and adolescents with different degrees using optical coherence tomography angiography(OCTA), then analyze their correlation.METHODS: Our prospective cross-sectional study included 230 eyes of 115 children and adolescents aged 6-18a. According to spherical equivalent power(SE), they were divided into four groups: emmetropia group(32 eyes of 16 cases), mild myopia group(94 eyes of 47 cases), moderate myopia group(68 eyes of 34 cases), and high myopia group(36 eyes of 18 cases). Using RTVue XR scans of the 6mm×6mm region of the macula, the system automatically divided it into three rings: 1mm(fovea)ring, 1mm-3mm(parafovea)ring, and 3mm-6mm(perifovea)ring. And each ring was further divided into four quadrants: temporal(T), superior(S), nasal(N), and inferior(I). Quantitatively analysis was performed for the superficial and deep capillary densities and retinal thickness of each sector.RESULTS: The superficial capillary density in the macula was in turn significantly decreased as in emmetropia(44.4±3.5)%, mild myopia(44.8±3.8)%, moderate myopia(44.3±3.8)%, and high myopia(42.6±4.5)% groups(F=2.963,P=0.033). The superficial capillary density of parafovea's temporal side were(46.1±3.5)%,(46.8±5.1)%,(46.2±4.3)%, and(43.8±5.5)% in the four groups, respectively(F=3.436, P=0.018). Similarly, the deep capillary density of the four groups was(49.9±4.1)%,(48.4±4.7)%,(47.9±5.5)%, and(45.3±4.7)%, respectively(F=4.806, P=0.003). The deep capillary density of the perifovea was(49±4.4)%,(47.2±5.2)%,(46.6±6)%, and(43.6±5.1)% in the 4 groups, respectively(F=5.495, P=0.001). The retinal thickness of the four groups was 293.9±12.9, 295.5±13.0, 290.9±12.0, and 284.5±10.7 μm(F=6.606, P<0.001). The superficial capillary densities of parafoveal's temporal and nasal sides were positively correlated with SE(r=0.221, 0.219, P=0.001, 0.001). The deep capillary density of perifovea's temporal, superior, nasal and inferior side were positively correlated with SE(r=0.172, 0.200, 0.250, 0.296, P=0.011, 0.003, <0.001, <0.001). The central retinal thickness except the fovea were positively correlated with SE(P<0.05).CONCLUSION: With the increase of myopia degree of children and adolescents, the superficial capillaries density in the macula decreases, especially in the parafovea's temporal side; as well as the deep capillaries density, especially decreases in the perifovea. The central retinal thickness decreases in both parafovea and perifovea. With the myopia degree of children and adolescents increases, the structure and capillary circulation of the macula will be influenced, especially in the high myopia group.

Abstract:AIM: To investigate the early changes of corneal higher-order aberrations(HOAs)of the anterior surface, posterior surface, and total cornea after femtosecond laser-assisted in situ keratomileusis(FS-LASIK)in mild to moderate myopic and high myopic patients. METHODS: This retrospective study included 129 patients(129 eyes)underwent FS-LASIK surgery from December 2018 to December 2019. Treated eyes were divided into two groups, according to the preoperative spherical equivalent(SE): mild to moderate myopic group(<-6.0D, 76 eyes)and high myopic group(≥-6.0D, 53 eyes). Corneal HOAs of the anterior surface, posterior surface, and total cornea were measured by Pentacam anterior segment analysis system preoperatively and 6mo postoperatively. RESULTS: The tHOAs, spherical aberrations and horizontal coma of the anterior surface and total cornea, significantly increased in both groups 6mo postoperatively(all P<0.01). And more tHOAs, spherical aberrations and horizontal coma of the anterior surface and total cornea were induced in high myopic group than mild to moderate myopic group postoperatively(all P<0.01). The horizontal coma of the posterior surface, significantly increased in both groups 6mo after operation(all P<0.01). And more horizontal coma of the posterior surface were induced in high myopic group than mild to moderate myopic group postoperatively(P<0.01). Changes in anterior surface and total corneal tHOAs, spherical aberrations and horizontal coma were related to the SE(all P<0.01).CONCLUSION:Anterior and total corneal tHOAs, spherical aberrations and horizontal coma, significantly increased after FS-LASIK, and aberration changes were related to SE. Whereas posterior corneal HOAs remained stable except horizontal coma. The long-term effect should be investigated in the future.

Abstract:MicroRNAs(miRNAs)are one of the most important regulatory factors of gene expression, which involved in the growth, development, differentiation and apoptosis of various cells, tissues and organs. TRPM3 is located in human chromosome 9 and belongs to M sub-family of the transient receptor potential(TRP)channels. MiR-204 is located on TRPM3 intron 6 and participates in the regulation of post-transcriptional gene expression through cleavage or translation inhibition of target mRNAs. Studies have shown that TRPM3/miR-204 complex locus plays an important role in the occurrence and development of eye diseases such as cataract, glaucoma, corneal neovascularization, corneal wound healing, retinal diseases, optic nerve diseases and so on. In this paper, the biological function of TRPM3/miR-204, its expression and regulation in the eyes and its correlation with a variety of ophthalmic diseases are reviewed.

Abstract:Exosomes are extracellular vesicles of sizes ranging from 50-150nm in diameter. Exosomes can deliver bioactive molecules(e.g. proteins, lipids, DNA, microRNA, etc.)into target cells which play an important role in cell-cell communication. Researches demonstrated that exosomes mediated cell-cell communication can impact cell apoptosis, invasion, migration, immune response and oxidative repair ability of recipient cells. Recently, researches on exosomes developed rapidly in the field of ophthalmology. This review summarized the latest research progress of exosomes in ophthalmic diseases.

Abstract:Dry eye is a common ocular surface disease accompanied by ocular discomfort, which severely affects the work and life of patients. There are numerous causes of dry eye, and the disease is easy to recur, which is difficult to cure effectively. With the application of polymerase chain reaction(PCR)and western blotting in study of dry eye, genomics events such as metagenomics, genetically engineered animals and gene transfection have been further explored in dry eye research. Advances in the application of genomics for dry eye are summarized, in order to provide an important basis for further revealing the risk factors and pathogenesis, and exploring new drugs and therapies for effective treatment of dry eye.

Abstract:Recent years, due to social and economic development, the popularization of electronic products and increasing work pressure of people, which resulting in the increasing of prevalence of sleep deprivation(SD)and dry eye(DE). This phenomenon not only affects people's physical and mental health, but also causes a certain burden on the social economy. Moreover, a series of studies show that sleep disturbance is one of the independent risk factors leading to dry eye of folks. Therefore, the influence of sleep factors should be considered in the diagnosis and treatment of dry eyes. At present, the mechanism of ocular surface lesions and how sleep disorders cause dry eye are frontier topic in the field. In this paper, we specifically analyze the correlation between sleep disorders and dry eye. Furthermore, the mechanism of this correlation is summarized. It can help to analyze the influence of improving the effect of sleep and provide a new way of diagnosis and treatment for ophthalmologists.

Abstract:Recurrent retinal detachment in silicone oil-filled eyes after vitrectomy is a special type of recurrent retinal detachment. Some patients require reoperation, which brings challenges for clinical work. The diagnosis and treatment of retinal detachment in silicone oil eyes have some characteristics. More attention should be paid to the identification of high-risk factors. Adequate doctor-patient communication and rational selection of treatment plan are essential for the prognosis of this disease.

Abstract:The retinal arterial macroaneurysm, also known as isolated aneurysm, is an acquired retinal vascular abnormality, which is characterized by fusiform or circular dilatation of the posterior polar retinal arteries, forming one or more aneurysms. Most of aneurysms are located on the temporal vessels of the retina. There are no clinical symptoms in the early stage. If the tumor ruptures and hemorrhage involving the macula, may suddenly appear central dark spots and vision loss. The hemorrhage may be located in the vitreous cavity, under the posterior vitreous boundary membrane, under the retinal inner boundary membrane, and subretinal region. Treatments for RAM include retinal laser photocoagulation, vitrectomy, intravitreal or intraretinal injection of tissue plasminogen activator, and anti-VEGF agent. In this paper, the latest research progress in the treatment of RAM is discussed and prospected.

Abstract:Toll-like receptors(TLRs)are bridges of innate and acquired immunity. With the deepening of the research on the pathogenesis of dry eye, the induction and regulation of TLRs and signaling pathways in the immune response to dry eye have attracted more and more attention. Current studies have shown that the regulation of TLRs and signaling pathways helps to reduce or prevent the inflammatory response process in dry eye, so the regulation and control of TLR signaling pathways in the treatment and prevention of dry eyes has important significance. In this paper, TLRs and their signaling pathways are summarized in the pathogenesis of dry eye, and the effects of different intervention methods on the TLR pathway of dry eye are discussed, and the future development prospects and problems are also discussed.

Abstract:Posterior sclera reinforcement(PSR), also known as posterior sclera strengthening or posterior sclera bandage, is a kind of operation to fix biological or non-biological materials to the posterior sclera, with the aim to strengthen sclera and improve the blood circulation of the choroid and retina by using the traction of materials or the immune inflammatory stimulation, thereby delaying the continuous extension of the axis and improving visual function. The main indications of PSR include pathologic myopia(PM)and its related complications. In addition, PSR can also help to improve blood circulation at the posterior pole of the eye in patients with retinitis pigmentosa(RP), especially in conjunction with superficial temporal artery ligation. After more than half a century's development, PSR has been currently considered as one of the few and effective methods to treat PM and RP, but as a more traumatic operation, the stability of its clinical effect varies greatly, so there is still room for improvement in surgical procedures and materials used.

Abstract:High myopia is a serious eye disease that jeopardizes the visual function of children because of the irreversible changes it caused to the fundus of the eye. High myopia needs to be detected, diagnosed and treated as early as possible, if not intervened in time, it may cause further aggravation or even blindness. However, screening for myopia often encounters the situation that children with low myopia at first who are found to have high myopia fundus changes by further examinations, and these insidious high myopia changes are easily overlooked in the diagnostic process. The study aims to summarize the literatures on choroidal thickness changes and their influencing factors in myopia children, which in order to provide relevant evidence for clinical studies in children with secretive high myopia.

Abstract:Microstrabismus is a kind of small angle strabismus, sometimes negative in cover test, accompanied by clinical characteristics such as abnormal retinal correspondence, eccentric fixation, amblyopia and rough stereopsis. Microstrabismus amblyopia treatment is very difficult, especially in eccentric fixation. In daily diagnosis and treatment, the microstrabismus often misdiagnosed due to the small squint degree and the negative coverage test, failed to be treated properly and in-time, the patient's eccentric fixation and fixation instability also been ignored, treated as normal amblyopia, while the result is not effective, sometimes even leads opposite effect, so it's important to recognize the microstrabismus.

Abstract:Strabismus is a common type of eye movement disorders, which is characterized by ocular misalignment and binocular visual dysfunction. Alignment relies on the normal structure and function of the visual and oculomotor systems. Any abnormalities of these regions may lead to strabismus. With the application of neurophysiological techniques and radioautography in the early years, the impairment of primary visual cortex was found, including decreased number of binocular neurons and metabolic changes of ocular dominant column. In recent years, the progress of functional magnetic resonance imaging has promoted to find more functional changes in human strabismic brains, especially in extrastriate cortex. In addition to the structural impairment of cerebral cortex and intercortical connections, functional remodeling of cerebral cortex was also observed in patients with strabismus. Besides, studies based on voxel-based morphometry and diffusion tensor imaging provided more precise anatomical evidence for human brain abnormalities. To provide reference for further studies, we review the current literature on functional and morphological deficits within brain regions in strabismus.

Abstract:AIM: To systematically evaluate the efficacy of sodium hyaluronate combined with recombinant human epidermal growth factor(rhEGF)eye drops in the treatment of dry eye after cataract surgery in recent 5a by Meta-analysis.METHODS: The databases of CNKI, WanFang, Chongqing VIP, CBM, Cochrane Library, Pudmed and MEDLINE from January 2015 to May 2020 were searched. Meta analysis and statistical analysis were performed with Revman 5.3 software on the clinical control study of sodium hyaluronate eye drops combined with rhEGF eye drops in the treatment of dry eye after cataract surgery.RESULTS: A total of 14 randomized controlled trials involving 1 529 eyes were included. Among them, 14 studies conducted corneal fluorescein staining(FL)score after the end of treatment, the results showed that the difference was statistically significant [MD= -0.86, 95%CI(-1.07 to -0.66), P<0.00001]; 14 studies conducted tear film break-up time(BUT)measurement after the end of treatment, the results showed that the difference was statistically significant [MD=2.33, 95%CI(1.64, 3.03), P<0.00001], 95%CI(1.76 to 2.15), P<0.00001]; tear secretion test(S I t)was measured in 12 studies after treatment, and the results showed that there was no significant difference [MD=0.49, 95%Cl(-0.52, 1.50), P=0.34]; the overall effective rate was calculated in 12 studies after treatment, and the results showed that the difference was statistically significant [OR=4.88, 95%Cl(3.34, 1.50), P=0.34]. The results showed that the difference was statistically significant [MD= -1.09, 95%Cl(-1.58, -0.61), P<0.00001].CONCLUSION: Sodium hyaluronate combined with rhEGF eye drops in the treatment of dry eye after cataract surgery can significantly improve the corneal repair ability and tear film BUT, which has more advantages in the overall efficacy of the treatment of dry eye after cataract surgery.

Abstract:AIM:To evaluate the effects of 0.01% atropine for Asian adolescents and children of low and medium myopia in diopter and axial length. METHODS:We searched on PubMed, the Cochrane Library, Embase, CNKI, CBM, VIP and WanFang Data database for randomized controlled trials(RCTs). The published languages were limited to Chinese and English. The risk bias tool provided by the Cochrane cooperation scale was used to assess the risk bias of included studies of RCTs. The published biases of included studies were assessed by the Egger's test. Meta-analysis was performed with Review Manager 5.4. RESULTS: Seven randomized controlled trials with a total of 979 subjects were included(440 in the 0.01% atropine group and 539 in the control group). The Meta-analysis showed that 0.01% atropine has a better effect than the control group in controlling the diopter growth in moderate and low myopia of Asian adolescents and children. The difference between the two groups was statistically significant [WMD=0.50, 95%CI (0.37, 0.64), P<0.00001]. And the results also indicated that the change in axial length of 0.01% atropine was significantly less than the control group, the difference between the two groups was statistically significant [WMD= -0.20, 95%CI (-0.30, -0.10), P=0.0001].CONCLUSION: Based on the available evidence, 0.01% atropine offer in controlling axial length and diopter growth of low and medium myopia in Asian adolescents and children.

Abstract:AIM: To systematically evaluate the effect and safety of cyclopentolate and atropine on ciliary muscle paralysis before optometry in myopic children. METHODS: Relevant references published before April 2020, which concerned about cyclopentolate compared with atropine for ciliary muscle palsy in children with myopia, were obtained by searching PubMed, EMBASE, Web of Science, The Cochrane Library, CNKI and WanFang Database. For the selected studies, after data extraction and methodological quality evaluation of the included study, RevMan5.3 software was used for Meta-analysis. RESULTS: Nine articles were finally included, containing 588 eyes using atropine and 592 eyes using cyclopentolate. Meta-analysis results indicated: comparing of cyclopentolate and atropine for cycloplegia in children with myopia before optometry, the diopter difference between the two is WMD: -0.01, 95%CI(-0.30, 0.27), P=0.93; the difference in residual accommodation power between the two is WMD: 0.22, 95%CI(-0.13, 0.58), P=0.22. In addition, the cyclopentolate is safer and has a lower incidence of adverse reactions.CONCLUSION: Compared with atropine, cyclopentolate has equivalent effects on ciliary muscle paralysis in myopic children, and has higher security. Cyclopentolate could replace atropine for myopic children before optometry.

Abstract:AIM:To compare the effectiveness and safety of intravitreal injection of conbercept(IVC)and intravitreal injection of ranibizumab(IVR)for type 1 retinopathy of prematurity(ROP).METHORDS: A retrospective case series observation was carried out. Clinical data of patients with type 1 ROP treated with IVC(46 cases, 91 eyes)or IVR(55 cases, 109 eyes)from August 2018 to January 2020 in Xijing Hospital were collected. Regression, progression, recurrence, retreatment of ROP, the proportion of adverse outcomes and ocular and systemic complications were all analyzed.RESULTS:All the 101 infants(200 eyes)with type 1 ROP treated with intravitreal injection of anti-vascular endothelial growth factor(VEGF)were enrolled, in which 20 eyes with aggressive posterior ROP(AP-ROP), 86 eyes with threshold ROP, and 94 eyes with type 1 pre-threshold ROP were included. There were no statistical differences in the basic conditions and the severity of ROP between the two groups before treatment(P>0.05). There was no difference in the primary cure rate between IVC and IVR groups(93.4% vs 87.2%, P>0.05). A total of 6 eyes(6.6%)developed ROP recurrence in the IVC group, in which 2 eyes received a second IVC, and 4 eyes were treated with laser photocoagulation(LP). In the IVR counterpart, 11 eyes(10.1%)developed ROP recurrence, among them 4 eyes underwent another IVR, and 11 eyes were treated with LP. The recurrence interval was 11.7±4.13wk and 9.82±4.02wk in the IVC and IVR groups. All these results of recurrence showed no significant statistical difference between these two groups(P>0.05). There was no progression of ROP appeared in IVC group. The progression of ROP developed in 3 eyes after initial ranibizumab injection, among them retinal fibrous proliferation and hemorrhage treated with LP in 2 eyes, and tractional retinal detachment treated with vitrectomy in 1 eye. No drug or injection related side effect was observed in infants of both groups. There were some adverse prognosis, such as temporal retinal folds, smaller angle between upper and lower temporal retinal vessel trunks caused by retinal vascular traction in 3 eyes in IVR group during the long-term follow up.CONCLUSION: Both IVC and IVR are effective and safety choices for the treatment of ROP. There was no significant difference between the first cure rate and the recurrence rate. Some of the most severe cases treated by IVR were at risk for progression or poor prognosis that need to be followed up for a long time.

Abstract:AIM: To investigate the changes of corneal endothelial cells and ocular surface after phacoemulsification for age-related cataract(ARC)patients with diabetes mellitus. METHODS: Retrospective case study. A total of 190 cataract patients with diabetes mellitus who received phacoemulsification combined with IOL implantation in 190 eyes admitted to our hospital from January 2017 to January 2019 were selected. In addition, 230 ARC patients without diabetes who underwent phacoemulsification and intraocular lens implantation at the same time were selected as the control group. Ocular surface disease index(OSDI)score, tear film rupture time(BUT), basal tear secretion test(S I t), corneal endothelial cell density and coefficient of variation were compared between the two groups.RESULTS: There was no significant difference in preoperative OSDI score, BUT, S I t, corneal endothelial cell density and coefficient of variation between the two groups(P>0.05). In the observation group, OSDI scores were significantly increased 1wk, 1mo and 3mo after surgery compared with those before surgery, with statistically significant differences(all P<0.01). The OSDI scores of patients in the control group increased significantly one week and one month after the operation compared with those before the operation, with statistically significant differences(all P<0.01). The OSDI scores in the observation group at each time point after the operation were higher than those in the control group, with statistically significant differences(all P<0.05). One week after surgery, 1mo after surgery, BUT and S I t in the two groups decreased significantly compared with that before surgery(P<0.05), and the difference was not statistically significant compared with that before surgery 3mo after surgery. In addition, compared with BUT between the two groups, the observation group had a lower tear film stabilization time and a more significant decrease(P<0.05). The corneal endothelial cell density in the two groups decreased significantly 1wk, 1mo and 3mo after surgery compared with that before surgery(P<0.05). The variation coefficient of corneal endothelial cells in the two groups was statistically significant 1wk after the operation and 1mo after the operation compared with that before the treatment(P<0.05). The variation coefficient of corneal endothelial cells in the observation group was more significant than that in the control group(P<0.05).CONCLUSION: Cataract patients with diabetes surgery tolerance is low, the corneal endothelial cell density and the central corneal thickness and corneal appears before tear secretion with stability and foundation treatment have significant changes, and its characteristic is cataract patients without diabetes more apparent, clinical intraoperative and postoperative corneal endothelial protection should be strengthened, and the surface of the eye protection ability of the organization.

Abstract:AIM: To investigate dynamic changes of posterior corneal power and astigmatism after cataract surgery based on Pentacam three-dimensional anterior eye segment analyzer.METHODS: Totally 96 elderly patients(116 eyes)with cataract underwent phacoemulsification combined with intraocular lens implantation in our hospital from January 2019 to January 2020 were selected. Parameters including anterior corneal power, posterior corneal power, flat keratometry, steep keratometry, mean keratometry, anterior corneal astigmatism, posterior corneal astigmatism, and total corneal astigmatism were obtained using Pentacam three-dimensional anterior eye segment analyzer system at postoperative 1wk, 1mo and 3mo. Spearan correlation analysis was performed on the anterior segment. RESULTS: The anterior corneal power(flat keratometry, steep keratometry, mean keratometry)was lower at postoperative 1wk than that before operation, and began to return to the preoperative level at postoperative 1mo and 3mo. The posterior corneal power and total corneal power(flat keratometry, steep keratometry, mean keratometry)were higher at postoperative 1wk than before operation, and began to stabilize at postoperative 3mo. The anterior corneal astigmatism, posterior corneal astigmatism, and total corneal astigmatism were also higher at postoperative 1wk than before operation, and began to decrease and stabilize at postoperative 3mo. The anterior corneal power was significantly positively correlated with total corneal power; The posterior corneal power was significantly negatively correlated with the total corneal power, and was significantly positively correlated with its absolute value(P<0.05). The total corneal astigmatism before operation and at postoperative 1wk and 3mo was significantly positively correlated with anterior corneal astigmatism at corresponding time points(P<0.01), while showed no significant correlation with posterior corneal astigmatism.CONCLUSION: Changes of posterior corneal power and astigmatism can be observed with 3mo of cataract surgery, and Pentacam three-dimensional anterior eye segment analyzer system can accurately assess the dynamic changes of anterior and posterior corneal power and astigmatism before and after operation, which is of great clinical value.

Abstract:AIM: To analyze the influence of total femtosecond laser small incision lenticule extraction(SMILE)on corneal surface regularity index(SRI).METHODS:Totally 210(401 eyes)myopic patients treated in Qinhuangdao Optometry Ophthalmology Hospital between January 2017 and December 2019 were enrolled in the study. Among them, patients treated with total femtosecond laser SMILE were included in the observation group(n=110, 205 eyes), while those treated with femtosecond laser-assisted in situ keratomileusis(FS-LASIK)were includded in the control group(n=100, 196 eyes). The uncorrected visual acuity(UCVA), best corrected visual acuity(BCVA), anterior corneal surface asphericity index(Q-value)at a diameter of 6mm and SRI were compared between the two groups before and after operation.RESULTS: The UCVA and BCVA of both groups were improved at 3mo and 6mo after operation(P<0.05), without significant differences between the groups(P>0.05). The observation group had higher SRI than the control group at 3mo, 6mo and 1a(P<0.05). The asphericity parameter Q-values increased at each time point after operation. Besides, the observation group had lower Q-values than the control group at 6mo and 1a(P<0.05).CONCLUSION: Compared with FS-LASIK, SMILE can achieve similar visual recovery effect. However, the SRI is larger after SMILE, and the influence on asphericity index Q-value is less.

Abstract:AIM: To investigate the changes and related factors of choroidal thickness(CT)in acute primary angle-closure glaucoma(APACG), and chronic primary angle-closure glaucoma(CPACG).METHODS: It was a retrospective study. A total of 35 patients(43 eyes)with APACG, 26 patients(46 eyes)with CPACG and 46 patients(81 eyes)with normal eye condition and used as the control group in the study. EDI-OCT was used to measure and compare the foveal, nasal, temporal, superior and inferior CT of APACG, CPACG and normal control groups. The CT were labeled as subfoveal choroidal thickness(SFCT), nasal 2mm(N 2mm), temporal 2mm(T 2mm), superior 2mm(S 2mm), inferior 2mm(I 2mm).Linear regression analysis was used to explore the related factors of CT. Logistic regression analysis was used to evaluate the association between CT and presence of APACG and CPACG.RESULTS: There was no significant difference in CT of APACG, CPACG and normal control group(P>0.05). CT of all sites was negatively correlated with axial length(AL). N 2 mm and I 2 mm were also negatively correlated with age, anterior chamber depth(ACD), SFCT was negatively correlated with age and AL(P<0.05). Multivariate Logistic analysis showed that there was an association between S 2mm and APACG(P=0.029), the odds ratio(OR)and 95% confidence interval(CI)was 0.975(0.953, 0.997). There was no association between CPACG and CT at all locations(P>0.05).CONCLUSION: Age, AL and ACD are the factors that related to choroidal thickness. It is also confirm that there is an association between decreased S 2mm and APACG. However, there is no correlation between CPACG and CT at all locations.

Abstract:AIM: To evaluate the changes of early visual quality of patients with high myopia after small incision lenticule extraction(SMILE)and femtosecond assisted laser in situ keratomileusis(FS-LASIK)by the double-pass optical quality analysis system Ⅱ(OQAS Ⅱ)and Pentacam corneal topography.METHODS: A prospective non-randomized controlled study was conducted among 148 eyes of 74 patients with high myopia. These patients were treated by the same surgeon in our hospital from March 2020 to September 2020. According to their wishes, 86 eyes with 43 patients were treated with SMILE and 62 eyes with 31 patients were treated with FS-LASIK. The uncorrected visual acuity(UCVA), modulation transfer function cut off frequency(MTF cut off), Strehl ratio(SR), objective scattering index(OSI), predicted visual acuity values(VA 100%, VA 20%, VA 9%), high-order aberration(HOA), horizontal aberration(Z 13), vertical coma(Z -13)and spherical aberration(Z 04)preoperatively, 1 and 7d postoperatively were collected and analyzed.RESULTS:There was no statistical significance in preoperative age, spherical equivalent(SE), UCVA, MTF cut off, SR, OSI, VA 100%, VA 20%, VA 9%, HOA, Z 13, Z -13 and Z 04(P>0.05). The OSI of the SMILE group was higher than the FS-LASIK group at postoperative 1d(2.3±2.1 vs 1.8±1.1). The difference in OSI between the two groups was not statistically significant at postoperative 7d(1.2±0.7 vs 1.3±0.7). The HOA and Z04 in the FS-LASIK group were higher than the SMILE group at postoperative 1d and 7d(P<0.001). The UCVA, Z 13, Z -13, MTF cut off, SR, VA 100%, VA 20%, and VA 9% between the two groups were no statistical significance at postoperative 1d and 7d(P>0.05).CONCLUSION:FS-LASIK is easier to introduce corneal high-order aberration and spherical aberration in the early postoperative period, while SMILE with 2mm incision only introduces higher scatter at postoperative 1d. Therefore, SMILE can obtain better visual quality than FS-LASIK in the early postoperative period among patients with high myopia after corneal refractive surgery.

Abstract:AIM: To explore the effect of the combination of standardized patient and CBL case-based teaching in clinical practice teaching for postgraduates majoring in ophthalmology.METHODS: From July 2017 to July 2019, a total of 40 postgraduates majoring in ophthalmology from 2017, 2018, and 2019 of Nanchang University First Affiliated Hospital were selected as the research objects and randomly divided into two groups: the observation group and the control group, each with 20 people. The observation group used the SP+CBL case-based teaching mode, the control group used the traditional teaching mode(LBL). The teaching teachers of the same group of graduate students is the same, the teaching content are the same, the teaching period was 12mo, observe and compare the two groups of students' learning ability, theoretical knowledge and clinical skills operation assessment grades, and conduct statistical analysis on the evaluation of the teaching effect of the students. RESULTS: There was no significant difference in the enrollment scores of the two groups of students. After teaching, students in the observation group had more advantages in learning enthusiasm, memory efficiency, clinical operation, and doctor-patient communication skills(P<0.05), and they got higher theoretical knowledge and clinical skills operation assessment scores than those in the control group(87.95±6.78 points vs 78.95±6.28 points, 82.20±4.53 points vs 75.95±4.05 points, P<0.05), and their evaluation of the SP+CBL case-based teaching model was significantly higher than that of the control group who implemented the LBL teaching model(P<0.05).CONCLUSION: The SP+CBL case-based teaching mode has significant advantages in clinical practice teaching for postgraduates majoring in ophthalmology, and is worthy of scientific popularization.

Abstract:AIM: To evaluate the clinical effect of a limbus protection technique during epithelium-on corneal collagen cross-linking(Epi-on CXL)for keratoconus treatment.METHODS: Prospectively clinical study. A total of 15 patients(30 eyes)with diagnosed binocular progressive keratoconus were selected and treated with Epi-on CXL in my hospital from Jan. to Dec. 2019, and divided into 2 groups, Limbus-protecting Group and Control Group. The differences in corrected distance visual acuity, astigmatism, Km, thickness at the thinnest point of cornea, postoperative discomfort score, corneal epithelium healing time, and tear breakup time were compared between the two groups pre- and postoperatively.RESULTS: The corrected distance visual acuity and astigmatism were improved at 3mo postoperatively(P<0.05). The thickness at the thinnest point of cornea and the tear breakup time decreased after Epi-on CXL surgeries(P<0.05). No difference was found in parameters of corrected distance visual acuity, astigmatism, Km, thickness at the thinnest point of cornea, tear break up time, and postoperative discomfort sore between the two groups(P>0.05). However, the postoperative corneal epithelium healing time in Limbus-protecting Group was shorter than in Control Group(3.20±0.56d vs 3.73±0.96d, P=0.041).CONCLUSION:This limbal protection technique can reduce the corneal epithelium healing time after Epi-on CXL surgery, which preliminarily shows the feasibility of this technique.

Abstract:AIM: To investigate the postoperative visual acuity and ophthalmic complications after phacoemulsification in cataract patients with acquired immunodeficiency syndrome(AIDS). METHODS: We enrolled 47 eyes of 33 patients with AIDS who underwent phacoemulsification and intraocular lens implantation in our department between May 2016 and April 2019. The visual acuity, diopter, intraocular pressure(IOP), anterior chamber cell count(ACCC), and postoperative complications were recorded postoperative 1d, 1wk, 1mo, and 3mo.RESULTS:The postoperative visual acuities, including uncorrected visual acuity(UCVA)and best corrected visual acuity(BCVA)at postoperative 1d, 1wk, 1mo, and 3mo, were significantly better than that of preoperation(P<0.05). The ACCC count on the first day after surgery increased as compared with preoperation, but the difference was not significant from the first week after surgery. Furthermore, there was no apparent ophthamolic complications occurred after surgery. CONCLUSION: The phacoemulsification and intraocular lens implantation is a safe and effective surgery for cataract patients with AIDS.

Abstract:AIM: To identify factors associated with metamorphopsia in patients with rhegmatogenous retinal detachment(RRD)who underwent primary vitrectomy(PPV). METHODS:This retrospective study included 94 patients(94 eyes)who underwent 23G PPV for repair of RRD between January, 2017 and January, 2019. Each patient were examined both eyes preoperatively and postoperatively(at 1, 6, 12mo and last visits). At each time-point, patients received a complete ophthalmological examination, including best corrected visual acuity(BCVA), intraocular pressure, slit-lamp biomicroscopy, optical coherence tomography(OCT), and M-chart examination.RESULTS: One month after surgery, metamorphopsia occurred in 53%(n=50), the mean M value was 0.68±0.28. The metamorphopsia rate differed significantly between macula-off and macula-on RRD(P<0.01). There was significant difference in M-chart among the different time(F=26.442, P<0.01). Univariate analysis demonstrated that the macula status, location of retinal breaks, and disrupted EZ was a risk factor that was significantly associated with metamorphopsia. In multivariate analysis, macula-involving retinal detachment(OR=9.020, 95% CI:1.808-45.011, P=0.007)and disrupted EZ(OR=10.570, 95% CI:2.909-38.400, P<0.01)was a significant predictors of metamorphopsia.CONCLUSION: The metamorphopsia was improved after anatomically successful RRD surgery. Macular involvement retinal detachment and disrupted EZ were more likely to develop metamorphopsia.

Abstract:AIM: To analyse the characteristic of macular microcirculation and structural features detected by optical coherence tomography angiography(OCTA)in retinal branch vein occlusion(BRVO), and analyse the risk factors of visual acuity(VA).METHODS: Eligible eyes from subjects(92 with BRVO and 38 healthy people)were included. The relationship between factors and VA was analyzed by retrospective. Vessel density affected by vein occlusion of 3×3mm2 centered on the fovea(3×3mm VD)and foveal vessel density(foveal VD)in the superficial capillary plexus(SCP)and deep capillary plexus(DCP), were measured by OCTA. Central macular thickness(CMT), neuroepithelial layer thickness and height of subcortical fluid in patients with BRVO were measured.RESULTS: The DCP, SCP, FD300, density of superficial fovea, density of superficial fovea and AI of the BRVO group were significantly different with control group(P<0.01). Multivariate regression: Age(P=0.033, OR=1.152, 95%CI=1.011-1.312). Density of superficial fovea(P=0.010, OR=1.260, 95%CI=1.056-1.504)and Macular fovea thickness(P<0.01, OR=1.033, 95%CI=1.021-1.045)were risk factors of VA. DCP and SCP were negatively related with CMT and neuroepithelial layer(P<0.01). CMT was positively correlated with the thickness of neuroepithelial layer and the height of subcortical fluid(P<0.01).CONCLUSION: Using OCTA, we can observe the BRVO retinal blood flow and the changes of the structure of the retinal section, and the pathological features of macular retina in BRVO patients can be observed more comprehensively. Age, density of superficial fovea and macular fovea thickness were risk factors of VA.

Abstract:AIM: To quantify changes in peripapillary vessel density in patients with type 2 diabetic mellitus(DM)without clinical features of diabetic retinopathy(DR)by OCT angiography(OCTA). METHODS:A retrospective clinical study. From January to December 2019, 38 type 2 DM patients without DR(38 eyes, NDR group)and 30 normal subjects(30 eyes, control group)in Eye Hospital of Wenzhou Medical University at Hangzhou were included in the study. The optic nerve head was scanned by OCTA with HD 4.5mm×4.5mm imaging scanning mode for all subjects.The software automatically divides the peripapillary region into 8 sectors, designated as nasal superior(NS), nasal inferior(NI), inferior nasal(IN), inferior tempo(IT), tempo inferior(TI), tempo superior(TS), superior tempo(ST)and superior nasal(SN). Radial peripapillary capillaries vessel density(ppVD)and peripapillary retinal nerve fiber layer(pRNFL)thickness of entire peripapillary area and each sector were measured. The discrepancy of ppVD and pRNFL thickness between the two groups was also analyzed. Pearson correlation analysis was used to analyze the correlation between ppVD and pRNFL in each quadrant of NDR group. RESULTS:The mean ppVD value and NS,NI,IN,IT,TI,TS,ST and SN sector values were all significantly lower in NDR group compared to normal controls(all P<0.05). The mean and each sector pRNFL thickness was reduced in NDR group compared with the control group, but the difference was not statistically significant(all P>0.05). Pearson correlation analysis showed that the significant positive correlation was found between ppVD and pRNFL thickness in TI, TS, SN, NS and NI sector(r=0.578, 0.427, 0.577, 0.397, 0.317; all P<0.05). CONCLUSION: Peripapillary vessel density has decreased in eyes of patients with type 2 DM before clinically detectable retinopathy and OCTA is helpful for early monitoring.

Abstract:AIM: To analyze the influence of bandage contact lens on corneal refractive status and postoperative complications in patients with pterygium. METHODS: Totally 116 patients with pterygium treated in the hospital between January 2018 and December 2019 were recruited in the study. They were divided into control group and observation group by random number table method, 58 cases in each group. The control group received extended pterygium resection and autologous corneal limbal stem cell transplantation. On this basis, the observation group was treated with bandage contact lens. The best corrected visual acuity(BCVA), surface asymmetry index(SAI)of corneal topography, surface regularity index(SRI), corneal refractive power and postoperative complications in the two groups were compared. RESULTS: Compared with preoperation, the BCVA of the two groups was significantly higher 1mo and 3mo after operation(P<0.05), without statistically significant difference between the groups(P>0.05). Corneal horizontal and vertical curvature of the two groups were significantly higher, while corneal astigmatism was significantly lower at 1mo and 3mo after surgery. Meanwhile, the observation group had significantly lower corneal astigmatism than the control group(P<0.05). SAI and SRI of the two groups significantly decreased, which were significantly lower in the observation group than in the control group(P<0.05). No complications such as infection, poor healing of grafts and subconjunctival cysts were observed. The incidence of eye irritation was significantly lower in the observation group than in the control group, and lower at 2wk than at 1wk before operation(P<0.05).CONCLUSION: Extended pterygium resection combined with autologous corneal limbal stem cell transplantation and bandage contact lens is more conductive to the improvement of corneal refraction in patients with pterygium, which also can reduce the incidence of eye irritation.

Abstract:AIM: To study the age distribution and refractive status of school age children with myopia and the correlation with ocular axis, corneal curvature and other biological parameters. METHODS: A total of 391 eyes of 196 school age children who were diagnosed as myopia were collected. Patients with other eye diseases causing vision loss were excluded. The patients were divided into three groups according to age and four groups according to diopter. All patients received visual acuity, intraocular pressure, slit lamp microscope, IOL master, optometry and fundus examination, and the results were recorded. Independent sample t-test, one-way ANOVA, LSD-t and linear regression were used to analyze the age distribution of diopter and its relationship with refractive parameters.RESULTS: There were 128(32.7%), 155(39.6%)and 108(27.6%)eyes in 6-8, 9-10 and 11-12 age groups. The average age was 9.29±1.64 years old. There were significant differences in SE(P<0.01)and AL(P<0.01)among different age groups. There were 134(34.3%), 162(41.4%), 74(18.9%)and 21(5.4%)eyes in SE ≤ -1.00D, -1.00D<SE≤ -2.00D, -2.00D<SE≤-3.00D and >-3.00D groups. The average SE was -1.54±0.89D. There was significant difference in AL among differences diopter groups(P<0.01). There was a linear relationship between SE and AL. The regression equation is (＾overY)=12.373-0.577X, R2=0.286, β=-0.577, P<0.001. And there was a linear relationship between astigmatism and corneal astigmatism. The regression equation is (＾overY)=0.084-0.502X, R2=0.389, β=-0.502, P<0.001.CONCLUSION: The age of the first onset of myopic ametropia in children is 9-10 years old, which is mainly low degree myopia. The growth of axial length is related to the increase of age and diopter and astigmatism is related to corneal astigmatism in children.

Abstract:AIM: To evaluate the centration of the SBL-3 multifocal intraocular lens, the size of the distant and near power zone in the pupil area and the area of the visual axis using Itrace visual function analyzer. METHODS: Retrospective case study. From January 2018 to January 2019, 51 eyes of 36 patients underwent phacoemulsification cataract combined with regional refraction multifocal intraocular lens implantation at Beijing Aier-Intech Eye Hospital were enrolled. The centration, visual axis, angle α, angle Kappa and the orientation of the intraocular lens measured by Itrace were used to calculate the position of the visual axis in the intraocular lens and the changes in the proportions of the distant and near power zones in the pupil area. RESULTS: The centration(R)of intraocular lens is 0.217±0.09mm. The distribution of the visual axis in the intraocular lens is 0.217±0.09mm. The visual axis is evenly distributed in the distant and near power zones. There was no statistical significance between the two groups with postoperative visual acuity ≥0.8 and <0.8(P>0.05). The size of the angle Kappa is 0.187±0.079mm. The displacement of angle Kappa on the y-axis is 0.10±0.06mm. There was no statistical significance between the changes in the pupil size of distant and near power zones in the pupil area caused by the deviation of the pupil and the postoperative visual acuity ≥0.8 and <0.8(P>0.05). CONCLUSION: The intraocular lens centration and axial data measured by the Itrace visual function analyzer can be used to estimate the area where the visual axis is located and the size of the distant and near power zones in the pupil area, thereby assisting in evaluating the postoperative visual quality of the regional refraction multifocal intraocular lens implanted after cataract surgery.

Abstract:AIM: To study the application value of digital and visual retinoscope in the detection of ametropia in adolescents.METHODS:A retrospective analysis of digital visual inspection and traditional retinography test results of 69 adolescents in the ophthalmology department of our hospital from January 2019 to October 2019. SPSS 20.0 software analyzed the correlation of spherical equivalent, diopter of cylindrical power and axial direction measured by two detection methods. Taking the clinical examination results as the control, the diagnostic value was compared. RESULTS: There was no statistically significant difference in the measuring of spherical equivalent, diopter of cylindrical power and axial direction between digital and visual retinoscope and traditional retinography(t=0.081, 1.778, 0.983, P=0.935, 0.077, 0.327). And there was a significant positive correlation(r=0.745, 0.572, 0.941, P<0.01). At the same time, two detection methods have the same sensitivity. Digital and visual retinoscope higher than traditional retinography at the specificity, accuracy, positive predictivevalue and negative predictive value.CONCLUSION: The detection of ametropia in adolescents with digital and visual retinoscope has a good correlation with traditional retinography. Compared with the latter, the former has improved for the diagnosis of ametropia, which deserves clinical attention.