Abstract:This literature review intends to provide an overview of the new non-invasive testing technologies and their role in the diagnosis of dry eye disease(DED). Including imaging technologies of tear volume, tear film stability, meibomian glands morphology and function, corneal morphology, biomarkers and ocular surface temperature, as well as tear osmolarity, optical quality, blinking test and so on. New testing technologies can provide an indirect and objective assessment of the ocular surface, tear condition and visual quality. Testing technologies, such as tear volume, meibography and tear osmolarity have been widely recognized and applied in clinical practice, showing higher specificity and sensitivity than traditional tests. Others, such as strip meniscometry, interferometer, light scattering technology, double-pass system, blinking test and so on, are currently in the stage of clinical research and improvement, and may translate to routine clinical detection techniques in the future. The new non-invasive testing technologies can non-invasively evaluate the ocular surface and tears, and measure the changes of components related to the disease, which play an important role in the diagnosis, classification, clinical management and curative effect evaluation of DED.

Abstract:AIM: To evaluate and compare the quality of life of patients submitted to phacoemulsification combined with goniosynechialysis(PPI+GSL)and trabeculectomy, and analyze the potentially involved variables.

METHODS: A perspective, randomized case-control study was conducted. Patients with acute primary angle-closure glaucoma(ACG)and early cataracts underwent PPI+GSL implantation(group A, n=29)and trabeculectomy(group B, n=30). The quality of life was assessed using the National Eye Institute 25-Item Visual Function Questionnaire(NEI-VFQ-25)before and 6mo after surgery. Intraocular pressure(IOP), best corrected visual acuity(BCVA), review frequency and the basic characteristics were recorded simultaneously.

RESULTS: Compared with preoperative status, the IOP in both groups was significantly decreased(all P<005), and the BCVA was significantly increased in group A(P<0.05), while did not differ significantly in group B(P>0.05). Besides, group B presented higher review frequency than group A(P<0.05). Moreover, significant increases in postoperative scores were founded in the two groups respectively(all P<0.05). Compared with group B, group A had better postoperative performance in items of general vision, ocular pain, long-distance activities, social functioning and role limitations(all P<0.05). Besides, group A presented significantly higher net increases in postoperative total scores than group B(P<0.05), which was positively associated with the degree of the BCVA recovery and negatively associated with review frequency(R²=0.48, F=5.00, P<0.05).

CONCLUSION: APACG patients with early cataracts, PPI+GSL determines better improvement in quality of life compared to trabeculectomy.

Abstract:AIM: To investigate subfoveal subretinal fluid thickness(SFT)and subfoveal choroidal thickness(CT)after scleral buckling surgery(SBS)for macula-off rhegmatogenous retinal detachment(RRD).

METHODS: Retrospective observational case series. Twenty-three patients with macula-off RRD underwent successful SBS combined with cryotherapy. Patients with recurrent retinal detachment and proliferative preretinal membranes were excluded. Optical coherence tomography(OCT)was used to measure subfoveal SFT and subfoveal CT. The OCT images were then evaluated preoperatively and postoperatively at 1wk, 1, 3, 6, and 12mo. Best-corrected visual acuity(BCVA)was measured preoperatively and postoperatively.

RESULTS: All of the patients had subretinal fluid 1wk after operation. Subfoveal SFT gradually reduced over time. The subfoveal CT was thicker 1wk postoperatively and gradually decreased subsequently. The BCVA(mean±SD, LogMAR)was 0.60±0.35, which was a statistically significant change from the preoperative BCVA(t=6.35, P<0.01).

CONCLUSION: The subretinal fluid was gradually absorbed with time, and the subfoveal CT gradually decreased after the early thickening. The SBS rapidly improved the visual acuity of the patients after the early postoperative period.

Abstract:AIM: To study the effect of monocular form deprivation(MD)on the synaptic density in the visual cortex of the amblyopic rats during the critical period of visual development, the visual cortical synaptophysin(SYN)expression and significance of its expression, as well as the relationship between the synaptic density and the visual function. This research will provide mechanisms underlying the pathogenesis and clinical treatment of amblyopia.

METHODS: Normal newborn Long Evans rats were randomly divided into normal control group and amblyopia model group, each with 16 rats. Both groups of rats were raised in the same environment. The normal control group did not receive any treatment. On the 13d after birth, the amblyopic model group received monocular suture to establish a classic monocular form deprived amblyopic model. Both groups of rats were received Visual evoked potential(F-VEP)detection on the 51d. Samples were taken immediately after the detection. The transmission electron microscope and Image J image analysis software were used to observe and analyse the synaptic density in the V1M of the primary visual cortex of the two groups of rats. Frozen sections of visual cortex were stained by immunofluorescence histochemical staining by bleaching method and the expression of SYN positive neurons was observed and quantitatively analyzed.

RESULTS: F-VEP examination showed that compared with the normal control group, the P2 latency of the deprived eyes in the amblyopic group was significantly long, and the amplitude of P2 wave was significantly lower than that of normal eyes(P<0.05); Transmission electron microscopy results showed that the synaptic density of the bilateral visual cortex of the amblyopic model group was significantly reduced compared with the normal control group(P<0.05), the contralateral visual cortex of the amblyopic eye decreased more significantly(P<0.05); immunofluorescence staining results showed that the brain slices in the visual cortex of the two groups were intact and the tissue structure was clear under the microscope. Compared with the normal control group, the expression intensity of SYN positive neurons in the amblyopic group was significantly reduced(P<0.01).

CONCLUSION: There is structural synaptic plasticity during the critical period of visual development. Monocular form deprivation can reduce the synaptic density, SYN expression and the visual function in the primary visual cortex of the amblyopic rats.

Abstract:AIM: To investigate the endoplasmic reticulum stress(ERS)induced by all-trans retinoic acid(ATRA)in ARPE-19 cells.

METHODS:Immunofluorescence, real-time quantitative polymerase chain reaction and Western blot were used to detect the protein and mRNA expression of related signal pathways during the process of endoplasmic reticulum stress response induced by ATRA in ARPE-19 cells.

RESULTS: With the accumulation of ATRA concentration, the protein and mRNA levels of endoplasmic reticulum stress response marker proteins chop and BiP were significantly increased(P<0.001); in the downstream signaling pathways, perk, eIF2 α, ATF4, IRE1 α and XBP1 were up-regulated(P<0.001), while the expression of ATF6 did not change(P>0.05).

CONCLUSION: Over accumulation of ATRA induces ERS in ARPE-19 cells and activates PERK-EIF2 α-ATF4 and IRE1 α-XBP1 signaling pathways

Abstract:AIM: To detect the expression of miR-486-3p in human pterygium tissue and normal conjunctival tissue and explore the possible mechanism of miR-486-3p in the development of pterygium.

METHODS: Totally 69 patients 69 eyes with primary pterygium treat in Zhongnan Hospital of Wuhan University and Hankou Aier Eye Hospital from September 2018 to December 2019 were collected by excision of pterygium during surgery(experimental group). At the same time, a total of 69 patients with normal conjunctival tissue of their same eyes were taken as control group during surgery. The relative expression levels of miR-486-3p in the experimental group and the control group were quantitatively detected by RT-PCR. The Targetscan database, miWalk3.0 database and miRDB database were used to predict the potential target genes of miR-486-3p. DAVID database was used to analyse and enrich the function and pathway of the potential target genes of miR-486-3p. The String website performed an interactional analysis of the potential target genes of miR-486-3p.

RESULTS: The relative expression level of miR-486-3p in the experimental group(6.183±1.366)×10^-6 was significantly different from that in the control group(7.930±1.394)×10^-5(P<0.0001). By the prediction of their target genes and bioinformatical analysis, a total of 436 potential target genes of miR-486-3p were found. The biological functions were mainly concentrated in the regulation of RNA polymerase II promoter transcription, vesicle-mediated transport, transcriptional regulation and the regulation of DNA-dependent RNA metabolism. The Kyoto Encyclopedia of Genes and Genomes(KEGG)pathway was mainly enriched in the Axon guidance pathway and lysosomal pathway. And the Axon guidance pathway might play an important regulatory role in the occurrence and development of pterygium. PPI network analysis further elucidated that the key genes of ABL1 and PLXNA1(cell protein receptor A1)play an important role in the Axon guidance pathway for pterygium.

CONCLUSION: MiR-486-3p might be involved in the occurrence and development of pterygium through SLIT(neuro-targeting factor)/Robo(rotatory guide receptor)and SEMA3A(neuro-guiding factor Semaphorin 3A)/ PLXNA1 of Axon guidance pathways, which resulted in the abnormal new blood vessels of pterygium.

Abstract:AIM:To explore the effects of recombinant human growth hormone(rHGH)on early rehabilitation in rabbit corneal epithelial wound.

METHODS:Thirty-two New Zealand rabbits were selected to establish the corneal epithelial defects models. One eye was treated with normal saline(NC group)and the other eye was treated with 20nmol/L rHGH(rHGH group)in a randomized double-blinded way. The corneal healing process was monitored by the corneal fluorescein staining scores at 0h, 24h, 48h, and 72h after the surgery. The central corneal sensitivity was detected by Cochet-Bonnet corneal esthesiometer and the concentrations of inflammatory mediators interlecukin-1α(IL-1α), interlecukin-17(IL-17), interlecukin-21(IL-21), Leptin, matrix metalloproteinase-9(MMP-9)and tumor necrosis factor-α(TNF-α)in collected tears were measured by multiplex antibody microarray.

RESULTS: The corneal epithelial healing rates of the NC group and rHGH group were(62.52±6.73)% and(79.62±10.62)%(P<0.05),(90.56±9.57)% and(98.43±3.65)%(P<0.05)at 48h and 72h postoperatively. The central corneal sensitivity of rHGH group(4.22±0.26)cm was better than that in NC group(3.22±0.42)cm at 48h after surgery(P<0.05). The expressions of TNF-α and IL-1α increased in both groups at each time point after operation, and the expressions in NC group were higher than those in the rHGH group. Both groups had higher MMP-9 concentrations in the tear fluid at 24 and 48h postoperation in comparison with the point before the operation. The MMP-9 expression in NC group was higher than that in the rHGH group at 48h postoperatively. The expressions of IL-21 in NC group were higher than those in the rHGH group at 24 and 48h postoperation in comparison with the point before the operation(P<0.05). No significant differences in tearIL-17 and Leptin were observed between groups before and after surgery(P>0.05).

CONCLUSION: Topical application of rHGH can accelerate the early stage of rabbit corneal epithelial wound healing in vivo.

Abstract:AIM: To evaluate the disruption degree of macular fovea structure by pre-operation SD-OCT examination and establish a new method of IMEM. Thus, to analysis the value of this method for predicting the visual functional prognosis of cataract patients complicated with idiopathic macular epiretinal membrane(IMEM)after cataract surgery alone.

METHODS: Totally 64 patients(80 eyes)diagnosed as cataract with IMEM, who simply underwent phaco cataract extraction combined with intraocular lens implantation were included in this study. These patients were admitted in Shenzhen Eye Hospital from October 2017 to November 2018. IMEM was divided into 4 stages based on the damage degree of macular fovea structure by pre-operative SD-OCT examination. The best corrected visual acuity(BCVA), mean retinal sensitivities(MS), central macular thickness(CMT)and the progression rate of IMEM in all the patients were compared and analyzed before and 3mo after the cataract operation.

RESULTS: With the IMEM grade rised, the epiretinal membranes became more obvious, the disruption of retinal layers and loss of the foveal depression became more serious on the SD-OCT image. The LogMAR BCVA of pre-operation and 3mo after cataract surgery progressively rised with the increasing of IMEM grade, and the differences were statistically significant(F=37.72, 26.43, P<0.001). Otherwise, The MS of pre-operation and 3mo after cataract surgery progressively declined with the increasing of IMEM grade, and the differences were statistically significant(F=43.77, 28.96, P<0.001). The change of CMT was not consistent with the progression rate of IMEM in 3mo after operation. There was no significant difference in CMT(P>0.05), but the progression rate of IMEM was increased significantly with the IMEM grading(χ²_Trend=12.59, P<0.001).

CONCLUSION: The new classification method was created for IMEM by SD-OCT will help to predict the visual functional prognosis for cataract patients complicated with IMEM after cataract surgery.

Abstract:AIM:To observe the value of intravitreal injection of Conbercept in the treatment of proliferative diabetic retinopathy(PDR).

METHODS: Totally 64 patients(75 eyes)with PDR admitted to the hospital between January 2016 and October 2019 were recruited and divided into observation group(32 cases, 38 eyes)and control group(32 cases, 37 eyes)by random number table method. The observation group received vitrectomy and intravitreal injection of Conbercept, while the control group received simple vitrectomy. The best corrected visual acuity(BCVA)was detected before treatment, at 1wk, 1mo, and 3mo after operation. Changes in central macular thickness(CMT)before treatment and at 3mo after operation were determined. Aqueous humor or vitreous humor samples were collected before and after treatment to measure concentrations of vascular endothelial growth factor(VEGF), placental growth factor(PIGF)and basic fibroblast growth factor(bFGF)by enzyme-linked immunosorbent assay. The operation time, intraoperative blood loss and improvement time of symptoms(retinal edema, fundus hemorrhage, exudation)of the 2 groups were statistically analyzed. Incidences of complications in the 2 groups were recorded.

RESULTS: The observation group had better BCVA than the control group at 1wk, 1mo and 3mo after operation(P<0.05), and had smaller CMT than the control group at 3mo after operation(P<0.001). The concentrations of VEGF, PIGF and bFGF in observation group during operation were lower than those in the control group(P<0.001). The operation time, absorption time of retinal edema, fundus hemorrhage and exudation, intraoperative blood loss, and the total incidence of complications in the observation group were shorter and lower than those in the control group(P<0.05).

CONCLUSION: Intravitreal injection of Conbercept before vitrectomy can degrade new blood vessels, and shorten the operation time. It can not only help improve vision and relieve macular edema but also reduce surgical complications and promote postoperative recovery.

Abstract:The blood-retinal barrier is an important structural basis for maintaining the homeostasis of the retinal environment, but there is still a lack of further research on its complete structure and function. The in vitro blood-retinal barrier model has the characteristics of controllable, efficient, fast and stable, and has become an effective tool to study the specific structure and function of the barrier. This paper mainly reviews the structure, function and in vitro model of blood-retinal barrier, which is helpful to promote the study of physiology, biochemistry, pathopharmacology and clinic of blood-retinal barrier. It also provides a common and key experimental basis for the study of fundus vascular diseases such as diabetic retinopathy.

Abstract:Retinal degenerative diseases are kinds of leading cause of blindness characterized by photoreceptor apoptosis and progressive neuronal degeneration. A large body of research has shown the evidence of inflammation reaction in such diseases. Retinal neuroinflammation may be a main factor resulting in apoptosis of photoreceptors and neurodegeneration of retina. In addition, the inflammatory response is not only detected in the retina, but also in aqueous humor, vitreous and even in blood, which forms a persistently very low degree, and chronic inflammatory environment. In this review, we focus on the development of microinflammatory response and its predictor for disease outcomes.

Abstract:Hydroxychloroquine and chloroquine play more and more important roles in the treatment of rheumatism, skin diseases and autoimmune diseases. Irreversible macular diseases,retinopathy and even permanent blindness are common side effects of them. High dose per kilogram of body weight, duration of treatment, presence or absence of keratosis and renal or liver dysfunction are all related to this. Therefore, the examination of the two kinds of drug lesions is also relatively complicated. FAF and SD-OCT are required for wide field examination. For patients with complicated retinopathy, multifocal electroretinogram and the like are also required for diagnosis. The specific examination methods need to be determined by clinical ophthalmologists according to the patient's medication and preliminary examination.

Abstract:Mesenchymal stem cells(MSCs)are pluripotent stem cells which are derived from avariety of tissues and have the potential for multidirectional cell differentiation and self-cell renewal. They can play a therapeutic effect on a variety of eye diseases. Studies have shown that the biological functions of MSCs are closely related to their secreted exosomes(MSC-Exo). Compared with MSCs, the biological performance of MSC-EXO is more stable and non-tumorigenic. Therefore, MSC-EXO is expected to be an effective substitute for the biological function of MSCs. In this paper, the application progress of MSC-EXO in ocular diseases is discussed in order to provide ideas and reference for the treatment of MSC-EXO in ocular diseases.

Abstract:Numerous studies have indicated that high myopiais associated with a higher risk for glaucomatous optic neuropathy. However, structural and functional changes induced by glaucoma can be confounded by high myopia because the latter itself can cause a series of retinal and nerve fiber layer damage. In order to find glaucomatous changes in high myopia and reduce the potential of missed diagnosis or misdiagnosis, a deep understanding of clinical features of high myopia with glaucoma was needed. This artical summarizes the functional roles and potential difficulties of classical stuctural and functional investigations in diagnosis of high myopia with glaucoma. This review is also introduced some possible solutions to navigate this diagnostic dilemma.

Abstract:Ophthalmology is a subject that mainly applying the imaging examination to diagnose. With the development of modern medicine, the study in clinical imaging of ophthalmology has made a great progress recently. Amblyopia is one of the common eye diseases, which usually result in devastating loss of vision. Sum of imaging technologies such as magnetic resonance imaging, functional magnetic resonance imaging, optical coherence tomography and optical coherence tomography angiography have been extensively used in the field of amblyopia. Then that contributed to stimulate the development of the related imaging studies. In this article, we summarized and overviewed the rencent progress of clinical imaging studies in various types of amblyopia.

Abstract:Congenital cataract is the most common cause of visual impairment and blindness in children worldwide, with about a quarter is related to genetics. To date, more than 100 gene mutations have been found in inherited congenital cataracts. As the most important component of the crystalline lens, the gene mutation of lens protein is closely related to congenital cataract. A large number of studies have confirmed that the pathogenic genes associated with congenital cataract include α/β/γ lens protein gene, membrane protein gene, cytoskeleton protein gene, and so on. About half of the mutations occurred in the lens protein genes, and the gene mutation may affect the stability, solubility and oligopoly of the protein, as well as interfere with the orderly arrangement of lens fibers, and lead to lens opacity. In this paper, the research progress of lens protein genes related to congenital cataract in recent years is reviewed.

Abstract:Glaucoma is the leading cause of irreversible vision loss in the world. Drugs and surgery can be used to control intraocular pressure, however, they can't reverse the apoptosis of retinal ganglion cells effectively. With the development of genetics and molecular biology, a large amount of research on the pathogenesis of glaucoma has been conducted. This review discusses the potential role of Rho/ROCK, TGF-β/Smad, PI3K/Akt, Nrf2/Keap1/ARE and BDNF/TrkB signaling pathways in the pathogenesis of glaucoma, and expects to provide new ideas and methods for the treatment of glaucoma.

Abstract:Thyroid associated ophthalmopathy(TAO)is an autoimmune orbital inflammatory disease. Imaging methods play an important role in evaluating the change of orbital structures and differential diagnosis of orbital disease. In addition, imaging studies can also contribute to analyze the activity and severity of TAO and estimate compressive optic neuropathy(CON).

Abstract:Circular RNAs(circRNAs)comprise a novel class of non-coding RNAs that are found to be highly abundant in eukaryotic cells and have implicated in various cellular functions such as cell proliferation, differentiation, and apoptosis. Recent advances have suggested that dysregulated circRNAs play a critical role in the pathogenesis of several proliferative retinal diseases including proliferative vitreous retinopathy, diabetic retinopathy, age-related macular degeneration, retinopathy of prematurity, and corneal neovascularization. Here, we review current knowledge about circRNAs and summarize new insights into potential functions of some aberrantly expressed circRNAs and possible future directions in ocular proliferative diseases.

Abstract:AIM:To systematically review the risk factors of age-related macular degeneration(ARMD)in China.

METHODS:PubMed, EMbase, Web of Science, The Cochrane Library, CBM, CNKI, Wan Fang Data VIP databases were electronically searched to collect case-control studies, cohort studies and cross-sectional studies on the risk factors of ARMD in China from inception to December, 2019. Two reviewers independently screened literature, extracted data and assessed risk of bias of included studies, then, Meta-analysis was performed by using RevMan 5.3 software.

RESULTS: A total of 27 studies involving 204 767 objects and 10 risk factors were included. The results of Meta-analysis showed that smoking \〖OR=2.30, 95%CI (1.95, 2.71), P<0.0001\〗, hypertension \〖OR=1.55, 95%CI (1.23, 1.95), P=0.0002\〗, HTRA1 rs11200638\〖OR=4.35, 95%CI (2.35, 7.48), P<0.0001\〗, CFH Y402H \〖OR=3.28, 95%CI (2.51, 4.28), P<0.00001\〗, LOC387715 rs10490924 \〖OR=7.09, 95%CI (3.48, 14.44), P<0.00001\〗. Desciptive analysis results showed that DR, Cataract surgery, NO₂, CO and HBV infection were risk factors of ARMD in China.

CONCLUSION: Current evidence shows that smoking, hypertension, HTRA1 rs11200638, CFH Y402H, LOC387715 rs10490924, DR, cataract surgery, NO₂, CO and HBV infection are the risk factors of ARMD in China.

Abstract:AIM: To explore the long-term efficacy of vitrectomy combined with or without anti-VEGF in the treatment of proliferative diabetic retinopathy(PDR).

METHODS: Randomized controlled trials(RCTs)comparing the efficacy of vitrectomy combined with or without anti-VEGF therapy for PDR were retrieved from databases including PUBMED, EMBASE, Cochrane Central Register of Controlled Trials(CENTRAL)and Web of Science. The retrieval time was from the establishment of the databases to July 2020. According to the inclusion and exclusion criteria, the literature was selected, then data extraction and quality evaluation was completed. Primary evaluation measures included postoperative incidence of retinal detachment, central retinal thickness(CRT), and best corrected visual acuity(BCVA).

RESULTS: In this article, 11 randomized controlled studies(880 eyes)were included. Meta-analysis results showed that the incidence of retinal detachment after vitrectomy was significantly lower in PDR patients who received anti-VEGF injection before vitrectomy than in patients who did not receive anti-VEGF injection \〖Risk ratio(RR)=0.39, 95% Confidence interval(CI)0.22 to 0.71, P=0.002\〗. There were significant differences in the incidence of retinal detachment after vitrectomy between the anti-VEGF group and the non-VEFG group in both Asian and non-Asian populations(Asian: RR=0.20, 95%CI 0.05 to 0.87, P=0.03; Non-Asian: RR=0.46, 95%CI 0.24 to 0.89, P=0.02). The central retinal thickness of PDR patients who received preoperative anti-VEGF therapy was significantly lower than that of patients who did not receive anti-VEGF therapy 3 and 6mo after PPV(MD=-78.49, 95%CI -94.81 to -62.17, P<0.00001. MD= -39.62, 95%CI -48.44 to -30.80, P<0.00001). The BCVA at 6mo after PPV in PDR patients with preoperative anti-VEGF treatment was better than that in patients without preoperative anti-VEGF treatment(MD=-0.16, 95%CI -0.21 to -0.10, P<0.00001).

CONCLUSION: Anti-VEGF injection before PPV can effectively reduce the incidence of retinal detachment, alleviate postoperative macular edema, reduce the central retinal thickness, and improve BCVA in PDR patients.

Abstract:AIM:To observe the effect of phacoemulsification and intraocular lens(IOL)implantation combined with trabeculectomy on the central anterior chamber depth(ACD)and astigmatism of patients with cataract and glaucoma.

METHODS:This prospective study included 100 patients(100 eyes)with cataract and glaucoma who were admitted to the hospital between November 2018 and November 2019. The patients were divided into control group(n=50, 50 eyes)and observation group(n=50, 50 eyes)by the random number table method. The control group was treated with phacoemulsification and IOL implantation, while the observation group was treated with phacoemulsification and IOL implantation combined with trabeculectomy. The LogMAR visual acuity, intraocular pressure(IOP), ACD and astigmatism at 1wk, 2wk and 1mo after operation, visual quality, and the incidence of complications were compared between the two groups.

RESULTS:Compared with preoperative, the ACD of the two groups increased, LogMAR visual acuity and IOP decreased at 1wk, 2wk and 1mo after operation(P<0.05). Moreover, the ACD of the observation group at 1wk, 2wk and 1mo after operation were higher than those of the control group, and the LogMAR visual acuity, IOP was lower than that of the control group(P<0.05). The astigmatism of the two groups increased at 1,2wk after operation, and obseration group decreased at 1mo after operation(P<0.05). Meanwhile, the astigmatism of the observation group was lower than that of the control group(P<0.05). At 1mo after operation, the scores of watching TV, reading and writing, and fine operation of the observation group were higher than those of the control group(P<0.05). The incidence of complications in the observation group was lower than that in the control group(6% vs 22%, P<0.05).

CONCLUSION:Phacoemulsification and IOL implantation combined with trabeculectomy is markedly effective in the treatment of patients with cataract and glaucoma, which can improve vision and visual quality. Lower intraocular pressure and astigmatism, reduce changes in astigmatism, deepen the central anterior chamber depth, and reduce the incidence of complications.

Abstract:AIM: To detect the relative expression levels of microRNA-27a(miR-27a)and nuclear factor erythroid-2-related factor 2(NRF2)in serum of patients with age-related macular degeneration(ARMD)bleeding, and to explore the correlation between the expression levels and the prognosis of ARMD bleeding.

METHODS: A retrospective case series observation was carried out.From June 2018 to October 2019, 80 patients with ARMD bleeding who were treated in our hospital were selected as ARMD bleeding group, and 80 healthy people who had routine examination in our hospital were selected as control group. The relative expression levels of miR-27a and NRF2 were detected by real-time fluorescent quantitative PCR(qRT-PCR), the diagnostic value of serum miR-27a and NRF2 expression for ARMD bleeding was evaluated by receiver operating characteristic curve(ROC). The incidence of poor prognosis was analyzed; in addition, Logistic regression was used to analyze the influencing factors of poor prognosis in patients with ARMD bleeding.

RESULTS: The relative expression level of miR-27a in serum of ARMD bleeding group was significantly higher than that of control group(P<0.01), and the relative expression level of NRF2 mRNA in serum was significantly lower than that in control group(P<0.01). ROC results showed that the AUC of serum miR-27a and NRF2 in the diagnosis of ARMD bleeding was 0.867 and 0.820 respectively, and the cutoff value was 1.10 and 1.08 respectively, at this time, the corresponding sensitivity was 71.3% and 91.3%, and the specificity was 90.0% and 63.7%, respectively. The AUC of serum miR-27a combined with NRF2 in the diagnosis of ARMD bleeding was 0.912, and the corresponding sensitivity and specificity were 86.3% and 85.0%, respectively. The incidence of poor prognosis in high miR-27a group was significantly higher than that in low miR-27a group(P<0.05); and the incidence of poor prognosis in high NRF2 group was significantly lower than that in low NRF2 group(P<0.05). Logistic analysis showed that the high expression of serum miR-27a was an independent risk factor for poor prognosis in patients with ARMD bleeding, and the high relative expression of NRF2 in serum was a protective factor for the poor prognosis of patients with ARMD bleeding.

CONCLUSION: The relative expression level of miR-27a in the serum of patients with ARMD hemorrhage is significantly increased, and the relative expression level of NRF2 is significantly decreased, both of them have certain diagnostic value for ARMD bleeding, and their relative expressions are closely related to the prognosis of patients, which is suggested that miR-27a and NRF2 can be used as potential biological indexes for early diagnosis and prognosis evaluation of ARMD bleeding.

Abstract:AIM: To explore the effects of internal limiting membrane transplantation, inverted internal limiting membrane flap and autologous blood filling in treatment of idiopathic macular hole(IMH)and the influence on macular structure and choroidal thickness.

METHODS: Clinical data of patients with IMH who were treated in the hospital between January 2017 and December 2019 were retrospectively analyzed. All patients were treated with standard vitrectomy combined with internal limiting membrane stripping and gas-liquid exchange. On this basis, patients treated with internal limiting membrane transplantation(28 cases, 29 eyes), inverted internal limiting membrane flap(26 cases, 28 eyes)and autologous blood filling(25 cases, 25 eyes)were included in the internal limiting membrane transplantation group, inverted internal limiting membrane flap group and autologous blood filling group, respectively. The situation of hole closure and shape of the closed hole were observed. The best corrected visual acuity(BCVA), hole photoreceptors inner segment/outer segment ellipsoid zone(EZ)and external limiting membrane(ELM)defect diameter, perimeter of foveal avascular zone(PERIM), superficial capillary plexus(SCP)blood flow density, subfoveal choroidal thickness(SFCT), temporal choroidal thickness(TCT)and nasal choroidal thickness(NCT)were determined.

RESULTS: All patients in the 3 groups successfully completed the surgery. The BCVA of internal limiting membrane transplantation group and inverted internal limiting membrane flap group was better than that of autologous blood filling group at 3mo after surgery(P<0.05). There were no significant differences in macular hole closure rate and ellipsoid closure rate among the 3 groups(P>0.05). However, there were significant differences in morphological classification of the closed macular hole(P<0.05), and the proportion of U-shaped hole was the highest in inverted internal limiting membrane flap group. The diameters of EZ defect and ELM defect of internal limiting membrane transplantation group and inverted internal limiting membrane flap group were smaller than those of autologous blood filling group at 3mo after surgery(P<0.05). There were no significant differences in PERIM, SCP blood flow density, SFCT, TCT and NCT among the 3 groups before and after surgery(P>0.05).

CONCLUSION:Internal limiting membrane transplantation, inverted internal limiting membrane flap and autologous blood filling can restore the closure of the macular hole. However, internal limiting membrane transplantation and inverted internal limiting membrane flap can better restore the macular structure and improve visual acuity, compared with autologous blood filling.

Abstract:AIM: To explore the correlation between age, OCT characteristics and the efficacy of anti-vascular endothelial growth factor(VEGF)drugs in the treatment of macular edema secondary to central retinal vein occlusion(CRVO).

METHODS: Retrospective case-control study. From July 2017 to July 2019,47 eyes of 47 patients with CRVO were included and divided into group A(elderly group, age>50y, n=27)and group B(young and middle-aged group, age≤50y, n=20). All patients were received anti-VEGF therapy(3+PRN)and followed up for at least 12mo. The best corrected visual acuity(BCVA), the number of hyper-reflective dots(HRD), the average retinal thickness(ART)and central retinal thickness(CRT)were observed before and after treatment. The number of injections, the recovery rate of outer membrane(ELM)and ellipsoidal zone(EZ)were compared between the two groups, and the related indexes affecting visual prognosis were analyzed.

RESULTS: After anti-VEGF treatment, BCVA was improved, the number of HRD decreased, CRT and ART thinned in both groups. During the follow up of 12mo after treatment, the frequency of injection of anti-VEGF drugs in the elderly group was higher than that in the young and middle-aged group(8.4±2.1 times vs 7.3±1.7 times, P=0.047), but there was no difference in the recovery rates of ELM and EZ between the two groups. BCVA in the elderly group was correlated with the age, HRD, ELM and EZ(all P<0.05). BCVA was correlated with age, ART, HRD, ELM and EZ in young and middle-aged patients(all P<0.05).

CONCLUSION: Intravitreal injection of anti-VEGF drugs can effectively treat macular edema secondary to CRVO and the prognosis of young and middle-aged patients is better than that of elderly patients. Age and OCT indexes such as HRD, ELM and EZ are related to visual prognosis.

Abstract:AIM: To explore the effect of intravitreal conbercept in the treatment of chorionic neovascularization(CNV)of macular macula with high myopia.

METHODS: Totally 56 patients with high myopia caused by macular angiogenesis in our hospital were retrospectively selected as the research objects from June 2015 to December 2019. According to the treatment methods, patients were divided into the control group and the observation group. The 28 cases(28 eyes)of patients in the control group were treated with the intravitreous injection of Rayzumab, and 28 cases(28 eyes)of patients in the observation group were treated with intravitreal injection of conbercept. After the last treatment, the patients were followed up for 3mo to record the intraocular pressure, the best corrected visual acuity(BCVA)and the incidence of complications. Optical coherence tomography(OCT)was used to measure the thickness of macular fovea retinal(CMT), and horizontal linear scanning of OCT instrument was used to measure the CNV area.

RESULTS:After treatment, the visual acuity of patients in the observation group gradually increased, and the improvement of BCVA was significantly higher than that of the control group at the same time point(P<0.05). After 3mo of treatment, it showed that IOP, CNV area and CMT in the observation group were significantly reduced after the combined treatment, and the improvement was better than that in the control group(P<0.05). The incidence of complications in the observation group(4%)was significantly lower than that in the control group(18%).

CONCLUSION:The treatment of intravitreal conbercept injection for the high myopia CNV was superior to lucentis, which could improve clinical efficacy by increasing BCVA, reducing CMT thickness, improving vision and reducing postoperative complications.

Abstract:AIM: To observe the changes of the vault height and the correlation analysis of visual quality under different pupil diameters after ICL surgery.

METHODS: Retrospective case study. Selected 43 patients(86 eyes)who implanted V4c ICL surgery successfully at Shanghai Aier Eye Hospital and followed up regularly to meet the measurement requirements from January 2018 to January 2019, Routine parameters and iTrace were checked before and 1wk, 1mo, and 3mo after surgery. Visante-OCT was used to measure the vault height under the pupils of 3mm and 5mm.

RESULTS: The vault height under the 3mm pupil at 1wk, 1mo and 3mo after surgery were(586.06±24.49, 560.16±21.31, 508.19±21.17)μm, the values under the 5mm pupil were(698.13±20.98, 667.69±20.16, 613.28±19.79)μm(F_Time=40.160,P_Time<0.001; F_Groups=56.835,P_Groups<0.001). The wave of vaule under the different pupils was(112.06±8.91, 107.53±6.94,101.01±10.64)μm(F=16.875, P>0.05). The total high-order aberration(HOA)and RMS of the whole eye after ICL were significantly reduced(F=29.847, 85.019; P<0.001). The MTF and SR value were significantly higher than before surgery(F=47.653, 33.264; P<0.001), and there was no statistical difference after ICL. At 3mo after surgery, the RMS and MTF values at 3mm and 5mm pupils were compared. The RMS value of the total HOA under the pupil of 5mm is significantly higher than that at 3mm, and the increase of spherical and trefoil aberration is significant(t=21.812, 17.136; P<0.001). No significant difference in coma value(t=2.028, P>0.05). The MTF at 5mm pupils were significantly lower than those at 3mm at spatial frequencies of 5, 10, 15, 20, 25, 30c/d(t=15.138, 9.147, 7.018, 4.693, 3.814 and 3.075, all P<0.05).

CONCLUSION: The impact of pupil movement on vault height fluctuation is about 110μm. It is recommended that the minimum vault height should be above 300μm. It can significantly reduce the root mean square value of total high-order aberration and aberration of the whole eye, and significantly increase the MTF and SR values after ICL surgery. The pupil size has a significant effect on visual quality after ICL. The spherical aberration and trefoil aberration increase under the condition of large pupil, and the MTF value generally decreases.

Abstract:AIM: To observe the morphological characteristics of posterior precortical vitreous pocket(PPVP)using swept-source optical coherence tomography(SS-OCT).

METHODS:Prospective study. One hundred and thirty-eight eyes of 91 cases with PPVP observed by SS-OCT in Henan Eye Hospital from March 2019 to June 2019 were included in the study. The average width and height size of PPVP was compared among subjects with different genders, age and equivalent spherical.

RESULTS: In 138 eyes, 112 eyes(81.2%)were ship shaped, 19 eyes(13.8%)were oval, and 7 eyes(5.1%)were hook shaped. Ninety-nine eyes(71.7%)had PPVP which connected with Martegiani area. The average width of PPVP was 6248.82±1117.87μm, and the average height of PPVP was 562.12±476.94μm. There was no difference in the width and height of PPVP between different genders(P>0.05), and the PPVP' width was positively correlated with age(r=0.32, P<0.01). The PPVP' height in low myopia group were lower than that in non-myopia and moderate myopia group eyes(P=0.01, 0.03).

CONCLUSION: PPVP is a boat-shaped fluid cavity in front of the macula, which communicates with the Cloquet canal. Its width is related to the age. The existence of PPVP may play a role in the development of PVD and its progress.

Abstract:AIM: To investigate the influencing factors of clear corneal incision(CCI)after phacoemulsification by Logistic regression analysis.

METHODS: A retrospective cases-control study was performed. 126 patients(138 eyes)who received phacoemulsification combined with implantation of foldable intraocular lens(IOL)were included in Erdos Central Hospital. Postoperative 1d, all of the CCIs were scanned by anterior segment optical coherence tomography(AS-OCT). According to whether there were presence of inner opening CCIs, the patients were divided into two groups. Group 1: inner opening CCIs(84 eyes)were absent. They were stable. Group 2: inner opening CCIs(54 eyes)were present. The factors affecting the stability of CCI were analyzed.

RESULT: The incidence of internal opening incisions was 39.1%(54/138). It decreased to 8.7%(12/138)at 1wk. One month postoperative, the internal mouths of the incisions were completely closed. The stability of the incisions was good. But AS-OCT scan found 3 cases with poor healing internal incisions. Binary Logistic regression analysis showed that age, incision length, incision angle, location of the internal incision, incision method and descemet's membrane detachment had statistically significant difference(OR=1.102, 0.994, 27.895, 0.127, 30.269, 6.750, all P<0.05).

CONCLUSION:Age, incision length, incision angle, location of the internal incision, incision method and descemet's membrane detachment are the influencing factors of CCI stability after phacoemulsification.

Abstract:AIM: To assess the accuracy of optical quality analysis system Ⅱ(OQAS Ⅱ)in predicting postoperative visual acuity of cataract patients.

METHODS: Prospective study, patients underwent cataract surgery in Daping Hospital from June 2019 to November 2019 were recruited. According to predicted visual acuity 100%(PVA100%)and best corrected visual acuity(BCVA), patients were dichotomized into group A(PVA100% worse than BCVA, 145 eyes)and group B(PVA100% equal to or better than BCVA, 114 eyes). Visual acuity improvement was compared between the two groups 1mo after surgery.

RESULTS: In group A, visual acuity of 112 eyes(77.2%)improved at least 2 lines. While in group B, 93 eyes(81.6%)improved at least 2 lines. There was no significant difference in visual acuity improvement ratio between the two groups(P=0.394). The average BCVA improvement of group A was 0.3(0.2, 0.4)LogMAR, and that of group B was 0.4(0.2, 0.5)LogMAR, revealed statistically significant differences(P=0.001). No significant correlation was found between preoperative PVA100% and postoperative BCVA in both of the two groups(P=0.888,0.304). In patients combined with preoperative ocular comorbidity, 17 eyes(94.4%)in group A and 26 eyes(65.0%)in group B improved at least 2 lines with significant difference between the two groups(P=0.041). BCVA improved 0.3(0.2, 0.4)LogMAR in group A and 0.3(0.1, 0.5)LogMAR in group B, there was no significant difference between the two groups(P=0.597).

CONCLUSION: The binary classification method based on the value of preoperative PVA100% and BCVA failed to accurately predict who shall benefit more from cataract surgery. In patients diagnosed with preoperative ocular comorbidity, BCVA is likely to be significantly improved if preoperative PVA100% were worse than BCVA. More data are needed to determine the clinical value of PVA100%.

Abstract:AIM: To compare the change of anterior chamber angle(ACA)and vault value before and after implantable collamer lens(ICL)in two implant positions.

METHODS: Randomized controlled study. A total of 83 patients(154 eyes)underwent ICL(V4c, 12.6mm)surgery from 2018 to 2019 were enrolled and divided into two randomly, including into horizontal group(79 eyes)and into vertical group(75 eyes). Pentacam was used to measure the ACA at 0°, 90°, 180°, 270° points before and after implantation and the ACA changes were calculated.

RESULTS: After 12mo, the changes of ACA at 0°, 90°, 180°, 270° position were 15.3°±6.1°, 13.9°±6.3°, 16.5°±5.5° and 12.9°±6.0° in horizontal group while 12.9°±3.7°, 14.5°±6.8°, 14.3°±5.4° and 13.2°±5.9° in vertical group. There was a significant difference in ACA change at 0°-180° position between the two groups(P<0.05). The vault value was 486±183μm, 422±203μm, 393±198μm and 345±165μm in the horizontal group and 432±163μm, 418±138μm, 379±133μm and 328±142μm in the vertical group at 1, 3, 6 and 12mo respectively. The vault value of the horizontal group at 1mo was significantly different from that at 6mo and 12mo after implantation(P>0.05). The vault value of the vertical group at 1mo was significantly different from that at 6mo and 12mo after implantation(P<0.05).

CONCLUSION: During one year after ICL implantation, the ACA changes significantly in horizontal setting than in vertical setting at 0° to 180° points and there is a dynamic decreasing change in vault value.

Abstract:AIM:To evaluate the efficacy and safety of dexamethasone intravitreal implant for the treatment of noninfectious refractory uveitis and analyze its influence on application and dose of systemic corticosteroids and immunosuppressive agent.

METHODS: This was a retrospective, case series study conducted between January 2018 and September 2019, the patients with noninfectious refractory uveitis and treated with intravitreal implantation of dexamethasone intravitreal implant were included. The best corrected visual acuity(BCVA), central retinal thickness(CRT), vitreous haze score, and intraocular pressure(IOP)at 1mo, 2mo, 4mo and 6mo after the implantation of dexamethasone intravitreal implant were compared with the baseline. Meanwhile, the dosage of corticosteroids and immunosuppressive agent used before and after the implantation of dexamethasone was also evaluated. The data was displayed as mean±standard deviation and analyzed using the paired t-test.

RESULTS: A total of 19 patients(21 eyes)were included in the present study. The mean baseline BCVA of the included patients was 0.671±0.469, while the mean CRT was 369.667±177.100μm, and the mean intraocular pressure(IOP)was 14.252±3.181mmHg. One month, 2mo, 4mo and 6mo after the injection of Ozrudex, BCVA was significantly improved compared with the baseline(P<0.05), while the CRT and vitreous haze score were significantly reduced(P<0.05, P<0.05). During the follow-up period, IOP of several patients significantly increased, but normal IOP can be observed at the end of the follow-up for all included patients. At baseline, 6 patients(6 eyes)were treated with systemic corticosteroids with an average dosage of 35.8mg/d, while only 2 patients were treated with systemic corticosteroids at the end of the 6mo follow-up(5mg/d). Apart from 3 eyes with Behcet's disease which showed recurrence of macular edema between 4-6mo, no other patient underwent that.

CONCLUSION: Dexamethasone intravitreal implantis considered to be a safe and effective approach for non-infectious refractory uveitis which can reduce systemic medication, with significant improvement of BCVA, reduction of CRT, vitreous haze score and the dosage of systemic corticosteroids.

Abstract:AIM: To evaluate the therapeutic effect on blepharitis by using hypochlorous acid eye cleansing wipes for 1wk.

METHODS: Prospective case-control study. Unlateral eyes of 48 patients with blepharitis who attended the ophthalmology clinic of our hospital on March 08, 2020 were selected and grouped according to the clinical diagnosis, including 16 patients in the staphylococcal blepharitis group and 22 patients in the seborrheic blepharitis group, 10 patients in the meibomian gland dysfunction blepharitis group. Hypochlorous acid eye cleansing wipes were given to clean the eyelid margin for 1wk, and related parameters of the eye surface and meibomian glands were collected before and after treatment.

RESULTS: Compared with pre-treatment, after 1wk of treatment, the overall ocular surface disease index(OSDI), conjunctival hyperemia, and eyelid margin hyperemia scores of the patients included in this study were significantly reduced(P<0.001), and the OSDI scores of the three groups of patients were all significantly decreased, the tear film rupture time(TBUT)of patients in the seborrheic blepharitis group was significantly increased, and the degree of conjunctival congestion was significantly alleviated, and the scores of blepharocongestion in the staphylococcal blepharitis group and the seborrheic blepharitis group were both significantly decreased(P<0.05).

CONCLUSION: The use of hypochlorous acid eye cleansing wipes to clean the eyelid margins for 1wk has a positive effect on different types of blepharitis. It could relieve the ocular symptoms of blepharitis and reduce the incidence of staphylococcal blepharitis and seborrheic blepharitis. Eyelid congestion, improve conjunctival hyperemia of seborrheic blepharitis, and improve tear film stability.

Abstract:AIM: To observe and analyze the changes of macular retina thickness in children with occult high myopia and its influencing factors.

METHODS: A prospective, non-randomized, contemporaneous controlled trial. From September 2019 to September 2020, 56 children(110 eyes)who first visited the ophthalmic clinic of the Affiliated Hospital of Chengde Medical College without any myopia correction training were enrolled in this study. According to the clinical manifestations of myopia in children, they were divided into occult high myopia group(27 cases, 52 eyes)and control group(29 cases, 58 eyes, children with common myopia). The retina thickness in each macular area was compared between the two groups, and we will analyze the correlation between macular fovea mean retinal thickness and baseline data in children with occult high myopia.

RESULTS: The average retinal thickness of 9 macular regions in the occult high myopia group was thinner than that in the control group, and there were significant differences in the macular fovea, the blow and temporal side of the outer ring area of macular fovea(P<0.05). Compared with the control group with the same spherical equivalent, there was significant difference in area that the temporal side of the outer ring of the macular fovea in the occult high myopia of 0.00D to -1.00D and the fovea in the occult high myopia group of >-2.00D to -3.00D(P<0.05), but there was no significant difference among the other regions(P>0.05). Pearson correlation analysis results showed that the average retinal thickness under macular fovea in children with secretive high myopia had no significant correlation with gender, age, eye axis, intraocular pressure and corneal curvature(P>0.05), but was negatively correlated with diopter(r=-0.201, P<0.05).

CONCLUSION: The thickness of macular retinal in children with occult high myopia is thinnest under macular fovea and the thickest above macular fovea in inner ring area. The average retinal thickness in each region of the macular is thinner than that in the common myopia children with the same diopter. The mean retinal thickness of macular fovea is negatively correlated with the diopter.

Abstract:AIM: To analyze the situations of poor vision and the incidence of myopia in adolescents of Chifeng and to explore the factors that affect the occurrence of myopia.

METHODS: A multi-stage random sampling method was adopted from September to December in 2019. A total of 2 070 students from primary 4^th grade to junior in high school in Chifeng were selected for questionnaire surveys and visual inspections to analyze influencing factors and the occurrence of myopia in the region.

RESULTS: Among 2 070 students in this research, the incidence of poor vision was 56.96% and the incidence of myopia was 52.22%. Multivariate Logistic regression analysis showed that the risk factors of myopia were senior grade, female, genetic history, loving to eat sweets, fried food, no breakfast, longer time homework and cram school, using mobile devices, having bad eye habits and using eyes for long time once. The protective factors of myopia were no other poor vision, eating fresh fruits, adjusting the height of tables and chairs, doing eye exercises, doing outdoor activities between classes, a one-foot sitting posture, supervising the sitting posture by parents and teachers, less watching TV, increasing outdoor exercise and sleeping time.

CONCLUSION: The myopia incidence of adolescents in Chifeng is generally higher. We should actively pay attention to the personal situation of students, improve visual environment inside and outside school, correct bad visual habits, and increase outdoor exercise and sleep time.

Abstract:AIM: To investigate the clinical effect of canaliculotomy joint novel R-S lacrimal tube implantation under lacrimal endoscope for canaliculitis.

METHODS: Thirty-one patients(thirty-two eyes)diagnosed as canaliculitis were investigated from July 2016 to September 2019 in our department. All patients have treated with canaliculotomy joint lacrimal tube implantation under lacrimal endoscope. The patients were randomly divided into two groups. Group A was treated with novel R-S lacrimal tube for 15 cases 15 eyes, and group B was treated with annular silicone tube. They were removed the lacrimal tube after 2-3mo, and followed postoperatively for at least 1a. The treatment results were comparatively analyzed.

RESULTS: The effective rate was 93% in group A and 94% in group B(P>0.05). The mean time of lacrimal tube implantation of group A was 2.27±1.335min, and group B was 5.29±1.404min. The total rate of complications was 7% in group A and 47% in group B. The rate of foreign body sensation in nasal cavity was 7% in group A and 41% in group B. The rate of increased nasal secretions was 0 in group A and 29% in group B. The difference of the mean time of lacrimal tube implantation, the rate of complications, the rate of foreign body sensation in nasal cavity and the rate of increased nasal secretions between two groups was statistically significant(P<0.05).

CONCLUSION: Canaliculotomy joint novel R-S lacrimal tube implantation under lacrimal endoscope is an effective way. The novel R-S lacrimal tube has the advantages of simple operation, less postoperative complications and high patient comfort.

Abstract:AIM: To identify pathogenic mutations of CYP4V2 gene in two Chinese families with Bietti crystalline corneoretinal dystrophy(BCD)by Sanger sequencing.

METHODS: The relevant clinical examination of BCD patients were collected. Peripheral blood of patients and their family members was collected. Then DNA was extracted from peripheral blood, and Sanger sequencing was used to identify mutation sites.

RESULTS: Two probands of BCD from different families were collected. All the probands showed progressive decrease of visual acuity and typical crystal-like material deposition could be seen in the fundus. Sanger sequencing showed that proband 1 and her brother and sister all had homozygous mutation of c.802-8_810del17insGC in CYP4V2 gene. On the other hand, proband 2 had a compound heterozygous mutation of c.219T>A(p.F73L)and c.802-8_810del17insGC in CYP4V2 gene.

CONCLUSION: The most common mutation was c.802-8_810del17insGC in Chinese BCD patients. The homozygous c.802-8_810del17insGC mutation was the cause of BCD in the proband 1 family. On the other hand, proband 2 had c.802-8_810del17insGC heterozygous mutation and c. 219T>A(p.F73L)heterozygous missence mutation, all of which affected the normal coding of CYP4V2 gene and led to disease.

Abstract:AIM:To observe the clinical effect of retrograde lacrimal duct drainage tube(RS-1 type)in the treatment of lacrimal canaliculus rupture in children.

METHODS: The clinical data of 37 cases(37 eyes)with lacrimal canaliculus rupture admitted to Handan Eye Hospital and Handan Central Hospital from March 2016 to November 2019 were retrospectively analyzed. New silicone tubes were retrograde implanted in all patients during the operation. 8-0 absorbable sutures were used to anastomose the broken end of the lacrimal canaliculus, 6-0 absorbable sutures were used to anastomose the “medial canthus ligament-orbicularis” complex intermittently, and muscle, subcutaneous tissue, skin wounds and conjunctival wounds were sutured intermittently. The catheter was extubated 2-3mo after operation, and the lacrimal passage patency and lacrimal ectorrhea were observed for 6-12mo.

RESULTS: Totally 31 eyes(84%)were cured, 5 eyes(14%)were improved, and 1 eyes(3%)was ineffective. The total effective rate reached 97%. None of the patients had lacrimal dot tearing, abnormal location of lacrimal dot, angulation deformity and other related complications, and 1 invalid eyes(3%)was combined with bone lacrimal tubule fracture, without obvious lacrimal ectorsion symptoms.

CONCLUSION: The new type of silicone tube combined with retrograde catheterization has the characteristics of simple operation, light postoperative stimulation, safe catheterization state and significant anastomosis effect. The retrograde catheterization can better protect the small lacrimal spots.