Abstract:AIM: To analyze the genotype of the allele distribution of a polymorphic G-954C within the 5' upstream promoter region of the nitric oxide synthetase 2A gene (NOS2A ) in samples of diabetic retinopathy in patients with cystoid macular edema in the mainland of China. · METHODS: Eighty-nine patients with diabetic retinopathy and cystoid macular edema and 90 healthy controls were enrolled in this study. Nest polymerase chain reaction (PCR) was performed, and restriction endonuclease digestion and gene fragments sequence were examined to detect the genotype of NOS2A G-954C. · RESULTS: The genotypes of the sample population of 89 cases and 90 healthy controls were all detected as GG. · CONCLUSION: The distribution of G-954C of NOS2A polymorphism are at a lower frequency in China, with little relevancy to the frequency of diabetic retinopathy combined with cystoid macular edema.

Abstract:AIM: To investigate the effects of pioglitazone on corneal neovascularization（CNV）induced by alkaline burn in rats and on expression of vascular endothelial growth factor (VEGF) and basic fibroblast growth factor (b-FGF). ·METHODS: CNV was induced by alkaline burn in rats which were then administered pioglitazone subconjunctivally. Corneal angiogenesis was evaluated and observed with a slit lamp microscope and the VEGF and b-FGF level were determined by immunohistochemistry and Western blot at different intervals. ·RESULTS: The CNV of the rats was shown two days after alkaline burn, and reached its highest level in 7-10 days. The mean values of the area and length of neovascularization and the VEGF and b-FGF levels in the pioglitazone-treated group were significantly lower than those in the control group at various time. · CONCLUSION: Local application of pioglitazone could remarkably inhibit CNV, probably by means of downregulation of VEGF and b-FGF expression.

Abstract:AIM: To explore the relationship between the expression of caspase-2 and caspase-3 and the apoptosis in retinal ischemia/reperfusion (I/R) injury of rats, as well as the therapeutic effects of brain derived neurotrophic factor （BDNF）on the ischemic and reperfused retina. · METHODS: This experiment was conducted at the laboratory of Affiliated Hospital of Qingdao University Medical College from February 2007 to July 2007. The models of retinal ischemia/reperfusion injury were made by transiently elevating intraocular pressure. A total of 28 rats were divided into normal and operative groups. Operative group was divided into six subgroups. In each subgroup there were four rats. The left eyes of rats were used for I/R and the right eyes were used for intravitreal injection of brain-derived neurotrophic factor (BDNF) as treatment group. After reperfusion we divided our subgroups according to the reperfusion time as 1, 6, 12, 24, 48, 72 hours. The retinal ganglion cell number was counted by using optic microscope (BX-51,Olympus). Apoptosis was assessed by the terminal deoxynucleotidyl transferase-mediated dUTP-biotin nick-end labelling (TUNEL) method, and the expression of caspase-2, caspase-3 was studied by enzyme linked immunosorbent assay (ELISA) and strept avidin-biotin complex (SABC) immunohistochemistry. ·RESULTS: No positive apoptotic cells were observed in the normal rats' retinae, but there were a significant number of positive apoptosis cells in 6-24 hours after transient ischemia followed by a decrease at 48 hours. The number of apoptotic cells reached a maximum at 24 hours after ischemia .The expression of caspase-2 gradually increased as early as at 6 hours, reached a peak at 24 hours, then decreased between 48 and 72 hours. Similarly, caspase-3 has the same rule with caspsae-2 in the time courses of expression in retinal tissues. BDNF administered before reperfusion inhibited the expression of apoptosis and ameliorated the retinal tissue damage. It also decreased caspase-2 and caspase-3 expression in ischemic/reperfused retina. ·CONCLUSION: Retinal ischemia-reperfusion can induce apoptosis of cells in the retina. BDNF rescues retinal ganglion cells (RGCs) fromretinal ischemia/reperfusion injury through down-regulation of cell apoptosis and caspase-2 and caspase-3 expression. BDNF have a neuroprotective effect on retina.

Abstract:AIM: To investigate the effect of vitamin A on the conjunctival goblet cells of rat after corneal transplantation. · METHODS: Rat graft rejection models of corneal transplant- ation were established. SD rats were receptor and Wistar rats were donors. After corneal allografts were performed, 48 SD rats were randomly divided into three groups, 16 rats in each group. Group A was blank control group; group B was treated by oculotect gel (containing vitamin A); group C was treated by 1g/L dexamethasone eyedrops. Besides, group D was normal unoperated eyes. Slit-lamp microscope was employed to record and compare rejection index (RI) of corneal transplantation. By HE, PAS staining of conjunctival histological sections and image analysis system, the number and morphology of conjunctival goblet cells were observed and analyzed between operation group and normal group. · RESULTS: The HE, PAS staining detection showed that the number of conjunctival goblet cells in oculotect gel group, 1g/L dexamethasone eyedrops group and control group is lower than that in normal group after surgery (P <0.01). The number of conjunctival goblet cells in oculotect gel group and 1g/L dexamethasone eyedrops group is higher than that in control group (P <0.05). The number of conjunctival goblet cells in 1g/L dexamethasone eyedrops group is higher than that in oculotect gel group (P <0.05). · CONCLUSION: The results indicate that vitamin A may inhibit the decrease of conjunctival goblet cells after corneal allograft rejection in rats.

Abstract:AIM: To explore the characteristic of relaxation of porcine cornea after LASIK. · METHODS: Usual LASIK was performed on fresh porcine corneas with stable intraoculer pressure(IOP) maintained through optic nerve irrigation . The ablation depth on stroma is 30%, 50% and 70% respectively. Then the dumbbell- shaped corneal strip specimens were cut and stored in 20% Human Albumin solution for use (4oC).Sip up the Albumin solution on specimens, and fixed them on homemade jig. Stress relaxation tests were performed on Tytron250 Dynamics Experiment System. The loading speed was 385mm/min，extending rate was 1.5, and relaxation time was 1 000s. The data were collected electronically and automatically. · RESULTS: In LASIK procedure, though a single flap-cutting can cause a little reduction of corneal stress relaxation (P < 0.05, P =0.49), the cornea may still remain its property of visco-elasticity. When ablation depth was 30% or more, corneal stress relaxation decreased to almost one half (P < 0.01).The change of corneal stress relaxation degree in vertical meridian specimen was lower than that in horizontal specimen, especially when ablation depth was 70%, and it's statistically significant（P <0.001）. In LASIK operation, the more depth the ablation, the more reduce the stress relaxation degree, and it’s easy to cause deformation and creep deformation. · CONCLUSION: The changes of the stress relaxation in vertical and longitudinal meridian specimens are similar, and slightly obvious in longitudinal specimen, especially in 70% ablation group.

Abstract:AIM: To determine whether a combined scleral buckle and pars plana vitrectomy, as a primary surgery, owns any advantage over a single scleral buckling in pseudophakic and aphakic retinal detachments. · METHODS: Thirty consecutive pseudophakic/aphakic retinal detachments were included in this retrospective study. Each patient underwent combined scleral buckle and pars plana vitrectomy, and was followed up for 3 to 14 months. Patients were examined with respect to anatomic reattachment, visual acuity improvement, and surgical complications. · RESULTS: All eyes were anatomically reattached after the first operation. All patients had an increase in their visual acuity, and there were no complications attributable to the vitrectomy procedure. · CONCLUSION: A combined surgery for primary pseudophakic/ aphakic retinal detachments offers significant benefits to scleral buckling alone. The improved success rate is contributing to the function of vitrectomy, which improves peripheral visibility and reduces the occurrence of proliferative vitreoretinopathy (PVR).

Abstract:AIM: To investigate a surgical method of modified lensectomy within combined lensectomy and vitrectomy surgery in traumatic eyes. · METHODS: Clinical records were studied retrospectively for a series of consecutive 27 traumatic patients who were performed vitrectomy combined with lensectomy surgery. A modified lensectomy through pars plana incision of sclera was performed to these cases and lens capsule was reserved. It was then combined with vitreous and retinal operations. · RESULTS: All lens were removed completely with lens capsule remained. All cases achieved improved visual acuity. Intraocular pressure (IOP) in all eyes was in normal range after surgery. · CONCLUSION: The modified lensectomy is a safe and effective surgery manner which has few complications and is more suitable for traumatic eyes in the combined lensectomy and vitrectomy surgery.

Abstract:AIM: To compare the optical performance of the anterior surface modified prolate Tecnis Z9000 IOL with the standard 911A IOL in terms of contrast sensitivity outcomes. · METHODS: The Tecnis Z9000 silicone IOL shares the same basic characteristics with the 911A IOL including a 12.0mm overall diameter, 3-piece equiconvex 6.0mm optic and angulated cap C polyvinylidene fluoride haptics. This is a randomized prospective study that involved ten consecutive patients (20 eyes) with bilateral cataracts. Each patient underwent phacoemulsification and received randomly the Tecnis Z9000 IOL in one eye and the control (911A IOL) in the fellow eye within 6 weeks period of one another. Contrast sensitivity was measured after six postoperative weeks. The collected data were analyzed through using Mann Whitney U test. · RESULTS: The mean pre-operative best spectacle corrected Snellen visual acuity in the eyes that were randomly selected to receive the Tecnis IOL was 6/8.5 (0.70) and in the eye selected to receive the 911A IOL was 6/9.4(0.64). Postoperatively all 20 eyes achieved best corrected Snellen visual acuity of 6/6 (1.0). Postoperative contrast sensitivity testing showed statistically significant differences (P <0.05) between the two IOLs at 12 and 18 cpd under photopic, at 1.5 and 3 cpd under mesopic, and at 1.5 and 3 cpd under mesopic with glare conditions. · CONCLUSION: The Tecnis Z9000 IOL proved to have statistically significant superior contrast sensitivity to the 911A IOL at high spatial frequencies under photopic conditions and at low spatial frequencies under mesopic and mesopic with glare conditions.

Abstract:AIM: To determine the indications for penetrating keratoplasty in Malaysia and to compare the leading indications with recently published data from other countries. · METHODS: A retrospective review of the medical records of all patients who underwent penetrating keratoplasty at Medical Centre, University of Malaya, Kuala Lumpur, Malaysia over a period of fifteen years (1991/2005) was done. The gender, age, race of patients, eye operated, indication for surgery were noted from the records, and analyzed. · RESULTS: A total of 125 penetrating keratoplasties were performed in 105 patients (male 71 and female 34; Chinese 55, Indians 33, and Malays 17; unilateral 85 and bilateral 20) during the study period. The mean age of patients was 51.3 years (range 13-79 years). The indications for penetrating keratoplasty were pseudophakic bullous keratopathy (28.8%), corneal scar (20.0%), keratoconus (17.6%), regrafts (9.6%), corneal dystrophies (8.8%) and corneal perforations (7.2%). · CONCLUSION: Pseudophakic bullous keratopathy is the most common indication for penetrating keratoplasty in Malaysia. The three leading indications (pseudophakic bullous keratopathy, corneal scar and keratoconus) in our study are similar to many countries in the world, but they differ in the order of frequency from some countries.

Abstract:AIM: To evaluate the clinical outcomes of management in younger patients with primary chronic angle-closure glaucoma (PCACG). ·METHODS: Thirty-eight patients (50 eyes) aged 40 or younger with confirmed diagnosis of PCACG in advanced or late stage who received surgical treatment in Zhongshan Ophthalmic Center from January 2000 to December 2005 were retrospectively investigated. All patients underwent trabeculectomy. The mean follow-up was 23.6± 7.5 months. Full ophthalmic examinations were performed. The clinical outcomes including clinical presentations, surgical results and complications were evaluated. ·RESULTS: The mean age of patients was 33.5± 6.1 years old. There was a female preponderance (60.5%). The mean axial length was 22.4 ± 3.5mm with 18.0% short axis of eyeball and 14% nanophthalmos. There was 60.0% flat anterior chamber depth (<1.9mm). Ultrasonic Biomicroscopy identified that plateau iris was the most common underlying etiology (80.6% ). There was a statistically significant differenceinintraocular pressure(IOP) reductionpostoperatively preoperatively ( <0.001). Four eyes failed to control IOP and received second filtration surgery. The main postoperative complications included shallow anterior chamber (20.0%) and malignant glaucoma (12.0%). ·CONCLUSION: The younger PCACG patients in advanced or late stage can be effectively managed by trabeculectomy. They have more frequency of postoperative sustained shallow anterior chamber and malignant glaucoma. Careful ophthalmic examinations, delicate surgical procedures and well-managed technique of complications were suggested on younger PCACG patients

Abstract:AIM: To investigate the efficacy of recombinant tissue plasminogen activator (TPA) for treatment of fibrinous membranes following cataract surgery. · METHODS: 25μg of TPA was injected into the anterior chamber of 15 pseudophakic eyes with moderate to severe fibrinous membranes that developed after cataract surgery. Simultaneously, topical corticosteroid and cycloplegic therapy was continued. Routine follow-up included slit-lamp examination and intraocular pressure measurement. · RESULTS: Injection of the solution of tissue plasminogen activator into anterior chamber of 15 eyes resulted in complete dissolution of the fibrinous membranes in 9 (60.0%) eyes after 2 hours, and 11 (73.3%) eyes within 1 day. In 3 eyes, within a few days after injection, fibrinous membrane recurred. Increased anterior chamber reaction (P =0.54) and corneal edema (P =0.083) were seen after 24 hours. No evidence of toxicity was observed as measured by slit-lamp biomicroscopy and intraocular pressure. Finally, expectable stable result was obtained in all of the eyes. · CONCLUSION: Safety and high efficacy of TPA in the treatment of fibrinous membranes after cataract surgery are confirmed.

Abstract:AIM: To investigate the changes of intraocular pressure (IOP) and associated factors of IOP elevation after 4mg intravitreal injection of triamcinolone acetonide (IVTA) in treatment of macular edema. ·METHODS: The study is prospective, consecutive, and non-comparative interventional case series including 93 eyes with macular edema associated with retinal vein occlusion ( =54 eyes) or diabetic retinopathy ( =39 eyes), which received 4mg IVTA injection. The change in IOP was followed for all cases at pre-operation and 14 days, 1, 2, 3, 4, 5, and 6 months post-operation. Associated factors of IOP elevation were examined regarding baseline IOP, causal disease, age and gender. ·RESULTS: IOP increased significantly ( <0.001) at 14 days 16.02 ± 2.45mmHg after injection and peaked at 18.80 ± 6.20mmHg at 2 months post-injection ( <0.001) from 14.85± 2.55 mmHg preoperatively. An IOP rise to the value higher than 21mmHg was observed in 2 (2.2%) eyes 14 days after injection and which was observed in 14 (15.1%), 18 (19.5%), 9(9.6%), 4(4.3%), 0, and 0 eyes respectively at 1, 2, 3, 4, 5, and 6 months after injection. One eye (1.07%) showed pressure elevation of over 5mmHg than baseline 14 days after injection and IOP peaked to 22mmHg (23.7%) at 2 months after injection. Five (5.3%) eyes had an increase of 10mmHg at 1 month and IOP peaked to 12mmHg (12.9%) at 2 months after injection. The rise in IOP was statistically associated with younger age (correlation coefficient -0.18- -0.29, <0.05), high baseline IOP (correlation coefficient 0.52-0.79, all <0.001), and the presence of diabetes mellitus (correlation coefficient 0.23, <0.001) but independent of gender (correlation coefficient -0.002-0.04, all >0.05). In all eyes, IOP could be lowered to the normal range with topical medication, without development of glaucomatous optic nerve head changes. ·CONCLUSION: Elevated IOP after 4mg IVTA injection is common and patients should be monitored beyond 6 months post-injection. In all the cases, IOP can be normalized by topical medication. Patients with high baseline IOP, diabetic retinopathy, and younger age should be carefully monitored for an elevated IOP.

Abstract:AIM: To investigate the incidence of retinopathy of prematurity(ROP) in the southern Brazil, the rate of treatment and outcomes in all premature infants born at Hospital de Clinicas de Porto Alegre, Brazil, from October 2002 to October 2006. · METHODS: A prospective cohort study was conducted on 323 premature children born at Hospital de Clinicas de Porto Alegre, Brazil, from October 2002 to October 2006 with birth weight equal to or less than 1 500g or a gestational age at birth of 32 weeks or less. All of the newborns were examined by indirect binocular ophthalmoscopy with the 28 diopters lens after pupil's dilation and a lid speculum after the sixth week of life with examinations repeated depending on the disease classification. The main clinical outcome was the occurrence of ROP at any stage. · RESULTS: ROP occurred in 82 infants with an incidence rate of 25.7%. Threshold disease occurred in only 17 of the patients (5.3%), all of them had the disease affecting posterior Zone II needing laser treatment. None of the treated children had Zone I or aggressive posterior disease despite that three of the treated children needed a second laser session. One patient of the re-treated group needed scleral buckling with an equatorial silicon band after progression to stage 4 of ROP. · CONCLUSION: The incidence of retinopathy and the threshold disease in this study was similar to the international results reported. This study showed a high survival rate (70.1%), high incidence of retinopathy, and high laser treatment necessity among newborns under 28 weeks of gestational age or under 1 000g of birth weight. This study drove attention about the no identification of any Zone I posterior disease in this cohort of patients.

Abstract:AIM: To evaluate the efficacy of vitrectomy in combination with intravitreal dexamethasone and vancomycin perfusion in the management of severe posttraumatic endophthalmitis. · METHODS: Thirty eyes of 30 cases diagnosed as posttraumatic infectious endophthalmitis were analyzed retrospectively from April 2004 to April 2006. All the patients underwent vitrectomy in combination with intravitreal drugs perfusion and were followed up for 12 to 24 weeks. The visual acuity, traumatic causes and microorganisms culture were analyzed. · RESULTS: There are significant reduction in inflammation at 3 months after surgery. Infectious symptoms were completely controlled in 97% of the cases(29/30). Final visual acuity were improved in 93% of cases (28/30). Among traumatic causes, foreign body is the most common cause (57%). Staphylococcus aureus is the commonest microorganism. · CONCLUSION: Vitrectomy in combination with intravitreal dexamethasone and vancomycin perfusion is the most effective method in the treatment of severe posttraumatic endophthalmitis.

Abstract:AIM: To compare the measurement of anterior chamber depth (ACD) and axial length (AL) by IOLMaster and contact ultrasonic (US) axial scan (A-scan). · METHODS: Measurements of ACD and AL were prospectively obtained in 137 eyes of 121 subjects with the IOLMaster compared with measurements with the US. · RESULTS: There was an excellent correlation between IOL Master and US measurements for the ACD (r =0.823;P < 0.001) and AL (r =0.996;P <0.001). The mean values of the parameters measured by IOLMaster and US were, respectively, as follows: ACD, 2.94±0.49mm, 2.58±0.51mm; AL, 24.37±3.04mm, 23.81±2.83mm. The mean differences of ACD and AL values between IOLMaster and US measurements were 0.36±0.30mm, 0.56±0.34 mm respectively, and they proved to be statistically significant (P < 0.001), with the 95% limits of agreement (LoA) from -0.08mm to +0.38mm for ACD and from -0.09mm to +0.69mm for AL. · CONCLUSION: As noncontact biometry, IOLMaster provides accurate values. A high degree of agreement between US and IOLMaster was noted. It not only has the advantage of performing noncontact examinations, but also produces various additional data simultaneously and may thus obviate the need for multiple examinations. Further studies are needed to assess the interchangeability of measurements in clinical practice.

Abstract:AIM：To evaluate the efficacy and safety of "one-stitch anastomosis through the skin" repair of canalicular laceration. METHODS：The data of 32 cases (32 eyes) of canalicular laceration who underwent repair of lacerated canaliculi with one-stitch anastomosis through the skin were retrospectively reviewed, inferior canalicular laceration in 29 patients, superior canalicular laceration in 1 patient, 2 cases involving both the inferior and superior canalicular laceration. All the operations were performed under surgical microscope, 5-0 silk sutures were used and silicone tube of 0.8mm diameter was employed in intubation. The stents were left in place for 3 months postoperatively and then removed. The follow-up period was 1 to 36 months. · RESULTS: In 32 patients, 28(88%) patients were cured entirely, 3 (9%)patients were meliorated, and 1(3%) patient had no effects. A total of 29 patients complied with scheduled follow up 1-36 months (average 12 months) after stent removal, and 3 patients were lost in follow-up. All the patients had got good recovery of eyelid laceration with no traumatic deformity in eyelid and canthus. · CONCLUSION: In "one-stitch anastomosis through the skin" repair of canalicular laceration, the cut ends could be anastomosed directly，for there was no suture remained in the wound permanently, so there was no suture-related granuloma which might cause obstruction or stenosis of canaliculi. It was simple, economical，effective and safe.

Abstract:AIM: To compare the occurrence of dry eye in post- menopausal women between those with hormone replacement therapy and those without hormone replacement therapy (HRT). · METHODS: A comparative cross-sectional study was carried out to determine the occurrence of dry eye in control subjects and those on HRT. Schirmer's test, tear film break-up time and Rose Bengal staining were performed on all participants. · RESULTS: Fifty-four women were examined. Among them 30 (55.6%) were on hormone replacement therapy (Group 2), while the control group consisted of 24 (44.4%) women without any hormone replacement therapy (Group 1). In Group 2 (HRT), 11 patients were on estrogen (Group 2A) and 19 patients were on combined estrogen and progesterone (Group 2B). Dry eye was found in 29.2% of patients in Group 1 (Control) and in 70.0% of patients in Group 2 (HRT) (P = 0.003). In Group 2 (HRT), dry eye was more common in Group 2B, 84.2% compared to Group 2A, 45.5% (P =0.042). · CONCLUSION: Dry eye was found more commonly in post-menopausal women who took HRT in our study. Our finding has negated the previous assumption that HRT is a protective factor against dry eye.

Abstract:AIM: To study the demographic pattern and indications for enucleation and evisceration in West Malaysia, and to evaluate the changing trends of the same over the past three decades. · METHODS: In a retrospective hospital based study, case records of all patients who underwent enucleation and evisceration at University of Malaya Medical Centre over a period of 20 years (1985/2004) were reviewed. Age, gender, ethnicity of patients, indications for enucleation and evisceration were evaluated. · RESULTS: Out of 160 patients, enucleation was done in one eye in 85 patients and evisceration was done in one eye in 75 patients during the study period. The mean age of patients was 36.4 years with a range of 6 months to 90 years. In our study, panophthalmitis (26.9%) and retinoblastoma (18.8%) were the most common causes of evisceration and enucleation respectively. Infections of the eye contributed to 72.0% of eviscerations while tumors contributed to 51.8% of enucleations. There was a significant decrease in the removal of eyes over the past three decades in our hospital. The number of removal of eyes for glaucoma and trauma-related causes significantly reduced while removal for infection- related causes and painful blind eyes significantly increased when compared to the figures reported three decades ago from our hospital. · CONCLUSION: Panophthalmitis and intraocular tumors are the major indications for the removal of eyes. Although the frequency of removal of eye has significantly decreased over time in our country, the indications for the same suggest that there is a need of further improvement of eye care services in Malaysia.

Abstract:AIM: To determine the clinical characteristics of a prospective study of patients with Graves' ophthalmopathy(GO). · METHODS: We reviewed clinical manifestations, and medical records of 103 patients in whom GO was diagnosed between 2003 and 2005. · RESULTS: Among 103 patients with GO, 48 (46.6%) male and 55 (53.3%) female, with mean age of 45 (range; 18-73) years, 95 (92.2%) patients had Graves' hyperthyroidism, 3 (2.9%) had primary hypothyroidism, and 5 (4.8%) were euthyroid. The mean duration of ocular symptoms was 13.2 (range 2-95) months while the mean duration of dysthyroid symptoms was 39.4 (range 6-180) months. Unilaterality occurred in 12 patients. Eyelid retraction was presented in 90 patients (87%), whereas the approximate frequency of exophthalmos was 77.6% (80 patients); restrictive extraocular myopathy, 29% (30 patients); evidence of extraocular enlargement on CT-scan in 52 patients of 70 patients (74%) that was evaluated, and optic nerve dysfunction, 5.8% (6 patients). 22 (21%) patients had glaucoma associated with GO that 7 (6.7%) of them were normal-tension glaucoma. · CONCLUSION: Eyelid retraction was the most common clinical sign of GO in our patients. Larger prospective studies are suggested to evaluate both the prevalence and possible racial difference in its clinical presentation in Iranian population.

Abstract:AIM: To evaluate contrast sensitivity in patients who had undergone uncomplicated excimer laser photorefractive keratectomy (PRK) for myopia. · METHODS: Monocular contrast sensitivity function was measured with the CSV-I000E chart in 41 patients who had received PRK by the Nidek EC-5000 excimer laser system. Mean preoperative refractive error was -2.62±1.33 D (range, -0.75 to -4.00 D). Contrast sensitivity function was measured preoperatively, 1week, 1, 3 and 6 months after surgery through the CSV-1000E contrast sensitivity unit (VectorVision). · RESULTS: Logarithmic values of contrast sensitivity at each spatial frequency were used for statistical analysis and normalized values were used for graphical representation. Contrast sensitivity decreased 1 week and 1 month postoperatively. Starting from the first month, there was rapid recovery of contrast sensitivity especially at low spatial frequencies, and at the third month, only at 6 and 12 cycles per degree (cpd) statistically significant decrease was seen. Six months after surgery, there was an increase in contrast sensitivity values at all spatial frequencies. · CONCLUSION: Photorefractive keratectomy can induce significant reductions in contrast sensitivity in the first month after surgery; these values returned to the preopereative values at 6 months after surgery.

Abstract:AIM: To evaluate the morphological and functional outcomes of earlier excimer laser phototherapeutic keratectomy (PTK) for treatment of recurrent corneal erosion (RCE). · METHODS: A total of 25 eyes of 23 patients with RCE were enrolled in a prospective non-randomized consecutive study. In all cases, RCEs were unresponsive to conventional treatment methods. No one had experienced stromal puncture or tried contact lens previously. After complete ophthalmologic examination, central excimer laser PTK with ablation depth of 10μm and optical zones of 4-8 mm was performed. Uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA), spherical equivalents (SE) and refractive cylinder (RC) were compared before and after phototherapeutic keratectomy. · RESULTS: Previously 2 patients had undergone epithelial scraping. Duration of disease ranged from 2 months to 3 years prior to PTK (mean=9.3 months). The mean follow-up time was 10.1±5.5 months (4.2-19.2 months). Success rate after PTK, regarding prevention of recurrence was 96% when they were under follow-up. BCVA was also increased from 0.69±0.30 to 0.90±0.23 (P <0.001). Mean SE remained constant with values of 0.41±1.67D preoperatively and 0.35?.63D postoperatively (P =0.26). Mean RC was also improved from -1.22±0.90D preoperatively to -0.57±0.57D postoper- atively (P <0.001). · CONCLUSION: PTK using 193nm excimer laser is an effective and safe choice of treatment for a fast epithelial closure, an increase of visual acuity and alleviating symptoms in most patients with RCE in earlier course of the disease.

Abstract:AIM: To assess the prevalence of refractive errors in middle school students in Lanzhou city and explore the risk factors for myopia. · METHODS: A cross-sectional survey was conducted. A questionnaire assessed the students' socioeconomic background and visual tasks followed by visual acuity assessment and a full eye examination including slit-lamp examination, fundus evaluation, retinoscopy, and subjective refraction. · RESULTS: Among 2 256 enumerated students aged 15-19 years,2 037(90.3%) students had significant refractive errors. Myopia was the leading refractive error (1 951/2 256, 86.5%), astigmatism was the second most common refractive error (921/2 256, 40.8%), but amblyopia (10/2 256, 0.4%), strabismus (5/2 256, 0.2%), hyperopia (4/2 256, 0.2%) and other treatable eye disorders were uncommon. Almost 95.3% of students with significant refractive errors wore spectacles before the survey. Age, sex, visual tasks, and a parental history of myopia were risk factors for myopia. · CONCLUSION: The prevalence of refractive errors and the risk factors for myopia in schoolchildren in Lanzhou city are similar to those reported in other regions of China. Interventions of myopia progression should be performed to protect the visual acuity of school-aged students.

Abstract:AIM: To report a case of unilateral optic neuritis with multiple sclerosis(MS) in an Asian child. · METHODS: A case report. · RESULTS: A 10-year-old Chinese girl presented with history of sudden loss of vision of the right eye for 3 days. It was associated with pain in eye movement. She gave history of fever associated with ataxic gait a year ago. She had been diagnosed with acute disseminated encephalomyelitis (ADEM). Visual acuity in the right eye was 'counting finger' with positive afferent pupillary defect. The optic disc was swollen and hyperemic. The colour vision was severely impaired. Visual field showed central scotoma and enlarged blind spot. Magnetic resonance imaging (MRI) of the brain revealed multiple intense lesions in the left occipital lobe, basal ganglia and periventricular regions suggesting MS. She was treated with intravenous methylprednisolone for 3 days, followed by oral prednisolone for 11 days. She had excellent recovery and her visual acuity improved to 6/9. She remained asymptomatic for 3 years. · CONCLUSION: The simultaneous occurrence of optic neuritis and MS is less common in children and seldom reported. We presented this case to highlight the possibility of this disease occurring in Asian population in a younger age group.

Abstract:AIM: To report a case of mucinous adenocarcinoma of the tail of the pancreas presenting with a solitary choroidal metastasis. ·METHODS: A 57 years old female patient presented with central metamorphosia in the right eye. Fundoscopy showed a solitary pale raised lesion in the central right macula about 6 disc diameters in length. Her past ocular and medical history was unremarkable. A B-scan confirmed a raised solid lesion in the posterior pole within the macula while fluorescein angiography revealed a central lesion with no areas of leakage. ·RESULTS: In view of the history and the clinical findings a FBC, ESR, LFT, Chest X-ray, and abdominal CT were requested .The chest X-ray revealed multiple opaque lesions in both lung fields suggestive of metastatic pulmonary nodules. The CT revealed multiple nodules in the liver and a 3.5cm x 2.6cmlesion in the tail of the pancreas. A CT guided liver biopsy was performed and it revealed moderately differentiated metastatic mucinous adenocarcinoma. Subsequent blood analysis revealed an elevated CA19-9. The primary tumour site was identified as the tail of the pancreas and was decided to instigate palliative treatment. ·CONCLUSION: There are few reports that demonstrate the significance of a solitary choroidal lesion as the initial clinical sign of cancer of the tail of the pancreas. This case highlights the importance of performing detailed abdominal imaging studies in cases where a solid choroidal lesion of unknown origin is identified.