Table of Content

22 February 2021, Volume 45 Issue 1

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Current situation and demand of medical eye protective devices in China

Shao Yuting, Bi Yanlong

2021, 45(1):  1-5.  doi:10.3760/ cma.j.issn.1673-5803.2021.01.001

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SARS-CoV-2 has caused a global pandemic, and infected numerous persons around the world. The technology and management of medical eye protective devices are significantly important for avoiding the occupational eye exposures such as radiation, infection and even death of medical staff. Medical eye protective devices should not only meet the technical requirements to prevent the splashing of patient body fluids or lavage fluids, but also have the function of anti-fog, anti-pathogen eye transmission, anti-ultraviolet radiation, and anti-eye and nasal pressure damage. Emergency management should be optimized in disinfection process to increase recycle rate and decrease the rate of resources waste. It is suggested that the standard of eye protective devices and the technical and management requirements of medical eye protective devices should be improved and established in China. In the emergency of public health, the life and health of medical staff should be guaranteed in an all-round way.

Anterior megalophthalmos and its cataract surgery

Chen Tianhui, Jiang Yongxiang

2021, 45(1):  6-11.  doi:10.3760/ cma.j.issn.1673-5803.2021.01.002

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Anterior megalophthalmos (AM), also called X\|linked megalocornea, is an rare congenital hypoplasia of ocular anterior segment. 90% of patients was approximately constituted by men. It is characterized by premature cataract and 360° zonular weakness with lens subluxation with megalocorneal, deep anterior chamber and the enlarged sulcus. Recently, cataract surgeries in AM patients still are a debatable point which is prone to challenge mainly because of zonular weakness and capsular bag. Characters of AM and cataract surgeries in AM patients remains unreviewed yet. For cataract and lens dislocation surgery in patients with AM, the proper choice of intraocular lens (IOL) and operation mode are the key points. It is difficult to implement phacoemulsification safely because of the large and unstable capsular bag and zonular weakness. Iris-claw IOL implantation or scleral fixated IOL implantation may be more suitable surgical way for AM patients. It is worthy of further research and exploration that how to choose individualized surgery according to different characteristics of capsular bag in AM patients in order to obtain better surgical effect.

Research progress on prediction of effective lens position

Li Xiuyuan, Chang Pingjun, Zhao Yune

2021, 45(1):  12-17.  doi:10.3760/cma.j.issn.1673-5803.2021.01.003

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Effective lens position (ELP) refers to the effective position of intraocular lens (IOL) after cataract surgery, which is especially important for the prediction of refractive power in the cataract surgery. Now many studies have found new methods of ELP prediction, such as the ELP prediction from preoperative lens equatorial plane, angle to angle (ATA), intraoperative anterior chamber depth (ACD), lens anterior and posterior surface depth, preoperative lens three-dimensional reconstruction, and even based on artificial intelligence methods to predict ELP. With the deepening of research, the prediction method of ELP is more accurate, not only the effect of ordinary cataract surgery is better, but also there are further explorations in some special cases such as IOL implantation in ciliary sulcus, after corneal refractive surgery and so on. In the future, with the progress of measurement and surgical techniques, and the evolution of prediction methods, cataract surgery will be more accurate.

Risk of cataract surgery in diabetic patients

Zhao Xinhui, Zhou Nan, Qi Yanhua

2021, 45(1):  18-22.  doi:10.3760/cma.j.issn.1673-5803.2021.01.004

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Cataract is one of the most common eye disorders in diabetic patients. Compared with non\|diabetic patients, the diabetic patients always have cataract disease and perform the operation in earlier age. Although phacoemulsification makes cataract surgery in short time and vision recovery faster, but the risk of cataract surgery complications for diabetic patients are still much higher than that of normal patients, such as small pupil during the surgery, and progress of diabetic retinopathy, macular edema, endophthalmitis, corneal damages, dry eye after the surgery.

Application of optical coherence tomography angiography in diagnosis of glaucoma

Gao Ruxin, Liu Xuyang, Wu Renyi

2021, 45(1):  23-28.  doi:10.3760/cma.j.issn.1673-5803.2021.01.005

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A growing body of evidences have revealed the role of vascular dysfunction in the pathogenesis and progression of glaucoma. As a fast noninvasive blood vessels imaging technology, optical coherence tomography angiography (OCTA) realizes the stratified imaging of the retinal and choroid microcirculation in each layer of tomography, provides a quantitative assessment of vessel density and blood flow index, and therefore is able to complement the deficiency of conventional optical coherence tomography (OCT) in providing direct flow information. OCTA seems to be very helpful in early diagnosis of glaucoma and accurately monitoring the progress of glaucoma. Its application on the clinical diagnosis and follow\|up of glaucoma is promising.

Research advances on etiologies of hemolacria

Jing Jiaona, Chen Zhijun

2021, 45(1):  29-33.  doi:10.3760/cma.j.issn.1673-5803.2021.01.006

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Hemolacria is a special clinical phenomenon. Hemolacria is caused by a wide range of disorders. It has been associated with eye diseases including eyelid, nasolacrimal system, lacrimal gland and conjunctiva. Other reported causes include hemotologic diseases, vascular disorders, psychiatric disorders and idiopathic haemolacria.

Impacts of eye cosmetics on ocular surface

Chen Yan, Sun Xuguang

2021, 45(1):  34-38.  doi:10.3760/cma.j.issn.1673-5803.2021.01.007

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With the popularity and daily use of cosmetics in recent years, eye makeup is becoming a major threat to the micro\|environment of the ocular surface. Eye makeup products and application methods are various, including eye liner, eye shadow, mascara, cosmetic contact lenses etc., which may induce or aggravate ocular diseases such as palpebral dermatitis, blepharitis, conjunctivitis, keratitis, corneal foreign bodies, dry eye and meibomian gland dysfunction (MGD) by mechanical friction, chemical substance migration and dissolution, allergy, infection and preservative toxicity. etc. This article reviews the pathogenicity and pathogenesis caused by eye makeup on ocular surface system in order to attract the attention of cosmetic crowd and clinicians.

Progress on treatment of blepharokeratoconjunctivitis

Chen Junyu, Pan Zhiqiang

2021, 45(1):  38-43.  doi:10.3760/cma.j.issn.1673-5803.2021.01.008

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Blepharokeratoconjunctivitis (BKC) refers to a group of chronic ocular surface diseases, which often involves the conjunctiva and cornea, and causes severe vision impairment. It’s easy to be misdiagnosed and missed diagnosed, because its onset is insidious and its clinical manifestations and signs are easily confused with other corneal and conjunctival diseases. It can cause amblyopia or severe visual impairment, especially for pediatric population. The treatment of BKC needs to control the inflammation of the eyelid margin first, with local treatment as the mainstay. Patients with severe disease, oral drug can be added. Non-steroidal anti-inflammatory drugs, glucocorticoids, immunosuppressants, can be added for corneal and conjunctival inflammation. Mild BKC should be treated with low\|concentration glucocorticoids or non-steroidal anti-inflammatory drugs. Moderate-to-severe BKC should be treated with high-concentration glucocorticoids or low-concentration glucocorticoids combined with immunosuppressive agents. Those with corneal ulcers need to use antibacterial eye ointments. Severe cases may require surgery.

Progress of metabolomics technology in diabetic retinopathy

Zhou Zixi, Zheng Zheng, Zheng Minming

2021, 45(1):  44-50.  doi:10.3760/cma.j.issn.1673-5803.2021.01.009

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Metabolomics is an emerging discipline that studies the whole and changes of endogenous metabolites produced by biological systems after external stimuli or disturbances. The common feature of diabetic retinopathy (DR) metabolomics is the significant enrichment of the three major metabolic pathways and the ascorbic acid pathway, including d\|glucose, 2\|deoxyribonate, asparagine, glutamine, arginine, citrulline, and proline and carnitine content increased, ascorbic acid，aspartic acid and glutamic acid content decreased.

Role of integrin αVβ3 on occurrence and development of diabetic retinopathy

Sarula, Yan Zhaoli, Ren Xiaoyan

2021, 45(1):  51-56.  doi:10.3760/cma.j.issn.1673-5803.2021.01.010

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Diabetic retinopathy (DR) is a progressive microangiopathy induced by long\|term hyperglycemia. The state of ischemia and hypoxia of retinal microvessels runs through the whole process of the occurrence and progression of DR. Integrin αVβ3 (ITG αVβ3), as an important cell adhesion molecule, the expression of itself and its ligand upregulate in hyperglycemia, and participate in various pathological stages of DR by promoting retinal microvascular permeability, neovascularization and retinal fiber membrane formation. ITG αVβ3 participates in DR through a variety of mechanisms, compared with the widely used anti-VEGF therapy, blocking the binding of ITG αVβ3 to its ligand can significantly improve retinal microvascular permeability and inhibit retinal neovascularization. In addition, ITG αVβ3 ligand contains the RGD sequence, made it has great potential in targeted therapy of DR.

Mechanisms of light damage to retinal cells

Xu Zehua, Jin Zibing

2021, 45(1):  57-60.  doi:10.3760/cma.j.issn.1673-5803.2021.01.011

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“Seeing” is the basic function of the human eye and the light is everywhere for the eyes. The light passes through the cornea and lens to the retina. After absorbing the photons, the outer segment of the photoreceptors completes the photoelectric transformation through the visual cycle, and transmitting the external visual information to the visual center in the brain. With the increased longevity and artificial light sources, light radiation has an increasing impact on our retinal health, but the mechanisms are not yet clear. We reviewed the studies on light\|induced damage in the retina and discussed the pathological changes such as increased reactive oxygen species, lipofuscin accumulation, and inflammatory activation in the retina: photoreceptor cells, retinal pigment epithelial cells, and glial cells after light damage. Knowledge of mechanisms of light damage can improve our understanding of some disease processes that may be associated with light damage, and aid in the development of new therapies.

Regression of uveal melanoma after episcleral plaque radiotherapy and its relationship with prognosis

Fang Rui, Li Yang, Wei Wenbin

2021, 45(1):  66-70.  doi:10.3760/cma.j.issn.1673-5803.2021.01.013

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Uveal melanoma is the most common malignant tumor in eyes for adults, and episcleral plaque radiotherapy is the primary eye\|conserving choice for uveal melanoma. Episcleral plaque radiotherapy can effectively control tumor growth, but tumor regression after radiotherapy has obvious heterogeneity. Some studies have suggested that the rate of postoperative tumor regression could be used as a prognostic factor for episcleral plaque radiotherapy, the faster the rate of tumor regression, the worse the prognosis of uveal melanoma. Some scholars have found that initial tumor thickness, chromosome 3 status and GEP typing are closely related to the tumor regression rate of uveal melanoma after episcleral plaque radiotherapy.

Research progress of cell senescence in ocular surface diseases

Liu Jiang, Wen Hang, Xiang Minhong

2021, 45(1):  71-75.  doi:10.3760/cma.j.issn.1673-5803.2021.01.014

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Cell senescence refers to the attenuation of cell physiological functions, including phenomena such as decreased proliferation capacity, cell cycle arrest, cell apoptosis, and increased expression of senescence\|related genes. In recent years, with people's further understanding of aging and the continuous supplement and upgrade of cell aging detection methods, new ideas and new methods have been provided for clinical treatment of aging\|related diseases. At present, many ocular surface diseases are found to be related to aging, such as dry eye, meibomian gland dysfunction, conjunctiochalasis, Fuchs corneal endothelial dystrophy, pterygium and pinguecula. It suggests that the ocular surface diseases can be further understood, diagnosed and treated from the perspective of cell senescence.

Effects of different correction methods on binocular visual function of myopia patients

LI Jingjiao, Jiang Hong, Fang Xiaomin, Zhang Su

2021, 45(1):  76-80.  doi:10.3760/cma.j.issn.1673-5803.2021.01.015

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At present, the common correction methods of myopia can be divided into three types: wearing glasses, wearing corneal contact lens and refractive surgery. Among them, glasses are safe and cheap to wear, and can be the first choice of the myopia who are mild or moderate and not anisometropia. The patients with high myopia or anisometropia were more likely to obtain good binocular visual function by wearing contact lens including orthokeratology lens, RGP, soft contact lens, etc. In reducing the anisometropia damage to the binocular visual function of the myopia, refractive surgery can also obtain good results.

Clinical application of macular pigment optical density

Tian Lulu, Zhou Xiyuan

2021, 45(1):  61-66.  doi:10.3760/cma.j.issn.1673-5803.2021.01.012

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Macular area in the posterior pole of human retina is rich in macular pigments (MP), which have important protective significance to the retina and are closely related to human visual function. MP levels were assessed by macular pigment optical density (MPOD). At present, more and more studies have shown that MP reduction or loss is of great significance for the development and prognosis of a variety of ophthalmic diseases (including age\|related macular degeneration, diabetic retinopathy, glaucoma, etc), and the measurement of MPOD also plays a role in the diagnosis, management and treatment of related systemic diseases (such as Sjogren-Larsson syndrome).