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Table of Content

    25 November 2025, Volume 34 Issue 6
    Emphasizing the diagnosis and management of special corneal infections
    He Yan, Yuan Jin
    2025, 34(6):  413-417.  doi:10.1328 1/i.cnki.issn.1004-4469.2025.06.001
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     Corneal diseases are an important leading cause of blindness in China, with infectious keratitis being a major contributor. The evolving lifestyle patterns, emerging infectious diseases, and shifts in clinical practices have heightened the risk of misdiagnosis for atypical corneal infections, posing severe threats to visual prognosis. For ocular surface infections, special attention should be paid to lifestyle-associated cases, including microsporidial keratoconjunctivitis (MKC) linked to pet exposure. Emerging pathogens (e.g., monkeypox virus, SARS-CoV-2) and classical diseases (e.g., tuberculosis, syphilis) can also involve the cornea, necessitating vigilance for ocular transmissibility. The rising use of contact lenses-particularly orthokeratology lenses-has increased the risk of acanthamoeba keratitis, while post-refractive surgery non-tuberculous mycobacterial (NTM) interface infections require close monitoring. Diagnosis should integrate confocal microscopy, mass spectrometry, and metagenomic next-generation sequencing (mNGS). While mNGS enables comprehensive detection of fastidious pathogens, clinical correlation is critical for data interpretation. Therapeutic strategies emphasize multidisciplinary collaboration, adopting innovations such as corneal cross-linking (CXL), intrastromal drug delivery, and advanced systems (e.g., nanocarriers, sustained-release implants). Novel agents like polymyxin B derivatives are under development for drug-resistant strains. Future efforts should focus on clinician-laboratory synergy, multimodal diagnostic systems, and AI-assisted analysis to achieve precision management under the "early diagnosis, rapid treatment, blindness prevention" framework.
    Applications and interpretations of indocyanine green angiography
    Huang Houbin
    2025, 34(6):  419-423.  doi:10.1328 1/i.cnki.issn.1004-4469.2025.06.002
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     It’s difficult to interpret the images of indocyanine green angiography (ICGA). For most ophthalmologists, they have been familiar with fundus fluorescein angiography (FFA) prior to ICGA. It’s reasonable for them to interpret ICGA with the same philosophy with FFA, whereas which would result to misunderstanding and misjudging. With the development of high-resolution optical coherence tomographic angiography, attention is less and less paid on ICGA. And the conception is up and up that FFA and ICGA can be replaced by OCTA and even be abandoned. This article analyzes the reasons which cause such misunderstandings and explores in depth the clinical values of ICGA, focusing on the irreplaceability of ICGA in demonstrating the choroidal circulation, evaluating the function of retinal pigment epithelium, illuminating the Bruch’s lesions rather than other multi-model imaging methods. It’s critical to widely apply ICGA and grasp its’ interpretations.
    Clinical and gene characteristics of patients with HGPPS
    Wang Dan, Jia Hongyan, Ma Qian, Yang Yanyan, Zhang Ranran, Liang Yi, Wang Yidi, Chang Qinglin, Jiao Yonghong
    2025, 34(6):  424-430.  doi:10.1328 1/i.cnki.issn.1004-4469.2025.06.003
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    Objective To investigate the clinical features, neuroimaging findings, and genetic etiology of horizontal gaze palsy with progressive scoliosis (HGPPS), and to enrich the spectrum of pathogenic mutations in the Chinese population. Design Retrospective case series study. Participants Seven HGPPS patients (from 6 non-consanguineous families) who presented between January 2013 and May 2025. Methods All patients underwent detailed ophthalmological examination, comprehensive physical examination, and spinal assessment. Four patients received magnetic resonance imaging (MRI) and spinal computed tomography (CT) of the brain and spine. Peripheral blood samples were collected from the patients and their core family members. Genomic DNA was extracted and subjected to whole-exome sequencing. Bioinformatic analysis was performed to identify causative genetic variants. Main Outcome Measures Primary position, ocular motility, brain MRI findings, and systemic developmental abnormalities, whole exome sequencing results. Results The cohort included 3 males and 4 females, with a mean age of (7.4±3.3) years. All patients exhibited complete or severe congenital limitation (-4 grade) of horizontal conjugate eye movements, with vertical movements remaining intact. Primary position was orthotropic in 4 cases, with esotropia in 2 cases and exotropia in 1 case. Refractive errors were present in all patients, and one case was accompanied by nystagmus. Scoliosis onset occurred in early childhood, with a mean age of (2.2±2.0) years. Brain MRI revealed characteristic "butterfly-shaped" medulla and "split pons" signs in all examined patients. Whole-exome sequencing identified pathogenic variants in the ROBO3 gene (NM_022370.3) in 4 patients. These included three previously reported pathogenic/likely pathogenic variants (c.1447C>T/p.R483X, c.2462G>C/p.R821P, c.C3412T/p.R1138X) and one variant of uncertain significance in a splice region (c.2594-4A>T). The inheritance patterns comprised both compound heterozygous and homozygous mutations. Conclusion HGPPS is characterized by congenital horizontal gaze palsy and progressive scoliosis, with typical brainstem malformations on neuroimaging. This study identified ROBO3 mutations in four patients, expanding the mutational spectrum of the disease. For children with congenital ocular motility disorders, even those with orthotropic primary position, HGPPS should be considered. Early multidisciplinary evaluation and ROBO3 genetic testing are crucial for diagnosis and management.
    Ocular phenotype diversity observed in a Chinese cohort of patients with FBN1 gene variants
    Yan Weiyu, Tian Lu, Xu Ke, Xie Yue, Li Nien, Xia Weiqiao, Jin Zibing, Li Yang
    2025, 34(6):  431-439.  doi:10.1328 1/i.cnki.issn.1004-4469.2025.06.004
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     Objective  To describe the genetic and clinical characteristics of a cohort of Chinese patients with FBN1 variants and to explore genotype-phenotype correlations in ocular manifestations. Design Retrospective case series. Participants 36 patients from 24 unrelated families who carried variants in FBN1. Methods Detailed ophthalmic/systemic evaluations were performed on the patients. Peripheral venous blood was collected from family members. Sanger sequencing was employed for validation and family co-segregation analysis to identify pathogenic variant sites. Main Outcome Measures Pathogenic gene variants, ocular clinical manifestations, and systemic manifestations. Results 23 variants in FBN1 were identified; seven variants were novel. The variants included 21 (91.3%) missense variants, one in-frame deletion, and one large novel deletion encompassing exon 47-54. The patients showed clinical diversity, ranging from typical Marfan syndrome to isolated ectopia lentis (EL) and Weill Marchesani syndrome. All patients with cysteine-erasing missense variants suffered from EL and high myopia, and approximately 30% occurred retinal detachment(RD). Conversely, patients with cysteine-forming variants exhibited a higher prevalence and severity of astigmatism. A patient with compound-heterozygous missense variants exhibited severe ocular and cardiovascular manifestations. Conclusions Our results expanded the pathogenic variant spectrum of FBN1. We observed that patients with cysteine-erasing missense variants were at a high risk of RD. These findings will provide some basis for genetic counselling and preventive treatment of RD risk.
    Prediction model and experimental validation of retinal irradiance for red laser
    Kang Mengtian, Li Zihao, Gao Yaxin, Song Qianqian, Xu Wenjun, Wang Ming, Zhang Yushi, Meng Xinyue, Xia Dongrui, Wang Ningli
    2025, 34(6):  439-446.  doi:10.1328 1/i.cnki.issn.1004-4469.2025.06.005
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    Objective To establish a mathematical model for retinal irradiance of 650 nm red laser, validate model accuracy, and explore effects of different laser powers, pupil diameters, and axial lengths on retinal irradiance. Design Animal experimental study. Participants Four two-month-old Tupaia and six four-month-old tricolor guinea pigs. Methods After enucleation of eyeballs (n=20), posterior sclera and corresponding retinal area were dissected. Retinal irradiance was measured at laser emission powers of 2 mW, 5 mW, 10 mW, and 18 mW. Ocular biological parameters were measured and combined with optical parameters to establish a light transmission model. The radiative transfer equation (RTE) mathematical model was constructed using the Henyey-Greenstein phase function, and theoretical values were compared with actual measurements. Main Outcome Measures Retinal irradiance under different conditions and theoretical model accuracy. Results For guinea pigs [pupil diameter (5.0±0.3)mm, axial length (7.52±0.11)mm], actual retinal irradiance at 2 mW, 5 mW, 10 mW, and 18 mW was 121.62 W/cm2, 396.67 W/cm2, 690.95 W/cm2 and 1335.24 W/cm2, respectively. Theoretical irradiance was 153.16 W/cm2, 381.84 W/cm2, 763.19 W/cm2 and 1373.75 W/cm2, with average relative differences of 0.259, 0.037, 0.105, 0.029. For tree shrews [pupil diameter (4.5±0.2)mm, axial length (6.78±0.17)mm], actual retinal irradiance was 163.21 W/cm2, 385.71 W/cm2, 751.19 W/cm2 and 1471.43 W/cm2, respectively, while theoretical values were 149.12 W/cm2, 372.80 W/cm2, 745.60 W/cm2 and 1339.66 W/cm2, with average relative differences of 0.086, 0.033, 0.007, 0.090. Based on the model's prediction for human eyes (axial length of 24 mm), at a laser power of 2 mW, as the pupil diameter increases from 2 mm to 7 mm, the retinal irradiance increases from 16.85 W/cm2 to 206.96 W/cm2. According to national laser safety standards, the safe exposure parameters for human eyes are determined as follows: for an exposure time of 180 s, the pupil diameter should not exceed 4.26 mm, and the emission laser power should not exceed 2 mW. Conclusion The RTE mathematical model accurately predicts retinal irradiance for 650 nm red laser. Retinal irradiance increases as laser power increases, axial length decreases, and pupil size increases, showing an incompletely linear relationship.
    Changes of the macular fovea thickness in outer retina in patients with cone dystrophy and cone-rod dystrophy at different stages
    Wang Cong, Liu Kegao, Peng Xiaoyan, Bai Fengge, Chen Changxi, Zhang Zheng
    2025, 34(6):  447-455.  doi:10.1328 1/i.cnki.issn.1004-4469.2025.06.006
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     Objective  To observe changes of the macular fovea thickness in outer retina layer by layer in patients with cone dystrophy (CD) and cone-rod dystrophy (CRD) at different stages. Design  Retrospective case series. Participants 14 cases (28 eyes) CD, 21 cases (42 eyes) CRD diagnosed clinically and 19 cases (38 eyes) normal control. Methods  Extent of the outer retina damage of all eyes was categorized into 4 grades (G1~G4) based on the extent of damaged layers in the outer retina by optical coherence tomography (OCT). OCT was adopted to measure the macular fovea thickness layer by layer. Layered changes of the macular fovea thickness were observed and compared with normal control in patients with CD and CRD at different stages, included central macular thickness (CMT), outer retina (OR), outer nuclear layer (ONL), myoid zone (MZ), ellipsoid zone (EZ), outer segment (OS), interdigitation zone (IZ), and RPE/Bruch membrane complex (RBC). Main Outcome Measures  The thickness of CMT, OR, ONL, MZ, EZ, OS, IZ and RBC in G1~G4. Results  The EZ (12.76±1.15) μm and IZ (16.80±1.38) μm of G1 eyes were thinner than EZ (13.80±0.99) μm and IZ (19.41±1.60) μm of the control group (all P<0.001). There was no significant difference between CMT, OR, ONL, MZ, OS, RBC and those of the control group (all P>0.05). The OR (96.72±5.82) μm, EZ (12.37±0.61) μm, IZ (15.44±2.21) μm and RBC (15.97±1.42) μm of G2 eyes were thinner than OR (105.62±3.56) μm, EZ, IZ and RBC (17.68±1.39) μm of the control group (all P<0.001). There was no significant difference between CMT, ONL, MZ, OS and those of the control group (all P>0.05). The CMT (191.26±25.51) μm, OR (80.61±8.40) μm and MZ (22.81±2.34) μm of G3 eyes were thinner than CMT (210.46±13.07) μm, OR and MZ (27.57±2.60) μm of the control group (all P<0.001). The EZ, IZ, OS and RBC were severely damaged and could not be measured layer by layer. The CMT (112.56±41.11) μm, OR (56.48±22.88) μm and ONL (56.08±21.54) μm of G4 were thinner than those of the control group (all P<0.001). MZ, EZ, OS, IZ and RBC could not be measured layer by layer. CD patients (14 cases, 28 eyes) were G1, CRD patients (21 cases, 42 eyes) were G2~4. Conclusion Layered measurement of the macular fovea thickness in outer retina can provide a basis for grading the extent of damage at different stages. thinned EZ and IZ may occur in early CD. 
    Clinical analysis of tumor recurrence characteristics during and after intra-arterial chemotherapy for  monocular stage D retinoblastoma
    2025, 34(6):  456-461.  doi:10.1328 1/i.cnki.issn.1004-4469.2025.06.007
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     Objective To analyze the characteristics, treatment methods and outcomes of tumor recurrence during and after intra-arterial chemotherapy (IAC) for intraocular stage D of monocular retinoblastoma (RB), and to provide a reference for its treatment. Design Retrospective case series study. Participants A total of 26 children (26 eyes) with retinoblastoma (RB) who were diagnosed with intraocular stage D of monocular at Baoding Hospital of Beijing Children's Hospital and Beijing Children's Hospital from January 2020 to June 2023 were included. Methods All of them were treated with IAC. Based on the results of whole exome sequencing gene detection in peripheral blood, it is classified into hereditary RB and non-hereditary RB. Observe and record the recurrence of tumor lesions in the affected eyes of the children during and after treatment, and use Fisher's exact probability test to compare the differences between groups. Main Outcome Measures Time of tumour recurrence, location of the recurrence, method of treatment, and outcome of the treatment. Results Among the included patients, there were 6 cases (6 eyes) of hereditary RB and 20 cases (20 eyes) of non-hereditary RB. The average age at diagnosis was (20.12±9.11) months, and the follow-up period was 8 to 24 months. In the treatment of IAC, there were 3 cases of recurrence of hereditary RB and 1 case of non-hereditary RB, and there were significant statistical differences between the two groups (P=0.028). After treatment with IAC, there was no recurrence of hereditary RB, and 3 cases of non-hereditary RB recurred 5-10 months after treatment, with no statistically significant difference between the two groups (P=0.562). The recurrence of hereditary RB was all subretinal tumor implantation. Among them, 2 cases were stable after two IVC treatments, and 1 case was stable after two IVC treatments combined with two intravitreal injection chemotherapy. Among non-hereditary RB, one case developed localized subretinal tumor implantation during treatment and remained stable after continuing to receive two sessions of IAC combined with two sessions of intravitreal injection chemotherapy. One case had a recurrence of the primary tumor lesion after treatment and remained stable after receiving three more IAC treatments. One case had a recurrence of the primary tumor lesion after treatment, and the other case developed a subretinal tumor implantation lesion after treatment. The lesions of both children involved the optic nerve. After enucleation, no tumor metastasis was found during the follow-up. Conclusion Hereditary RB in the intraocular stage D of monocular is more likely to have tumor recurrence characterized by subretinal implantation during IAC treatment than non-hereditary RB. Genetic testing has guiding significance for the treatment of monocular retinoblastoma.  For hereditary RB in the intraocular stage D of monocular, to prevent recurrence during treatment, a sequential chemotherapy regimen of IAC combined with IVC can be adopted. 
    Risk factors related to idiopathic epiretinal membrane in Guangzhou population
    Yang Tangjian, Jiang Yu, Zhou Yong
    2025, 34(6):  464-468.  doi:10.1328 1/i.cnki.issn.10048-4469.2025.06.008
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    Objective  To analyze the correlation between idiopathic epiretinal membrane and systemic factors in middle-aged and elderly individuals in Guangzhou. Design Cross sectional study.  Participants 9,111 physical examination subjects aged ≥40 years who completed ophthalmic examinations at the 11th People's Hospital of Guangzhou from January to December 2019. Methods All participants underwent fundus color photography of both eyes and result interpretation, with records of ophthalmic history, height, weight, blood pressure, and various blood tests including six lipid indicators, fasting blood glucose, and serum uric acid. SPSS 26.0 was used for univariate and multivariate Logistic regression analysis for idiopathic epiretinal membrane and systemic factors. Main Outcome Measures The correlation between gender, age, body mass index, hypertension, diabetes, dyslipidemia, hyperuricemia, and the risk of idiopathic epiretinal membrane. Result  A total of 9,111 subjects (aged 40-94 years, mean 58.73±10.62 years) were included, with 158 diagnosed with idiopathic epiretinal membrane. Univariate regression analysis showed increased disease risk in female subjects and those aged >60 years, while hyperuricemia was associated with reduced risk. After multivariate logistic regression correction, age >60 years was identified as an independent risk factor for idiopathic epiretinal membrane. Compared to the 40-49 age group, the 60-69 and ≥70 age groups exhibited approximately 9.948-fold (OR=10.948, 95% CI: 4.746-25.253, P<0.001) and 4.507-fold (OR=5.507, 95% CI: 2.300-13.183, P<0.001) higher disease risk, respectively. Hyperuricemia significantly reduced the likelihood of idiopathic epiretinal membrane by nearly 30% compared to subjects without hyperuricemia(P=0.031). Conclusion Age ≥60 years old is the main risk factor for idiopathic macular membrane, and hyperuricemia is a barrier to the occurrence of idiopathic macular membrane. Clinical workers need to strengthen fundus screening for high-risk individuals aged 60 and above, achieving early detection, early intervention, and early treatment.
    Clinical comparative study on a new generation of wavefront-guided objective refraction technology based on point cloud modeling and simulation calculation and subjective refraction technology
    Zhen yi, Huang Yan, Gao Jie, Huang Haikuo, Chen Changxi
    2025, 34(6):  469-475.  doi:10.1328 1/i.cnki.issn.10048-4469.2025.06.009
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     Objective To explore the clinical differences between point cloud modeling and simulation calculation-based wavefront-guided objective refraction technology (point cloud wavefront-guided objective refraction) and subjective refraction, and verify the accuracy and efficiency of this novel objective refraction technology. Design A prospective randomized controlled cross-over clinical trial. Participants Sixty-seven adolescents aged 8-18 years with refractive errors were recruited from Beijing Tongren Hospital, between May and June 2025. Participants were excluded if their refractive errors exceeded the device detection range (-10 to +10 diopters [D]), cylinder power >3 D, or had other ocular diseases except refractive errors. Methods The technical framework of point cloud wavefront-guided objective refraction was constructed, including data layer, modeling layer, simulation and optimization layer, and closed-loop feedback layer. Data were collected by Shack-Hartmann aberrometer, and refraction prescriptions were generated through point cloud modeling and surface reconstruction. A randomized controlled cross-over trial was conducted to compare with subjective refraction. Participants wore trial glasses with the two prescriptions successively and completed corrected visual acuity tests. Pearson correlation coefficient, Bland-Altman plots, and paired t-test were used for statistical analysis. Main Outcome Measures Consistency of refraction prescriptions (M, J0, J45 components) and corrected visual acuity. Results There were no significant differences in M (-0.02±0.17)D, J0 (-0.01±0.13) D, and J45 (0.00±0.10) D components between subjective refraction and point cloud wavefront-guided objective refraction (all P>0.05). The 95% confidence intervals for consistency were (-0.35 to 0.31) D for M, (-0.26 to 0.24) D for J0, and (-0.20 to 0.19) D for J45. The difference in corrected visual acuity (0.00±0.05) was not statistically significant (P=0.665). The time consumed by point cloud wavefront-guided objective refraction (26.9±0.17) seconds was significantly shorter than that by subjective refraction (479.1±64.8) seconds (P<0.001). Conclusions The point cloud wavefront-guided objective refraction technology shows high consistency with subjective refraction in prescription and corrected visual acuity, with significantly shorter testing time. It demonstrates remarkable advantages in improving refraction efficiency and visual quality, providing a low-cost and high-precision refraction solution for regions with limited medical resources. 
    Study on the mechanism of neuroprotective action of puerarin on retinal ganglion cells in a rat model of optic nerve clipping injury
    Guo Tonglin, Ma Ke, Zhang Junxiu
    2025, 34(6):  476-482.  doi:10.1328 1/i.cnki.issn.10048-4469.2025.06.010
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     Objective To study the mechanism of neuroprotective action of puerarin on retinal ganglion cells in a rat model of optic nerve clipping injury. Design Experimental study. Participants 54 SD rats. Method SD rats were randomly divided into three groups ( each group n=18). The treatment group (optical nerve crush+puerarin, ONC+PUE) received puerarin eye drops (10mg/ml) twice a day, since 2 hours after optic nerve clipping injury. The control group rats were treated with sterile physiological saline eye drops twice a day, since 2 hours after optic nerve clipping injury. Blank group rats were not injury operated on. Rats were euthanized 15 days later and subjected to retinal cell apoptosis, transcriptome, and metabolome analysis. Main Outcome Measures The number of TUNEL positive cells in retina, transcriptome and metabolome data analysis. Results The number of apoptotic cells of retina in the control group increased compared to the blank group, while the number of apoptotic cells in the treatment group decreased compared to the control group (P<0.01). Puerarin regulates the expression of Col6a2, Col1a2, Vcan, and Fbln1 genes through the AGE-RAGE pathway and cytoskeleton pathway (all P<0.05), and participates in regulating the metabolism of substances such as alanine, aspartate, glutamate, and arginine in retina (all P<0.05). Conclusion Puerarin treatment may reduce apoptosis of optic ganglion cells in a rat model of optic nerve clipping injury. Puerarin can regulate the expression of Col6a2, Col1a2, Vcan, and Fbln1 genes, as well as the metabolism of alanine, aspartate, glutamate, and arginine in the retina of rats after optic nerve clipping injury, and may therefore have a neuroprotective effect on the damage and apoptosis of the retinal ganglion cells in rats after optic nerve clipping injury.
    Evaluation of the quality of life and effectiveness of visual aids in patients with visual disability 
    Zhao Weiqi, Meng Lianxi, Zhao Yu, Han Linxi, Yang Xiaohui
    2025, 34(6):  482-488.  doi:10.1328 1/i.cnki.issn.10048-4469.2025.06.011
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    Objective  To investigate the causes of visual disability patients in low vision clinic, and evaluate the usage effectiveness and reasons for discontinuation of low vision aids and the effectiveness in improving visual acuity and quality of life. Design  Prospective cohort study. Participants  The study was conducted on 150 patients with visual disability recruited from Beijing Tongren Hospital during the period of January 2025 to May 2025, including 81 females. Methods  Far and near low vision aids were prescribed for visual disability patients. The low vision acuity chart and the Chinese-version low vision quality of life questionnaire(CLVQOL) were applied to evaluate and compare the improvement of visual acuity and quality of life in visual disability patients before and one month after fitting low vision aids. The effectiveness and the reasons for abandonment of low vision aids were also evaluated. Main Outcome Measures  Etiology of visual disability, best-corrected visual acuity (BCVA), the rate of visual acuity relieved from blindness (number of eyes with BCVA≥0.05/total number of blind eyes ×100%), the rate of visual acuity relieved from visual disability (number of eyes with BCVA≥0.3/total number of eyes with low vision×100%), effectiveness rate of visual aids (number of visual aids that improved visual function and can satisfactory or basically complete visual tasks/tatal number of visual aids), reasons for discontinuation, CLVQOL scores. Results The main causes of visual disability patients (aged 8~76 years) were macular degeneration (34.0%), optic neuropathy (24.67%), retinal pigment degeneration (14%), respectively. After fitting distance optical low vision aids, BCVA of visually disability patients improved from 1.3±0.4 to 0.8±0.3 (t=43.65, P<0.001). The rate of visual acuity relieved from blindness and from visual disability were 82.22% and 38.10%, respectively. The efficacy rates of optical low vision aids and electronic vision enhancement devices were 71.3%、100%, respectively, with the differences being statistically significant(?字2=14.95,P=0.01). Electronic vision enhancement devices demonstrated superior effectiveness compared to +10 D,+12 D,and +16 D optical magnifiers(?字2=7.78, 8.82, 10.16; P=0.02, 0.006, 0.002). The discontinuation rates for far and near optical low vision aids were 9.85% and 15.65%, respectively. The main reasons for discontinuation of low vision aids were minimal visual improvement, close working distance, and poor usability while walking, with the differences being statistically significant (?字2=8.60,P=0.006). The discontinuation of low vision aids were associated with the underlying etiology but independent of gender and educational attainment. Among 150 patients, 132 patients completed the CLVQOL scale before and after low vision aids fitting. After fitting low vision aids, the overall score of CLVQOL has significantly improved compared to before fitting low vision aids, the quality of life scores increased from 74.94±10.41 to 88.5±13.86(t=37.36,P<0.001). The scores of the dimensions of light perception, distant vision and mobility, psychological adjustment, reading and fine work, and daily activities in CLVQOL scale have significantly improved compared to before fitting low vision aids, with a statistically significant difference(all P<0.001). There was no significant correlation between gender, educational level and CLVQOL scores(P=0.06, 0.38). Conclusions Fundus diseases and optic neuropathy have become the main causes of visual disability in low vision clinic. The personalized fitting and proper utilization of low vision aids could enhance its effectiveness, reduce discontinuation rates, and improve the quality of life in visual disability patients. 
    Analysis of medical costs of ophthalmic ambulatory surgery model 
    Zhang Rui, Zhong Wei, Xiao Xiao
    2025, 34(6):  489-492.  doi:10.1328 1/i.cnki.issn.10048-4469.2025.06.012
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     Objective  To explore the impact of ophthamic ambulatory surgery model on total medical expenses, medical insurance fund payment, and individual patient payment. Design Retrospective cohort study. Participants Data of 362,492 inpatients from a class-A tertiary hospital in Beijing, between 2022 and 2024. The participants were divided into two groups based on the exposure factor of whether they had undergone ambulatory surgery. Methods Descriptive statistics were used to compare differences in demographic characteristics and expense indicators between the two groups. A multiple linear regression model was applied to control for confounding factors and analyze the independent impact of ambulatory surgery on expenses. Main Outcome Measures Medical insurance fund payment, individual patient payment. Results  86.2% of ophthalmic inpatient surgeries adopting the ambulatory model, compared to only 10.6% of non-ophthalmic surgeries. The average age of patients in the ambulatory surgery group was significantly higher than that in the non-ambulatory surgery group (62.9 years vs. 52.9 years, P<0.001). Expense analysis showed that the median total expenses (5340 yuan), medical insurance fund payment (3101 yuan), and individual patient payment (2361 yuan) in the ambulatory surgery group were significantly lower than those in the non-ambulatory surgery group (14456 yuan, 8249 yuan, and 4624 yuan respectively, all P<0.001). Multiple linear regression analysis indicated that after controlling for factors such as year, age, gender, and type of medical insurance, choosing ambulatory surgery could reduce the medical insurance fund payment by an average of 6983 yuan (95% CI: 6870~7096) and the individual and the individual patient payment by an average of 4698 yuan (95% CI: 4620~4777). Conclusions  The ambulatory surgery model in ophthalmology can significantly reduce the total medical cost, effectively alleviate the pressure on the medical insurance fund and the economic burden of individual patients, and thus is an efficient medical service model worthy of promotion.