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    25 March 2026, Volume 35 Issue 2
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    Macular pigments
    Huang Houbin
    2026, 35(2):  81-91.  doi:10.13281/j.cnki.issn.1004-4469.2026.02.001
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    Macular pigments refers to lutein, zeaxanthin, and meso-zeaxanthin that are concentrated in macula lutea. They all belong to xanthophyll which is a subclass of carotenoid. These pigments are closely associated with eye diseases, particularly age-related macular degeneration, as well as fundus imaging. Currently, it is widely believed that dietary intake or supplementation of these three xanthophylls may benefit eye health and visual function. This article systematically sorts out the sources, chemical structures, distribution within the body, transport and uptake mechanisms, spectral characteristics, clinical detection methods, functions, and clinical significance of macular pigment, aiming to raise attention to macular pigment and related researches.
    Surgical strategies based on the pathophysiological mechanism of complications in nanophthalmos with secondary angle-closure glaucom
    Yu Xiaowei, Shi Yan, Fan Zhigang
    2026, 35(2):  92-96.  doi:10.13281/j.cnki.issn.1004-4469.2026.02.002
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    Nanophthalmos with secondary angle-closure glaucoma (NSACG) carries significant surgical risks, including malignant glaucoma, uveal effusion, and even suprachoroidal hemorrhage. To address the complex pathogenesis of NSACG and its underlying pathophysiological mechanisms leading to severe complications, we developed a modular surgical strategy targeting three core factors: anterior segment dysgenesis, angle closure, and uveal effusion. This integrated approach combines: phacoemulsification with intraocular lens implantation (Phaco-IOL), irido-zonulo-hyaloid-vitrectomy (IZHV), goniosynechialysis (GSL) or Ahmed glaucoma valve (AGV) implantation, and sclerotomy with scleral window. By selectively tailoring these surgical components according to individual ocular characteristics, we provide personalized modular surgical management for this refractory glaucoma subtype. This strategy aims to reduce surgical complication risks and improve long-term outcomes.
    Analysis of the efficacy of different lens combination surgeries for the treatment of secondary glaucoma in nanophthalmos
    Jin Manman, Gao Feng, Wang Jiajian, Kong Xiangmei
    2026, 35(2):  97-102.  doi:10.13281/j.cnki.issn.1004-4469.2026.02.003
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     Objective  To investigate the efficacy and complications of different combined lens surgeries for secondary glaucoma in nanophthalmos. Design Retrospective case series. Participants Sixty-eight patients (68 eyes) suffered from secondary angle-closure glaucoma with nanophthalmos (axial length ≤20.5 mm) who underwent combined lens surgery at Fudan University Eye and ENT Hospital between October 2015 and November 2023. Methods Patients were divided into three groups according to surgical approach: Group A (phacoemulsification combined with goniosynechialysis, 18 eyes), Group B (phacoemulsification combined with goniosynechialysis and sclerectomy, 12 eyes), and Group C (phacoemulsification combined with goniosynechialysis, sclerectomy, and anterior vitrectomy, 38 eyes). All patients were followed up for more than 6 months postoperatively. Complete intraocular pressure (IOP) control was defined as IOP ≤21 mmHg without antiglaucoma medications. Malignant glaucoma, choroidal detachment, suprachoroidal hemorrhage, and retinal detachment were considered severe complications. Main Outcome Measures  Complete IOP control rate, visual acuity maintenance rate, incidence of severe complications, and reoperation rate. Results  At the final follow-up, in Group A, Group B, Group C, the complete IOP control rates were 50.0% (9 eyes), 83.3% (10 eyes), and 81.6% (31 eyes) respectively; the visual acuity maintenance rates were 77.8% (14 eyes), 66.7% (8 eyes), and 52.6% (20 eyes), respectively; the incidences of severe complications were 22.3% (4 eyes), 16.7% (2 eyes), and 13.2% (5 eyes), respectively； the reoperation rates were 27.8% (5 eyes), 16.7% (2 eyes), and 5.3% (2 eyes), respectively. Compared with Group A, Group C demonstrated significantly better IOP control (P=0.025) and lower reoperation rate (P=0.029), although the difference in visual acuity decline was not statistically significant (P=0.087). Compared with Group A, Group B showed higher IOP control rate (P=0.121) and lower reoperation rate (P=0.669), but neither reached statistical significance; however, visual function was better preserved in Group B (P=0.678). The incidence of severe complications was highest in Group A, followed by Group B and Group C, though no statistically significant differences were observed among the groups. Conclusions The surgical approach combining phacoemulsification, goniosynechialysis, sclerectomy, and anterior vitrectomy provides favorable single-surgery IOP control with relatively low complication rates, making it suitable for extremely high-risk eyes prioritizing IOP control and reduction of reoperations. The approach combining phacoemulsification, goniosynechialysis, and sclerectomy offers better preservation of visual function and is more appropriate for patients with acceptable visual reserve but high anatomical risk. Both represent viable surgical options for secondary glaucoma in nanophthalmos..
    The short-term efficacy of micro-pulse transscleral cyclophotocoagulation for the treatment of refractory glaucoma
    Tao De, Su Yufang, Yang Yajun
    2026, 35(2):  103-108.  doi:10.13281/j.cnki.issn.1004-4469.2026.02.004
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     Objective To assess the short-term efficacy and safety of micro-pulse transscleral cyclophotocoagulation (MP-TSCPC) in refractory glaucoma. Design Retrospective case series. Participants  Twenty-nine patients (31 eyes) with refractory glaucoma whose intraocular pressure (IOP) was uncontrolled despite prior medical or surgical treatment, treated at Baotou Chaoju Eye Hospital between August 2023 and January 2025. Methods The MP-TSCPC procedure was performed using a Cyclo G6 laser system with a MicroPulse P3 probe. The fiberoptic probe was positioned approximately 1 mm posterior to the limbus, maintaining gentle contact with the conjunctiva, and swept continuously for 45~60 seconds in each quadrant at a power setting of 2000 mW. IOP, best-corrected visual acuity (BCVA), number of glaucoma medications, NEI-VFQ-25 quality-of-life score, and visual analog scale (VAS) pain score were assessed preoperatively and at 3 months postoperatively. Main Outcome Measures IOP, number of glaucoma medications, BCVA, score of VAS and NEI-VFQ-25. Results The mean IOP at 1 day, 1 week, 1 month, and 3 months postoperatively was (18.61±7.97) mmHg, (14.16±3.86) mmHg, (18.90±7.84) mmHg, and (20.97±9.00) mmHg, respectively, all significantly lower than the preoperative value of (46.35±15.02) mmHg (F=57.302, P<0.001). The median number of glaucoma medications decreased from 3 preoperatively to 2 postoperatively (Z=-3.973, P<0.001). BCVA showed no significant change (Z=-0.618, P=0.536). The preoperative VAS score was (1.74±3.15), while it decreased significantly to (0.58±1.45) on postoperative day 1 and to (0.10±0.53) on postoperative week 1, with statistical significance (P=0.025, 0.002). By postoperative month 1, all ocular pain had completely resolved. NEI-VFQ-25 scores improved significantly in the domains of general health, overall vision, and ocular pain. Preoperatively, 11 eyes experienced pain; this decreased to 5 eyes at postoperative day 1 and to 1 eye (mild) at postoperative week 1. The proportion of pain-free eyes increased from 64.5% preoperatively to 99.6% at 1 week postoperatively. All eyes were pain-free at 1 month and 3 months postoperatively. Within 3 months, 3 eyes developed complications: 2 eyes of choroidal detachment and 1 case of corneal epithelial injury, all of which resolved with medical treatment. No other complications were observed. Conclusions MP-TSCPC effectively lowers IOP and reduces medication burden within 3 months postoperatively, while improving quality of life and alleviating ocular pain in patients with refractory glaucoma, with a favorable safety profile.
    Analysis of clinical characteristics of solitary peripapillary choroiditis
    Hao Hongxiang, Ma Ya, Peng Xiaoyan,
    2026, 35(2):  109-113.  doi:10.13281/j.cnki.issn.1004-4469.2026.02.005
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     Objective To describe clinical and fundus imaging features of solitary peripapillary choroiditis patients. Design Retrospective case series. Participants Patients diagnosed as solitary peripapillary choroiditis in Beijing Tongren Hospital, Beijing Aier Eye Hospital and Beijing Aier Yingzhi Eye Hospital from June 2013 to January 2025. Six patients (9 eyes) with solitary peripapillary choroiditis were enrolled. There were 3 males (3 eyes) and 3 females (6 eyes) with the median age of 31 years. Three of them had binocular disease at onset of disease. Methods History of systemic comorbidities and results of systemic and ophthalmological examinations, including fundus photography, optical coherence tomography (OCT), fluorescein fundus angiography (FFA) and indocyanine green angiography (ICGA) were evaluated. Cases with infectious diseases or autoimmune diseases were excluded. Follow-up duration ranged from 1 month to 48 months, with an average of 13.1 months. Main Outcome Measures Characteristic signs of fundus imaging. Results In 9 eyes of the 6 patients, the lesion of solitary peripapillary choroiditis was unifocal, adjoining to one side of the optic disc, or surrounding the optic disc in all eyes. The area and severity of the lesion vary from peripapillary retinal pigment irregularity (3 eyes), to optic disc edema （1 eye), peripapillary subretinal yellow-whitish exudation (1 eye), and peripapillary subretinal fibrotic membrane (5 eyes), along with cystoid macular edema and macular hard exudates secondary to choroidal neovascularization (CNV) (5 eyes). In all the 9 eyes, OCT showed discontinuity and blurred reflection of retinal pigment epithelium, (RPE) with underlying choriocapillaris and choroidal Sattler layer atrophy, as well as destruction of the outer retina above. Furthermore, macular edema can be found when secondary CNV arose in 5 eyes. Four patients (6 eyes) received FFA and ICGA. FFA showed ill-defined slightly hyperfluorescent lesion temporally adjoining to optic disc in the early phase, and staining in late phase in 1 eye. In the rest 5 eyes, due to secondary CNV, the FFA showed fluorescence leakage inside the peripapillary lesion, and pooling in late phase. On ICGA of all 6 eyes, persistent hypofluorescence and reduce of choroidal large vessels were seen correspondingly. Conclusions The prominent fundus appearance of solitary peripapillary choroiditis is unifocal lesion adjoining to optic disc or surrounding optic disc. It is a kind of idiopathic choroiditis mainly affected RPE, choriocapillaris and choroidal Sattler layer. Secondary subretinal fibrosis and CNV can be seen.
    Multimodal imaging observation of one-year follow-up for acute macular neuroretinopathy after COVID-19 infection
    Zhang Shujun, Wang Lifang, Lv Aiguo, Huang Shuai, Wang Yanna, Li Ping, Shi Wei
    2026, 35(2):  114-120.  doi:10.13281/j.cnki.issn.1004-4469.2026.02.006
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     Objective To observe the characteristic multimodal imaging features of acute macular neuroretinopathy (AMN) after COVID-19 infection. Design Retrospective case series. Participants Eleven patients (22 eyes) diagnosed with AMN following COVID-19 infection at Handan Eye Hospital between December 2022 and February 2024, who completed one-year follow-up. All patients presented with visual decline within 1~5 days. The cohort included 2 males and 9 females, all with bilateral involvement, aged 16~44 years (mean 29.9±9.1 years). Methods All patients underwent multimodal imaging including color fundus photography (CFP), infrared (IR) imaging, autofluorescence (AF) imaging, optical coherence tomography (OCT), fundus fluorescein angiography (FFA), and indocyanine green angiography (ICGA). Imaging characteristics were documented. Follow-up examinations were conducted within 1 week and at 1, 3, 6 months, and 1 year after onset.  Main Outcome Measures Imaging features on CFP, IR, AF, OCT, FFA, and ICGA. Results In the acute phase: all eyes exhibited radial, patchy, or wedge-shaped grayish-white and orange-red lesions in the macular area on CFP, and irregular patchy hyporeflective lesions were observed on IR. AF showed speckled hyperfluorescence in 7 eyes. Late-phase ICGA displayed patchy hypofluorescence in 7 eyes. OCT demonstrated patchy hyperreflective signals primarily involving the outer plexiform layer (OPL) and outer nuclear layer (ONL) in all eyes. Visual field testing revealed central or paracentral scotomas in 19 eyes. At 1-year follow-up, CFP showed no abnormalities in all eyes. Late-phase ICGA showed slight reduction of patchy hypofluorescence. OCT indicated thinning of the OPL in 12 eyes, among which 7 eyes showed focal ellipsoid zone (EZ) disruption. Visual field abnormalities(central or paracentral scotomas) persisted in 14 eyes. Conclusions AMN in the acute phase exhibits distinct characteristic findings on CFP and OCT. At 1-year follow-up, some patients still present with central or paracentral scotomas. 
    The effect of intravitreal injection of triamcinolone acetonide during primary suture for severe open eye trauma in preventing proliferative vitreoretinopathy
    Cui Ying, Fang Yuxin, Wang Ge, Zhou Dan
    2026, 35(2):  121-126.  doi:10.13281/j.cnki.issn.1004-4469.2026.02.007
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     Objective  To evaluate the efficacy of intravitreal triamcinolone acetonide (TA) injection during primary repair surgery for severe open globe injury in preventing proliferative vitreoretinopathy (PVR). Design Retrospective case series. Participants Thirteen patients (13 eyes) with zone III open eye trauma who underwent primary surgical repair with immediate intravitreal TA injection followed by secondary PPV at Beijing Tongren Hospital between January 2023 and December 2023. The cohort included 10 males and 3 females, with ages ranging from 32 to 68 years (mean, 46.5±12.3 years). Methods PVR grading was documented during PPV. The patients were followed up for 3 to 24 months (mean, 12.1±7.0 months). Best-corrected visual acuity (BCVA), intraocular pressure (IOP), and axial length (AL) were compared between baseline and the final follow-up visit. Data on retinal reattachment, choroidal detachment resolution, and silicone oil removal were also recorded. Main Outcome Measures PVR grade, the condition of retinal reattachment and choroidal detachment recovery. Results PVR grading revealed 4 eyes (30.8%) at grade 0, 0 eye (0%) at grade I, 2 eyes (15.4%) at grade II, 4 eyes (30.8%) at grade III, and 3 eyes (23.1%) at grade IV. At the final follow-up, the mean BCVA was (1.25±0.90) LogMAR, which was significantly improved compared with the baseline value of (2.51±0.28) LogMAR (t=5.689, P<0.001). The mean IOP at final follow-up was (11.4±3.9) mmHg, showing a significant increase from the baseline value of (8.4±3.4) mmHg (t=-5.555， P<0.001). The mean AL at final follow-up was (23.28±1.72) mm, with no statistically significant difference from the baseline value of (23.20±1.56) mm (t=-0.883， P=0.454). Among the 9 eyes with preoperative retinal detachment, 8  eyes achieved complete retinal reattachment while 1 remained detached at the final follow-up. Of the 8 eyes with preoperative choroidal detachment, 6 showed complete resolution at the final follow-up. Silicone oil had been removed in 3 out of the 9 eyes that received silicone oil tamponade by the final follow-up visit. No TA-related adverse reactions were observed. Conclusions For severe open globe injury, intravitreal injection of TA during primary repair surgery can inhibit or alleviate PVR.
    Observation of the effect of vitrectomy combined with internal limiting membrane inversion for the treatment of highly myopic macular hole without retinoschisis at 6 months
    Zhang Lei, Liu Dachuan, Wu Hang
    2026, 35(2):  127-131.  doi:10.13281/j.cnki.issn.1004-4469.2026.02.008
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    Objective To evaluate the efficacy and safety of vitrectomy combined with inverted internal limiting membrane flap technique for treating high myopic macular hole (HMMH) without retinoschisis. Design Retrospective case series. Participants A total of 25 patients (25 eyes) with HMMH without retinoschisis who were treated in the Department of Ophthalmology, Beijing Xuanwu Hospital from February 2019 to May 2022 were included. The mean axial length was (28.38±0.93) mm, and the mean diopter of refractive error was (-10.96±2.31) D. Methods All patients underwent vitrectomy combined with inverted internal limiting membrane flap surgery. Best corrected visual acuity (BCVA) (LogMAR) and morphological results from optical coherence tomography (OCT) were collected preoperatively and at 1, 3, and 6 months postoperatively. Macular hole closure was assessed using OCT. Main Outcome Measures BCVA, number and proportion of eyes with macular hole closure, and incidence of postoperative complications. Results BCVA improved significantly from baseline (1.39±0.62) LogMAR to (1.06±0.24) LogMAR at 1 month postoperatively (Z=-3.930, P<0.001), (1.01±0.26) LogMAR at 3 months (Z=-4.025, P<0.001), and (0.99±0.27) LogMAR at 6 months (Z=-4.023, P<0.001). The number of eyes with HMMH closure at 1, 3, and 6 months postoperatively was 21 (84%), 22 (88%), and 22 (88%), respectively. No postoperative complications were observed in any patients. Conclusion The follow-up results over a period of 6 months indicate that vitrectomy combined with inverted internal limiting membrane flap technique can improve BCVA and promote HMMH closure, representing an effective and safe treatment for HMMH.
    Observation of the effect of intraocular lens implantation without scleral flap fixed by scleral suture at 6 months
    Pang Jing, Ren Cong, Li Zhongen
    2026, 35(2):  131-136.  doi:10.13281/j.cnki.issn.1004-4469.2026.02.009
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    Objective To evaluate the clinical efficacy and safety of a novel intrascleral fixation technique for intraocular lens (IOL) implantation without creating a scleral flap. Design Retrospective case series. Participants 48 patients (49 eyes), including 25 eyes with aphakia, 7 patients (8 eyes) with dislocated crystalline lenses, 10 eyes with IOL displacement, and 6 eyes with IOL dislocation. Methods All patients underwent intrascleral fixation of IOL without creating scleral flaps. The suture was tunneled through the superficial sclera, leaving an external loop. The needle was redirected along the same path, exiting and tied to the pre-formed loop at the entry site. The knot was buried at the entry point, and the suture thread was then tied to the loop apex, forming a single strand which was subsequently tunneled back through the intrascleral space. Patients were followed up for 6 months. Visual acuity was measured using a standard logarithmic chart and converted to LogMAR. Uncorrected visual acuity (UCVA) was recorded preoperatively and at 6 months postoperatively, while best-corrected visual acuity (BCVA) was recorded preoperatively and at 1 week and 6 months postoperatively. Intraocular pressure (IOP) was measured preoperatively and at 1 week postoperatively using non-contact tonometry. IOL position was assessed postoperatively via slit-lamp microscopy and ultrasound biomicroscopy (UBM). Postoperative complications were monitored. Main Outcome Measures Visual acuity, IOP, IOL position, postoperative complications. Results BCVA at 1 week postoperatively (0.56±0.31)LogMAR was comparable to the preoperative value (0.58±0.42)LogMAR (t=0.268, P=0.39). UCVA at 6 months postoperatively (0.57±0.31)LogMAR was significantly better than the preoperative value (1.43±0.42)LogMAR (t=11.532, P<0.001). BCVA at 6 months postoperatively (0.44±0.30)LogMAR was significantly improved compared to the preoperative level (t=1.899, P=0.03). Preoperative IOP (15.07±5.01 mmHg) was similar to that at 1 week postoperatively (15.43±3.98 mmHg) (t=0.394, P=0.347). During the 6-month follow-up, no cases of infection or IOL dislocation occurred. Postoperative complications included transient IOP elevation in 3 eyes, vitreous hemorrhage in 1 eye, and retinal detachment in 1 eye. Conclusion The follow-up results after 6 months showed that intrascleral fixation of IOL without creating a scleral flap is a simple, effective, and safe surgical technique for treating patients with abnormalities in certain lens capsules or zonules.
    Study on the prevalence of obstructive sleep apnea in patients with keratoconus using polysomnography
    Shi Xianping, Zheng Chun, Wang Shengguo, Li Longqiao, Chen Zhitai, Wu Feifeng, Liu Yang
    2026, 35(2):  137-142.  doi:10.13281/j.cnki.issn.1004-4469.2026.02.010
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     Objective To investigate the prevalence of obstructive sleep apnea (OSA) in patients with keratoconus (KC) and analyze the correlation between OSA and KC severity. Design Prospective case-control study. Participants 93 patients with KC who attended the 901 Hospital of the Joint Service Support Force of the Chinese PLA between January 1, 2020, and December 31, 2023, in addition to 97 age- and sex-matched control group participants without ophthalmological comorbidities, recruited during the same period. Methods All participants underwent polysomnography and ophthalmological examinations, and the following data were collected: height, weight, and apnea-hypoventilation index (AHI). The prevalence of OSA was compared between the two groups using the χ2 test. Univariate and multivariateo Logistic regression analyses were used to identify potential risk factors associated with OSA. The severity of KC was classified according to the Amsler-Krumeich classification, and the differences between grades were compared. Main Outcome Measures Prevalence of OSA, odd katios (OR). Results In the KC group, 20 patients (20/93, 21.5%) were diagnosed with OSA, whereas only 5 patients (5/97, 5.2%) were diagnosed with OSA in the cohort without this diagnosis（χ2=11.109，P=0.001）. Univariate logistic regression analysis revealed that a higher BMI (OR: 1.707, 95% CI: 1.340~2.173) and a family history of OSA (OR: 5.750, 95% CI: 1.378~23.990) were significant risk factors for OSA development in patients with KC（all P＜0.05）. Among KC patients with OSA, the proportion of those with grade 3 and grade 4 was significantly higher than that of patients without OSA（χ2=6.735, P=0.009）. Conclusion The prevalence of concomitant OSA was markedly higher among individuals with KC than in the general population. Additionally, there was a notable correlation between KC severity and OSA incidence. 
    The study of axial length-to-corneal curvature ratio （AL/CR） in the grading assessment of myopia in adolescents
    Liu Nian’en, Zhang Yue, Jia Yuanyuan, Ye Hong, Yu Xiaobing
    2026, 35(2):  143-147.  doi:10.13281/j.cnki.issn.1004-4469.2026.02.011
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     Objective To investigate the differential characteristics of AL/CR（axial length/corneal radius） in adolescents with different degrees of myopia, to evaluate its utility as an auxiliary tool for screening myopia severity under non-cycloplegic conditions, and to explore its correlation with spherical equivalent (SE) and the optimal diagnostic threshold for screening. Design Cross-sectional study. Participants Include a total of 5779 adolescents aged 7~15 years in Beijing with low myopia （-1.00≥SE>-3.00 D）, moderate myopia （-3.00≥SE>-6.00 D）, and high myopia (≤-6.00 D). Methods AL and CR were measured and AL/CR was calculated. The differences between groups were compared by analysis of variance, and the strength of association of AL/CR with SE was clarified by Pearson's correlation analysis, and the receiver operating characteristic (ROC) curve and area under the curve (AUC) were used to evaluate the sensitivity, specificity, and optimal cutoff value of AL/CR for diagnosing different degrees of myopia. Main Outcome Measures AL, CR, AL/CR, AUC. Results With the increase of myopia, AL increased from (24.18±0.90) mm to (26.26±1.12) mm (P<0.001), and AL/CR increased from 3.08±0.10 to 3.39±0.16 (P<0.001). AL/CR showed a significant negative correlation with SE (r=-0.363 in the low myopia group, r=-0.466 in the moderate myopia group, r=-0.395 in the high myopia group, all P<0.001). The ROC curve analysis showed that AL/CR had good diagnostic efficacy for low myopia (AUC=0.885), moderate myopia (AUC=0.806), and high myopia (AUC=0.924), with the best results in the high myopia group. The optimal cutoff values for AL/CR were 3.178 for low myopia, 3.161 for moderate myopia, and 3.264 for high myopia, respectively. Conclusions The AL/CR ratio increases significantly with the severity of myopia in adolescents and exhibits a strong negative correlation with SE. AL/CR provides effective diagnostic performance for low, moderate, and high myopia (particularly high myopia) under non-dilated conditions.
    Observation of the 4-year changes in refractive status of school-age children in Urumqi region
    Wei Bixia, An Xin, Lou Hongyan, Liu Xiaodi, Liu Liming, Ding Lin
    2026, 35(2):  148-153.  doi:10.13281/j.cnki.issn.1004-4469.2026.02.012
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     Objective To analyze the changes in refractive status among children in the Urumqi region and to explore the characteristics of refractive status across different ethnic groups and genders. Design Prospective cohort study. Participants A cluster sampling method was used to select 1151 first-grade children aged 6 to 8 from five primary schools in Urumqi as study subjects. Among them, there were 913 children of Han nationality and 238 non-Han children, including the Uyghur, Kazakh, Hui and other ethic groups. The sample included 607 males and 544 females. Methods All participants underwent non-cycloplegic autorefraction for both eyes to calculate spherical equivalent refraction (SE). Axial length (AL) and corneal curvature (K) were measured using optical biometry, and further calculation was performed to obtain corneal radius of curvature (CR) and the AL to CR ratio (AL/CR). Myopia was defined as SE≤-0.50 D, and anisometropia as an interocular SE difference ≥ 1.0 D. The cohort was followed up for 4 years to analyze trends and differences across ethnic groups and genders. Main Outcome Measures SE, AL/CR, myopia prevalence, anisometropia prevalence, Odds Ratios (OR). Results At baseline, the average age of the study subjects was (7.01±0.43) years, with 79.3% being of Han nationality and 52.7% being male. The overall myopia rate increased from 25.1% to 61.8% over 4 years, with the myopia rate among Han children rising from 26.0% to 64.3%, a higher increase than that observed among non-Han children, whose rate rose from 21.8% to 51.7% (P=0.001). The overall SE decreased from (-0.08±1.07) D to (-1.33±1.87) D, with the SE among Han children decreasing from (-0.11±1.10) D to (-1.45±1.93) D, a larger decrease than that observed among non-Han children, whose SE changed from (0.06±0.93) D to (-0.87±1.57) D (P<0.001). The rate of anisometropia increased from 10.0% to 21.2%, and from grades 3 to 5, the rate of anisometropia among Han children (13.5%, 20.7%, 22.8%) was significantly higher than that among non-Han children (8.1%, 11.7%, 14.9%) (P=0.033, 0.003, 0.014). Risk factor analysis indicated that Han nationality (OR=2.155) and a higher AL/CR (OR=2.106) were independent risk factors for new-onset myopia, while non-Han nationality (OR=0.522), male sex (OR=0.631), and a higher baseline SE (OR=0.489) had protective effects. Conclusion Four years of follow-up observation have shown that the prevalence of myopia among children in the Urumqi region increases rapidly with age. Han Chinese children face a higher risk of developing both myopia and anisometropia. The AL/CR is a significant biological indicator in predicting the onset of myopia. Han and non-Han children exhibit distinct developmental patterns in these conditions.
    Systematic review of risk prediction models for myopia-related fundus lesions
    Yin Hang, Yu Jia, Ma Zhangfang, Li Yue, Yuan Yan, Fu Yuqing, Song Wei
    2026, 35(2):  156-161.  doi:10.13281/j.cnki.issn.1004-4469.2026.02.013
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     Objective Systematic review of risk prediction models for fundus lesions in myopic patients.Design Systematic review. Participants Literature on risk prediction model of myopia-related fundus lesions. Methods A computerized search was conducted in CNKI, Wanfang Data, CBM, PubMed, Web of Science, Embase, CINAHL, and the Cochrane Library for studies related to prediction models of fundus lesions in myopic patients, covering the period from database inception to August 2025. Data were extracted from the CHARMS list, and the PROBAST tool was used to assess the risk of bias and suitability of the study. If any one of the four items, namely study subjects, predictors, outcomes, and statistical analysis, was rated as "high risk", then the model was considered to be at "high risk". If one or more of the three items, study subjects, predictors, and outcomes, are rated as "No" or "Possibly No", then the model was at high risk in terms of applicability. The area under the working characteristic curve (AUC) of the subjects was used to evaluate the model differentiation with reference to general empirical criteria. AUC≥0.70 was considered an acceptable degree of discrimination. Extract and record the validation type (internal/external validation) of the model, and summarize the most important predictors. Main Outcome Measures Model performance, predictors, validation, bias risk and applicability of the model were analyzed. Results A total of 10 studies involving 24 models were included. The models demonstrated acceptable discrimination (AUC: 0.73~0.95). However, only five studies underwent both internal and external validation, indicating insufficient independent validation. Based on the PROBAST tool evaluation, 7 studies were rated as high risk of bias due to single-center small sample size and incomplete measurement procedures for predictors, and 6 studies were rated as high applicability risk because they rely on specific techniques or equipment that were difficult to popularize in clinical practice. Key predictors included axial length, refractive error, age, retinal and choroidal thickness, ocular complications, and laboratory inflammatory markers. Conclusions Most of the existing 10 risk prediction models for myopia-related fundus lesions demonstrate good discriminative power, but over half exhibit high bias risks, and half lack external validation with suboptimal methodological quality. These models are not recommended for direct application in routine clinical decision-making.
    Exploration of CBL based TBL teaching model in ophthalmology teaching
    Zheng Xinbao, Yang Aiping, Chen Jiayu, Xia Jing, Wei Jiahong, Zhao Yongwang
    2026, 35(2):  162-167.  doi:10.13281/j.cnki.issn.1004-4469.2026.02.014
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     Objective  To explore the application value of case-based learning (CBL) combined with team-based learning (TBL) teaching model in ophthalmology teaching. Design  Teaching research. Participants Two classes of five-year program undergraduate students majoring in clinical medicine, with a total of 89 students, who participated in clinical probation at Songjiang Hospital Affiliated to Shanghai Jiao Tong University School of Medicine in 2023. Methods The control group (44 students) adopted TBL alone, while the experimental group (45 students) adopted the CBL-TBL integrated teaching model. Teaching effectiveness was comprehensively evaluated through multi-dimensional indicators, with specific assessment methods detailed as follows: Phased tests (100-point scale): conducted monthly for 3 consecutive times (Phased test Ⅰ, Ⅱ, Ⅲ), with the score calculated as the average of the three tests. Each test included two components: a closed-book basic theory test (individual assessment), covering question types such as term explanation and multiple-choice questions; and a practical application ability test (group assessment), focusing on teamwork performance and knowledge application capacity. Questionnaire survey: scoring was carried out from three dimensions, namely students' satisfaction with teaching, self-evaluation of learning outcomes, and teachers' satisfaction with teaching. Final overall score (100-point scale): calculated via a weighted conversion mechanism, where stage test scores accounted for 20%, final theory scores accounted for 60%, and questionnaire survey scores accounted for 20%. Main Outcome Measures  Scores of Phased test Ⅰ, Ⅱ, Ⅲ, final theory scores, score of the teaching effectiveness questionnaire, and final total score. Results No statistically significant difference was observed in the score of Phased test Ⅰ between the two groups (88.02±6.01 vs. 87.11±5.44, t=0.746，P=0.457). The scores of Phased test Ⅱ (91.24±4.58 vs. 87.91±6.10), Phased test Ⅲ (92.02±4.14 vs. 88.09±6.36) and final theory score (92.66±3.89 vs. 88.34±5.55) of the experimental group were significantly higher than those of the control group (t=2.920, 3.460, 4.218; all P<0.05). At the end of the semester, there were no statistically significant differences between the two groups in terms of students' satisfaction with teaching methods, learning interest, learning efficiency, self-learning ability, team cooperation ability, language communication ability, literature reading ability, PPT-making ability, and the degree of emotional improvement among students (all P>0.05). Nevertheless, the experimental group outperformed the control group in clinical thinking ability, ability to integrate theory with practice, and the possibility of choosing ophthalmology as a specialty after graduation (all P<0.05). No statistically significant differences were found between the two groups in teachers' satisfaction with teaching methods, satisfaction of other teachers with teaching methods, rationality of teaching design, and ideological and political education effectiveness. As for the evaluation of teaching effectiveness (final total score), the experimental group achieved a significantly higher score than the control group (91.91±4.30 vs. 87.82±6.31, t=3.578, P＜0.001). Conclusion The integration of CBL and TBL in undergraduate ophthalmology teaching enhances medical students' clinical reasoning and theoretical-practical application abilities, warranting wider implementation.
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