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    Analysis of the prognosis of visual function in blinding neuromyelitis optica spectrum disorders associated with optic neuritis
    Yang Qinglin, Sun Houliang, Meng Chao, Wang Jiawei
    Ophthalmology in China    2023, 32 (5): 392-396.   DOI: 10.13281/j.cnki.issn.1004-4469.2023.05.006
    Abstract780)            Save
     Objective To analyze the clinical and immunological features of blinding neuromyelitis optica spectrum disorders associated optic neuritis, and to explore the predictive factors of visual function prognosis. Design Retrospective case series. Participants Patients with blinding neuromyelitis optica spectrum disorders related optic neuritis admitted to our department from 2018 to 2022 were enrolled. Methods The patients were divided into poor prognosis group (27 cases) and good prognosis group (18 cases). The demographic characteristics, symptoms, laboratory and imaging examinations, treatment methods, and visual acuity improvement at 6 months after treatment were compared between the two groups. Main Outcome Measures Clinical features, visual acuity improvement. Results In the poor prognosis group, the proportion of patients with optic nerve involvement longer than half was higher (P=0.009), the positive rate of serum immune antibody was lower (P=0.028), and the time from onset to methylprednisolone pulse therapy was longer (P=0.032). Logistic regression showed that the length of optic nerve involvement greater than 1/2 (OR=16.247, 95%CI: 10.834-24.363, P<0.01), serological immune antibody negative (OR=13.965, 95%CI: 9.465-20.603, P<0.01), the time from onset of methylprednisolone pulse therapy (OR=1.107, 95%CI: 1.075-1.139, P<0.01) were the risk factors for poor prognosis. ROC curve analysis showed that the area under the ROC curve (AUC) for predicting poor prognosis was 0.794 (P=0.001, 95%CI: 0.659-0.928) when the time from onset was more than 7 days. Conclusions The prognosis of blinding neuromyelitis optica spectrum disorders associated with optic neuritis is poor, and the duration of methylprednisolone pulse therapy is closely related to the prognosis. (Ophthalmol CHN, 2023, 32: 392-396)
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    The ocular manifestations of patients with neurofibromatosis type 1
    Liang Xiaofang, Wang Kaiyue, Yang Liu, Zhang Xuxiang
    Ophthalmology in China    2023, 32 (5): 421-424.   DOI: 10.13281/j.cnki.issn.1004-4469.2023.05.011
    Abstract692)            Save
     Objective To investigate the ocular clinical manifestations of patients with neurofibromatosis type 1 (NF1). Design Retrospective case series. Participants 17 cases (34 eyes) of NF1 in Beijing Tiantan Hospital from October 2021 to February 2022. Methods Clinical data of 17 patients diagnosed with NF1 were retrospectively analyzed. All patients underwent detailed ophthalmic examination and related general check-up. Main outcome measures The incidence of iris hamartoma and ocular and systemic related clinical manifestations. Results 17 patients ranged in age from 10 to 52 years were enrolled in this study, including 9 males (18 eyes) and 8 females (16 eyes). The best corrected vision acuities were from no light perception to 1.2. The intraocular pressures of all patients were normal. 11 patients (64.7%) suffered iris hamartomatain of both eyes, presenting as light brown to dark brown slightly raised nodules with clear boundaries, and ranged in number from 3 to 25, with diameters ranging from 0.5 mm to 1.5 mm. Their positions ranged from close to the pupil margin to any part of the iris, 73.3% distributed on inferior part of the iris. One patient suffered eyelid and orbital plexiform neurofibroma and one patient suffered choroidal abnormalities. The systemic manifestations also included milk coffee spots and neurofibroma of multiple types, and 12 cases combined with axillary groin freckles. Conclusion We found that 65% of patients presented with iris hamartoma of both eyes, which was manifested as brown micro-raised nodules of varying size and number. Iris hamartoma is one of the most important clinical manifestations of NF1, and this study provides a reference for clinicians to fully understand NF1 and determine the disease condition and classification. (Ophthalmol CHN, 2023, 32: 421-424)
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    Ocular metastatic carcinoma
    Zhu Yu, Li Yanyan
    Ophthalmology in China    2023, 32 (5): 381-386.   DOI: 10.13281/j.cnki.issn.1004-4469.2023.05.004
    Abstract659)      PDF(pc) (1216KB)(1650)       Save
     With the aging of society and the improvement of medical level, the number of people with tumor in society is increasing, and the number of patients with ocular metastatic cancer is also increasing, and 30% to 50% of the patients have the primary tumor site detected after the first symptom of the eye. Therefore, for middle-aged and elderly people, the ocular space-occupying lesion should be analyzed whether it is the primary tumor or metastatic cancer, and the cause should be found as soon as possible for the corresponding treatment. This article introduces the common primary foci, clinical manifestations and imaging features of the choroidal and orbital metastases, the diagnostic procedures, treatment methods and prognosis of ocular metastases. (Ophthalmol CHN, 2023, 32: 381-386
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    Clinical study on the effects of posterior corneal astigmatism (PA) on Toric intraocular lens (IOLs) cylinder calculation 
    Jin Tianru, Li Jingjing, Yu Lan, Zhou Yanwen
    Ophthalmology in China    2023, 32 (5): 397-402.   DOI: 10.13281/j.cnki.issn.1004-4469.2023.05.007
    Abstract645)            Save
     Objective To assess the effects of selecting keratometer astigmatism (KA) or total corneal astigmatism (TCA) as a reference on toric IOL calculation among subjects with age-related cataract and high posterior corneal astigmatism (PA). Design A retrospective comparative case series. Participants The present study included 77 eyes with against the role astigmatism (ATR) from age-related cataract patients and measured PA of more than 0.5 D in Aier Eye Hospital (Shenyang) from June 2017 to December 2021. Method The subjects were randomly divided into the KA and TCA groups and each group selected KA and TCA for toric IOL cylinder power calculations with Alcon Acrysoft Toric online calculator (https://www.acrysoftoriccalculator.com/). Holladay formula was choose to calculate the IOL cylinder power by using TCA and Barrett formula was choose to calculate the IOL cylinder power by using KA. Main Outcome Measures The uncorrected visual acuity (UCVA), best-corrected visual acuity (BCVA), subjective refraction, magnitude of error (ME) and correction index (CI) and the centroid error in predicted residual astigmatism in two groups. Results The postoperative UCVA in the KA and TCA groups were 0.14±0.80 logMAR and 0.15±0.72 logMAR, respectively, whereas the difference between the two groups was not statistically significant(t=0.79, P=0.718). The subjective refraction stigmatism value in the KA group was similar to that noted in the TCA group (KA group: -0.27±0.92 D, TCA group: -0.40±0.64 D, t=-0.55, P=0.582). The ME value was 0.33±0.33 D in the KA group and -0.22±0.52 D in the TCA group, suggesting postoperative undercorrection in KA group and overcorrection in TCA group. The absolute ME values of the two groups were not statistically significant (t=-0.46, P=0.542). According to the double-angle plot, the postoperative refractive prediction errors were 0.49±0.56 at 175° and 0.13±0.71 at 10°. The postoperative refractive astigmatism prediction error in KA group (48%) was similar with TCA group (43%) in <0.5 D. Conclusions In the eyes of high PA, the choice of TCA for Toric IOL lens calculation will lead to mild overcorrection and postoperative with the role astigmatism, which is an ideal refractive state. (Ophthalmol CHN, 2023, 32: 397-402)
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    Establishment of immortalized human scleral fibroblast cell line
    Li Jiaying, Li Peng, Cheng Zhen, Wang Wenbin, Li Shiming, Tian Jiaxin, Qi Yue, Qian Yuyang, Liu Zihan, Wang Ningli
    Ophthalmology in China    2023, 32 (5): 387-391.   DOI: 10.13281/j.cnki.issn.1004-4469.2023.05.005
    Abstract636)            Save
     Objective To establish an immortalized human scleral fibroblast cell line and analyze the effect of immortalization using transcriptome sequencing. Design Experimental study. Participants The experimental group was immortalized human scleral fibroblasts, and the control group was primary human scleral fibroblasts. Methods Lentiviral particles were obtained by transfection of HEK293T using calcium phosphate transfection method using plasmid carrying SV40 T gene and lenti-Mix lentivirus packaging plasmid. The obtained lentiviral particles were transfected with primary cells and exposed to puromycin containing 1 μg/ml for 2 days, and the surviving cells were continued to be cultured for 25 generations to obtain immortalized human scleral fibroblast cell lines. Afterward, total RNA of primary human scleral fibroblasts and immortalized human scleral fibroblasts were extracted and sequenced to analyze the transcript characteristics of immortalized cells and primary cells. Differential genes were analyzed using the DESeq package and gene ontology (GO) analysis was performed using Clusterprofiler.  Main Outcome Measures Cell morphology, collagen-related gene expression and transcript correlation. Results Immortalized human scleral fibroblasts maintained the morphology of the primary cells and showed significantly enhanced proliferation ability and were successfully cultured for more than 20 generations. The transcriptomes of the immortalized and primary cells were highly similar, and the correlation between the two was r2=0.995 obtained by RNA sequencing. The transcriptome yielded 22903 genes and 33691 isoforms, and the eifferential gene analysis based on DESeq package revealed that 2063 (3.6%) genes were up-regulated and 2776 (4.9%) genes were down-regulated. GO functional analysis showed that the up-regulated genes were mainly clustered in DNA replication, cell division and other basic cellular metabolic activities and interactions with viruses, while the down-regulated genes were mainly enriched in extracellular matrix regulation and intercellular junction pathways. As for the extracellular matrix-related gene pathways, transcription of genes encoding collagen and fibronectin was slightly downregulated (log2 fold change=-0.4~-3.1), and COL1A1 transcription was downregulated 3.34-fold. Conclusion In this study, an immortalized human scleral fibroblast cell line was constructed by introducing SV40T exogenous gene using lentiviral transfection method, with high similarity to primary cells and good stability, which can provide sufficient research material for sclera-related experiments. (Ophthalmol CHN, 2023, 32: 387-391)
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    Anomalous posterior vitreous detachment
    Huang Houbin
    Ophthalmology in China    2023, 32 (5): 369-375.   DOI: 10.13281/j.cnki.issn.1004-4469.2023.05.002
    Abstract631)      PDF(pc) (1891KB)(1693)       Save
     Other than innocuous posterior vitreous detachment (PVD), anomalous PVD indicates partial adhesion of posterior vitreous cortex to retina inner limiting membrane, or remnants of posterior vitreous cortex on the surface of inner limiting membrane. Anomalous PVD can result in vitreoschisis, retinal breaks, etc. The residual vitreous cortex could be fibrous with few cells or cell-rich, which are highly associated with the pathogeneses of full-thickness macular hole, lamellar macular hole, pseudomacular hole and epimacular membrane. (Ophthalmol CHN, 2023, 32: 369-375)
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    Focal scleral nodules
    Ran Zhenlong, Peng Xiaoyan
    Ophthalmology in China    2023, 32 (5): 376-380.   DOI: 10.13281/j.cnki.issn.1004-4469.2023.05.003
    Abstract629)      PDF(pc) (1141KB)(2811)       Save
    Solitary idiopathic choroiditis (SIC) has been renamed as focal scleral nodule (FSN) based on multimodal imaging findings. FSN presents as yellow-white elevated nodules located between the posterior pole and the equator of the fundus. It exhibits hyperautofluorescent and hyperechogeneic characteristics. On optical coherence tomography (OCT), FSN appears as a highly reflective mass protruding inward from the sclera, and OCT angiography confirms the absence of blood flow within the lesion. FSN can remain stable over a long period without requiring treatment. But it can be misdiagnosed as amelanotic choroidal lesions, especially when there is suspicion of choroidal metastasis. Accurate identification of FSN contributes to making correct clinical decisions for ophthalmologists. This article elucidates the nomenclature process, demographic distribution, multimodal imaging features, and differential diagnosis of FSN. (Ophthalmol CHN, 2023, 32: 376-380)
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    Surgical strategy of angle closure glaucoma secondary to lens subluxation 
    Yu Xiaowei, Fan Zhigang, Shi Yan
    Ophthalmology in China    2023, 32 (5): 363-368.   DOI: 10.13281/j.cnki.issn.1004-4469.2023.05.001
    Abstract594)      PDF(pc) (1085KB)(1691)       Save
     Angle closure glaucoma (ACG) secondary to lens subluxation is a clinical problem with complex etiology. Its essential anatomic change in its pathogenesis is zonulopathies caused by various reasons. Based on the anatomical characteristics and pathophysiological functions of zonule, this article reconceptualizes the adjacent tissue complex of the zonule, and proposes that the change of pressure between the adjacent tissue complex caused by zonulopathies is the key to understand the physiological process of ACG secondary to lens subluxation. Based on the pathogenesis of various types of lens subluxation and the pathophysiological process of complex pressure change, we can understand the ocular phenotype of zonulopathy and predict its possible surgical risks. Further, we propose four modular treatment methods to make apersonalized treatment for ACG secondary to lens subluxation, including the treatment of aqueous humor countercurrent, lens extraction, maintenance of long-term stability of intraocular lens and reconstruction of angle filtration, which provides guidance for the scientific treatment strategy of this kind of refractory glaucoma. (Ophthalmol CHN, 2023, 32: 363-368)
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    Efficacy of improved pars plana vitreous drainage in the combined surgery of glaucoma and cataract for angle closure #br# glaucoma with abnormal lens suspensory ligament#br#
    Yin Ruimei, Chen Lin, Wang Tao
    Ophthalmology in China    2023, 32 (5): 403-408.   DOI: 10.13281/j.cnki.issn.1004-4469.2023.05.008
    Abstract588)            Save
    Objective To analyze the therapeutic effect of improved pars plana vitreous drainage in the combined surgery of glaucoma and cataract for angle closure glaucoma with abnormal lens suspensory ligament. Design Retrospective case series. Participants 18 patients (18 eyes) with angle closure glaucoma with abnormal lens suspension ligament were reviewed from January 2021 to February 2023 in Beijing Tongren Hospital. Methods All patients were treated with improved pars plana vitreous drainage, phacoemulsification and cataract extraction. All patients were implanted with intraocular lens (IOL) in the bag at the first stage. All patients were treated with wide base peripheral iridectomy. 11 patients were implanted with capsular tension ring, 5 patients with trabeculectomy, and 3 patients with ciliary body photocoagulation under endoscope. The average postoperative follow-up was (8.3±3.6) months. Main Outcome Measures Anterior chamber depth (ACD), visual acuity (VA), intraocular pressure (IOP), number of anti glaucoma drugs used, and surgical complications. Result At the last follow-up, all patients' VA improved compared to before surgery, with an average improvement of (3.7±2.2) lines on the standard VA chart. 16/18 eyes maintained 7~21 mmHg without the use of IOP lowering drugs and 2/18 eyes maintained normal IOP 6 months after surgery with the addition of a local IOP lowering drug. After the improved pars plana vitreous drainage, all patients had a decrease in IOP during surgery, and the ACD deepened compared to before drainage. No serious complications occurred during or after the surgery in all patients. Conclusion The improved pars plana vitreous drainage is a safe and effective method for the combined surgery of glaucoma and cataract in the treatment of angle closure glaucoma with abnormal lens suspensory ligament. (Ophthalmol CHN, 2023, 32: 403-408)
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    Ophthalmology in China    2023, 32 (5): 430-430.   DOI: 10.13281/j.cnki.issn.1004-4469.2023.05.013
    Abstract587)      PDF(pc) (218KB)(1616)       Save
    剥脱性青光眼;房角镜辅助360°小梁切开术 
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    Clinical features and etiological analysis of candida keratitis 
    Wang Zhiqun, Deng Shijing, Zhang Yang, Liang Qingfeng, Chen Kexin, Sun Xuguang
    Ophthalmology in China    2023, 32 (5): 416-420.   DOI: 10.13281/j.cnki.issn.1004-4469.2023.05.010
    Abstract562)            Save
     Objective To analyze the clinical and etiological characteristics of candida keratitis. Design Retrospective case series. Participants 18 patients (18 eyes) diagnosed with candida keratitis in the Beijing Tongren Hospital from January 2016 to December 2018 were enrolled. Methods Patient's medical records were reviewed. Clinical data was collected and the characteristics were observed by stages according to the severity. Corneal scraping, fungal culture or in vivo confocal microscopy was performed. Main Outcome Measures Clinical characteristics by stages, corneal scraping, fungal culture and identification of isolated strains, drug sensitivity results and result of laser confocal microscopy. Results 11 of the 18 (61.11%) patients had history of viral keratitis with long-term antiviral treatment. Of all the 11patients, 8 cases were combined with corticosteroids therapy and 3 cases were diabetes mellitus. 7/18 cases(38.89%) were in early stage with epithelial defect and multiple localized grey colonies like infiltration in epithelium and superficial stroma. 5/18 cases(27.78%) were in advanced stage with progressed infiltration and stromal ulcer, some were accompanied with hypopyon. 6/18 cases(33.33%) were in late stage, corneal ulcer enlarged and infiltration intensified, the edge of the ulcer became thinner and sulcus dissolved, often accompanied by hypopyon. 14 of the 18 patients were examined by confocal microscopy. Fungal spores were found in 13 patients and pseudohypha was found in 6 patients. Yeast-like fungi and / or pseudohyphae were detected in 11 cases (61.11%). 17 cases underwent fungal culture, 10 cases (58.82%) were Candida albicans, and 3 cases (17.64%) were Candida glabrata. The drug sensitivity of the isolated strains was more than 88.24%, and 100% to the voriconazole and amphotericin B. Conclusion Candida keratitis is more common in chronic recurrent viral keratitis patients. Clinical characteristics are aggravated colony like infiltrates and ulcer with hypopyon in severe cases. Corneal scraping, fungal culture combined with laser confocal microscopy can improve the diagnosis,and the main pathogen is Candida albicans and sensitive to voriconazole and Amphotericin B. (Ophthalmol CHN, 2023, 32: 416-420)
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    Assessment of ocular torsion in patients with intermittent exotropia
    Liu Peipei, Dai Wei, Fu Jing
    Ophthalmology in China    2023, 32 (5): 425-429.   DOI: 10.13281/j.cnki.issn.1004-4469.2023.05.012
    Abstract552)            Save
     Objective To evaluate the distribution of ocular torsion in intermittently exotropic patients. Design Retrospective case series. Participants 108 patients with intermittent exotropia aged 5~16 years presented from October 2021 to July 2022, and 108 patients without strabismus were collected as the control group in Beijing Tongren Hospital. Method All subjects underwent non-mydriatic fundus photography. The disc-foveal angle (DFA) was measured using Image J software. Photographs of the fundus were classified as normal (no torsion) when the fovea lay between the center and the inferior margin of the optic disc. There was an intorsion when the fovea was above the disc center. Extorsion when the fovea was situated below its inferior margin. The correlation between DFA and the Revised Newcastle Control Score (RNCS) and strabismus angle, stereoacuity was analyzed. Main Outcome Measures DFA, ocular torsion and correlation with RNCS, strabismus angle, and stereopsis. Results The mean DFA in the intermittent exotropia group was significantly greater than that in the normal control group (6.17°± 3.18 °; 5.36 °± 2.50°, respectively, P=0.003), and the incidence of ocular torsion (extorsion or intorsion) in the intermittent exotropia group was significantly higher than that in the control group (33 eyes, 15.28%; 14 eyes, 6.48%, P=0.003). DFA size has significant positive correlation with RNCS, strabismus angle and stereoacuity in patients with intermittent exotropia (r=0.634, P<0.001; r=0.353, P<0.001; r=0.370, P<0.001; r=0.271, P=0.005). Conclusion Intermittent exotropia patients exist more obvious the ocular torsion when their control scores were poor, their strabismus angles were larger, and their stereoacuities were poorer. (Ophthalmol CHN, 2023, 32: 425-429)
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    Ophthalmology in China    2023, 32 (5): 443-443.   DOI: 10.13281/j.cnki.issn.1004-4469.2023.05.020
    Abstract515)      PDF(pc) (164KB)(1529)       Save
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    Ophthalmology in China    2023, 32 (5): 445-446.   DOI: 10.13281/j.cnki.issn.1004-4469.2023.05.022
    Abstract501)      PDF(pc) (368KB)(1515)       Save
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    Association study of serumcarotenoids with retinal vessel caliber in type 2 diabetic patients
    She Chongyang, Shen Zhijun, Li Yunyun, Cui Min, Liu Ningpu
    Ophthalmology in China    2023, 32 (5): 409-415.   DOI: 10.13281/j.cnki.issn.1004-4469.2023.05.009
    Abstract485)            Save
     Objective To observe the association between serum carotenoid level and retinal vessel caliber in type 2 diabetic patients. Design Cross-sectional study.  Participants A total of 462 subjects with type 2 diabetes mellitus (T2DM) from the Desheng Diabetic Eye Study were enrolled in this study. Methods 21 subjects were excluded according to the inclusion and exclusion criteria. 189 patients with diabetes without retinopathy (DWR) and 252 patients with mild to moderate non proliferative diabetic retinopathy (NPDR) were included. Demographic and lifestyle characteristics were collected through questionnaires. All subjects underwent general physical and ophthalmic examinations. Serum carotenoid levels were detected by high performance liquid chromatography. The calibers of retinal vessels, including central retinal arteriolar equivalent (CRAE), central retinal vein equivalent (CRVE) and arteriovenous ratio (AVR), were measured by semi-automatic software. Variables of the two groups were compared. Multivariate Logistic regression analysis was used to analyze the association of serum carotenoid level with retinal vessel caliber. Main Outcome Measures CRAE, CRVE, AVR, serumcarotenoids level. Results The CRAE was 150.8±16.0 μm in DWR group and 149.9±14.4 μm in mild and moderate NPDR group (t=0.58, P=0.56). The CRVE was 220.9±22.2 μm in DWR group and 230.3±25.1 μm in mild and moderate NPDR group (t=3.97, P<0.001). The AVR were 0.68±0.06 in DWR group and 0.65±0.06 in mild and moderate NPDR group (t=4.85, P<0.001). After adjusting for other risk factors, serum zeaxanthin was positively associated with CRVE in DWR group (OR=4.03, 95%CI: 1.40, 19.62, P=0.01), and lycopene was positively associated with CRVE in mild and moderate NPDR group (OR=1.01, 95%CI: 1.0002, 1.02, P=0.01). Conclusions The CRVE of NPDR patients was significantly wider and the AVR was significantly lower than those of DWR subjects. Higher levels of serum zeaxanthin and lycopene were associated with wider CRVE. (Ophthalmol CHN, 2023, 32: 409-415)
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    The impact of swept-source optical coherence tomography (SS-OCT) development on clinical practice of fundus diseases
    Peng Xiaoyan, Zhang Zhihan
    Ophthalmology in China    2023, 32 (6): 451-453.   DOI: 10.13281/j.cnki.issn.1004-4469.2023.06.001
    Abstract477)      PDF(pc) (840KB)(1294)       Save
    Swept-source optical coherence tomography (SS-OCT) and Swept-source optical coherence tomography angiography (SS-OCTA), compared to traditional spectral-Domain OCT/OCTA, have several technical advantages such as longer wavelength, deeper scanning depth, faster scanning speed, and shorter image acquisition time. These advancements allow clear imaging of various layers of tissues from the vitreous to the sclera, and enable wide-angle imaging of retinal and choroidal vasculature. Clinical practitioners need to focus on harnessing the rich information provided by SS-OCT/SS-OCTA technology (including more accurate choroidal thickness measurements, clearer observation of choroidal vascular and stromal-dominant lesions, and easier differentiation between choroidal and scleral diseases) to improve the clinical diagnostic and treatment processes, thus effectively enhancing clinical service capabilities. It is crucial to move beyond solely observing imaging features and actively integrate these advancements into clinical practice. (Ophthalmol CHN, 2023, 32: 451-453)
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    Ophthalmology in China    2023, 32 (6): 524-525.   DOI: 10.13281/j.cnki.issn.1004-4469.2023.06.017
    Abstract473)            Save
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    Ophthalmology in China    2023, 32 (5): 380-380.   DOI: 10.13281/j.cnki.issn.1004-4469.2023.05.027
    Abstract462)      PDF(pc) (286KB)(1579)       Save
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    Ophthalmology in China    2023, 32 (6): 526-528.  
    Abstract454)            Save
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    Ophthalmology in China    2023, 32 (6): 515-515.   DOI: 10.13281/j.cnki.issn.1004-4469.2023.06.020
    Abstract443)            Save
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    Comparative study on the measurements of biological parameters of anterior segment by two anterior segment  analyzers: Scansys and Pentacam
    Liu Yin, Jiang Wenshan
    Ophthalmology in China    2023, 32 (6): 502-508.   DOI: 10.13281/j.cnki.issn.1004-4469.2023.06.010
    Abstract443)            Save
     Objective To evaluate the difference and consistency of biological parameters of anterior segment measured by two anterior segment analyzers: Scansys and Pentacam. Design Consistency evaluation study. Participants Randomly select 158 initial visit patients (158 eyes) who received myopia surgery at General Hospital of Central Theater Command in August 2022. The comparison will be based on the right eye. Methods The  anterior segment biometric parameters were measured using both Scansys and Pentacam anterior segment analyzers by the same physician. The differences and agreements in the anterior segment biometric parameters were evaluated using the Bland-Altman method, while the comparison of corneal astigmatism (CA) was performed using vector analysis. Main Outcome Measures Parameters of anterior segment, including K1, K2, Km, Rm, CA, central corneal thickness (CCT), anterior chamber depth (ACD), corneal diameter (WTW), pupil diameter (PD), anterior chamber volume (ACV), anterior chamber angle (ACA). Results Compared to Pentacam, Scansys measured smaller values for K1, K2, Km, CCT, ACD, WTW, and ACV, while Rm, PD, and ACA were  larger. The differences between the two instruments in measuring K1, K2, Km, Rm, CCT, ACD, WTW, PD, ACV, and ACA were (-0.12±0.19)D, (-0.15±0.20)D, (-0.13±0.16)D, (0.03±0.03)mm, (-17±7.0)μm, (-0.04±0.18)mm, (-0.36±0.14)mm, (0.36±0.45)mm, (-21±20)mm3, and (3.5±4.8)°, respectively. The 95% limits of agreement (95% LoA) were (-0.48~0.25)D , (-0.54~0.24) D, (-0.45~0.18) D, (-0.03~0.08)mm, (-31~-3.5)μm, (-0.38~0.30)mm, (-0.64~-0.08)mm, (-0.52~1.2)mm, (-61~19)mm3, and (-6~13)°, with 94.3%, 95.6%, 95.6%, 93.0%, 98.1%, 94.9%, 96.2%, 96.2%, 95.6% and 98.1% of the data falling within the confidence intervals. There were some differences in CA measurements between the two instruments, with a 95% LoA ranging from -0.51~0.44 D, and the Bland-Altman plot showing that 94.9% of the data fell within the confidence interval. The vector analysis results showed that on the anterior corneal surface, the horizontal and vertical astigmatism values measured by Pentacam were approximately 0.04 D higher than those measured by Scansys, while the 45° axis astigmatism value measured by Pentacam was approximately 0.10 D lower than that measured by Scansys. The total refractive power measured by Pentacam was approximately 0.30 D higher than that measured by Scansys. Conclusion Scansys has a good consistency with Pentacam on the measurement of K2, Km, CCT, WTW, PD, ACV and ACA. However, in the measurement of K1, Rm, ACD and CA, there are significantly differences between Scansys and Pentacam, which should be comprehensively analyzed combined with more examination results in the application of different refractive surgeries. (Ophthalmol CHN, 2023, 32: 502-508)
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    Ophthalmology in China    2023, 32 (5): 415-415.   DOI: 10.13281/j.cnki.issn.1004-4469.2023.05.029
    Abstract439)      PDF(pc) (205KB)(1585)       Save
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    Re-illuminating photophobia
    Huang Houbin
    Ophthalmology in China    2023, 32 (6): 454-461.   DOI: 10.13281/j.cnki.issn.1004-4469.2023.06.002
    Abstract433)      PDF(pc) (1985KB)(1307)       Save
    As a common symptom, photophobia is usually refereed to ocular surface diseases. In fact, it is also manifested in ocular fundus diseases, neuropathy and a certain of systemic disorders. This review re-illuminates in detail the history, definition, etiology of photophobia, especially pays attention to the up-to-date pathogenesis of photophobia resulted from various diseases and the neural circuits. If a patient complains photophobia without evident causes, retinopathies and optic neuropathies should be considered, especially when vision decrease is associated. (Ophthalmol CHN, 2023, 32: 454-461)
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    Ophthalmology in China    2023, 32 (5): 368-368.   DOI: 10.13281/j.cnki.issn.1004-4469.2023.05.026
    Abstract432)      PDF(pc) (234KB)(1576)       Save
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    Ophthalmology in China    2023, 32 (5): 444-445.   DOI: 10.13281/j.cnki.issn.1004-4469.2023.05.021
    Abstract432)      PDF(pc) (468KB)(1465)       Save
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    The effect of shallow chamber depth on the prediction error of different intraocular lens calculation formulas 
    Xian Jinzhui, Guo Juan, Zou Yanhong
    Ophthalmology in China    2023, 32 (6): 483-487.   DOI: 10.13281/j.cnki.issn.1004-4469.2023.06.006
    Abstract430)            Save
    Objective To investigate the effect of shallow aqueous depth (AD) on the prediction error of four different intraocular lens (IOL) calculation formulas. Design Retrospective observational study. Participants A total of 176 cataract patients (176 eyes) who had cataract surgery with single focus IOL in-the-bag implantation from the First Hospital of Tsinghua University from Jan 1st, 2019 to Dec. 31th, 2021. Methods Axial length (AL), corneal curvature and AD were measured before operation. Patients were divided into shallow AD group (AD<2.5 mm) and non-shallow AD group (AD≥2.5 mm) according to AD. And the shallow AD group was further divided into short AL (AL<22.0 mm) and normal AL (AL≥22.0 mm) subgroups. Manifest refraction results were collected 1 to 3 months after operation to calculate the postoperative prediction errors of SRK/T, Hoffer Q, Haigis and Barrett formulas. Main Outcome Measures The prediction error (PE) and absolute prediction error (AE) of IOL values after operation. Results The difference of PE of 4 formulas was statistically significant (P<0.001) in the shallow AD group, while not in the non-shallow AD group (P=0.438). In the shallow AD group,the PE of Haigis (0.00±0.41) D and Barrett (0.04±0.41) D were smaller than that of SRK/T (-0.18±0.45) D and Hoffer Q (-0.21±0.41) D (P<0.05), there were no significant difference in the PE between Haigis and Barrett (P=0.614). In the shallow AD short AL group, the PE of SRK/T (-0.41±0.56) D and Hoffer Q (-0.45±0.44) D tended towards nearly a 0.50 D myopic shift which was statistically different from Haigis [(0.05±0.42) D, P<0.05]. Compared with itself, the PE of SRK/T and Hoffer Q tended towards a myopic shift under the influence of shallow AD [P(SRK/T) =0.031, P(Hoffer Q) <0.001]. There was no significant difference in the AE of different formulas within the group (the shallow AD group, P=0.393, and non-shallow AD group, P=0.369) nor between (P>0.05). In the shallow AD group, AE of SRK/T (P=0.044) and Hoffer Q (P=0.02) was statistically bigger in the short AL group. In the shallow AD short AL group, the percentage of AE within 0.50 D was 90% of Haigis, and only 50% of Hoffer Q without statistically difference (P=0.098). Through Logistic regression analysis, only SRK/T was found a greater possibility to get a >0.50 D AE with a steeper cornea (OR 1.71), a longer AL (OR 2.03) and a shallower AD (OR 0.327). Conclusions In patients with shallow AD, Haigis and Barrett formulas had more accurate predictions than SRK/T and Hoffer Q formulas. These two formulas were recommended in clinical practice. (Ophthalmol CHN, 2023, 32: 483-487)
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    A study on histocompatibility between a new type of endotamponade hydrogel substitute and Müller cells of human retina in vitro
    Gou Yueqin, Ran Ruijin, Tao Mengying, Zhang Ming
    Ophthalmology in China    2023, 32 (6): 509-515.   DOI: 10.13281/j.cnki.issn.1004-4469.2023.06.011
    Abstract428)            Save
    Objective To investigate the histocompatibility between a new type of endotamponade hydrogel substitute and human retinal Müller cells in vitro. Design Experiment study. Participants Human retinal Müller cell line (MIO-M1). Methods Human retinal Müller cells were passaged and cultured until stable growth, and then divided into three groups, which were respectively treated with a certain concentration of balanced salt solution (BSS), new type of Hydrogel extract, and perfluorocarbon liquid (PFCL) for cultivation. The morphology of cells in each group was observed after 24 h. The cells were cultured for 1 h, 4 h, 12 h, 24 h, 48 h, and 72 h, respectively. The cell viability was measured using MTT assay at different time points. Flow cytometry was used to detect the cell apoptosis, and the concentration of IL (interleukin)-6 in the supernatant was measured using ELISA at different time points. Meanwhile, expression of intracellular reactive oxygen species (ROS) was identified by immunofluorescence after 24 h of culture. Main Outcomes Measures Cell morphology, cell viability, IL-6 concentration, cell apoptosis rate, ROS concentration. Results After co-culturing the new hydrogel extract and Müller cells for 72 h, compared with the group of BSS, there was no decrease in cell viability or cell survival rate, no significant change in cell morphology, no significant increase in the secretion level of IL-6 and intracellular ROS after 24 h. In addition, compared with the group of BSS, after co-culturing PFCL and Müller cells for 12 h, the secretion level of IL-6 was increased (P=0.0105), the cell viability started to decrease after 24 h (P=0.0147), and the cells in contact with PFCL shrank, the number of the cells decreased, and the arrangement of cells was loose. Meanwhile, the analysis of apoptosis at different time points showed that the late apoptosis and necrosis rate of Müller cells increased after 24 h (P=0.0201). The level of intracellular ROS significantly increased after 24 h(P<0.0001). Conclusions The new type of endotamponade hydrogel substitute has good histocompatibility with human retinal Müller cells in 72 h. Exposing Müller cells to PFCL for 12 h can increase the secretion level of IL-6. After 24 hours, the cell viability decreased and the level of apoptosis increased, which may be related to the oxidative stress mechanism activated by ROS in cells. (Ophthalmol CHN, 2023, 32: 509-515)
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    Ophthalmology in China    2023, 32 (5): 440-441.   DOI: 10.13281/j.cnki.issn.1004-4469.2023.05.018
    Abstract427)      PDF(pc) (569KB)(1526)       Save
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    Ophthalmology in China    2023, 32 (5): 408-.   DOI: 10.13281/j.cnki.issn.1004-4469.2023.05.028
    Abstract423)      PDF(pc) (297KB)(1612)       Save
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    Ophthalmology in China    2023, 32 (5): 438-439.   DOI: 10.13281/j.cnki.issn.1004-4469.2023.05.017
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    Ophthalmology in China    2023, 32 (6): 529-530.   DOI: 10.13281/j.cnki.issn.1004-4469.2023.06.019
    Abstract413)            Save
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    Ophthalmology in China    2023, 32 (5): 441-442.   DOI: 10.13281/j.cnki.issn.1004-4469.2023.05.019
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    Effect of different refractive correction therapy on the treatment of high AC/A ratio accommodative esotropia
    Wang Yachen, Cheng Luyao, Chang Di, Liu Zhihan, Zhang Weijia, Fu Tao
    Ophthalmology in China    2023, 32 (6): 488-491.   DOI: 10.13281/j.cnki.issn.1004-4469.2023.06.007
    Abstract408)            Save
    Objective To compare the effect of bifocal lenses, progressive addition lenses and single vision lenses on stereoscopic vision recovery in patients with high AC/A ratio esotropia. Design Prospective study. Participants A total of 57 cases were enrolled, including 18 cases with progressive addition lenses, 23 cases with bifocal lenses, and 16 cases with single vision lenses. Methods All patients in the three groups had full orthoptic correction and were in the orthoptic position when viewing the distance. The additional diopter of progressive addition lenses and bifocal lenses was +2.50~+3.00 D. After 3~5 years’ follow-up, the differences of deviation at distance and near, AC/A ratio and near stereoscopic vision in each group after the treatment were statistically analyzed. Main Outcome Measures Orthotropic rate at near, AC/A ratio, near stereoscopic vision. Results There were no significant differences of the baseline data of age, gender, refractive status, AC/A before treatment among the three groups (all P>0.05), the stereoscopic vision of the three groups was all lost before treatment. After follow-up of 3~5 years, the orthotropic rate at near of the bifocal lenses, progressive addition lenses and single vision lenses groups was 10/23(43%), 10/18(56%), and 6/16(38%), respectively (χ2=0.71,P=0.70). The stereoscopic vision of patients in the three groups was improved to (6.79±1.67) lnArcsec, (7.43±1.50) lnArcsec, and (7.41±1.48) lnArcsec, but there was no statistically significant difference among the three groups (F=1.12, P=0.33). Conclusion Bifocal lenses, progressive addition lenses, and single vision lenses have a similar therapeutic effect on high AC/A ratio esotropia. (Ophthalmol CHN, 2023, 32: 488-491)
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    Ophthalmology in China    2023, 32 (5): 447-448.   DOI: 10.13281/j.cnki.issn.1004-4469.2023.05.023
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    Experimental study of rabbit on reducing intraocular pressure by drainage of aqueous humor through lamina cribrosa 
    Tao Yan, Wen Liang, Guo Chaoqun, Zhang Shaodan, Liang Yuanbo, Wu Wencan, Wang Ningli
    Ophthalmology in China    2023, 32 (6): 462-468.   DOI: 10.13281/j.cnki.issn.1004-4469.2023.06.003
    Abstract399)      PDF(pc) (1611KB)(1244)       Save
     Objective To determine the feasibility of lamina cribrosa puncture in intraocular pressure (IOP) reduction in rabbit eyes. Design Experiment study. Participants 4 healthy adult New Zealand rabbits (4 eyes). Methods Four healthy adult New Zealand rabbits were selected and 3 randomly for the experimental group to puncture lamina cribrosa and implant drainage tube. A sham rabbit eye with vitrectomy was used as a control. All surgeries were performed on the right eye only, with no treatment gived to the left eye. Intraocular pressure (IOP) was measured at pre-operative and postoperative 7 consecutive days, 18th day, 20th day, 21st day, 22nd day, 24th day, 25th day. Ophthalmic Ultrasound B was obtained at the 2nd day, 3rd day, and 7th day after the operation. All 4 rabbits were sacrificed 1 month postoperatively, and the eyeballs were enucleated for histopathological examination and hematoxylin-eosin (HE) staining and one of the experimental eyes was injected 100 μL of Japanese ink filtered by 0.2 μm filter membrane to vitreous cavity half an hour before death. Main Outcome Measures IOP and histopathological result. Results IOP measurements of all animals decreased 1 week after the operation, and the control rabbit eye increased gradually to the baseline at the 18th day postoperatively. IOP measurements of 2 experimental eyes in the experimental group during the observation period of the past month were (9.77±1.30) mmHg and (10.08±0.76) mmHg respectively, and were always lower than the pre-operative intraocular pressure (16.00 mmHg and 14.00 mmHg) and the contralateral untreated eyes (14.85±1.46) mmHg and (15.65±1.93) mmHg. The HE staining showed an accumulation of Japanese ink in para-vascular spaces around blood vessel walls in the one experimental eye. Conclusion Experimental study in rabbit preliminarily shows it is possible to drainage aqueous humor through a hole of lamina cribrosa to subarachnoid space. (Ophthalmol CHN, 2023, 32: 462-468)
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    Short-term effects of intravitreous Conbercept injection on choroid thickness in neovascular age-related macular degeneration eyes
    She Chongyang, Jiao Jian, Wang Jing, Lu Hong, Hua Wen
    Ophthalmology in China    2023, 32 (6): 478-482.   DOI: 10.13281/j.cnki.issn.1004-4469.2023.06.005
    Abstract397)            Save
    Objective To evaluate the short-term effects of intravitreal Conbercept injection (ICI) on intraocular pressure (IOP), retinal thickness, and choroidal thickness. Design Prospective cohort study. Participants A total of 42 patients with neovascular age-related macular degeneration treated with 0.05 ml intravitreal Conbercept injection (ICI) by the same physician between October 2020 and May 2021 were collected. Methods All subjects underwent general physical and ophthalmic examinations. Eye axial length (AL) was measured using IOL Master before ICI. To observe the changes of central subfoveal thickness (CFT), retinal nerve fibre layer (RNFL) thickness, subfoveal choroidal thickness (SFCT) and parafoveal choroidal thickness (PFCT) within 1 hour before ICI, 1 hour after ICI, and 24 hours after ICI. Factors associated with SFCT and PFCT measured within 1 hour before ICI were analyzed by multiple linear regression. Main Outcome Measures CFT, RNFL thickness, SFCT, PFCT. Results The IOP was 15.8±3.6 mmHg before the injection, 17.8±4.3 mmHg at 1 hour after the injection, and 13.8±2.6 mmHg at 24 hours after the injection, with a significant increase followed by a significant decrease after ICI (F=5.43, P=0.006). The PFCT was 244.2±78.8 μm before the injection, 197.3±84.1 μm at 1 hour after ICI, and 307.9±74.2 μm at 24 hours after ICI, with a significant decrease followed by a significant increase after ICI (F=3.48, P=0.04). There were no significant differences in CFT (F=0.19, P=0.83), RNFL (F=0.45, P=0.64) and SFCT (F=1.53, P=0.23) among the different time point before and after ICI. Both SFCT [B (95% CI): -7.77 (-12.25, -3.29), P=0.002] and PFCT [B (95% CI): -6.87 (-10.51, -3.23), P=0.005] were negatively associated with age. Conclusion ICI has an immediate effect on choroidal thickness in the short term, which may lead to transient choroidal ischemia that recovers 24 hours after ICI. (Ophthalmol CHN, 2023, 32: 478-482)
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    Ophthalmology in China    2023, 32 (5): 435-437.   DOI: 10.13281/j.cnki.issn.1004-4469.2023.05.016
    Abstract396)      PDF(pc) (1329KB)(1557)       Save
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    Ophthalmology in China    2023, 32 (5): 433-434.   DOI: 10.13281/j.cnki.issn.1004-4469.2023.05.015
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    Ophthalmology in China    2023, 32 (6): 519-521.   DOI: 10.13281/j.cnki.issn.1004-4469.2023.06.015
    Abstract395)            Save
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    Ophthalmology in China    2023, 32 (6): 476-477.   DOI: 10.13281/j.cnki.issn.1004-4469.2023.06.013
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