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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 Ophthalmology in China    2025, 34 (6): 439-446.   DOI: 10.1328 1/i.cnki.issn.1004-4469.2025.06.005 Abstract （427）            Knowledge map    Save 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. Related Articles | Metrics

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A randomized controlled study on myopic and astigmatism control of children aged 6-12 years between single spectacle lenses and defocus incorporated multiple segments spectacle lenses Chen Ying, Sun Wenfeng, Zhen Yi Ophthalmology in China    2025, 34 (5): 366-370.   DOI: 10.13281/j.cnki.issn.1004-4469.2025.05.006 Abstract （414）            Knowledge map    Save  Objective To compare the effects of defocus incorporated multiple segments spectacle lenses (referred to as defocus lenses) and single-vision lenses on astigmatism and myopia in children and whether defocus lenses increase the risk of astigmatism progression and their efficacy in myopia control.  Design Randomized controlled trial. Participants 102 Volunteers aged 6-12 years with myopia, recruited from University of Science and Technology of China Hospital between 2022 and 2023. Method Eligible children were randomly assigned to the defocus lens group (n=51) or single-vision lens group (n=51) for 12 months. Comprehensive ophthalmic examinations were performed, including slit-lamp microscopy, computer-assisted autorefraction under cycloplegia, retinoscopy, and subjective refraction to determine corrective prescriptions. Main Outcome Measures Changes in J0, J45, spherical equivalent refractive error (SER), and axial length. Results At baseline, there were no statistically significant differences between the defocus group and the single-vision group in terms of age, J0, J45, spherical equivalent refraction, or axial length. After 12 months of lens wear, the changes in J0 were (0.08±0.13) D and (0.08±0.13) D in the defocus and single-vision groups, respectively, with no statistically significant difference between the two groups (t=-0.193, P=0.424). The changes in J45 were (0.01±0.06) D and (-0.01±0.07) D, respectively, with no statistically significant difference between the two groups (t=0.029, P=0.977). The changes in spherical equivalent refraction were (-0.51±0.59) D and (-0.74±0.42) D, respectively, showing a statistically significant difference between the two groups (t=2.229, P=0.014). The progression of spherical equivalent refraction in the defocus group was reduced by 31.1% compared with the single-vision group. The axial elongation was (0.25±0.22) mm and (0.39±0.22) mm, respectively, showing a statistically significant difference between the two groups (t=-3.083, P=0.003). Axial elongation in the defocus group was reduced by 35.8% compared with the single-vision group. Conclusions The 12-month observation results show that compared to single-vision lenses, defocus incorporated multiple segments spectacle lenses do not increase the risk of astigmatism progression and demonstrate superior efficacy in controlling myopia progression of children aged 6-12 years.   Related Articles | Metrics

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Comparison of control efficiency on axial length growth among different kinds of orthokeratology lens and spectacle lenses with aspherical lenslets in children with mild myopia in a year Qin Shiyuan, Zhang Ruina, Jiang Yujuan, Guo Tengjun, Li Yanjin, Gong Lihua Ophthalmology in China    2025, 34 (5): 371-376.   DOI: 10.13281/j.cnki.issn.1004-4469.2025.05.007 Abstract （408）            Knowledge map    Save   Objective To compare the control efficiency on axial length growth among different orthokeratology lenses and spectacle lenses with aspherical lenslets in children with mild myopia in a year. Design  A retrospective cohort study. Participants  A total of 125 low myopic children were recruited.  Method  Myopic children were recruited and divided into three groups: Group A （42 patients wearing orthokeratology lenses(brand: Lucid), group B (44 patients wearing orthokeratology lenses(brand: CRT), and group C(39 patients wearing spectacle lenses with aspherical lenslets). Only right eye data were used for statistical analysis. One-way analysis of variance, LSD-t test and multiple linear regression were employed to compare the changes in axial length growth among groups at 3 months, 6 months, 9 months, and 12 months after wearing glasses and the incidence of corneal staining. Main Outcome Measures Axial length growth, the incidence of corneal staining. Results Axial length elongation in group A at 3 months， 6 months, 9 months and 12 months were (0.013±0.093) mm and (0.088±0.076) mm, (0.137±0.105) mm and (0.242±0.120) mm respectively. Axial length elongation in group B at 3 months， 6 months, 9 months and 12 months were (0.031±0.091) mm and (0.128±0.137) mm (0.178±0.141) mm and (0.291±0.139) mm respectively. No statistical difference (P>0.05) was found between the two groups in axial length elongation at the four time points. The increase of axial length in group C at 6 months and 12 months were (0.094±0.130) mm and (0.230±0.247) mm, which were no statistical difference compared with group A and group B (P>0.05) .After merging the data from Groups A and B, the axial length increase of the orthokeratology lens group at 6 months and 12 months was (0.104±0.113) mm and (0.270±0.131) mm, respectively, with no statistically significant difference compared to Group C (P＞0.05). After adjusting those covariate factors such as gender, age, initial SE, and initial axial length, the multiple linear regression analysis demonstrated that there was no significant difference in axial length growth between group A and group B at 3 months （β： 0.185， t=1.506， P=0.137， 95%CI： -0.010~0.075）, 6 months （β： 0.171， t=1.397， P=0.167， 95%CI： -0.018~0.103）, 9 months（β： 0.225， t=1.816， P=0.075， 95%CI： -0.006~0.124） and 12 months （β： 0.180， t=1.543，P=0.127， 95%CI： -0.016~0.124）. No statistical significant difference in the incidence of corneal staining (χ2=0.940, P>0.05)  was found between group A and group B. Conclusion In this study, there was no significant difference in the control efficiency of axial elongation and the incidence of corneal staining between VST-designed and CRT-designed  orthokeratology lenses. Spectacle lenses with aspherical lenslets demonstrated comparable performance with orthokeratology lenses on slowing axial length growth in low myopia. Related Articles | Metrics

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Short term observation of IOL centration after cataract surgery in eyes undergoing vitrectomy He Siqing, Shi Yuqing, Zhang Chuan, Dong Zhe Ophthalmology in China    2025, 34 (5): 341-345.   DOI: 10.13281/j.cnki.issn.1004-4469.2025.05.002 Abstract （365）      PDF（pc） （1053KB）（315）       Knowledge map    Save Objective To observe the decentration and tilt of intraocular lenses (IOLs) after cataract surgery in eyes that have undergone vitrectomy. Design Retrospective comparative case series. Participants Sixty-two patients (62 eyes) who underwent cataract surgery at Beijing Tongren Hospital from August 2024 to January 2025 were included. Among them, 31 patients (31 eyes) with cataract after vitrectomy were assigned to the observation group, and 31 patients (31 eyes) with age-related cataract without previous surgical history were assigned to the control group. The axial lengths of both groups were within the normal range. Methods All patients underwent IOL Master 700 and AS-OCT (CASIA 2) examinations to measure axial length, anterior segment biological parameters, and lens position parameters before cataract surgery. All patients underwent phacoemulsification and IOL implantation under topical anesthesia by the same surgeon. One month after surgery, AS-OCT was used to measure the position parameters of the IOL. Main Outcome Measures Axial length, white-to-white distance, lens thickness, equatorial diameter of the lens, preoperative lens tilt and decentration, and postoperative IOL tilt and decentration. Results There were no statistically significant differences between the observation group and the control group in axial length [24.56(23.72, 25.97)mm vs. 24.91(23.58, 26.02)mm], white-to-white distance [11.70(11.40, 12.10)mm vs.  11.60(11.50, 11.70)mm], lens thickness [4.43(4.30, 4.73)mm vs. 4.45(4.19, 4.86)mm], and equatorial diameter of the lens [10.28(9.94, 10.65)mmvs.11.60(11.50, 11.70)mm)] (P =0.916, 0.419, 0.949, 0.104). There were no statistically significant differences in preoperative lens tilt [4.30(3.50, 5.20)° vs. 4.50(3.80, 6.30)°] and decentration [0.19(0.09, 0.24)mm vs.  0.12(0.07, 0.20)mm] between the two groups (P values were 0.275 and 0.123, respectively). There were no statistically significant differences in postoperative IOL tilt [4.70(3.40, 5.10)°  vs. 4.60(3.70, 5.20)°] and decentration [0.17(0.11, 0.26)mm vs. 0.19(0.08, 0.29)mm] between the two groups (P=0.827， 0.767). There were no statistically significant differences in the changes in postoperative IOL tilt [1.10(0.40, 1.80)° vs. 0.80(0.30, 1.30)]° and decentration  [0.06(0.04, 0.12)mm vs. 0.07(0.04, 0.15)mm)] between the two groups (P=0.084, 0.693). Conclusion The short-term follow-up of this study showed that patients with normal axial length who have undergone vitrectomy and subsequently cataract surgery do not experience more significant IOL decentration and tilt. Related Articles | Metrics

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Observation of the effect of wearing scleral lenses for 6 months in patients with keratoconus Qi Yan, Hu Yan, Xue Jinsong, Xu Yingnan Ophthalmology in China    2025, 34 (5): 359-365.   DOI: 10.13281/j.cnki.issn.1004-4469.2025.05.005 Abstract （344）            Knowledge map    Save   Objective  To observe the clinical efficacy of wearing scleral lenses in patients with keratoconus. Design  Retrospective case series. Participants 21 patients (29 eyes) with keratoconus of completion period stage 3 or below and fitted with scleral lenses at the Affiliated Eye Hospital of Nanjing Medical University. Methods All patients underwent a standard fitting procedure for scleral lenses. The fitting status of scleral lenses, as well as the differences in tear film clearance between the lenses and the central and peripheral cornea at 1 week, 1 month, 3 months, and 6 months was observed and compared. Changes in visual acuity, refractive error, corneal parameters, and other indicators were compared between baseline (before wearing glasses), at 1 week, 1 month, 3 months, and 6 months of wearing scleral lenses. Patients completed the NEI-VFQ-25 questionnaire to assess the quality of life and vision of wearing scleral lenses for 6 months. Main Outcome Measures Corrected visual acuity, intraocular pressure (IOP), flat anterior corneal surface refractive power (K1), steep anterior corneal surface refractive power (K2), steepest anterior corneal surface refractive power (Kmax), corneal thinnest point thickness (TCT), center corneal thickness (CCT), corneal staining score (CSS), corneal endothelial cell density (ECD), NEI-VFQ-25 scores, tear film clearance. Results At 6 months of wearing scleral lenses, the tear film clearance in the central, nasal, temporal, upper, and lower regions of the scleral lenses were 221 (177, 274)μm, 98 (68, 133)μm, 138 (81, 213)μm, 145 (95, 190)μm and 360 (289, 478)μm, respectively, there was no significant differences compared to the 240 (184, 282)μm, 98 (62, 121)μm, 120 (95，207)μm, 145 (82，192)μm and 326 (270, 450)μm at 1 week of wearing scleral lenses (all P>0.05). At 1 week and 6 months of wearing scleral lenses, the corrected visual acuity with scleral lenses was 0.30 (0.05, 0.40) LogMAR and 0.22 (0.02, 0.30) LogMAR, respectively, which were significantly improved compared to the corrected visual acuity with frame glasses of 0.52 (0.22, 0.76) LogMAR (P=0.013, P=0.001). Before wearing scleral lenses, at 1 week and 6 months, K1 was (57.70±10.71) D, (58.05±10.90) D and (58.43±11.20) D, K2 was (63.25±13.17) D, (63.42±13.22) D and (63.24±13.00) D, Kmax was (72.60±16.94) D, (72.46±16.47) D and (72.30±16.04) D, TCT was 410 (356, 453)μm, 416 (362, 457)μm and 400 (336, 462)μm, CCT was (410.55±74.25) μm, (416.93±80.98) μm and (421.31±81.56) μm, IOP was (10.38±3.91) mmHg, (10.41±4.63) mmHg and (9.79±4.29) mmHg, CSS was 0 (0,1), 0 (0,1)and 0 (0,1), with no statistically significant differences at each time point (all P>0.05). After wearing scleral lenses for 6 months, the ECD was 2905 (2542, 3019.5) cells/mm2, and there was no significant change compared to 2876 (2659, 3148.5) cells/mm2 before wearing scleral lenses (P=0.691). After wearing scleral lenses for 6 months, the patients'NEI-VFQ-25 score was 2175 (1925, 2450), which was significantly higher than 1750 (1337.5, 2025) before wearing scleral lenses (P=0.001). Conclusions The 6-month observation results of this small sample size indicate that scleral lenses have good corrective effects and safety in patients with keratoconus at completion period stage 3 or below, and wearing scleral lenses significantly improves the visual function and quality of life of keratoconus patients.    Related Articles | Metrics

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One year clinical observation of XEN gel stent implantation for advanced primary glaucoma Li Qiumei, Wang Weilin, Zhao Ruihua, Bi Huiwen, Li Shaowei Ophthalmology in China    2025, 34 (5): 346-352.   DOI: 10.13281/j.cnki.issn.1004-4469.2025.05.003 Abstract （335）            Knowledge map    Save  Objective  To evaluate the efficacy and safety of XEN gel stent implantation in the treatment of advanced primary glaucoma. Design Retrospective case series. Participants From March 2022 to December 2023, 29 patients (33 eyes) with advanced primary glaucoma underwent consecutive XEN gel drainage tube implantation in Beijing Aier-Intech Eye Hospital. There were 16 cases (19 eyes) in the XEN group and 13 cases (14 eyes) in the Phaco combined XEN group. Method The patient's medical records were reviewed. Main Outcome Measures Visual acuity, intraocular pressure (IOP), number of IOP-lowering drugs, surgical success rate, and postoperative complications. Results  For all patients preoperative IOP，number of IOP-lowering medications and visual acuity (LogMAR) were 25.0 (IQR: 19.0, 34.0) mmHg, 4 (IQR: 3, 4) medications and 0.4 (IQR: 0.9, 0.2), respectively. At 1 year postoperatively, the IOP, mean IOP reduction, number of IOP-lowering medications, surgical success rate and visual acuity were 13.0 (IQR: 11.0, 16.0) mmHg, 46.0%, 0 (IQR: 0, 0) medications, 80.7% (25/31) and 0.3 (IQR: 1.0, 0.1), respectively. In the XEN group, preoperative IOP, number of IOP-lowering medications and visual acuity (LogMAR) were 26.0 (IQR: 19.0, 30.0) mmHg, 4 (IQR: 2, 4) and 0.2 (IQR: 0.7, 0.1), respectively. At 1 year postoperatively, the IOP, mean IOP reduction, number of IOP-lowering medications, surgical success rate and visual acuity (LogMAR) were 13.0 (IQR: 10.0,15.0) mmHg, 57.7%、0 (IQR: 0, 2) medications, 82.4% (14/17) and 0.3 (IQR: 0.7, 0.1) . In the PhacoXEN group, preoperative IOP, number of IOP-lowering medications, and visual acuity (LogMAR) were 24.5 (19.9, 32.0) mmHg, 3.5 (IQR: 3, 4) medications, and 0.7 (IQR: 2.0, 0.3), respectively. At 1 year postoperatively, the IOP, mean IOP reduction, number of IOP-lowering medications, surgical success rate, and visual acuity (LogMAR) were 13.0 (IQR: 12.0, 16.0) mmHg, 57.1%, 0 (IQR: 0, 0) medications, 78.6% (IQR: 11/14), and 0.3 (IQR: 1.0, 0.2), respectively.  There was no statistically significant difference in the surgical success rate at 1 year between the XEN and PhacoXEN groups (χ2=0.45，P=0.9299). Complications included hyphema (12.1%, 4/33), shallow anterior chamber (21.2%, 7/33), choroidal detachment (12.1%, 4/33), hypotony maculopathy (3.0%, 1/33), and blebitis (3.0%, 1/33), all managed conservatively. Bleb needling was required in 39.4% (13/33) of cases, significantly higher in the PhacoXEN group (50%, 7/14) than in the XEN group (31.5%, 6/19). No complications such as stent migration, exposure, or endophthalmitis occurred. Conclusion The results of the one-year follow-up with a small sample size in this study show that XEN gel stent implantation demonstrates favorable clinical efficacy and safety in advanced primary glaucoma, with comparable outcomes between standalone and combined procedures. However, the PhacoXEN group exhibited a higher rate of postoperative bleb needling. Related Articles | Metrics

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Reconsidering primary angle-closure glaucoma from the pathophysiological perspective of abnormal intraocular fluid circulation and imbalance of chamber pressure Zhao Hanxue, Yu Xiaowei, Fan Zhigang, Shi Yan Ophthalmology in China    2026, 35 (1): 1-8.   DOI: 10.13281/j.cnki.issn.1004-4469.2026.01.001 Abstract （324）            Knowledge map    Save Primary angle-closure glaucoma (PACG) is a vision-threatening eye disease that can lead to blindness, and its pathogenesis has long been debated. Traditionally, anatomical factors such as iris bombe, anterior lens displacement, and anterior rotation of the ciliary body have been considered the primary causes. However, the inconsistent therapeutic outcomes targeting these structural abnormalities suggest that they may represent concomitant changes during disease progression rather than the fundamental cause. Drawing from this insight, this article explores how intraocular chamber pressure imbalances, triggered by abnormal intraocular fluid circulation, affect different intraocular structures and functions, with the goal of clarifying the pathophysiological mechanisms underlying the development and progression of PACG. The proposed mechanisms mainly include: pathological choroidal expansion or abnormal suprachoroidal fluid transport leading to altered choroidal-vitreous pressure; abnormalities of the ciliary body-zonules-crystalline lens-hyaloid-anterior vitreous complex (CZLHV) resulting in changes in vitreous cavity-posterior chamber pressure; and forward displacement of the CZLHV complex compressing the iris, thereby creating a posterior-anterior chamber pressure gradient. This sequence ultimately causes iridotrabecular contact, angle closure, and obstruction of aqueous humor outflow through the trabecular meshwork. By systematically summarizing the roles of choroidal expansion, the vitreous buffering system, and the CZLHV complex in the pathogenesis and progression of PACG, this article aims to provide new insights for precision management and future pathogenesis research in PACG. Related Articles | Metrics

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Inner retina cloudy swelling  Huang Houbin Ophthalmology in China    2025, 34 (5): 333-340.   DOI: 10.13281/j.cnki.issn.1004-4469.2025.05.001 Abstract （321）      PDF（pc） （3970KB）（217）       Knowledge map    Save   Mistaken as edema, inner retina cloudy swelling in fact is the ischemic whitening and oncosis of inner five layers of retina following retinal artery occlusion. Its pathological nature is cellular swelling, or intracellular edema, but not fluid accumulation intercellularly as edema. The inner retina cloudy swelling is different from cotton spot, outer retina cloudy swelling, whole-thickness retina cloudy swelling and inflammatory cloudy swelling, although the pathological natures of them are cellular swelling too. However, the appearance of Berlin edema mimics inner retina cloudy swelling very much, although it is neither cellular swelling nor edema. It is injures, malpositions, even fractures of the interdigitation  between photoreceptors and retinal pigment epithelia. Strictly discrimination of these conceptions especially their phathophysiological bases is of vital importance to recognize and illuminate the associated diseases. Related Articles | Metrics

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Analysis of multimodal imaging characteristics of combined hamartoma of the retina and the retinal pigment epithelium in macula Feng Sijia, Liu Wei Ophthalmology in China    2025, 34 (5): 384-388.   DOI: 10.13281/j.cnki.issn.1004-4469.2025.05.009 Abstract （318）            Knowledge map    Save  Objective To analyze the multimodal imaging features of combined hamartoma of the retina and retinal pigment epithelium (CHRRPE) in macula. Design Retrospective case series. Participants Nine patients (9 eyes) with CHRRPE diagnosed at Daping Hospital, Army Medical University from November 2020 to May 2025. Methods A retrospective review of patient medical records. Main Outcome Measures Image findings of Color fundus photography, fundus fluorescein angiography (FFA), indocyanine green angiography (ICGA), spectral-domain optical coherence tomography (SD-OCT), and optical coherence tomography angiography (OCTA). Results This study included 9 patients (9 eyes) with a mean age of 16.44±10.24 years. All cases were unilateral. Color fundus photography showed that all lesions were located in the macular area, presenting with retinal vascular tortuosity, pigmentary disturbances, and membranous proliferation. Optical coherence tomography (OCT) revealed increased inner retinal thickness and structural disorder in all patients, while the outer retinal layers, RPE band, and choroid remained intact. A "shark-teeth sign" was observed in the outer plexiform layer in all 9 cases, and 6 patients exhibited an "omega sign" configuration in the inner retina. OCT angiography (OCTA) demonstrated high-density filamentous vessels within the macular retina in all 9 cases. Fundus fluorescein angiography (FFA) in the early phase showed tortuous and dilated capillaries across all lesions and patchy blocked fluorescence was seen in 5 cases. In the late phase, slight vascular staining was observed around the tumor in 1case, whereas no leakage was detected in the other 8 cases. Indocyanine green angiography (ICGA) performed in 5cases revealed varying degrees of choroidal fluorescence masking by the tumor, although no obvious choroidal vascular abnormalities were identified in any case. Conclusion The clinical features of CHRRPE in the macular area manifest as membrane-like proliferation at the macula, which can easily be confused with epiretinal membrane. Integrating multimodal imaging, particularly the "shark tooth" sign in the outer plexiform layer on OCT and the Ω-shaped configuration of the inner retinal layers, can significantly improve the diagnostic accuracy of this condition Related Articles | Metrics

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One year efficacy observation of fully degradable sinus drug stents in endoscopic dacryocystorhinostomy for chronic dacryocystitis Zheng Qun, Zhang Yi Ophthalmology in China    2025, 34 (5): 377-383.   DOI: 10.13281/j.cnki.issn.1004-4469.2025.05.008 Abstract （316）            Knowledge map    Save  Objective To explore the clinical efficacy of utilizing fully biodegradable sinus drug scaffolds in endoscopic dacryocystorhinostomy for the treatment of chronic dacryocystitis. Design Retrospective case series. Participants From February 2021 to February 2024, 286 patients (286 eyes) underwent endoscopic dacryocys torhinostomy for chronic dacryocystitis in Nanjing Aier Eye Hospital. Method  The patient's medical records were reviewed. 286 patients were divided into three groups: 94 cases with simple dacryocystorhinostomy, 95 cases with dacryocystorhinostomy combined with RS tube insertion, and 97 cases with fully degradable sinus drug stent used as stent support between the lacrimal sac and nasal mucosa during surgery (with a specification of 25 mm×14 mm and 70 degrees). A one-year postoperative follow-up was conducted. The criteria for effective treatment are unobstructed irrigation of the lacrimal passage, no or reduced overflow of tears. Main Outcome Measures The effectiveness rate and the number of endoscopic interventions post-surgery. Results Following a one-year postoperative follow-up, the cure rate for cases utilizing fully degradable sinus drug stents intraoperatively was 97.9%, with an overall effectiveness rate of 100%. The effectiveness rate for simple dacryocystorhinostomy stood at 92.6%, whereas for dacryocystorhinostomy combined with RS tube insertion, it was 94.7%. The statistical difference in effectiveness rates among the three groups was significant (P=0.013). The number of endoscopic interventions within one year after surgery were (1.54±0.60), (2.08±0.54), and (0.13±0.37) times, respectively (P=0.000). Conclusion The combination of endoscopic dacryocystorhinostomy and fully degradable sinus drug stent has significant clinical advantages than simple dacryocystorhinostomy and dacryocystorhinostomy combined with RS tube insertion in the treatment of chronic dacryocystitis and is worthy of clinical application and promotion. Related Articles | Metrics

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Diagnosis and management of microsporidial keratitis Sun Xuguang Ophthalmology in China    2026, 35 (1): 9-17.   DOI: 10.13281/j.cnki.issn.1004-4469.2026.01.002 Abstract （299）            Knowledge map    Save In recent years, the number of cases of microsporidial keratitis reported abroad has been increasing and many domestic ophthalmic institutions have also reported and diagnosed such cases. Microsporidia is a unicellular, intracellular parasitic protozoa, which mainly infects the cornea through contact contamination. Because its clinical manifestations are similar to common superficial punctate keratitis or fungal keratitis, its diagnosis mainly depends on laboratory examination of etiology. At present, the treatment of microsporidia cornea mainly depends on the combination of antifungal drugs such as voriconazole and antibiotics such as gatifloxacin, and patients with severe corneal stromitis need timely surgical treatment. The etiology, pathological mechanism, rapid diagnosis and treatment of microsporidia keratitis need further study. Related Articles | Metrics

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Emphasizing the diagnosis and management of special corneal infections He Yan, Yuan Jin Ophthalmology in China    2025, 34 (6): 413-417.   DOI: 10.1328 1/i.cnki.issn.1004-4469.2025.06.001 Abstract （296）      PDF（pc） （3773KB）（47）       Knowledge map    Save  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. Related Articles | Metrics

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Analysis of factors affecting the 2-year prognosis of penetrating keratoplasty for congenital corneal leukoplakia Ma Siyi, Hong Jing Ophthalmology in China    2025, 34 (5): 353-358.   DOI: 10.13281/j.cnki.issn.1004-4469.2025.05.004 Abstract （295）            Knowledge map    Save Objective To study the factors affecting the prognosis of children with congenital corneal leukoplakia after corneal penetrating keratoplasty. Design Retrospective case series. Participants 63 children (63 eyes) with congenital corneal leukoplakia who underwent penetrating keratoplasty at Peking University Eye Center from 2018 to 2020. Methods The electronic medical records of children were evaluated retrospective, including gender, age, corneal disease type, diagnosis and treatment history, postoperative complications and so on. A binary multivariate Logistic regression analysis was performed on the survival rate of corneal grafts at 24 months after surgery to explore the factors affecting the prognosis, and survival curves were plotted. Main Outcome Measures Postoperative complications and survival time of corneal grafts. Results The average age of the children who underwent penetrating keratoplasty was （11.71±10.44） months (3~55 months). The 2-year survival rate of the grafts after surgery was 61.9%. Logistic regression analysis showed that persistentcorneal epithelial defects(P=0.048), immune rejection(P=0.002) and postoperative high intraocular pressure (IOP) (P=0.030) were the main factors leading to failure. Persistent corneal epithelial defects occured one week after surgery, and had not fully healed after using medication for more than one month. Immune rejection and high IOP mainly occured between 1 to 6 months after surgery. After the occurrence of persistent corneal epithelial defects, the survival rate of corneal grafts was 33.33% and 22.22% at 1 and 2 years after surgery. After immune rejection, the survival rate of corneal grafts was 22.22% and 11.11% at 1 and 2 years after surgery. After the occurrence of high IOP, the survival rate of corneal grafts was 45.45% and 18.18% at 1 and 2 years after surgery. All of them were significantly lower than the 97.44% (P<0.001) and 87.18% (P<0.001), which were the survival rate of corneal grafts of children without major complications. Conclusion The factors affecting the prognosis of children with congenital corneal leukoplakia after corneal penetrating keratoplasty are immune rejection, high IOP, and corneal epithelial defects. Related Articles | Metrics

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Clinical features and etiological analysis of microsporidial keratoconjunctivitis Huang Jiahe, Zhang Yang, Han Bing, Fu Ming, Zhu Huimin, Zhang Tianyi, Wang Wenying, Zou Jingling, Deng Shijing, He Yan Ophthalmology in China    2026, 35 (1): 18-26.   DOI: 10.13281/j.cnki.issn.1004-4469.2026.01.003 Abstract （290）            Knowledge map    Save Objective To abserve the clinical features, etiological findings of a case series of patients with microsporidial keratoconjunctivitis (MKC). Design Retrospective case series. Participants Thirty-four patients with MKC at Beijing Tongren Hospital, between September 2024 and August 2025. Methods All patients were diagnosed through clinical feature evaluation, etiological examinations, and molecular biological methods. Diagnostic procedures included corneal scraping cytology, metagenomic next-generation sequencing (mNGS), nested PCR, and in vivo confocal microscopy (IVCM). Treatment consisted of isolating infected animals, administering oral albendazole, and applying topical polyhexamethylene biguanide or voriconazole eye drops. Treatment outcomes and recurrence were assessed. Therapeutic efficacy was defined as the disappearance of patient symptoms and improvement of slit-lamp findings, including resolution of conjunctival hyperemia, negative fluorescein staining of the corneal epithelium, disappearance of raised lesions, and absorption of stromal infiltrates. Main Outcome Measures Clinical symptoms, ocular signs, in vivo confocal microscopy findings, corneal scraping cytology, pathogen culture and PCR detection results, metagenomic sequencing findings, disease recurrence rate, and cure rate. Results The 34 patients had a mean age of 33.6±16.6 years (range: 7~67 years), and 91.1% had a clear history of animal contact. Clinically, most presented with epithelial keratitis and conjunctivitis; four patients progressed to subepithelial or stromal keratitis. Etiological examinations revealed microsporidia structures in corneal scraping samples from 28 cases. Among the 34 patients, 33 were infected with Encephalitozoon hellem (EH) and 1 with Enterocytozoon bieneusi (EB). Using a comprehensive treatment strategy(animal isolation, oral albendazole, and topical ophthalmic medications), all patients achieved complete symptom resolution, persistent negative fluorescein staining, and remission of inflammatory signs, resulting in effective cure. However, 7 patients who had previously used corticosteroids or immunosuppressants, or had repeated animal exposure, experienced symptom or sign exacerbation after initial improvement, or persistent inflammatory findings. These cases showed recurrent or prolonged disease, with a recurrence/prolongation rate of 20.59%. Conclusion MKC may have specific sources and routes of transmission in mainland China, closely related to animal contact. Related Articles | Metrics

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Ophthalmology in China    2025, 34 (5): 395-397.   DOI: 10.13281/j.cnki.issn.1004-4469.2025.05.011 Abstract （262）            Knowledge map    Save Related Articles | Metrics

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Applications and interpretations of indocyanine green angiography Huang Houbin Ophthalmology in China    2025, 34 (6): 419-423.   DOI: 10.1328 1/i.cnki.issn.1004-4469.2025.06.002 Abstract （259）      PDF（pc） （3712KB）（46）       Knowledge map    Save  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. Related Articles | Metrics

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Discovery and validation of serum hsa_circ_0000615 as a potential biomarker for proliferative diabetic retinopathy Zhang Qing, Li Jing, Fu Jiao Ophthalmology in China    2025, 34 (5): 389-394.   DOI: 10.13281/j.cnki.issn.1004-4469.2025.05.010 Abstract （250）            Knowledge map    Save   Objective To screen and determine whether serum hsa_circ_0000615 can be used as a new non invasive biomarker for proliferative diabetic retinopathy (PDR). Design Prospective case series. Participants  A simple random sampling method was used to select 50 non-diabetic volunteers (as control group), 48 patients with type-2 diabetes mellitus (T2DM), 50 PDR patients and 50 patients with non-PDR (NPDR). Methods  High throughput whole transcriptome sequencing was performed to explore the expression profile of serum circRNAs, and the candidate circRNAs were validated by quantitative real-time polymerase chain reaction (qRT-PCR). Receiver operating characteristic (ROC) analysis evaluated the ability of serum hsa_circ_0000615 in discriminating PDR patients from NPDR patients, T2DM patients and control subjects. Main Outcome Measures  Serum circRNAs expression profile and has_cic_0000615 expression level. Results  By sequencing and qRT-PCR, serum hsa_circ_0000615 expression in PDR patients [12.015 (8.530, 14.325)] was significantly higher than that in control group [3.998 (3.220, 5.156)], T2DM group [5.118 (3.895, 7.247)] and NPDR group [5.250 (4.045, 7.763)] (all P＜0.05).  By correlation analysis and linear regression analysis, the level of hsa_circ_0000615 expression was positively correlated with the course of diabetes (r=0.429, P＜0.001) and the level of glycated hemoglobin (r=0.567, P＜0.001). ROC curve analysis showed that the area under curve of serum hsa_circ_0000615 was 0.803±0.036 (95% CI: 0.731～0.874), 0.796±0.039 (95% CI: 0.719～0.872) and 0.976±0.010 (95%CI: 0.956～0.997), respectively. Conclusion  The present findings indicate that serum hsa_circ_ 0000615 may serve as a novel diagnostic biomarker and potential therapeutic target for PDR. Related Articles | Metrics

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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 Ophthalmology in China    2025, 34 (6): 469-475.   DOI: 10.1328 1/i.cnki.issn.10048-4469.2025.06.009 Abstract （242）            Knowledge map    Save  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.  Related Articles | Metrics

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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 Ophthalmology in China    2025, 34 (6): 424-430.   DOI: 10.1328 1/i.cnki.issn.1004-4469.2025.06.003 Abstract （241）      PDF（pc） （1521KB）（25）       Knowledge map    Save 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. Related Articles | Metrics

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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 Ophthalmology in China    2025, 34 (6): 431-439.   DOI: 10.1328 1/i.cnki.issn.1004-4469.2025.06.004 Abstract （238）            Knowledge map    Save  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. Related Articles | Metrics

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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 Ophthalmology in China    2025, 34 (6): 447-455.   DOI: 10.1328 1/i.cnki.issn.1004-4469.2025.06.006 Abstract （235）            Knowledge map    Save  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.  Related Articles | Metrics

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Ophthalmology in China    2025, 34 (5): 411-412.   DOI: 10.13281/j.cnki.issn.1004-4469.2025.05.018 Abstract （228）      PDF（pc） （541KB）（148）       Knowledge map    Save Related Articles | Metrics

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Ophthalmology in China    2025, 34 (5): 405-406.   DOI: 10.13281/j.cnki.issn.1004-4469.2025.05.015 Abstract （227）            Knowledge map    Save Related Articles | Metrics

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Ophthalmology in China    2025, 34 (6): 417-418.   DOI: 10.1328 1/i.cnki.issn.10048-4469.2025.06.013 Abstract （225）            Knowledge map    Save Related Articles | Metrics

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Ophthalmology in China    2025, 34 (5): 345-345.   DOI: 10.13281/j.cnki.issn.1004-4469.2025.05.019 Abstract （221）      PDF（pc） （294KB）（181）       Knowledge map    Save Related Articles | Metrics

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Clinical analysis of tumor recurrence characteristics during and after intra-arterial chemotherapy for  monocular stage D retinoblastoma Ophthalmology in China    2025, 34 (6): 456-461.   DOI: 10.1328 1/i.cnki.issn.1004-4469.2025.06.007 Abstract （219）            Knowledge map    Save  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.  Related Articles | Metrics

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Ophthalmology in China    2025, 34 (5): 402-404.   DOI: 10.13281/j.cnki.issn.1004-4469.2025.05.014 Abstract （217）            Knowledge map    Save Related Articles | Metrics

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Observation on hemostatic effect of new-type precision temperature-controlled disposable electrocautery pen in pterygium surgery Tang Jiayang, Li Shang, Wu Qianru, Jie Ying Ophthalmology in China    2026, 35 (1): 48-53.   DOI: 10.13281/j.cnki.issn.1004-4469.2026.01.008 Abstract （214）            Knowledge map    Save Objective To explore the clinical application effect of the new-type precision temperature-controlled disposable electrocautery pen in hemostasis during pterygium surgery under local anesthesia. Design Case-control study. Participants A total of 400 patients with primary pterygium who underwent surgery at Beijing Tongren Hospital from February 2024 to April 2025. Methods The patients were randomly divided into the electrocoagulation group and the control group, with 200 cases in each group. The electrocoagulation group used a new type precision temperature-controlled disposable electrocoagulation pen for hemostasis, while the control group used an integrated spherical ophthalmic cautery for hemostasis. Intraoperative hemostasis time, operation time, presence of crusting after hemostasis, postoperative subjective symptoms, subconjunctival hemorrhage, and postoperative recurrence rate in the two groups were recorded, compared, and statistically analyzed. Main Outcome Measures Intraoperative hemostasis time, operation time, presence of crusting after hemostasis, postoperative subjective symptoms, subconjunctival hemorrhage, and postoperative recurrence rate. Results The mean hemostasis time in the electrocautery group (33.96±4.56 s) was significantly shorter than that in the control group (116.36±12.49 s) (t=-87.634, P<0.001). The total operative time in the electrocautery group (36.60±5.10 min) was also shorter than that in the control group (39.91±3.63 min) (t=-7.450, P<0.001). Regarding intraoperative eschar formation, the incidence in the electrocautery group (2.00%) was significantly lower than that in the control group (10.50%) (χ2=12.331, P<0.001). Both groups provided satisfactory surgical field clarity, with a clear visual field rate of 97.50% in the electrocautery group and 95.00% in the control group. On the first postoperative day, there were no statistically significant differences between the two groups in terms of subjective symptoms (pain, foreign body sensation, irritation, epiphora), subconjunctival hemorrhage, or the one-year postoperative recurrence rate (all P>0.05). Conclusion The novel precise temperature-controlled disposable electrocautery pen demonstrated reliable hemostatic efficacy in pterygium surgery, effectively reducing both hemostasis time and operative time while minimizing intraoperative eschar formation, without increasing postoperative complications. Related Articles | Metrics

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Ophthalmology in China    2025, 34 (6): 461-463.   DOI: 10.1328 1/i.cnki.issn.10048-4469.2025.06.014 Abstract （213）            Knowledge map    Save Related Articles | Metrics

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Ophthalmology in China    2025, 34 (5): 358-358.   DOI: 10.13281/j.cnki.issn.1004-4469.2025.05.021 Abstract （212）      PDF（pc） （568KB）（212）       Knowledge map    Save Related Articles | Metrics

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Application of different staining methods in corneal scraping cytology and metagenomic next-generation sequencing in diagnosis of ocular microsporidiosis Zhang Yang, Liang Qingfeng, Wang Zhiqun, He Yan, Xu Yingnan, Qu Hongnan, Chen Kexin, Deng Shijing, Han Bing Ophthalmology in China    2026, 35 (1): 27-32.   DOI: 10.13281/j.cnki.issn.1004-4469.2026.01.004 Abstract （210）            Knowledge map    Save Objective To explore the diagnostic value of different corneal scraping cytology staining methods and metagenomic next-generation sequencing (mNGS) for ocular microsporidiosis. Design Retrospective study. Participants Thirty-three patients (40 eyes) with ocular microsporidiosis admitted to Beijing Tongren Hospital. Methods Corneal scraping cytology was performed with four staining methods (Giemsa, fungal fluorescence, Gram, acid-fast staining). Combined with mNGS, the detection rates of each method and the pathogenic spectrum of mNGS were analyzed. Main Outcome Measures Detection rates of different staining methods and mNGS. Results The overall detection rate of scraping cytology was 90.9%. The detection rates of Giemsa, fungal fluorescence, Gram, and acid-fast staining were 81.8%, 63.6%, 24.2%, and 9.1%, respectively. The combined Giemsa and fungal fluorescence staining achieved the highest detection rate (90.9%). Pearson's chi-square test showed significant differences in positive rates among the four staining methods (χ2=33.056, df=3, P<0.001). The detection rate of mNGS was 93.9%, with 5 microsporidia species identified. Conclusion Both corneal scraping cytology and mNGS are effective for diagnosing ocular microsporidiosis. Combination of Giemsa and fungal fluorescence staining is recommended. Related Articles | Metrics

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Ophthalmology in China    2025, 34 (5): 370-370.   DOI: 10.13281/j.cnki.issn.1004-4469.2025.05.022 Abstract （209）      PDF（pc） （240KB）（162）       Knowledge map    Save Related Articles | Metrics

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Risk factors related to idiopathic epiretinal membrane in Guangzhou population Yang Tangjian, Jiang Yu, Zhou Yong Ophthalmology in China    2025, 34 (6): 464-468.   DOI: 10.1328 1/i.cnki.issn.10048-4469.2025.06.008 Abstract （208）            Knowledge map    Save 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. Related Articles | Metrics

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Ophthalmology in China    2025, 34 (5): 388-388.   DOI: 10.13281/j.cnki.issn.1004-4469.2025.05.023 Abstract （205）      PDF（pc） （533KB）（169）       Knowledge map    Save Related Articles | Metrics

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Ophthalmology in China    2025, 34 (5): 400-401.   DOI: 10.13281/j.cnki.issn.1004-4469.2025.05.013 Abstract （204）            Knowledge map    Save Related Articles | Metrics

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Combined OCTA and spectral-domain-OCT for assessing macular microcirculation and choroidal structure in high myopia  Guan Xiaorong, Du Jing, Zhang Yu Ophthalmology in China    2026, 35 (3): 209-215.   DOI: 10.13281/j.cnki.issn.1004-4469.2026.03.005. Abstract （198）            Knowledge map    Save   Objective  To investigate the clinical value of optical coherence tomography angiography (OCTA) combined with spectral-domain OCT (SD-OCT) in the quantitative assessment of macular microcirculation and choroidal structural changes in patients with high myopia, and to clarify the advantages of their synergistic evaluation and the correlations between various parameters and myopic maculopathy. Design Prospective case-control study. Participants A total of 50 patients (50 eyes) with high myopia (spherical equivalent ≤-6.00 D, axial length ≥26.5 mm) who visited the 969th Hospital of the Joint Logistics Support Force of the Chinese People's Liberation Army from January 2023 to December 2024 were included. Forty age- and sex-matched healthy individuals (40 eyes, refractive error ±0.50 D, axial length 22.0~24.5 mm) served as normal controls. The high myopia group was further divided into refractive subgroups (30 cases in the -6.00 D to -9.00 D group, and 20 cases in the <-9.00 D group) and lesion subtype subgroups [35 cases of simple high myopia, and 15 cases of myopic maculopathy, which included a choroidal neovascularization (CNV) subgroup of 7 cases]. Methods  All participants underwent OCTA (5 mm×5 mm scan) to detect superficial and deep retinal vessel density, choriocapillaris density, foveal avascular zone (FAZ) characteristics, and hemodynamic parameters. SD-OCT was performed to measure the subfoveal choroidal thickness (SFCT), choroidal layer parameters, and choroidal non-perfusion spot density. Independent sample t-tests and Chi-square tests were used to compare differences between groups. Spearman rank correlation was utilized to analyze the correlation among parameters, and partial correlation analysis was applied to evaluate the association between visual function and microcirculation parameters after controlling for refractive error. Main Outcome Measures  Microcirculation parameters (based on OCTA): superficial/deep retinal vessel density, choriocapillaris density, choroidal non-perfusion spot density, FAZ area, and morphological abnormality rate; Choroidal structural parameter (based on SD-OCT): SFCT; Clinical correlation indicators: best-corrected visual acuity (BCVA, LogMAR), macular ischemia index, and CNV detection rate. Results The superficial/deep retinal vessel density and choriocapillaris density in the high myopia group were significantly lower than those in the control group (all P<0.001), while the FAZ area, morphological abnormality rate, and choroidal non-perfusion spot density were significantly higher than those in the control group (all P<0.001). The SFCT significantly thinned with the progression of myopia severity [(215.34±32.15)μm in the -6.00 D to -9.00 D group vs. (168.76±28.45)μm in the <-9.00 D group, P<0.001)], and was significantly positively correlated with choriocapillaris density (r=0.412, P=0.005) and negatively correlated with BCVA (LogMAR) (r=-0.456, P=0.002). Compared with high myopia patients without CNV, the CNV subgroup exhibited lower deep retinal vessel density (19.87%±2.89% vs. 27.02%±2.65%, P<0.001), higher macular ischemia index (32.15%±5.12% vs. 18.67%±3.56%, P<0.001), greater choroidal non-perfusion spot density (0.92±0.31 spots/mm2 vs. 0.45±0.18 spots/mm2, P<0.001), and thinner SFCT (156.34±25.78 μm vs. 208.67±30.25 μm, P<0.001). The deep vessel density in the myopic maculopathy group was significantly lower than that in the simple high myopia group (22.15%±3.12% vs. 27.89%±2.34%, P<0.001), with a CNV detection rate reaching 46.67%. Conclusions  OCTA can non-invasively quantify the retinochoroidal vessel density, hemodynamics, and non-perfusion characteristics of the macular region in high myopia, whereas SFCT can accurately reflect the atrophic changes of choroidal anatomy. Their synergistic evaluation achieves a dual quantification of macular microvascular "structure-function," revealing the multi-level microcirculatory damage in high myopia more comprehensively than a single modality. The CNV subgroup presents with more prominent macular microcirculation impairments, suggesting that severe microcirculatory damage may be an essential pathological basis for CNV development. The combination of OCTA and SFCT provides comprehensive imaging evidence for the early screening, subtype differentiation, and severity assessment of myopic maculopathy. Related Articles | Metrics

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Distribution characteristics of angle Alpha and angle Kappa and their association with ocular biometric parmeters Liu Shuaishuai, Ren Qianwen, Ding Xiaochen, Liu Yong Ophthalmology in China    2026, 35 (1): 54-60.   DOI: 10.13281/j.cnki.issn.1004-4469.2026.01.009 Abstract （197）            Knowledge map    Save Objective To observe and describe the distribution characteristics of angle Alpha and angle Kappa in adults with normal axial length, as well as their correlations with age and ocular biological parameters.Design Retrospective study. Participants A total of 9,272 cases (18,544 eyes), with an age range of 6~95 years (33.27±25.70 years), who underwent Lenstar 900 examination at Hefei Aier Eye Hospital from January 2018 to December 2022 were included. All participants had an axial length of 21~26 mm and no history of refractive surgery, contact lens wear, ocular trauma, or other ocular surgeries. Methods Participants were divided into 10 groups by age (≤10 group, >10~20 group, >20~30 group, >30~40 group, >40~50 group, >50~60 group, >60~70 group, >70~80 group, >80~90 group, >90 group). Each eye was measured consecutively 3 times using the Lenstar 900, and the average value was taken for analysis. The Lenstar 900 expresses the angle Kappa as the distance between the pupil center and the corneal vertex. The angle Alpha is represented by the distance between the corneal center and the corneal vertex. The Kolmogorov-Smirnov test was used to verify the data distribution; non-normally distributed data were expressed as median (P25, P75). The Wilcoxon signed-rank test was applied to compare differences in angle Alpha and angle Kappa between the left and right eyes, as well as between genders. Spearman correlation analysis was used to explore the relationships between angle Alpha/angle Kappa and ocular parameters. A linear mixed-effects model was used to control the correlation between the two eyes of the same subject, and nonlinear regression was used to fit the age-related change curves of angle Alpha and angle Kappa. Main Outcome Measures The distribution of angle Alpha and angle Kappa, and their correlations with age and ocular biological parameters. Results Both angle Alpha and angle Kappa showed a non-normal skewed distribution. For angle Alpha, 71.70% of eyes had a value <0.5 mm, and 93.97% had a value <0.8 mm. For angle Kappa, 94.86% of eyes had a value <0.5 mm, and 99.39% had a value <0.8 mm. Angle Alpha in both eyes was mostly distributed in the superotemporal quadrant, with the largest value in the superotemporal quadrant; angle Kappa in both eyes was mostly distributed in the inferotemporal quadrant with the largest value in the inferotemporal quadrant. The median angle Alpha was 0.42 (0.26, 0.53) mm for the right eye and 0.41 (0.26, 0.52) mm for the left eye (P=0.004); it was 0.41 (0.26, 0.53) mm in males and 0.40 (0.25, 0.52) mm in females (P=0.001). The median angle Kappa was 0.24 (0.14, 0.31) mm for the right eye and 0.23 (0.13, 0.30) mm for the left eye (P＜0.001); it was 0.23 (0.13, 0.30) mm in males and 0.24 (0.13, 0.31) mm in females (P=0.825). There was a moderate positive correlation between angle Alpha and angle Kappa (r=0.352, P<0.001). Neither angle Alpha nor angle Kappa showed a significant linear correlation with age; instead, they exhibited a non-linear relationship of first decreasing and then increasing. The regression equations were as follows: angle Alpha=0.5076-0.0101Age+0.0001Age2 and angle Kappa=0.2139-0.0014Age+0.00003Age2. The smallest values of both angles were observed in the 20~30 years age group. Additionally, angle Alpha and angle Kappa were positively correlated with lens thickness (r=0.166， P＜0.001； r=0.215， P＜0.001), negatively correlated with anterior chamber depth (r=-0.223， P＜0.001； r=-0.234， P＜0.001), axial length (r=-0.295， P＜0.001； r=-0.162， P＜0.001), and white-to-white distance (r=-0.079， P＜0.001； r=-0.119， P＜0.001), and showed no correlation with central corneal thickness and corneal curvature radius. Conclusion Alpha and Kappa angles are primarily distributed on the temporal side of the visual axis, both exhibiting a trend of initially decreasing and then increasing with age. Alpha and Kappa angles measured by Lenstar 900 both show non-normal distribution, Alpha angles are greater individual variation compared with Kappa angles. Alpha and Kappa angles exhibit significant correlations with the ocular structural parameters. Related Articles | Metrics

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Analysis of medical costs of ophthalmic ambulatory surgery model  Zhang Rui, Zhong Wei, Xiao Xiao Ophthalmology in China    2025, 34 (6): 489-492.   DOI: 10.1328 1/i.cnki.issn.10048-4469.2025.06.012 Abstract （197）            Knowledge map    Save  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. Related Articles | Metrics

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Ophthalmology in China    2025, 34 (5): 409-410.   DOI: 10.13281/j.cnki.issn.1004-4469.2025.05.017 Abstract （195）            Knowledge map    Save Related Articles | Metrics

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Ophthalmology in China    2025, 34 (5): 397-397.   DOI: 10.13281/j.cnki.issn.1004-4469.2025.05.024 Abstract （191）      PDF（pc） （604KB）（139）       Knowledge map    Save Related Articles | Metrics