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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 Abstract （519）      PDF（pc） （840KB）（1364）       Knowledge map    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) Related Articles | Metrics

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Ophthalmology in China    2023, 32 (6): 524-525.   DOI: 10.13281/j.cnki.issn.1004-4469.2023.06.017 Abstract （506）            Knowledge map    Save Related Articles | Metrics

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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 Abstract （490）            Knowledge map    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) Related Articles | Metrics

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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 Abstract （481）      PDF（pc） （1985KB）（1404）       Knowledge map    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) Related Articles | Metrics

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Ophthalmology in China    2023, 32 (6): 515-515.   DOI: 10.13281/j.cnki.issn.1004-4469.2023.06.020 Abstract （481）            Knowledge map    Save Related Articles | Metrics

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Ophthalmology in China    2023, 32 (6): 526-528.   Abstract （480）            Knowledge map    Save Related Articles | Metrics

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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 Abstract （477）            Knowledge map    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) Related Articles | Metrics

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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 Abstract （470）            Knowledge map    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) Related Articles | Metrics

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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 Abstract （458）            Knowledge map    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) Related Articles | Metrics

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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 Abstract （447）      PDF（pc） （1611KB）（1330）       Knowledge map    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) Related Articles | Metrics

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Ophthalmology in China    2023, 32 (6): 529-530.   DOI: 10.13281/j.cnki.issn.1004-4469.2023.06.019 Abstract （438）            Knowledge map    Save Related Articles | Metrics

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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 Abstract （428）            Knowledge map    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) Related Articles | Metrics

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Clinical comparative study on the treatment of juvenile open-angle glaucoma with gonioscopy-assisted transluminal trabeculotomy and microcatheter-assisted circumferential trabeculotomy  Di Haohao, Chen Xuhao, Zhang Weijia, Gao Chuanwen, Qian Lifeng, Wang Huaizhou Ophthalmology in China    2023, 32 (6): 471-476.   DOI: 10.13281/j.cnki.issn.1004-4469.2023.06.004 Abstract （425）      PDF（pc） （986KB）（1355）       Knowledge map    Save Objective To systematically compare the long-term postoperative efficacy and safety of gonioscopy-assisted transluminal trabeculotomy (GATT) and microcatheter-assisted circumferential trabeculotomy (MAT) and to provide a reference for the treatment of juvenile open-angle glaucoma (JOAG). Design Retrospective case series. Participants From January 2018 to June 2021, a total of JOAG patients who visited the Glaucoma Department of the Second People's Hospital of Zhengzhou and underwent trabeculotomy surgery were included in the study. Among them, there were 22 cases (30 eyes) in the GATT group and 19 cases (24 eyes) in the MAT group. Methods The patients were divided into the GATT group and the MAT group according to the surgical procedure. The preoperative and postoperative (at 1 day, 1 week, 1, 3, 6, 9 months, and 1 year) intraocular pressure (IOP) were recorded, as well as the types of antiglaucoma medications used during the 1-year follow-up. Complete success of the surgery was defined as achieving an IOP between 6~18 mmHg or a reduction in IOP by more than 20% from baseline without the use of antiglaucoma medications. Qualified success was defined as an IOP ＜21 mmHg or a reduction in IOP by more than 20% from baseline, along with a decrease in the use of antiglaucoma medications. Compare the IOP levels, medication use, and surgical success rates at different time points. Main Outcome Measures IOP, medications, success rate. Results The IOP in both groups was significantly lower than before surgery in 1 day, 1 week, 1 month, 3 months, 6 months, 9 months, and 1 year after surgery (all P<0.05). Compared to preoperative levels, the decrease in IOP at 1 day after surgery was greater in the MAT group (21.1±14.8) mmHg compared to the GATT group (13.4±12.2) mmHg (t=-2.105, P=0.040). However, there was no statistically significant difference in the change of IOP between the two groups at the various follow-up time points from 1 week to 1 year after surgery. One year after surgery, the median number of drugs in both the GATT and MAT groups decreased by three, which was significant compared to before surgery (both P<0.001). One year after surgery, the complete success rate was 60.0% in the GATT group and 70.8% in the MAT group, while the qualified success rate was 90.0% in the GATT group and 95.8% in the MAT group, with no significant difference between the two groups. The two groups had no significant difference in the abnormal IOP events. Conclusion For JOAG population, MAT demonstrates a greater reduction in IOP in the early stage, while GATT and MAT have the same long-term IOP lowering effect and success rate, and there is no difference in the abnormal IOP events between both surgeries. (Ophthalmol CHN, 2023, 32: 471-476) Related Articles | Metrics

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Ophthalmology in China    2023, 32 (6): 476-477.   DOI: 10.13281/j.cnki.issn.1004-4469.2023.06.013 Abstract （421）            Knowledge map    Save Related Articles | Metrics

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Ophthalmology in China    2023, 32 (6): 519-521.   DOI: 10.13281/j.cnki.issn.1004-4469.2023.06.015 Abstract （420）            Knowledge map    Save Related Articles | Metrics

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Comparison of corneal thickness and diopter stability after SMILE, FS-LASIK and Trans-PRK for correcting myopia   Xu Lingling, You Changtao, Li Shuaifei, Chen Dongdong Ophthalmology in China    2023, 32 (6): 496-501.   DOI: 10.13281/j.cnki.issn.1004-4469.2023.06.009 Abstract （418）            Knowledge map    Save Objective To compare the corneal thickness and diopter stability after SMILE、FS-LASIK and T-PRK for correcting myopia. Design Retrospective cases series. Participants From January 2021 to July 2021,108 patients(108 right eyes) who underwent corneal refractive surgery in Zhengzhou Aier Eye Hospital. According to the accepted surgery, the patients were divided into SMILE（36 eyes）, FS-LASIK （36 eyes） and T-PRK（36 eyes）. Methods Apical corneal thickness (ACT) and spherical equivalent (SE) were reviewed preoperative, 2 weeks, 1 month, 3 months, 6 months and 1 year after surgery. The ACT and SE of one kind of surgery at different time and each time point were analyzed. Main Outcome Measures ACT, SE. Results Comparison of postoperative ACT: After SMILE the thinnest was 2 weeks, and the second was 1 month (all P＜0.05). After FS-LASIK, there were no significant differences between 1 month, 6 months with 3 months, but the thickness were gradually increased at other times(all P＜0.001). There were significant differences between 1 month and 3 months with other times after Trans-PRK (all P＜0.05) . The ACT became thicker in the early period after Trans-PRK, then became thinner, until stablily. Statistically significant differences of SMILE and Trans-PRK were thicker than FS-LASIK at any time (P＜0.05). Comparison of postoperative SE: Statistically significant differences of 2 weeks after SMILE was higher than 1 year (P=0.037). The diopter was unstable in the 1 month after FS-LASIK (all P＜0.05). There were significant differences between 1 month, 6 months with 1 year after Trans-PRK (all P=0.002). Statistically significant differences of SMILE was lower than FS-LASIK at 2 weeks (P=0.002). There was no statistical significance between the three surgery at other time. At 1 year after surgery,  SE within range ±0.50 D at SMILE, FS-LASIK and Trans-PRK group was 61%, 53% and 64%, respectively, and SE within range ±1.00 D was 93%, 89% and 89%, respectively. Conclusion The ACT all tended to be stable and slightly thickened after 3~6 months of the three refractive surgery. The corneal thickness of SMILE and Trans-PRK were thicker than FS-LASIK. The three refractive surgery all had a slight regression with time. Trans-PRK was preferred for low-moderate myopia or thin cornea, SMILE was preferred for moderate-high myopia, while FS-LASIK for high myopia or thin cornea should pay more attention to regression. (Ophthalmol CHN, 2023, 32: 496-501) Related Articles | Metrics

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Ophthalmology in China    2023, 32 (6): 516-518.   DOI: 10.13281/j.cnki.issn.1004-4469.2023.06.014 Abstract （413）            Knowledge map    Save Related Articles | Metrics

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Ophthalmology in China    2023, 32 (6): 522-523.   DOI: 10.13281/j.cnki.issn.1004-4469.2023.06.016 Abstract （386）            Knowledge map    Save Related Articles | Metrics

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Ophthalmology in China    2023, 32 (6): 461-461.   DOI: 10.13281/j.cnki.issn.1004-4469.2023.06.021 Abstract （363）            Knowledge map    Save Related Articles | Metrics

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Ophthalmology in China    2023, 32 (6): 468-470.   DOI: 10.13281/j.cnki.issn.1004-4469.2023.06.012 Abstract （357）            Knowledge map    Save Related Articles | Metrics

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Ophthalmology in China    2023, 32 (6): 492-495.   DOI: 10.13281/j.cnki.issn.1004-4469.2023.06.008 Abstract （351）            Knowledge map    Save Objective To investigate the difference of the diopter between non-cycloplegic refraction and cycloplegic refraction in 7-17 years old myopic children with different accommodation conditions, and to analyze the feasibility of prescription of glasses according to non-cycloplegic refraction. Design Matched case-control study. Participants The adolescents and children aged 7 to 17 years old with  equivalent spherical lens ≤-0.75 D (cycloplegia refraction) and cylindrical lens diopter ≤1 D (non-cycloplegia refraction and cycloplegia refraction) who underwent cyclopletic optometry using compound tropicamine eye drops from January 2015 to April 2022 in the optometry Department of Jinan Aier Eye Hospital. Methods The medical records of the optometry outpatient department were reviewed. All subjects underwent comprehensive refraction, NRA (negative relative accommodation), BCC (binocular cross-cylinder), PRA (positive relative accommodation) before cycloplegia, and comprehensive refraction after cycloplegia. Patients with BCC ≥0.25 and NRA ≥1.75 were taken as group A (normal or large-behind accommodation), and BCC ≤0 or NRA ≤1.5 were taken as group B (super-normal accommodation). The data of the two groups were obtained by propensity score matching. 884 cases (1310 eyes) were screened to meet the requirements, including 416 males and 468 females. After grouping, there was no significant difference in age, diopter after cycloplegia and PRA between the two groups (472 cases with 650 eyes in group A and 412 cases with 660 eyes in group B), which was comparable (P>0.05). Main Outcome Measure The diopter before and after ciliary paralysis and the difference between them. Results After cycloplegia, the spherical and equivalent spherical mirrors of the eyes were significantly lower than those before cycloplegia (the spherical t=23.318, P<0.001, the equivalent spherical t=19.871, P<0.001). Bland Altman pairing analysis was used to test the consistency of the optometry results before and after cycloplegia in the two groups. The results showed that the diopters before and after cycloplegia in the two groups A and B were consistent; When the change of spherical lens diopter before and after ciliary paralysis was ≥0.5 d, 11.54% and 12.58% of the eyes in groups A and B had changes in diopter between non-cycloplegic and cycloplegic, and there was no significant difference between the two groups (X2=0.332, P=0.564). Conclusion It should be cautious to take the accommodation conditions as the basis of whether the cycloplegia optometry is required when prescribing glasses, and it should be made with caution in combination with other factors even it’s adjustment function is normal or large-behind. (Ophthalmol CHN, 2023, 32: 492-495) Related Articles | Metrics

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Comparing of macular retinal thickness parameters at acute attack with after intraocular pressure control in primary acute angle-closure glaucoma Lu Ping, Lv Aiguo, Wu Jian, Guo Lixia, Guo Li, Zhang Zhihong, Cui Hongyu, Li Xiaoyan, Fan Sujie Ophthalmology in China    2024, 33 (1): 23-27.   DOI: 10.13281/j.cnki.issn.1004-4469.2024.01.004 Abstract （347）            Knowledge map    Save  Objective  To measure macular parameters in patients with acute primary angle closure glaucoma (APACG) and investigate the differences in these parameters between the acute phase and the long-term period after intraocular pressure (IOP) control by using of optical coherence tomography (OCT). Design Retrospective case series. Participants Thirty patients with APACG acute attack in Handan Eye Hospital from December 2016 to December 2017 were enrolled. The affected eyes were used as the study group (33 eyes), and the contralateral eyes were used as the control group (27 eyes). Methods IOP, OCT, visual acuity, and slit lamp examination were performed at acute attack stage and 6 months after IOP control. The differences of retinal thickness parameters in macular OCT images at acute attack eyes from after IOP control were compared, and compared with the contralateral eyes. The image features of the OCT topographic map in the macular region were observed and analyzed. The macular central foveal thickness, retinal thickness, retinal volume, and average thickness of the scanned area were calculated using system software. Main Outcome Measures IOP and retinal thickness parameters. Results The mean intraocular pressure was (52.6±8.2) mmHg at the acute attack, and (14.2±4.1) mmHg at 6 months after treatment. Compared with the control of IOP, the thickness of the outer quadrant of the macular area, the inferior inner ring and the temporal retina at the acute attack were thicker (all P<0.05); the retinal volumes were increased (all P<0.05) and the average thickness of the scanning area was thickened (P=0.009). There was no significant difference in the macular thickness of the contralateral eye between the acute attack period and 6 months after IOP control (P=0.750). The mean retinal thickness of the attack eyes was thicker than that of the contralateral eyes during the acute attack period (P=0.001), and the mean retinal thickness of the attack eyes was thinner than that of the contralateral eyes at 6 months after IOP control (P=0.001). Conclusion Compared with that after IOP control, the macular retinal thickness becomes thicker in the acute stage of APACG, and the macular retinal thickness becomes thinner after 6 months of APACG. It is suggested that the macular retinal ganglion cells atrophy and thinning due to acute ocular hypertension injury. It is suggested to reduce the intraocular pressure as soon as possible to reduce the damage to the macular retina. (Ophthalmol CHN, 2024, 33: 23-27) Related Articles | Metrics

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Effect of early mydriasis after cataract surgery on pupil diameter in patients with diabetic retinopathy Sun Lin, Wu Xiaoqiang, Ning Chaobing Ophthalmology in China    2024, 33 (1): 53-56.   DOI: 10.13281/j.cnki.issn.1004-4469.2024.01.009 Abstract （342）            Knowledge map    Save Objective To investigate the effect of early mydriasis on pupil diameter in patients with diabetic retinopathy after cataract surgery. Design Randomized clinical trial. Participants 256 patients with diabetic retinopathy combined with cataract who underwent cataract surgery in Zigong Third People's Hospital from December 2020 to December 2021. Methods The patients were divided into 128 cases each in the experimental and control group according to the random number table method. The experimental group was given compound tropicamide eye drops to dilate the pupil on the 1st to 7th postoperative days, and the control group was given dilation on the 7th to 14th postoperative days. Pupil diameter≥7 mm at 5 min after the end of pupil dilation was considered to have reached the standard. Comparing the clinical data of the two groups, Logistic regression was used to correct the influencing factors of pupil diameter and analyze the correlation between the early pupil dilation and the diameter after pupil dilation. Main Outcome Measures Pupil diameter and pupil diameter attainment. Results The ideal and total attainment of pupil diameter in the experimental group were higher than that in the control group (χ2=9.976, P=0.002). After adjusted for age, duration of diabetes mellitus, diabetic retinopathy stage, preoperative corrected visual acuity, hemoglobin A1c (HbA1c) level, and albumin creatinine ratio (ACR) level, the pupil diameter after pupil dilation in the experimental group was greater than that in the control group (P<0.05). Early postoperative pupil dilation was independently associated with increased diameter after pupil dilation (OR=0.53, 95%CI: 0.38~0.71, P<0.001). Conclusion Early postoperative dilation is helpful to the  better pupil diameter attainment and larger pupil diameters in the caract patients with diabetic retinopathy. (Ophthalmol CHN, 2024, 33: 53-56) Related Articles | Metrics

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Circulation control characteristics of retina and choroid  Huang Houbin Ophthalmology in China    2024, 33 (1): 1-8.   DOI: 10.13281/j.cnki.issn.1004-4469.2024.01.001 Abstract （334）      PDF（pc） （1459KB）（930）       Knowledge map    Save The circulation mechanisms of retina and choroid are different in various aspects including autoregulation, neuro-regulation, humor regulation and neurovascular regulation, which is closely associated with the development of retinochoroidal ischemic diseases. The circulation characteristics of retina and choroid also have many imparities. It is usually considered that central retina artery predominantly contributes the blood supply of retina but in fact choroid does. This article details above topics so as to be able to explore the pathogeneses of retinochoroid vasculopathies in depth. (Ophthalmol CHN, 2024, 33: 1-8) Related Articles | Metrics

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Clinical characteristics analysis of 29 patients with oscillopsia presenting initially to ophthalmology with visual swaying Cui Shilei, Peng Jingting, Kong Xiuyun, Wu Jing, Wang Jiawei, Jiang Hanqiu Ophthalmology in China    2024, 33 (1): 9-14.   DOI: 10.13281/j.cnki.issn.1004-4469.2024.01.002 Abstract （323）            Knowledge map    Save Objective To conduct a retrospective analysis of the characteristics of visual swaying, types of abnormal eye movements, and relevant etiological factors and treatment outcomes in patients presenting with oscillopsia. Design Retrospective case series. Participants 29 patients with visual swaying initially presenting at the Department of Ophthalmology, Beijing Tongren Hospital, Capital Medical University, from January 2019 to January 2023. Methods Clinical data, including features of visual swaying, characteristics of video-nystagmography (VNG), brain MRI findings, etiological diagnosis, treatment, and outcomes, were retrospectively reviewed. Main Outcome Measures Clinical manifestations, VNG, brain MRI, and treatment outcomes. Results All 29 patients exhibited oscillopsia and visual related dizziness, with 27 cases (93.1%) presenting with binocular symptoms, 18 cases with vertical oscillopsia, 8 cases with horizontal oscillopsia, and 1 case with seesaw (vertical and torsional mixed type) oscillopsia. Two cases (6.9%) presented with monocular symptoms, including torsional or horizontal oscillopsia. 27 cases (93.1%) had persistent symptoms, while 2 cases (6.9%) had episodic symptoms. VNG revealed that the direction of visual swaying was consistent with abnormal eye movement, 23 cases (79.3%) showed nystagmus, including 17 cases with downbeat nystagmus, 3 cases with periodic alternating nystagmus, 2 cases with acquired pendular nystagmus, and 1 case with pendular seesaw nystagmus. Three cases (10.3%) exhibited saccadic intrusion, 2 cases (6.9%) had bilateral vestibular dysfunction, and 1 case (3.4%) had superior oblique myokymia. All patients underwent at least one MRI examination, with 21 cases (87.5%) showing positive abnormal changes in cerebellar tonsils or optic nerves. Fourteen cases (48.3%) demonstrated improvement with different targeted treatments, such as surgical decompression or gabapentin, baclofen, or clonazepam. Conclusion Patients with oscillopsia commonly present with vertical and horizontal binocular visual swaying phenomena. Among etiology is varied, its characteristics are related to the type of abnormal eye movement, acquired nystagmus is predominant. Early recognition and understanding of visual symptoms and signs contribute to the prompt diagnosis and treatment. (Ophthalmol CHN, 2024, 33: 9-14) Related Articles | Metrics

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Risk factors of recurrence after vitrectomy surgery for rhegmatogenous retinal detachment Bai Junxing, Peng Xiaoyan, Zhu Xiaoqing Ophthalmology in China    2024, 33 (1): 35-38.   DOI: 10.13281/j.cnki.issn.1004-4469.2024.01.006 Abstract （320）            Knowledge map    Save  Objective To investigate the baseline ocular characteristics of patients with recurrence following vitrectomy for primary rhegmatogenous retinal detachment (RRD) and identify potential risk factors for the recurrence. Design Retrospective case series. Participants 16 patients (16 eyes) with recurrent retinal detachment after initial vitrectomy for RRD at Beijing Hua'er Hospital from January 2017 to December 2021 were selected, and 45 patients (45 eyes) who did not experience recurrence after initial vitrectomy during the same period were randomly selected as the control group. Methods Clinical data and ophthalmic examination results of the patients were analyzed retorspetively. We compared the clinical data at the initial diagnosis (course of disease, lens status, macular involvement, hole location, extent of detachment, inferior involvement, PVR grading, axial length, preoperative visual acuity, preoperative intraocular pressure) between the two groups, and recorded the characteristics in recurrence and follow-up. Logistic regression analysis was used to identify risk factors for recurrent retinal detachment after vitrectomy. Main Outcome Measures Course of disease, lens status, macular involvement, hole location, extent of detachment, inferior involvement, PVR grading. Results Univariate analysis showed that wider extent of retinal detachment (χ2=10.048, P=0.002), poor visual acuity (χ2=10.678, P=0.001), inferior hole location (χ2=5.972, P=0.045), inferior quadrant involvement (χ2=5.054, P=0.025), and PVR≥C grade (χ2=16.775, P<0.001) were associated with recurrence. Logistic regression analysis further indicated that the OR value for PVR grading ≥C (X1) was 8.47 (95% CI: 1.521~47.163, P=0.015). The main effect model for risk factors of recurrent retinal detachment was established as Logit (P)=β0(-3.322)+2.136X1 (χ2=23.133, P<0.001). Conclusion C grade or worse PVR is an important risk factor for recurrence of retinal detachment after vitrectomy for RRD. (Ophthalmol CHN, 2024, 33: 35-38) Related Articles | Metrics

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Ophthalmology in China    2024, 33 (1): 8-.   DOI: 10.13281/j.cnki.issn.1004-4469.2024.01.021 Abstract （303）            Knowledge map    Save Related Articles | Metrics

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Clinical study on the selection of intraocular lens power calculation methods after radial keratotomy Li Enjie, Yu Yangfan, Wang Xiaozhen, Liu Zhaochuan, Song Xudong Ophthalmology in China    2024, 33 (2): 94-98.   DOI: 10.13281/j.cnki.issn.1004-4469.2024.02.003 Abstract （303）            Knowledge map    Save Objective To evaluate the accuracy of Barrett True-K formula, Shammas formula and Haigis formula in the intraocular lens (IOL) of cataract patients after radial keratotomy (RK). Design Retrospective case series. Participants 28 patients (49 eyes) diagnosed with cataracts after RK at Beijing Tongren Hospital from January 2017 to February 2024. Methods IOL Master was used to obtain the parameters of the anterior segment of the patient before surgery. SRK/T formula, Shammas formula or Barrett True-K formula were used to calculate IOL diopter before surgery. The refractive status of the eye was obviously checked by optometry one month after surgery. The actual diopter was recorded by equivalent spherical (SE). Log on to the official website of American Refractive Association (www. ascrs.org) and apply Barrett True-K formula, Shammas formula and Haigis formula to calculate the predicted IOL diopter by replacing the actual postoperative diopter and the measured data of IOL Master. Then the actual implanted IOL diopter was subtracted from each formula to predict IOL diopter, denoted as IOL diopter error, and its absolute value was denoted as absolute diopter error. Main Outcome Measures Refractive error and absolute refractive error. Results For the 28 patients (49 eyes) included in the study, the refractive error of Barrett True-K formula method was 0.13 (-0.75, 0.89) D at one month after surgery, which was significantly lower than that of Shammas formula method -1.20 (-1.94, -0.54) D, Haigis formula method -1.59 (-2.54，-0.49) D (S=39.837, P<0.001). The absolute refractive error of Barrett True-K formula method was 0.79 (0.39, 1.58) D, which was lower than that of Shammas formula method 1.21 (0.57, 1.94) D and Haigis formula method 1.59 (0.49, 2.54) D (S=9.959, P=0.007). In all 28 patients (49 eyes), Barrett True-K formula method accounted for 39%, 67% and 96% of refractive errors in the range of ±0.5 D, ±1.0 D and ±2.0 D, respectively.  Shammas formula method accounted for 29%, 51%, 88%, and Haigis formula method accounted for 33%, 43%, 80%, respectively. The difference of refractive error between the three formulas in the range of ±1.0 D (χ2=6.130, P=0.047) and ±2.0 D (χ2=6.078, P=0.048) was statistically significant. The absolute refractive error of Barrett True-K formula was negatively correlated with the axial length of the eye (r=-0.397, P=0.008). For patients (19 cases, 33 eyes) who applied Barrett True-K formula method to calculate IOL diopter before surgery, the diopter error of Barrett True-K formula method was 0.30 (-0.78, 1.56) D, which was significantly lower than that of Shammas formula method-1.18 (-1.77, -0.59)D, -1.31 (-2.46, -0.34)D (S=28.42, P<0.001) for Haigis formula method. There was no statistical significance in the absolute refractive error of Barrett True-K formula compared with Shammas formula and Haigis formula (S=3.697, P=0.157). In the patients with IOL diopter calculated by Barrett True-K formula before surgery, Barrett True-K formula method accounted for 24%, 61% and 97% of refractive errors in the range of ±0.5 D, ±1.0 D and ±2.0 D, respectively. Shammas formula method accounted for 15%, 42% and 87%. Haigis formula method accounted for 30%, 39% and 64%, respectively. The proportion of refractive error of Barret True-K formula method within ±2.0 D was higher than that of Shammas formula method and Haigis formula method (χ2=13.778, P=0.001). Conclusion For cataract patients after RK, there are some differences in the accuracy of Barrett True-K formula method, Shammas formula method and Haigis formula method. The absolute refractive error of Barrett True-K formula method is negatively correlated with the length of the axis of the eye, that is, the longer the axial length of the eye, the lower the absolute refractive error and the higher the accuracy. (Ophthalmol CHN, 2024, 33: 94-98) Related Articles | Metrics

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Twenty-one months efficacy of intravitreal chemotherapy for retinoblastoma with vitreous seeding Li Cheng, Zhang Chengyue, Cui Yanhui, Li Li Ophthalmology in China    2024, 33 (1): 47-51.   DOI: 10.13281/j.cnki.issn.1004-4469.2024.01.008 Abstract （302）            Knowledge map    Save Objective To explore the clinical efficacy of intravitreal chemotherapy for retinoblastoma with vitreous seeding. Design  Retrospectvie case series. Participants 18 patients (18 eyes) unilateral group cT2 retinoblastoma patients diagnosed and treated at Beijing Children’s Hospital from October 2019 to October 2020 were recruited. Methods According to the morphological characteristics of vitreous implant lesions, the patients were divided into type 1 (dust-like) and type 2 (spherical). All the patients received intravitreal injection of melphalan. Number of intravitreal injection, time to regression of vitreous seeds, follow-up time, complications related to surgery and extraocular extension were recorded. Globe salvage rate were computed. Number of intravitreal injection and time to regression of vitreous seeds in different group were compared with rank sum test. Main Outcome Measures The Times of intravitreal chemotherapy, the regression time of vitreous implantation tumor, the follow-up time, the occurrence of surgery-related complications, the presence of extraocular metastasis of tumor, and the eye preservation rate. Results Among 18 patients (18 eyes) unilateral group cT2 retinoblastoma patients, the morphologic feature of vitreous seeds was dustlike (type1) in 10 patients (10 eyes), was spherelike (type 2) in 8 patients (8 eyes). Vitreous seeds of all patients regressed after intravitreal injection of melphalan. During the treatment and follow-up period, 8 eyes (44.4%) had pepper-and-salt retinopathy close to the injection location in the retina and 2 eyes(11.1%) had mild vitreous hemorrhage. No patient died or had extraocular extension. The follow-up time was （21.08±2.18）months. The median number of intravitreal injection for type 1 and type 2 was 2.5（2, 3） and 5.5（5, 6）, respectively (Z=-3.679, P<0.05). The median time to regression of vitreous seeds for type 1 and type 2 was 1.875 months（1.56，2.00） and 3.875 months（3.50, 4.06）, respectively (Z=-3.586, P<0.05). Conclusion Intravitreal chemotherapy is the very effective treatment modality for retinoblastoma with vitreous seeds. (Ophthalmol CHN, 2024, 33: 47-51) Related Articles | Metrics

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Patterns of persistent submacular fluid after scleral buckling and its relationship with visual prognosis Chen Yanyun, Zhou Dan, Li Lei, He Lei, Yu Jie, Shi Xiangyu Ophthalmology in China    2024, 33 (1): 29-34.   DOI: 10.13281/j.cnki.issn.1004-4469.2024.01.005 Abstract （298）            Knowledge map    Save Objective To investigate the different patterns of persistent submacular fluid (PSF) in rhegmatogenous retinal detachment (RRD) after scleral buckling and its relationship with visual prognosis. Design Retrospective case series. Participants From June 2020 to February 2023, 50 cases (50 eyes) of RRD patients who was undergone the scleral buckling and successful retinal reattachment at one time and were observed PSF after 1 month after the sugrey. Methods The surgery followed the rules of minimal scleral buckling design. PSF was defined as that submacular fluid was not absorbed for more than one month. All patients were followed up at 1 day, 3 days, 7 days, one month, and every month after operation until the PSF was absorbed completely. Visual acuity, intraocular pressure and OCT were checked at every visit. Based on the PSF pattern in OCT at 1 month after the surgery, patients were divided into 3 groups:  single discrete bleb of fluid group, multiple blebs of fluid group, and confluent fluid group. Main Outcome Measures PSF patterns, PSF absorption time, best corrected visual acuity (BCVA, LogMAR). Results Among 50 cases (50 eyes), 6 eyes(12%) were in single discrete bleb of fluid pattern group, 12 eyes (24%) were in multiple blebs of fluid pattern group and 32 eyes (64%) were in confluent fluid pattern group. During follow-up, 9 eyes changed from multiple blebs pattern to single discrete bleb pattern, 25 eyes changed from confluent fluid pattern to multiple blebs pattern and single discrete bleb pattern. There were no significant differences among the 3 groups in preoperative BCVA ≥0.05 (χ2=2.13, P=0.345), high myopia(χ2=1.64，P=0.441), duration of disease within 1 month (χ2=2.10，P=0.350), drainage (χ2=0.44，P=0.803) and surgical method segmental combined encircling episcleral buckles (χ2=2.47，P=0.291). The PSF absorption time was 4.50 (2.75, 5.25) months, 6.00 (3.00, 8.75) months, and 7.50 (4.25, 9.75) months in single discrete bleb of fluid pattern, multiple blebs of fluid pattern and confluent fluid pattern, respectively, without significant difference (H=5.26，P=0.072). The BCVA (LogMAR) at final visit was 0.20 (0.10, 0.33), 0.10 (0.00, 0.45), 0.15 (0.10, 0.50) in single discrete bleb of fluid pattern, multiple blebs of fluid pattern, and confluent fluid pattern group, respectively, without significant difference (H=1.16，P=0.560). At final visit, there was no significant difference in the continuity of the outer retinal ellipsoid zone among 3 groups (χ2=0.87, P=0.648). Conclusion Different patterns of PSF after scleral buckling can change during follow-up, and the multiple blebs pattern is an intermediate process between confluent fluid pattern and single discrete bleb pattern. There is no difference among different patterns of PSF in the absorption time, visual prognosis and the continuity of the outer retinal ellipsoid zone. (Ophthalmol CHN, 2024, 33: 29-34) Related Articles | Metrics

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Six months efficacy of vitrectomy combined with different dosage intravitreal injection of triamcinolone acetonide for idiopathic macular Chen Fei, Qiu Yan, Tang Leilei, He Huijun, Wang Bing, Gao Feng Ophthalmology in China    2024, 33 (1): 39-45.   DOI: 10.13281/j.cnki.issn.1004-4469.2024.01.007 Abstract （294）            Knowledge map    Save Objective To investigate the effect and safety of 25-gauge vitrectomy combination with different dosage of intravitreal injection of triamcinolone acetonide (IVTA) for the treatment of the patients with idiopathic macular epiretinal membrane (iERM). Design Randomized controlled trial. Participants From April to October 2022, sixty eyes of 60 patients with iERM diagnosed by department of Ophthalmology at Tengzhou Central People’s Hospital were included. Methods The patients were classified randomly into vitrectomy combined with IVTA 1 mg group (20 eyes of 20 patients) and vitrctomy combined with IVTA 2 mg group (20 eyes of 20 patients) , and vitrectomy group (control group, 20 eyes of 20 patients). Before and 1, 3, 6 months after the surgery, best corrected visual acuity (BCVA, LogMAR) was measured using the international standard decimal visual acuity chart, intraocular pressure (IOP) was measured with non-contact tonometer, and central macular thickness (CMT), disorganization of retinal inner layers (DRIL) was assessed using the optical coherence tomography (OCT). Chi-square test was used for counted data and ranked data. One-way ANOVA was used for measurement data conforming to normal distribution, otherwise Kruskal-Wallis H test was applied. Comparison of BCVA and CMT before and after treatment within the group was performed using Friendman test. Main Outcome Measures BCVA, IOP, CMT, DRIL. Results One and three months after the surgery, the mean BCVA in vitrectomy combined with IVTA 1 mg and 2 mg group was higher than in vitrectomy group, and CMT was less than that in vitrectomy group (all P<0.05). But the difference was not statistically significant between vitrectomy combined with IVTA 1 mg group and IVTA 2 mg group (P>0.05). However, at 6 months postoperatively, there was no statistical differences among all the three groups regarding CMT, DRIL, and BCVA (all P>0.05). Three patients (15%) in the IVTA 2 mg group had varying degrees of IOP increase 1 month after surgery, all of which decreased to normal after medication. Conclusion Vitrectomy combined with IVTA 1 mg or 2 mg can accelerate postoperative visual improvement and CMT reduction in patients with iERM, but can not improve long-term prognosis. The effect of IVTA 1 mg is similar to that of IVTA 2 mg, but safer. (Ophthalmol CHN, 2024, 33: 39-45) Related Articles | Metrics

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Six months efficacy of shave excision on lid margin nevus without invasion of tarsus or conjunctiva Hu Yifan, He Yueqing, Hou Zhijia Ophthalmology in China    2024, 33 (1): 67-71.   DOI: 10.13281/j.cnki.issn.1004-4469.2024.01.012 Abstract （292）            Knowledge map    Save Objective To observe the efficacy of the shave excision on the benign lid margin nevus without invasion of tarsusor or conjunctiva. Design Retrospective case series. Participants 110 eyes of 106 patients diagnosed as benign lid margin nevus without invasion of tarsusor or conjunctiva between August 2019 and March 2023 in the Beijing Tongren Hospital. Methods The clinical data of the patients were retrospectively described and analyzed. All patients were treated with shave excision, and were followed up for 6 months after operation. Age and gender of the patients, the location, shape, size of the nevus, the duration of the operation, pathological results, the complications and recurrence of the nevus were recorded. Main Outcome Measures The duration of the operation, pathological results, the complications and recurrence of the nevus. Results The average operation time was 4±1 minute (2~11 minutes). After operation, all patients had good appearance, no obvious scar, no bleeding or infection. Complete removal of nevus was achieved in all patients. Pathological examinations revealed 76 intradermal nevus and 5 compound nevus. No recurrence was found during the follow-up period. There was no complication such as eyelid deformities, ectropion, entropion, or baldness postoperatively. Only 2 patients developed trichiasis after operation, and their symptoms relieved after treatment. Conclusion For the benign lid margin nevus that have no invasion of tarsus or conjunctiva, shave excision is a safe, effective and rapid surgical method. (Ophthalmol CHN, 2024, 33: 67-71) Related Articles | Metrics

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Observation of imaging features in different stages of idiopathic posterior scleritis using swept-source optical coherence tomography#br# Wang Ge, Ma Ya, Guan Wenxue, Cheng Yizhe, Zhang Zhihan, Peng Xiaoyan Ophthalmology in China    2024, 33 (2): 107-113.   DOI: 10.13281/j.cnki.issn.1004-4469.2024.02.005 Abstract （291）            Knowledge map    Save Objective To observe the image features of swept-source optical coherence tomography (SS-OCT) in patients with idiopathic posterior scleritis at different disease stages. Design Retrospective case series. Participants A total of 27 patients with idiopathic posterior scleritis diagnosed at Beijing Tongren Hospital from September 2018 to February 2021 were included in the study. Among them, 14 patients were bilateral involved and other 13 patients were unilateral involved. A total of 41 affected eyes were selected as the study group, and other 13 eyes were selected as the control group. Methods Disease staging was conducted based on the clinical manifestations of the enrolled patients. The active stage was defined as the period from the onset of symptoms to the stabilization stage. The stabilization stage was defined as the disappearance of patient discomfort complaints, discontinuation of medication, or use of the minimum maintenance dose of oral glucocorticoids (5-10 mg/day) and/or immunosuppressants (oral methotrexate 7.5 mg per week or lower doses). The recurrence stage was defined as the reappearance of symptoms and/or re-diagnosis of active posterior scleritis after the stabilization stage. All patients underwent SS-OCT examination at the initial visit, 1 and 2 weeks, and at 1, 3, 6, and 12 months after treatment. The abnormal features of the retina and choroid, as well as the thickness of the retinal and choroidal layers in the posterior pole of SS-OCT images, were compared among different stages. Main Outcome Measures The abnormal signs of retina and choroid showed by SS-OCT and their resolving time, thickness of retinal and choroid. Results Abnormal signs observed using SS-OCT in the active stage (n=41) included retinal folds in 23 eyes (56.10%), subretinal fluid in 11 eyes (26.83%), punctate hyperreflectivity in the retina and/or choroid in 35 eyes (85.37%),  RPE wave-like change in 11 eyes (26.83%), optic disc and/or macular edema in 25 eyes (60.98%), and choroidal structural abnormalities in 12 eyes (29.27%). These abnormal signs could occur simultaneously in different or the same regions of the fundus in the same patient. The choroidal thickness in the macular fovea of the eyes in the stabilization stage (n=41) was (245.923±6.829) μm, which was significantly lower than that in the active stage (n=41) (405.640±40.629) ?滋m (P=0.001). Compared with the stabilization stage, the choroidal thickness in the eyes in the recurrence stage (n=12) (354.917±62.034 ?滋m) increased again (P=0.001). Conclusion Abnormal imaging signs including punctuate hyperreflectivity in retina and/or choroid, increased choroidal thickness could be seen in active idiopathic posterior scleritis, while the choroidal thickness decreased significantly during stabilization stage and re-increased during recurrence stage. (Ophthalmol CHN, 2024, 33: 107-113) Related Articles | Metrics

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Exploration of the application of a new ophthalmic probationary assessment method Shi Xiangyu, Wang Yidi, Zhou Jun, Qin Yi Ophthalmology in China    2024, 33 (2): 150-153.   DOI: 10.13281/j.cnki.issn.1004-4469.2024.02.013 Abstract （282）            Knowledge map    Save  Objective To explore the application effect of a new ophthalmic probationary assessment method. Design Prospective comparative teaching study. Participants 22 ophthalmic graduate students in probationary training. Methods After completing standardized training for 4 weeks, a clinical oriented assessment method with a total of 7 items scoring 100 points for each, covering the basic content of clinical work (diagnosis and management of common diseases, application of electronic consultation system, medical record writing, and surgical microscope suturing operation) were designed and applied.  There were slit lamp operation, surgical microscope operation, external eye examination, direct ophthalmoscope, diplopia imaging examination, electronic system application for consultation, outpatient medical record writing. 22 students were randomly divided into two groups, assessment group A and non-assessment group B. At the end of the probation, group A conducted all assessment, and the teacher provided a detailed explanation for error afterwards. Immediately after, all students started clinical work for 4 weeks, and all students participated in the same assessment. The scores of two groups were compared. Main Outcome Measures Assessment scores. Results After 4 weeks clinical work, the average score of seven assessments for two groups was 94.47±1.96 in group A, which was significantly higher than group B's 86.51±5.38 (t=12.83, P<0.001). Group A scored higher than Group B in each assessment (all P<0.05). For slit lamp operation, the score was 96.0±1.9 in group A and 89.0±3.9 in group B. For surgical microscope operation, the score was 94.0±2.0 in group A and 88.0±4.9 in group B. For external eye examination, the score was 95.0±2.0 in group A and 83.0±5.0 in group B. For direct ophthalmoscope, the score was 94.0±1.7 in group A and 83.0±1.8 in group B. For diplopia imaging examination, the score was 93.8±2.4 in group A and 83.0±7.1 in group B. For electronic system application for consultation, the score was 95.2±1.5 in group A and 91.0±3.2 in group B. For outpatient medical record writing, the score was 94.0±2.1 in group A and 87.0±3.0 in group B. Conclusion The ophthalmic probationary assessment method in this study can improve the effect of clinical learning in ophthalmic graduate students. (Ophthalmol CHN, 2024, 33: 150-153) Related Articles | Metrics

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Clinical characteristics and quality of life of adult patients with sensory exotropia Gao Fei, Fu Jing, Ma Yingnan, Li Ran, An Ying, Wang Xin, Zhao Bowen Ophthalmology in China    2024, 33 (2): 127-131.   DOI: 10.13281/j.cnki.issn.1004-4469.2024.02.008 Abstract （281）            Knowledge map    Save  Objective To study the clinical characteristics and quality of life of adult patients with sensory exotropia in China, and to analyze the factors affecting the quality of life of patients. Design Prospective case-control study. Participants Twenty-seven adult patients with sensory exotropia were enrolled in Beijing Tongren Hospital from January 2023 to September 2023 as the case group, and 54 patients with other types of strabismus were collected as the strabismus control group, and 54 orthotropic people were enrolled as the normal control group. Methods The causes of disused eyes in patients with sensory exotropia were analyzed. Patients aged 18-40 years were treated with compound topiramate mydriasis refraction, patients aged over 40 years were treated with apparent refraction, best corrected visual acuity (BCVA) was tested by standard logarithmic visual acuity chart. The near stereopsis was tested by Yan-style stereogram, the far stereopsis was tested by synoptophore, and the horizontal and vertical deviations were measured by prism+alternate covering or prism+corneal reflection (low vision, unable to gaze). The quality of life of patients was evaluated by the Chinese version of the Adult Strabismus Patients Quality of Life Scale (CAS-20). The differences in general characteristics, visual function and quality of life among normal control group, sensory exotropia group and other type’s strabismus group were analyzed. The effects of individual factors and visual function on the quality of life of patients with sensory exotropia were analyzed. Main Outcome Measures BCVA, refraction, deviation, far and near stereopsis, course of disease, the quality of life scores of social psychology and visual function. Results The BCVA of 27 patients with disused exotropia was lower than 0.1. The average deviation was (84.60±12.73)△. The average deviation of other strabismus group was (57.45±17.65)△, the difference was statistically significant (Z=5.063, P=0.014). The main causes of sensory exotropia were acquired (ocular trauma was the most common). The proportion of patients with family history (0%) was lower than that of other types of strabismus group (16.67%) (P=0.024). All patients with sensory exotropia had no stereopsis, which was significantly lower than that of normal group and other strabismus groups (P<0.001). The course of sensory exotropia was longer than that of other strabismus groups (Z=9.556, P=0.002). There were statistically significant differences in the social psychological scores and visual function scores among the three groups. The total score of social psychological score insensory exotropia group was significantly lower than that of normal group (Z=-7.368, P<0.001) and other strabismus groups (Z=-3.139, P=0.020). The total score of visual function in sensory exotropia group was significantly lower than that of normal group (Z=-7.286, P<0.001), but there was no statistically significant difference between sensory exotropia group and other strabismus groups (Z=-1.540, P=0.124). Among the influencing factors of the quality of life of patients with sensory exotropia, the diopter of the disused eye was negatively correlated with the social psychological score (r=-0.375, P=0.002). The diopter of the disused eye was negatively correlated with the visual function score (r=-0.366, P=0.003). The BCVA of the disused eye was positively correlated with the social psychological score (r=0.326, P=0.005). The BCVA of the disused eye was positively correlated with the visual function score (r=0.313, P=0.006). The longer the course of strabismus was, the lower the social psychological score was (Z=7.037, P=0.021). Conclusion Compared with the normal population and other strabismus patients, the visual function of the affected eye in Chinese adult patients with sensory exotropia is seriously damaged, completely without binocular visual function, and the health-related quality of life is significantly reduced. The higher diopter of the disused eye, the poorer corrected visual acuity, and the longer course of strabismus are the main factors affecting the quality of life of patients. (Ophthalmol CHN, 2024, 33: 127-131) Related Articles | Metrics

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One year efficacy of nasal endoscopic surgery on congenital dacryocystocele Zheng Yingjie, Zhang Yi, Liu Yujuan Ophthalmology in China    2024, 33 (1): 71-75.   DOI: 10.13281/j.cnki.issn.1004-4469.2024.01.013 Abstract （278）            Knowledge map    Save Objective To observe the efficacy of nasal endoscopic surgery on congenital dacryocystocele. Design Retrospective case series. Participants A total of 131 children with congenital dacryocystocele admitted to Shaying Hospital, Ma'anshan, Anhui Province, Nanjing Aier Eye Hospital, and Jinzhou Aier Eye Hospital from January 2018 to January 2021 were included. Methods The patients' data were reviewed, and all patients underwent nasal endoscopic surgery (nasal cyst endoscopic marsupialization or endoscopic intranasal dacryocystorhinostomy). The follow-up time was 3 to 24 months, with an average of (14.3±2.1) months. Cure was defined as the disappearing of the mass, overflow of tears, and breathing difficulties; improvement was defined as the disappearance of mass, overflow empyema, and the presence of residual tears (due to trocar andtears puncture); unhealed was defined as the presence of overflowing pus and tears. Main Outcomes Measures Cure rate, improvement rate and complications. Results No serious intraoperative complications (such as bleeding and tissue damage) and postoperative complications (bleeding, infection, and hole atresia) were found. 85.5% cases (112/131 cases) were postoperatively cured; 14.5% cases (19/131 cases) were improved after surgery. Conclusion Nasal endoscopic surgery is relatively safe, with high success rate for treatment of congenital dacryocystocele. (Ophthalmol CHN, 2024, 33: 71-75) Related Articles | Metrics

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One year efficacy of penetrating canaloplasty without viscoelastic for primary open-angle glaucoma Liu Yacong, Zhou Wenzong, Liang Situo, Sun Jun, Zhao Hua, Wu Xintong, Wang Yali, Li Xiwei Ophthalmology in China    2024, 33 (1): 16-20.   DOI: 10.13281/j.cnki.issn.1004-4469.2024.01.003 Abstract （275）            Knowledge map    Save Objective To observe the efficacy and safety of penetrating canaloplasty without viscoelastic for primary open angle glaucoma (POAG). Design Prospective case series. Participants 25 patients (35 eyes) with POAG penetrating canaloplasty without viscoelastic at Cangzhou Aier Eye Hospital from December 2021 to June 2022 were treated. Methods Record preoperative and postoperative intraocular pressure (IOP), number of anti-glaucoma drugs, LogMAR best corrected visual acuity (BCVA), average retinal nerve fiber layer (RNFL) thickness, vertical C/D, average gangline cell layer (GCL) thickness in the macular area, intraoperative and postoperative complications. Time points of follow-up were arranged at 1 day, 7 days, 1 month, 3 months, 6 months, and 1 year after the surgery. Complete success was defined as IOP ≤21 mmHg without any glaucoma medications. Qualified success was defined as IOP≤21 mmHg with glaucoma medications (within 2 types). Main Outcom Measures Rate of circumferential catheterization of the canal, IOP, surgical success rate, and intraoperative and postoperative complications. Results 33 eyes (94.3%) achieved the 360 degrees’catheterization of the canal without viscoelastic. All patients completed a 12 month follow-up, with an average preoperative IOP of (25.8±7.7) mmHg. The postoperative IOP at 1 day, 7 days, 1 month, 3 months, 6 months, and 1 year were (14.1±6.1), (13.3±4.9), (14.8±4.4), (15.0±4.8), (15.2±4.0) and (14.7±3.6) mmHg, respectively. There were statistically significant differences between the preoperative and postoperative IOP (all P<0.001). The complete success rate and qualified success rate at 1 year after surgery were 90.9% (30/33) and 97.0% (32/33), respectively. Conclusion The penetrating canaloplasty without viscoelastic is safe and effective for the treatment of POAG. Which has a significant short-term effect on reducing IOP. (Ophthalmol CHN, 2024, 33: 16-20) Related Articles | Metrics

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Ophthalmology in China    2024, 33 (1): 14-15.   DOI: 10.13281/j.cnki.issn.1004-4469.2024.01.015 Abstract （271）      PDF（pc） （389KB）（802）       Knowledge map    Save Related Articles | Metrics

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Six months efficacy of inferior oblique muscle belly transposition in treating small angle congenital superior oblique muscle palsy Liu Xiuping, Zhang Chengyue, Wang Fengxian, Liu Dongyue, Wang Zheng, Han Ningze Ophthalmology in China    2024, 33 (1): 61-65.   DOI: 10.13281/j.cnki.issn.1004-4469.2024.01.011 Abstract （269）            Knowledge map    Save Objective To investigate the clinical effect of inferior oblique muscle belly transposition in the small angle congenital superior oblique muscle palsy with compensatory head position. Design Retrospective cases series. Participants The 18 patients (18 eyes) who has single eye small angle congenital superior oblique muscle palsy with compensatory head position and treated in the Ophthalmology Department of Baoding Hospital of Beijing Children's Hospital from April 2019 to December 2022. Methods For the above 18 patients, give the surgery of inferior oblique muscle belly transposition. The muscle abdomen was about 10-11 mm away from the inferior oblique muscle end and was fixed 5 mm after the temporal end of the lower rectus muscle. Observe the angle of vertical strabismus at the first-eye position measured with a prism, according to the Hunter grading method inferior oblique muscle hyperactivity of sick eye, compensatory head position, the fovea-disc angle (FDA) of fundus photograph was measured using Photoshop7.0 software. Main Outcome Measures The angle of vertical strabismus, inferior oblique muscle hyperactivity, compensatory head position and FDA. Results The angle of vertical strabismus at the first-eye position at 6 months after surgery was (0.51±0.60) PD, it was significantly lower than before (5.03±0.84) PD (t=14.241, P＜0.001). In the 18 eyes, before surgery,  the oblique muscle hyperactivity was 2+ in 10 eyes, 6 eyes disappeared and 4 eyes were 1+ after surgery; before surgery the oblique muscle hyperactivity was 1+ in 8 eyes, all disappeared after surgery, which was 100% effective. Before surgery all the 18 children showed the head tilt toward the healthy eye side, disappeared after surgery in 12 patients, and the compensatory head position was significantly improved in 6 children, there’s no reverse tilt, which was 100% effective. The FDA after surgery (4.81±2.53)° decreases (3.02±0.91)° than before surgery (9.82±5.17)°. During the 6 months’ follow-up, none of the patients developed relevant complications. Conclusion Inferior oblique muscle belly transposition is safe and effective for the treatment of small angle congenital superior oblique muscle palsy, especially in patients with compensatory head position. (Ophthalmol CHN, 2024, 33: 61-65) Related Articles | Metrics

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Prevalence and risk factors of hypertensive retinopathy in Zhangjiakou City in 2021-2022 Zhang Jia, Wang Yanli, Song Xiaocong, Wang Shuzhen Ophthalmology in China    2024, 33 (1): 57-60.   DOI: 10.13281/j.cnki.issn.1004-4469.2024.01.010 Abstract （265）            Knowledge map    Save  Objective To investigate the prevelence and risk factors of hypertensive retinopathy in Zhangjiakou City, Hebei province. Design Cross-sectional study. Participants Residents in 19 counties of Zhangjiakou city from May 2021 to December 2022. Methods The residents were screened for hypertension and hypertensive retinopathy. Blood pressure measurements, eye examinations and venous laboratory tests were performed on all the subjects. Age, gender, course of disease, body mass index and complications of the patients were collected by questionnaire. The prevalence of hypertensive retinopathy among residents in Zhangjiakou City was analyzed and the risk factors affecting the prevalence were analyzed. Main Outcome Measures Prevalence, the risk factors. Result A total of 1320 hypertension patients were detected in 8056 residents, and the prevalence rate of hypertension was 16.39%. 212 of the 1320 hypertensive patients were found to have retinopathy, the prevalence was 13.06% in hypertensive patients and 2.63% in all the examined residents. There was no difference between the proportion of male and female patients with hypertensive retinopathy, and the proportion of patients aged ≥60 years old was higher than that of patients aged < 60 years old (P<0.05). The disease course, systolic blood pressure, diastolic blood pressure, diabetes and smoking history in the patient group were higher than those in the control group (P<0.05). Regression results showed that long course of disease (OR=1.747), high systolic blood pressure (OR=2.340), high diastolic blood pressure (OR=1.424), diabetes history (OR=13.481) were risk factors for the occurrence of hypertensive retinopathy (all P<0.05). Conclusion The prevalence of hypertensive retinopathy in 19 counties and districts of Zhangjiakou City was about 13%, and the prevalence was high among residents aged ≥60 years. The risk factors were long course of disease, high systolic blood pressure, high diastolic blood pressure, and diabetes history. (Ophthalmol CHN, 2024, 33: 57-60) Related Articles | Metrics