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Efficacy of vitrectomy combined with internal limiting membrane peeling for proliferative diabetic retinopathy with macular detachment Jia Liyun, Zhang Yongpeng, Ma Kai Ophthalmology in China    2021, 30 (3): 222-226.   DOI: 10.13281/j.cnki.issn.1004-4469.2021.03.011 Abstract （466）            Knowledge map    Save Objective To observe the clinical efficacy of vitrectomy combined with inner limiting membrane (ILM) peeling in the treatment of proliferative diabetic retinopathy (PDR) with macular detachment. Design Retrospective comparative case series. Participants 39 cases (45 eyes ) diagnosed as PDR with macular detachment in Tongren Eye Center． Methods Vitrectomy and ILM peeling were performed in the ILM-removed group, in which there were 21 patients ( 24 eyes ); vitrectomy only were performed in the control group, in which there were 21 eyes of 18 patients. All the surgeries were performed by the same surgeon. Best corrected visual acuity (BCVA, LogMAR), complications, and the center macular thickness (CMT) and subretinal fluid height (SFH) were examined before the surgery and during follow-up at one week, one month, three month and six month postoperative． Main Outcome Measures BCVA, SFH, and CME. Results The BCVA of the combined group and the control group were significantly higher at 1 week, 1 month, 3 months and 6 months after operation than before operation (F=17.63, 16.94; P<0.001). The BCVA in the ILM-removed group (0.71±0.65) was higher than the control group (1.02±0.53) at three month after operation (t=2.73，P=0.009). The SFH of the two groups at 1 week, 1 month, 3 months and 6 months after operation was significantly lower than that before operation (F=17.63, 16.94; P<0.001). The CMT in the ILM-removed group (218.56±49.51 μm) was thinner than in the control group (289.32±65.34 μm ) at six month after operation (t=2.84，P=0.006). The SFH of the two groups decreased significantly at 1 week, 1 month, 3 months and 6 months after operation (F=17.63, 16.94, P<0.05). The SFH in the ILM-removed group (15.07±12.01 μm) was lower than in the control group (42.67±30.21 μm) at three month after operation (t=2.24，P=0.003). Conclusion In the treatment of PDR with macular detachment, vitrectomy combined with ILM peeling can effectively and safely improve visual acuity, reduce the thickness of macular center area and promote SRF absorption． (Ophthalmol CHN, 2021, 30: 222-226) Related Articles | Metrics

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Short-term efficacy of vitrectomy combined with air tamponade on rhegmatogenous retinal detachment with inferior holes Zhuang Jingjing, He Yongning, Luo wei, Tang Ruifei Ophthalmology in China    2021, 30 (3): 217-221.   DOI: 10.13281/j.cnki.issn.1004-4469.2021.03.010 Abstract （456）            Knowledge map    Save Objective To observe the short-term efficacy and feasibility of vitrectomy combined with air tamponade for rhegmatogenous retinal detachment (RRD) with inferior holes. Design Retrospective case series. Participants Forty-five patients with RRD with inferior holes who underwent pars plana vitrectomy（PPV）combined with air tamponade from June 2017 to October 2020 in Nanjing Aier Hospital. Methods All patients underwent 23-gauge vitrectomy combined with air tamponade. Best corrected visual acuity (BCVA), non-contact intraocular pressure (NCT), slit lamp microscope, indirect funduscopy with slit lamp, wide-angle fundus photography, optical coherence tomography (OCT), ophthalmic AB ultrasound examination and length of optic axis with IOL-Master were performed before surgery and 5 days, 3 weeks and 3 months postoperation. Retinal reattachment, BCVA, intraocular pressure (IOP) and complications were observed. Main Outcome Measures Retinal reattachment, BCVA, IOP and complications. Results Local retinal redetachment occurred in one patient at the second month after surgery. This patient underwent scleral buckling and got final reattachment. Initial reattachment was achieved 97.8% in the rest 44 patients in 3 months after surgery. No other patient suffered retinal redetachment during follow-up. Preoperative LogMAR BCVA was 1.82±0.83, and postoperative LogMAR BCVA was 0.71±0.34, 0.59±0.32, 0.56±0.30 respectively at 5 days, 3 weeks, and 3 months after surgery. All patients gained better postoperative BCVA. Increased IOP was found in two cases on the first postoperative day. Conclusion Vitrectomy combined with air tamponade is an effective treatment for RRD patients with well relaxed retina and closed inferior retinal holes. (Ophthalmol CHN, 2021, 30: 217-221) Related Articles | Metrics

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Incidence and influencing factors of anterior chamber reaction after intravitreal injection of ranibizumab and conbercept Zhang Xifang, Chen Rui, Miao Jingpeng, Qi Yue, Deng Guangda, Yang Fan, She Haicheng Ophthalmology in China    2021, 30 (4): 283-289.   DOI: 10.13281/j.cnki.issn.1004-4469.2021.04.007 Abstract （761）            Knowledge map    Save  Objective To compare the incidence of positive anterior chamber reaction after intravitreal injection of ranibizumab and conbercept, and analyzing the influencing factors. Design Prospective cohort study. Participants 877 patients received intravitreal injection of ranibizumab or conbercept in the day care unit of Fundus Department of Beijing Tongren Hospital between January 2020 and October 2020. Methods Intravitreal injection was performed according to the unified operation standard. At the first day after operation, the patients were examined and recorded for pain, blurred vision. Slit lamp examination was conducted to observe the ciliary congestion, anterior chamber cells, aqueous flare and hypopyon. Anterior chamber cells and aqueous flare were recorded according to the scheme determined by the standardized uveitis nomenclature (SUN) working group. Anterior chamber reaction was recognized as positive if anterior chamber cell or aqueous flare> 0 and following treatment were recorded. The incidence of positive reaction in ranibizumab and conbercept injection groups was compared, and its influencing factors were analyzed by generalized additive mixed model (GAMM). Main Outcome Measures Incidence of anterior chamber reaction and its risk factors. Results There were 418 males and 459 females with an average age of 60.8 ± 14.4 years (range, 11~92 years). The average injection times per person were 2（1~3）, and the total number of injections was 1148.  Among the 1148 intravitreal injections, 27 eyes (27 patients) had positive anterior chamber reaction. The anterior chamber cell grade was 0.5+~2+, and the aqueous humor flash grade was 1+~2+. The incidence of positive anterior chamber reaction after ranibizumab or conbercept intravitreal injection was 2.5% (18/721 injection) and 2.1% (9/427 injection), respectively. There was no significant difference between the two groups (χ2=0.176, P=0.674). No patients had complaints of eye pain or vision loss, and no ciliary hyperemia or hyphema was detected. All patients were followed up without additional treatment except one case, for whom prednisolone acetate eye drops were prescribed. Multivariate regression analysis showed that the incidence of positive anterior chamber reaction decreased with the increase of injection times (OR=0.48, 95%CI: 0.26~0.88, P=0.0179), and the risk of anterior chamber reaction increased by 8.27 times (P＜0.001) and 9.6 times (P＜0.001) in patients with vitreous hemorrhage or neovascular glaucoma, respectively. There was no correlation with age, gender, eye laterality and diagnosis (P>0.05). Conclusion The incidence of positive anterior chamber reaction after intravitreal injection of ranibizumab and conbercept was 2.5% and 2.1%, respectively. The patients with vitreous hemorrhage, neovascular glaucoma and the first-time injection were prone to positive anterior chamber reaction. (Ophthalmol CHN, 2021, 30: 283-289) Related Articles | Metrics

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Clinical characteristics of endogenous endophthalmitis in patients with acquired immunodeficiency syndrome Liu Xiyao, Mao Feifei, Li Dan, Lu Dan, Wang Shengnan, Sun Huiyu Ophthalmology in China    2021, 30 (4): 290-294.   DOI: 10.13281/j.cnki.issn.1004-4469.2021.04.008 Abstract （329）            Knowledge map    Save Objective To investigate the clinical characteristics of endogenous endophthalmitis in patients with acquired immunodeficiency syndrome. Design Retrospective case series. Participants 12 patients (15 eyes) with acquired immunodeficiency syndrome diagnosed with endogenous endophthalmitis in Beijing Ditan Hospital from 2014 to 2020. Methods The medical records of the patients were reviewed. Aqueous fluid tests include bacterial culture, fungal culture and detection of non-cultured suppurative pathogens or metagenomics next generation sequencing. Vitreous injection and/or vitrectomy were performed to treat. Main Outcome Measure Visual acuity, anterior segment and fundus manifestations, and aqueous humor test. Results All the 12 cases were male with an average age of 41.83±8.50 years. There were 4 cases of pulmonary tuberculosis, 5 cases of syphilis, 3 cases of cryptococcal meningitis, 3 cases (4 eyes) of cytomegalovirus retinitis, and 4 cases of fever. 6 eye had fungal endophthalmitis. 9 eye had bacterial endophthalmitis (staphylococcus aureus in 2 eyes, staphylococcus epidermidis in 1 eye, streptococcus in 1 eye, escherichia coli in 2 eyes, bradylosis streptococcus in 1 eye, haemophilus influenzae in 1 eye, sphingomonas paucimobilis in 1 eye). 7 eyes were complicated with virus infection (varicella zoster virus in 2 eyes, cytomegalovirus in 4 eyes, EB virus in 1 eye). Vitreous injections were performed in 14 eyes and vitrectomy was performed in 4 eyes. Endophthalmitis was controlled in 14 eyes, and 1 eye ruptured. Conclusion Early diagnosis and treatment of endogenous endophthalmitis with acquired immunodeficiency syndrome can control infection. The detection efficiency can be improved by bacterial culture and fungal culture in the intraocular fluid, combined with the detection technology of non-cultured pathogens. Attention should be paid to the presence of virus infection in these patinets. (Ophthalmol CHN, 2021, 30: 290-294) Related Articles | Metrics

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Distribution of lens vault and its correlation with primary angle-closure glaucoma in people over 45 years old: Beijing Eye Study Chen Changxi, Cao Kai, Wang Jinda, Li Jianjun, Xu Liang, Wang Yaxing Ophthalmology in China    2021, 30 (3): 200-203.   DOI: 10.13281/j.cnki.issn.1004-4469.2021.03.007 Abstract （400）            Knowledge map    Save Objective To describe the characteristics of lens vault (lens vault, LV) in people over 45 years old in Beijing Eye Study and explore its correlation with primary angle closure glaucoma (PACG). Design Cross-sectional study. Participants 2792 subjects of 45-years old or more in 5-year followed population of Beijing Eye Study. Methods Detailed eye examinations were performed for the subjects, including refractive measurement, intraocular pressure (non-contact tonometer), digital anterior segment photography of slit lamp after mydriasis, and axis of the eye measurement of academic parameters (Lenstar) and fundus photography. The Heidelberg anterior segment OCT was used to take pictures and the LV (the vertical distance between the anterior pole of the lens and the horizontal line of the two scleral processes) was measured through the built-in software. The content of the questionnaire involved smoking history, drinking history, diabetes and hypertension and other medical history. Logistic regression was used to explore the correlation between LV and PACG, and odds ratios (OR) and 95% confidence interval (CI) were used to assess the strength of the association. Main Outcome Measures LV, OR value and 95%CI. Results The average LV level of people over 45 years old in Beijing Eye Study was 0.43±0.26 mm, the average LV level of men was 0.38±0.28 mm, and that of women was 0.45±0.28 mm (t=4.76, P<0.001). The LV levels of people 45~54 years old, 55~64 years old, 65~74 years old and ≥75 years old are 0.33±0.26 mm, 0.42±0.27 mm, 0.48±0.29 mm and 0.58±0.29 mm, respectively, increasing with the increasing of age (F=7.84, P<0.001). The LV levels of myopia, emmetropia, and hyperopia were 0.26±0.31 mm, 0.43±0.26 mm, and 0.56±0.26 mm, respectively. As the refractive status changed from nearsightedness to farsightedness, the LV level also showed an upward trend (F=4.86, P<0.001). The average LV levels of healthy people and PACG patients were 0.42±0.28 mm and 0.84±0.25 mm, respectively (t=5.66, P<0.001). Logistic regression showed the correlation between LV and PACG(OR=1.022; 95% CI: 1.005, 1.040). Conclusion The average LV value of healthy people over 45 years old in Beijing area is 0.42±0.28 mm. LV increases with age. Women's LV value is higher than that of men, and the LV value of hyperopia is higher than that of myopia. larger LV is a risk factor for PACG. (Ophthalmol CHN, 2021, 30: 200-203) Related Articles | Metrics

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Clinicopathological analysis of 12 cases of intraocular lymphoma Zhang Xu, Xu Xiaolin, Li Bin, Peng Xiaoyan, Gao Fei, Zhang Zhibao Ophthalmology in China    2021, 30 (4): 295-299.   DOI: 10.13281/j.cnki.issn.1004-4469.2021.04.009 Abstract （369）            Knowledge map    Save Objective To investigate the clinicopathological features and prognosis of intraocular lymphoma. Design Retrospective case series. Participants 12 cases of enucleation patients with intraocular lymphoma diagnosed from 2012 to 2019. Methods Clinical features, histopathological morphology and prognosis in medical records were reviewed. Main Outcome Measures Tumor site, pathological classification and prognosis. Results There were 7 males in 12 cases. Mean age was 58.2±10.9 years. None of the patients had a history of lymphoma in other parts of the body. The most common presentation was visual acuity loss (11/12), with a mean course of 12.6±10.3 months. The most common site of intraocular lymphoma was choroid (9/12), in which the retina was involved in 1 case (1/9) , iris and ciliary body were involved in 6 cases (6/9). Only 1 case (1/12) was located in both the ciliary body and the iris. Only the retina involved was found in 2 cases (2/12). The pathologic classification of primary choroidal lymphoma was mainly diffuse large B-cell lymphoma (DLBCL) (5/9), followed by mucosa-associated lymphoid tissue marginal B-cell lymphoma (MALT) (3/9). 1 case of primary iridociliary body lymphoma was DLBCL. 2 cases of primary retinal lymphoma were DLBCL. Extraocular diffusion occurred in 4 patients, 3 with MALT and 1 with mantle cell lymphoma (MCL). Both of the 2 patients with central nervous metastasis were DLBCL. All cases were followed up for 11-99 months. All the DLBCL patients received systemic chemotherapy with methotrexate drug after enucleation. All the 6 patients with tumors located in the choroid and iridociliary body were survived, and 1 of the 2 patients with tumors located only in the retina died and 1 was lost to follow-up. None of the 3 MALT patients with tumors located in choroid received systemic chemotherapy, and all of them have survived without disease at present. Of the 2 DLBCL patients with central nerve metastasis, 1 patient with whole uveal and retinal involvement survived after systemic chemotherapy, while 1 patient with retinal involvement only died after chemotherapy. Conclusion Choroidal lymphoma was the most common intraocular lymphoma. DLBCL was the most common pathological type, followed by MALT.  The survival prognosis of choroidal DLBCL patients after systemic chemotherapy was good. Choroidal MALT patients are prone to extraocular metastasis, and the survival prognosis is good despite no postoperative chemotherapy. All retinal lymphomas are DLBCL with poor survival and prognosis. (Ophthalmol CHN, 2021, 30: 295-299) Related Articles | Metrics

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Analysis of clinical characteristics of 12 cases of scleral penetration caused by retrobulbar anesthesia Zeng Rui, Yang Jiasong, , Li Yunpeng, Li Honghui, Li Wensheng, Ophthalmology in China    2021, 30 (4): 278-282.   DOI: 10.13281/j.cnki.issn.1004-4469.2021.04.006 Abstract （397）            Knowledge map    Save Objective To summarize the clinical characteristics and management of scleral perforation during retrobulbar anesthesia. Design Retrospective case series. Paticipants 12 cases of scleral perforation during retrobulbar anesthesia were enrolled from 2012 to 2019. Methods Patient’s medical records were reviewed. The follow-up period of 12 patients was 9.5±5.4 months. Main Outcome Measures Age, gender, medical history, clinical manifestations, intraoperative conditions, and postoperative follow-up results. Results The average age of 12 patients was (54.9 ±7.8) years, including 8 females. There were 11 patients with high myopia. The operations to be performed under retrobulbar anesthesia were vitrectomy for rhegmatogenous retinal detachment in 8 cases, silicone oil removal in 2 cases, silicone oil removal combined with phacoemulsification in 1 case, and vitrectomy combined with phacoemulsification in 1 case of myopic foveoschisis. Eyeball perforation was found in time during the operation. All patients with rhegmatogenous retinal detachment were tamponaded with silicone oil after scleral perforation was found. In addition, patients with silicone oil removal and myopic foveoschisis were tamponaded with air at the end of the operation. The treatment of scleral penetration was laser photocoagulation of the retina after the removal of hemorrhage beneath or above the retina, silicone oil tamponaded in the case with retinal detachment, and disinfection air tamponaded in the case with no retinal detachment. At the last follow-up, the best corrected visual acuity was from HM to 0.6, and was improved compared with before surgery in 10 cases. Among the 12 patients, 7 of 8 patients with rhegmatogenous retinal detachment underwent vitrectomy combined with silicone oil filling, and no retinal detachment was found after silicone oil removal. In one case of high myopia, the posterior retina was not reattached and the silicone oil could not be removed. Conclusions The complications of eyeball penetration caused by retrobulbar anesthesia can cause serious eye damage, which can be minimized by timely and appropriate treatment. (Ophthalmol CHN, 2021, 30: 278-282) Related Articles | Metrics

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Short-term efficacy of oral bromohexine hydrochloride on dry eye Zhong Zubin, Feng Bing Ophthalmology in China    2021, 30 (3): 195-198.   DOI: 10.13281/j.cnki.issn.1004-4469.2021.03.006 Abstract （611）            Knowledge map    Save Objective To explore the efficacy of oral bromhexine hydrochloride tablets combined with sodium hyaluronate on ocular symptoms and inflammation in patients with dry eye. Design Prospective case series. Participants 120 patients with different types of dry eye who were treated in Department of Ophthalmology, Affiliated Hospital of Southeast University, Jiangbei Hospital from June to December 2018 were selected. Methods patients were divided into observation group and control group by random number table, 60 in each group. The control group was treated with sodium hyaluronate eye drops. The observation group was combined with bromhexine hydrochloride tablets on the basis of the control group, orally 1 tablet each time, 3 times/day, the course of treatment was 4 weeks. After 4 weeks of treatment, the clinical effect, Ocular Surface Disease Index (OSDI) score, tear film rupture time (BUT), tear secretion test (SIt), inflammatory factors [interleukin-6 (IL-6), IL-8, IL-1β)] levels and adverse reactions were compared between the two groups. Main Outcome Measures OSDI score, BUT, SIt, iIL-6, IL-8, IL-1β levels in tears and adverse reactions. Results The total effective rate in the observation group was significantly higher than that in the control group（95% vs. 85%, χ2=6.667, P=0.010）; at 4 weeks after treatment, BUT and SIt in the two groups were significantly higher than those before treatment （all P=0.000）, and BUT and SIt in the observation group were significantly higher than those in the control group （t=9.506，8.767, all P=0.000）, OSDI scores in the two groups were significantly lower than those before treatment （all P=0.000）, and OSDI scores in the observation group were significantly lower than those in the control group （18.84±5.33 vs. 32.21±6.76, t=-17.014, P=0.000）. The levels of IL-6, IL-8 and IL-1β in the two groups were significantly lower than those before treatment （all P=0.000）, and the levels of IL-6, IL-8 and IL-1β in the observation group were significantly lower than those in the control group （t=-19.033, -13.904, -6.212, all P=0.000）; there was no significant difference in adverse reactions between the two groups （3.33% vs. 3.33%, χ2=0.000, P=1.000）. Conclusion Oral bromhexine hydrochloride tablets for 4 weeks has a good clinical effects for the patients with dry eye, which can effectively improve the patients' ocular symptoms, reduce the level of inflammatory factors in the patients' tears, and has good safety. (Ophthalmol CHN, 2021, 30: 195-198) Related Articles | Metrics

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Efficacy comparison of 2 mg or 3 mg doses of ganciclovir intravitreal injection on cytomegalovirus retinitis in acquired immunodeficiency syndrome Liu Xiyao, Li Dan, Mao Feifei, Lu Dan, Wang Shengnan, Sun Huiyu Ophthalmology in China    2021, 30 (3): 227-231.   DOI: 10.13281/j.cnki.issn.1004-4469.2021.03.012 Abstract （456）            Knowledge map    Save Objective To compare the efficacy and safety of 2 mg and 3 mg ganciclovir intravitreal injection on cytomegalovirus retinitis (CMVR) in patients with acquired immunodeficiency syndrome (AIDS). Design Prospective comparative case series. Participants 63 cases (86 eyes) of patients with AIDS complicated with CMVR in Beijing Ditan Hospital from 2016 to 2020. Methods All patients were randomly divided into 2 mg group (41 eyes) and 3 mg group (45 eyes) and received ganciclovir intravitreal injection of 2 mg or 3 mg based on the systemic ganciclovir treatment. Before vitreous injection, aqueous humor was extracted for PCR detection of cytomegalovirus. Intravitreous injection was given once a week until the fundus lesion was controlled and cytomegalovirus PCR in the aqueous humor was negative. Main Outcome Measures The fundus statues, cytomegalovirus (CMV) load in aqueous humor[log（CMV DNA）], the frequencies of the injection, visual acuity, complications. Results All the active retinal necrosis lesions were controlled and gradually transformed into atrophy lesions. Viral load in aqueous humor decreased weekly and eventually turned negative. The viral loads of CMV in the 2 mg group was 3.90±0.73 copies/ml, 3.88±0.82 copies/ml, 3.06±0.93 copies/ml, 2.85±0.75 copies/ml and 2.32±0.50 copies/ml respectively before initial treatment, and at the first, second, third and fourth weeks of treatment (F=28.54，P<0.01). In 3 mg group, the viral loads of CMV was 4.10±0.94 copies/ml, 3.76±0.90 copies/ml, 3.50±0.81 copies/ml, 2.90±0.91 copies/ml, 2.57±0.79 copies/ml, respectively (F=18.21，P<0.01). Initial CMV viral load was positively correlated with the frequency of injection in both 2 mg groups (r=0.69, P<0.01) and 3 mg groups (r=0.82, P<0.01). Visual acuity improved or remained unchanged in 31 of 41 eyes in the 2 mg group and 33 of 45 eyes in the 3 mg group (χ2=0.06，P=0.81). No serious complications occurred in any of the patients. There were no significant differences in lesion recovery rate, viral load in aqueous humor, number of injections, complications between the two groups (all P>0.05). Conclusion Intravenous ganciclovir combined with ganciclovir intravitreal injection of 2 mg or 3 mg can effectively treat CMVR. In order to reduce retinal toxicity, 2 mg of intravitreal ganciclovir is a relatively safe and effective dose for the treatment of CMVR. (Ophthalmol CHN, 2021, 30: 227-231) Related Articles | Metrics

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Analysis of early stage of corneal epithelial remodeling after SMILE for moderate and high myopia Zhang Qiulu, Song Yanzheng, Fu Caiyun, Zhai Changbin Ophthalmology in China    2021, 30 (4): 270-274.   DOI: 10.13281/j.cnki.issn.1004-4469.2021.04.004 Abstract （379）            Knowledge map    Save  Objective To analyze the characteristics of early corneal epithelial thickness changes after femtosecond laser small incision corneal stromal lens extraction (SMILE) with anterior segment OCT. Design Retrospective case series. Participants 70 patients (140 eyes) with mean age (27.03±5.55) years old of moderate or high myopia and myopic astigmatism were underwent SMILE surgery from May to August 2020 by a single surgeon in Beijing Tongren Hospital. Method The patients’ medical records were reviewed, including the preoperative refractive diopter, preoperative and postoperative corneal epithelial thickness by anterior segment OCT. Main Outcome Measures Preoperative refraction diopter, Ks, Kf value of the cornea anterior surface and the central corneal thickness(CCT). The corneal epithelial thicknesses of 0-2 mm in the center of the cornea, the superior (S), inferior (I), nasal (N), temporal (T), superior-nasal (SN), superior-temporal (ST), inferior-nasal (IN) and inferior-temporal (IT) positions within the range of 2-5 mm and 5-6 mm before and 1 month after the operation. Results At 1 month after SMILE, the corneal epithelial of moderate myopia group had statistically significant thickening (all P<0.05) at 0-2 mm (t=3.956); 2-5 mm S (t=5.898), I (t=7.333), T (t=8.011), IN (t=3.878), ST (t=5.803), IT (t=9.160); and 5-6 mm I (t=4.668), T (t=7.470), IN (t=2.285), ST (t=5.389) and IT (t=6.805) compared with preoperation. And the corneal epithelialum of high myopia group had statistically significant thickening (all P<0.05) at all locations compared with preoperation [0-2 mm（t=6.144）; 2-5 mm（tS=7.770, tI=7.399, tN=5.294, tT=8.902, tSN=5.599, tIN=6.413, tST=7.628, tIT=8.055）; 5-6 mm（tS=3.373, tI=2.927, tN=5.373, tT=5.847, tSN=3.770, tIN=4.166, tST=4.826，tIT=4.219）]. Conclusion At 1 month after SMILE, the corneal epithelium thickness increased unevenly in the high myopia group, especially in the temporal and inferiorside. The corneal epithelium thickened much more in high myopia group than moderate myopia group. The central corneal epithelial thickness increment was negatively correlated with preoperative SE and postoperative corneal Km, and positively correlated with intraoperative corneal ablation depth. (Ophthalmol CHN, 2021, 30: 270-274) Related Articles | Metrics

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Biometric characteristics of primary angle closure glaucoma with zonular abnormality found during cataract surgery Pei Xueting, Fan Zhigang, Qing Guoping, Li Dongjun, Wang Shuhua Ophthalmology in China    2021, 30 (4): 264-269.   DOI: 10.13281/j.cnki.issn.1004-4469.2021.04.003 Abstract （327）            Knowledge map    Save  Objective To observe the characteristics of ocular parameters in primary angle closure glaucoma (PACG) combined cataract patients with zonular abnormality found during cataract surgery. Design Retrospective comparative case series. Participants Patients with PACG who underwent cataract surgery from May, 2019 to December, 2020 at Beijing Tongren Hospital were reviewed, which include 45 PACG eyes with zonular abnormality found during cataract surgery(zonular abnormality group), 95 PACG eyes without zonular abnormality, and 41 eyes with secondary angle closure glaucoma induced by lens subluxation (SACG-LS). Methods Medical records of all patients were reviewed, including ocular parameters measured using IOL master and UBM.  Main Outcome Measures Anterior chamber depth (ACD), lens vault (LV), lens thickness (LT), and axial length (AL).  Results There was no statistically significant difference in AL [(22.07±0.78) mm vs (22.20±0.75) mm, P=0.650] and ACD [(1.61±0.31) mm vs (1.74±0.35) mm, P=0.074] between zonular abnormality group and without zonular abnormality group. LV was 1.41±0.35 mm in zonular abnormality group, 1.04±0.21 mm in without zonular abnormality group, and 1.73±0.45 mm in SACG-LS group. The LV differences between every two groups reached statistical significance (all P=0.000). The LV inter-eye difference reached statistical significance [(1.42±0.25) mm vs (1.24±0.27) mm, P=0.049] in zonular abnormality group. LT showed no statistical significance between zonular abnormality group and SACG-LS group [(5.14±0.26) mm vs (5.18±0.29) mm, P=0.808], and thicker than without zonular abnormality group. 80% patients of zonular abnormality group showed LV higher than 1.2 mm as well as LT thicker than 4.9 mm. Conclusion It is probability that the zonule may be abnormal in PACG patients with preoperative LV higher than 1.2 mm as well as LT thicker than 4.9 mm. (Ophthalmol CHN, 2021, 30: 264-269) Related Articles | Metrics

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Establishment and evaluation of ovalbumin induced allergic conjunctivitis in mice Bao Jiayu, Zhang Peng, Zhu Lei, Wen Ya, Wang Jingyi, Wang Yinghui, Feng Jun, Li Siyuan, Tian Lei, Jie Ying Ophthalmology in China    2021, 30 (3): 189-194.   DOI: 10.13281/j.cnki.issn.1004-4469.2021.03.005 Abstract （432）            Knowledge map    Save Objective To establish a mouse model of allergic conjunctivitis by intraperitoneal injection of ovalbumin (OVA) and ovalbumin eye drops. Design Experimental study. Participants 20 SPF BALB/c mice aged 6~8 weeks. Methods 20 BALB/c mice were randomly divided into normal control group (PBS group) and allergic conjunctivitis group (OVA group). OVA group was intraperitoneally injected with 200 μl ovalbumin sensitizing solution on day 0, 2, 4, 6 and 8. On the 10th, 11th, 12th, 13th and 14th day, 10 μl ovalbumin solution drops was applied to the eyes of mice respectively. In PBS group, the intraperitoneal injection and eye drops were replaced with PBS. The ocular surface state was evaluated 15~30 minutes after the allergic provocation solution was applied. Animals were sacrified by euthanasia on the 15th day, Giemsa staining and immunohistochemistry (IHC) staining revealed pathological change. The typical manifestations of allergic conjunctivitis, including lid edema, conjunctival redness, chemosis, tearing, and frequent scratching were examined with a slit lamp. On the 15th day, the spleen was separated, the weight of spleen was weighed, and the spleen index was calculated. The expression of interleukin (IL)-8, IL-6 and thyonic stromal lymphopoietin (TSLP) was detected by immunohistochemistry, and the infiltration of inflammatory cells was evaluated by Giemsa staining. Main Outcome Measures The symptom score of allergic conjunctivitis, the number of eyes scratching, spleen index, the expression of IL-8, IL-6, TSLP and inflammatory cells infiltration. Results The survival rate of OVA group was 100%. Compared with PBS group, the mice in OVA group showed obvious splenomegaly, eyelid edema, hyperemia and epiphora. The symptom scores of OVA group and PBS group were 3.1±1.45, 6.6±1.71, 5.7±1.34, 6.4±1.51, 10.1±1.66 and 1.3±0.95, 1.9±0.99, 1.7±0.82, 1.3±1.06, 1.4±0.84 on day 10, 11, 12, 13 and 14, respectively (all P<0.05); the times of eye scratching in two groups were 28.8±5.88, 29.3±7.42, 27.2±8.2, 28.0±6.82, 26.2±5.09 and 12.3±4.32, 12.7±5.03, 13.3±5.62, 12.7±5.54, 16.4±2.67, respectively (all P<0.05). On day 15, the spleen index of OVA group and PBS group were 6.67±0.66 and 4.21±0.40 respectively (t=10.02, P=0.0001). The average optical density of TSLP in PBS group and OVA group was 10.23±1.52 and 20.25±1.75 (t=7.482, P=0.0017), the average optical density of IL-6 was 13.15±1.68 and 24.93±3.02 (t=5.911, P=0.0041), and the average optical density of IL-8 was 12.23±3.22 and 22.12±4.00 (t=3.337, P=0.0289). The results of Giemsa staining showed that eosinophil infiltration was observed in the conjunctival tissue of OVA group. The eosinophil count in the conjunctival tissue of PBS group and OVA group was 266.67±57.74/mm2 and 1366.67±57.74/mm2 respectively (t=23.33, P=0.0001). Conclusion The mouse model of allergic conjunctivitis was successfully established by intraperitoneal injection of ovalbumin and repeated eye stimulation, which can provide a simple and reliable experimental tool for the mechanism research and drug development of human allergic conjunctivitis. (Ophthalmol CHN, 2021, 30: 189-194) Related Articles | Metrics

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Prevalence and influencing factors of myopic maculopathy in myopic population aged 40 or more in rural area of China: Handan Eye Study Cao Kai, Lin Caixia, Hu Ailian, Yang Xiaohui, Wang Bingsong, Zhang Qing, Hu Jianping, Hao Jie, Zhang Ye, Wang Ningli, Handan Eye Study Group Ophthalmology in China    2021, 30 (3): 177-183.   DOI: 10.13281/j.cnki.issn.1004-4469.2021.03.003 Abstract （355）            Knowledge map    Save Objective To report the prevalence of myopic maculopathy in people over 40 years old in rural area of China, and to explore the influencing factors of myopic maculopathy based on Synthetic Minority Over-Sampling Technique（SMOTE） algorithm. Design Cross-sectional study. Participants 1177 myopia patients in the Handan Eye Disease Study from 2012 to 2013, aged 40 years and above. Methods Questionnaire was done to obtain subjects’ basic demographic data and behavioral data such as smoking and drinking history; Subjects’ height, weight and blood pressure were measured through physical examination; blood samples of each subject was collected for laboratory examinations; Early Treatment Diabetic Retinopathy (EDTRS) eye chart was used to measure the subject’s presenting visual acuity and best-corrected visual acuity (BCVA); Kowa applanation tonometer was used to measure the introcular pressure (IOP); Topcon automatic refractor (model KR8800) was used to measure diopter; A-ultrasound (10 MHz) was used to measure the eye axis and other biological parameters; use Canon fundus camera (model CR-2) to take two fundus photos that centered on the optic disc and the macula; the diagnosis method of maculopathy: based on the myopic population (spherical equivalent refraction less than -0.5 D), any of the following symptoms in the fundus was judged to be maculopathy: diffuse chorioretinal atrophy, patchy chorioretinal atrophy, macular atrophy, lacquer cracks, and myopic choroidal neovascularization appeared in the posterior pole. Fuchs spots were classified as myopic choroidal neovascularization. Using the sixth census data of China, the prevalence of maculopathy was graded and gender-standardized. The SMOTE algorithm was used to balance data. Logistic regression was used to explore the influencing factors of myopic maculopathy. the ROC curve was used to estimate the predictive power of the influencing factors. Main Outcome Measures Crude prevalence and age-sex standardized prevalence of maculopathy. Results Of the 5055 people over the age of 40 with clear-readable fundus photographs, 1177 had myopia, of which 35 had myopic maculopathy. In the myopic population, the prevalence of myopic maculopathy was 2.97%, and the age-gender standardized prevalence was 2.65%. Univariate analysis showed: for age (t=10.910, P<0.001), education (χ2=21.511, P<0.001), marital status (χ2=62.488, P<0.001), BMI (t=-6.400, P<0.001), blood glucose (t=-4.199, P=0.014), diopter value (Z=-15.766, P<0.001), intraocular pressure (Z=-7.384, P<0.001) and BCVA (t=-24.384, P<0.001), there was statistically significant difference between the myopic maculopathy group and the control group. Logistic regression results showed that age and diopter were risk factors for myopic maculopathy. IOP was a protective factor for myopic maculopathy. The odds ratio (OR) values were 1.056 (95% confidence interval, CI: 1.025, 1.087), 0.667 (95% CI: 0.603, 0.738) and 0.841 (95% CI: 0.762, 0.928) respectively; ROC curve analysis showed that using age, diopter and IOP to predict myopic maculopathy, the area under the curve can reach 0.936 (95% CI: 0.918, 0.953). Conclusion The age-gender standardized myopic maculopathy prevalence rate in myopic population over 40 years old in rural area of China is 2.65%. Age, spherical refractive error, and IOP are influence factors of myopic maculopathy. Older age, lower IOP, and larger refractive error will increase disease risk. (Ophthalmol CHN, 2021, 30: 177-183) Related Articles | Metrics

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Association of diabetic macular edema with impaired renal function Zhao Huiying, Liu Yan, Yin Yingxia, Wang Wei, Zhou Huaiyu, Wu Xiangli, Chen Dongjun, Chen Jianhua Ophthalmology in China    2021, 30 (3): 232-235.   DOI: 10.13281/j.cnki.issn.1004-4469.2021.03.013 Abstract （485）            Knowledge map    Save Objective To investigated the association of diabetic macular edema (DME) with the impaired renal function in a sample of patients with type 2 diabetes. Design Retrospective case series. Participants A total of 1023 patients with type 2 diabetes hospitalized in the Endocrinology Department of Beijing Geriatric Hospital, who were consulted in ophthalmology, from Jan 2016 to Dec 2020. Methods Age, blood pressure, serum creatinine, fasting venous blood glucose, glycosylated hemoglobin and urinary microalbumin were obtained by reviewing the medical records. Estimated glomerular fifiltration rate (eGFR) was assessed using the CKD-EPI formula and graded (normal renal function ≥ 90 mL/min/1.73 m2; impaired renal function, 60~89 mL/min/1.73 m2; and renal inadequacy < 60 mL/min/1.73 m2). Stereoscopic color fundus image and optical coherence tomography image were also reviewed. DME was confirmed according to standard of Early Treatment Diabetic Retinopathy Study. The correlation between stage of eGFR and presence of DME was assessed by Logistic regression. Main Outcome Measures The presence of DME in different eGFR group. Results Of the 1023 patients with type 2 diabetes included, 120 patients had DME. In patients with normal, impaired and impaired renal function, the presence of DME were 8.30%, 20.51% and 24.63% (χ2=34.252, P=0.000). Logistic regression showed that the risk of DME in patients with impaired renal function and renal insufficiency was 1.604 and 2.573 times higher than those with normal renal function. Conclusion DME is associated with impaired renal function and its severity. (Ophthalmol CHN, 2021, 30: 232-235) Related Articles | Metrics

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Effect of reducing the interval of spherical trail lens in improving the rate of red-green balance on the Duochrome test and visual quality Zhen Yi, Wei Shifei, Gao Jie, Sun Yunyun, Wang Wenhua, An Wenzai, Zhang Wei, Wang Ningli Ophthalmology in China    2021, 30 (3): 184-188.   DOI: 10.13281/j.cnki.issn.1004-4469.2021.03.004 Abstract （630）            Knowledge map    Save Objective Discuss whether reducing the interval of spherical trail lens can increase the Duochrome test realization rate and help myopia patients obtain better visual quality. Design Prospective clinical controlled studies. Participants 98 myopia patients who were recruited to undergo a vision test and refraction in Beijing Tongren Eye Center. Methods Use spherical trail lenses with 0.25 D intervals and 0.05 D intervals to perform Optometry using the same steps. If red and green balance can be achieved, the prescription of spherical power is equal to the count point; if the red and green balance cannot be achieved, record the maximum redness spherical power. Compare the rate of red-green balance on the Duochrome test, prescription spherical lens power, best corrected visual acuity (BCVA, LogMAR), and contrast sensitivity obtained by the same patient using different interval trail lens. Record the minimum spherical lens power change that can cause changes in the definition of the red and green background as the red-green difference perception threshold, and analyze the difference in the red-green difference perception threshold between different people. Main Outcome Measures The realization rate of red-green balance, prescription spherical lens power, BCVA. Results The realization rate of red-green balance on the Duochrome test for the 0.05 D interval group was significantly higher than for the 0.25 D interval group in both eyes (Right eye 82.6 % vs 11.2 %, χ2=100.38, P<0.01; Left eye 81.6 % vs 7.1%, χ2=110.14, P<0.01). The prescribed spherical power of the 0.05 D interval group was significantly higher than the 0.25 D interval group in both eyes (Right eye -3.79±1.52 D vs -3.70±1.52 D, t=11.86, P=0.000; Left eye -3.49±1.63 D vs -3.40±1.63 D, t=13.24, P=0.002). The BCVA (LogMAR) in the 0.05 D interval group was significantly better than in the 0.25 D interval group on both eyes (Right eye -0.039±0.076 vs -0.009±0.069, t=6.485, P=0.000; left eye -0.028±0.068 vs -0.003±0.070 t=6.209, P=0.000). 83.7% of people can distinguish the changes in the definition of the red and green visual indicators caused by the ≤0.05 D spherical trail lens. Conclusion Reducing the interval between spherical refraction lenses can significantly increase the realization rate of the red-green balance test. Myopias who use the red-green balance prescription obtained with 0.1 D interval spherical refraction lenses can obtain better visual quality. (Ophthalmol CHN, 2021, 30: 184-188) Related Articles | Metrics

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Effect of cefuroxime sodium anterior chamber injection on corneal endothelium Guo Zuofeng, Zhou Yanwen Ophthalmology in China    2021, 30 (4): 275-278.   DOI: 10.13281/j.cnki.issn.1004-4469.2021.04.005 Abstract （327）            Knowledge map    Save Objective To observe the effect of cefuroxime sodium anterior chamber injection on corneal endothelial cells. Design Prospective comparative case series. Participants 100 eyes of 100 patients with age-related cataract who underwent phacoemulsification. Methods Randomly divided into two groups. 50 eyes of 50 cases in the experimental group were injected with cefuroxime sodium 1mg (0.1 ml) into the anterior chamber at the end of phacoemulsification, and 50 eyes of 50 cases in the control group were injected with 0.1 ml of compound sodium chloride solution in the anterior chamber. Both groups of patients were operated by the same surgeon, the same phacoemulsification equipment and the same parameters. Corneal endothelial cell density (CD), corneal endothelial hexagonal cells (HEX), central corneal thickness (CCT) were compared between the two groups at one month after the surgery. Main Outcome Measures CD, HEX, CCT. Results The preoperative CD of the experimental group and the control group were (2472.23±312.24) and (2534.12±324.58)/mm2 (P>0.05), respectively, and the CD at 1 month after surgery were (2338.32±356.89) and (2456.12±375.23/mm2) (P>0.05); the HEX of the experimental group and the control group were (69.21±12.51%) and (73.24±15.68%) (P>0.05) before the operation, and the HEX at 1 month after the operation was respectively (62.82±14.61%), (60.19±16.37%) (P>0.05); the preoperative CCT of the experimental group and the control group were (535.26±34.25) and (527.89±31.11) μm (P>0.05), respectively. The CCT at 1 month was (579.4±24.6) and (571.3±31.2) μm (P>0.05). Conclusion Phacoemulsification for cataract combined with 1 mg cefuroxime sodium injection in the anterior chamber has no significant effect on the count and morphology of corneal endothelial cells. (Ophthalmol CHN, 2021, 30: 275-278) Related Articles | Metrics

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Clinical characteristics and treatment of children orbital Langerhans cell histiocytosis Zhang Shaobo, Wang Ping, Cheng Qilin, Zhang Qiong, Ning Xiaona, Li Yangjun Ophthalmology in China    2021, 30 (4): 300-306.   DOI: 10.13281/j.cnki.issn.1004-4469.2021.04.010 Abstract （432）            Knowledge map    Save Objective  To investigate the clinical features and treatment of children orbital Langerhans cell histiocytosis (LCH). Design Retrospective case series. Participants  From April 2013 to May 2019, 7 patients (8 eyes) with orbital LCH were confirmed in the Second Affiliated Hospital of Air Force Military Medical University. Method The general  situation, clinical manifestations, imaging and general examination, pathological features, treatment plan and clinical follow-up results were summarized. Main Outcome Measures Clinical and pathological characteristics, treatment and follow-up results. Results Of the all 7 patients, 5 were unifocal lesions and 2 were multifocal lesions. All patients were male with an age range of 8 months to 10 years. Course range was 3 days to 2 months. The clinical manifestations of unifocal lesions were monocular, with eyelid swelling as the main symptom, 1 case with eyelid mass. The clinical manifestations of multifocal lesions were monocular or binocular eyes, with exophthalmos as the main symptom, and 1 case with red eyes and tears. On CT images in unifocal lesions, there were lateral and upper orbital soft tissue mass with typical wormlike destruction of peripheral cranio-orbital bone. In multifocal lesions, there was monocular or bilateral orbital soft tissue mass with multiple map bone defect of cranio-orbital bone, and 1 case with insect-like destruction of rib. There were iso-hypointense on T1-weighted MR imaging and iso-hyperintense mixed signals on T2-weighted imaging. With T1 enhancement, most of the cases lesions presented obvious marked enhancement at the edges and the surrounding tissues, and with heterogeneous obvious enhancement of the lesion center. On histopathology, there were clonal proliferation of pathological Langerhans cells with infiltration of monocytes, lymphocytes and eosinophils. On immunohistochemical staining, CD1a, CD207 and S100 were showed positive signals. In unifocal lesions, all the 5 cases were treated with complete resection, curettage of bone cavity and repair of bone defect, combined with intraoperative or postoperative local triamcinolone acetonide injection. In multifocal lesions, one patient with monocular involvement underwent complete resection, curettage of bone cavity and local triamcinolone acetonide injection, and the other patients with binocular involvement underwent surgical biopsy. Multifocal lesion patients were also treated with systemic intravenous chemotherapy after operation. In unifocal lesions, the lesions disappeared completely without recurrence and were followed up for 30-85 months. In multifocal lesions for the observation 12-13 months, the disease was stable during treatment. Conclusions Children orbital LCH has typical clinical manifestations of eyelid swelling or exophthalmos. CT or MRI imaging and pathological examination are the basis of diagnosis. Complete resection of the focus, curettage of the bone cavity and local corticosteroid injection should be selected for unifocal lesions. Patients with multifocal lesions should be examined to exclude other systemic diseases, and intravenous chemotherapy after surgical resection is needed. (Ophthalmol CHN, 2021, 30: 300-306) Related Articles | Metrics

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Ophthalmology in China    2021, 30 (3): 194-194.   DOI: 10.13281/j.cnki.issn.1004-4469.2021.03.021 Abstract （221）            Knowledge map    Save Related Articles | Metrics

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Genotypic and phenotypic characteristics of Chinese carriers with CHM gene variation Song Yuning, Chen Chunjie, Xie Yue, Sun Tengyang, Xu Ke, Li Yang Ophthalmology in China    2021, 30 (3): 211-216.   DOI: 10.13281/j.cnki.issn.1004-4469.2021.03.009 Abstract （429）            Knowledge map    Save Objective To summarize and analyze the phenotypic and genotypic characteristics of Chinese carriers with CHM gene variation and compare with foreign carriers. Design Retrospective case series. Participants Six carriers from five choroideremia families with CHM gene variation identifying in the Beijing Tongren Eye Center. Methods The proband and family members underwent detailed ophthalmological examination. Sanger sequencing, target exonm sequencing (TES) and real-time quantitative PCR were used to determine the pathogenic variations of CHM gene in 5 CHM families. Main outcome measures Visual acuity, fundus image, optical coherence tomography image (OCT), fundus autofluorescence (FAF) and gene variations carried by each carrier. Results 6 carriers came from 5 unrelated families. A total of 5 CHM gene variations were detected in these carriers. The average age of all female carriers was（34.00±14.83） years (range 8~53 years old). They had no symptoms, such as decreased vision, night blindness, and visual field contraction. The fundus images showed punctate or flaky hypopigmentation of the retina, which can be accompanied by small yellowish well-defined dots. Mottled flake or mosaic-like low fluorescence could be seen on FAF, with dotted hyperfluorescence. Two carriers were followed up for three years. Their eyesights were stable and their fundus was almost unchanged. Conclusion This study expanded the variation spectrum of CHM gene variations. Compared with European and American carriers with CHM gene variations, the damage of visual function and fundus changes of Chinese female carriers were slighter. (Ophthalmol CHN, 2021, 30: 211-216) Related Articles | Metrics

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The efficacy of foldable capsular vitreous body implantation in the treatment of severe traumatic ruptures and silicone oil dependent eyes Wang Dayu, Zhu Xiaobo, , Yang Yan, Li Yan, Zhang Wei, Li Jing Ophthalmology in China    2021, 30 (4): 311-315.   DOI: 10.13281/j.cnki.issn.1004-4469.2021.04.012 Abstract （629）            Knowledge map    Save  Objective To investigate the efficacy of foldable capsular vitreous body (FCVB) primary implantation in severe traumatic ruptures with loss of intraocular tissue and secondary implantation in silicone oil dependent eyes. Design Retrospective case series. Participants From 2017 to 2020, patients with eye traumatic ruptures (7 cases) and silicone oil dependent eyes (14 cases) underwent FCVB implantation in Beijing Aier-Intech Eye Hospital. Methods The medical records of 21 FCVB implantation patients were reviewed. The average follow-up period was (15.6±9.8) months. Main Outcome Measures Visual acuity, intraocular pressure（IOP）, anterior chamber depth, retinal reattachment and appearance. Results In 21 patients 17 cases were male (81.0%). The average age was (36.1 ± 14.2) years old. There were no serious complications during surgery in all cases. Visual acuity was improved in 8/21 cases after FCVB surgery. The mean IOP was (6.81±3.34) mmHg before surgery and (11.62±5.44) mmHg at the last follow-up. All patients had anterior chamber depth 2.5 CT or more. The retina of all patients was reattached and satisfactory appearance was obtained. No obvious emulsification or leakage of silicone oil was observed. Conclusion The primary FCVB implantation in traumatic ruptures with loss of intraocular content eyes and the secondary FCVB implantation in silicone oil dependent eyes, can maintain eyeball shape and intraocular pressure in a certain period of time, reduce the burden of multioperation injuries. (Ophthalmol CHN, 2021, 30: 311-315) Related Articles | Metrics

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Clinical characteristics and treatment of eyelid lipogranuloma caused by autologous fat facial filling Wang Yue, Xin Yue, Zhang Zheng, He Yueqing, Zhao Xiaoli, Li Yong, Ma Jianmin, Chen Tao Ophthalmology in China    2021, 30 (3): 204-209.   DOI: 10.13281/j.cnki.issn.1004-4469.2021.03.008 Abstract （360）            Knowledge map    Save Objective To investigate the clinical characteristics and treatment of eyelid granuloma after autologous fat facial filling. Design Retrospective case series. Participants From August 2017 to December 2020, 9 patients (11 eyes) with orbital granuloma caused by autologous fat facial filling were collected from the Beijing Tongren Eye Center. Methods The sex, age, eye type of onset, location of eyelid mass, symptoms, clinical manifestations, location of autologous fat transplantation, time from autologous fat transplantation to eyelid mass, characteristics of imaging examination, treatment methods and therapeutic effects, and the results of pathological examination were collated and described, the follow-up period was 6 months. Main Outcome Measures Clinical characteristics, treatment, and efficacy. Results All patients were female, aged from 25 to 51 years old, with an average age 36.33±8.86 years old. Two patients had binocular involvement (22.2%) and 7 patients had monocular involvement (77.8%), including 2 cases in the right eye (22.2%) and 5 cases in the left eye (55.6%). Both upper and lower eyelids were involved in 1 patient (11.1%), upper eyelid in 5 patients (55.6%), lower eyelid in 3 patients (33.3%). The patient's eyelids were slightly red, swollen and painful, and the eyelids can touch a lump, and 2 patients were associated with ptosis. 3 patients received oral methylprednisolone, the tumor became smaller obviously and was not completely absorbed after 6 months. One patient received local injection of triamcinolone acetonide，the tumor became smaller obviously after 1 month, and the lower eyelid did not touch the tumor after 6 months. 3 patients underwent surgical resection of lipogranuloma. Histopathology showed the characteristics of lipogranuloma reaction, foreign body giant cells gathered around lipid-rich microcapsules of different sizes. No recurrence was found after follow-up for 6 months. 1 patient received ultrashort wave and laser physiotherapy, the inflammation subsided and the tumor decreased. The boundary gradually became clear, but there was a relapse after the cessation of physiotherapy. 1 patient refused operation and medicine because the tumor was small, and was observed regularly. Conclusion Facial injection of autologous fat can lead to a delayed benign lesion in the orbital region, the fat granuloma. and surgical resection can be taken when observation and drug conservative treatment are ineffective. (Ophthalmol CHN, 2021, 30: 204-209) Related Articles | Metrics

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Evalution of the macular function by microperimetry in dabetic macular edema Li Hong, Song Yanping Ophthalmology in China    2021, 30 (3): 236-239.   DOI: 10.13281/j.cnki.issn.1004-4469.2021.03.014 Abstract （586）            Knowledge map    Save Objective To evaluate the visual function of diabetic macular edema (DME) patients by microperimetry, and evaluate the association of microperimetry measurements and visual acuity. Design Retrospective case series. Participants 220 eyes of 164 patients with DME were enrolled in Wuhan General Hospital of Chinese People's Liberation Army from April 2016 to January 2018. Methods All patients were examined with best corrected visual acuity (BCVA, logMAR), fluorescein fundus angiography (FFA), optical coherence tomography(OCT), full retinoscoppy, MAIA microperimetry. According to the fixation rate, the subjects were divided into 3 groups：stable fixation，relative unstable fixation, and unstable fixation. According to the difference of retinal sensitivity, 3 stages of fixation stability were divided: A1 (normal), A2 (suspicious), and A3 (abnormal), and the visual acuity of different retinal sensitivity groups in the fixation group were compared. Main outcome measures BCVA, average threshold (AT), 2 degree fixation rate (P1), 4 degree fixation rate (P2) and bivariate contour ellipse area for 63% (BCEA63), BCEA95. Results In patients with DME, the AT of stable group, relatively unstable group and unstable group was 23.55±3.90 dB, 20.87±6.04 dB, 19.30±5.41 dB, respectively (F=9.824，P=0.00). The BCVA (logMAR) of stable group, relatively unstable group and unstable group was 0.38±0.24, 0.59±0.29, 0.63±0.31, respectively (F=9.808，P=0.000). In the stable group, the BCVA of A1, A2 and A3 groups were 0.22±0.15, 0.36±0.21, 0.51±0.24, respectively (F=16.14, P＜0.001). In the patients of DME, logMAR BCVA was negatively correlated with AT（r=-0.712，P=0.000）、P1（r=-0.380，P=0.000）、P2 （r=-0.370，P=0.000）, and positively correlated with BCEA 63 (r=0.352, P=0.000), and BCEA95 (r=0.355, P=0.000). Multiple linear regression analysis showed that logMAR BCVA was independently affected by AT (OR=0.576，P=0.000) and P1（OR=0.800，P=0.000). Conclusion MAIA microperimetry can assess macular visual function in patients with DME. AT and P1 can be used as a good indicator for the evaluation of macular visual function and a predictor of logMAR BCVA. It can reflect the visual function of patients with DME. (Ophthalmol CHN, 2021, 30: 236-239) Related Articles | Metrics

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Ophthalmology in China    2021, 30 (3): 206-210.   DOI: 10.13281/j.cnki.issn.1004-4469.2021.03.017 Abstract （371）            Knowledge map    Save Related Articles | Metrics

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Ophthalmology in China    2021, 30 (3): 183-183.   DOI: 10.13281/j.cnki.issn.1004-4469.2021.03.020 Abstract （297）            Knowledge map    Save Related Articles | Metrics

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The clinical data and problems analysis of prehospital diagnosis and treatment in 51 cases with sebaceous gland carcinoma Huang Zhengtai, Zhang Ke, Wang Lili, Zhu Yu Ophthalmology in China    2021, 30 (4): 307-311.   DOI: 10.13281/j.cnki.issn.1004-4469.2021.04.011 Abstract （373）            Knowledge map    Save Objective To analyze the clinical data and the existing problems of prehospital diagnosis and treatment in sebaceous gland carcinoma (SGC). Design Retrospective case series. Participants 51 cases of SGC in the First Affiliated Hospital of Zhengzhou University. Methods The clinical data and the existing problems of prehospital diagnosis and treatment of patients with SGC were analyzed. Main Outcome Measures Clinical data, onset age of disease, prehospital diagnosis and treatment course, posthospital condition and TNM stage. Results The average age of 51 patients with SGC was 59.8±13.0 years. 29 cases were on upper eyelid and 22 cases on lower eyelid. The medical history was 6 months and less in 15 cases (29.4%) and more than 6 months in 36 cases (70.6%). Prehospital diagnosis included 39 cases of eyelid tumor, 6 cases of palpebral conjunctivitis and 6 cases of chalazion. 40 patients underwent at least one and up to five operations during prehospital treatment. Among the 31 cases, 14 cases of SGC, 15 cases of other eyelid tumors, 1 case of sebaceous hyperplasia and 1 case of chalazion. On admission, 29 cases had recurrent eyelid tumors, 15 cases were referred to further treatment duo to maligmant transformation, and 7 cases did not receive treatment. On admission, 3 cases were at TNM T1 stage, 29 cases at TNM T2 stage, 13 cases at TNM T3 stage and 6 cases at TNM T4 stage. Conclusion About 70% of the patients with SGC in this group did not receive appropriate treatment within 6 months of onset. The misdiagnosis rate of clinical and pathogical diagnosis was high. The treatment was not standard, and most of the patients were recurrent and advanced cases at admission. At present, the diagnosis and treatment of patients with SGC in primary and second hospitals remain to be standardized. (Ophthalmol CHN, 2021, 30: 307-311) Related Articles | Metrics

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Ophthalmology in China    2021, 30 (3): 198-199.   DOI: 10.13281/j.cnki.issn.1004-4469.2021.03.016 Abstract （344）            Knowledge map    Save Related Articles | Metrics

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Ophthalmology in China    2021, 30 (3): 244-245.   DOI: 10.13281/j.cnki.issn.1004-4469.2021.03.018 Abstract （523）            Knowledge map    Save Related Articles | Metrics

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Application of virtual reality technology in clinical teaching of ophthalmology Xu Manhua, Wang Yanxi, Kang gangjin, Li Kaiming Ophthalmology in China    2021, 30 (3): 240-243.   DOI: 10. 13281/j. cnki. issn.1004-4469. 2021. 03. 015 Abstract （303）            Knowledge map    Save Objective To observe the applicational value of virtual reality technology in ophthalmology clinical teaching. Design Prospective randomized controlled study. Participants 48 undergraduate students of ophthalmology internship in Affiliated Hospital of Southwest Medical University from March to October in 2019. Methods 48 students were divided into two group, the experimental group (24 students) and the control group (24 students) randomly. The experimental group were taught with virtual reality technology and the control group were given traditional teaching. They were taught with the anatomy, physiology and biochemistry of the eyes. Six teachers were randomly assigned, and each teaching time was 120 minutes. The students were tested after the course on the day and 1 month after internship. The students and teachers were evaluated by questionnaire. Main Outcome Measures Paper tests and questionnaire score. Results The average paper test score of experimental group (90.63±6.65) was higher than that of control group (86.04±8.07) (t=-2.147, P=0.037); the average paper test score for one month after class of experimental group (85.21±7.14) was higher than that of control group (78.54±9.50) (t=-2.748, P=0.009). The questionnaire score of students in experimental group (8.53±0.49) was higher than that of control group (7.49±0.58) (t=-6.701, P=0.000); the questionnaire score of teachers in experimental group (9.03±0.21) was higher than that of control group (8.17±0.47) (t=-2.907, P=0.044). Conclusion Compared with traditional teaching, the virtual reality technology in clinical ophthalmology teaching has potential advantages, and it is a new teaching method worth popularizing. (Ophthalmol CHN, 2021, 30: 240-243) Related Articles | Metrics

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Ophthalmology in China    2021, 30 (4): 319-320.   DOI: 10.13281/j.cnki.issn.1004-4469.2021.04.014 Abstract （579）            Knowledge map    Save Related Articles | Metrics

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Ophthalmology in China    2021, 30 (3): 246-248.   DOI: 10.13281/j.cnki.issn.1004-4469.2021.03.019 Abstract （185）            Knowledge map    Save Related Articles | Metrics

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Ophthalmology in China    2021, 30 (4): 320-321.   DOI: 10.13281/j.cnki.issn.1004-4469.2021.04.015 Abstract （621）            Knowledge map    Save Related Articles | Metrics

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Ophthalmology in China    2021, 30 (4): 322-322.   DOI: 10.13281/j.cnki.issn.1004-4469.2021.04.016 Abstract （447）            Knowledge map    Save Related Articles | Metrics

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Ophthalmology in China    2021, 30 (4): 323-324.   DOI: 10.13281/j.cnki.issn.1004-4469.2021.04.017 Abstract （379）            Knowledge map    Save Related Articles | Metrics

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Ophthalmology in China    2021, 30 (4): 325-326.   DOI: 10.13281/j.cnki.issn.1004-4469.2021.04.018 Abstract （110）            Knowledge map    Save Related Articles | Metrics

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Ophthalmology in China    2021, 30 (4): 327-328.   DOI: 10.13281/j.cnki.issn.1004-4469.2021.04.019 Abstract （95）            Knowledge map    Save Related Articles | Metrics

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The influence on corneal endothelial cells of anterior chamber bubbles during femtosecond laser in situ keratomileusis Wang Xingcun, Zhang Guangfeng, Zhu Liqiang, He Jiao Ophthalmology in China    2021, 30 (5): 360-366.   DOI: 10.13281/j.cnki.issn.1004-4469.2021.05.007 Abstract （601）            Knowledge map    Save  Objective To explore the influence on corneal endothelial cell of anterior chamber bubbles during femtosecond laser in situ keratomileusis (LASIK). Design Retrospective cases series. Participants Twenty-three patients (23 eyes with anterior chamber bubbles) in The Central Theater Command Air-Force Hospital of PLA from February 2012 to November 2017 who accept LASIK surgeries using femtosecond leaser. Methods The eyes with anterior chamber bubbles during IntraLase femtosecond laser LASIK were included in observation group, and the eyes without anterior chamber bubbles during LASIK were included in the control group. Anterior chamber bubbles based on the number of bubbles divided into first-level (a little bubbles in pupil area), second-level (medium dose bubbles covering pupil area) and third-level (a lot of bubbles covering completely pupil area). The mean central corneal endothelial cell density(CED), percentage of hexagonal endothelium (HEX) and coefficient of variation(CV) of corneal endothelial cell area measured by Topcon SP-2000P noncontact specular microscope of two groups were compared at preoperation, and at 1 day, 1 week, 1 month, 3 months, 6 months after operation.  Main Outcome Measures CED, percentage of HEX and CV of corneal endothelial cell area. Results Anterior chamber bubbles located on nasal side in 11 eyes (47.83%), on bitamporal side in 8 eyes (34.78%), on below side in 3 eyes (13.04%) and on upward side in 1 eye (4.35%). All anterior chamber bubbles moved from anterior chamber angle to pupil. 15 eyes (65.22%) were the first-level anterior chamber bubbles, 7 eyes (30.43%) were the second-level and 1 eye (4.35%) was the third-level. The CED of observation group at preoperative and postoperative 1day, 1 week, 1 month, 3 months, 6 months was 2901±180 cells/mm2, 2833±153 cells/mm2, 2852±149/mm2, 2835±171 cells/mm2, 2863±117 cells/mm2 and 2854±88 cells/mm2, respectively. The percentage of HEX of observation group at preoperative and postoperative 1 day, 1 week, 1 month, 3 months, 6 months was 45.2%±5.4%, 46.5%±5.4%, 46.2%±5.4%, 47.3%±5.5%, 47.6%±4.7% and 47.7%±4.5%, respectively. The CV of corneal endothelial cell area of observation group at preoperative and postoperative 1 day, 1 week, 1 month, 3 months, 6 months was 45.17%±5.39%, 46.50%±5.43%, 46.22%±5.43%, 47.32%±5.50%, 47.62%±4.68% and 47.72%±4.52%, respectively. The CED of control group at preoperative and postoperative 1 day, 1 week, 1 month, 3 months, 6 months was 2989±349 cells/mmm2, 2948±246 cells/mm2, 2958±331 cells/mm2, 2972±321 cells/mm2, 2958±342 cells/mm2 and 2962±355 cells/mm2, respectively. The percentage of HEX of control group at preoperative and postoper-ative 1 day, 1 week, 1 month, 3 months, 6 months was 46.3%±7.5%, 44.1%±8.2%, 43.9%±7.3%, 43.7%±7.4%, 44.3%±6.9% and 43.9%±7.1%, respectively. The CV of corneal endothelial cell area of control group at preoperative and postoperative 1 day, 1 week, 1 month, 3 months, 6 months was 43.81%±8.15%, 46.41%±6.37%, 46.58%±6.67%, 46.73%±7.12%, 46.81%±6.12% and 46.76%±7.06%, respectively. The difference of CED between control group and observation group was statistically significant (F=2.486, P=0.022), and the difference between postoperative and preoperative parameters of CED in the same group was not statistically significant (F=1.342, P=0.260). The difference of percentage of HEX between control group and observation group was not statistically significant (F=0.469, P=0.497), and the difference between postoperative and preoperative parameters of percentage of HEX in the same group was statistically significant (F=5.966, P=0.004). The difference of CV of corneal endothelial cell area between control group and observation group was not statistically significant (F=0.4106, P=0.746), and the difference between postoperative and preoperative parameters of CV of corneal endothelial cell area in the same group was statistically significant (F=21.248, P=0.000). Conclusion The anterior chamber bubbles produced in femtosecond laser LASIK have a certain effect on CED in a short time. However, it had no significant effect on percentage of HEX and CV of corneal endothelial cell area. (Ophthalmol CHN, 2021, 30: 360-366) Related Articles | Metrics

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Evaluation of the diagnostic accuracy in three kinds of artificial intelligence diagnosis model for detection of diabetic retinopathy on fundus photographs Zhao Qi, Yang Wenli, Wei Wenbin, Zhang Yongpeng, Li Lei, Zhang Mengyu, Guo Jing Ophthalmology in China    2021, 30 (5): 355-359.   DOI: 10.13281/j.cnki.issn.1004-4469.2021.05.006 Abstract （493）            Knowledge map    Save Objective To compare the consistency of artificial intelligence (AI) diagnosis models and ophthalmologist in grading diabetic retinopathy (DR). Design Diagnosis tests. Participants 236 cases (468 eyes) of diabetic patients in Beijing Tongren Hospital were selected. Methods Two-field non-mydriatic macula- or optic disc-centered fundus photographs were performed. Using ophthalmologist diagnosis as the golden standard, three kinds of AI diagnosis model(model 1, 2, 3) based on Convolutional Neural Network (CNN) were evaluated, including DR yes/no, referable DR and DR stagingtests. Main Outcome Measures Sensitivity (Se), specificity (Sp), area under curve (AUC). Results The Se, Sp and AUC of DR yes/no were 95.8%, 90.1% and 0.930 on model 1, 96.5%, 85.2% and 0.908 on model 2, and 96.2%，83.5% and 0.917 on model 3, respectively. The Se, Sp and AUC of referable DR were 93.9%, 90.1% and 0.933 on model 1, 97.7%，89.3% and 0.935 on model 2, and 95.4%, 89.8% and 0.926 on model 3, respectively. The Se, Sp and AUC of stages of DR were 72.9%~90.1%, 93.9%~97.8% and 0.854~0.930 on model 1, 68.8%~92.1%， 90.6%~98.2% and 0.831~0.914 on model 2, and 75.0%~83.5%, 89.2%~96.8% and 0.849~0.917 on model 3, respectively. Conclusion Three kinds of AI diagnosis model have good sensitivity and specificity for the determination of DR and referable DR, and it could be used as an auxiliary tool for DR screening of diabetic patients. (Ophthalmol CHN, 2021, 30: 355-359) Related Articles | Metrics

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Incidence and risk factors of intraocular pressure elevation within postoperative three days in retinal detachment patients treated by pars plana vitrectomy with silicone oil tamponade Xue Cancan, Li Shushan, Miao Jinhong, Zhang Chun Ophthalmology in China    2022, 31 (1): 26-32.   DOI: 10.13281/j.cnki.issn.1004-4469.2022.01.005 Abstract （1232）            Knowledge map    Save Objective To investigate the incident rate and risk factors of intraocular pressure(IOP) elevation within 3 days afterpars plana vitrectomy and silicone oil tamponade for retinal detachment. Design Prospective case series. Participants 135 cases of retinal detachment patients who were treated by vitrectomy with silicone oil tamponade from February to August 2018 in Peking University Third Hospital were consecutively included. Methods IOP at hours 2, 4, 6~8, and days 1, 2, 3 after surgery were recorded. IOP≥25 mmHg at any time was defined as IOP elevation. Survival time was defined as the time interval (hours) from the end of vitrectomy to the onset of the first IOP elevation. Cox regression analysis was used to evaluate the risk factors associated with postoperative IOP elevation. Kaplan-Meier survival curves were constructed to visualize the probability of overall survival of patients with different etiology of retinal detachment. Main Outcome Measures Incidence and risk factors for IOP elevation. Results Among 135 patients enrolled, 44 (32.6%) patients developed IOP elevation, with the incident rate peaked at the postoperative day one (20.2%). The etiology of retinal detachment was significantly associated with the IOP elevation (P=0.006). Compared to primary rhegmatogenous retinal detachment, patients with diabetic tractional retinal detachment and recurrent retinal detachment had 3.5 (P=0.002, hazards ratio (HR) =3.41) and 3 (P=0.010, HR=2.91) folds of increased risk for IOP elevation. The overall survival probability of diabetic traction retinal detachment and recurrent retinal detachment was significantly lower than that of primary rhegmatogenous retinal detachment and traumatic retinal detachment (all P<0.05). Conclusion Early-onset IOP elevation occurs in one-third of retinal detachment eyes with silicone oil tamponade, with the incidence peaked at the first postoperative day. The first postoperative day visit, at least IOP examination, is still necessary for eyes underwent vitrectomy and silicone oil tamponade, especially those with diabetic tractional retinal detachment and recurrent retinal detachment. (Ophthalmol CHN, 2022, 31: 27-32) Related Articles | Metrics

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Epidemiologic characteristics of acute spring allergic conjunctivitis in ophthalmic emergency in 2019-2021 Ma Nan, Fu Jing, Meng Zhaojun, Yang Yiquan, Li Jian Ophthalmology in China    2021, 30 (5): 369-373.   DOI: 10.13281/j.cnki.issn.1004-4469.2021.05.008 Abstract （542）            Knowledge map    Save Objective To investigate the trend changes and influencing factors of spring allergic conjunctivitis in ophthalmic emergency in 2019-2021. Design Retrospective cases series. Participants 1985 patients with acute allergic conjunctivitis in the ophthalmic emergency department of Beijing Tongren Hospital in March 2019, and 912 and 2343 patients with acute allergic conjunctivitis in the same period of 2020 and 2021. Method Date was extracted from hospital information system, including ages, genders, diagnoses and number of patients. The air quality index and pollen concentration index were analyzed with daily allergic conjunctivitis patient number. Patients were divided into juvenile group (0-17 years old), youth group (18-45 years old), middle-aged group (46-64 years old) and elderly group (≥ 65 years old). Main Outcome Measures Ages, number of patients, air quality index and pollen concentration index. Result In March 2019, 2020, 2021, there were 1985 cases (34.5%), 912 cases (29.9%) and 2343 cases (39.7%) of allergic conjunctivitis patients. In March 2019, there were 541 (27.2%), 1083 (54.6%), 301 (15.2%) and 60 (3.0%) cases in juvenile group, youth group, middle-aged group and elderly group, respectively. In March 2020, there were 125 (13.7%), 562 (61.6%), 177 (19.4%) and 48 (5.2%) cases, respectively. In March 2021, there were 549 (29.4%), 1266 (54.0%), 251 (13.4%) and 73 (3.1%) cases, respectively. In March 2019, 2020 and 2021, there was no correlation between the number of allergic conjunctivitis patients and the air quality index (r=0.186, 0.111, 0.172, all P>0.05). In March 2021, the number of allergic conjunctivitis patients was highly correlated with the pollen concentration index (r=0.908, P＜0.001). Conclusion Influenced by the COVID-19 epidemic and home isolation, the number of ophthalmic emergency visits of allergic conjunctivitis in March 2020 was decreased 1/2. Moreover the number of juvenile groups visits were decreased 3/4 in March 2020 compared with in March 2019. Rising pollen concentrations increased the incidence of allergic conjunctivitis in Beijing in March 2021. (Ophthalmol CHN, 2021, 30: 369-373) Related Articles | Metrics

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The short-term analysis of different active age-related macular degeneration after anti-VEGF treatment by optical coherence tomography angiography Gu Zheyao, Yao Yong, Xi Ting, Zhang Chunyuan, Yang Guang Ophthalmology in China    2021, 30 (5): 349-353.   DOI: 10.13281/j.cnki.issn.1004-4469.2021.05.005 Abstract （538）            Knowledge map    Save Objective To observe the response of different activity of age-related macular degeneration(AMD) to anti-vascular endothelial growth factor (VEGF) treatment observed by optical coherence tomography angiography(OCTA), and to analyze the correlation between the difference of response and the imaging features of choroidal neovascularization (CNV). Design Retrospective case series. Participants 54 patients (54 eyes) with wet AMD confirmed by fluorescein fundus angiography and/or indocybanine green angiography in Suzhou Municipal Hospital(North District). Methods According to the morphology of macular CNV based on OCTA, AMD patients were divided into active group and inactive group. The average number of anti VEGF was (4.06±0.89) in the active group and (3.83±0.79) in the inactive group. The differences of best corrected visual acuity (BCVA)(LogMAR) and central macular thickness (CMT) before and after anti-VEGF treatment were observed. The average follow-up was (4.17±1.02) months. Main Outcome Measures BCVA, CMT. Result In the active group, BCVA ( LogMAR)was (0.36±0.12) after anti-VEGF treatment, which was significantly higher than that before treatment (0.59±0.10) (t=5.962, P=0.000). In the inactive group, the BCVA of patients after anti-VEGF treatment was (0.62±0.11), which was not significantly higher than that before treatment (0.70±0.13) (t=1.445, P=0.182). In the active group, the CMT after anti-VEGF treatment was (286.17±97.47) μm, which was significantly lower than that before treatment (350.09±131.09) μm (t=3.792, P=0.001). In the inactive group, the CMT after anti-VEGF treatment was (222.40±34.93) μm, which was significantly lower than that before treatment (302.93±132.67) μm (t=2.756, P=0.015). Conclusion The morphological features of different active CNV observed by OCTA can effectively assess the response to anti-VEGF treatment in wet AMD patients. Wet AMD patients with active CNV have a good response to anti-VEGF treatment.  (Ophthalmol CHN, 2021, 30: 349-353) Related Articles | Metrics