Table of Content

25 November 2014, Volume 23 Issue 6

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Genetic diagnosis of hereditary retinal diseases

SUI Rui-fang, ZOU Xuan

2014, 23(6):  361-364.  doi:10.13281/j.cnki.issn.1004-4469.2014.06.001

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Inherited retinal diseases are a group of blindness disease with high clinical and genetic heterogeneity. Clinical diagnosis cannot provide enough information for etiology, treatment and prognosis. Genetic diagnosis, by identifying the disease-causing mutation, is very important for genetic counseling and proper therapy. Traditional genetic testing techniques include linkage analysis, direct sequencing (Sanger sequencing) and DNA chip technology. Recently, next generation sequencing (NGS) has been successfully applied to a variety of retinal disease researches, which improved the molecular diagnostic rate and reduced time and cost. Genetic diagnosis of hereditary retinal diseases in China is in the early stage. Funding support, specialized personnel and professional standards are essential for an ideal clinical diagnostic platform.

Diagnosis and treatment keys for Duane's retraction syndrome

ZHOU Jin-qiong, FU Jing, LU Wei

2014, 23(6):  365-368.  doi:10.13281/j.cnki.issn.1004-4469.2014.06.002

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Duane's retraction syndrome (DRS) is characterized by limitation of horizontal duction associated with globe retraction and consequent narrowing of the palpebral fissure in adduction, with occasional upshoot or downshoot during adduction. It can be devided into type Ⅰ, Ⅱ, Ⅲ based on different ocular signs. As originally, DRS was thought to be due to anatomical abnormality, but new findings suggested that the pathogenesis was related to congenital dysinnervation of the lateral rectus muscle. The surgical strategy for DRS posed a challenge as all components of the disorders need to be taken into account on a case-by-case basis.

Is it necessary for treatment of vitreous floaters with neodymium YAG laser?

ZHANG Feng, TIAN Bei, SHI Xue-hui

2014, 23(6):  369-370.  doi:10.13281/j.cnki.issn.1004-4469.2014.06.003

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YAG laser vitreolysis for vitreous Weiss ring is a therapy to smash the Weiss ring using the gasification of the YAG laser in order to eliminate the symptoms of the spotted vision. The therapy was developed in the 1990s. Some evidences showed its validity, and its complications as well. In current, there are certains of the controversies on its application on the clinic. In the current periodical we published a relative original article, the results can be referenced by the readers. In the curent article, three experimental ophthalmologists state thier own views to discuss if it is necessary for treatment of vitreous floaters with neodymium YAG laser.

Efficacy of YAG laser vitreolysis on vitreous Weiss ring

GONG Song-jian, FU Zheng

2014, 23(6):  371-374.  doi:10.13281/j.cnki.issn.1004-4469.2014.06.004

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Objective  To observe the efficacy of YAG laser vitreolysis on vitreous Weiss ring. Design Retrospective case series. Participants 192 patients (218 eyes) complained of floaters because of vitreous floaters (Weiss ring) second to posterior vitreous detachment during the period of October 2004 to July 2013 in Xiamen Eye Center. Methods All the 218 eyes underwent Nd:YAG laser vitreolysis for vitreous Weiss ring and were followed up 3 to 36 months, average 12±3 months. Preoperative visual acuity, intraocular pressure, three mirror examination, slit lamp photography, eye B-mode ultrasound, panoramic laser photography, autofluorescence examination and fundus fluorescein angiography were performed to determine the location and size of Weiss ring in vitreous. According to the size, the Weiss rings were divided into grand central (＞4 mm, 19 eyes), central (2~4 mm, 80 eyes), small ring(<2 mm, 119 eyes), and all were treated by Nd:YAG laser (ZEISS, VISULAS YAGII or YAGIII, the single pulse mode, energy 5~10 mJ). The therapeutic effects were observed and evaluated according to the smyptoms completely disappeared, improved, or invalid. Main Outcome Measures  Effective rate, improving rate, complicatins. Results Individual patients with single treatment of total energy from 56 mJ to 2136 mJ, the average was (961 ± 354) mJ. A single treatment time: 4~31 minutes, average (18 ± 5.2) minutes. 166 eyes were treated once, twice in 35 eyes, and 3 times in 17 eyes. Symptoms disappeared completely in 182 eyes (83.49%)，in which the effective rate was 94.12 in the small ring, 77.50% in the central ring, and 42.11% in the grand central ring; improved in 32 eyes (14.68%), invalid in 4 eyes (1.83%). No direct laser damages such as induced vision or visual field damage, damage of lens, intraocular pressure increasing, retinal vascular lesions, RPE autofluorescence damage etc were appeared. Conclusion For the Weiss ring caused by vitreous floaters, in strictly selected indications, Nd:YAG laser vitreolysis therapy is a relatively safe and simple, fast means, especially in the small floater.

Application of noninvasive tear film function examinations on dry eye diagnosis

LIANG Qing-feng1, YAO Wei-lan1, ZHANG Yang1, WANG Zhi-qun1， LABBE Antoine2

2014, 23(6):  375-379.  doi:10.13281/j.cnki.issn.1004-4469.2014.06.005

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 Objective To analyze tear film function and the location of first breakup point in dry eye patients using Oculus Keratograph. Design Prospective comparative case series. Participants Fifty-one patients with dry eye and eighty-six healthy age- and sex-matched control subjects were included from July to September 2013. Methods The dry eye symptoms in all subjects were evaluated with the Ocular Surface Disease Index (OSDI) questionnaire. Noninvasive tear breakup time (NITBUT) and tear meniscus height (TMH) were tested with Oculus Keratograph. One eye of each subject was included in the study. Differences of OSDI scores, first NITBUT (NITBUTf), average NITBUT (NITBUTav) and TMH between dry eye group and control group were compared. The correlations of these parameters were assessed. Locations of first tear film breakup point were observed and differences between two groups were analyzed. Main Outcome Measures OSDI scores, NITBUTf, NITBUTav, TMH and first tear film breakup point location. Results Differences of OSDI scores, NITBUTf, NITBUTav between dry eye group and control group were significant（P=0.000， 0.000， 0.016， respectively）. No significant difference of TMH between two groups was found (P=0.217). There were linear negative correlations between NITBUTf, NITBUTav and OSDI scores (r=-0.760, -0.490, respectively; P=0.000). Linear positive correlation was found between NITBUTf and NITBUTav (r=0.671，P=0.000). There was no correlation between OSDI scores, NITBUTf, NITBUTav and TMH（r=-0.099,0.116,0.019; P=0.252, 0.178, 0.824, respectively). The occurrence of first tear film breakup point of dry eye group and control group was mainly emerged in loop 2 to 5 (73.08% and 75.42%, respectively). The occurrence has significant difference among different loops in both groups (χ2=13.897, 30.017; P=0.031, 0.000, respectively). There was no significant difference between different quadrants in both groups (χ2=2.103, 5.186; P=0.551, 0.159, respectively). Conclusion Oculus Keratograph could be used to analyze noninvasive tear film function. NITBUT was related to the OSDI. It showed that the first tear film breakup point of dry eye patients occurred in the pupil area of cornea most frequently．

Short-term effect of intravitreal injection Ranibizumab on intraocular pressure in wet age-related macular degeneration patients

SONG Shuang, YU Xiao-bing, DAI Hong

2014, 23(6):  380-384.  doi:10.13281/j.cnki.issn.1004-4469.2014.06.006

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Objective To observe the short-term effect of intravitreal injection Ranibizumab(Lucentis) on intraocular pressure (IOP). Design Prospective case series. Paticipants  135 eyes from 135 patients (70.54±8.69 y) with wet age-related macular degeneration treated with Ranibizumab in Beijing Hospital. Methods  The IOP were measured by  non-contact tonometer before injection, and at 10, 30,120 minutes and 1 day after injection in a sitting position. Main Outcome Measures  The IOP pre and post-injection. Results    Mean IOP was (15.41±2.69)mmHg , (21.07±5.83) mmHg, (18.24±4.17)mmHg, (17.57±4.60 )mmHg, (15.20±3.05)mmHg, respectively, for the time points immediately before, 10,  30, 120 minutes, and 1 day after injection. Differences of IOP  between before and after injection were statistically significant at 10, 30, 120 minutes (all P<0.05) except 1 day (P=0.239); The ratio of  increasing IOP  gradually decreased after injection, and the ratio at 10 minutes was significantly higher than other times (the ratio of  IOP≥21 mmHg was 45.93%, ≥25 mmHg was 21.48%, ≥30 mmHg was 8.15%; the ratio of IOP  increasing 10 mmHg was 17.78%, increasing 15 mmHg  was 5.19%). The higher the baseline IOP was the more patients with abnormal IOP postinjection occured (P=0.000, OR=0.117, 95%CI: 0.051-0.268).  Conclusion   Intravitreal injection Ranibizumab  (Lucentis) causes a considerable short-term transient rise on IOP in most of wet age-related macular degeneration patients. The IOP increase can be statistically significant from 10 minutes to 2 hours after injection. The high baseline IOP may be a risk factor for short-term rise on IOP postinjection.

Drug resistance analysis of corneal pseudomonas aeruginosa infection in 2007-2013

ZHANG Yang, WANG Zhi-qun, SUN Xu-guang

2014, 23(6):  384-387.  doi:10.13281/j.cnki.issn.1004-4469.2014.06.007

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Objective To analyze the drug sensitivity and resistance of corneal pseudomonas aeruginosa from Beijing Tongren Hospital in 2007-2013 in order to provide guidance for clinical drug treatment. Design Experimental study. Participants 100 corneal pseudomonas aeruginosa in Beijing Tongren Hospital were isolated from ophthalmological specimens for microbiological examination. Methods  Kirby-Bauer disk diffusion method in vitro is done by spreading bacterial diluents containing isolated and cultured corneal pseudomonas aeruginosa on Mueller-Hinton (M-H) agar plate and pasting drug disks. Sensitivity is interpreted according to inhibition zone diameter and standards from Clinical Laboratory Standards Institute (CLSI). Based on principles of bacterial biochemical tests, ATB Expression can semi-automatically identify bacteria. WHONET 5.6 and SPSS 16.0 are applied for data processing. Main Outcome Measures Drug sensitivity and resistance. Results Sensitive and resistance rates of 9 drugs were: amikacin 93.8% and 3.1%, tobramycin 86.9% and 12.1%, gentamicin 67.3% and 17.3%, ciprofloxacin 89.1% and 8.7%, levofloxacin 88.7% and 10.3%, levofloxacin 86.9% and 11.1%, gatifloxacin 87.4% and 11.5%, moxifloxacin 41.7% and 36.5%, ceftazidime 84.8% and 8.1%. 3% of the isolates were resistant to all drugs tested. Conclusion Corneal pseudomonas aeruginosa is most sensitive and least resistant to amikacin. Sensitive rates of ciprofloxacin, levofloxacin, ofloxacin, gatifloxacin and tobramycin all exceed 85%. Clinical application of combination drug therapy should be considered. Corneal pseudomonas aeruginosa is highly resistant to moxifloxacin which application should be cautious.

Comparison on 18 months results of trabeculetomy for chronic angle closure glaucoma with acute attack to those without acute attack

CHEN Yan-yun1, FAN Su-jie2， LIANG Yuan-bo3， RONG Shi-song4， MENG Hai-lin5， WANG Xing6， WANG Ning-li1.

2014, 23(6):  388-391.  doi:10.13281/j.cnki.issn.1004-4469.2014.06.008

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Objective To compare the 18 months results of initial trabeculectomy in patients with chronic angle closure glaucoma (CACG) with acute attack with those without acute attack.  Design Prospective comparative case series. Participants 48 CACG patients with acute attack (48 eyes) (acute attack group) and 101 CACG patients without acute attack (101 eyes) (without acute attack group) from 4 ophthalmic centers were included retrospectively.  Methods All patients underwent trabeculetomy and follow-up for 18 months. Visual acuity (VA), intraocular pressure (IOP), medication and complications for baseline and postoperation (postoperation 1, 3 days, 1, 2 weeks, 1, 3, 6, 12, 18 months) were recorded. Complete success was defined as IOP was less than 21 mmHg without any medication at the final visit. Main Outcome Measures IOP, changes of VA (VA at final visit-VA at baseline visit), IOP fluctuation (IOP standard deviation during follow-up), success rate. Results Change of VA in acute attack group and without acute attack group was -0.06±0.47 and 0.02±0.36, respectively (P=0.166). Mean IOP during follow-up in acute attack group and without acute attack group was 14.9±4.0 mmHg and 14.6±2.8 mmHg, respectively (P=0.601). Long term IOP fluctuation was not significantly different between acute attack group and without acute attack group （P=0.452）, which was 3.1±2.5 mmHg and 2.8±1.6 mmHg, respectively. The IOP at postoperation 18 months in acute attack group and without acute attack group was 16.8±7.5 mmHg and 15.4±4.0 mmHg, respectively（P=0.259）. The success rate of the trabeculectomy was better in without acute attack group (93.1%) than that in acute attack group (85.7%), however, the difference between two groups was not significant （x²=2.11， P=0.146）. Conclusion The success rate of the trabeculectomy was similarly high in both acute attack group and without acute attack group.

Effect analysis of treatment for post-penetrating keratoplasty glaucoma

HAO Jing-hua1, LUO Fei2, YAN Chao2, PAN Zhi-qiang2

2014, 23(6):  392-397.  doi:10.13281/j.cnki.issn.1004-4469.2014.06.009

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Objective To investigate the treatment efficacy of the secondary glaucoma after penetrating keratoplasty (post-penetrating keratoplasty glaucoma, PPKG). Design Retrospective case series. Participants 34 patients（34 eyes）with PPKG in Beijing Tongren Hospital from January 2010 to January 2013. The primary diseases were as the following: 12 eyes of ocular trauma, 6 eyes of  bullous keratopathy in aphakic or pseudophakic eyes, 4 eyes of adhesive walleye, 4 eyes of corneal ulcers. There were 23 eyes of high-risk corneal keratoplasty. Methods A retrospective clinical data of patients, including corrected visual acuity, intraocular pressure(IOP), anterior segment slit lamp, ultrasound biomicroscopy (UBM) and anterior segment optical coherence tomography (AS-OCT) were reviewed. Patients were treated thoroughly with IOP lowering medications, if which was ineffective the glaucoma surgery underwent. Clinical efficacy criteria: after appropriate treatment, IOP ≤21 mmHg or needn't any medication in the end is effective, > 21 mmHg as invalid. The follow-up time was 6～18 months (mean 12.21±3.86 months). Main Outcome Measures IOP. Results In the 34 eyes, 11 eyes (32.4%) used local or systemic hypotensive drugs, 23 eyes (67.6%) used drug and operation treatment. It was found that in the 23 cases who accepted the glaucoma operation, 11 eyes were operated 1 time, 8 eyes 2 times, 2 eyes 3 times , 2 eyes 4 ~ 5 times. Surgical options consisted of diode laser cyclophotocoagulation in 7 eyes, ciliary body cryotherapy in 2 eyes, cyclophotocoagulation, ciliary body cryotherapy in 5 eyes, cyclophotocoagulation, cyclocryotherapy, trabeculectomy in 5 eyes, cataract extraction and small beam excision of anterior vitrectomy + pupil forming operation in 1 eye, cyclophotocoagulation, trabeculectomy in 1 eyes, EX-PRESS drainage screw implantation in 1 eye, trabeculectomy, cyclophotocoagulation, cyclocryotherapy, cyclodialysis + cyclophotocoagulation 1 eye. At the end of the follow-up, in the 11 eyes who simply used the IOP lowering drugs, 5 eyes (45.5%) did not need any drug treatment in the end, 5 eyes (45.5%) still needed 1~2 kinds of intraocular pressure lowering drops, 1 eye (9%) invalid; in the 23 eyes who accepted the operations, 6 eyes (26.1%) did not need any drug treatment, 12 eyes (52.2%) still needed 1~2 kinds of intraocular pressure lowering drops, 2 eyes (8.7%) still needed 3 kinds of drops, 3 eyes (13%) invalid. Conclusion  More than half of the patients with PPKG still need 1 to 2 kinds of intraocular pressure lowering medications after ocular hypotensive drugs and surgery.

Association of iVue OCT Signal Strength Index with blur degree of fundus photographs in cataracts

ZHANG Jing-shang, WANG Jin-da, WAN Xiu-hua, AN Ying, SU Bing-nan, XU Liang, LI Jian-jun

2014, 23(6):  398-401.  doi:10.13281/j.cnki.issn.1004-4469.2014.06.010

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Objective To analyze the association of the iVue OCT Signal Strength Index with the blur degree of fundus photographs in cataracts and to explore the feasibility to evaluate the severity of the cataract using the index． Design Evaluation of diagnostic methods. Participants 162 patients (324 eyes) with cataract  at Beijing Tongren Hospital in 2013． Methods All cases were confirmed by slit-lamp microscope examination. Fundus photographs and anterior segment photographs were taken with the non-mydriatic fundus digital camera. The grade of fundus photographs was based on the blur degree. The ratio of the diameter of the pupil and corneal diameter was obtained according to anterior segment photographs. The Signal Strength Index was obtained by the iVue OCT. Main Outcome Measures The grade of fundus photographs, the grade of the Signal Strength Index, sensitivity, and specificity． Results  With the increasing of the fundus photographs blur degree, the Signal Strength Index of iVue OCT decreased (r=0.891, P<0.001).  The sensitivity of high Signal Strength Index  evaluating the 0 degree of cataract fundus photographs was 89% and the specificity was 78%. The sensitivity of the moderate Signal Strength Index evaluating the 2 degree of cataract fundus photographs was 88% and the specificity was 67%. The sensitivity of the  low Signal Strength Index evaluating the 4 degree of cataract fundus photographs was 100% and the specificity was 94%. There is no significant correlation between pupil size and the Signal Strength Index (P=0.989). Conclusion The Signal Strength Index and the blur degree of fundus image in cataract have a good correlation. The Signal Strength Index of iVue OCT could accurately evaluate the blur degree of fundus photographs in the mild and severe cataracts.

Neuroprotective effects and its mechanism of Qizhen on retinal ganglion cells in rat optic nerve crush model

YOU Yu-xia, LI Yu-jie, ZHANG Hai-juan, MA Ke

2014, 23(6):  402-405.  doi:10.13281/j.cnki.issn.1004-4469.2014.06.011

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Objective To investigate the protective effect and its mechanism of Qizhen capsule on the retinal ganglion cell （RGCs） of the rat optic nerve crush model. Design Experimental study. Participants 72 healthy adult male SD rats. Methods The 72 rats were divided randomly into two groups: treatment group (36 rats) and control group (36 rats). All the right eyes were selected as the experimental eyes, using a micro optic nerve forceps with the clipping pressure of 40 g to crush the exposed optic nerve for 60 s at 2 mm from the optic disc. The left eyes served as normal controls. The rats were given drug by gastric perfusion 2 h after the crushing, and then once daily. The rats of treatment group were given 20% Qizhen solution with a dose of 2.5 ml/kg; control group rats were given saline with same does for consecutive four weeks. At the 28 days after injury, the rats were sacrificed, HE staining, the expression of Caspase-3 protein and Tunel were detected with 24 rats of each group. The rest 12 rats each group were used to detect the expression of Bax and Bcl-2. Main Outcome Measures The thickness of retina, the expression of Bax and Bcl-2. Results The average thickness of retina in Qizhen treatment group was (109.0±4.4) μm, and (101.8±7.6) μm in the control group（P=0.028）. The difference of the expression of Bax was significant （t=1.089，P=0.028）, but there was no significant difference of Bcl-2 (t=0.553，P=0.692) between the two groups. Conclusion Qizhen plays a protective role for RGCs in rat optic nerve crush model, decreasing the apoptosis of RGCs may through reducing the expression of Bax and Caspase-3.

Effects of axial length on retinal vascular filling state in non-proliferative diabetic retinopathy

XUE Shang-cai, WANG Xiu-lan, LI Hui-rong, SUN Jian-ling

2014, 23(6):  406-409.  doi:10.13281/j.cnki.issn.1004-4469.2014.06.012

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Objective  Observe the effects of axial length on the retinal vascular filling state in non-proliferative diabetic retinopathy (NPDR). Design prospective case series. Participants 254 cases (254 eye) of Diabetes without retinopathy and NPDR patients hospitalized in the department of Ophthalmology and Endocrinology in the Gansu second people's Hospital were included. Methods All patients underwent fluorescence fundus angiography（FFA） and optical coherence tomography (OCT) examination. The axial length was measured using  A type ultrasonic diagnostic apparatus. And the participants was divided into three groups according to the axial length:  normal group(22~24 mm), long axial group (>24 mm and <26 mm),  extr-long axial group(26 mm or more). Each group of patients underwent FFA retinal vascular filling indicators, which for comparison to observe the different hemodynamic parameters in patients with different axial shaft length. Main Outcome Measures  Arm - retinal circulation time, retinal A-V fluorescence filling time, and axial length. Results The arm-retinal circulation time averaged (12.94±0.46)s, (10.42±0.51)s, and (10.36±0.64)s in normal, long axial, and extra-long axial group, respectively (F=1.289，P=0.252). The retinal A-V fluorescence filling time averaged (13.56±2.04)s, (9.15±1.36)s, and (6.36±1.15)s, respectively in the three groups (F=103.364，P=0.000). The vascular filling time in extr-long axial group faster than the normal group (F=108.863，P=0.000), and the long axial group (F=175.516，P=0.000). Conclusion The longer the axial length，the shorter the retinal vascular filling time, and the faster the retinal vascular filling, in the patients with NPDR. Which reflects, in a certain aspect, the effects of the axial lenth on the retinal hemodynamic state in the NPDR patients.

Bibliometric analysis of current AION research based on Pubmed database

ZHAO Xin, SUN Ye, ZHAO Zhao, TIAN Mei-li，DONG Ya-fei, SHI Yi-ning, ZHAO Tong, ZHANG Yu-jie， LI Ming-hui， GUO Yong-qiang， ZHANG Wei， ZHANG Shu-yuan

2014, 23(6):  410-415.  doi:10.13281/j.cnki.issn.1004-4469.2014.06.013

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Objective  To survey the distribution pattern and subject domain knowledge of worldwide anterior ischemic optic neuropathy (AION) researches based on literatures in Pubmed database. Design Biblionmetric analysis. Participants Literatures on AION published in 1994 to 2013 were identified in Pubmed database. Methods Literatures on AION published in 1994 to 2013 were identified in Pubmed database. The analytic items of an article include published year, country language and journal. After core mesh terms had been characterrized by Bibliographic item co-ocurrence matrix builder(BICOMS), the co-occurrence matrix was built. Cluster analysis was finished by SPSS20.0. Then visualized network was drawn using Ucinet 6.0. Main Outcome Measures Cluster analysis, social network analysis and the visualized knowledge mapping based on high-frequency subjects.  Results Totally 1599 literatures were included, the number of annual articles changed slightly between 1994 and 2013. The United States, England, Germany and France together accounted for 77% of articles. There were 55 high-frequency subjects and hot topics were cluster into the following 11 categories: (1) AION caused of aged, risk factors and visual disorders, as well as blindness. (2) Diagnosis of AION visual disorder and optic neoropathy, as well as differential. (3) Pathology and physiopathology of AION, visual disorder, nerve and disk, as well as disease models. (4) Examination of visual acuity. visual fields, fundus oculi and intraocular pressure. (5) Complications of AION and giant cell arteritis. (6) Drug therapy of AION and giant cell arteritis, as well as AION prevention and contral. (7) Chemically induced of AION and adverse effects of phosphodiesterase inhibiters includs of piperazines, purines and sulfones. (8) Methods of nerve system examinations including fluorescein angiography, megnetic resonance imaging and ultrasonography. (9) Methods of restrspective and prospectives studies. (10) Metabolism and blood supply of AION optic nerve, as well as the physiology of visual acuity and visual fields. (11) Surgery and other postoperative complications of AION. The visualized domain knowledge mapping was successful built. The etiology and risk factors in the core domain, which have an important link to diagnosis and therapy. The researches on AION gene, drug therapy were not developed well, which was of great promotion space. Conclusions The distribution pattern and subject domain knowledge of worldwide AION researches in the recent twenty years were shown by using bibliometric analysis. Western developed countries play a leading role in the field of AION research, which needs to be strengthened in China.

Perceptual eye position and gaze stability of the children with amblyopia

LIN Nan1， LU Wei1， SUN A-li1, YAN Li2, ZHANG Ling-ge2, LIU Jun2, WU Dian-peng2

2014, 23(6):  417-419.  doi:10.13281/j.cnki.issn.1004-4469.2014.06.014

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Objective To investigate the perceptual eye position and gaze stability of the children with amblyopia under dichoptic vision condition. Design Prospective case series. Participants 90 mild, moderate, severe amblyopic children with normal eye position, each include 30 cases. Method The main test method was the computer based visual perceptual test software, each amblyopic child must take the visual perceptual test and gaze stability test. Main Outcome Measures The deviation pixels of perception eye position and the gaze stability. Results When the target size was 3 degree, the mean horizontal eye position of mild, moderate, severe amblyopic children was 12.70±9.57, 23.33±21.03, 53.79±58.92 pixels respectively (H=14.765, P=0.001); the mean vertical eye position was 4.93±5.21, 9.23±9.03, 20.48±23.75 pixels respectively (H=13.569，P=0.001). When the target size was 1 degree, the mean horizontal eye position of mild, moderate, severe amblyopic children was 18.67±16.19, 33.27±27.95, 81.61±76.02 pixels respectively (H=17.941，P=0.000); the mean vertical eye position was 4.27±5.46, 7.50±10.52, 20.75±22.99 pixels respectively (H=19.927，P=0.000). The mean gaze stability deviation of mild, moderate, severe amblyopic children was 4.77±3.18, 7.23±5.54, 20.44±22.99 pixels respectively (H=29.944，P=0.000). Conclusion The deviation pixels of perception eye position and the gaze stability were abnormal in the amblyopic children with normal eye position. The more severe the degree of amblyopia, the more serious the abnormality. The treatment of amblyopia should focus on the improvement of the binocular vision.

Performance management practices of ophthalmology-the key discipline of class-Ⅲgeneral hospital

LIU Yan-ting, WU Ji-xiang, WANG Yu, DUAN Jin-ning, YANG Yao

2014, 23(6):  420-423.  doi:10.13281/j.cnki.issn.1004-4469.2014.06.018

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Performance management of the key discipline is an important management tool to strengthen the discipline construction and development advantage of the hospital. Based on application examples of the department of ophthalmology in Beijing Tongren Hospital, this thesis describes the basic principles of the key disciplines’ performance management, and how to build a performance appraisal system scientifically and rationally based on the characteristics of the key disciplines. The data of ophthalmology departement in 2011-2013 shows the effect of performance management. Several success factors of the key disciplines’ performance management are summarized, providing a reference for other general hospitals.

Pay attention to the cultivation of research thinking in seven-year program education of ophthalmology

ZHANG Feng-ju, SONG Yan-zheng, SUN Ming-shen

2014, 23(6):  424-426.  doi:10.13281/j.cnki.issn.1004-4469.2014.06.019

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Medical clinical seven-year program is one of the basic approaches for high level medical education. The key point of seven-year-program education is to enable the students to master good research abilities and clinical skills, and improve their comprehensive skills in a short time. The training of scientific research thinking should be emphasized in their ophthalmology teaching, so that the students will be trained with keen research insight as well as an exact thought of clinical diagnosis and treatment. It is necessary for the students to adapt to the increasing requirements of ophthalmic medical service and to contribute to our society in China.

Training pattern centrering on clinical abilities training of a master's degree in ophthalmology

ＷANG Hua, PENG Xiao-yan, LI Jian-jun

2014, 23(6):  427-428.  doi:10.13281/j.cnki.issn.1004-4469.2014.06.020

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From 2012, the training programs of the post-graduate students with professional degree were reformed in focusing on the clinical fundamental training in the department of Ophthalmology in Beijing Tongren Hospital. In the past, the 2-month ophthalmic centralize course was the main pattern of training for the post-graduate students. And now, the students attended 1-hour morning training course twice every week during the 1st year’s rotation period. Thus the theories could be combined with practice closely, and the students could have deep impression and master the clinical skills rapidly.

Systemic risk factors of glaucoma

WU Ren-yi， HUANG Chang-quan

2014, 23(6):  429-431.  doi:10.13281/j.cnki.issn.1004-4469.2014.06.021

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Glaucoma is a series of ocular disorders characterized by the atrophy of the optic nerve and visual field defect. Glaucomatous changes occurs mainly in the eye and the visual pathway, nevertheless, as a part of the body, systemic factors such as family history, gender, age and ethnicity, or systemic diseases such as diabetes mellitus, hypertension, thyroid disease, corticoid hormone use and some nerve system disorders, impact significantly on the occurrence and development of glaucoma. A full understanding of the systemic risk factors to glaucoma will benefit to the screening of subjects with high risk, the prevention and treatment of glaucoma, and the improvement of the prognosis of glaucoma.