Table of Content

25 July 2018, Volume 27 Issue 4

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Diagnosis and treatment of punctate inner choroidopathy 

PENG Yu-ting1, WEN Feng2.

2018, 27(4):  241-245.  doi:10. 13281/j. cnki. issn.1004-4469.2018.04.001

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Punctate inner choroidopathy (PIC) primarily affects young myopic women, and its general visual prognosis is moderately good. Complicated choroid neovascularization (CNV) is frequent, and it is the main cause of visual impairment. Early detection and early treatment of CNV is essential for protecting the visual acuity of patients. To identify the features of multimodal imaging is conducive to the diagnosis of PIC, distinguishing between inflammatory lesions and CNV, and quantitatively evaluating the therapeutic response of CNV.  (Ophthalmol CHN, 2018, 27: 241-245)

Cross-sectional study of retinal vascular diameters in elderly population in Beijing

WANG Shuang, WEI Chuan-chuan,LIU Xue, XU Liang, WANG Ya-xing.

2018, 27(4):  246-253.  doi:10. 13281/j. cnki. issn.1004-4469. 2018. 04. 002

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Objective To quantitatively describe the population, age and gender distribution of retinal vascular diameters in elderly population in Beijing. Design Cross-sectional study.  Participants Baseline population of Beijing Eye Study. Methods Quantitative measurement software (Singapore I Vessel Assessment, SIVA 3.0) was used to measure the parameters of retinal vascular diameters on zone B and zone C in color fundus photographs from 3901 subjects. One eye of each participant was randomly selected. The region from 0.5 to 1 PD away from the disc margin is zone B, 0.5~2 PD away from the disc margin is zone C. Main Outcome Measures Central retinal artery equivalent(CRAE), central retinal vein equivalent (CRVE), arteriole-to-venular ratio(AVR), mean width arteriole(MWa), mean width venule (MWv), standard deviation width arteriole (STDWa) and standard deviation width venule (STDWv), length-diameter ratio arteriole (LDRa) and length-diameter ratio venule (LDRv). Results In this study, the average CRAE, CRVE and AVR in zone B of 3901 elderly people was （165.45±12.80）μm, （238.66±18.68）μm and 0.70±0.06, respectively; these parameters in zone C was（165.53±11.98）μm, （241.54±17.83）μm and 0.69±0.05, respectively. The CRAE and CRVE in different age groups were significantly different (all P<0.05), but there was no significant difference in AVR among all age groups (all P>0.05). The CRAE of men was narrower than women (all P<0.05), the CRVE in zone C was significantly wider (P=0.002) and the AVR was smaller (P=0.000). MWa and STDWa in zone C was （89.83±6.55）μm and 5.04±0.61, respectively. MWa and STDWa in zone B was（89.72±6.82）μm and 4.93±0.61, respectively. MWv and STDWv in zone C was （102.31±8.23）μm and 4.90±0.54, respectively. MWv and STDWv in zone B was（101.24±8.20）μm and 4.89±0.58, respectively. MWa and MWv were not different among all age groups (all P>0.05), but the STDWa and STDWv were different significantly (all P<0.05). The MWa and STDWa, STDWv in zone C of men were narrower than those of women (all P<0.05). The LDRa and LDRv of elderly people with age of 40+ years was 13.246±7.510 and 11.798±7.071, respectively. There was no significant difference in LDRa and LDRv among different age and gender groups (all P>0.05). Conclusion The AVR was about 0.69 (close to 2: 3) in elderly population with age of 40+ years in Beijing. Increased with age, central retinal artery and vein were tapered. AVR, MWa, MWv, LDRa and LDRv were all stable, but the MWa and MWv were different between individuals. Men's arteries were thinner than women's and the AVR was smaller. (Ophthalmol CHN, 2018, 27: 246-253)

Comparison of computer automated screening system with ophthalmologist for grading of diabetic retinopathy

WANG Juan1, CHEN Shu-juan1, DONG Fang-tian2, GONG Di2, TANG Yi1, JIN Meng1, ZHAO Lei1, CHANG Hai-lian3, LIU Feng-tong3, ZHANG Jian3, REN An-na3, ZHANG Fan3

2018, 27(4):  254-257.  doi:10. 13281/j. cnki. issn.1004-4469. 2018. 04. 003

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Objective Comparison of the sensitivity and specificity of computer automated screening system and ophthalmologist in grading diabetic retinopathy(DR). Design Diagnosis tests. Participants One thousand, one hundred and fifty-five cases of diabetic patients over 40 years old in Beijing Pinggu district were selected. Methods Two-field non-mydriatic fundus photographs center on macular and optic disc were performed. Grading of DR was carried out by two retinal images of one eye. Computer automated screening system carried out by the Software Huiyan from Daheng Prust Medical Technology Co. Ltd. Main Outcome Measure Kappa value, sensitivity, specificity. Results Computer automated screening system and ophthalmologist on the presence of DR with the result of the Kappa values was 0.58. The sensitivity and specificity of the presence of DR on computer automated screening system and ophthalmologist were 87.47% and 74.39% respectively. Computer automated screening system and ophthalmologist on the presence of severe non-proliferative DR with the result of the Kappa values was 0.35. The sensitivity and specificity of the presence of severe non-proliferative DR on computer automated screening system and ophthalmologist were 87.47% and 74.39% respectively. Conclusion These results show that computer automated screening system can efficiently screen retinal images from diabetes populations to reduce the workload of doctors. (Ophthalmol CHN, 2018, 27: 254-257)

Effects of intravitreal ranibizumab injection on VEGF-A, VEGF-B, PIGF and vitrectomy in eye of proliferative diabetic retinopathy

 

LIU Zhao-hui, GAO Xiao-hong, LI Gai-yun, LI Hai-yan, ZHANG Xi-mei, MA Tao.

2018, 27(4):  258-263.  doi:10. 13281/j. cnki. issn.1004-4469. 2018. 04. 004

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Objective To observe the concentration of the vascular endothelial growth factor (VEGF)-A, VEGF-B and placental growth factor(PIGF) in aqueous humor ,vitreous and neovascular membrane of proliferative diabetic retinopathy (PDR) and the safety of vitrectomy after intravitreal ranibizumab injection(IVR). Design Prospective study. Participants A total of 60 PDR patients (60 eyes) were enrolled in this study from January 2015 to October 2016 in Shanxi Eye Hospital. Methods The patients were randomly divided into pars plana vitrectomy (PPV) group and IVR combined with PPV group, 30 eyes in each group. Samples of aqueous humor, vitreous and neovascular membrane were collected in the PPV group. Samples of aqueous humor were collected before IVR and samples of vitreous and neovascular membrane on 7th day after IVR during PPV in the IVR combined with PPV group. The concentrations of VEGF-A, VEGF-B and PIGF in the aqueous humor and vitreous were measured with enzyme linked immunosorbent assay (ELISA). The expression of VEGF-A, VEGF-B and PIGF in the proliferative membrane was also studied with immunohistochemistry method. The number of blood vessels in the proliferative membrane was observed with haematoxylin and eosin (HE) stains. The surgical time, severity of intraoperative bleeding between the two groups was observed. Main Outcome Measures The contents of VEGF-A, VEGF-B and PIGF in aqueous humor, vitreous and proliferating membrane were observed. The operation time and intraoperative bleeding were observed. Results The VEGF-A concentration (108.30±27.13) after IVR was significantly lower than that before IVR (384.84±114.17) (P=0.000) in the aqueous humor. There was no significant difference between VEGF-B and PIGF before and after IVR (all P>0.05). The levels of VEGF-A in the aqueous humor, vitreous and proliferative membrane on 7th day after IVR in IVR combined with PPV group were significantly lower than those in the PPV group (all P<0.05). There was no significant difference in VEGF-B and PIGF (all P>0.05). Compared with the PPV group, the number of blood vessels, the degree of intraoperative blood and the operation time in IVR combined with PPV group were significantly lower (all P<0.05). Conclusion Ranibizumab significantly decreased VEGF-A concentration, the number of blood vessels in the proliferative membrane, the surgical time, severity of intraoperative bleeding, which improved surgical safety and reduced postoperative complications. However, the content of VEGF-B and PIGF loss in aqueous humor, vitreous and proliferative membrane was not obvious. (Ophthalmol CHN, 2018, 27: 258-263)

Analysis on vision impairment burden in China in 2015 

WANG Bing-song1, DONG Wen-lan2, CAO Kai1, ZHAO Ai-ping3, HU Jian-ping1.

2018, 27(4):  264-268.  doi:10. 13281/j. cnki. issn.1004-4469. 2018. 04. 005

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Objective To assess the vision impairment burden in China in 2015 and to analyze the trend of it from 1990 to 2015. Design A systematic analysis. Participants Chinese population data from the Global Burden of Diseases Study 2016(GBD 2016). Methods Analyzing methods and data from GBD2016 were used. GBD study is a worldwide collaboration aimed at quantifying various health metrics of loss to diseases and injuries using standardized analysis program. These metrics enable comparison of health data across time and place, and across different diseases and injuries. Main Outcome Measures Years lived with disability (YLD), including YLD, YLD rate, proportion of YLD due to vision impairment. Results In 2015, the YLD for vision impairment burden in China was 4885 thousand, accounting for 17.3% of the total global visual imapairment YLD. YLD induced by visual impairment showed a trend of gradual increase with age. From 1990 to 2015, YLD for vision impairment increased year by year in China. In 2015, YLD (4885 thousand) increased by 69.4% compared with 1990 (2883 thousand). The age standardized YLD rate for vision impairment increased year by year from 1990 to 2010, but decreased from 2010 to 2015. The age-standardized YLD rate for vision impairment in China in 2015 (340.1/per 100 000) increased by 2.94% compared with 1990 (330.4/per 100 000). Conclusion From 1990 to 2015, the visual impairment burden in China was increasing year by year. After adjusting for age and population size, the burden of visual impairment decreased slightly after 2010. (Ophthalmol CHN, 2018, 27: 264-268)

Meta analysis of the glucocorticoid of different administration methods for moderate and severe thyroid-associated ophthalmopathy 

ZHOU Li-ping, LI Jia, LIU Ming-ming, YUAN Hong-feng.

2018, 27(4):  269-275.  doi:10. 13281/j. cnki. issn.1004-4469. 2018. 04. 006

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 Objective To systematically review the effectiveness and safety of different glucocorticoid administration methods in the treatment of thyroid-associated ophthalmopathy (TAO). Design Systematic review. Participants Published articles associated with corticosteroids therapy for moderate to severe TAO. Methods Databases including PubMed, EMBase, The Cochrane Library (Issue 6, 2017), CBM, CNKI, VIP and Wan Fang Data were searched to collect randomized controlled trials (RCTs) about the effectiveness and safety of different glucocorticoid administration methods in the treatment of TAO from inception to June 2017. Two reviewers independently screened literatures, extracted data and assessed the quality of included studies. Then meta-analysis was conducted by RevMan 5.3 software. Main Outcome Measures Effective rate and CAS score. Results A total of 12 studies involving 589 patients were included. The results of meta-analysis showed that: compared with the oral administration group, effective rate of intravenous administration group was higher[RR=1.38, 95%CI (1.19, 1.60), P＜0.0001], the CAS score improved better[MD=0.84, 95%CI (0.32, 1.36), P=0.002], the quality of life improved better [MD=1.22, 95%CI (1.04, 1.44), P=0.01], the improvement of the exophthalmos of the retrobular injection group was higher than oral administration group[MD=1.01, 95%CI (0.83, 1.20), P＜0.00001]. Compared with the intravenous administration group, the improvement of the exophthalmos of the retrobular injection group was higher [MD=-3.60, 95%CI (-4.93, -2.27), P＜0.00001], improvement of palpebral fissure width was higher[MD=-3.57, 95%CI (-4.84, -2.30), P<0.00001]. Compared with the intravenous administration group, the incidence rate of adverse reactions such as hypertension [RR=0.26, 95%CI (0.08, 0.87), P=0.03], weight gain [RR=0.27, 95%CI (0.11, 0.70), P=0.007] and Cushing syndrome [RR=0.23, 95%CI (0.12, 0.44), P<0.0001] in the oral administration group was higher, and the difference was statistically significant. Conclusion Current evidence shows that intravenous administration has a more potent effect on TAO treatment efficiency, CAS score improvement, improvement in quality of life, and reduction of adverse events and posterior balloon injection is more effective in improving exophthalmos. Due to the limited quality of included studies, the above conclusion still needs to be verified by more high quality studies. (Ophthalmol CHN, 2018, 27: 269-275)

Clinical phenotype and MRI image characteristics of congenital fibrosis of extraocular muscles with different TUBB3 mutations

JIA Hong-yan1, JIAO Yong-hong1, CHANG Qing-lin2, WANG Hui1, LIANG Yi1, GUO Rui1.

2018, 27(4):  276-280.  doi:10. 13281/j. cnki. issn.1004-4469. 2018. 04. 007

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 Objective To identify the clinical phenotype and MRI manifestation of congenital fibrosis of extraocular muscles (CFEOM) with different TUBB3 gene mutations. Design Retrospective case series. Participants Seven CFEOM patients with four different TUBB3 gene mutations (p.R262C, p.R262H, p.R380C, p.E410K) in Beijing Tongren Hospital from Mar 2013 to Apr 2018 were involved. Methods The clinical data and magnetic resonance imaging(MRI) of the ocular motor nerves and brain were collected for comparative analysis according to the difference of TUBB3 gene mutations. Main Outcome Measures Ocular examination results, physical examination results, MRI of the ocular motor nerves and brain. Results All the patients with TUBB3 mutations showed typical CFEOM phenotype, Neuroimaging reveals hypoplasia of oculomotor nerves and the atrophy of corresponding extraocular muscles. Thereinto, CFEOM was the only abnormality in patients with R262C mutation; patients with R262H, R380C and E410K mutation had mild to moderate intellectual, behavioral and movement impairments, common finding of brain imaging were dysgenesis of the corpus callosum; individuals with R262H also had multiple limb abnormalities, including congenital finger contracture, funnel chest and coxa valga etc. Conclusion TUBB3 gene mutations are one of the leading causes of Chinese CFEOM patients, different mutations in TUBB3 gene correspond to different clinical phenotypes. Genotype-phenotype association could assist clinical diagnosis and phenotyping. (Ophthalmol CHN, 2018, 27: 276-280)

Determination of multiple cytokines in aqueous humor of primary open angle glaucoma based on Luminex multiplex immunoassay

ZHANG Yong, YANG Qin-mei, GUO Feng, CHEN Xia, XIE Lin.

2018, 27(4):  281-285.  doi:10. 13281/j. cnki. issn.1004-4469. 2018. 04. 008

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Objective To measure cytokine concentrations in aqueous humor of patients with primary open-angle glaucoma (POAG) and cataract with the Luminex multiplex immunoassay. Analyze the relationship between these cytokines and disease. Design Experimental study. Participants This study included aqueous humor of 24 eyes with POAG and 22 eyes with cataract. Methods The concentrations of nine cytokines in aqueous humor were measured using the Luminex suspension array technique. The clinical characteristics of patients were also obtained for correlation analysis. Main Outcome Measures The concentrations of platelet derived growth factor-AA (PDGF-AA), platelet derived growth factor-AB (PDGF-AB), epidermal growth factor(EGF), vascular endothelial growth factor (VEGF), granulocyte colony-stimulating factor (G-CSF), interleukin-6(IL-6), interleukin-6(IL-8), regulated on activation, normal T cell expressed and secreted (RANTES), interferon-γ (IFN-γ) and tumor necrosis factor-α (TNF-α) in the aqueous humor. Results Compared with the cataract group, the levels of PDGF-AB (P=0.040), EGF (P=0.048), VEGF (P=0.037), G-CSF (P=0.029) and IL-6 (P=0.018) were significantly lower in the aqueous humor of POAG. The level of PDGF-AA was significantly higher in POAG patients than in cataract patients. The level of IL-8, RANTEs, IFN-γ and TNF-α did not differ among the groups (all P>0.05). Mean deviation (MD) values were significantly associated with the levels of IL-6 (P<0.001, ?籽=-0.778), IL-8 (P=0.001, ?籽=-0.623) and TNF-α (P<0.001, ?籽=-0.685).  Conclusion Cytokine levels in the aqueous humor of POAG patients are lower than in cataract patients, and whether this reflects the damage of optic nerve and trabecular meshowrk is worthy of further study. (Ophthalmol CHN, 2018, 27: 281-285) 

Evaluation of accuracy of measuring intraocular pressure using iCare HOME tonometer 

TAN Juan, ZHAO Ping, LIU Rui, PENG Yue, LIU Yang, WU Bo.

2018, 27(4):  286-290.  doi:10. 13281/j. cnki. issn.1004-4469. 2018. 04. 009

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Objective  To evaluate the accuracy of iCare HOME tonometer measuring intraocular pressure(IOP) at different levels compared with Goldmann applanation tonometer (GAT) and non-contact tonometer (NCT). Design Diagnostic trial. Participants A total of 120 eyes of 76 patients or normal subjects in Shenyang Aier Eye Hospital were examined, including glaucoma (77 eyes of 48 patients), glaucoma suspect (13 eyes of 8 patients), cataract patients (23 eyes of 16 patients) and normal subjects (7 eyes of 4 subjects).  Methods All participants’ IOP was measured with iCare HOME, GAT and NCT, and grouped according to the results of GAT (group A: IOP <16 mmHg, group B: 16~21 mmHg, group C: >21 mmHg). One-way ANOVA, Bland-Altman analysis and linear correlation analysis were used to compare the consistency and correlation of iCare HOME, GAT and NCT measurements. Main Outcome Measures IOP. Results  The mean IOP measured with iCare HOME, GAT and NCT was (18.32±6.52) mmHg, (18.14±5.82) mmHg and (19.10±5.85) mmHg respectively (F=0.846, P=0.430). The correlation coefficients (r) of iCare HOME and GAT, iCare HOME and NCT, GAT and NCT was 0.947, 0.961 and 0.937 (all P<0.01) respectively. The results of three types of tonometer were different with different IOP levels. The difference between iCare HOME and GAT increased with the increase of IOP, while the difference between iCare HOME and NCT decreased with the increase of IOP. Bland-altman analysis showed that there was a good consistency between the three types of IOP measurement. Conclusion The accuracy of iCare HOME is good for the measurement of IOP, and it is consistent with GAT and NCT measurements. (Ophthalmol CHN, 2018, 27: 286-290)

Effect of argon laser peripheral iridoplasty on corneal endothelium in acute angle closure glaucoma 

LI Qi-yan, MOU Da-peng, LI Hang, QING Guo-ping.

2018, 27(4):  291-295.  doi:10. 13281/j. cnki. issn.1004-4469. 2018. 03. 010

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Objective To evaluate the effect of argon laser peripheral iridoplasty (ALPI) on corneal endothelium in the acute attack stage of acute angle closure glaucoma(AACG). Design Retrospective case series. Participants 162 patients with unilateral AACG successfully managed with either anti-glaucoma medication or ALPI. Methods Gender, age, pro-and post-treatment intraocular pressure (IOP), anti-glaucoma medication, corneal endothelial cell density of the patients were reviewed and analyzed statistically. Main outcome measures Loss of corneal endothelial cell, pro- and post-treatment IOP, anti-glaucoma medications of the effected eye. Results 61 cases received successful ALPI for the acute attack of AACG, with average age of 59.8±10.2 years old. The mean IOP of the effected eyes was 44.7±4.1 mmHg. In the medication group, 101 cases were included with average age of 58.6±6.1 years old. The mean IOP in the effected eyes was 45.3±4.8 mmHg. After treatment, the average IOP in ALPI group was 11±2.6 mmHg, in which the average loss of corneal endothelium was 1613±332/mm2. Mean IOP of treated AACG eyes in medication group was 14.5 ±3.1 mmHg，in which the corneal endothelial cell loss was 1321±290/mm2，which was significantly less than that of ALPI group(P=0.000). Conclusion Both ALPI and medication can arrest the acute attack of AACG, while the former may cause more corneal endothelial cell loss. (Ophthalmol CHN, 2018, 27: 291-295)

Comparison of ocular optical biometers between a new swept-source optical coherence tomography and IOLmaster

TIAN Fang, DAI Hong.

2018, 27(4):  296-300.  doi:10. 13281/j. cnki. issn.1004-4469. 2018. 04. 011

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Objective  To Compare ocular biometric measurements between a new swept-source optical coherence tomography OA-2000 and IOLmaster, and evaluate the detection rate, correlation and agreement. Design Diagnostic trial. Participants A sample of 83 eyes were selected from Department of Ophthalmology Beijing Hospital during December 2017. Methods The same eye of the same patient was measured by OA-2000 and IOLMaster respectively. Axial length (AL), keratometry (K) and anterior chamber depth (ACD) were compared and draw the correlation curve and bland-altman plot to evaluate the correlation and consistency of the two methods. Main Outcome Measures The detection rate, correlative coefficient, mean difference. Results The detection rate of OA-2000 and IOLmaster on AL was 97.6%, 75.3%, respectively. The detection rate of OA-2000 and IOLmaster on keratometry was 94.0%, 97.6%, respectively. The detection rate of OA-2000 and IOLmaster on ACD was 95.2%, 96.4%, respectively. The correlation coefficient of AL between OA-2000 and IOLmaster is almost 0.99, 0.97 or more of keratometry, and 0.88 of ACD. Bland-Altman plot showed the mean difference of both methods on AL is only 0.01mm, which is very close to the mean line. The mean difference of keratometry and ACD are more or less the mean line, but all of them are within the 95%CI. Conclusions The detection rate of new optical biometric OA-2000 on AL is significant better than IOLMaster. And the new method shows great advantage in opacity of refractive media. However, the result of corneal refraction and ACD is a little difference, which needs larger samples to observe. (Ophthalmol CHN, 2018, 27: 296-300)

Clinical characteristics of complicated traumatic cyclodialysis

WANG Cong1, YOU Qi-sheng2, ZHOU Jun1, PANG Xiu-qin1, SHI Xiang-yu1, LIU Yi1.

2018, 27(4):  301-304.  doi:10.13281/j.cnki.issn.1004-4469.2018.04.012

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Objective To analyze the clinical characteristics of complicated traumatic cyclodialysis. Design Retrospective case series. Participants 44 patients (44 eyes) with complicated traumatic cyclodialysis in Beijing Tongren Eye Center during January 2013 to January 2015. Methods Retrospective analysis of demographic and clinical characteristics of patients was performed. Main Outcome Measures Age, gender, laterality, etiology of trauma, visual acuity, intraocular pressure(IOP), range of cyclodialysis, and other trauma related complications.  Results Average age of patients was 43±14 years old. There were 39 cases (88.6%) in men and 52.3% in the right eye. The most common injury reason was blunt trauma (95.5%), mainly with iron block, firecracker and boxing. The mean visual acuity on first visit was 2.3±1.1 logMAR. The mean IOP was 8.0±3.4 mmHg. 79.6% of the patients had low intraocular pressure while 31.8% had shallow anterior chamber. The IOP was not significantly associated with the range of cyclodialysis(r=-0.09, P=0.56). The mean cyclodialysis range was 4.8±3.2 clock hours, of which 16 cases (37%) had a range of over 180 degrees, and 3 cases had a range of 360 degrees. The superior temporal quadrant of the right eye, nasal superior quadrant and superior temporal quadrant of the left eye were liable to cyclodialysis. Other  trauma-related complications included lens dislocation and cataract(84.1%), hyphema(31.8%), angle recession (18.2%), iridodialysis (34.1%), vitreous hemorrhage (54.5%), and retinal detachment (31.8%). Conclusion Traumatic cyclodialysis is usually complicated with multiple ocular tissue damage mainly with lens injury. Clinicians need to be vigilant about cyclydialysis in complicated blunt trauma even if without intraocular hypotony or shallow anterior chamber. (Ophthalmol CHN, 2018, 27: 301-304)

Application of three-dimensional animation teaching model in SMILE procedure training

ZHAI Chang-bin.

2018, 27(4):  310-311.  doi:10. 13281/j. cnki. issn.1004-4469. 2018. 04. 015

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 With the success and development of small incision lenticule extraction (SMILE) , its demanding prompts the spreading this technique. However, the professional learning has been prevented for some reasons, for example, the complex skill of the surgery procedure. The traditional teaching model cannot display the three-dimensional (3D) anatomical structure of cornea, so we carried out 3D animation teaching model. The new model can vividly show the procedure and corneal anatomical structure, promote the students’ mastery and application of the technique and help to acquire better effect of teaching about SMILE. (Ophthalmol CHN, 2018, 27: 310-311)

Experience of standardized training of ophthalmologists in minority areas 

WANG Fen, CHEN Chen, WU Ming-yan, ZHANG Dong-hua.

2018, 27(4):  312-313.  doi:10. 13281/j. cnki. issn.1004-4469. 2018. 04. 016

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The Second Affiliated Hospital of Guizhou Medical University became a standardized training base for ophthalmologists in 2014. Under the impetus of policy support, scientific management, financial support, and the effective mobilization of students and teachers' enthusiasm, the standardized training system of resident physicians will cultivate more excellent ophthalmologists for Qiandongnan Miao and Dong Autonomous Prefecture. (Ophthalmol CHN, 2018, 27: 312-313)