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Table of Content

    25 September 2018, Volume 27 Issue 5
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    The value of imaging in evaluating disease activity of thyroid associated ophthalmopathy
    LI Mei1， YAN Fei2
    2018, 27(5):  321-324.  doi:10.13281/j.cnki.issn.1004-4469.2018.05.001
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    Thyroid-associated ophthalmopathy (TAO) is an organ-specific autoimmune disease. Clinical activity score (CAS) is often used for the assessment of disease activity in TAO, but it has certain limitations. The morphology of extraocular muscles（orbital extraocular muscle coronal area/total orbit coronal area ratio，OM/TOA ratio）in compated tomography (CT) imaging were positively correlated with CAS. Quantitative analysis of T2 mapping magnetic resonance imaging (MRI) of extraocular muscle indicated that T2 value of extraocular muscle was closely related to the effect of immunosuppression, which was helpful for evaluating the effect of immunosuppression treatment. SPECT/CT using 99mTc-DTPA for the assessment of disease activity in TAO, which can obtain functional information and anatomical information in one imaging. It can be used as an effective complement to CAS. Modern medical imaging, especially functional imaging, has great application value in evaluating disease activity of TAO. （Ophthalmol CHN， 2018, 27： 321-324）

    Pediatric clinical visual electrophysiology
    HUAN Hou-bin
    2018, 27(5):  325-330.  doi:10.13281/j.cnki.issn.1004-4469.2018.05.002
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    Pediatric clinical visual electrophysiological recordings are different from that of adults, so do the interpretations of results, due to the development and immaturity of children’s optic pathway and electrophysiology. An ideal or satisfactory pediatric clinical visual electrophysiological examination and evaluation requires full awareness of the developmental procedures of optic pathway and visual electrophysiology, recognition of physical and mental characteristics in children with various age. Appropriate adoption of corresponding recording protocol, and correct analysis with related reference data on the basis of a full understanding of the urgent clinical need and the most required realistic problems the child patient involved. (Ophthalmol CHN, 2018, 27: 325-330)
     

    Quantitative analysis of orbit structure on computed tomography to assess the activity of thyroid associated ophthalmopathy
    TUO Xiu1, XIN Zhong1, YAN Zhong-yu2, LIU Yun-fu2
    2018, 27(5):  333-337.  doi:10.13281/j.cnki.issn.1004-4469.2018.05.003
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     Objective To analyze the extraocular muscle thickening on computed tomography (CT) images using easy methods and assess its correlation with the activity of thyroid associated ophthalmopathy（TAO） to provide objective evaluation indicators. Design Retrospective case-control study. Participants 116 cases of TAO patients and 30 cases of normal control were included. Method Auto-CAD software was used to calculate the cross-sectional area of eye muscles, total orbit coronal area and exophthalmos at 2 mm behind the eyeball, and its correlation with clinical activity score（CAS） was analyzed. The receiver operating characteristic curve (ROC) was used to determine the diagnostic value of these CT parameters for the disease activity. Main Outcome Measures Orbital extraocular muscle coronal area/total orbit coronal area ratio (OM/TOA ratio), exophthalmos, CAS. Results The cross-sectional area of the superior rectus muscle, inferior rectus muscle, medial rectus muscle, lateral rectus muscle, and the OM/TOA ratio in the TAO group was 56.39±22.77 mm2, 43.72±16.63 mm2, 43.51±13.70 mm2, 34.15±7.05 mm2 and 0.21±0.043 respectively. These parameters were significantly greater than that in the normal control group (28.47±2.30 mm2, 22.53±2.5 mm2, 28.21±1.66 mm2, 28.21±1.66 mm2 and 0.15±0.017 respectively) (all P<0.001). The OM/TOA ratio was positively correlated with the CAS (r=0.593, P<0.001). There was no significant correlation between the exophthalmos and the CAS(r=0.086, P=0.361). The cutoff value of OM/TOA ratio 0.18 was the best for detection TAO as active, with sensitivity 89.0% and the specificity 53.5% (area under the curve=0.761, P<0.001). Conclusion The OM/TOA ratio at 2 mm behind the eyeball on the CT image can be used as an objective quantitative parameter for assessing the TAO activity. Combined with CAS, it can be used for accurately assessing the disease and guiding treatment. （Ophthalmol CHN, 2018, 27： 333-337）

    T2 mapping MRI study on immunosuppression therapy of thyroid associated ophthalmopathy
    JIANG Hong1, YAN Fei1, XIAN Jun-fang1, AI Li-kun2, WANG Xue3
    2018, 27(5):  339-343.  doi:10.13281/j.cnki.issn.1004-4469.2018.05.004
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    Objective To evaluate the value of T2 mapping MRI in evaluating immunosuppression therapy of thyroid associated  ophthalmopathy (TAO). Design Prospective case series. Participants 74 TAO patients with immunosuppression therapy. Method Coronal T2 mapping MRI was performed. According to the changes of main symptoms, sign and extraocular muscles (EOMs) function, the outcomes of immunosuppression therapy were divided into effectiveness and non-effectiveness. Effectiveness included excellent, well and general cases. Non-effectiveness included unchanged and deterioration cases. Main Outcome Measures T2 values of EOMs and the maxT2 changes. Results The treatment effect was excellent, well, general, unchanged and deteriorated in 18, 13, 11, 30 and 2 cases respectively. The maxT2 was significantly higher in effective group than in non-effective group (P<0.001). MaxT2 value decreased significantly after treatment (P<0.001). Correlation analysis revealed negative correlation between maxT2 and changes of maxT2 after therapy (r=0.643, P＜0.0001). Conclusions T2 mapping MRI is valuable in evaluation of TAO immunosuppression therapy effect. (Ophthalmol CHN, 2018, 27: 339-343)

    Evaluation of the activity in thyroid associated ophthalmopathy with  99mTc-DTPA SPECT/CT
    LUO Sha1, WANG Shuang1, LI Mei1, LIU Li-jie1, XIN Zhong2
    2018, 27(5):  344-348.  doi:10.13281/j.cnki.issn.1004-4469.2018.05.005
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    Objective To explore the value of 99mTc-diethylenetriaminepentaacetic acid (DTPA) SPECT/CT in evaluating the activity of thyroid associated ophthalmopathy(TAO). Design Retrospective case series. Participants 104 patients with TAO (191 afflicted eyes). Methods Orbital 99mTc-DTPA SPECT/CT and the clinical activity score (CAS) were separately performed to patients. Main Outcome Measures The results of film-reading, the area of high uptake (N), an uptake radio between the posterior orbit and the occipital (URP), an uptake radio between the anterior orbit and the occipital (URA), and CAS. Results There were high uptake in active TAO, but low uptake or no uptake in inactive TAO. URP, URA, CAS in active TAO were significantly higher than those in inactive TAO according to the results of film-reading (P<0.001). URP, URA, N in active TAO were significantly higher than those in inactive TAO according to CAS (P<0.001). There was a positive correlation between URP, URA, N and CAS (r=0.47, 0.42, 0.55 respectively and all P<0.001). There was consistency between 99mTc-DTPA SPECT/CT and CAS (Kappa=0.37), but this consistency reduces in treated TAO. There were 54.7% of orbits with CAS<3 presenting high uptake, of which 97.9% orbits’ values were from 1 to 3. Conclusion As a complement to the CAS, 99mTc-DTPA SPECT/CT has good clinical application value in evaluating the activity of TAO. (Ophthalmol CHN, 2018, 27: 344-348)

    Comparison of IOL Master 500 and IOL Master 700 for measuring parameters in silicone oil filled eyes
    CHEN Wei1, YANG Wen-li1, LI Dong-jun1, WANG Zi-yang1, ZHAO Qi1, LI Yi-feng1, CUI Rui1, SHEN Lin1, XIAN Jun-fang2
    2018, 27(5):  349-352.  doi:10.13281/j.cnki.issn.1004-4469.2018.05.006
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    Objective To compare two optical biometric instruments IOL master 500 and IOL master 700 for measuring the axial length(AL), keratometry(K) and anterior chamber depth(ACD) in silicone oil filled eyes. Design Prospective case series. Participants 34 cases (38 eyes) of silicone oil filled eyes were selected in September 2017 in Beijing Tongren Hospital Ophthalmology Inpatient Department. Methods The AL, K and ACD were measured using IOL master 500 and IOL master 700 successively. The results of two groups were compared using paired t test, reliability analysis, and MedCalc software was used to do the Bland-Altman analysis. Main Outcome Measures AL, mean keratometry(Km) and ACD. Results The AL detection rate of IOL master 500 and IOL master 700 were 89.5% (34/38) and 97.4% (37/38), respectively. There was no significant differences in AL, Km and ACD between IOL master 500 and IOL master 700. The AL was (25.05±3.37)mm and (25.03±3.35)mm (t=1.351, P=0.186) respectively. The Km was (43.42±3.10)D and (43.45±2.99)D (t=-0.393, P=0.697), and the ACD was (3.42±0.80)mm and (3.56±1.01)mm (t=-1.184, P=0.247), respectively. Reliability analysis of the two groups demonstrated AL(ICC＝1.000), Km(ICC＝0.996) and ACD(ICC＝0.857). The 95% consistency limits of Bland-Altman analysis showed AL(-0.1514 mm, 0.1920 mm), Km(-0.7723D, 0.7205D), ACD(-1.4057 mm, 1.1222 mm) and there were 2.94% (1/34), 8.82%(3/34) and 3.45%(1/29) of the points outside 95% consistency limit respectively. Conclusion There were no statistically significant differences in the axial length and mean keratometry of silicone oil filled eyes measured with IOL master 500 and IOL master 700. IOL master 700 had a higher detection rate of axial length in silicone oil filled eyes than IOL master 500 did. （Ophthalmol CHN，2018, 27： 349-352）

    Three years clinical effect of wearing high precision ORTHO-K contact lens  for myopic children and adolescents
    CHANG Yong, XIE Pei-ying, WANG De-chen, CHI Hui, ZHOU Jian-lan
    2018, 27(5):  353-357.  doi:10.13281/j.cnki.issn.1004-4469.2018.05.007
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    Objective To evaluate the effect and safety of long-term wearing high precision ORTHO-K contact lens for myopic children and adolescents. Design Retrospective case series. Participants 150 myopic children and adolescents. Methods We examined 150 patients ( 300 eyes) who wore ORTHO-K lens for 3 years in Beijing Internet Eyecare Optometry ＆ Ophthalmology Clinic. Following examinations had been performed for baseline and all annual follow-up visits: slit lamp exam, uncorrected visual acuity(UCVA), and tear secretion, eye axial length, corneal thickness, corneal endothelial cell density, percentage of hexagon and corneal curvature values. We also selected 66 eyes switching to ORTHO-K from other brands for evaluation of comfort, clarity and cleanliness. Main Outcome Measures The UCVA corneal endothelial cell density, percentage of hexagon cells, axial length, tear secretion, corneal thickness, and corneal conjunctival health condition. Results No obvious adverse reaction was found on the cornea and conjunctival. The UCVA improved significantly (4.55 ±0.34 before wearing vs. 4.88±0.25 after three years, P<0.001). The refractive error decreased during early wearing period. The spherical and cylindrical diopters were (-2.99±2.44) D and (-1.17±1.20) D at baseline; which decreased to (-1.95±2.12) D and (-1.11±1.06) D respectively after initial wearing stage (P=0.01, P=0.001). The axial length increased slightly but not significantly (0.28±0.12) mm after three years. The corneal thickness decreased by (-7.71±2.88) μm, (-2.56±2.78) μm and (0.44±2.95) μm at one, two and three year respectively, reaching to a significant thinning at 3 year compared to baseline (P=0.001). The endothelial cell density was（3244±309）pieces /mm2, （3265±304)pieces /mm2, (3264±299)pieces/mm2, (3270±296)pieces/mm2 at baseline, year 1, year 2 and year 3 respectively (all P>0.05). There was no significant change on tear secretion. The scores of comfort, clarity, cleanliness of the original type of lenses were 8.69±0.62, 9.26±0.72, 9.37±0.58, which improved significantly to 9.16±0.36, 9.33±0.65, 9.62±0.47 respectively （t=-2.181，-0.601，-0.830; all P<0.05） after switching to high precision type.  Conclusion The result of 3 years follow-up shows that the subjective comfort improved after switching to high precision lens. Wearing high precision ORTHO-K lens enhanced unaided vision acuity and showed myopia control effects. With regular and scientific fitting, ocular surface would remain unaffected. （Ophthalmol CHN， 2018, 27： 353-357）

    Changes of corneal morphology and diopter in keratoconus over time with RGPCLs wearing: 7-year retrospective analysis
    GUO Yin, LIU Li-zhou, PENG Li, FU Jia, GUO Wei, MI Lan, TANG Ping, LV Yan-yun, WU Jing-jing
    2018, 27(5):  358-361.  doi:10.13281/j.cnki.issn.1004-4469.2018.05.008
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    Objective To observe the efficacy of rigid gas permeable contact lens (RGPCL) on the change of corneal morphology and diopter over time in Chinese keratoconus patients during seven-year follow up. Design Retrospective case series. Participants 62 patients (124 eyes) with clinically evident keratoconus from Tongren Eye Care Center were included. Methods All participants underwent comprehensive examinations including noncontact intraocular pressure (IOP), corneal topography, corrected visual acuity (VA), slit lamp, refraction at initial visit, which were all repeated at every visit once a year in the follow up. Main Outcome Measures Corneal curvature, refraction. Results Mean K-steep and K-flat were 52.37±5.70 D and 51.33±5.49 D, 46.56±4.68 D and 46.48±4.59 D at baseline and last visit, respectively. The changes of K-steep, K-flat and corneal astigmatism were similar, which decreased in the first three years and then increased slowly in the following years. Mean uncorrected VA, spectacle corrected VA and RGP corrected VA at first visit were LogMAR 1.18±0.46, 0.39±0.39 and 0.04±0.09 respectively and LogMAR 1.19±0.16, 0.31±0.28, and 0.04±0.06 at last visit, respectively. RGP correction maintained a good visual acuity, despite the corneal curvature fluctuated a lot during the follow up. Mean sphere and cylinder at first visit was -6.70±3.89 D and -3.63±1.71 D. At last visit, the sphere and cylinder was -8.81±3.93 D and -3.08±1.67 D, respectively. Sphere increased smoothly during the follow up period. Cylinder decreased in the first three years, then got into a plateau. Conclusion  Natural course of keratoconus could be changed by the RGP correction. Patients achieved a sustained good visual quality via a long term wearing. The change of corneal curvature was not linear but parabolic shape. (Ophthalmol CHN, 2018, 27: 358-361)

    Modified shortening of levator palpebrae superioris for the treatment of severe congenital ptosis in adults
    LI Yan-fei, LIU Feng-hua, CHEN Yuan-zhi
    2018, 27(5):  362-365.  doi:10.13281/j.cnki.issn.1004-4469.2018.05.009
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    Objective  To investigate the feasibility and efficacy of modified shortening of levator palpebrae superioris muscle for treatment of severe congenital adulthood blepharoptosis. Design Retrospective case series. Participants Twenty-seven cases (36 eyes) of severe congenital ptosis in adults. Methods Charts of consecutive 27 patients, 18 to 45-year old, with severe congenital ptosis, presented from January 2013 to December 2014 were retrospectively reviewed. The patients underwent a modified shortening of levator palpebrae superioris surgery to correct ptosis, and were followed at postoperative 1 year. Clinical efficacy was observed. The evaluation standards were as following. (1) Satisfaction：the upper eyelid margin was 1~2 mm below the upper edge of the cornea and palpebral margin curves naturally without complications; (2) Over-straightening: the position of upper eyelid margin was above the cornea margin; (3) Undercorrection: the upper eyelid margin covered up to 1/3 of the pupil; (4) Recurrence: the upper eyelid margin occluded more than 1/3 pupil. Main Outcome Measures The eyelid position, eyelid curvature and complications (entropion, conjunctival prolapse, exposure keratitis) recorded at the 1 year follow-up visit. Results Twenty-two cases (31 eyes) showed satisfactory correction. One eye showed entropion. Two showed conjunctival prolapse and 2 eyes showed undercorrection. Conclusions Our modified levator muscle resection is effective and safe for treatment of severe adult congenital ptosis in one year. (Ophthalmol CHN, 2018, 27: 362-365)

    Evaluation of two different types of Ahmed valve in the treatment of refractory glaucoma
    XIAO Hong-xia, YE Han-yuan
    2018, 27(5):  367-371.  doi:10.13281/j.cnki.issn.1004-4469.2018.05.010
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    Objective To evaluate the efficacy and safety of two different types of Ahmed Glaucoma Valve (AGV) in the treatment of refractory glaucoma. Design Retrospective case control study. Participants Patients with refractory glaucoma in whom AGV implantation was performed in our hospital between July 2010 and July 2015. Methods The patients were divided into two groups according to the different type of AGV: FP8 group and FP7 group. Patients underwent FP8 or FP7 Ahmed Glaucoma Valve implantation. Patients were followed at post-operative day 1, week 1, month 1, month 3, month 6, and month 12. Main Outcome Measures The intraocular pressure (IOP), number of antiglaucoma medication used, surgical success rate, best correct visual acuity (BCVA), and postoperative complications. Results The preoperative IOP of FP8 and FP7 groups was 39.78±7.37 mmHg and 41.68±9.60 mmHg respectively. The post-operative mean IOP of FP8 and FP7 groups at all follow-up time point was 15.13±7.41 mmHg and 16.32±6.94 mmHg respectively, significantly lower than preoperative value (all P<0.001). The mean number of antiglaucoma medication of FP8 and FP7 groups before operation was 3.44±0.78 and 3.35±0.66 respectively. It was 0.28±0.67 and 0.33±7.36 respectively post-operatively (all P<0.001). At the 12-month follow-up visit, the BCVA was decreased in 5 eyes of the FP8 group and in 8 eyes of the FP7 group, unchanged in 19 eyes of the FP8 group and in 22 eyes of the FP7 group, and improved in 22 eyes of the FP8 group and in 30 eyes of the FP7 group. There were no significant differences in visual changes between the 2 groups at post-operative 12 months(χ2=0.049, P=0.824). Kaplan-Meier survival curves showed that the success rate was 69.6% for FP8 group and 78.3% for the FP7 group at follow-up endpoint. There was no significant difference between the two groups (P=0.499). Conclusions  The AGV implantation may be an effective method in managing refractory glaucoma. The two different types of AGV had similar efficacy in treatment of refractory glaucoma. （Ophthalmol CHN， 2018, 27： 367-371）

    Cross-sectional study of retinal vascular fractal dimension in elderly population in Beijing
    WEI Chuan-chuan, WANG Shuang, PENG Xiao-yan, LIU Xue, XU Liang, WANG Ya-xing
    2018, 27(5):  372-376.  doi:10.13281/j.cnki.issn.1004-4469.2018.05.011
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    Objective To quantitatively assess the retinal vascular fractal dimension and its associations in an 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 fractal dimension 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 was zone B, and 0.5~2 PD away from the disc margin was zone C. Main Outcome Measures Retinal vascular fractal dimension (RVDf), fractal dimension arteriole (RVDfa), fractal dimension venule (RVDfv). Results In this study, the RVDf, RVDfa and RVDfv of 3901 elderly people was 1.37±0.04, 1.15±0.05 and 1.16±0.05 respectively. The RVDf, RVDfa and RVDfv in different age groups were significantly different (all P<0.001). These parameters gradually decreased with age. There was no significant difference in RVDf between different genders (P=0.83), but RVDfa and RVDfv were significantly different. Men's RVDfv was larger than women's (P<0.001). RVDfa was smaller in men than in women (P=0.03). Multivariate analysis showed that RVDf was significantly associated with hypertension (r=-0.001, P=0.047). RVDfa was significantly associated with BMI (r=-0.001, P<0.0001). RVDfv was significantly associated with BMI (r=0.0008, P=0.001) and drinking habit (r= 0.0025, P=0.028). Conclusion Retinal vascular fractal dimension gradually decreased with age in elderly population in Beijing. The density of retinal vessels decreased with age as well. Men's RVDfv was larger than women's, but RVDfa was a little smaller in men than in women. (Ophthalmol CHN, 2018, 27: 372-376)

    Short-term effects of 25G vitrectomy with air tamponade for primary rhegmatogenous retinal detachment
    ZHANG Hui, LI Yun-yun, MA Kai, LIU Ning-pu
    2018, 27(5):  377-380.  doi:10.13281/j.cnki.issn.1004-4469.2018.05.012
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    Objective To evaluate the effects of 25G vitrectomy with sterile air tamponade in primary rhegmatogenous retinal detachment(RRD) surgery. Design Retrospective case series. Participants RRD cases who underwent 25G minimally invasive vitrectomy with three channels through the pars plana of ciliary body with sterile air tamponade were consecutively collected from Aug. to Dec. 2016. Methods Best corrected visual acuity(BCVA), intraocular pressure(IOP), slit lamp microscope, indirect ophthalmoscope, color fundus photography, color doppler ultrasound and optical coherence tomography (OCT) were performed before surgery. Patients were followed up after operation, and the BCVA, IOP, retinal reattachment and complications were observed. Main Outcome Measures BCVA, IOP, retinal reattachment and complications. Results At the last follow-up visit, the retina reattached in all 13 eyes (100%). Choroidal detachment occurred in 3 cases on postoperative day 3, which improved after oral prednisone. Postoperative BCVA was logMAR 0.63±0.43, which  improved significantly compared to preoperative value (Compared rank sum test, S=-34, P=0.005). At the last follow up visit, the average IOP was 15.95±4.12 mmHg, significantly different from pre-operative value(t=-2.65, P=0.02). Conclusion Short-term air tomponade combined with 25G vitrectomy can be used as an alternative choice for primary rhegmatogenous retinal detachment with tear located above and not exceeding 3 quadrants. (Ophthalmol CHN, 2018, 27: 377-380)

    Disease constituent ratio of hospitalized patients with neuro-ophthalmic diseases: A single center analysis
    WANG Xue-qiong1, LI Jun1, ZHOU Huan-fen2, SONG Hong-lu2, LIU Hong-juan2, WEI Shi-hui2, XU Quan-gang2
    2018, 27(5):  381-385.  doi:10.13281/j.cnki.issn.1004-4469.2018.05.013
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    Objective To analyze the distribution and characteristics of different neuro-ophthalmic diseases. Design Retrospective case series. Participants 2166 patients with neuro-ophthalmic diseases. Methods Clinical data of hospitalized patients with neuro-ophthalmic diseases in department of neuro-ophthalmology in the Chinese PLA General Hospital from January 2015 to December 2017 were collected and the disease spectrum, age and living region distribution were analyze. Main Outcome Measures Disease constituent ratio. Results A total of 2166 patients with the male/female ratio of 1:1.2 were included in this study. The mean age at onset was 38.6±17.9 years (range 1~87 years). 348 patients (16.1%) aged below 18 years, 1582 patients  (73.0%) aged over 18 years and below 60 years, 236 patients (10.9%) aged over 60 years. The most common diseases in children included hereditary optic neuropathy (87 patients, 4.0%) with the mean onset age of 21.3±10.0 years and traumatic neuropathy (85 patients, 3.9%) with the mean onset age of 24.0±14.5 years. The disease that occurs mostly in old people was ischemic optic neuropathy (293 patients, 13.5%) with the mean onset age of 53.3±10.0 years. The most common diseases happened in men was ischemic optic neuropathy (293 patients, 13.5%), traumatic neuropathy (85 patients, 3.9%) and hereditary optic neuropathy (87 patients, 4.0%). The most common diseases in women included inflammatory demyelinate optic neuritis (838 patients, 38.7%), cerebral venous sinus thrombosis (37 patients, 1.7%) and nonorganic vision loss (21 patients, 1.0%). The three main etiology were inflammatory demyelinated optic neuritis in 838 patients  (38.7%) , nonarteritic anterior ischemic optic neuropathy in 285 patients (13.2%) and traumatic optic neuropathy in 85 patients (3.9%). Conclusion The patients with a great diversity of neuro-ophthalmic diseases are mainly young and middle-aged in this center. The optic nerve diseases, especially demyelinating optic neuritis, are particularly worth study in depth due to its high frequency. (Ophthalmol CHN, 2018, 27: 381-385)

    The safety and efficacy of domestic radioactive plaque for treatment of uveal metastasis
    LIU Yue-ming, YAN Yan-ni, LI Yang, WEI Wen-bin
    2018, 27(5):  388-391.  doi:10.13281/j.cnki.issn.1004-4469.2018.05.014
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    Objective To observe the safety and efficacy of domestic radioactive plaque for treatment of uveal metastasis. Design Retrospective case series. Participants 16 patients of uveal metastasis that were treated with domestic radioactive plaque in Beijing Tongren Hospital from October 2015 to March 2018. Methods We recorded data of visual acuity(VA), intraocular pressure (IOP), size of the tumor (maximum base diameter, maximum height) measured by CDI, changes in the subretinal fluid observed by indirect ophthalmoscope, CDI and OCT, and the data were retrospectively analyzed using SPSS 22.0. Main Outcome Measures VA, IOP, size of the tumor, changes in the subretinal fluid, occurrence rates of complications. Results  The surgery was performed smoothly in all 16 cases, without active hemorrhage, injury of extraocular muscle or vortex vein occurred during the operation, and no infection or scleral melting happened after the surgery. 14 patients received at least one follow-up. There was no statistical difference between preoperative and latest follow-up in either VA (pre-operation 0.24±0.29 versus latest follow-up 0.21±0.26, P=0.69) or IOP (pre-operation 13.3±5.8 mmHg versus latest follow-up 16.0±12.9 mmHg, P=0.39). Tumor regressed in all cases (maximum basal diameter: pre-operation 14.9±2.6 mm versus latest follow-up 9.9±3.9 mm, P<0.001; maximum height: pre-operation 6.3±1.9 mm versus latest follow-up 2.4±1.3 mm, P<0.001), and no subretinal fluid was observed by indirect ophthalmoscope, CDI and OCT at the latest follow-up. Conclusion The domestic radioactive plaque is safe and effective in treatment of uveal metastasis. (Ophthalmol CHN, 2018, 27: 388-391)

    Application of virtual reality technique in pediatric strabismus education
    SHI Wei, LIN Qi, YU Ji-feng, LI Si-yuan, CAO Di, LI Mo-qing, LI Li
    2018, 27(5):  395-397.  doi:10.13281/j.cnki.issn.1004-4469.2018.05.021
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    Strabismus is a difficult education point in pediatric ophthalmology. With the development of virtual medical technology in recent years, it becomes an effective tool for education of strabismus in pediatric ophthalmology. We used desktop, immersive virtual reality system and augmented reality system, with helmets and 3D displays to vividly display the teaching points such as squint eye position and stereoscopic vision through specific visual stimulation image software, which is convenient for students to operate and experience. These virtual medical technologies is significant for improving the level of pediatric strabismus education. （Ophthalmol CHN，2018, 27： 395-397）

    Practice of teaching pediatric vitreoretinal diseases using 3D video display system
    LIU Jing-hua, LU Hai
    2018, 27(5):  398-400.  doi:10.13281/j.cnki.issn.1004-4469.2018.05.022
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     Pediatric vitreoretinal disease is an important and difficult part of ophthalmology for residents. Three dimensional (3D) video display system shows clear, stereoscopic, amplified videos and pictures both for surgeons and for residents. Combined with basic knowledge learning and other teaching technologies, 3D video display system may give great help for residents to improve the apprehension of complicated pediatric retinal diseases. （Ophthalmol CHN， 2018， 27： 398-400）

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