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AIM: To observe the clinical efficacy of the traditional Chinese medicine Yiqi Yinshui Xiaozhong decoction combined with anti-VEGF drug and retinal laser in the treatment of diabetic macular edema(DME).METHODS: From January 2016 to October 2018, 60 eyes of 60 patients with diabetic macular edema were included in the prospective clinical control study. They were divided into control group and Chinese and Western medicine group according to the random number table method. The patients in control group were injected with anti-vascular drug into the vitreous cavity. After the injection, the patients were treated with photocoagulation. The patients in Chinese and Western medicine group were treated with the Yiqi Yinshui Xiaozhong decoction on the basis of the treatment of the control group. The best corrected visual acuity(BCVA), and macular foveal thickness(CMT)were observed before treatment and at 1, 3, and 6mo after treatment. The macular fluorescence leakage in fluorescein fundus angiography(FFA)and the recurrence rate of macular edema were observed at 6mo after treatment. RESULTS: BCVA was 0.92±0.26 before treatment, 0.58±0.18, 0.60±0.27 and 0.62±0.28 at 1, 3 and 6mo after treatment, BCVA in the Chinese and Western medicine group BCVA was 0.94±0.31 before treatment, 0.56±0.20, 0.50±0.25, 0.51±0.21 after treatment; CMT in the control group was 461.62±84.26 before treatment, 299.92±43.18, 290.60±39.36, 311.10±42.78 at 1, 3 and 6mo after treatment, CMT in the Chinese and Western medicine group was 455.74±83.89 before treatment, 288.96±40.20, 265.86±32.55, 270.38±31.60 at 1, 3 and 6mo after treatment. Both groups had improved BCVA and CMT after treatment(Pt=0.539, 0.739, P>0.05), BCVA and CMT after 3 and 6mo of treatment in the Chinese and Western medicine group improved significantly, and the difference was statistically significant compared with the control group(3mo after treatment t=2.891, 2.992, P=0.004, 0.021; 6mo after treatment t=3.733, 3.643, P2=4.344, PCONCLUSION: Combined application of the Yiqi Yinshui Xiaozhong decoction, anti-VEGF drugs and laser to treat diabetic macular edema can improve vision, reduce macular edema, reduce the recurrence rate of edema, and bring better prognosis for patients.

AIM: To measure the tear film thickness when with a good fitted night wear orthokeratology lens in youth, and observe the change of corneal parameters. METHODS: From July 2015 to August 2016, 51 eyes of 26 teenagers with myopia who would wear orthokeratology and accept regular follow-up were enrolled. The mean spherical equivalent refraction of teenagers was -2.78D±1.53D(-1.00D to-6.00D)before wearing orthokeratology, and the mean astigmatism was 1.29D±0.61D(0 to -2.68D). The tear film thickness were measured by optical coherence tomography(OCT)when the eyes wearing orthokeratology for 1mo. The surface regularity index(SRI)value was measured by corneal topography to compare its relationship with the tear film thickness and the changes of corneal anterior surface parameters during the period of wearing lens were observed. RESULTS: At 1mo after wearing orthokeratology, the mean tear film thickness of right eyes was 230.09±10.40μm, and that was 224.38±10.57μm of left eyes. The mean tear film thickness was 228.75±9.66μm in male eyes and that was 224.80±6.74μm in female eyes. The mean tear film thickness of all eyes was 227.05±10.29μm, and the mean SRI value was 0.16±0.14. There was no correlation between tear film thickness and SRI value(P>0.05). The FK value, SK value and average K value from before wearing to after wearing for 2d and 1wk gradually decreased, the difference was statistically significant(PP>0.05). CONCLUSION: OCT can be used as a safe and reliable method for measuring the thickness of the tear film space during the wearing of orthokeratology, which may be of certain value for the safety assessment of the long term wearing of orthokeratology. Orthokeratology works very quickly, corneal curvature decreases rapidly 2d after wearing and stabilizes during the period.