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In recent years, metagenomics(MGS)is the fastest growing fields in microbiology, and has been broadly applied in the detection of pathogenic microorganisms. Comparing with the traditional poly merase chain reaction(PCR)-based detecting technology which relies on microbial culture, MGS can directly detect the sequences of the total microbial DNA from uncultured samples with the high-throughput sequencing platform. It can help the doctors identify the involved pathogens more quickly and provide better medication guidance. Among the known ophthalmic diseases, a lot of them are caused by the infection of pathogens and have many difficulties in clinical diagnosis and treatment. The development of metagenomics provides us a more effective and reliable way for detecting the pathogens of ophthalmic diseases. This article was aimed to review the development of MGS, applications and in the field of ophthalmology, as well as its current deficiencies and the possible development directions in the future.

The Notch signaling pathway is an evolutionarily highly conserved signaling pathway that exists in a wide variety of tissue cells and plays an important role in embryonic development, cell proliferation, differentiation and apoptosis, as well as in the maintenance of multicellular biosynthesis, angiogenesis, and the development of various cancers. In recent years, it has been found that the Notch signaling pathway is abnormally activated in cataract, uveitis and other ophthalmic diseases, regulating the process of ocular disease development. This article provides a brief review of the regulatory role of the Notch signaling pathway in the development of ophthalmic diseases.

Myopic retinoschisis(MRS)is a major complication of pathological myopia. The pathogenesis of MRS is not yet fully understood and it can be the result of a number of different factors. The posterior vitreous cortex and the internal limiting membrane(ILM)are thought to play a role in the formation of the retinal splitting. In addition, retinal arteriole traction has been associated with axial length extension and the pathogenesis of MRS. The diagnosis of MRS is done by using optical coherence tomography(OCT), B-mode ultrasound and ultra-wide field fundus autofluorescence(UWF-FAF). The main treatment methods of MRS are pars plana vitrectomy(PPV)and the macular buckling technique(MB). This article reviews the pathogenesis, the course and the diagnostic methods of MRS, as well as, the treatment progress.

AIM: To study the effect of monocular form deprivation(MD)on the synaptic density in the visual cortex of the amblyopic rats during the critical period of visual development, the visual cortical synaptophysin(SYN)expression and significance of its expression, as well as the relationship between the synaptic density and the visual function. This research will provide mechanisms underlying the pathogenesis and clinical treatment of amblyopia.METHODS: Normal newborn Long Evans rats were randomly divided into normal control group and amblyopia model group, each with 16 rats. Both groups of rats were raised in the same environment. The normal control group did not receive any treatment. On the 13d after birth, the amblyopic model group received monocular suture to establish a classic monocular form deprived amblyopic model. Both groups of rats were received Visual evoked potential(F-VEP)detection on the 51d. Samples were taken immediately after the detection. The transmission electron microscope and Image J image analysis software were used to observe and analyse the synaptic density in the V1M of the primary visual cortex of the two groups of rats. Frozen sections of visual cortex were stained by immunofluorescence histochemical staining by bleaching method and the expression of SYN positive neurons was observed and quantitatively analyzed. RESULTS: F-VEP examination showed that compared with the normal control group, the P2 latency of the deprived eyes in the amblyopic group was significantly long, and the amplitude of P2 wave was significantly lower than that of normal eyes(P

AIM: To discuss the clinical effects of pars plana vitrectomy(PPV)combined with interal limiting membrane peeling(ILMP)for macular hole(MH)in pathological myopic eyes.METHODS: This is a retrospective case study. Eighteen patients(19 eyes)with high myopic MH diagnosed in our hospital from January 2017 to January 2019 were enrolled in this study. All eyes were grouped for pathological myopia(9 patients 10 eyes)and non-pathological myopia groups(9 patients 9 eyes). All eyes were treated with PPV combined with ILMP surgery. Postoperative follow up was 3-23mo, the efficacy was determined at the final follow up, including BCVA, visual deformation symptoms and macular hole closure.RESULTS: During the final follow up, BCVA was improved in 6 eyes,stable in 2 eyes, more severe in 2 eyes in pathological myopia group, and MH was fully closed in 7 eyes(70%), bareness-closed in 2 eyes(20%)and not closed in 1 eye(10%). In non-pathological myopia group, BCVA was improved in 6 eyes,stable in 2 eyes, more severe in 1 eyes, and MH was fully closed in 8 eyes(88%), not closed in 1 eye(11%). There were significant differences in the axial length between the two groups before surgery, axial length was negatively correlated with the macular hole closure rate at the last follow up(rs= -0.477, P=0.039).CONCLUSION: PPV combined with ILMP for the treatment of MH in high myopia can effectively improve BCVA. However, the hiatal closure rate of pathological myopia patients was lower than that of non-pathological myopia patients.

In modern society, children and adolescents are experiencing an increasing incidence of myopia, resulting from the combined influence of genetic factor and environmental factor. Despite the influence of genetic factor, a great number of researches indicate that environmental factor has been playing a crucial role. Outdoor activity proves to be a major protective factor to reduce the incidence of children's myopia. Sunlight is one of the important ones among various factors of outdoor activity. The intensity, wavelength and rhythm of sunlight may all affect eyeball's refraction development. Varied sunlight environment may have different influences on eyeball's refraction development. The paper has summarized clinical and trial and animal experiment research results on how sunlight affects eyeball's refraction development, and it has offered references to further study on refractive error development mechanism and prevention strategy.

The occurrence and development of ophthalmic diseases are closely related to the abnormality of cellular regulation and ocular tissue function, in which the relevant signaling pathways play an important role in the regulation of physiological functions. The Rho/ROCK signaling pathway is involved in a variety of cellular events, including cytoskeletal reorganization, cell adhesion, cell proliferation and angiogenesis, and also plays a significant role in cell cycle progression, cell differentiation and apoptosis. Studies have shown that the Rho/ROCK signaling pathway is widely distributed in ocular tissues, and its aberrant activation can affect the normal physiological function of ocular tissues, demonstrating it is closely related to the occurrence and development of ophthalmic diseases. This paper briefly reviews the role of Rho/ROCK signaling pathway in the occurrence and development of ophthalmic diseases, providing new insights into the clinical treatment of ophthalmic diseases.

AIM: To evaluate the one-year outcome of intravitreal conbercept injections for the treatment of choroidal neovascularization secondary to pathological myopia(pm-CNV)by optical coherence tomography angiography(OCTA).METHODS: The medical records of 26 consecutive eyes of 23 patients who received intravitreal injections of conbercept for pm-CNV with a follow-up of 1y were retrospectively reviewed. All the patients were diagnosed by fundus fluorescein angiography(FFA)and OCTA at the first visit. All approaches were performed as “1+PRN” treatment. Outcomes included best-corrected visual acuity(BCVA), central foveal thickness(CFT)and the mean CNV area by OCTA.RESULTS: Mean BCVA improved from(0.66±0.51)at baseline to(0.39±0.38)at 1y(t=3.528, P=0.004). The CFT before treatment and after 1y after were(275.08±48.74)μm and(205.15±43.74)μm respectively(t=4.630, P=0.001). The mean pm-CNV areas before treatment and after 1y treatment were(0.48±0.24)mm2 and(0.15±0.11)mm2 respectively, with a significant difference among them(t=5.329, P=0.000). Twenty-one eyes had no needs after the first treatment. Four eyes received 2 injections and only one eye received 3 injections. No severe adverse events were noted relevant to the therapy.CONCLUSION: Intravitreal conbercept can improve the vision and relieve CFT and CNV area for the treatment of pm-CNV with “1+PRN” by OCTA for 1y, however, long-term follow-up still need to be performed.

Calcium is an important messenger in the mammalian nerve cells which mediates a variety of intracellular signal transduction pathways and plays critical roles in regulating the neuronal functions. Calcium signaling exerts its highly specific function in a defined sub-region of the cell, especially in the visual cortex of the brain. Detection of calcium signals in neurons is particularly important for the studying of neuronal function. The two-photon microscope has a unique advantage in the detection of calcium signal in the superficial cortex. In this paper, the application of two-photon in the in vivo detection of the visual cortical Ⅱ/Ⅲ layer of model animals are reviewed.

Contrast sensitivity(CS)has been widely studied in the research of ophthalmology and optometry. Compared with visual acuity(VA)test, CS assessment can fully and accurately reveal the state of visual function, which has become an important indicator for the prediction, diagnosis of eye diseases and for the evaluation of the disease progression and therapeutic effect. To improve the accuracy of CS measurement, CS detection methods have been constantly improved and innovated, mainly including objective examination and subjective psychophysical examination. Both methods have their advantages and limitations and the main target population is slightly different. With the development of the current Internet Plus, the CS detect software based on computer technology has been successively developed by many research institutions, which provide more convenient detection methods. Therefore, this paper reviews the visual standard design, measurement requirements and main applicable characteristics of common CS detection.

Amblyopia is a disease which is caused by abnormal visual experience during the critical period of the visual development, and it has no organic diseases of the eye. Visual examination is an important part of the screening and diagnosis of amblyopia. However, the vision test is limited for the young children who can't express verbally. Refraction error and anisometropia are most common risk factors for amblyopia. In recent years, the early screening of amblyopia has been extended to the early screening of amblyopia-related risk factors. Moreover, the screening methods and technologies for amblyopia have also been developed and updated. In this paper, the methods of vision examination and refractive screening for amblyopic patients are reviewed.

At present, myopia has become a public health disease worldwide, and its occurrence is mostly caused by genetic and environmental factors. Single nucleotide polymorphisms(SNPs)are the changes in single base at the genomic level caused by DNA sequence polymorphisms. In recent years, it is reported that the change of SNPs in myopic related gene loci is closely related to the occurrence and development of myopia. The present paper reviewed the current status of the association between SNPs of myopia-related genes and the development of myopia, providing a new insight into the future research of pathogenesis of myopia.

Myopia has become a common disease in the world. In our country, myopia shows a trend of high incidence and young age. Myopia affects people's psychological development. As a unique psychological characteristic that distinguishes it from others, personality is also associated with myopia. Most patients with myopia are mainly introverted personality and emotional personality, but some studies have shown that myopia patients have not yet had personality traits that are significantly different from ordinary people. This article reviews the related literatures at home and abroad to review the research progress of myopia factors from the relationship between myopia and personality factors, the interaction of the two.

As magnetic resonance imaging(MRI)technology has the features of non-invasive, clear imaging, and high resolution to soft tissue, it has been used to both the clinic applications and basic researches of ophthalmic diseases. The most important applications of MRI in ophthalmology are orbital and ocular tumor diseases. In recent years, MRI has been gradually applied to clinical and scientific research of visual impairment. The purpose of this paper is to introduce the applications of MRI in the field of ametropia, cataract, glaucoma, amblyopia, optic nerve diseases, choroidal disease, retinopathy, and so on.

AIM: To compare the effect of fixation and select the optimal fixation solution and condition for PAS staining of guinea pig eyes among three different fixation solution: 4% paraformaldehyde solution, 4% glutaraldehyde solution and Davidson solution. METHODS: Totally 30 healthy guinea pigs were divided into 6 groups: Group I-II were fixed in 4% paraformaldehyde solution and 4% glutaraldehyde solution for 24h, respectively; Group III-V were fixed in Davidson solution for 3, 6 and 24h, respectively; and Group VI were fixed in Davidson solution for 3h and then transferred into 10% neutral formaldehyde solution for 48h. All groups were sectioned by routine section method and undergone PAS staining, and then observed by light microscope. RESULTS: It was found that the group which was fixed by Davidson solution for 3h, remained the most complete structure for PAS staining(Group III). While the effect of fixation for the group which was transferred into 10% neutral formaldehyde solution for preserving for 48h after fixing in Davidson solution for 3h was also acceptable for PAS staining(Group VI). The retinal cells remained clear and in order for both groups which was mentioned above. CONCLUSION: The best fixation condition for PAS staining for eyes of guinea pigs is fixation in Davidson solution for 3h among these fixation conditions, while it is also suitable to transfer the eyes into neutral formaldehyde solution after fixing in Davidson solution for 3h for preserving for long periods, which is not severely reduced the effect of fixation for PAS staining.

Rodents have been used widely in the research of eye diseases to study visual function in animal models. Two methods of visual acuity testing in animals have been internationally recognized: the electrophysiological visual acuity test and the behavioral visual acuity test. Both of these methods have their advantages and limitations. The electrophysiology test(visual evoked potential)is invasive, and animals need recovery time after being implanted with electrodes. Also, the electrophysiological visual acuity test only reflects the electrical activity of a single cell or nuclei, it does not reflect the overall visual function of the animal. The widely used behavioral visual acuity test is able to compensate for these limitations. This paper gives a brief overview of the methods of the behavioral visual acuity test for rodents(rats, mice, guinea pigs, etc.).

AIM: To observe the efficacy and safety of a new posterior chamber intraocular lens(ICMO V4c)implantation in patients with high myopia and low astigmatism and to provide reference for the clinical diagnosis and treatment of these patients. METHODS: The study was to analyze the clinical data of patients with high myopia who underwent ICMO V4c implantation with low degree of astigmatism in our hospital from January 2015 to December 2016. The patients were followed up for 1, 3 and 6mo after operation. The items we analyzed including preoperative and postoperative uncorrected visual acuity(UCVA)and best corrected visual acuity(BCVA), diopter, spherical and cylinder equivalent, and manifest refraction spherical equivalent(MRSE), intraocular pressure(IOP), endothelial cell counting, anterior chamber depth(ACD), arch height and postoperative complications. RESULTS: Postoperative UCVA and BCVA improved compared with preoperative, and the difference between preoperative and postoperative was statistically significant(Pt=38.510, 20.100, 34.300; Pt=3.998, 2.837, all Pt=0.383, P>0.05). The corneal endothelium counts in the patients at 3mo and 6mo after surgery were lower than those before surgery(t=2.119, 2.411; all Pt=5.850, 5.260, 2.556; all PCONCLUSION: The new posterior chamber intraocular lens implantation in the treatment of high myopia with low astigmatism reaches satisfaction with less complications, is a good supplement to corneal refractive surgery.

AIM:To explore the levels of serum total adiponectin, high-molecular-weight(HMW)adiponectin and its ratio in type 2 diabetic retinopathy and to investigate risk factors of non-proliferative diabetic retinopathy.METHODS:Three hundred and seventy-four subjects were recruited from an epidemiological survey, including 88 patients with proliferative diabetic retinopathy, 124 patients with non-proliferative diabetic retinopathy, 78 patients only with type 2 diabetes mellitus and 84 healthy volunteers. Demographics, physical and laboratory parameters were collected. Serum total and HMW adiponectin levels were detected by ELISA. The main statistical analysis included covariance analysis and cumulative logit model.RESULTS:Total adiponectin level was higher in healthy group than in groups of only diabetes, non-proliferative and proliferative diabetic retinopathy(harmonic mean, 5.717, 3.310, 3.288, 3.822 μg/ml, F=18.792, PPF=14.025, PP>0.05). The ratio of HMW adiponectin and total adiponectin had no differences among four groups(F=0.650, P>0.05). Drug history, high levels of high density lipoprotein cholesterol, total and HMW adiponectin had protective effects to the non-proliferative diabetic retinopathy(PCONCLUSION:The lower concentrations of serum total and HMW adiponectin may result in the occurrence of non-proliferative diabetic retinopathy. And the total adiponectin level was related to the severity of diabetic retinopathy.

In view of the anatomical and physiological barrier of the ocular surface and the intraocular structure, the conventional ophthalmic agents cannot efficiently reach the lesion site. Currently, the different types of nanomaterials possess great advantages in delivering drugs due to their characteristics of small size, easy preparation, degradability, strong targeting and less irritation to biological tissue. As drug delivery carriers, nanomaterials have been widely used in ocular drug delivery so as to treat different types of eye diseases. In this paper, the applications of nanomaterials as drug delivery carriers in treating eye diseases are briefly reviewed.

AIM:To evaluate the effect of phagocytic load on apoptosis of cultured aged bovine retinal pigment epithelium(RPE)cells.METHODS: The third generation of cultured aged bovine RPE cells was cultured respectively with culture medium, containing 200μg/mL photoreceptor outer segment(POS)and 400μg/mL POS. Then the apoptosis rates of RPE cells after 24, 48 and 96h were detected with flow cytometry instrument(AnnexinⅤ/PI double staining).RESULTS: In blank control group, the apoptosis rates were very low at different time. After RPE cells were cultured with culture medium containing 200μg/mL POS for 24h, the apoptosis rate including early apoptosis and late apoptosis was 1.73%. As time going, the apoptosis rate increased rapidly and reached 65.92% after 96h. After RPE cells were cultured with culture medium containing 400μg/mL POS for 24h, the apoptosis rate was 4.02%. And it reached 91.34% significantly after 96h.CONCLUSION: Phagocytic loads can induce the apoptosis of RPE depending the time and dose.

AIM:To establish the model of age-related macular degeneration through blue light burning human retinal pigment epithelium(hRPE)cells in vitro and to investigate the possible mechanism of lycium barbarum polysaccharide(LBP)protecting the hRPE cells from blue light irradiation-induced damage.METHODS: hRPE cells were cultured in Dulbecco's modified eagle's medium with high glucose and were pretreated with different concentrations(0.01mg/mL, 0.1mg/mL and 1mg/mL, respectively)of LBP solution, respectively. Further, hRPE cells were irradiated with different intensities(2000±500 LUX)of blue light(wave length 470-520nm)for 12h and the cellular morphology was observed by inverted phase contrast microscopy for every sample. Using flow cytometry, the alterations in the levels of reactive oxygen species, mitochondrial membrane potential and apoptosis were determined, respectively. RESULTS: The level of reactive oxygen species in hRPE cells in blue-light treatment group was the highest, whereas the level in control group was the lowest. The fluorescent level of reactive oxygen species among different concentrations of LBP-treatment groups had specifically significant differences compared with that in blue light irradiation group(PPP>0.05). CONCLUSION: LBP can efficiently inhibit apoptosis induced by blue light irradiation in hRPE cells and 1mg/mL of LBP has the strongest protective ability in blue light irradiation-induced damage in hRPE cells. The possible mechanism may attribute to the protective effect of LBP in inhibiting the overgeneration of reactive oxygen species and apoptosis in hRPE cells.

AIM: To investigate the effects of ginkgo biloba extract(EGb 761)on laser-induced choroidal neovascularization(CNV)in rats.METHODS: Totally 60 BN rats were randomly divided into 4 groups: normal control group, model group, experimental group, physiological saline group with 15 in each group. All CNV models were made by krypton laser. Rats in experimental group were intraperitoneally injected with 0.35% EGb761(100mg/kg)every day after laser exposure until they were sacrificed. Rats in physiological saline group were intraperitoneally injected physiological saline every day after laser exposure until they were sacrificed. Fundus fluorescein angiography(FFA)was performed on every rat on the 7th day, 14th day and the 21st day after laser exposure, then the rats were sacrificed immediately. The eyes were enucleated and processed for histopathologic examination.RESULTS: There was no choroidal fluorescein leakage staining in normal rats. There were obviously less choroidal fluorescein leakage points in experimental groups than that in the corresponding model groups(PCONCLUSION: EGb761 len inhibit the formation of laser-induced CNV in rats. The longer the time, the better curative effect.

AIM: To investigate the utility of ultrasound in the diagnosis of posterior vitreous detachment(PVD). METHODS: From September 2011 to September 2012, 506 eyes of 305 cases(male 191, female 114)of PVD patients in our hospital were checked and analyzed with ultrasound.RESULTS: Totally, 179 eyes were diagnosed as partial PVD, the proportion was 35.4%. And 327 eyes were diagnosed as complete PVD, the proportion was 64.6%. Among the 61 eyes(12.1%)with a small amount of hemorrhage of vitreous humor,retinal breaks of 26 eyes(5.1%)were founded. Given the photocoagulation nicely heal to the breaks and then recovered. CONCLUSION:Ultrasonography can accurately diagnose PVD. It has non-invasive,convenience, and other characteristics, and it is worthy of clinical popularization.