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Objective: To identify the pathogenic mutation in a four-generation Chinese family with autosomal dominant retinitis pigmentosa (ADRP) and to analyze its associated clinical phenotypes., Methods: Twelve participants from the index family were recruited, including 5 patients, 6 asymptomatic siblings, and one spouse. All participants underwent ophthalmic examinations, including best-corrected visual acuity (BCVA), visual field (VF) testing, fundus photography, and full-field flash electroretinography (ERG). Targeted sequence capture array technique with next-generation of high throughput sequencing(NGS) was performed to detect variants in 189 hereditary retinal disease (HRD) related genes, comprising 179 identified HRD-causing genes and 10 potential causative genes which were involved in pre-messenger RNA(pre-mRNA) splicing. Variants detected by targeted sequencing were filtered by bioinformatic analyses, validated by Sanger sequencing and intra-familiar analysis.Genotype-phenotype correlation was also analyzed., Results: SNRNP200 p.S1087L was identified as the disease causative mutation for this family by targeted sequencing and optimized bioinformatic analyses. This family demonstrated early onset of the disease by presenting nyctalopia among 6 to 8 years old, performed rapid disease progression and severely impaired visual function by displaying loss of VF among 14 to 17 years old and decreased central vision among 21 to 28 years old. The fundus presentations and ERG results showed typical RP presentations., Conclusions: SNRNP200 p.S1087L is identified as a hotspot mutation but correlates with distinct phenotypes in the present family, including early onset of the disease, rapid disease progression, and severely impaired visual function. This study also give evidence to that molecular diagnostic platform for HRD can improve the detection rate of causative genes/mutations in HRD patients, thus providing important approaches for further investigation of the genetic causes for HRD.

Objective: To demonstrate the surgical choices for patients with complicated head posture associated with nystagmus., Methods: It was a retrospective clinical study. Thirty-eight cases of congenital nystagmus with abnormal head posture in all three axes without strabismus were retrospectively analyzed. Twenty-nine(76.32%) cases whose dominant head posture were with face turn, 3 cases (7.89%) with chin up or down , respectively, were performed horizontal null zone shift as well as vertical null zone transposition; 2 cases (5.26%) with head tilt as the dominant position were underwent one tendon width transposition of all four vertical muscles;4 cases (10.53%)basically with the same degree for face turn and chip up or down, 2 cases were preferred with recess a group of horizontal yoke muscles and a group of vertical yoke muscles, the other 2 cases were combined with weaken both synergistic oblique muscles. SPSS 13.0 was used to analyse the difference of them., Results: In 29 patients with horizontal head posture dominanted, 15 cases (68.18%) with 25 °-30 ° in horizontal head posture were corrected completely, 5°-15° was the residue for 7 cases (31.82%) with 35 °- 40 °degree in horizontal before surgery. 15 °-20° was residue for 3 cases larger than 40 ° before operation after modified Parks procedure. Anderson procedure can correct the angle of 15°-20° in 4 cases. The horizontal, vertical and torsional components of 22 cases whose predominant head posture were in horizontal with 25°-40° (3.18° ± 1.01°, 4.32° ± 1.14°, 4.55° ± 1.95°) were significantly reduced (t = 63.13, 3.57, 3.95;P < 0.01) after Parks procedure. Recession a group of vertical muscles 5mm or combined with oblique muscles in 3 patients could correct the 20° of vertical head posture, but the improvement of the other two axes was about 5°-10°.One tendon width transposition of all four vertical muscles in 2 cases could correct the 10° of head tilt and 10°-15°of chip up or down. Recession a group of horizontal and vertical muscles can correct 20°-25° of face turn and 20° of vertical head posture., Conclusions: When head turn with 25°-40°predominates over the vertical and torsional components, recess the horizontal muscles could be effective way in diminishing the abnormal head position on all three axes.When vertical or torsional head posture predominates for the complicated nystagmus, individual designs should be considered.When necessary, reoperations should be needed.

Hereditary retinal disease(HRD) is a group of retinal degenerations seen frequently at clinic,which can lead to severe visual impairments or even blindness.Identifying genetic causes and developing advanced and applicable molecular diagnostic tools for HRD is essential to lower the prevalence of HRD, and to find the therapeutic method of HRD. HRD is known to be both clinically and genetically heterogeneous. The large number of causative genes together with the limitation of routine technique hinder the investigators from further investigating the genetic causes of HRD. Targeted genes capture with next-generation high throughput sequencing yield high sensitivity and speed for mutation detection.When compared with traditional techniques, targeted sequencing presents tremendous advantages. Therefore, the development of a powerful molecular diagnostic platform for HRD aims to improve the detection rate of causative genes/mutations in HRD patients, to further investigate the genetic causes for HRD, to better understand the pathological basis of HRD, and to promote the fast development of molecular diagnosis in China. Meanwhile, it will have significance for the clinical and prenatal diagnosis of HRD, and thus providing rationale for gene therapy on HRD.

Objective: Screening KIF21A gene mutation in 9 families with congenital fibrosis of extraocular muscles and 7 sporadic cases., Methods: Families were ascertained and patients underwent complete ophthalmological examinations. The probands of 9 families with CFEOM and 7 sporadic patients were recruited for this study after informed consent. Genomic DNA was isolated from 5 ml peripheral blood samples according to the standard methods. Direct sequencing was performed after PCR amplification to genomic DNA for detection of KIF21A gene mutation., Results: We identified heterozygous KIF21A mutations in 14 of sixteen patients. Twelve of them harbor the most common mutation, c.2860C > T (p.R954W) and two of them harbor the second most common mutation, c2861G > A(p.R954Q). The R954 mutations account for 87.5% (14/16), in which 75% (12/16) are R954W, 12.5% (2/16) are R954Q., Conclusion: The R954 mutations are also hotspots in Chinese patients with CFEOM.

Objective: The purpose of this research lied in studying the structure and function of connective tissue of inferior oblique (IO) in rhesus, rabbit and rat., Methods: It was an experimental study. Two adult monkeys (rhesus), five adult rabbits and five adult Wistar rats were involved in this study. The gross anatomy of an orbit in each animal was observed. Meanwhile, the fellow orbit was processed with paraffin imbedding and coronal serial section. Masson trichrome stain was used to distinguish muscle and collagen, and Weigert stain was performed for identification of elastin., Results: The connective tissue around IO muscle in rhesus, rabbits and rats all connected with inferior rectus (IR) and lateral rectus (LR), but the arrangements among them were not entirely similar. Only the connective tissue around IO in rhesus consisted of dense collagen, scattered elastic fiber, and connected closely with IR, LR Pulley. The connective tissue circling IO in rabbit and rat were crumbly, and was not connected closely with the connective tissue around IR., Conclusion: IR and LR Pulley has some mechanics link with IO in rhesus, and can play roles in covergence in rhesus.

Objective: To evaluate the application of relative reference point photographic analysis method and goniometer method for head posture measurement, and compare the characteristics of the two methods., Methods: Thirty patients from March 2011 to April 2011 and August to September with AHP in our hospital were recruited. The AHP were measured by photographic analysis and goniometer method respectively. The data were analyzed by SPSS software., Results: The mean AHP was 15.62° ± 7.48° by photographic analysis measurement, 15.50° ± 6.99° by goniometer measurement. The Pearson's correlation coefficient (r = 0.955, P < 0.001, t = 0.286, P = 0.777)., Conclusions: Relative reference point photographic analysis is a simple and effective way to measure AHP. The results measured by the two methods are highly consistent.

Objective: To evaluate the effect of Recession of both horizontal rectus muscles in Duane Retraction Syndrome with significant globe retraction., Methods: Sixteen cases with DRS were summarized retrospectively. All patients had undergone surgery with recession of both horizontal rectus muscles. All clinical records, including sex, age, types of DRS, clinical features, surgical methods and clinical outcomes were analyzed. All patients were followed up for 3 months to 1 year., Results: Fifteen cases had only monocular involvement while one had both eyes. The number of type I DRS was 3 cases, 1 case was esotropia while others were orthotropic in primary position. Type III DRS was observed 13 cases. Esotropia was seen in 6 cases (7 eyes), exotropia of 1 cases and orthotropic in primary position of 6 cases. 10 cases exhibited marked face turn. An upshoot or downshoot and variable severity of retraction of globe were found in all patients on attempt adduction of the affected eye. All patients had undergone surgery with recession of both horizontal rectus muscles. The medical rectus muscles were recessed from 5 mm to 7 mm and lateral rectus muscles 3 mm to 9 mm simultaneously, which was based on the amount of primary position deviation. Among these 2 cases were combined with Y-splitting of lateral rectus muscle. After surgery, all patients were orthotropic in primary position. Their symptom of unacceptable abnormal head position, significant globe retraction, noticeable narrowing of the palpebral fissure and significant upshoot or downshoot were ameliorated or disappeared. Especially the recession of lateral rectus muscle in addition to Y-splitting combining with the simultaneous medial rectus recession resulted in further amelioration of globe retraction in addition to upshoot and downshoot., Conclusion: Recession of both horizontal rectus muscles is effective in the treatment of significant globe retraction in Duane syndrome. Type III DRS with significant globe retraction but has no marked deviation and face turn can adopt this method to ameliorate their aspect. The method of lateral rectus muscle in addition to Y-splitting plays an important role in the treatment of upshoot and downshoot.

Objective: To observe the characters of EPSC-IPSC induced by paired-pulse stimulation of rat visual cortex layer II/III pyramidal neurons during critical period of visual development, and discuss their relationships, to discuss the role of short-term synaptic plasticity in the critical period of visual development of rats., Methods: Thirty Wistar rats were used, they were divided into P10-P12, P14-P16, P21-P23, P28-P30, P35-P37 five groups, n = 6. Whole-cell voltage clamp recording was performed, the membrane potential was clamped on -50 mV, 0 mV respectively to separate EPSC and IPSC. We set the PPR as the observation indicator, analyzed the developmental features of EPSC and IPSC induced by paired-pulse stimulation of different groups., Results: The PPR of layer II/III pyramidal neurons in group P10-P12, P14-P16, P21-P23, P28-P30, P35-P37 was 0.43 ± 0.08, 0.07 ± 0.08, 0.10 ± 0.10, 0.20 ± 0.07, 0.22 ± 0.12 respectively. The PPR of group P14-P16 decreased, the difference was statistically significant compared with the group before eyes open (t = -3.13, P = 0.04). The PPR of corresponding groups was 0.6036 ± 0.3021, 0.2830 ± 0.0504, 0.0287 ± 0.0907, -0.0449 ± 0.1443, -0.3089 ± 0.05553 respectively (F = 5.0799, P = 0.0037), the PPR of IPSC gradually reduced with age, and turned negative from the P28-P30 group, changed from PPF to PPD., Conclusions: The PPR of EPSC response to visual stimuli rapidly, but did not change significantly in the critical period of visual development (P19-P32). The short-term depression of IPSC increased gradually from the eyes open to the end of the critical period of visual development, which may play a more important role in the process of layer II/III pyramidal neurons maturation and the critical period of visual development ending.

Objective: To describe the clinical features and surgical outcomes in a series of patients with perforating injuries and foreign bodies located at the exit wound in posterior global wall., Methods: Retrospective case series of 17 eyes of 17 patients were included in the study, each patient who received treatments between January 2006 and December 2010 had perforating injuries with foreign bodies located at posterior global wall. The exit wounds of perforating injuries were in the area of optic disc and macula in 8 eyes. Seventeen eyes had vitreous hemorrhage, 11 eyes had traumatic cataract, 8 eyes had retinal detachment and one eye had endophthalmitis. According to different therapeutic regimen, cases were divided into two groups. Group A (7 cases) underwent vitrectomy combined with extraction of foreign body as an emergency operation. Group B (10 cases) underwent extraction of foreign body as an emergency operation and secondary vitrectomy were performed 1 - 2 weeks later. The mean follow-up time was 18 months (ranged from 9 - 47 months). The functional and anatomical results were compared between Group A and B. Fisher's exact test were used to analyze the data., Results: The foreign bodies were extracted in 17 cases. Poor final best corrected visual acuity (BCVA) (worse than or equal to 0.1) was presented in all 8 cases with the exit wound being in the area of optic disc and macula, but only in 4 of 9 cases with the exit wound located in other sites, the difference between these two groups was statistically significant (P = 0.029). At final follow-up, vision was improved in 5 cases from Group A and 7 cases from Group B (P = 1.000); BCVA were better than or equal to 0.1 in 4 cases from Group A and 3 cases from Group B (P = 0.350) the differences were statistically nonsignificant. Intraoperative leakage at the exit wound occurred in 4 cases from Group A and one from Group B, the difference was statistically significant (P = 0.015). Intraoperative retinal detachment and postoperative silicone oil leakage occurred in 2 cases from Group A and none from Group B (P = 0.154). Postoperative retinal detachment occurred in 1 case from Group A and 3 cases from Group B (P = 0.603). Silicone oil-dependent eye occurred in 1 case from Group A and 2 cases from Group B (P = 1.000); the differences were statistically nonsignificant., Conclusions: The visual prognosis is worse in cases with the exit wound being in the area of optic disc and macula. Both therapeutic regimens were effective, but each has their pros and cons. Appropriate therapeutic regimen should be selected in term of situations. To avoid leakage at the exit wound in vitrectomy, we recommend therapeutic regimen B be selected first.

Objective: To map and to identify the causal gene of autosomal dominant congenital coralliform cataract (ADCC) in a Chinese family., Methods: Case series study. Clinical features of all affected members in this family were examined. Blood samples were collected from nine family members for genetic linkage analysis. Polymorphic microsatellite markers were selected from the regions which harbor all known loci linked with ADCC. Direct genomic sequencing was used to evaluate the candidate gene., Results: The affected members in this family showed classic phenotype of ADCC. The maximum two-point LOD score of 1.51 was obtained for marker D2S325 (θ = 0). The LOD score of 1.20 was obtained for marker D11S925. The CRYGC/CRYGD gene located on 2q33-q35 and the CRYAB gene located on 11q22-q22.3. Therefore, the CRYGC/CRYGD and CRYAB gene may be the candidate gene in this family. Sequencing of the coding regions of the CRYGD gene showed the presence of a heterozygous C→A transversion at nucleotide 70 in exon 2 of CRYGD that is associated with cataracts in this family. This mutation resulted in a proline to threonine substitution at amino acid 23 of the protein in the first of the four Greek key motifs that characterized this protein. No mutation in all exons of CRYGC and CRYAB gene were found in the family., Conclusion: Direct DNA sequence analysis revealed a C-to-A transition at nucleotide 70 of the CRYGD gene in this ADCC family.

Objective: To study the disease-causing gene mutation in a Chinese family with ectopia lentis., Methods: The phenotype of each family member in a Chinese family with ectopia lentis was identified by detailed clinical examination. The inheritance mode in this family was ascertained by the pedigree analysis. Linkage analysis was performed by microsatellite markers on chromosome 15 and LOD Score was calculated by Mlink program. Gene mutations were detected by sequence analysis to the whole coding region and exon-intron boundaries of the candidate gene., Results: A significant LOD score of 3.01 was obtained at D15S978 on chromosome 15q21.1, where FBN1 gene was located. A C3519G change in exon 29 of FBN1 gene, resulting in asparagine change to lysine at codon 1173, was detected by direct sequence analysis. This mutation was absent in the normal family members and 100 normal controls., Conclusions: Our results indicate that c.C3519G (p.N1173K) mutation in FBN1 gene is the underlying molecular pathogenesis of this family with ectopia lentis.

Objective: The purpose of this research lied in studying the structure and function of connective tissue of superior oblique (SO) in rhesus and rabbit., Methods: It was an experimental study. Two adult monkeys (rhesus) and five adult rabbits were involved in this study. The gross anatomy of an orbit in each animal was observed. Meanwhile, the fellow orbit was processed with paraffin imbedding and coronal serial section. Masson trichrome stain was used to distinguish muscle and collagen, and Weigert stain was performed for identification of elastin., Results: Connective tissue around SO in both mammals thickened anteriorly, reflected in the trochlea along with the SO tendon, and became contiguous with the nasal aspect of the SR connective tissue ring, while the tendon passed inferior to the SR pulley to insert on the sclera., Conclusion: The contraction of SO OL can cause SR shift nasally. This may explain the mechanism of vestibulo-ocular reflex (VOR) partly.

Objective: To investigate the clinical characteristics and surgical treatment of bilateral Duane retraction syndrome., Methods: To collect 24 cases with bilateral DRS among 123 cases with DRS from hospital data during 2005.7 to 2009.11. Retrospective study included the clinical types, characteristics, plus diseases and surgical treatments., Results: Fourteen male cases (58.3%) and 10 female cases (41.7%), aging 2 to 23-year-old. 16 cases were type I (66.7%), 1 case was type II (4.2%). 7 cases were type III (29.1%), in which patients with esotropia or exotropia were 3 and 4 cases respectively. 11 cases had up- or down-shoot pre-operation, which disappeared or improved post-operation in 8 cases (73%). 15 cases had abnormal head posture (AHP) and AHP disappeared or improved in all. Seven cases (29%) were associated with other congenital ocular or systemic anomalies. For horizontal deviation, unilateral medial or lateral rectus weakening procedures were performed in 13 cases and bilateral procedures in 11 cases. Post-operation, horizontal deviation was less than ± 10(Δ) in 21 patients (91%), 1 case was under-corrected and 2 cases were overcorrected. Simultaneously, the restriction of ocular motility and global retraction were improved in all the patients. Additional vertical or oblique muscle procedures were performed in 4 patients among 7 with vertical deviation more than 10(Δ) and up- or down-shoot., Conclusions: Bilateral DRS has more frequency in male, obviously horizontal deviation in primary position and more cases with vertical deviation which is related with up- or down-shoot phenomenon. The key point for successful surgery are forced duction test pre- and during operation to conform to relieve the mechanical factor and estimating abnormal innervation in horizontal and vertical rectus.

Congenital idiopathic nystagmus (CIN) is genetically heterogeneous. Autosomal dominant, autosomal recessive and X-linked patterns of inheritance have described. At least three distinct loci are related to autosomal dominant and X-linked patterns. One causative gene for X-linked form has been identified (FRMD7, Xq26.2) through linkage analysis. The molecular genetics advances of the congenital idiopathic nystagmus (CIN) are reviewed.

Objective: To described the clinical feature and MRI imaging of six children with vertical retraction syndrome., Methods: Six children with unilateral vertical retraction syndrome between 15 months and 8 years of age, mean age was (5.01 ± 1.27) years old. Strabismus examination included diopter, prism diopters, eye movement examination, binocular vision and fundus examination. Imaging of the ocular motor nerves at the brainstem was performed in 0.8 mm thickness image planes using 3D-FIESTA sequence, the orbits were imaged with FSE T1, T2WI using surface coils, and within 2.0 mm thick planes., Results: Four children showed hypertropia, characterized by limited depression, a light retraction of the globe during downward gaze and eyelid lag. The MRI imaging showed anomalous orbital structure in the superonasal quadrant that between medial rectus and superior rectus or adjacent to the superior rectus. Two children showed intermittent exotropia, characterized by limited elevation, retraction of the globe and narrowing of the palpebral fissure during upward gaze. The MRI imaging showed anomalous orbital structure was present in the inferotemporal quadrant, one originate in inferior rectus and another close to the lateral rectus., Conclusion: Anomalous orbital structures are a main cause of vertical retraction syndrome. The presence of specific unusual eye movement and MRI imaging may assist in diagnosis. When the eyelid lag was found since the early age, anomalous orbital structures were implied.

Intermittent exotropia is a type of strabismus between exophoria and constant exotropia. The onset age is usually one to four years old. Different from other types of strabismus, intermittent exotropia patient can maintain normal binocular vision in a long period of time. So how to choose the optimal timing and effective treatment is a challenge for clinicians. The objective of this article is to review the recent research progress of intermittent exotropia, including the severity classification, non-surgical treatment, timing of surgery and surgical methods, overcorrection and under correction treatment etc., and give some recommendations for the treatment of intermittent exotropia.

Objective: To evaluate the surgical results of modified Yokoyama's procedure for treating myopic strabismus fixus., Methods: Retrospective analysis of records of 5 patients (7 eyes) with high myopic strabismus. Pre- and postoperative orthoptic measurements were recorded and analyzed. Anatomic relationships between the muscle cone and globe were analyzed using MRI or CT scan. The surgical procedure is a modification of Yokoyama's technique and medial rectus muscle was also recessed., Results: The average axis length of 7 eyes was 32.62 mm (SD1.84). The mean preoperative horizontal deviation was 82.86 PD (SD 37.62) esotropia and mean vertical deviation was 20 PD (SD 7.91) hypotropia. All patients had marked limitation of elevation and abduction. Displacement of the lateral rectus inferiorly and superior rectus medially was demonstrated in each patient by CT or MRI scan of the orbits and by observation during surgery. After surgery, the supertemporal dislocation of globe was improved. Both the horizontal and vertical deviations decreased significantly, and the abduction and sursumduction motility were also improved gradually. The average follow-up was 5 months, all patients achieved satisfactory results and remained stable., Conclusions: In high myopic patients, if the deviant paths of the LR and SR muscles were demonstrated by MRI or CT scan, the surgical procedure to restore the dislocated globe back into the muscle cone by uniting muscle bellies of the superior rectus and lateral rectus muscles is effective and recommended.

Objective: To quantitatively investigate the characteristics of the microsaccadic eye-movements in anisometropic amblyopia and to evaluate the using value of high-speed eye-movement recording in objective and quantitative evaluation and diagnosis of amblyopia., Methods: From September in 2010 to March in 2011, 19 cases of anisometropic amblyopic patients (19 amblyopic eyes as group AM and 19 their sound eyes as group AS) and 19 cases of subjects with normal corrected visual acuities (19 dominant eyes as group ND and 19 non-dominant eyes as group NN) were recruited from the outpatient clinic at Tianjin Eye Hospital. A high-speed eye-movement recording system was used to monocularly record the fixational eye-movements of subjects' both eyes. A Matlab routine was used to detect and analyze the microsaccadic components of eye-movement waveforms. The microsaccadic amplitudes, peak velocities, occurrence rates, inter-microsaccadic intervals, cumulative probabilities of all groups were analyzed and compared using Origin8.0 and Matlab2008 statistics toolbox., Results: The mean microsaccadic amplitude of group AM (0.76 ± 0.07)° was larger than groups AS, ND and NN (F = 49.95, P = 0.000). The mean peak velocity of group AM (79.72 ± 5.64)°/s was faster than groups AS, ND and NN (F = 4.93, P = 0.004). The mean occurrence rate of group AM (1.52 ± 0.08) Hz was less than groups AS, ND and NN (F = 120.39, P = 0.000). The mean inter-microsaccadic interval of group AM (537.40 ± 65.47) ms was longer than groups AS, ND and NN (F = 4.41, P = 0.007). The amplitude dependent cumulative probability curve of group AM shifted to right compared with other groups and its amplitude 0.67° ± 0.06° at half cumulative probability was obviously increased compared with other groups (F = 203.05, P = 0.000)., Conclusion: Microsaccadic amplitude, peak velocity, occurrence rate, inter-microsaccadic interval and cumulative probability could be used as the parameters for objective and quantitative evaluation of eye-movement function in amblyopia. High-speed eye-movement recording could provide useful assistance in evaluation of eye-movements in amblyopic patients.

In the past 5 years of the new century, with the development of national power and the accompanied increase of international academic communication, the researchers and clinical scientists of pediatric ophthalmology and strabismus in China actively participated in the international academic communication and competition and made great achievements. Many excellent works of clinical studies or basic researches in this field were recognized by the academic community of the world. Young ophthalmologists in pediatric ophthalmology and strabismus have been trained and well developed. The position of Chinese pediatric ophthalmology and strabismus in the global academic community has been moved up gradually.

When we celebrate the diamond jubilee of Chinese Journal of Ophthalmology (CJO), we also reviewed its past and prospected its future. Under the effort by the editorial members and the great majority of ophthalmologists for sixty years, CJO has become the most authoritative and academic journal in ophthalmology in China, and has formed the fine tradition of "to respect the profession, to believe the truth and to advance bravely". At present, CJO has a basis to further become the most authoritative academic journal in ophthalmology not only in the domestic but also in the world. For realizing the grand prospect, we should do more arduous effort for facing the all kind of the challenges in our ways forward; we should let the editorial committee to play the full role in our work; we should continue to raise the professional level of all editorial personnel; we should make great efforts to find and edit more and more articles with the high quality; we should observe the morals and ethics for editorial personnel; we should hear and accept the opinions, suggestions and criticisms; we should strength the international cooperation and communication.

Objective: To determine the effect of methimazole (MMI) on retinal vascular development in the oxygen-induced retinopathy neonatal rat., Methods: It was an experimental study. Control and MMI-exposed newborn rats were raised either in room air or variable oxygen (40%/15%) every 24 hours until P14. All groups were then exposed to room air between postnatal day P14 and P18. Dams drank either tap water or water containing 0.1% MMI. Eyes in all groups were fixed, and retinas were dissected and stained with adenosine diphosphatase, then analyzed for retinal vascular areas, vascular density, and NV incidence and severity. Serum IGF-1 level was measured by radioimmunoassay. Body weight were measured every day. NV incidence between groups were analyzed with Chi-square tests. Ratio of peripheral avascular area to the whole retina area, vascular density, the nucleus of vascular endothelial cells breaking inner limiting membrane count and Serum IGF-1 level between groups were tested by One-Way ANOVA analysis and independent-samples t-test., Results: Compared with untreated 40%/15% pups, 40%/15% newborn rats receiving MMI exhibited significant changes in NV incidence (26%:57%, χ(2) = 4.38 P = 0.04) and the nucleus of vascular endothelial cells breaking inner limiting membrane count (33.17 ± 3.06:65.64 ± 3.85, t = 17.73, P = 0.00). Ratio of peripheral avascular area to the whole retina area of MMI treated 40%/15% rats was 6.37% ± 1.23%, and the development of retinal blood vessels in other groups reached periphery. Retinal NV was not found in MMI control retinas, although retinal vascular density was significantly lower (P < 0.05) in MMI-treated pups (52.57 ± 4.14) than in the control group (95.21 ± 6.17). Serum IGF-1 levels were markedly (P < 0.05) reduced in MMI treated control rats (235.94 ± 29.09) mg/L compared with untreated control animals (536.43 ± 32.65) mg/L and in MMI treated 40%/15% rats (227.24 ± 19.59) mg/L compared with untreated 40%/15% group (526.50 ± 26.83) mg/L. Compared with non-MMI pups, newborn rats receiving MMI exhibited significant growth retardation in body weight., Conclusions: MMI aggravates NV in oxygen-induced retinopathy neonatal rats. This may be mediated by the initial suppression of serum IGF-1. The relationship between the temporal course of serum IGF-1 and NV in immature retinas needs further investigation.

Objective: To investigate changes of visual performance and effects of higher order aberration on visual performance after Epi-LASIK for myopia., Method: In this prospective study, 102 patients were included. The trial group had 52 patients with Epi-LASIK, and 50 cases with LASIK as the control group. Ocular higher order aberrations were measured with the Hartman-shack wavefront analyzer, and high (100%), moderate (25%), low contrast (10%) and very low contrast (5%) visual acuity with and without glare were measured with Multi-Function Visual Acuity Tester under mesopic condition preoperatively and 4 - 6 months after surgery. 35 subjects in Epi-LASIK and 33 cases in LASIK were followed up 4 - 6 months later. Paired t test were used to analyze different contrast visual acuity before and after Epi-LASIK. Multiple linear regression analysis was performed to find the explanatory aberrations which contributed to the visual acuity. The Pearson correlation was used to explore the correlation between high- and low-contrast visual acuity and the explanatory higher order aberrations. The independent t test was used to analyze the difference of refraction power and visual acuity between Epi-LASIK and LASIK., Results: There were significantly statistical differences at 5% and 10% contrast level compared to preoperation with glare and with no glare. With no glare, the mean logMAR visual acuity at 5% and 10% contrast level were 0.32 + or - 0.14 and 0.21 + or - 0.12 preoperatively, and 0.47 + or - 0.15 and 0.33 + or - 0.16 postoperatively (t = -4.863, 3.950; P = 0.000, 0.000). With glare, the mean logMAR visual acuity were 0.37 + or - 0.20 and 0.22 + or - 0.13 preoperatively, and 0.46 + or - 0.18 and 0.30 + or - 0.17 postoperatively (t = -1.949, -2.283; P = 0.047, 0.029). Using stepwise multiple linear regressions to evaluate which higher order aberration was significantly associated with each contrast VA. For each order RMS, S(4) was positive correlated with 5% contrast visual acuity (r(2) = 0.282;P = 0.025); S(4) was positive and S(5) was negative correlated with 10% contrast visual acuity (r(2) = 0.192;P = 0.033). None of the higher order RMS can significantly affect the 25% and 100% contrast visual acuity. For each Zernike coefficients, C(4)(0) and C(6)(4) were positive correlated with 5% contrast visual acuity (r(2) = 0.233; P = 0.024); C(4)(-4) was negative, C(4)(0) and C(5)(-5) were positive correlated with 10% contrast visual acuity (r(2) = 0.289; P = 0.013); None of Zernike coefficients had a significant correlation with 25% and 100% contrast visual acuity. The Pearson correlated coefficients between S(4), C(4)(0) and each contrast visual acuity increased as the contrast level decreased. S(4) and C(4)(0) were associated significantly with 5% contrast visual acuity, the correlation coefficients were 0.378 and 0.390 (P = 0.025 and 0.021). The visual acuity under 100% contrast with no glare was a little poorer than in LASIK., Conclusions: At the early stage after Epi-LASIK, the visual acuity for lower contrast level was worse compared to preoperative with glare and with no glare. Spherical aberration and the spherical-like aberration may contribute to this.

The advent of magnetic resonance imaging (MRI) has given us previously unavailable opportunities to visualize the functional anatomy of extraocular muscles and corresponding ocular motor nerves along the intraorbital and intracranial course of living subjects. Ophthalmologists should be aware of these new MRI techniques. We believe that MRI will play a more marked role in the diagnosis and management of incomitant strabismus.

Objective: To investigate the modification function of visual experience onto synapses by recording developmental changes of spontaneous excitatory postsynaptic currents (sEPSC) in layer 2 and 3 pyramidal neurons of rat visual cortex, and to observe the spontaneous synaptic activities during the earlier postnatal period., Methods: This was an experimental study. By combining infrared differential interference contrast (IR-DIC) technique and a CCD-camera system with visual patch clamp whole-cell recording technique, spontaneous EPSCs of P2 approximately 7, P8 approximately 14, P15 approximately 21 and P22 approximately 28 groups were observed and analyzed. The neurons were stained by adding 0.3% Lucifer yellow to the pipette solution simultaneously., Results: The amplitude of sEPSC was enhanced when aging (F = 20.69, P < 0.01). The sEPSC frequency increased with age (F = 87.46, P < 0.01). There was no significant difference between P2 approximately 7 groups and P8 approximately 14 groups (P > 0.05). The electrophysiology and dendrite of neuron became mature whilst development., Conclusions: During the early postnatal days neurons were relatively immature, and became mature during development. Visual experience played an important role in this process. In spite of most synapses were taken silent at early postnatal days, and NMDA receptor-mediated function was revealed exclusively, these results suggested that early AMPA receptor-mediated functional activities existed in layer 2 and 3 pyramidal neurons. Synapses were not completely silent, but had early spontaneous activities.

Objective: To investigate the changes of the Modulation Transfer Function (MTF) and its effect on visual and optical quality with or without low and higher order wavefront aberration after conventional and wavefront guild laser in situ keratomileusis., Methods: It was a comparative case series. An aberrometer with Hartmann-shark sensor was used to measure the monochromatic aberration of eyes. One hundred and two cases entered the study; 38 cases were randomized to LASIK and 64 were randomized to WFG-LASIK. MTFs of optical system were calculated at various pupil size (3, 4, 5 and 6 mm) respectively and compared pre and 3 month postoperatively between conventional and wavefront guide ablation with or without higher order aberration., Results: There was a significant increase in MTF positively compared with preoperative values at all spatial frequency (5-60 cycles per degree, c/d ), P < 0.05. MTF values got more improvement without spherical aberration than without coma aberration after LASIK surgery and there was significant different at a spatial frequency of 5 c/d. Higher MTFs were showed in the WFG-LASIK group although there were no significant difference between conventional LASIK group and WFG-LASIK group. However, there were apparently changed without high order aberration as compared to that with high order aberration at all spatial frequency (5-60 c/d. ) in WFG-LASIK group and higher MTFs were showed in the WFG-LASIK group compared with conventional LASIK group and there were significant different (P < 0.05) by calculation and evaluation., Conclusion: Spherical aberration have more negative role on visual quality than coma aberration after LASIK surgery. With the optical benefits expected from correcting higher aberration, wavefront guide ablation have shown a great benefit for low and high order aberration but it still leave a small amount of high order aberration and need further investigation. MTF is a sensitive and extensive in demonstrating the optical quality in refractive surgery.

Objective: To display the detail functional anatomy of ocular motor nerves in the orbits, cavernous sinus and brainstem by high-resolution MRI., Methods: Twenty normal subjects between 24 and 38 years of age, mean age was 28.25 +/- 4.07 (SD). Imaging of the ocular motor nerves at the brainstem was performed in 0.8 mm thickness image planes using 3D-FIESTA sequence; nerves in the cavernous sinus was imaged with a head coil, the FSE/T(1)WI was obtained in coronal planes; nerves to extraocular muscles (EOMs) in the orbits were imaged with FSE/T(1)WI oblique-coronal planes using surface coils, and within 2.0 mm thick planes. A human orbit was celloidin embedding and serially sectioned at 0.1 mm of thickness for HE stain, which would be used to distinguish motor nerves to the EOMs., Results: Oculomotor nerves (CN3) and abducens (CN6) of the cisternal segment were well demonstrable in all normal subjects. Trochlear nerves (CN4) were depicted 95%. CN3 could be demonstrated consistently in the cavernous sinus, because of their small diameter, CN4 and CN6 not always detectable. The larger inferior division of CN3 and branches to the target EOMs and CN6 were demonstrated well in all species. The superior division of CN3 was demonstrated 60%, CN4 was showed 40%., Conclusion: 3D-FIESTA Sequence combined with MPR (Multiplanar Reformation) could precisely show the ocular motor nerves, as well as the relationships with adjacent structures in the cistern. The inferior division of CN3 and the CN6 could be well depicted in the orbits. But of the small sizes and complicated neighboring structures in the orbit, the superior division of the CN3 and the CN4 could not be demonstrated consistently. The capabilities of MRI can be fully used only with thorough knowledge of the complicated topographic relationships in the corresponding region.

Objective: To observe the change of expression in quantity of AMPA receptor subunit GluR2 and mEPSCs from monocular derivated rats. The preparative work was conducted for the further study on mechanism involved in regulation and control of the visual development plasticity., Methods: It was an experimental study. Forty 14 d healthy Wistar rats were divided into two groups randomly; twenty in each group which were divided into two groups (I, II) and derivated monocular in experiment group (group I), and then were killed at a week later. ForIA and IIA 5 microm thick section was cut from tissue of visual cortex in coronary side, then the expression of GluR2 was observed by microscope and image analyze of GluR2 was conducted after immunohistochemical staining; for IB and IIB, mEPSCs was investigated which was used Voltage-clamp technique with whole-cell mode., Result: The level of GluR2 in visual cortex of normal rats was higher than experiment group. The mean amplitude and frequency of mEPSCs increased in the derivated monocular group., Conclusions: The level of GluR2 has changed association with the visual stimulation, which suggests that GluR2 should have the important physiological function on the postnatal development of visual system of rats.

Visual experience plays an instructive role in the development of the visual nervous system., it can induce persistent modification of developing visual circuits via Hebb's synaptic plasticity. The application of in vivo two-photon imaging to monitor structural changes during Monocular deprivation (MD) will determine how amblyopia are related to remodelling of synapses. As the most important process of amblyopia, ocular dominance (OD) shifts served as a usefull model for examining how cortical circuits are shaped by experience. MD can induce OD shifts toward the no-visual deprivation eye, what are the neuronal mechanisms underlying it? How the functional plasticity turn to structural plasticity? Do the adults share the common mechanisms with the juveniles? In this review we will discuss the researching progress of neuronal mechanisms of amblyopia in these years.

Objective: To study the morphology differences of ocular rectus muscles pulley between preschool children and adults., Methods: It was an experimental research. Ten fresh cadaver orbits (five children and five adults) were fixed in situ and serially sectioned at 4 microm thickness. Every section was stained with Masson's trichrome and picrosirius red methods. After being stained, extraocular muscle pulley in typical sections was examined through gross anatomy and light microscopy. Two-factor analysis of variance for quantitative data was used in statistical treatment., Results: Near the equator of the globe, the children and adults' extraocular muscle pulleys were all at the points where the rectus penetrate posterior Tenon's fascia, encircling the rectus orbit side by fiber ring structure. There were pulley bands among rectus pulleys. The rectus pulley length and the origin distance from the corneoscleral limbus of the children were significantly less than those from the adult group (P < 0.05). The main composition of the children rectus pulley was similar to that of the adults, but the smooth muscle and collagen type III fibers contents of the medial rectus pulley in children were significantly greater than those in the adults group (P < 0.05). Collagen type I fibers in the children were significantly less than that of the adults group (P < 0.05)., Conclusion: There are morphological differences in rectus pulley between preschool children and adults, which provides an anatomic basis for the better understanding of the pathogenesis of strabismus.

Objective: To investigate the expression and significance of vascular endothelial growth factor (VEGF) and pigment epithelium derived factor (PEDF) in oxygen-induced mouse retinopathy., Methods: This experiment was a control experiment study. Newborn C57BL-6 mice were exposed to hyperoxia, and then returned to normoxia to induce retinal neovascularization. Mice were sacrificed at postnatal days 12, 14 and 17 and the retina were processed for RT-PCR, Western Blot and fluorescein angiography. Analysis of variance and Dunnett's t3 was used to compare the mRNA and protein level of VEGF and PEDF between experiment and control groups. Statistical difference was considered significant at a P value less than 0.05., Results: At any of the time points tested, there was significant difference at VEGF protein level (A value) between the experiment (0.47 +/- 0.12, 2.15 +/- 0. 46, 5.49 +/- 0.97) and control (l.81 +/- 0.50, 0.90 +/- 0.05, 0.88 +/- 0.91) groups (P = 0.009, 0.010, 0.000, respectively); the same situation occurred at PEDF protein level (P = 0.002, 0.046, 0.000, respectively). At postnatal day 12, 14 and 17, a significant difference at VEGF protein level was observed among the different experiment groups (P = 0.002, 0.001, 0.000, respectively); the same situation occurred at PEDF protein level (P = 0.009, 0.010, 0.000, respectively). There was significant difference at VEGF mRNA level between the experiment and control groups (P = 0.001, 0.000, 0.001); at postnatal day 12 and 14, the same situation occurred at PEDF protein level (P = 0.001, 0.000, respectively), but there was no significant difference at postnatal day 17 (P = 0.612). At postnatal day 12, 14 and 17, a significant difference at VEGF mRNA level was observed among different experiment groups (P = 0.000, 0.001, 0.000, respectively); the same situation occurred at PEDF mRNA level (P = 0.000, 0.001, 0.000, respectively). The time course of the decrease of PEDF was consistent with the increase of VEGF expression. VEGF/PEDF ratio change was correlated with the development and progression of retinal neovascularization. The time course of PEDF mRNA down-regulation was consistent with the VEGF mRNA up-regulation, similar with the changes of the protein. The change of VEGF and PEDF mRNA was prior to that of the protein., Conclusions: One of the mechanisms for development of retinal neovascularization is the changes of VEGF\PEDF level in the retina.

Objective: Mapping the mutation gene for a Chinese family with autosomal dominant cataract., Methods: It was a retrospective study. Thirty-two individuals in this family, including fifteen patients, eight normal siblings and nine spouses, were investigated and 8 ml blood was collected from each member under informed consent. Genomic DNA of all 29 members was isolated by standard protocol. A genome wide scan was performed after PCR amplification for microsatellite makers on autosomal chromosomes. LOD score was calculated by Linkage 5. 1 and GeneHunter software., Results: Positive Lod score were obtained in 10 microsatellite makers (D20S186, D20S163, D20S915, D20S152, D20S98, D20S904, D20S875, D20S112, D20S1140, D20S432) on chromosome 20q, and the maximum LOD score with D20S904 was 6.02., Conclusions: Haplotype construction and multipoint analysis mapped the mutation gene in this inherited cataract family to the chromosome 20p12. 1-20p11.23 region between D20S186 and D20S912, which is an approximately 5.47 centimorgan length. This is the second congenital cataract locus linked to chromosome 20q.

Objective: To study the disease-causing gene for a Chinese family with X-linked congenital idiopathic nystagmus., Methods: It was a retrospective study. The phenotype of a Chinese family with congenital nystagmus was identified by investigating the history and the clinical features of each family member. The mode of inheritance in this family was ascertained by the pedigree analysis. Linkage analysis was performed to identify the possible locus harboring the disease-causing gene. Direct DNA sequence analysis was performed to find the mutation responsible for this disease., Results: The positive LOD score was obtained for 10 microsatellite makers on chromosome Xq25-Xq27, and the maximum LOD score with DXS1211 was 3.91. A 2-bp deletion in exon 8 of FRMD7 was detected after direct DNA sequence analysis, which was cosegregated with all patients in this family., Conclusion: Congenital nystagmus is a clinically and genetically heterogeneous ocular movement disease. Mutation of the FRMD7 gene is the cause of congenital nystagmus in this family.

Objective: To establish 3-D visible human model of the rectus EOM Pulley., Methods: The pictures of Masson stained adjacent coronal sections of a whole orbit were imaged by digital camera, which were entered into computer continuously after removing spottiness through PhotoShop 7.0 software. 3D-Doctor software was used to register and split the image. Finally three-dimensional computerized reconstructions of the rectus EOM pulley and eye ball were achieved. At the same time pulley system structure was analyzed using the 3D-Doctor software., Results: Three-dimensional model of the rectus EOM pulley displayed directly the three-dimensional relationship of pulley and the eye ball, extraocular muscles and orbit. This three-dimensional model could be rotated randomly, providing convenience for multi-angle observation. The demonstration of the three-dimensional model selectively provides a approach to get rid of disturbance and lock the aim for observation. The length of pulley was about 4.6 to 5.8 mm. The origin of the four rectus pulleys was 13.8 to 18.0 mm from the corneoscleral limbus. Media rectus pulley was thickest among four rectus pulley. The ratio between media rectus pulley thickness and corresponding media rectus thickness could reach 1.11., Conclusions: Three-dimensional model of the rectus EOM pulley provided direct picture for clinic doctors to understand the structure of pulley, which also provided three-dimensional anatomic basis for iconography research of the rectus EOM pulley. The data of pulley could be helpful to establish Chinese rectus EOM pulleys data bank.

Objective: To analyze the clinical manifestations of affected individuals in a family of congenital fibrosis of the extraocular muscles (CFEOM) with juvenile canities., Methods: All affected and unaffected individuals were retrospectively analyzed in this study. The clinical features include genetic aspects, sex, age, ptosis, restriction of eye movement, aberrant innervation and surgical procedures, were evaluated., Results: This pedigree was inherited as autosomal dominant. There were 14 cases suffering from congenital fibrosis of extraocular muscles in four generations. They had congenital blepharoptosis, head-tilt, chin lift and primary gaze fixed in a hypotrophic position. But vertical and horizontal positions of the eye and restriction of eye movement were different among affected individuals. Some of them also had pupillary abnormally, aberrant innervation and juvenile canities. Inferior rectus recession improved hypotropia in patients with infraducted eyes and chin elevation. Horizontal muscle recession corrected horizontal strabismus satisfactorily in most cases. Ptosis was repaired by frontalis sling or levator resection., Conclusions: This is the first report of CFEOM associated with juvenile canities. There was phenotypic heterogeneity in this CFEOM pedigree. So the phenotype alone is not sufficient to distinguish among the 3 genotypically distinct CFEOM syndromes. The combination of clinical characteristics and genetic analysis are the basis for the establishment of diagnosis.

Congenital cranial dysinnervation disorders (CCDDs) are congenital non-progressive, sporadic or familial abnormalities of cranial musculature that result from developmental abnormalities of, or the complete absence of, one or more cranial nerves with primary or secondary muscle dysinnervation. These disorders include vertical disorders of ocular motility, horizontal disorders of ocular motility and disorders with abnormalities of facial motility that were previously referred to as "congenital fibrosis syndromes". The advances in clinical and molecular genetics of congenital cranial dysinnervation disorders are reviewed.

Objective: To clone and eukaryotic express wild type and truncated mouse ciliary neurotrophic factor (CNTF) gene, and to observe the biological effect of two types of CNTF gene expressing in ARPE-19 cells., Methods: RT-PCR was used to amplify the cDNA of CNTF gene, and truncated CNTF cDNA was obtained by site-directed mutagenesis. The two types of CNTF gene were cloned into plasmid pTracer-CMV and transfected to ARPE-19 cells. Dot blotting was used to detect the expression of CNTF. MTT and flow cytometry apoptosis assay were performed to observe the biological effect of CNTF expressing in ARPE-19 cells., Results: Wild type and truncated CNTF gene were amplified by RT-PCR, and their eukaryotic expression plasmids were successfully constructed. After ARPE-19 cells transfected with two types of recombinant plasmids, the CNTF were detected in the supernatant of cells culture. MTT result shows that two types of CNTF have no proliferation promoting effect to ARPE-19 cells, and quantitive apoptosis assay implicated that CNTF could partially suppress the apoptosis that induced by the cells culturing with serum free culture., Conclusion: Expression of two types of CNTF in ARPE-19 cells gets prepared for gene therapy research of retinitis pigmentosa.

Objective: To elucidate the difference in the pathogenesis between strabismic amblyopia and anisometropic amblyopia., Methods: Using an EPI gradient echo sequence in 1.5 T MRI and visual electrophysiological system, the pattern visual evoked potentials and calcarine activation by monocular viewing of check-board pattern with reversal were examined in 18 strabismic amblyopes and 15 anisometropic amblyopes. The calcarine activation in terms of binocular voxels index and dependence on the spatial frequency of the stimuli were compared. The correlation between PVEP P(100) latency and activation intensity was also analyzed., Results: The binocular voxels index was lower in the strabismic amblyope than that in the anisometropic amblyope. The calcarine activation from amblyopic eyes in strabismic amblyopes was more suppressed at higher spatial frequencies (1, 2 c/d); while that from amblyopic eyes in anisometropic amblyopes was more suppressed at all spatial frequencies (0.25, 0.5, 1 and 2 c/d). Inverse correlations existed between PVEP P(100) latency and activation intensity in two types amblyopia (P < 0.05)., Conclusions: The binocular interaction is not equal in these two different types of amblyopia. Meanwhile, the amblyopia-related deficits in the low and high-spatial-frequency pathway of visual system are not similar between these two different types of amblyopia.

Objective: To investigate a high molecular weight fluorescein angiography in the application of retinal neovascularization model in mouse., Methods: retinal neovascularization model was induced by exposure mouse to an environment containing high concentration of oxygen. High molecular weight fluorescein isothiocyanate dextran were perfused through the left ventricle directly, then the mouse eyes were enucleated and fixed with 4% paraformaldehyde. The retina was separated from the eyecup and flat mounting was performed on a gelatin coated slide. The vasculature was examined under fluorescent microscope., Result: The whole retinal vasculature was clearly visualized under fluorescent microscope. By focusing on different layer of the tissue, superficial, deep vascular plexus and connecting vessels also could be distinguished. The neovascular response occurred at the junction between the vascular and the avascular retina., Conclusion: High molecular weight fluorescein angiography can be applied for retinal neovascularization evaluation.

Objective: To study the structure and three-dimensional distribution of extraocular muscle Pulley in orbit., Methods: 5 fresh cadaver orbits were fixed in situ and serially sectioned at 4 microm thickness. Every nearby sections were stained using Masson's trichrome, Van Gieson'stain and immunohistochemical staining, the stained tissue was examined by gross anatomy and light microscopy., Results: Near the equator of the globe, extraocular muscle Pulleys were at the points where rectus penetrate posterior Tenon's fascia, encircling the rectus orbit side by fiber ring structure. There was Pulley Band among extraocular muscle Pulleys. The main composition of the Pulley and Pulley Band were collagen (I and III type), elastic and smooth muscle., Conclusion: Constitution of Pulley provides dissection basis as the functional origins of the extraocular muscle.

Objective: To analyze the clinical manifestations and the methods and effects of surgical management on Duane's Retraction Syndrome (DRS)., Methods: 67 cases with DRS were summarized retrospectively. The data were recorded and analysed, including sex, age, type, clinical features, surgical methods and the results., Results: 63 cases had only monocular involvement. The number of Type I DRS was 47 cases (35 cases with esotropia, 12 cases with exotropia). 8 cases were Type II DRS with exotropia and 12 cases were Type III DRS (11 of them with exotropia). In 37 cases with upshoot and/or downshoot phenomenon, 31 of them were associated with exotropia. Ipsilateral medial rectus or lateral rectus recession, or bilateral medial rectus recession, improved the head compensation position, narrow palpebral fissure and globe retraction, with improvement or elimination of the deviation. After the operation, 60 cases (90%) showed horizontal tropia less than 10 prism diopters. Upshoot and/or downshoot were improved in all of the 37 cases after recessing medial or/and lateral recti, or simultaneously weakening of the inferior oblique muscle., Conclusion: Weakening medial and/or lateral recti can improve the clinical manifestations of DRS. Upshoot and downshoot are more common in eyes with exotropia. Lateral rectus recession is the main treatment method for relieving upshoot and downshoot in DRS with exotropia. We infer that the upshoot and downshoot phenomenon mainly related to the "bridle" effect. Recession of both horizontal recti can improve the serious clinical manifestations.

In the last 5 years, we witnessed the progress in the basic and clinical research of strabismus and amblyopia in China, which should be attributed to the effective leadership of the Chinese Ophthalmological Society and the efforts of all members of the professional team. We are glad to see the work of our researchers and clinical scientists in the studies on the molecular and neuronal mechanisms of amblyopia, visual developmental plasticity and functional brain imaging of amblyopia, in the studies on the extraocular muscle's pulley and in the studies on the diagnoses and therapies of strabismus and amblyopia, and furthermore, in epidemiological studies of strabismus and amblyopia. We expect more fruits and creative findings in this field in China in the next decade.

Objective: To investigate the stereoacuity before and after superior oblique sagittal transposition in patients with acquired excyclotorsion., Methods: 14 cases of acquired excyclotorsion who had complaints of forward and downward torsional diplopia were treated with superior oblique sagittal transposition. All patients were examined with Titmus test prior and after surgery., Results: Surgical treatment greatly improved torsional diplopia. The stereoacuity improved gradually from 800 to 60 seconds of arc, peripheral to macular stereoacuity, and even foveal stereoacuity., Conclusion: The superior oblique sagittal transposition is an effective method for primary and down gaze acquired excyclotorsion. The operation not only alleviated diplopia in the practical fixation field, but also improved stereoacuity.

Objective: To describe the clinical phenotype in a Chinese family with congenital fibrosis of extraocular muscles and to identify the location of candidate gene of the disease in chromosome., Methods: The clinical feature of all affected members in this family were examined. A genome-wide linkage screening was conducted. Direct genomic sequencing was used to evaluate the candidate gene KIf21A., Results: Four affected members in the pedigree were born with classic phenotype of CFEOM. By linkage analysis the disease gene was mapped to chromosomal region 12p11.2-q12 defined by microsatellite markers D12S1648 and D12S1668. The maximum Lod Score was 2.12 (D12S1090). Direct sequence showed no mutation in all exons and exon-intron boundaries of the candidate gene KIF21A, a polymorphism substitution occurred in the exon 21., Conclusions: The disorder in this family should be referred as CFEOM1 which was inherited as an autosomal dominant trait. The candidate gene was linked to CFEOM1 locus on chromosome 12p11.2-q12, between marker D12S1648 and D12S1668. It's more likely that KIf21A is not the disease causing gene in this family.

Objective: To assess the effects of 20% ethanol used in LASEK on corneal wound healing., Methods: Forty-eight eyes from 24 rabbits were deepithelialized by two techniques. The epithelium were detached with either 20% ethanol (applied for 30 seconds) or mechanical scraping, then ablated was performed. The number of superficial stromal keratocytes was counted and the morphologic changes were observed. Expression of TGF-beta1 and bFGF mRNAs was detected and analyzed by reverse transcription-polymerase chain reaction and immunocytochemical methods at 1, 7, 30 and 90 days after the surgery., Results: One day after the surgery, the expression of TGF-beta1 and bFGF in the keratocytes in both treated groups was lower than that of the normal controls. Seven days after the surgery, the expression of TGF-beta1 and bFGF in both treated groups was greater than that of the normal controls (P < 0.01). The expression in the alcohol-treated group was greater than that of the surgical-treated group (P < 0.01). The expression of TGF-beta1 and bFGF reached the peak 30 days after the surgery, no significant difference was detected between the alcohol-treated and surgical-treated groups. There was no significant difference in expression level between the alcohol-treated and surgical-treated groups 3 months after the surgery; as well as between treated groups and normal group. The amount of TGF-beta1 and bFGF mRNA was positively correlated with the number of keratocytes. The correlation coefficient between TGF-beta1 and bFGF mRNA and the number of the keratocytes was 0.744 (P < 0.01) and 0.738 (P < 0.01) in the alcohol-treated group; and was 0.664 (P < 0.01) and 0.785 (P < 0.01) in the surgical-treated group, respectively., Conclusions: The expression of TGF-beta1 and bFGF mRNA undergo a dynamic process of "decrease-increase-normal". Although ethanol has a slight toxic effect on rabbit epithelial cells, but the effects do not persist over time, therefore, it is relatively safe to use the alcohol treatment in the LASEK.