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AIM: To examine neuroretinal function by using the multifocal electroretinography (mfERG) test in patients with neurofibromatosis type 1 (NF1) without optic pathway gliomas (OPGs). METHODS: This study was conducted on 35 patients (35 eyes) with NF1 and 30 healthy subjects (30 eyes) for the control group. Each subject underwent a complete ophthalmological examination including spectral domain-optical coherence tomography (SD-OCT) and mfERG. The 1.5-Tesla magnetic resonance imaging (MRI) scan of the brain was performed in NF1 patients to assess the presence of OPGs. All participants were recruited having a best corrected visual acuity (BCVA) of no less than 20/20 in each eye. The amplitude and implicit time of the P1 wave (first-order Kernel component) were evaluated on mfERG. Data analysis was carried out in the two central degrees and in the four quadrants from two to 25 degrees of visual field. RESULTS: Statistically significant results were obtained for the P1 wave amplitudes in the 4 quadrants in NF1 patients compared to healthy controls, while the reduction was not significant in the 2 central degrees between the groups. A statistically significant difference was observed among the P1 wave amplitudes as recorded in the 4 quadrants within the NF1 group, with lower amplitudes detected in the nasal quadrants. No differences in the implicit times were recorded in the 2 central degrees and in the 4 quadrants as compared between NF1 patients and controls. CONCLUSION: Impaired neuroretinal function in NF1 patients is expressed in a decreased amplitude of the P1-wave between 2 and 25 central retinal degrees on mfERG. Altered intracellular signal transduction due to abnormal neurofibromin-mediated cyclic adenosine monophosphate (cAMP) generation, can be involved. The possible use of mfERG as subclinical retinal damage indicator has a potential utility in clinical practice for the follow-up of NF1 patients.

AIM: To identify the predictive factors and laser photocoagulation associated with the use of silicone oil as endotamponade during primary diabetic vitrectomy. METHODS: The medical and surgical records of 690 patients (798 eyes) who underwent primary diabetic vitrectomy at a tertiary eye hospital in China from January 2018 to December 2018 were reviewed in this retrospective cohort study. The patients' baseline characteristics and preoperative treatments were recorded. The binary Logistic regression model was used to evaluate the risk factors for the use of silicone oil as endotamponade agent during primary vitrectomy for proliferative diabetic retinopathy (PDR)-related complications. RESULTS: Among 690 patients with mean age of 52.1±10.5y (range: 18-85y), 299/690 (43.3%) were female. The 31.6% of the eyes received preoperative laser treatment, and 72.4% of the eyes received preoperative anti-VEGF adjuvant therapy. Non-clearing vitreous haemorrhage (VH) alone or combined with retinal detachment was the main surgical indication (89.5%) for primary vitrectomy. Silicone oil was used as endotamponade in 313 (39.2%) eyes. Lack of preoperative laser treatment [odds ratio (OR) 0.66, 95% confidence interval (CI): 0.48-0.92; P=0.015] and older age (OR 0.96, 95%CI: 0.95-0.98; P

Primary angle-closure glaucoma(PACG)is an irreversible disease-causing blindness, the damage of optic nerve is caused by elevated intraocular pressure(IOP)as a result of angle-closure. Angle-closure is a fundamental pathologic process in PACG. In addition, PACG is characterized by elevated IOP as a result of mechanical obstruction of the trabecular meshwork by either apposition of the peripheral iris to the trabecular meshwork or by a synechial closed angle. In recent years, with the development of ophthalmic imaging technology, the iris has been recognized as necessary to complement anatomical risk factors in assessing the risk of PACG. In this review, we intend to describe the potential role of the iris in the pathogenesis of PACG, so as to provide new ideas and directions for prevention and treatment of such disease.

AIM:To quantitatively evaluate the macular microvasculature and visual function in patients with macular edema secondary to retinal vein occlusion(RVO)by optical coherence tomography angiography(OCTA)combined with microperimetry. METHODS: Totally 36 patients(36 eyes)with monocular RVO complicated with macular edema were enrolled, including 15 patients(15 eyes)in central retinal vein occlusion(CRVO)group and 21 patients(21 eyes)in branch retinal vein occlusion(BRVO)group(all with superior temporal vein occlusion), 15 age-matched healthy subjects(24 eyes)were included as controls. OCTA was used to scan macular retina in the range of 3mm×3mm in all three groups and measure the vascular density(VD)of superficial capillary plexus(SCP)and deep capillary plexus(DCP), the area of foveal avascular zone(FAZ)and the central retinal thicknes(CRT); the retinal mean sensitivity(RMS)at 10°was measured by MP-3 microperimetry. VD and RMS in BRVO group were further divided into lesion area(superior), non-lesion area(inferior)VD and RMS. The lesion area and non-lesion area of the control group were divided according to corresponding regions of the BRVO group. The changes of above indexes in CRVO group and BRVO group were compared with control group respectively, and the correlation between RMS and VD, CRT and FAZ areas in CRVO group and BRVO group was analyzed.RESULTS:The overall VD(SCP and DCP)in CRVO group were lower than those in control group(t= -2.536, P=0.016; t= -8.834, P

AIM: To explore the value of corneal epithelial thickness parameters in the diagnosis of early keratoconus by Fourier domain optical coherence tomography(FD-OCT).METHODS: Retrospective control study. Patients with early keratoconus who were admitted to the Department of Ophthalmology of the First Affiliated Hospital of Soochow University from January 2015 to October 2020 and patients who received laser refractive surgery for myopia during the same period were included in this study. Using FD-OCT to measure the cornea in circle centralized by the pupil and with diameter of 9mm in the early-keratoconus group and the control group. This was to obtain the thickness parameter of corneal epithelium with diameter of 7mm, the respective averaged thickness value of corneal epithelium and the respective averaged thickness value of the full corneal layer on each of the 25 divisions. The parameter value differences between the early-keratoconus group and the control group were compared, and the diagnosis value of parameters that hold difference was analyzed. RESULTS: The Min-e value in early-keratoconus group was significantly lower than that of the control group. On contrary, the value of Std.Dev, Max-Min-e, and Max-e were significantly higher in early-keratoconus group than that in latter one(all P

Nonarterial anterior ischemic optic neuropathy(NAION)is a group of common optic nerve diseases that seriously endanger visual function. It is resulted from insufficient perfusion of the posterior ciliary artery, which causes acute ischemia, structural and functional disorders of the optic nerve, and ultimately leads to hypopsia and even vision loss. The etiology and pathogenesis of this disease is complex. It is nowadays considered that multiple factors including local anatomy, risk of systemic vascular cause this disease together, which result in no clear, unified and recognized treatment. Early detection, diagnosis and treatment are of great significance in the prognosis of NAION. Possible therapeutic methods include etiological treatment, drug therapy, traditional Chinese medicine(TCM)treatment, combined medication, optic nerve sheath decompression, adjuvant treatments and exosomes. With the continuous development and application of various anti-NAION drugs in recent years, a variety of therapeutic methods have been proposed, especially with the exosomes as the research focus. In order to better treat NAION with improvement of the cure rate and guidance for clinical work, this paper mainly reviews the progress in the treatment of NAION in recent years.

AIM: To analysis the epidemiological and clinical characteristics of ocular trauma in Shaanxi and surrounding areas, and provide research support for the formulation of prevention and treatment measures for ocular trauma. METHODS: Retrospective study. The general data and clinical data of 1 723 unilateral ocular trauma patients(1 723 eyes)admitted to our hospital from January 2 018 to April 2 020 were collected to establish the ocular trauma database and analyzed.RESULTS: Among the 1 723 cases(1 723 eyes)of ocular trauma patients, young and middle-aged patients(20-59 years old)accounted for the majority(1 149 eyes, 66.69%)and mainly were male patients(1 392 eyes, 80.79%), and the vast majority of patients came from rural areas(1 270 eyes, 73.71%)and engaged in manual labor(1 288 eyes, 74.75%). The main causes of ocular trauma were blunt tools(511 eyes, 29.66%), sharp objects(423 eyes, 24.55%), splashing metal(non-metal)foreign bodies(299 eyes, 17.35%), falling(183 eyes, 10.62%), etc. The main places of injury were workplaces(633 eyes, 36.74%), farming places(474 eyes, 27.51%), residential homes(302 eyes, 17.53%), public places(248 eyes, 14.39%), etc. The main type of ocular trauma was open globe injury(1 311 eyes, 76.09%), and the main therapy was surgical treatment(1 638 eyes, 95.07%). Logistic analysis found that age, post-injury visit time, types of ocular trauma, complications of ocular trauma, history of ocular trauma were all important factors influencing prognosis of ocular trauma patients(P

AIM: To develop and evaluate a new fundus image optimization software based on red, green, blue channels (RGB) for the evaluation of age-related macular degeneration (AMD) in the Chinese population. METHODS: Fundus images that were diagnosed as AMD from the Shanghai Changfeng Study database were analyzed to develop a standardized optimization procedure. Image brightness, contrast, and color balance were measured. Differences between central lesion area and normal retinal area under different image brightness, contrast, and color balance were observed. The optimal optimization parameters were determined based on the visual system to avoid image distortion. A paired-sample diagnostic test was used to evaluate the enhancement software. Fundus optical coherence tomography (OCT) was used as the gold standard. Diagnostic performances were compared between original images and optimized images using McNemar's test. RESULTS: A fundus image optimization procedure was developed using 86 fundus images of 74 subjects diagnosed with AMD. By observing gray-scale images, choroid can be best displayed in red channel and retina in green channel was found. There was limited information in blue channel. Totally 104 participants were included in the paired sample diagnostic test to assess the performance of the optimization software. After the image enhancement, sensitivity increased from 74% to 88% (P=0.008), specificity decreased slightly from 88% to 84% (P=0.500), and Youden index increased by 0.11. CONCLUSION: The standardized image optimization software increases diagnostic sensitivity and may help ophthalmologists in AMD diagnosis and screening.

AIM: To discuss the measurement of retinal thickness in each macular region, fixation property, best corrected visual acuity(BCVA), eye axis and equivalent spherical power and treatment time for the children with hyperopia anisometropic amblyopia before and after treatment.METHODS: This study was a prospective longitudinal controlled trial. The subjects were 40 hyperopia anisometropia children aged 4-8 years with monocular amblyopia who had not been treated with amblyopia before diagnosis in our hospital(20 cases of central fixation and 20 cases of paracentral fixation)from August 2018 to August 2019. Atropine mydriatic optometry, fundus macular fixation quality, ocular axis and optical coherence tomography(OCT)retinal thickness were used in the initial diagnosis and 6mo and 1a follow-up. Statistical analysis was used to analyze whether the macular retinal thickness of hyperopia amblyopia had changed in the treatment and the related factors, and whether had differences between different fixation properties.RESULTS: There were significant differences in foveal retinal thickness and nasal retinal thickness of inner ring between central fixation group and paracentral fixation group at different measurement times(before treatment, 6 and 12mo after treatment)(P0.05). With the extension of treatment time, the foveal retinal thickness and the nasal retinal thickness of the inner ring in the central fixation group and the paracentral fixation group became thinner(all P0.05). There were significant differences in ocular axis, BCVA and equivalent spherical power of amblyopia before and after treatment(all P

AIM: To evaluate the differences of macular vascular network measured by optical coherence tomography angiography(OCTA)between severe non-proliferative diabetic retinopathy(S-NPDR)eyes and health eyes, and explore the changes of these OCTA characteristics in patients with S-NPDR before and after panretinal photocoagulation(PRP).METHODS: This was a prospective study including 31 eyes from 18 consecutive patients with S-NPDR and 31 eyes of healthy subjects. We measured macular vascular density and foveal avascular zone(FAZ)area and volume by an OCTA device.RESULTS: Compared to the normal control group, in superficial retinal capillary plexus(SCP), macular vascular density decreased in S-NPDR group, except foveal vascular density unchanged. Consistently, in deep retinal capillary plexus(DCP), macular vascular density was also lower in S-NPDR group. In addition, FAZ area and volume expanded in S-NPDR eyes. At 6mo post-PRP in S-NPDR eyes, foveal SCP and DCP densities increased significantly, while FAZ area and volume decreased. At 3mo post-PRP, only foveal vascular density in DCP increased. The changes of foveal SCP and DCP densities as well as FAZ area and volume were not statically significant at 1mo post-PRP.CONCLUSION: Macular vascular network was impaired in S-NPDR assessed by OCTA. Although OCTA parameters were not significantly affected by PRP in 1 and 3mo period, at 6mo follow-up parameters became significant after PRP.

AIM: To investigate the prevalence and risk factors of pterygium in Zhuang and Miao nationality adults aged 40 and over in Wenshan prefecture, Yunnan Province.METHODS: An epidemiological survey of Zhuang and Miao nationality in Yunnan Province was conducted by using the portable slit-lamp and Keratograph-D eye surface analyzer. The Logistic regression analysis was operated to determine the impact of gender, age, occupation, outdoor activities and nationality on pterygium.RESULTS: Totally 1 239 participants were included from March to November 2019, 437 people had pterygium in one or both eyes, and the total prevalence was 35.27%. Pterygium of both eyes accounted for 59.27% while pterygium of single eye accounted for 40.73%. The prevalence of pterygium was 34.84%(224 people)in Zhuang population and 35.74%(213 people)in Miao population, there was no significant difference between the two groups(P=0.740). According to the result of Logistic regression analysis, opening of meibomian is the influencing factor of pterygium(P=0.019), with OR=1.348. Gender, age, education, outdoor activities, hypertension and eating habits were not the influencing factors of pterygium. Logistic regression was used to analyze the invasion degree of pterygium. The results showed that the height of lacrimal river was the influencing factor of pterygium(P=0.048). The lower the lacrimal river height, the greater the degree of invasion.CONCLUSION: The prevalence of pterygium in Zhuang and Miao nationality aged 40 and over in Wenshan prefecture, Yunnan Province is high, with no significant difference between the two nationalities. The function of meibomian gland, the quality and quantity of tears are related to pterygium.

Brain-derived neurotrophic factor(BDNF)is a basic protein, and a member of neurotrophic factor family, which plays an important role in the development, differentiation and maintenance of neurons. A large number of studies have confirmed that BDNF is involved in the occurrence and development of neurodegenerative diseases such as Parkinson's disease and Alheimer's disease, and has a neuroprotective effect. In the retina, BDNF is mainly produced by retinal ganglion cells, amacrine cells, astrocytes, retinal glial cells(Müller cells)and photoreceptors. In recent years, related studies have found that BDNF is involved in the occurrence and development of glaucoma, diabetic retinopathy(DR)and other ocular diseases, and may have a diagnostic role, which will be beneficial to early intervention of patients to avoid the development of advanced glaucoma or DR. On the other hand, BDNF-based therapies have achieved good results in in vitro and in vivo experiments of glaucoma, DR and amblyopia, which may provide more choices for the treatment of these ocular diseases. In this manuscript, the research progresses of BDNF in ocular diseases in recent years were reviewed.

AIM:To investigate the correlation among corneal densitometry, corneal topographic parameters, and corneal biomechanical properties in keratoconus.METHODS: Retrospective case study. A total of 70 eyes of 48 keratoconus patients were enrolled in this study. Corneal topography were measured using Pentacam, inclding the flat keratometry of anterior cornea(K1), the steep keratometry of anterior cornea(K2), the mean keratometry of anterior cornea(Km), the maximum keratometry of anterior cornea(Kmax), anterior corneal elevation(ACE), posterior corneal elevation(PCE), thinnest corneal thickness(TCT), and the distance from cone to apex(DCA). Corneal optical density of different corneal layers and zones were measured with the Scheimpflug-based Pentacam corneal densitometry module. Corneal biomechanical properties were measured using CorVis ST, inclding time of the first applanation(AT1), length of the first applanation(AL1), velocity of the first applanation(V1), time of the second applanation(AT2), length of the second applanation(AL2), velocity of the second applanation(V2), the highest concavity time(HCT), the highest concavity deformation amplitude(HCDA), the highest concavity radius(HCR), the highest concavity peak distance(HCPD), stiffness parameter applanation 1(SPA1), Ambrósio's relational thickness horizontal(ARTh).RESULTS: Correlation between corneal densitometry and topographic parameters: The corneal densitometry values of the anterior ≤2mm layer correlated with the K1, K2, Km and Kmax values positively(r=0.291, 0.315, 0.315, 0.387; P=0.015, 0.008, 0.008, 0.001). The corneal densitometry values of the anterior ≤2mm, anterior >2 and ≤6mm, total ≤2mm, total >2 and ≤6mm, and posterior >2 and ≤6mm layers correlated with the anterior corneal elevation positively(r=0.465, 0.302, 0.317, 0.291, 0.335; P2 and≤6mm, posterior >2 and ≤6mm, and total >2 and ≤6mm layers all correlated with AL1 negatively(r= -0.284, -0.290, -0.245, -0.326, -0.282, -0.395, -0.310; P=0.017, 0.015, 0.041, 0.006, 0.018, 0.001, 0.009). The corneal densitometry values of central ≤2mm, central >2 and ≤6mm, and posterior >2 and ≤6mm layers all correlated with AL2 negatively(r= -0.246, -0.256, -0.256; P =0.041, 0.032, 0.032). The corneal densitometry values of anterior ≤2mm layer correlated with HCR negatively(r= -0.308, P=0.010). The corneal densitometry values of central ≤2mm, posterior ≤2mm, and certral >2 and ≤6mm layers all correlated with HCT negatively(r= -0.292, -0.340, -0.262; P=0.014, 0.004, 0.028). The corneal densitometry values of anterior ≤2mm, total ≤2mm, and posterior >2 and ≤6mm layers all correlated with ARTh negatively(r= -0.430, -0.293, -0.319; P

AIM: To demonstrate an improved surgical technique of whole piece consecutive internal limiting membrane (ILM) peeling without preservation of the epi-fovea to treat high myopic foveoschisis (MF). METHODS: A 23-gauge 3-port pars plana vitrectomy was performed on 16 patients with high MF. A parallel arc line along the vascular arcades was scraped out with a curved membrane scraper DSP. Next, an ILM forceps was used to catch hold of the incisal edge of the ILM flap, and the action of releasing and separating was subsequently taken toward the direction of the macular fovea. Next, the ILM forceps was used to grasp the released area, and the whole area coherent ILM peeling covering the macular fovea was implemented thereafter. Finally, the ILM was folded backwards and peeled off in the arc direction. RESULTS: At the final visit, the average central macular thickness decreased remarkably from 423.76±177.67 to 178.24±66.21 µm. The mean logarithm of the minimum angle of resolution best-corrected visual acuity of 1.37±0.59 was significantly alleviated to 0.74±0.59. CONCLUSION: The wide range of whole piece consecutive ILM peeling without preservation of the epi-fovea is proven to be effective and significantly reduced the occurrence of retinal tear and macular hole.

AIM:To investigate the clinical efficacy and safety of trans-epithelial accelerated corneal collagen cross-linking in the treatment of progressive keratoconus.METHODS: A prospective before-after self-control study. A total of 47 eyes of 37 patients with progressive keratoconus who underwent trans-epithelial accelerated corneal collagen cross-linking in our hospital from August 2016 to November 2019 were collected. Uncorrected visual acuity(UCVA), best corrected visual acuity(BCVA), refractive status, corneal transparency, maximum keratometry value of the anterior corneal surface, thinnest corneal thickness, corneal endothelial cell counts and intraocular pressure(IOP)were analysed preoperatively and at 1, 3, 6 and 12mo postoperative.RESULTS: UCVA of patients 1, 3, 6 and 12mo after surgery was higher than that before surgery, but there was no difference(F=1.372, P=0.261). BCVA at 1, 3, 6 and 12mo after surgery was higher than that before surgery, the difference was statistically significant(F=3.308, P=0.019). There were no differences in the spherical and cylindrical power, Kmax and thickness of the thinnest point of cornea at 1, 3, 6 and 12mo postoperatively compared with those before surgery(F=0.293, 1.378, 2.448, 1.970; P=0.881, 0.258, 0.061, 0.116). There was no difference in corneal endothelial cell counts between 1mo after surgery and before surgery(t=1.156, P=0.25). There was no difference in IOP at all postoperative time points compared with that before surgery(F=1.221, P=0.321). The corneal Haze(grade 1-2)appeared in 7 eyes after surgery, and subsided in 5 eyes from 3-6mo after surgery, and the corneal transparency recovered. The corneal nebula remained in 1 eye, and the corneal central stroma linear opacity existed in 1 eye, but the visual acuity of both eyes was not affected.CONCLUSION: Trans-epithelial accelerated corneal collagen cross-linking can significantly improve BCVA, stabilize refractive status, corneal morphology and thickness, prevent or delay the progression of keratoconus, and enable patients to obtain better visual function. At the same time, the operation time is short, postoperative complications are less, and the operation has good safety.

Diagnosis of early keratoconus(KC)contributes to identifying potential patients before typical clinical symptoms. It also contributes to timely intervention of the progress of disease and improvement of long-term prognosis. Hence, it is crucial to prevent iatrogenic corneal ectasia and reduce the burden of keratoplasty. There are diverse kinds of early KC diagnosis techniques, including corneal topography, corneal aberrations, epithelial and corneal thickness measurement, corneal confocal microscopy, corneal biomechanics, and genetic examination. Since it is often difficult to ensure sufficient sensitivity and specificity with single technique, multiple techniques are beneficial to evaluate the cornea comprehensively, which may become the development tendency of early KC diagnosis in the future.

AIM: To study the braking effectiveness of artesunate on transforming growth factor (TGF)-β2 mediated epithelial-mesenchymal transition (EMT) in retinal pigment epithelium (RPE) in vitro. METHODS: The fostered ARPE-19 cells were processed with artesunate alone or combined with the TGF-β2. The CCK-8 examination was utilized to test the cell propagation. Cell migration was detected by scratch as well as the Transwell examination. The EMT characters and activation of PI3K/Akt signal channel were estimated by Western blotting and immunofluorescence. The Western blotting was utilized in order to confirm the vitreous of controls as well as patients with proliferative vitreoretinopathy (PVR) were collected and the levels of PI3K, phospho-PI3K, Akt. RESULTS: Disposal of ARPE-19 cells with artesunate (50-150 μmol/L) obviously suppressed their propagation and immigration, which dependent on the concentration and time. Artesunate suppressed the EMT which was induced by TGF-β2 in ARPE-19 cells through sustaining the expression of vimentin and α-SMA through the suppression of PI3K, phospho-PI3K, phospho-Akt and Akt. Levels of PI3K, phospho-PI3K, AKT and phospho-Akt was increased in the vitreous in PVR (P

Age-related macular degeneration(ARMD)is a main cause of irreversible visual impairment in the elderly. The major pathological features are drusen formation, macular pigment disorder, geographic atrophy and abnormal neovascularization. Retinal pigment epithelium(RPE)function is impaired in ARMD. Endoplasmic reticulum(ER)is an organelle in eukaryotes responsible for protein synthesis, modification, integration and quality control. ER also participates in the maintenance of calcium homeostasis and lipid biosynthesis. Stimuli from the external and internal environment may trigger ER stress and therefore activate the intracellular signal transduction pathway-the unfolded protein response(UPR), to restore cell homeostasis. However, prolonged ER stress may lead to apoptosis. The pathogenesis of ARMD has not been fully elucidated, nevertheless, compelling evidence demonstrates that ER stress is involved. In this article, we summarize recent advances in UPR pathways, as well as the role of ER stress in the physiological function of RPE and in the pathogenesis of ARMD.

AIM:To compare the effect of comprehensive treatment in children with anisometropia and strabismus amblyopia.METHODS: Prospective study. Forty-six individuals(mean age 9±3 years old, 26 males, 20 females)with previously untreated monocular amblyopia were recruited in our hospital from July 2018 to January 2020. There were 23 patients with strabismus monocular amblyopia(mean age 9±3 years old, 12 males, 11 females)and 23 patients with anisometropia monocular amblyopia(mean age 9±3 years old, 14 males, 9 females). The best corrected visual acuity(Tumbling E Chart)and stereopsis(Titmus)were measured before and after a 6mo period of comprehensive treatment(refractive correction, patching and precision eyesight training). The differences of monocular visual benefits(visual acuity)and binocular visual benefits(stereopsis)between two groups before and after treatment were compared. RESULTS: Before treatment, there was no significant difference of best corrected visual acuity between anisometropia amblyopia and strabismus amblyopia(t= -0.475, P>0.05), but the stereopsis of strabismus amblyopia was significantly lower than that of anisometropia amblyopia(t= -3.919, P0.05). After 6mo treatment, there was a significant difference in visual acuity benefits between anisometropia amblyopia and strabismus amblyopia(t= -2.353, P

AIM: To evaluate the ophthalmic manifestations, radiographic features, and prognosis of Chinese patients with primary orbital mesenchymal chondrosarcoma (MCS). METHODS: The study included 6 cases with primary orbital MCS treated at Tianjin Eye Hospital from January 2009 to December 2019. Patitent ophthalmic manifestations, radiographic features, diagnosis, pathology, therapeutic regimens, and prognosis were retrospectively reviewed. RESULTS: Six patitents with primary orbital MCS were identified. The mean age at the first visit was 33y (range, 25-42y). All six patients displayed manifestations of exophthalmos, diplopia, limitation of eye displacement, upper eyelid oedema, decreased visual acuity and ptosis. The mean disease history and range were 5 and 2-8mo, respectively. The tumors were located in the superonasal extraconal compartment (2/6, 33.3%), intraconal compartment (2/6, 33.3%), and bitemporal extraconal compartment (2/6, 33.3%), respectively. Radiographic features were a well-defined, orbital mass with calcification and ossification on computed tomography (CT), and marked heterogenous enhancement on dynamic magnetic resonance imaging (MRI). Five patients were treated with tumor resection and one patient received orbital exenteration. Five patients in the cohort received postoperative radiation therapy, two patients received chemotherapy, and one patient did not receive postoperative adjuvant therapy because he refused. The histopathologic classification revealed a tumour composed of a mixture of mature chondroid tissue surrounded by small, round, and undifferentiated mesenchymal cells. Immunohistochemistry revealed Bcl-2, vimetin, CD99, and S-100 were expressed were expressed. After surgeries, two patients have developed a local recurrence. The median recurrence time of 58mo (52-64mo). One patient had distant recurrence included the lungs occurred 52mo after the initial surgery. CONCLUSION: The possibilty of orbital MCS need to be considered when a painless, slowly growing orbital mass with calcification and ossification. From our experience, trimodality treatment of radiation therapy, chemotherapy and surgery maybe the best option. Orbital MCS has a high tendency for late recurrence, regular long-term follow-up after complete excision is mandatory.

AIM: To evaluate the visual quality of patients with high myopia complicated with cataract after implantation of trifocal intraocular lens by OPD-Scan Ⅲ aberration analyzer.METHODS: Totally 32 patients(38 eyes)with high myopia complicated with cataract who underwent femtosecond laser assisted cataract phacoemulsification combined with trifocal intraocular lens implantation in Foshan Aier Eye Hospital from June 2018 to December 2020 were selected. Uncorrected distance visual acuity(UCDVA), uncorrected intermediate visual acuity(UCIVA)and uncorrected near visual acuity(UCNVA)were compared before, and 1wk, 3mo after surgery; OPD-Scan Ⅲ aberration analyzer measured objective visual quality before, and 1wk and 3mo after surgery. RESULTS: There were significant differences in UCDVA, UCIVA and UCNVA before, and 1wk, 3mo after operation(P

AIM: To investigate the effects of long-term orthokeratology lens wearing on corneal morphology, corneal biomechanics and objective visual quality.METHODS: A retrospective study was conducted to collect 33 myopic patients(60 eyes), including 19 males(35 eyes)and 14 females(25 eyes), mean age 11.80±1.51 years old, with an average equivalent spherical lens of -3.25±0.69D, who had been wearing orthokeratology lens for 2a from October 2019 to December 2020 in our hospital. Relevant data were collected before wearing and 2a after wearing. The radius of curvature(ARC and PRC), the thickness of the thinnest cornea(THP)and the index of comprehensive deviation analysis of corneal dilation(BADD)were measured by Pentacam anterior segment analysis system. Corvis ST biomechanical analyzer measured non-contact biomechanical corrected intraocular pressure(blOP), maximum deformation amplitude(DA), maximum reverse radius(HCR), ratio of deformation amplitude between apex and 1mm(DR), hardness parameters(SPA1), and corneal biomechanical parameters(CBI). The biomechanical index(TBI)of CT scan was obtained by the combined diagnosis system of Pentacam and Corvis ST. OQAS-II objective visual quality analysis system measured modulation transfer function cutoff frequency(MTF cutoff), Stryl ratio(SR), objective scattering coefficient(OSI)and OV value(OV100%, OV20% and OV9%). The above parameters were compared before and continuously wearing orthokeratoscope for 2a. RESULTS: After 2a of wearing orthokeratology, ARC increased, THP decreased, and BADD increased(t=-9.38, 2.85, -13.08; all P0.05). DA increased and HCR decreased compared with before wearing orthokeratology lens(t=-2.37, 2.28; all P0.05). SR was higher than before, OV20% and OV9% were lower than before(t=-5.31, 8.37, 2.34; all P0.05).CONCLUSION: Long-term wearing of orthokeratology lens changed the morphology of the anterior corneal surface, but had no significant effect on the corneal biomechanics, and the objective visual quality of patients was improved during the day, but decreased at night.

AIM: To describe the clinical heterogeneity of patients with novel mutations in BEST1. METHODS: All the members in the two Chinese families underwent detailed clinical evaluations including best-corrected visual acuity, slit-lamp examination, applanation tonometry, and dilated fundus examination. Fundus autofluorescence, fundus fluorescein angiography, spectral-domain optical coherence tomography, electrooculography, and electroretinogram were also performed. Genomic DNA was extracted from venous blood for all the participants. The targeted next-generation sequencing of inherited retinal disease-associated genes was conducted to identify the causative mutation. RESULTS: A novel BEST1 missense mutation c.41T>C (p.Leu14Ser) was identified in Family 1. It was co-segregated with the phenotype of best vitelliform macular dystrophy (BVMD) and bioinformatics analysis confirmed it was harmful. Another novel BEST1 frameshift mutation c.345_346insGGCAAGGACG (p.Glu119Glyfs*116) and a novel USH2A missense mutation c.12560G>A, p.Arg4187His were identified in family 2 with retinitis pigmentosa (RP), which might interact and lead to the phenotype of RP. CONCLUSION: Two novel mutations in the BEST1 gene in two unrelated families with distinct phenotypes and BEST1 mutation accompanied with USH2A mutation would result in RP, which could be enormously helpful in understanding the pathogenesis of the inherited retinal disease caused by a BEST1 mutation.

AIM: To investigate the changes of tear film function and symptoms of dry eye in patients with diabetic peripheral neuropathy(DPN).METHODS: Retrospective case-control study was conducted. A total of 59 patients(59 eyes)with tear film abnormalities who were diagnosed with type 2 diabetes mellitus(T2DM)were divided into group T2DM(31 cases, 31 eyes)and group DPN(28 cases, 28 eyes)depending on the presence or absence of diabetic peripheral neuropathy. Patients at the Department of Ophthalmology who met the criteria of tear film abnormalities and without diabetes were selected as the non-T2DM group(33 cases, 33 eyes). All subjects were completed the Ocular Surface Disease Index(OSDI), and underwent fluorescein breakup time test(BUT), fluorescein staining(FL), Schirmer Ⅰ test(SchirmerⅠ)and infrared meibomian gland photography.RESULTS: A statistically significant difference was observed among the three groups for the BUT values(F=9.43, P0.05). There was statistically difference among the three groups for meibomian gland loss scores(χ2=8.433, P0.05), meanwhile between DPN group with non-T2DM group or T2DM group, the differences were statistically significant(P

AIM: To compare the therapeutic effects of high-intensity focused ultrasound cycloplasty(UCP)and cyclocryotherapy on refractory glaucoma.METHODS:This retrospective study included 45 patients(81 eyes)with refractory glaucoma admitted to the hospital between January 2017 and December 2020. According to the treatment method, patients enrolled were divided into cyclocryotherapy group(22 patients, 40 eyes)and high-intensity UCP group(23 patients, 41 eyes). Changes in intraocular pressure at 1d, 1wk, 1 and 3mo after operation were compared between the two groups. The Numerical Rating Scale(NRS)was used to evaluate eyeball pain. Surgical results and complications in the two groups were compared. RESULTS:The total effective rate of operation in the high-intensity UCP group was significantly higher than that in the control group(P

AIM: To investigate the therapeutic effect of femtosecond laser-assisted cataract surgery(FLACS)in eyes with shallow anterior chamber depth.METHODS: Totally 60 eyes of 55 cataract patients with shallow anterior chamber who received cataract phacoemulsification in Tangshan eye hospital from November 2020 to February 2021 were selected, and divided into two groups according to the surgical methods on patient's subjective willingness: Patients who received FLACS were assigned to the FLACS group(28 patients, 30 eyes), and patients who received conventional Phaco(27 patients, 30 eyes)were assigned to the Phaco group. Preoperative general conditions, cumulative dissipated energy(CDE), effective phacoemulsification time(EPT), postoperative best corrected visual acuity(BCVA), uncorrected visual acuity(UCVA), endothelial cell loss rate(ECL), central macular thickness(CMT)and complications were compared and analyzed.RESULTS:There was no significant difference in preoperative general data between the two groups(P>0.05). In both groups, UCVA at 1d, 1wk and 1mo after surgery and BCVA at 1wk and 1mo after surgery were better than those before surgery, and at 1d after surgery, UCVA in FLACS group was better than that in Phaco group, the difference was statistically significant(P0.05).CONCLUSION:FLACS is safe and effective in patients with shallow anterior chamber cataract, which can significantly reduce the rate of endothelial cell loss, quickly restore vision, reduce the incidence of complications, and has no significant effect on macula.

AIM: To investigate the current quality of life in children with amblyopia and its influencing factors.METHODS: Cross-sectional study. Using random sampling method, 178 children with amblyopia were selected as the research objects, and the Chinese version of the Universal Core Scale of Children's Quality of Life was used to investigate the research objects. The impact of amblyopia on children's quality of life was analyzed. RESULTS:The quality of life score of children with amblyopia was(77.23±15.52)points. The results of multiple linear regression showed that parental education, left eye best-corrected visual acuity, right eye corrected visual acuity, coverage, premature delivery, hypoxia at birth and delivery way were the main factors affecting the quality of life of amblyopic children. It can explain 38.6% of the variance in the quality of life of children with amblyopia(F=15.242, P

AIM: To establish a rabbit model with chronic condition of retinal neovascularization (RNV) induced by intravitreal (IVT) injection of DL-2-aminoadipic acid (DL-AAA), a retinal glial (Müller) cell toxin, extensive characterization of DL-AAA induced angiographic features and the suitability of the model to evaluate anti-angiogenic and anti-inflammatory therapies for ocular vascular diseases. METHODS: DL-AAA (80 mmol/L) was administered IVT into both eyes of Dutch Belted rabbit. Post DL-AAA delivery, clinical ophthalmic examinations were performed weekly following modified McDonald-Shadduck Scoring System. Color fundus photography, fluorescein angiography (FA), and optical coherence tomography (OCT) procedures were performed every 2 or 4wk until stable retinal vascular leakage was observed. Once stable retinal leakage (12wk post DL-AAA administration) was established, anti-vascular endothelial growth factor (VEGF) (bevacizumab, ranibizumab and aflibercept) and anti-inflammatory (triamcinolone, TAA) drugs were tested for their efficacy after IVT administration. Fluorescein angiograms were scored before and after treatment following a novel grading system, developed for the DL-AAA rabbit model. RESULTS: Post DL-AAA administration, eyes were presented with moderate to severe retinal/choroidal inflammation which was accompanied by intense vitreous flare and presence of inflammatory cells in the vitreous humor. Retinal hemorrhage was restricted to the tips of neo-retinal vessels. FA revealed maximum retinal vascular leakage at 2wk after DL-AAA injection and then persisted as evidenced by stable mean FA scores in weeks 8 and 12. Retinal vascular angiographic and tomographic features were stable and consistent up to 36mo among two different staggers induced for RNV at two different occasions. Day 7, mean FA scores showed that 1 µg/eye of bevacizumab, ranibizumab, aflibercept and 2 µg/eye of TAA suppress 65%, 90%, 100% and 50% retinal vascular leakage, respectively. Day 30, bevacizumab and TAA continued to show 66% and 44% suppression while ranibizumab effect was becoming less effective (68%). In contrast, aflibercept was still able to fully (100%) suppress vascular leakage on day 30. On day 60, bevacizumab, ranibizumab and TAA showed suppression of 7%, 12%, and 9% retinal vascular leakage, respectively, however, aflibercept continued to be more effective showing 50% suppression of vascular leakage. CONCLUSION: The DL-AAA rabbit model mimics RNV angiographic features like RNV and chronic retinal leakage. Based on these features the DL-AAA rabbit model provides an invaluable tool that could be used to test the therapeutic efficacy and duration of action of novel anti-angiogenic formulations, alone or in combination with anti-inflammatory compounds.

AIM: To explore the effects of different intensity aerobic exercises on macular retinal vascular density in patients with primary open angle glaucoma(POAG). METHODS: Prospective case-control study, 88 eyes of 48 patients with POAG diagnosed in our hospital from January 2019 to April 2021 were included(POAG group), 43 cases(86 eyes)were included in the normal control group(control group). The fundus photographic examination without mydriasis was performed with a mydriatic fundus camera, and the operation and film reading were carried out by a special ophthalmologist. Macular vascular density was measured by macular vascular segmentation method. According to macular vascular density, 48 patients with POAG were divided into low vascular density group and high vascular density group, with 24 cases in each group. 48 patients with POAG were instructed to perform treadmill load exercise to compare the vascular density levels in macular area of patients with high intensity(76%-87% HRmax), moderate intensity(64%-75% HRmax)and low intensity(52%-63% HRmax).RESULTS: The vascular density in macular area of control group was significantly higher than that of POAG group; Compared with the high vascular density group, the age and systolic blood pressure were significantly higher in the low vascular density group, and the body weight was significantly lower; In both low and high vascular density groups, the retinal vascular density of macular area under moderate intensity aerobic exercise was significantly higher than that of low intensity and high intensity aerobic exercise; Systolic blood pressure and aerobic exercise were the influencing factors of vascular density in macular area; the above results showed statistically significant differences(P

AIM: To assess the effectiveness of core vitrectomy-phacoemulsification-intraocular lens (IOL) implantation-capsulo-hyaloidotomy in treating phakic eye at least 1mo after the onset of malignant glaucoma. METHODS: A retrospective analysis were performed on malignant glaucoma patients treated in Zhongshan Ophthalmic Center between 2016 and 2018. Demographic and clinical data were described. The preoperative and postoperative visual acuity (VA), intraocular pressure (IOP), number of IOP-lowering medications used, and anterior chamber depth (ACD) of the case series were compared by Wilcoxon signed-rank test. RESULTS: Thirteen phakic eyes with long time intervals between onset and surgery were identified in this case series. Core vitrectomy-phacoemulsification-IOL implantation-capsulo-hyaloidotomy reduced the IOP (P=0.046) and the number of IOP-lowering medications used (P=0.004), deepened the ACD (P=0.005). Complete success was achieved in 38.5% of the eyes, and anatomical success was achieved in 100% of the eyes without any recurrence. The only postoperative complication observed is corneal endothelial decompensation. It occurred in two cases. CONCLUSION: Core vitrectomy-phacoemulsification-IOL implantation-capsulo-hyaloidotomy is safe and effective for treatment of long onset phakic malignant glaucoma.

Proliferative vitreoretinopathy(PVR)is a eye disease characterized by the formation of epiretinal membranes(ERM)composed of extracellular matrix(ECM)and various types of cells in the vitreous and/or the surface of the retina through the wound repair and fibrotic process. ERM shrinks to form retinal folds and stretches the retina to cause retinal detachment(RD). Epithelial-mesenchymal transition(EMT)of retinal pigment epithelial(RPE)cells and accumulation of ECM are considered to be the main pathological mechanisms for the formation of ERM. RPE cells undergo a process named EMT induced by transforming growth factor-β(TGF-β), by which differentiated epithelial cells go through epithelial phenotypic loss, the weakness of cell-cell contact and mesenchymal phenotype expression. Fibroblast-like cells differentiated from mesenchymal cells produce ECM and other components, which forms ERM together with glial cells and fibroblasts, etc. Recent studies indicated a lot of cytokines/growth factors, transcriptional factors, and microRNA(miRNA)regulate the development of EMT in RPE cells, in which miRNA is a novel and powerful regulatory gene and plays a critical regulatory role in the EMT process of PVR. This review focuses on the current understandings of the mechanism and the interventional treatments of miRNA in PVR.

AIM: To determine the role of heparanase-1 (HPSE-1) in orbital rhabdomyosarcoma (RMS), and to investigate the feasibility of HPSE-1 targeted therapy for RMS. METHODS: Immunohistochemistry was performed to analyze HPSE-1 expression in 51 cases of orbital RMS patients (including 28 cases of embryonal RMS and 23 cases of alveolar RMS), among whom there were 27 treated and 24 untreated with preoperative chemoradiotherapy. In vitro, studies were conducted to examine the effect of HPSE-1 silencing on RMS cell proliferation and tube formation of human umbilical vein endothelial cells (HUVECs). RD cells (an RMS cell line) and HUVECs were infected with HPSE-1 shRNA lentivirus at a multiplicity of infection (MOI) of 10 and 30 separately. Real-time PCR and Western blot were applied to detect the mRNA and protein expression levels of HPSE-1. Cell viability of treated or control RD cells was evaluated by cell counting kit-8 (CCK-8) assay. Matrigel tube formation assay was used to evaluate the effect of HPSE-1 RNAi on the tube formation of HUVECs. RESULTS: Immunohistochemistry showed that the expression rate of HPSE-1 protein was 92.9% in orbital embryonal RMS and 91.3% in orbital alveolar RMS. Tissue from alveolar orbital RMS did not show relatively stronger staining than that from the embryonal orbital RMS. However, despite the types of RMS, comparing the cases treated chemoradiotherapy with those untreated, we have observed that chemoradiotherapy resulted in weaker staining in patients' tissues. The expression levels of HPSE-1 declined significantly in both the mRNA and protein levels in HPSE-1 shRNA transfected RD cells. The CCK-8 assay showed that lentivirus-mediated HPSE-1 silencing resulted in significantly reduced RD cells viability in vitro. Silencing HPSE-1 expression also inhibited VEGF-induced tube formation of HUVECs in Matrigel. CONCLUSION: HPSE-1 silencing may be a promising therapy for the inhibition of orbital RMS progression.

Ocular cicatricial pemphigoid(OCP)is a special manifestation of mucosal pemphigoid(mucous membrane pemphigoid, MMP), and the pathogenesis is not clear at present. It can be caused by variety factors such as antigen-antibody reaction, inflammation cell infiltration, the action of various cytokines, elevated calcium ion levels and susceptibility genes. In the early period of diseases, conjunctival present chronic progressive fibrotic inflammation, later the corneal opacity and the neovascularization will eventually lose vision. Therefore, it is particularly important to carry out clinical standardized treatment for OCP patients in a timely manner. To use medicine to control the inflammation and delay the progression of the disease, for example, dapsone, intravenous immunoglobulin(IVIG), rituximab(RTX), tumor necrosis factor antagonists and adrenocorticoids. Surgical treatment can be considered appropriately when OCP patients are complicated by severe trichiasis, corneal disease and cataract.

AIM: To investigate the incidence, risk factors, clinical course, and outcomes of corneal epithelial defects (CED) following vitreoretinal surgery in a prospective study setting. METHODS: This was a post-hoc analysis of all participants in DISCOVER intraoperative optical coherence tomography study. Subjects with CED 1d after surgery without intraoperative corneal debridement was defined as the postoperative CED group. Subjects who underwent intraoperative debridement were defined as intraoperative debridement group. Eyes were matched 2:1 with controls (eyes without postoperative CED) for comparative assessment. The primary outcomes were the incidence of CED on postoperative day one and the incidence of required intraoperative debridement. Secondary outcomes included time to defect closure, delayed healing (>2wk), visual acuity (VA) and presence of scarring at one year and cornea consult. RESULTS: This study included 856 eyes that underwent vitreoretinal surgery. Intraoperative corneal debridement was performed to 61 (7.1%) subjects and postoperative CED developed spontaneously in 94 (11.0%) subjects. Significant factors associated with postoperative CED included prolonged surgical duration (P=0.003), diabetes mellitus (P=0.04), postoperative ocular hypotension (P2wk) was associated with corneal scar formation at the end of the 1y in all epithelial defect subjects (P

AIM: To determine the prevalence of focal lamina cribrosa (LC) defect among patients with pachychoroid disease spectrum (PDS) in the absence of peripapillary retinoschisis. METHODS: This retrospective, cross-sectional study comprised of 180 patients with PDS, including polypoidal choroidal vasculopathy (PCV), central serous chorioretinopathy, and pachychoroidal neovasculopathy. Medical records and optic nerve head evaluations conducted using spectral-domain optical coherence tomography with enhanced depth imaging were reviewed. As a control group, 236 patients who underwent ophthalmologic evaluation for vitreous floaters, without obvious ocular disease, were also included. RESULTS: The mean age of the PDS group, which included 118 male patients (65.6%), was 57.4±11.1y. There was no significant difference between the two groups in age (P=0.710) or sex (P=0.248). Six patients (3.3%) in the PDS group and none in the control group showed focal LC defect (P=0.318). Among the six patients with focal LC defect in the PDS group, four eyes had PCV, one eye was the fellow eye of a PCV eye, and one eye had pachychoroidal neovasculopathy. CONCLUSION: Focal LC defect can be defected in patients with PDS in the absence of peripapillary retinoschisis. However, the prevalence of focal LC defect was not different significantly between PDS patients and those who did not have PDS.

AIM:To investigate changes in the normal intraocular pressure(IOP)fluctuation range after the small incision lenticule extraction(SMILE)in patients with low, moderate and high myopia and to explore new methods for postoperative IOP(IOPpost)correction.METHODS: In this prospective case series study, 79 patients(158 eyes)who underwent SMILE at the Affiliated Hospital of Qingdao University from March 2018 to September 2019 were involved, and they were divided into low myopia(A), moderate myopia(B), and high myopia(C)groups. The 24-hour IOP was measured by the non-contact tonometer(NCT)and Goldmann applanation tonometer(GAT). Spherical equivalent(SE), central corneal thickness(CCT), the horizontal corneal diameter(WTW), corneal curvature, corneal volume(CV), ratio of the central 3-mm diameter CV(CCV3mm)to the total CV, and the ratio of the cutting CV(ΔCV)to the CV were measured 3d preoperatively and 6mo postoperatively. The correlation between the postoperative NCT measurements(NCTpost)and various factors was statistically analysed, and the IOPpost expression model was established by phased multiple linear regression analysis.RESULTS:The differences in IOP measured by NCT and GAT were not statistically significant(P>0.05), but the differences in IOP of the three groups were statistically significant(P

AIM: To explore the effects of ranibizumab and conbercept combined with photodynamic therapy(PDT)on vision and hemorheology of polypoid choroidal vascular(PCV)lesions. METHODS: Prospective research. A total of 120(120 eyes)PCV patients who were admitted to our hospital from 2017-02/2020-06 were enrolled and divided into 61 cases(61 eyes)in the ranibizumab combined with PDT treatment group according to the random number table. Conbercept combined with PDT treatment group of 59 patients(59 eyes), compared the intraocular pressure, best corrected visual acuity(BCVA), central retinal thickness(CRT), blood flow, and the incidence of complications within 3mo of follow-up between the two groups before and after treatment.RESULTS: There was no difference in intraocular pressure, CRT, and BCVA at 1 and 3mo after treatment between the two groups(all P>0.05). The whole blood high shear viscosity and whole blood of the ranibizumab combined with PDT treatment group were 1 and 3mo after treatment. The low-shear viscosity was lower than the conbercept combined with PDT treatment group(all P

AIM: To compare the optic disc microvessel density(MVD)with different degrees of myopia and to evaluate the association of MVD with axial length(AL)and retinal nerve fibre layer thickness(RNFL)by using optical coherence tomography angiography(OCTA).METHODS: Prospective and pathological control study. A total of 94 eyes [31 eyes with mild myopia(SE: +0.50D to -0.50D), 32 eyes with low and moderate myopia(-0.75D≤SE

The incidence of dry eye is increasing year by year, and it has become one of the most common ophthalmic diseases. The main symptoms of dry eye disease are dry, foreign body sensation, burning in eyes, itchy and viscous secretion. These discomforts affect the daily life, efficiency of work and study, mental health and physical function of patients with dry eye. Dry eye is a multifactorial disease of the ocular surface characterized by a loss of homeostasis of the tear film, and accompanied by ocular symptoms, in which tear film instability and hyperosmolarity, ocular surface inflammation and damage, and neurosensory abnormalities play etiological roles. Meanwhile, there are changes in the tissue structure and ocular surface microenvironment of the eyes of patients with dry eye. In view of the fact that dry eye is an important public health problem, which seriously affects people's visual quality and life quality, studying the pathophysiology of dry eye is of great significance for efficient diagnosis, more targeted treatment and reduction of adverse events. This paper reviewed the research progress in the pathophysiology of dry eye in recent years.

AIM: To evaluate foveal vessel density (VD) and foveal thickness using optical coherence tomography angiography (OCTA) in retinopathy of prematurity (ROP) children treated with laser photocoagulation or anti-vascular endothelial growth factor (VEGF) injection. Additionally, we assessed the relationship between foveal microvascular anomalies and different therapies in ROP children. METHODS: This was a single-center, retrospective study of patients with a diagnosis of type 1 ROP. Twenty-three eyes (14 patients) treated with anti-VEGF injection and twenty-nine eyes (17 patients) treated with laser coagulation were included in this study. The foveal VD, inner thickness and full thickness were measured at the central 0°, 2° to 8°, and 8° of the retina (centered on the fovea) using OCTA and cross-sectional OCT, respectively. RESULTS: Foveal VD, inner thickness and full thickness were significantly smaller within the central 8° of the retina in ROP children treated with anti-VEGF injection than in those treated with laser photocoagulation (P=0.013, 0.009, 0.036, respectively). The full thickness was also smaller in the anti-VEGF group than in the laser group at the central 0° of the retina (P=0.010). The grade of foveal hypoplasia is lower in the anti-VEGF group than in the laser group (P=0.045). Multivariable analysis did not find any risk factors associated with visual acuity in our study. CONCLUSION: In children with type 1 ROP, the better structural development of fovea in those who were treated with anti-VEGF injection compared with laser photocoagulation are identified. However, visual acuity outcomes are similar 70mo after the treatments.

AIM: To summarize the data of epidemiological studies on cataract prevalence over 50 years old in urban and rural areas of China from 2000 to 2020, and to analyze the prevalence of cataract and operation rate in China. METHODS: By searching PubMed, EMBASE, Web of Science, Wanfang Data and CNKI, Chinese and English literatures on the prevalence of cataract in China were retrieved, and the relevant characteristic data were extracted. Then, Stata v15SE software was used for Meta-analysis and heterogeneity test. According to the results of heterogeneity, the corresponding effect models were selected to combine the extracted data. RESULTS: A total of 20 studies were included in this study, with a total of 111 434 cases. Meta-analysis showed heterogeneity. According to the random effect model, the overall prevalence of cataract in Chinese people over 50 years old was 27.45%, that in rural was 28.79%, and that in urban was 26.66%. The overall coverage rate of cataract surgery was 9.19%. CONCLUSION: The prevalence of cataract is high in China, and there is still room for improvement in surgical coverage, so it is very important to promote cataract screening and prevention.

AIM: To investigate the difference of the optic vessel density in early primary open angle glaucoma(POAG), ocular high tension subjects and healthy subjects. METHODS: A cross-sectional study. From January 2019 to April 2021, patients were selected in the Department of Glaucoma in Fuzhou Southeast Eye Hospital. There were 45 patients(70 eyes)of early POAG group, including 32 males(49 eyes)and 13 females(21 eyes)with age of 48.50(26.75, 64.50)years. There were 37 patients(65 eyes)of ocular high tension group, including 17 males(29 eyes)and 20 females(36 eyes)with age of 37.00(27.00, 47.00)years. There were 51 patients(94 eyes)of healthy group, including 23 males(39 eyes)and 28 females(55 eyes)with age of 46.00(34.50, 56.50)years. Ophthalmic examinations including best-corrected visual acuity(BCVA), intraocular pressure, central corneal thickness(CCT), mean deviations(MD), retinal nerve fiber layers thickness(RNFL)were measured in three groups. The center area, the inner circle area, the outer circle area, and the whole area of the optic vessel density in three groups were measured via optical coherence tomography angiography(OCTA)device.RESULTS: The difference of the intraocular pressure in early POAG group-ocular high tension group was not significant(H=146.876,P