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To evaluate the risk of AAC and intraocular pressure (IOP) changes in diabetic patients after pupil dilation.This cross-sectional study enrolled 2,287 diabetic patients among community residents in Guangzhou, China. All participants underwent routine pupil dilation unless they had a history of glaucoma. IOP was measured using a non-contact tonometer before and one hour after pupil dilation with tropicamide 0.5% and phenylephrine 0.5% eye drop. The proportion of AAC and changes in IOP after pupil dilation were evaluated.Only one of the 2,287 participants (0.04%) with diabetes developed post-dilation AAC. The mean pre and post-dilation IOP in the right was 16.1 ± 2.7 and 16.5 ± 2.8 mmHg (P 0.001); mean pre and post-dilation IOP in the left was 16.5 ± 2.7 and 16.8 ± 2.8 mmHg (P 0.001). Sixty-one participants (2.7%) showed an increase in IOP ≥ 5 mmHg and 25 participants (1.1%) showed a post-dilation IOP 25 mmHg, including 11 participants (0.5%) who had both an increase in IOP ≥ 5 mmHg and post-dilation IOP 25 mmHg. Lower pre-dilation IOP (OR = 0.827; 95% CI, 0.742-0.922; P = 0.001) and shallower anterior chamber depth (ACD) (OR = 0.226; 95% CI, 0.088-0.585; P = 0.002) were significant risk factors for an increase in IOP ≥ 5 mmHg in multivariate logistic regression analysis.The risk of developing AAC after pupil dilation in diabetic patients was very low. Lower pre-dilation IOP and shallower ACD are risk factors for increased post-dilation IOP.

To investigate the associations of renal function with diabetic retinopathy (DR) and diabetic macular oedema (DMO) in diabetic patients.A total of 1877 diabetic participants aged 30 to 80 years were consecutively recruited between October 2017 and April 2019. The presence of DR, vision-threatening DR (VTDR) and DMO were graded using seven-field fundus photographs. Renal function was defined as normal, mildly impaired or indicative of chronic kidney disease (CKD) based on different estimated glomerular filtration rates (GFR).In the multivariable logistic regression model, decreased GFR was associated with the presence of any DR only in the presence of microalbuminuria (OR = 2.40 for mildly impaired and 3.37 for CKD, all P 0.05), while an impaired GFR was an independent risk factor for VTDR regardless of microalbuminuria status (all P 0.05). The risks of any DR (OR = 1.74 for quartile 2 and 3.09 for quartile 4) and VTDR (OR = 3.27 for quartile 2 and 6.41 for quartile 4) increased gradually along with microalbuminuria quartile (all P 0.05). CKD (OR = 3.07, P = 0.012) and high microalbuminuria (OR = 3.22 for quartile 3 and 5.25 for quartile 4, all P 0.05) were independent DMO risk factors.There is a strong association between GFR and VTDR, whereas the association between GFR and any DR was significant only under the premise of microalbuminuria. High microalbuminuria and CKD were significantly associated with DMO.

To assess changes in intraocular pressure (IOP) 1 hour after pharmacological dilation in eyes treated with laser peripheral iridotomy (LPI) and untreated fellow eyes of primary angle closure suspects (PACS).A prospective randomized, fellow-eye controlled trial.A total of 889 participants with PACS aged 50 to 70 years with LPI in 1 randomly selected eye and a fellow untreated eye were included. All participants underwent comprehensive examinations before and at 2 weeks, 6 months, 18 months, 36 months, 54 months, and 72 months after LPI. The IOP was measured using Goldmann applanation tonometry before and 1 hour after pharmacological dilation.The mean predilation IOP in the untreated eyes was 14.8 ± 2.7 mm Hg, which increased to 16.4 ± 2.7 mm Hg after pharmacological dilation (P.001). The treated and untreated eyes had similar predilation and postdilation IOP (all P0.05). The average postdilation IOP elevation was 1.5 mm Hg in the treated eyes and 1.6 mm Hg in the untreated eye, without significant differences (P = .802). Lower predilation IOP (P.001), smaller AOD500 (P = 0.001), smaller ARA500 (P = .030), smaller TISA500 (P = .043), and larger Iarea (P0.001) were associated with postdilation IOP elevation of 5 mm Hg and greater. Three untreated eyes (1.04 per 1000 pupil dilation) and 1 treated eye (0.34 per 1000 pupil dilation) developed acute angle closure (AAC) after dilation during the 72-month follow-up.Postdilation IOP elevation was similar among treated and untreated eyes, and the risk of developing AAC was very low, even among patients with PACS. Routine LPI before pupil dilation for people with PACS is not recommended.

Introduction To evaluate the incidence, severity, and risk factors of early-onset posterior capsule opacification (PCO) following uneventful phacoemulsification and intraocular lens (IOL) implantation. Methods Patients with cataracts who underwent phacoemulsification and IOL implantation surgery for 3 months from September 2019 to April 2020 were enrolled. All the subjects completed a comprehensive ocular examination. Retroillumination images of the posterior capsule were obtained using a slit lamp with imaging system, and PCO was graded by two ophthalmologists. Univariate and multivariate logistic regression analyses were performed to assess the risk factors for PCO. Results A total of 1039 subjects were enrolled, with mean age 66.68 ± 11.43 years and 42.06% were male. The incidence of early-onset PCO in the 3 months after cataract surgery was 29.93%, and PCO of grade 3 and grade 4 was present in 31 patients (2.98%). Patients with complicated cataract had a higher incidence of PCO than age-related cataract, especially for patients with previous pars plana vitrectomy (PPV) surgery (P

Approximately 10% of cataract patients have a tilt of 7 degrees or greater and decentration of 0.4 mm or greater. Axial length, front curvature radius, lens thickness, and age correlate with tilt and decentration., Purpose: To investigate the characteristics and factors associated with crystalline lens tilt and decentration measured by CASIA2 anterior segment optical coherence tomography. Setting: Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China. Design: Cross-sectional study. Methods: 1097 eyes of 1097 patients who planned to undergo cataract surgery were enrolled. All patients underwent a general ophthalmologic examination. Lens thickness (LT), front curvature radius (FCR), back curvature radius, lens equator diameter (LED), tilt, and decentration of preoperative crystalline lenses were measured by CASIA2. Univariate and multivariate regression analyses were performed to evaluate the relationships between the tilt and decentration of crystalline lens with related factors. Results: The natural crystalline lenses showed a mean tilt of 5.16 degrees toward the inferotemporal direction and a mean decentration of 0.22 mm toward the temporal direction. Of the total 1097 eyes, 119 eyes (10.85%) had a tilt greater than 7 degrees, and 89 eyes (8.11%) had a decentration more than 0.4 mm. Multivariate regression analysis showed that larger decentration, thicker LT, shorter axial length (AL), and FCR were associated with greater lens tilt (P < .001, P = .007, P = .006, and P = .003, respectively). In addition, greater tilt, older and thinner LT were correlated with larger decentration (all P < .001). Conclusions: Preoperative crystalline lens had a certain degree of tilt and decentration in age-related cataract. The greater tilt of the crystalline lens was, the larger decentration of it was. In addition, AL, FCR, LT, and age also correlated with tilt and decentration.

To explore the relationship between serum uric acid (SUA) and retinochoroidal microcirculation in the Chinese population.This prospective cross-sectional study was conducted among the residents of Guangzhou, southern China. A commercially available optical coherence tomography angiography (OCTA) device was used to obtain the superficial vessel density (SVD) and deep vessel density in the retina and the choriocapillaris flow deficit (CFD) in the macular region. Univariable and multivariable linear regression models were used to assess the association of hyperuricemia and SUA levels with OCTA parameters.A total of 638 participants with normal SUA and 296 participants with hyperuricemia were included in the study. Parafoveal SVD was significantly reduced among the participants with hyperuricemia compared to participants with normal SUA (P0.001), while the parafoveal CFD was higher in hyperuricemic participants than those of normal SUA levels (P = 0.007). After adjusting for potential confounders, greater SUA levels was associated with lower SVD (β = -0.078; P0.001) and greater CFD (β = 0.015; P = 0.011). Gender difference analysis indicated that a 10-µmol/L increase in SUA levels among the female participants led to a 0.144 decrease in SVD (P0.001), but it was not statistically significant for the male participants (P = 0.653).An elevated uric acid level and its fluctuations were independently associated with impaired retinal and choroidal microcirculation using OCTA in the study population. Women appear to be more sensitive to high SUA levels than men.Elevating uric acid concentration may play a role in the development and progression of cardiovascular diseases through microvascular alteration, as demonstrated by OCTA parameters.

OBJECTIVES: To explore associations between visual impairment (VI) and mortality in an adult population in urban China. METHODS: The Liwan Eye Study was a population-based prevalence survey conducted in Guangzhou, Southern China. The baseline examination was carried out in 2003. All baseline participants were invited for the 10-year follow-up visit. VI was defined as the visual acuity of 20/40 or worse in the better-seeing eye with habitual correction if worn. Correctable VI was defined as the VI correctable to 20/40 or better by subjective refraction, and non-correctable VI was defined as the VI correctable to worse than 20/40. Mortality rates were compared using the log-rank test and Cox proportional hazards regression models. RESULTS: Of the 1399 participants (mean age: 65.3 ± 9.93 years; 56.4% female) with available baseline visual acuity measurement, 320 participants (22.9%) had VI. After 10 years, 314 (22.4%) participants died. Visually impaired participants had a significantly increased 10-year mortality compared with those without VI (40.0% vs. 17.2%, P

Prcis A data simulation study suggests that prevalence of occludable angle will decrease when the cataract surgical rate increases in particularly when the surgery focuses on 70+ years old. Purpose The purpose of this study was to estimate the effects of cataract surgical rates (CSR) on the prevalence of primary angle-closure glaucoma in the Chinese population. Methods Participants aged 50 years and older from the Liwan Eye Study were included as the study sample. Occludable angle (OA) as a surrogate of primary angle-closure glaucoma was evaluated using static gonioscopy and anterior chamber depth was measured before dilation using A-mode ultrasound. Random sampling was used to generate 50 cohorts with a sample size of 200 for each predefined CSR at 2000, 4000, 6000, 8000, 10,000, 12,000, according to the multinomial distribution. The mean anterior chamber depth and OA rates of each cohort were calculated. Logistic function models of nonlinear least-squares estimation were used to predict the prevalence of OA. Results Data of the right eye from 1280 participants were included. The prevalence of cataract surgery and OA was 2.27% and 11.3%, respectively. The projected prevalence of OA in the cohorts with CSR of 2000, 4000, 6000, 8000, 10,000 and 12,000 was 11.4% [95% confidence interval (CI), 10.8%-12.0%], 11.2% (95% CI, 10.6%-11.9%), 10.9% (95% CI, 10.3%-11.6%), 11.4% (95% CI, 10.8%-12.1%), 10.8% (95% CI, 10.2-11.4%), and 10.1% (95% CI, 9.46-10.7%), respectively. The OA rates decreased remarkably as CSR increased for those aged 70 years and older. Conclusions Our study indicated that with CSR increased, the OA prevalence could decrease remarkably especially in the older population. It is advisable to perform cataract surgery at an appropriate time for patients in their late 60s to 70s with significant cataracts.

PURPOSE To analyze the characteristics and factors associated with intraocular lens (IOL) tilt and decentration after uneventful phacoemulsification with IOL implantation. SETTING Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China. DESIGN Cross-sectional study. METHODS All patients underwent a general ophthalmologic examination and anterior segment photography. IOL tilt and decentration were measured with a second-generation anterior segment optical coherence tomography (Casia2). Univariate and multivariate regression analyses were performed to assess the association between IOL tilt and decentration with ocular biometric and systemic parameters, and the visual acuity. RESULTS A total of 196 eyes of 196 patients were enrolled in this study. IOLs showed a mean tilt of 4.8 degrees toward the inferotemporal direction, and the mean decentration was 0.21 mm. Both eyes presented a mirror symmetry relationship. Twenty-two eyes (11.22%) had a tilt greater than 7 degrees, and 21 eyes (10.72%) had a decentration more than 0.4 mm. Multivariate regression analysis showed previous pars plana vitrectomy (PPV) and short axial length (AL) were associated with greater IOL tilt (P = .014 and P < .001). In addition, long AL, thicker lens, and less capsulorhexis-IOL overlap were positively correlated with decentration (P < .001, P = .029, and P = .026). Corrected distance visual acuity did not directly correlate with IOL tilt and decentration (P = .417 and P = .550). CONCLUSIONS PPV history and short AL were associated with greater IOL tilt, whereas longer AL, thicker lens, and overlarge capsulorhexis contribute to greater decentration. Implantation of toric and multifocal IOLs in these patients should be cautious.

AimsTo investigate the relationship between retinal vessel density and renal function in patients with diabetes mellitus (DM) using non-invasive optical coherence tomographic angiography (OCTA).MethodsThis prospective cross-sectional study recruited ocular-treatment-naïve patients with DM registered in the community of Guangzhou, China. The retinal vessel density of the superficial capillary plexus in the macula was obtained by using swept-source OCTA imaging. The Xiangya equation was used to calculate the estimated glomerular filtrate rate (eGFR). Participants were divided into the following groups by eGFR: no chronic kidney disease (non-CKD), mild CKD and moderate-to-severe CKD (MS-CKD).ResultsA total of 874 patients with DM (874 eyes), with a mean age of 64.8±7.1 years, were included in the final analysis. The vessel density was significantly lower in patients with CKD than in non-CKD patients in a dose–response pattern, with a parafoveal vessel density of 49.1%±2.1% in non-CKD, 48.4%±1.9% in mild CKD and 47.2%±1.7% in MS-CKD (pConclusionRetinal vessel density decreased with renal function impairment, underlining the potential value of OCTA to detect early microvascular damage in the kidney in patients with diabetes.

To evaluate the role of the peripapillary retinal nerve fiber layer (pRNFL) and peripapillary choroidal thickness (pCT) in the development and progression of diabetic retinopathy (DR).This is a cohort study based on the baseline and 2-year follow-up data of the Guangzhou Diabetic Eye Study. Patients with type 2 diabetes mellitus between the ages of 30 and 80 years were recruited from communities in Guangzhou. DR was graded by seven-field fundus photography after dilation of the pupil. pRNFL and pCT were measured via swept-source optical coherence tomography.A total of 895 patients were included in the study; of these, 748 did not have DR at baseline and 147 had DR at baseline. During the 2-year follow-up, 80 developed DR (10.7%), and 11 experienced DR progression (7.5%). After adjusting for confounding factors, a higher risk of incident DR was strongly associated with a lower average thickness of the pRNFL (risk ratio [RR] per 1 SD, 0.55; 95% confidence interval [CI], 0.42-0.72; P0.001) and average pCT (RR per 1 SD, 0.49; 95% CI, 0.34-0.70; P0.001). Adding both metrics to the DR prediction model significantly improved the discriminant ability of the model for incidences of DR (area under the curve increased by 15.38% from 0.673 to 0.777; P0.001).Neurodegeneration shown by the thinning of pRNFL and impaired choroidal circulation shown by the thinning of pCT are independently associated with DR onset, and assessing both metrics can improve the risk assessment for DR incidences.

To investigate the association of body mass index (BMI) and waist-to-hip ratio (WHR) with macular vessel density (VD) and foveal avascular zone (FAZ), using optical coherence tomography angiography (OCTA), in healthy Chinese adults.Cross-sectional study.A total of 1555 Chinese adults aged ≥ 50 years with no history of ocular disease were recruited from communities in Guangzhou, China. The OCTA was performed with a 6 × 6 mm macular angiography model. The FAZ of the superficial capillary plexus (SCP), and VD of SCP and deep capillary plexus (DCP) were calculated. Univariable and multivariable linear regression analyses were used to evaluate the effect of BMI and WHR on VD and FAZ.The VD of the SCP increased as BMI increased, with average measurements of 39.30 ± 2.14 for normal, 39.52 ± 2.07 for overweight, and 39.76 ± 2.03 for obesity (P = .001). The VD of the DCP also increased with increasing BMI (P = .009). Multiple regression models confirmed a positive association between generalized obesity and superficial VD in the whole image (β = 0.350, P = .008), inner circle (β = 0.431, P = .032), and outer circle (β = 0.368, P = .005). After adjusting for confounders, tertile 3 of the WHR level was positively associated with superficial VD (β = 0.472, P = .033) and deep VD (β = 0.422, P = .034) only in the inner circle.Generalized obesity was associated with increased superficial VD, while abdominal obesity was associated with increased superficial and deep VD only in the inner circle. Different manifestations of the retinal microvasculature may reflect distinct roles of body composition on macular vessel alterations and disease occurrence.

IMPORTANCE: The conventional 2.2-mm clear corneal incision is relatively narrow compared with the sleeves of Phaco handpieces, resulting in friction at the incision site and increased risk of incision-related Descemet membrane detachment (DMD). The modified 2.2-mm incision only enlarged internal width to 3.0 mm, forming a trapezoid incision shape, which may reduce the friction of surgical instruments and decrease the risk of incisional DMD. OBJECTIVE: To compare the incidence of incision-related DMD between eyes undergoing modified vs conventional 2.2-mm incision phacoemulsification for hard nuclear age-related cataract. DESIGN, SETTING, AND PARTICIPANTS: This double-masked, parallel randomized clinical trial was conducted from July 22, 2019, to January 22, 2020, at Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China. The study included patients with age-related cataract and nuclear opalescence grade of 4.0 or greater based on the Lens Opacities Classification System III. Patients were enrolled in this study according to the following inclusion criteria: (1) age between 65 to 90 years; (2) pupil size of 6 mm or greater after dilation; (3) Lens Opacities Classification System III nuclear opalescence grade of 4.0 or more; and (4) corneal endothelial cell density greater than 1500 cells/mm(2). INTERVENTIONS: Modified (enlarged internal width to 3.0 mm) or conventional 2.2-mm incision phacoemulsification with intraocular lens implantation. MAIN OUTCOMES AND MEASURES: Incidence of incision-related DMD at postoperative day 1. RESULTS: A total of 130 eyes of 130 patients were randomized into the conventional group (n = 65) or the modified group (n = 65). The mean (SD) age of participants was 74.5 (5.9) years and 74.3 (6.0) years in the conventional and modified groups, respectively. A total of 26 participants in the conventional group (40%) and 27 in the modified group (42%) were men. Compared with eyes in the conventional group, the incidence of DMD in eyes in the modified group was significantly lower at postoperative day 1 (difference, 26.15; 95% CI, 9.60-42.71; P = .003). The difference at postoperative day 7 was 16.92 (95% CI, 2.91-30.94; P = .02). The length of DMD (postoperative day 1: difference, 0.188; 95% CI, 0.075-0.301; P = .002) and maximal corneal thickness at incision site (postoperative day 1: difference, 0.032; 95% CI, 0.006-0.057; P = .02; postoperative day 7: difference, 0.019; 95% CI, 0.003-0.035; P = .02) were lower in the modified group, while visual quality parameter modulation transfer function (postoperative day 1: difference, −0.033; 95% CI, −0.064 to −0.001; P = .04) was higher. No difference was observed between the 2 groups in best-corrected visual acuity, central corneal endothelium loss, or surgically induced astigmatism at any follow-up time. There were no intraoperative complications in the 2 groups. CONCLUSIONS AND RELEVANCE: These findings suggest that modified 2.2-mm trapezoid incision phacoemulsification reduces the incidence of DMD for hard nuclear age-related cataract at postoperative day 1 and might be considered in patients at high risk of incision-related DMD, although the clinical relevance cannot be determined with certainty from this trial. TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT04014699

The purpose is to explore the prediction of epidemiological characteristics of vascular cognitive impairment based on susceptible infectious recovered and immune hosts (SIR) mathematical model and the effect of brain rehabilitation health measurement system on cognitive function of patients. SIR mathematical model was used to predict the epidemiological characteristics of vascular cognitive impairment (VCIND). Then, 60 patients with non dementia vascular cognitive impairment were randomly divided into training group and control group. Both groups were given conventional drug therapy and traditional rehabilitation training. The training group increased brain rehabilitation on this basis. Health measurement system cognitive training, 40 min/time, once a day, 5 times a week for a total of 4 weeks. A simple intelligent mental scale (MMSE), Montreal Cognitive Assessment Scale (MoCA), Barthel Index (BI), and myoelectric evoked potentiometer were used for cognitive function, daily life activity (ADL) ability, and P300 of two groups of patients. assessment. The purpose of this study was to investigate the effects of brain rehabilitation health care measurement system-assisted cognitive training on cognitive function and event-related potential (ERP) P300 in patients with VCIND. The study found that the brain rehabilitation health care measurement system assisted cognitive training can effectively improve the cognitive function of patients with VCIND and their daily activities.

Tritrophic interactions involving a biocontrol agent, a pathogen, and a plant have been analyzed predominantly from the perspective of the biocontrol agent. To explore the adaptive strategies of wheat in response to beneficial, pathogenic, and combined microorganisms, we performed the first comprehensive transcriptomic, proteomic, and biochemical analysis in wheat roots after exposure to Bacillus velezensis CC09, Gaeumannomyces graminis var. tritici, and their combined colonization, respectively. The transcriptional or translational programming of wheat roots inoculated with beneficial B. velezensis showed mild alterations compared with that of pathogenic G. graminis var. tritici. However, the combination of B. velezensis and G. graminis var. tritici activated a larger transcriptional or translational program than for each single microorganism, although the gene expression pattern was similar to that of individual infection by G. graminis var. tritici, suggesting a prioritization of defense against G. graminis var. tritici infection. Surprisingly, pathogen-associated molecular pattern-triggered immunity and effector-triggered immunity made wheat pretreated with B. velezensis more sensitive to subsequent G. graminis var. tritici infection. Additionally, B. velezensis triggered a salicylic acid (SA)-dependent mode of induced systemic resistance that resembles pathogen-induced systemic acquired resistance. Wheat plants mainly depend on SA-mediated resistance, and not that mediated by jasmonic acid (JA), against the necrotrophic pathogen G. graminis var. tritici. Moreover, SA–JA interactions resulted in antagonistic effects regardless of the type of microorganisms in wheat. Further enhancement of SA-dependent defense responses such as lignification to the combined infection was shown to reduce the level of induced JA-dependent defense against subsequent infection with G. graminis var. tritici. Altogether, our results demonstrate how the hexaploid monocot wheat responds to beneficial or pathogenic microorganisms and prolongs the onset of take-all disease through modulation of cell reprogramming and signaling events.

PurposeTo investigate the 5-year changes in static and dynamic anterior segment optical coherence tomography (AS-OCT) parameters and their predictors.MethodsThis was a prospective, population-based cohort study of people aged 50 years and older residing in the Liwan District, Guangzhou, China. Standardised AS-OCT scans were performed in November 2008 and November 2013 under dark and light conditions. Customised software was used to analyse horizontal AS-OCT images. Parameters in dark and measurements of light-to-dark changes were used for analyses.ResultsA total of 186 (71.8%) subjects underwent AS-OCT twice, 5 years apart and were included for analyses. The mean age in 2008 was 64.7±7.0 years, and 60.2% were women. The anterior chamber width (ACW) decreased from 11.74±0.44 mm in 2008 to 11.60±0.37 mm in 2013 (p=0.001). There was a trend towards a decrease in dynamic capacity (light-to-dark changes) in the anterior segment, with decreased iris thickness at 750 µm (ΔIT750), ΔACW, Δ anterior chamber area (ACA) and Δ pupil diameter at 5 years (all pConclusionsAnterior chamber angle width decreased and the amount of light-to-dark changes declined during 5-year follow-up. Subjects with greater height, wider angle width and thicker iris at baseline have greater angle narrowing at follow-up.

Purpose The purpose of this study was to investigate the change in axial length (AL) after cataract surgery measured by swept source optical coherence tomography (IOLMaster 700), and explore ways to eliminate this AL measurement error in pseudophakic eyes. Methods Patients with cataract who underwent unilateral phacoemulsification with four types of intraocular lens (IOLs) implantation (Asphina 509M, Tecnis PCB00, enVista MX60, and Acrysof SN60WF) were enrolled. Bilateral AL measurements were performed before and 1 month after cataract surgery utilizing IOLMaster 700. The postoperative AL of the operated eye was evaluated using three different modes (phakic, aphakic, and pseudophakic), and the fellow eye was measured by phakic mode. Associations among the AL change and cataract grade, lens thickness, preoperative AL, or refractive index of IOL were investigated using stepwise multivariate linear regression. Results A total of 305 patients with cataract with mean age of 65.97 ± 13.39 years were recruited. The mean postoperative AL was 0.10 mm and 0.21 mm shorter than the pre-operative AL utilizing pseudophakic and phakic modes, respectively (P < 0.001). No significant difference was observed between pre-operative and postoperative AL using aphakic mode (P = 0.264). There were no significant associations among AL change in pseudophakic eye and cataract grade, lens thickness, pre-operative AL, or refractive index of IOL (P > 0.05). Conclusions A correction factor of 0.10 mm is suggested to eliminate AL measurement error of IOLMaster 700 in pseudophakic eyes before further improvement of AL measurement accuracy. Translational Relevance Our study may help to eliminate the AL measurement error of IOLMaster 700 in pseudophakic eyes.

Purpose The purpose of this study was to evaluate the effect of high myopia on anterior angle change after pharmacologic mydriasis in patients with cataract using swept-source anterior segment optical coherence tomography (SS-ASOCT). Methods This prospective cross-sectional study continuously recruited patients with cataract aged 40 years and older during the period August 2019 to August 2020. The anterior segment parameters, including central corneal thickness (CCT), anterior chamber depth (ACD), angle opening distance (AOD), angle recess area (ARA), trabecular iris space area (TISA), trabecular-iris angle (TIA), angle to angle width (ATA), and anterior chamber volume (ACV), were obtained using SS-ASOCT at baseline and 30 minutes after mydriasis. Regression analyses were performed to identify the factors related to the relative change of AOD500 (ΔAOD500). Results A total of 938 patients (938 eyes) were included. The AOD500 decreased from 0.46 ± 0.22 mm to 0.40 ± 0.19 mm, with percent ΔAOD500 of -13.59% ± 37.73% (P = 0.005). The patients with high myopia had a smaller reduction of anterior angle parameters, with a percent ΔAOD500 of -22.74% ± 58.09%% in non-high myopic eyes and -0.84% ± 45.47% in high myopic eyes (P < 0.001). The stepwise multivariate regression demonstrated that the smaller reduction of AOD500 were independently associated with younger age (coefficient = -2.11, 95% confidence interval [CI] = -2.59 to -1.64, P < 0.001), presence of high myopia (coefficient = 15.35, 95% CI = 3.63 to 27.07, P = 0.010), greater baseline TISA500 (coefficient = 60.78, 95% CI = 8.75 to 112.82, P = 0.022), and ATA (coefficient = 11.21, 95% CI = 4.53 to 17.89, P = 0.001). Conclusions The anterior chamber angle decreased after pharmacologic mydriasis in these patients with cataract. Angle shallowing after pharmacologic mydriasis was significantly less pronounced in high myopic eyes than in non-high myopic eyes. Translational Relevance These findings are informative for the relative less risk of angle-closure glaucoma in highly myopic eyes.

BACKGROUND: Chronic kidney disease (CKD) and diabetic retinopathy (DR) are two serious complications of diabetes. However, the association between retinal neurodegeneration in DR and renal function decline is still unclear. Our objective was to evaluate the association by measure estimated glomerular filtration rate (eGFR), macular ganglion cell–inner plexiform layer (GC–IPL), and ganglion cell complex (GCC) thickness in patients with type 2 diabetes mellitus (T2DM). METHODS: We analyzed the baseline data of the Guangzhou Diabetic Eye Study. T2DM patients from communities in Guangzhou were enrolled and all participants went through ophthalmic and general examinations. The thickness of the macular GC–IPL and GCC in their right eyes were measured by swept-source optical coherence tomography. CKD was defined as eGFR

To characterize the morphologic features of corneal parameters and their correlation with axial length (AL) elongation in patients with high axial myopia.Cross-sectional comparative study.A total of 299 eyes with high myopia (299 patients) and 266 eyes of age- and sex-matched control subjects (266 patients) were examined by anterior segment swept-source optical coherence tomography (SS-OCT) and an IOL Master. Central corneal thickness (CCT), thinnest corneal thickness (TCT), corneal volume (CV), and anterior corneal curvature (CC), posterior CC, and total CC were obtained, and their correlation with AL was investigated using multiple linear regression model.The CCT, TCT, CV, and anterior, posterior, and total CC of patients with high myopia were smaller than those of the control subjects. The CCT, TCT, and CV had a continuous downward trend with AL. However, CC decreased rapidly with AL when AL was26 mm and the slope decreased when AL was 26 to 28 mm. This linear association was absent when AL was28 mm. Multiple linear regression showed that the CCT (β = -1.98, P = .007), TCT (β = -1.63, P = .019), and CV (β = -0.13, P = .001) were associated with AL. Anterior, posterior, and total CCs were negatively associated with AL when AL was26 mm (all P.001) and when AL was between 26 and 28 mm (all P.05).CC decreases may serve as a refractive compensation on myopia when AL is28 mm. However, this effect does not exist when AL is28 mm. Consideration should be given to the special distribution of cornea curvature for IOL calculations in subjects with high myopia.

To investigate the occurrence and risk factors of clinically significant intraocular lens (IOL) decentration and tilt in highly myopic eyes using swept-source anterior segment optical coherence tomography (SS-AS-OCT).Cross-sectional study.This study included 334 participants (334 eyes) with high myopia, defined as axial length (AL) ≥26 mm, who underwent phacoemulsification with IOL implantation. Decentration and tilt of IOL were assessed by SS-AS-OCT. Clinically significant IOL decentration and tilt was defined as decentration ≥0.4 mm and tilt ≥7°. Routine preoperative and postoperative examinations included visual acuity, refraction, biometric measurement using IOLMaster 700 (Carl Zeiss Meditec), and objective visual quality evaluated by OPD-Scan III (Nidek Technologies).Among the 334 highly myopic participants, 71 (21.3%) had clinically significant IOL decentration, and 26 (7.78%) had clinically significant IOL tilt. The proportion of clinically significant IOL decentration (37.1% vs 14.0%, P.001) and tilt (16.2% vs 3.90%, P.001) in those with AL ≥30 mm was significantly higher than in those with AL30 mm. The multivariable logistic regression model showed only AL ≥30 mm was associated with clinically significant IOL decentration (odds ratio, 1.65; P = .002). AL ≥30 mm (odds ratio, 2.09; P = .001) was an independent risk factor for clinically significant IOL tilt after adjusting for confounders. AL ≥30.3 mm could effectively predict IOL decentration ≥0.6 mm (area under the curve, 0.802).Participants with AL30 mm have a higher risk of clinically significant IOL decentration and tilt, thus caution should be taken to implant multifocal or toric IOL for these patients.

Background/aimsThe primary objective is to quantify the lens nuclear opacity using swept-source anterior segment optical coherence tomography (SS-ASOCT) and to evaluate its correlations with Lens Opacities Classification System III (LOCS-III) system and surgical parameters. The secondary objective is to assess the diagnostic performance for hard nuclear cataract.MethodsThis cross-sectional study included 1222 patients eligible for cataract surgery (1222 eyes). The latest SS-ASOCT (CASIA-2) was used to obtain high-resolution lens images, and the average nuclear density (AND) and maximum nuclear density (MND) were measured by a custom ImageJ software. Spearman’s correlations analysis was used to assess associations of AND/MND with LOCS-III nuclear scores, visual acuity and surgical parameters. The subjects were then split randomly (9:1) into the training dataset and validating dataset. Receiver operating characteristic curves and calibration curves were constructed for the classification on hard nuclear cataract.ResultsThe AND and MND from SS-ASOCT images were significantly correlated with nuclear colour scores (AND: r=0.716; MND: r=0.660; pConclusionObjective and quantitative evaluation of the lens nuclear density using SS-ASOCT images enable accurate diagnosis of hard nuclear cataract.

IntroductionAlthough obesity is one of the established risk factors of diabetes mellitus, the relationship between obesity and diabetic retinopathy (DR) remains unclear in different studies. This study aimed to investigate the association of DR with four obesity-related indexes, including body mass index (BMI), waist to hip ratio (WHR), waist to height ratio (WHtR) and body adiposity index (BAI) in patients with diabetes.Research design and methodsWe prospectively enrolled 2305 patients with diabetes (2305 eyes) in the Guangzhou Diabetic Eye Study between November 2017 and December 2019 to investigate the prevalence and the association of different types of obesity with DR using BMI, WHR, WHtR and BAI. DR, diabetic macular oedema (DME) and vision-threatening DR (VTDR) were selected as primary outcomes. BMI was categorised as normal (18.5–22.9 kg/m2), overweight (23.0–25.0 kg/m2) and obese (>25.0 kg/m2); WHR, WHtR and BAI were categorised into quarters.ResultsA total of 336 (14.58%), 93 (4.03%) and 98 (4.25%) developed DR, DME and VTDR, respectively. The prevalence of DR, DME and VTDR was higher in patients with higher BMI/WHR or lower WHtR/BAI. In the univariate regression model, WHR correlated positively with DR, while WHtR and BAI correlated negatively with DR, DME and VTDR. The association remained independent of age, sex and lipid metabolism parameters. In the multivariate model, obese presented as a protective factor for DME and VTDR, while the second quarter of WHtR(Q2-WHtR) presented as a risk factor.ConclusionsAs high as 67.8% of patients with diabetes were overweight or obese. Obese presented as a significant protective factor of VTDR, while Q2-WHtR presented as a significant risk factor. Therefore, more attention should be paid to centripetal obesity as well as general obesity. Further research is also needed to focus on the improvement of sex-specific weight management in patients with diabetes.

BackgroundChronic kidney disease (CKD) and diabetic retinopathy (DR) are two serious complications of diabetes. However, the association between retinal neurodegeneration in DR and renal function decline is still unclear. Our objective was to evaluate the association by measure estimated glomerular filtration rate (eGFR), macular ganglion cell–inner plexiform layer (GC–IPL) and ganglion cell complex (GCC) thickness in patients with type 2 diabetes mellitus (T2DM).MethodsWe analyzed the baseline data of the Guangzhou Diabetic Eye Study. T2DM patients from communities in Guangzhou were enrolled and all participants went through ophthalmic and general examinations. The thickness of the macular GC–IPL and GCC in their right eyes were measured by swept-source optical coherence tomography. CKD was defined as eGFR < 60 mL/min/1.73 m2.Results1,309 patients were included (mean age 64.4 ± 7.6 years, 59.1% female), and fifty-eight (4.4%) of them had CKD. Average macular GC-IPL thickness was significantly thinner in CKD patients (96.5 ± 9.1 μm) than non-CKD patients (101.3 ± 9.2 μm) (p < 0.01). Average macular GCC thickness was also significantly thinner in CKD patients (123.5 ± 13.2 μm) than non-CKD patients (129.9 ± 12.8 μm) (p < 0.01). The significant thinning of macular GC-IPL and GCC thickness presented in every gird in macula (all, p < 0.05) except for central grid (p ≥ 0.05). In the patients without DR, the eGFR was linearly correlated with the average macular GC–IPL thickness (β = 0.07 [95% CI 0.02–0.12], p < 0.01) and GCC thickness (β = 0.09 [95% CI 0.03–0.16], p < 0.01) after adjustment for age, sex, axial length, intraocular pressure and combination of hypertension. However, no linear correlation was found between eGFR and macular GC-IPL or GCC thickness in DR patients.ConclusionsRenal function decreases is associated with the thinning of the macular GC–IPL and GCC in T2DM patients, suggesting the potential value of ganglion cell lose to detect early function decline in the kidney in diabetic patients, especially in patients without DR.

PurposeTo investigate the associations between renal function and the presence of diabetic retinopathy (DR) in diabetic patients.MethodsA total of 1877 diabetic participants aged 30 to 80 years were consecutively recruited from October 2017 to April 2019. All participants underwent blood and urine analyses and standardized 7-field fundus imaging. The presence of DR, vision-threatening DR (VTDR) and DME was graded based on the fundus photographs. Renal function was defined as normal, mildly impaired or chronic kidney disease (CKD) based on different estimated glomerular filtration rates (GFRs).ResultsUnlike a normal GFR, CKD was significantly associated with any DR (OR=1.89, P=0.017) and VTDR (OR=2.76, P=0.009), and mildly impaired renal function was associated with only any DR (OR=1.39, P=0.031). The analysis of the effect of microalbuminuria on relationship between GFR and DR showed that the GFR was associated with any DR only in the presence of microalbuminuria, while the GFR was an independent risk factor for VTDR regardless of microalbuminuria status (all PConclusionsThere was a strong association between GFR and VTDR, whereas the association of GFR and any DR was significant only under the premise of microalbuminuria. High microalbuminuria was significantly associated with DR and DME.

Purpose: To investigate the associations of the estimated glomerular filtration rate (eGFR) with peripapillary choroidal thickness (pCT) and retinal nerve fiber layer (pRNFL) thickness in diabetic patients by using swept-source optical coherence tomography (SS-OCT). Methods: Ocular treatment-naive patients with type 2 diabetes mellitus registered in the community health system in Guangzhou, China, were recruited to participate in this prospective cross-sectional study. The eGFR was determined using the Xiangya formula, and the renal function was categorized into non-chronic kidney disease (non-CKD), mild CKD, and moderate to severe CKD (MS-CKD) according to the guidelines. The pCT and pRNFL thicknesses at 12 o'clock were obtained using an SS-OCT by a circular scan with a diameter of 3.4 mm centering on the optic nerve head, and the data from only one eye in each patient were used. Results: This study included 1,408 diabetic patients, with a mean age of 64.4 ± 7.8 years. The average pCT decreased with renal function deterioration, with 126.0 ± 58.0 μm for non-CKD, 112.0 ± 51.2 μm for mild CKD and 71.0 ± 22.9 μm for MS-CKD, respectively (P

Purpose To investigate the relationship between renal function and choroidal thickness (CT) in ocular treatment-naive patients with diabetes mellitus using swept-source optical coherence tomography (SS-OCT). Methods This cross-sectional study recruited type 2 diabetes mellitus (T2DM) patients with no history of ocular treatment from communities in Guangzhou, China. The estimated glomerular filtration rates (eGFR) were calculated by using the Xiangya formula. The impaired renal function was defined as eGFR

BACKGROUND Background: Vascular cognitive disability (VCI) includes various degrees of mental decline related to cerebrovascular disease. It refers to the basic pathological process of the formation of Alzheimer's disease. Its early diagnosis and treatment are beneficial to improve the prognosis of patients. OBJECTIVE Objective: To explore the effect of individualized therapy based on brain rehabilitation health measurement system on the cognitive function and event-related potential (ERP) P300 of patients with vascular cognitive impairment no dementia (VCIND). METHODS Methods: Sixty patients with non-dementia vascular cognitive impairment were randomly divided into a training group and a control group. Both groups were given conventional medication and traditional rehabilitation training. Based on it, the training group added cognitive training of the brain rehabilitation health measurement system, 40 minutes/time, once a day, 5 times a week for 4 weeks. Then, the mini-mental state examination (MMSE), Montreal cognitive assessment (MoCA), Barthel Index (BI) and myoelectric evoked potential were used to measure and evaluate the cognitive function, daily life activities and P300 of the two groups of patients. RESULTS Results: After treatment, the MoCA score, MMSE, BI score, visual space and executive function, attention, language function, and delayed memory of the training group were significantly improved compared with the control group, and the difference was significant (P CONCLUSIONS Conclusions: Brain rehabilitation health measurement system assisted cognitive training can effectively improve the cognitive function and daily activities of VCIND patients. CLINICALTRIAL

PurposeTo investigate the association between the estimated glomerular filtration rate (eGFR) and peripapillary choroidal thickness (pCT) and retinal nerve fibre layer (pRNFL) thickness in diabetic patients by using swept-source optical coherence tomography (SS-OCT).MethodsOcular treatment-naïve patients with type 2 diabetes mellitus registered in the community health system in Guangzhou, China were recruited to participate in this prospective cross-sectional study. The eGFR was determined using the Xiangya formula, and the renal function was categorized into non-chronic kidney disease (non-CKD), mild CKD, and moderate to severe CKD (MS-CKD) according to the guidelines. The pCT and pRNFL thicknesses at 12 o’clock were obtained using a SS-OCT by a circular scan with a diameter of 3.4 mm centring on the optic nerve head, and the data from only one eye in each patient were used.ResultsThis study included 1,408 diabetic patients, with a mean age of 64.4±7.8 years. The average pCT decreased with renal function deterioration, with 126.0 μm ± 58.0 μm for non-CKD, 112.0 μm ± 51.2 μm for mild CKD and 71.0μm ± 22.9 μm for MS-CKD, respectively (PConclusionImpaired renal function was associated with a reduction of pCT and pRNFL thickness in patients with type 2 diabetes. The measurement of pCT and pRNFL may provide additional information for predicting renal impairment.

PurposeTo investigate the association between ocular biometrical parameters and diabetic retinopathy (DR) in ocular treatment naive patients with diabetes.MethodsThis cross-sectional study recruited type 2 diabetes mellitus patients with no history of ocular treatment in Guangzhou, China. The ocular biometrical parameters were obtained by Lenstar, including corneal diameter, central corneal thickness (CCT), corneal curvature (CC), anterior chamber depth (ACD), lens thickness (LT), and axial length (AL). The lens power and axial length-to-cornea radius ratio (AL/CR ratio) were calculated. Spherical equivalent (SE) was determined by auto-refraction after pupil dilation. Multivariate logistic regression analyses were performed to explore the associations of ocular biometry with any DR and vision threatening DR (VTDR).ResultsA total of 1838 patients were included in the final analysis, involving 145 5(79.2%) patients without DR and 383(20.8%) patients with DR. After adjusting confounding factors, any DR was independently associated with AL (OR = 0.84 per 1 mm increase, 95%CI: 0.74, 0.94), lens power (OR = 0.9951 per 1 D increase, 95%CI: 0.9904, 0.9998), and AL/CR ratio (OR = 0.26 per 1 increase, 95%CI: 0.10-0.70). Similarly, the presence of VTDR was independently related to AL (OR = 0.67 per 1 mm increase, 95%CI: 0.54-0.85), lens power (OR = 0.99 per 1 D increase, 95%CI: 0.98, 0.997), and AL/CR ratio (OR = 0.04 per 1 increase, 95%CI: 0.01, 0.25). The CC, corneal diameter, and refractive status were not significantly correlated with presence of DR or VTDR.ConclusionLonger AL, deeper ACD, higher lens power, and higher AL/CR ratio may be protective factors against DR. Considering the high prevalence of myopia in the Chinese juvenile population, it is worth paying attention to how the incidence of DR in this generation may change over time.

ObjectiveTo determine the relationship between grip strength and retinal or choroidal thickness in Chinese patients with type 2 diabetes mellitus.DesignObservational study-cross-sectional design.Setting and ParticipantsThe study was conducted among diabetes patients without retinopathy registered in the community health system in Guangzhou, China.MeasuresGrip strength was measured twice for each hand with a dynamometer in kilograms (kg). The retinal and choroidal thickness in macular Early Treatment Diabetic Retinopathy Study (ETDRS) sectors were measured by commercial swept-source optical coherence tomography (SS-OCT; DRI OCT-2 Triton; Topcon, Tokyo, Japan).ResultsA total of 1,029 patients were included in the study. Both retinal thickness and choroidal thickness increased with the higher quartile of grip strength. Regression analyses indicated that the average retinal and choroidal thickness increased by 0.14 μm (95%CI: 0.03-0.25 μm, P=0.011) and 0.57 μm (95%CI: 0.03-1.11 μm, P=0.037) for each additional kg of grip strength following adjustment for age and gender. Further adjustments were made for axial length, HbA1c, length of time the patient had diabetes, insulin usage, height, weight and systolic and diastolic blood pressure, which resulted in an average retinal and choroidal thickness increase of 0.13 μm (95%CI: 0.02-0.24 μm, P=0.024) and 0.65 μm (95%CI: 0.13-1.16 μm, P=0.013) for each additional kg of grip strength. Consistent results were obtained in the analyses in ETDRS 9 sectors.ConclusionGreater hand grip strength was found to be significantly associated with thicker retinal and choroidal layers in diabetic patients. Grip strength may provide a useful indicator of retinal health in diabetic patients. Further studies are needed to determine directionality and causality, and to examine whether improving muscle strength has a positive effect on retinal and choroidal thickness.Article summaryStrengths and limitations of this studyGrip strength is an indicator of upper limb muscle function and tension, and it is one of the important indicators of aging in the human population. This is one of the few studies to examined the relationship between grip strength and retinal thickness and choroidal thickness in a large sample size of patients with diabetes mellitus.Greater hand grip strength was found to be significantly associated with thicker retinal and choroidal thickness in diabetic patients, and grip strength may provide an easily-administered marker of retinal health in diabetic patients.Causal inferences could not be inferred due to the cross-sectional design of the study.The dynamic changes in grip strength and their impact on retinal and choroidal thickness are warranted to be explored in longitudinal studies.

PurposeTo assess the association of anterior segment optical coherence tomography (AS-OCT) parameters and 5-year incident narrow angle in China.MethodsThis was a prospective cohort study of people aged 50 and older residing in Liwan District, Guangzhou, China. Random clustering sampling was used to identify adults aged 50 years and older in Liwan District, Guangzhou. In 2008 and 2013, this study was repeated and added AS-OCT imaging under dark and light conditions. Customised software (ZAAP) was used to analyse horizontal AS-OCT scans. Angle opening distance (AOD), trabecular iris space area (TISA), anterior chamber volume (ACV) and maximal iris thickness (ITM) were measured. Multiple logistic regression analysis models were used to investigate the associations of the final angle status with baseline AS-OCT parameters. ORs and 95% CIs were calculated.ResultsOf the 220 subjects with eligible AS-OCT images and gonioscopic results in 2008, the response rate was 77.3%. A total of 27 (15.9%) subjects developed narrow angles and 143 (84.1%) had open angles on gonioscopy in 2013. Subjects developed narrow angles had greater spherical equivalent and shallower anterior chamber depth, smaller angle parameters, thicker IT750 and ITM, smaller anterior chamber parameters, greater lens vault, and smaller dynamic parameters (ΔITM, ΔACA, ΔACV) at baseline. After adjusting confounders, the predictors of incident narrow angles included smaller AOD750, TISA750, ΔACA and greater ITM, ΔIarea.ConclusionsIncident narrow angles were associated with smaller anterior ocular dimensions, thicker iris and smaller light-to-dark changes at baseline. These findings can help in early diagnosis in this population.

PurposeTo determine the 10-year incidence of all forms of primary angle closure (PAC) in phakic eyes and its risk factors in an urban Chinese population aged 50 years and older.MethodsSurvivors of 1405 baseline participants were invited to attend the 10-year follow-up visit in the Liwan Eye Study. Participants with established baseline angle closure, including primary angle closure suspects (PACS), PAC and primary angle closure glaucoma (PACG), or those who underwent bilateral cataract surgery during the 10-year period, as well as those who did not tolerate gonioscopic examinations, were excluded from this analysis. Incident PAC was present when those with open angles at baseline developed angle closure in any form in either eye during the 10-year period.ResultsAmong 791 participants who returned during the 10-year follow-up visit, 620 (78.4%) provided data on PAC incidence. The 10-year cumulative incidence of any forms of PAC was 20.5% (127/620, 95% CI 17.4% to 24.9%), including 16.9%, 2.4% and 1.1% with incident PACS, PAC and PACG in either eye, respectively. In multiple logistic regression, significant risk factors for incident angle closure were greater baseline lens thickness (OR=1.82 per mm, p=0.003), shallower anterior chamber depth (OR=3.18 per mm decreased, p=0.010) and narrower angle width (OR=1.63 per decreased angle width, pConclusionsApproximately one in five people aged 50 years and older developed some form of angle closure over a 10-year period. Small ocular dimensions and hyperopia at baseline were associated with the development of angle closure.

IMPORTANCE: Longitudinal data on visual outcome of correctable visual impairments (VI) are of paramount importance for decision-maker to estimate burden and demand to treat avoidable VI. BACKGROUND: To assess the 5-year visual outcome among participants with correctable VI and to identify associated risk factors. DESIGN: Population-based longitudinal cohort study. PARTICIPANTS: Participants with correctable VI at baseline attended the 5-year follow-up visit of the Liwan Eye Study. METHODS: Presenting visual acuity (PVA) with habitual refractive correction was assessed using an Early Treatment Diabetic Retinopathy Study (ETDRS) chart. Then participants with PVA

The melting and recrystallization behavior of -iPP crystal induced by β -nucleating agent was studied. A new type of α-modification has been developed by self-seeding process. The growth process of these crystals is just like “photographic development process.” Crystalline phase transformation and the memory effect caused by local order was observed during the melting and annealing process. A high temperature is sufficient to destroy the local order and the β-nucleating agent efficiently induces formation of β-form.

PurposeTo describe the prevalence of age-related macular degeneration (AMD) among older adults in rural southern mainland China.MethodsEligible persons aged 50 years or over were identified by geographically defined cluster sampling from Yangxi County, Guangdong Province, China. Participants underwent a standardised interview and comprehensive eye examinations from August to November in 2014. Digital retinal photographs were graded for AMD lesions using the Clinical Classification of Age-Related Macular Degeneration developed by the Beckman Initiative for Macular Research Classification Committee. Age-standardised prevalence of AMD and AMD lesions was calculated using the 2010 world population data and compared with those of other populations.ResultsOf 5825 subjects who participated (90.7% response rate), 4881 (83.8%) had fundus photographs gradable for AMD. Early, intermediate and late AMD were present in 2003 (41.0%), 879 (18.0%) and 42 (0.86%) participants. The age-standardised prevalence of early, intermediate and late AMD was 40.4% (95% CI 39.6% to 41.2%), 17.6% (95% CI 17.0% to 18.2%) and 0.79% (95% CI 0.65% to 0.95%), respectively. Total AMD was more prevalent in men than in women (62.8% vs 57.1%).ConclusionsAMD is an important public health concern for rural southern China, and the prevalence of AMD was higher in men than in women.

We sought to estimate the 10-year incidence of cataract surgery and its associated factors in an adult urban Chinese population.Population-based cohort study.The Liwan Eye Study is a population-based study initiated in 2003 with 1405 eligible participants. All baseline participants were invited to return for a 10-year follow-up examination with the same protocol. Having incident cataract surgery was defined as participants with native crystalline lens at baseline who underwent cataract surgery performed in either eye during the 10-year follow-up period. A detailed questionnaire was administrated to collect information regarding income, education, and medical history of hypertension and diabetes at baseline examination.Seven hundred ninety-one (86.2%) of 918 eligible survivors attended the 10-year follow-up examination, and 778 participants without previous binocular cataract surgery were eligible for analysis. The overall 10-year incidence of any cataract surgery was 73 of 778 patients (9.4% [95% confidence interval 7.4%-11.7%). The incident cataract surgery increased with age, and increased from 1.5% among participants 50 to 54 years of age, to 23.2% for those ≥75 years of age (P.001); the same trends were also observed for incident unilateral (P.001) and bilateral surgery (P.001). In the multivariate logistic regression model, income¥1000 renminbi (approximately $141.30) (odds ratio [OR] 0.2, P = .023), education level (OR 0.1, P.001), and presence of diabetes (OR 3.9, P = .038) had a significant positive effect on cataract surgery incidence.Approximately 1 in 10 participants ≥50 years of age underwent cataract surgery over 10 years. The incidence was lower than that reported in developed countries, suggesting a substantial unmet demand even in a major urban city in China.