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To observe the characteristics of highly myopic macular holes (HMMHs) with macular retinoschisis (MRS) by optical coherence tomography (OCT) and explore the possible relationship between HMMHs and different types of MRS.We consecutively reviewed the clinical data and OCT images of the patients with HMMHs from June 2015 to February 2021. Then we picked eyes with MRS from these HMMHs for analysis. The minimum linear diameter (MLD), basal diameter (BD), and height (H) of HMMHs were measured. HMMHs were grouped according to the extent or layer involvement of the concomitant MRS and the characteristics were compared among groups. The impact of MRS on the MLD of macular hole was analyzed with multivariable linear regression.We included 127 patients with MRS from 168 HMMHs (75.5%) for analysis. According to the different classification systems, the most frequent type of MRS in HMMHs was S3 (foveal but not entire macular area MRS) (62.2%) and both inner- and outer- (I/O-MRS) involved types. In our study, HMMHs with more extensive MRS had larger MLD, larger BD, larger H, and poorer best-corrected visual acuity (BCVA). Meanwhile, HMMHs with outer layer-involved MRS (outer MRS and I/O-MRS) had larger BD than HMMH with only inner layer-involved MRS. (All P 0.05) Multivariable linear regression further illustrated only the extent of MRS was significantly associated with the MLD of HMMH, while there was no significant correlation between the involved retinal layers and the MLD of HMMH.HMMH with MRS presented as a predominant type in HMMHs. The MRS was always with a relatively large extent and involved both inner and outer layers. MLD of HMMH was mainly affected by the extent of MRS.

This study aimed to evaluate fixation stability and position changes after epiretinal membrane (ERM) surgery.This is a retrospective study that included 60 consecutive eyes with idiopathic ERM. All patients received comprehensive ophthalmic examinations preoperatively and 1, 4, and 10 months postoperatively. Main outcome measures included fixation stability and position, bivariate contour ellipse area, and preferred retinal locus.The number of patients with stable fixation and predominantly central fixation was increased significantly after ERM surgery (61.7 vs. 73.3%, P = 0.001; 41.7 vs. 71.7%, P = 0.037). The correlation analysis showed that the preoperative factors associated with improved postoperative fixation stability were a larger bivariate contour ellipse area value (P0.001), poorer visual acuity (P = 0.002), advanced stage (P = 0.002), thicker central fovea thickness (P = 0.015), and a longer preferred retinal locus-fovea distance (P = 0.025). As for the improved fixation location, the associated preoperative factors were age (P = 0.003), central fovea thickness (P = 0.044), and preferred retinal locus-fovea distance (P0.001).Our observations point to the changes of fixation parameters in patients after ERM surgery. We found that patients with preoperative unstable, eccentric fixation and poor BCVA can significantly benefit from the surgery. This result indicates that even in patients with severe macular damage, the ERM surgery still has great benefits in recovering visual function.

To observe the characteristics and prognosis of different types of intraretinal cystoid spaces in idiopathic epiretinal membranes (iERMs).Two hundred and seven consecutive patients with symptomatic iERM who underwent vitrectomy between September 2016 and December 2019 were included. According to spectral-domain optical coherence tomography images, intraretinal cystoid spaces were classified into cystoid macular edema (CME) and microcystic macular edema (MME). Other optical coherence tomography characteristics, including ectopic inner foveal layers, central foveal thickness, and interdigitation zone integrity, were also evaluated.Intraretinal cystoid spaces were presented in 30.1% of the iERMs, 21.5% were CME-type, 66.2% were MME-type, and 12.3% were combined-type. Compared with CME, eyes with MME-type and combined-type showed a significantly lower best-corrected visual acuity (BCVA) preoperatively and postoperatively. Cystoid macular edema is always presented in earlier stages (92.9%) and has no significant effects on BCVA (PStage I = 0.927, PStage II = 0.985). Conversely, MME is the primary type in advanced stages associated with a longer duration of symptoms (P = 0.037) and lower preoperative BCVA (P = 0.008). After surgery, cystoid spaces were newly occurred in 33 eyes (21.6%), with no effects on BCVA (P = 0.668). In the multiple regression analysis, the presence of MME was a risk factor for preoperative BCVA (P = 0.001). However, it is not an independent predictor for the postoperative VA.Our research further proved that MME is an adverse factor for preoperative and postoperative VA in iERMs. Moreover, we underlined the importance of distinguishing between CME and MME, which may affect prognosis differently.

To investigate the effects of ectopic inner foveal layers (EIFLs) on foveal configuration recovery and visual acuity after idiopathic epiretinal membrane removal and analyze the relationship of foveal configuration recovery between 1-month and long-term postoperatively.This retrospective study included 216 consecutive eyes with idiopathic epiretinal membrane that underwent vitrectomy surgery. A comprehensive ophthalmic examination was performed for all patients before and 1, 4, 10, and 24 months after surgery. We observed the postoperative anatomical and functional recovery of eyes with and without EIFLs and analyzed the association between short-term and long-term anatomical recovery.The presence of EIFL was associated with severe preoperative visual damage ( P0.001) and was considered as a negative factor for postoperative foveal depression recovery ( P0.001). No significant difference was found in postoperative best-corrected visual acuity between the eyes with and without EIFLs ( P = 0.442). For eyes with Stage II epiretinal membranes, 17.6% developed EIFLs postoperatively, which did not affect the final best-corrected visual acuity. Overall, 24.5% of epiretinal membranes restored the foveal configurations at 1 month postoperatively, and 14.7% continued recovering during the follow-up. Foveal structure recovery in eyes with EIFLs was associated with earlier stage, fewer microcystic macular edema, complete interdigitation zone layer, and a thinner central foveal thickness (all P0.05) at 1 month postoperatively.The EIFL is associated with severe preoperative visual damage and is a negative factor for postoperative anatomical recovery, but it is a minor factor for postoperative visual acuity. We also found an association of foveal configuration recovery between 1 month and long-term after surgery.

Purpose: To investigate the reconstructive changes in foveal microstructures postoperatively and analyze the visual predictors in eyes with surgically closed traumatic macular holes (TMHs). Methods: Seventy-one eyes with TMHs that underwent vitrectomy, internal limiting membrane (ILM) peeling, and gas tamponade were reviewed. Clinical data, best-corrected visual acuity, and spectral-domain optical coherence tomography (SD-OCT) images were recorded. The length of the ellipsoid zone (EZ) defect and the integrity of postoperative external limiting membrane (ELM) were measured. Preoperative and 1-month postoperative features were analyzed, respectively, as potential predictors of visual acuity at 6 months postoperatively. Results: The primary hole closure rate was 90.14% (64/71). In 43 cases of initially closed TMHs with SD-OCT scans preoperatively and at 1 and 6 months postoperatively, the number of eyes with intact ELM increased from 18 (41.86%) at 1 month to 26 (60.47%) at 6 months ( p = 0.08), while the number of eyes with a restored EZ band remained the same in 2 eyes (4.65%). The mean length of the EZ defect progressively decreased postoperatively ( p < 0.001). Poorer preoperative visual acuity ( p = 0.002), lower mean macular hole (MH) height ( p = 0.012), and greater preoperative mean length of EZ defect ( p < 0.001) were associated with worse visual acuity 6 months postoperatively, but only the preoperative length of the EZ defect was proved to be a predictor, with the cutoff value of 1,800 μm provided by the receiver-operating characteristics (ROC) curve. Worse visual acuity and greater mean length of the EZ defect at 1 month were also associated with worse final visual acuity. Conclusions: The mean length of the EZ defect both preoperatively and 1 month postoperatively were predictors of visual outcomes at 6 months postoperatively.

To explore the evolution of outer foveolar lucency (OFL) after vitrectomy and the correlation between OFL and visual acuity (VA) outcome in eyes with large idiopathic macular hole (IMH). In this retrospective study, 244 eyes of 233 subjects with large IMH (diameter > 400 μm), who underwent vitrectomy, were included. Preoperative clinical data, postoperative optical coherence tomography (OCT) images, and VA at 1-, 4-, and 10-month visits were documented. The prevalence, incidence, and width of OFL and their correlation with postoperative VA were analyzed. The prevalence of OFL was 10.4% (24/231) at 1 month and significantly increased to 30.4% (55/181) at 4 months (P

Background To evaluate the effect of internal limiting membrane (ILM) peeling surrounding macular holes (MH) for the function of retina by microperimetry-3(MP-3). Methods This is a prospective, cohort study which included patients with MHs who were treated by 23-gauge 3-port pars plana vitrectomy and ILM peeling with air tamponade. Color fundus photography, retinal optical coherence tomography and MP-3 were performed 1 week before, 1 and 4 months after the operation. In MP-3 examination, a customized follow-up pattern with 45 spots in the central 8° visual field was used. The spots corresponding to the retina surrounding macular holes were selected for comparison of pre- and post-operative function. Results We incuded 44 eyes of 44 patients with best corrected visual acuity (BCVA) of 1.06 ± 0.40 (logMAR). All eyes achieved an anatomical success at 4 months. BCVA significantly improved at 1 month (0.53 ± 0.30, P P P P P P Conclusion ILM peeling in normal retina will not decrease the retinal function in a short-term after surgery.

AimsTo investigate characteristics of intraoperative iatrogenic retinal breaks in 23-gauge vitrectomy for idiopathic macular hole and classify the breaks based on their causes to analyse the risk factors.MethodsThis retrospective study enrolled patients with stage 3 or 4 idiopathic macular hole who underwent 23-gauge vitrectomy in Beijing Tongren Hospital from July 2015 to August 2018. The intraoperative iatrogenic retinal breaks were classified into three types: by induction of posterior vitreous detachment (type 1), by peripheral vitreous cutting (type 2) and by others (type 3). The types, incidence and distribution of the breaks were analysed, and all clinical features were compared between eyes with and without the breaks.ResultsA total of 364 eyes from 341 patients were recruited. Twenty-five breaks from 24 eyes (6.6%) were encountered, 52% (13/25) of which distributed in the superior region. Type 1 and type 2 breaks contributed 52% (13/25) and 44% (11/25) to all, respectively. Eyes with stage 3 and stage 4 holes showed no significant differences in incidence or distribution in type 2 breaks. No breaks occurred on the surface of lattice degenerations. All clinical features showed no significant differences between eyes with and without the breaks.ConclusionDistribution of intraoperative iatrogenic retinal breaks shows no preference for the superior or inferior region. Induction of posterior vitreous detachment and traction from peripheral vitreous cutting are major causes of the breaks, which classify them into two main types. The presence of lattice may not be one of the risk factors if treated properly.

To evaluate the effect of internal limiting membrane peeling and air tamponade for idiopathic macular hole, and explore reasons and interventions for persistent holes.One hundred and thirty-five eyes with Stage III and IV idiopathic macular hole that underwent 23-gauge vitrectomy, internal limiting membrane peeling, and air tamponade were reviewed. Eyes with persistent holes underwent a second surgery. Outcome-related factors and interventions treating persistent holes were discussed.The initial closure (Type I) rate was 89.63% (121/135). Eyes that underwent the second surgery all obtained final closure (Type I). Diameter of macular hole was significantly smaller (P0.001) and duration of symptoms was significantly shorter (P = 0.017) in initially closed cases than in unclosed ones. Binary logistic regression indicated large diameter of macular hole as a risk factor for initial closure (P = 0.004). A cutoff value of 677 μm was provided by receiver operating characteristic curve to predict initial closure (P0.001). Best-corrected visual acuity of all individuals improved significantly (P0.001) from 20/154 to 20/40 (mean follow-up: 4.5 months).Internal limiting membrane peeling and air tamponade for idiopathic macular hole provide satisfactory morphologic and functional outcomes. Large diameter of macular hole and long duration of symptoms are risk factors for initial closure. Proper second surgery can obtain satisfactory outcomes for persistent holes.

Background: Strong evidence of the correlation between age-related macular degeneration (AMD) and vitreomacular interface abnormality (VMIA). Meanwhile, as a crucial mechanism of retinal pigment epithelial (RPE) cells’ homeostasis, autophagy induction by cyclic stretch appears to be particularly significant.Methods: Cultured ARPE-19 cells were subjected to cyclic stretch (20% elongation, 1HZ) for 1h, 2h, 6h, 12h,24h and 48h by FX-5000 Tension System. Then, we observed the expression levels of LC3I, LC3II, Beclin-1, SQSTM1/p62, LAMP-1, mTOR and phosphorylated mTOR(pmTOR), AMPK and pAMPK, NADPH oxidase 4 (NOX4), and vascular endothelial growth factor (VEGF) in RPE cells under stretch by western blot and immunofluorescence.Results: We found autophagic proteins mostly induced by cyclic stretch in a time-dependent fashion via mTOR suppression and AMPK activation, except for SQSTM1/p62. 3-Methyladenine(3-MA), an inhibitor for autophagy, could reduce the up-regulation of autophagy due to cyclic stretch, leading to higher level of VEGF release after 24h cyclic stretch. Rapamycin could narrow the increase degree of VEGF and NOX4 by cyclic stretch by raise autophagic level in RPE cells.Conclusion: Stretch might induce autophagy in RPE cells by mTOR or AMPK pathway. Autophagy might play the protective function for RPE cells away from mechanical stress derived from VMIA-related AMD.

In this study, cellulose nanofibrils (CNFs) fabricated from rice straw were utilized to reinforce poly (ε-caprolactone) (PCL), and the structure and properties of these CNF/PCL composite films were analyzed by morphology observation and the characterization of X-ray diffraction (XRD), differential scanning calorimeter (DSC), thermogravimetric analyzer (TGA), mechanical property and water absorption tests. The experimental results revealed that in PCL matrix, CNF exhibits a homogeneous distribution at low content, but shows some aggregates at high content. The incorporation of CNFs doesn’t change the crystal type, crystallinity and melting temperature of PCL, but accelerates the crystallization of PCL due to the heterogeneous nucleating agent effect of CNF. Compared with PCL film, the CNF/PCL composite films show obvious improvement of mechanical strength and Young’s modulus. However, after the CNF content exceeds 10%, the tensile strength of the composite films begins to decrease, and high loading of CNFs also causes remarkable negative influences on the thermal stability and hydrophobicity of the composite films.

Background To compare idiopathic macular holes (IMHs) between male and female before and after surgery. Methods Patients with IMHs of stage 3 and stage 4 who underwent 23-gauge vitrectomy were retrospectively enrolled. Pre-operative clinical features like age of onset, and best-corrected visual acuity (BCVA) were reviewed. Optical coherence tomography parameters including minimum linear diameter (MLD), central macular thickness and some other indexes were measured and calculated. Main surgical outcomes included the primary closure rate, the highest BCVA during follow-up, and the recovery duration. All the metrics mentioned above were compared between genders with appropriate statistical methods. Results A total of 298 eyes from 280 patients (male: 51; female: 229) were enrolled. Compared with men, women demonstrated a significantly higher ratio of stage3/stage4 (P = 0.045), larger horizontal MLD (P = 0.009), but similar surgical outcomes except for a relatively longer recovery duration (P = 0.024). For stage 3 IMHs, women exhibited significantly younger age of onset (P = 0.023), larger MLD (P = 0.003), and smaller height of the hole (P = 0.029). However, for stage 4 IMHs, all the pre- and post-operative metrics showed no differences between genders. Conclusions Female IMHs seem to demonstrate an earlier age of onset and larger size of hole, especially in IMHs of stage 3. However, these differences, which may owe to normal gender-related variations, have limited influence on the surgical outcomes.

Summary: In this study, we reviewed 101 eyes with stage III or IV IMHs treated by PPV combined with ILM peeling and room air tamponade, took the ratio of minimum diameter to maximum diameter (hole diameter ratio, HDR) as the predictive factor and found HDRPurpose: To identify hole diameter ratio (HDR) as the predictive factor for unclosed stage III and IV idiopathic macular holes (IMHs) by the use of preoperative optical coherence tomography (OCT).Methods: 101 eyes with stage III or IV IMH were included in this retrospective case series study. All cases were treated with vitrectomy combined with ILM peeling and room air tamponade. The MH minimum and maximum diameter, the ratio of the minimum to the maximum diameter (which defined as HDR) were performed. Results: 81 eyes (80.2%) got a Type I closure after surgery (group A). Postoperative unclosed MHs were found in 20 eyes (19.8%) (group B). The minimal diameter of IMHs (703.6±116.1um VS 597.6±120.1um, PConclusions: HDR

To compare clinical and morphological differences in idiopathic macular holes (IMHs) between stage 3 and stage 4. In this retrospective cross-sectional observational study, patients with stage 3 and stage 4 IMHs based on Gass’s classification in 1988 were enrolled. Horizontally and vertically, optical coherence tomography (OCT)-based parameters including minimum linear diameter (MLD), basal diameter (BD), and macular hole height (H) were measured; fluid cuff (FC), diameter hole index (DHI), macular hole index (MHI), traction hole index (THI), and hole form factor (HFF) were calculated. Afterwards, stage 3 IMHs smaller than 400 μm were excluded according to Gass’s classification in 1995. Clinical features, such as age, duration of symptoms, and baseline best-corrected visual acuity (BCVA), and OCT parameters were compared respectively between two stages based on both classifications. Given classification of 1988, stage 3 IMHs had significantly shorter duration of symptoms (P = 0.020) and smaller horizontal BD (P = 0.041). Horizontally and vertically, MLD (P = 0.001, 0.004 respectively), DHI (P = 0.032, 0.021 respectively), and HFF (P = 0.032, 0.017 respectively) were significantly smaller and THI (P = 0.011, 0.020 respectively) was significantly larger in stage 3 holes. Clinical features like age and baseline BCVA showed no significant differences. When staged by classification of 1995, IMHs of the two stages shared similar features. Stage 3 IMHs, instead of owning shorter duration of symptoms and smaller diameters, share similar clinical and morphological features with stage 4 IMHs according to Gass’s classification in 1995, which excludes IMHs smaller than 400 μm from stage 3 compared to his 1988 version.

In this study, cellulose nanofibrils (CNFs), obtained from the chemical treatment of steam exploded rice straw fibers and the following oxidation by 2,2,6,6-tetramethylpiperidine-1-oxyl radical (TEMPO)-mediated system, were utilized to prepare the reinforced polyvinyl alcohol (PVA) composite films by solution casting method, and the morphology, transparency, thermal stability, mechanical properties and water absorption of these rice straw CNFs/PVA composite films were also investigated compared with the rice straw cellulose microfibrils (CMFs) reinforced PVA composite films. As compared with the rice straw CMFs/PVA composite films, the rice straw CNFs/PVA composite films exhibited more uniform fiber dispersion, better mechanical properties and transparency, and similar thermal stability. However, the rice straw CNFs/PVA composite films showed weaker water resistance than the rice straw CMFs/PVA composite films due to the existence of more polar groups in rice straw CNFs.

Background To evaluate the effect of internal limiting membrane (ILM) peeling to the function of retina surrounding macular holes (MH) by microperimetry-3(MP-3). Methods This is a prospective, cohort study which included 44 eyes of 44 patients with MHs who were treated by 23-gauge 3-port pars plana vitrectomy and ILM peeling with air tamponade. Color fundus photography, retinal optical coherence tomography and MP-3 were used 1 week before and 1, 4 months after operation. In MP-3 examination, a customized follow-up pattern with 45 spots in the central 8° visual field was used. The spots corresponding to the retina surrounding macular holes were selected for comparison of pre- and post-operative function. Results All eyes had achieved an anatomical success at the last follow-up. BCVA (logMAR) significantly improved both in 1 and 4 months after surgery (1.06±0.40 versus 0.53±0.30 and 0.31±0.24, P

Background Vitreomacular adhesion (VMA) has been reported to associated with age-related macular degeneration (AMD). Understanding the mechanisms underlying cyclic stretch induced in retinal pigment epithelial cells (RPE) may be important for the treatment of VMA-related AMD. Method Cyclic stretch (1HZ, 20% elongation) was applied to cultured ARPE-19 cells for 15 min, 2 h, 6 h, 12 h, 24 h by flexcell FX-5000 Tension system. Total reactive oxygen species (ROS) were detected using DCFH-DA. Mitochondrial superoxide were detected using MitoSOX Red mitochondrial superoxide indicator. NADPH oxidases (NOX) and signaling pathways, such as p38 and PKC, were detected using western blot. Apocycin (Apo) were used as NOX inhibitors. Result High levels of total ROS were detected from 15 min to 24 h, whereas mitochondrial superoxide were higher only in early time. NOX2 were significantly increased at 24 h. NOX4 were significantly increased at 2 h and reach its peak at 24 h. P-p38 was significantly increased at 12 h and 24 h. P-PKC was significantly increased at 15 min and kept a persistent high level. The upregulated expression of NOX4 by cyclic stretch can be significantly decreased under p-PKC inhibitor other than p-p38 inhibitor. Conclusion Cyclic stretch induce oxidative stress from both mitochodrial and NADPH oxidase in RPE cells, which may prompt oxidative damage in VMA-related AMD.

Background: Vitreomacular adhesion (VMA) has been theorised to be a prospective risk factor for anti-vascular endothelial growth factor (VEGF) therapy. The mechanisms underlying VMA are not fully understood. Therefore, we investigated whether exposure to cyclic stretch was associated with increasing VEGF and related signalling pathways in vitro. Methods: A cyclic stretch model of adult retinal pigment epithelial cell line-19 (ARPE-19) was conducted using a Flexcell-5000 strain system at a regimen of 10% prolongation stretch (1/2 sine, 1Hz). We observed the effect of cyclic stretch on VEGF and transforming growth factor-β (TGF-β) by using western blot and real-time polymerase chain reaction (PCR) for 3 h, 6 h, 9 h and 12 h. Enzyme-linked immunosorbent assay was used to measure the secretion of VEGF in the supernatant. To quantitatively detect the angiogenesis capacity of VEGF in vitro, tube formation assay was performed. The effects of TGF-β receptor I inhibitor SB335242 on stretch-induced VEGF protein expression and secretion were evaluated by western blot and ELISA. Components of the p38 mitogen-activated protein kinase (MAPK) and c-Jun NH2-terminal kinase (JNK) in the stretch group were analysed using western blot. Results: We discovered that cultured ARPE-19 undergoing cyclic stretch significantly increased VEGF and TGF-β in a time-dependent manner and tube formation. Stretch-induced VEGF expression was inhibited by TGF-β receptor I inhibitor SB335242. In vitro, we also verified P38 MAPK and JNK expression. In western blot analysis, mechanical stretch evaluated P38 and JNK protein expression. Conclusion: In this study, we first demonstrated that cyclic stretch induces the increasing VEGF through TGF-β in RPE cells. Mechanical stretch stimulates VEGF in a time-dependent manner and maintains angiogenesis ability. It is thus possible that RPE cells under mechanical stretch, such as VMA, may generate high levels of TGF-β. Sequentially, the overexpressed TGF-β stimulates VEGF production, triggering CNV events and aggravating wAMD. Keywords: Mechanical cyclic stretch; vascular endothelial growth factor; retinal pigment epithelium; transforming growth factor-beta; mitogen-activated protein kinase; vitreomacular adhesion.

To explore a measuring method for retinal sensitivity in macular hole area by Microperimeter-3 (MP-3) and evaluate its predictive value on visual prognosis. This was a case series study including 44 eyes of 44 patients with idiopathic macular hole. Retinal sensitivity inside and 0.5 degree outside the macular hole margin was measured, and its mean value was defined as macular hole sensitivity (MHS). Best-corrected visual acuity (BCVA), minimum diameter of macular hole (MD), IS/OS defect diameter, retinal sensitivity in 8 degrees and 2 degrees were also recorded preoperatively and 4 months after operation. All macular holes were closed after surgery. BCVA was significantly improved from 1.06 ± 0.39 at baseline to 0.31 ± 0.24 at 4 months postoperatively (P

BACKGROUND AND OBJECTIVE: To investigate changes in the pattern of metamorphopsia in patients after idiopathic macular hole (MH) surgery and the relationship between metamorphopsia, visual acuity (VA), and macular parameters. PATIENTS AND METHODS: This prospective, interventional study included 53 eyes of 53 patients with idiopathic full-thickness MH. The severity of metamorphopsia was quantified using M-CHARTs. Minimal and basal diameter of MH and disrupted length of ellipsoid zone were measured using spectral-domain optical coherence tomography. RESULTS: Preoperative mean M-score was significantly improved from 0.95 (0.73–1.60) (expressed as median [25% percentile, 75% percentile]) to 0.5 (0.28–0.63) after surgery (Z = −5.573; P < .001). Postoperative mean M-score was significantly correlated with mean minimal diameter of MH, preoperative mean M-score, and preoperative logMAR best-corrected VA. Multiple regression analysis verified that postoperative mean M-score was significantly correlated with mean minimal diameter of MH (adjusted r 2 = 0.113; P = .008). CONCLUSION: Metamorphopsia and VA were significantly improved after successful MH surgery. Mean minimal diameter of MH is valuable prognostic factor to metamorphopsia after MH surgery. [ Ophthalmic Surg Lasers Imaging Retina . 2018;49:595–602. ]

A new thermal storage system, a heat pipe heat exchanger with latent heat storage, is reported. The new system may operate in three basic different operation modes, the charging only, the discharging only and the simultaneous charging/discharging modes, which makes the system suitable for various time and/or weather dependent energy systems. In this part of the paper, the basic structure, the working principle and the design concept are briefly introduced. Extensive experimental results are presented of the charging only and discharging only operations, and the effects of the inlet temperature and the flow rate of the cold/ hot water were also investigated. The results show that the heat exchanger performs the designed functions very well and can both store and release the thermal energy efficiently. � 2005 Elsevier Ltd. All rights reserved.