Abstract AIM: To evaluate the changes of choroid thickness in adolescence with different types of high myopia. METHODS: From January to November 2021, 134 eyes of 78 adolescents with myopia in Liaocheng Aier Eye Hospital were collected and analyzed. According to the Mean Spherical Equivalent(MSE) and Corneal Curvature(CC), subjects are divided into mild myopia or emmetical eye group (ME group), high myopia group (HM group), occult high myopia group(OHM group) and super high myopia group(SHM group). The macular foveal choroidal thickness(CT) of the four groups was analyzed by Using Zeiss frequecy domain optical coherence tomography (Cirrus HD OCT), acquire horizontal and vertical cross-sectional images of macular. The CT values were measured manually subfoveal choroidal thickness(SFCT) and 1mm,3mm from the fovea at 9 sites, including the superior, nasal, inferior, temporal. The same operator completed the measurement 3 times ,and took the average numerical value as the final reference data.RESULTS:. There were significant differences in choroid thickness at 1mm and 3mm in macular fovea (P < 0.05). Compared with the ME group, SFCT, 1mm and 3mm in the HM group, OHM group and SHM group were significantly thinner than those in ME group (P < 0.05). Compared with SHM, HM and OHM group were significant differences in CT (P < 0.05). There was no statistical significance in CT of each point in HM group and OHM group (P > 0.05). CONCLUSION: The CT of SHM is significantly lower than that of HM and OHM. Although OHM has a lower degree of myopia, the CT has become significantly thinner, and the degree of choroid thinning is almost the same as that of OHM.

Objective:To investigate the changes of choroid thickness in adolescents with different types of non-pathological high myopia (HM).Methods:A retrospective observational study. From January 2021 to April 2022, 179 eyes of 101 adolescents with myopia in Liaocheng Aier Eye Hospital were collected and analyzed. According to the spherical equivalent (SE) and corneal curvature, subjects were divided into mild myopia or emmetical eye group (control group), HM group, occult HM group (OHM group) and super HM group (SHM group). There were 52 eyes in 30 cases, 47 eyes in 26 cases, 42 eyes in 24 cases and 38 eyes in 21 cases, respectively. Medical optometry, intraocular pressure, optical coherence tomography (OCT), axial length (AL) and corneal curvature were measured. The macular foveal choroidal thickness was analyzed by using spectral-domain OCT. The diopter was expressed in SE. The thickness of choroid in the fovea of macular region was measured by enhanced deep imaging with frequency domain OCT. The thickness of choroid was measured in 9 regions within 1 mm, 3 mm from the fovea, including the upper, lower, nasal and temporal regions. Generalized estimating equation was used to compare the data among groups, and the least significant difference t-test was used to compare the data among groups. The correlation between AL, corneal curvature, intraocular pressure and choroidal thickness was analyzed by Pearson correlation. Results:The choroidal thickness in the foveal macula and the areas 1 mm and 3 mm away from the fovea were compared among the control group, HM group, OHM group and SHM group, the difference were significant ( χ2=76.646, 36.715, 27.660, 35.301, 24.346, 38.093, 36.275, 33.584, 36.050; P<0.05). Compared with the control group, the choroidal thickness of the fovea and the choroidal thickness in each area within 1 and 3 mm from the fovea in the HM group, the OHM group and the SHM group were significantly thinner than those in the control group, and the difference was statistically significant ( P<0.05). There were statistically significant differences in choroidal thickness in each region between the group and the SHM group, and between the OHM group and the SHM group ( P<0.05). The results of correlation analysis showed that AL was negatively correlated with choroidal thickness in various regions ( P<0.05); SE was positively correlated with choroidal thickness in various regions ( P<0.05); corneal curvature and intraocular pressure had no significant correlation with choroidal thickness in various regions ( P>0.05). Conclusions:The choroidal thickness of SHM is significantly lower than that of OHM and HM; OHM patients have lower SE. However, the choroidal thickness is significantly thinner. AL and SE are the influencing factors of choroidal thickness.

Objective:To observe the surgical skills and efficacy of proliferative diabetic retinopathy (PDR) with traction-rhegmatogenous retinal detachment (RRD).Methods:This was a retrospective case series study.The clinical data of 30 eyes of 30 patients with PDR complicated with traction-rhegmatogenus retinal detachment were collected from Dec.2019 to Dec.2020 in Liaocheng Aier Eye Hospital.All patients were treated with standard three-channel minimally invasive vitrectomy.The PDR membrane was dissected and peeled off with viscoelastic agent or double-handed stripping under the chandelier after complete vitrectomy; the rigid and contracted retina was excised.The peripheral retinal 360-degree incision or excision and panretinal photocoagulation were performed in patients with severe anterior proliferative vitreoretinopathy.The follow-up time was 6-12 months. The visual acuity and fundus were observed.Results:The fibrovascular membranes of all patients were divided and stratified, 14 eyes underwent partial retinotomy or excision, 2 eyes underwent 360 degree retinotomy or excision of peripheral retinas, and all eyes received silicone oil tamponade.Postoperative visual acuity was improved in 24 eyes.Conclusion:The application of single-handed membrane stripping assisted by viscoelastic agent or double-handed membrane stripping technology under ceiling lamp in vitrectomy for the treatment of rhegmatogenous retinal detachment with PDR traction is effective.

目的 探讨青少年高度近视(HM)和超高度近视(SHM)患者视网膜微血管的变化.方法 收集2021年1月至2021年11月在聊城爱尔眼科医院就诊的37例(64眼)近视青少年患者进行分析.根据平均等效球镜度(MSE)和眼轴长度(AL),将受试者分为HM组(23例41眼,-9.0 D<MSE≤-6.0 D,25 mm≤AL≤27 mm)和SHM组(14例23眼,MSE≤-9.0 D,AL>27 mm).将黄斑中心凹6 mm范围内划分为以黄斑中心凹为中心的3个同心圆,直径为1 mm的黄斑中心凹、1～3 mm的内环区、3～6 mm的外环区,应用光学相干断层扫描血流成像(OCTA)对3个区域的浅层视网膜血管长度密度(SRVD)、浅层视网膜血管灌注密度(SBPD)和直径6 mm完整图像(整体黄斑区)的SRVD和SBPD及其内环区和外环区各个象限的患者SRVD和SBPD进行分析,并对两组患者视网膜厚度和黄斑中心凹无血管区(FAZ)面积进行分析.结果 SHM组患者整体黄斑区、黄斑中心凹、内环和外环的SRVD分别为(15.63±1.91)mm-1、(4.99±3.05)mm-1、(14.09±2.71)mm-1和(16.49±1.78)mm-1,HM组患者整体黄斑区、黄斑中心凹、内环和外环的SRVD分别为(16.94±1.30)mm-1、(7.46±2.96)mm-1、(16.18±2.12)mm-1和(17.52±1.15)mm-1,两组患者间的各区域SRVD比较差异均有统计学意义(均为P<0.05);SHM组患者整体黄斑区、黄斑中心凹、内环和外环SBPD分别为(37.33±4.87)％、(11.01±7.07)％、(32.60±6.69)％和(39.50±4.92)％,HM组患者整体黄斑区、黄斑中心凹、内环和外环SBPD别为(40.57±3.26)％、(15.95±6.68)％、(37.77±5.24)％和(42.33±2.89)％,两组患者间各区域SBPD比较差异均有统计学意义(均为P<0.05);两组患者间内环和外环各象限比较,除外环区鼻侧和下方SRVD和SBPD比较差异均无统计学意义(均为P>0.05)外,其余内环区和外环区各象限SRVD和SBPD比较差异均有统计学意义(均为P<0.05).SHM组和HM组患者各区域视网膜厚度和FAZ面积比较差异均无统计学意义(均为P>0.05).结论 SHM患者黄斑区视网膜SRVD和SBPD明显低于HM患者,而视网膜厚度和FAZ保持稳定.

AIM: To explore the efficacy of intravitreal injection of ranibizumab and conbercept in the treatment of exudative age-related macular degeneration(ARMD), and analyze the effects on best corrected visual acuity(BCVA), central retinal thickness(CRT)and complications of patients. METHODS: The clinical data of 60 patients(60 eyes)with exudative ARMD in the hospital between January 2017 and January 2020 were collected for retrospective analysis. According to different treatment drugs, they were divided into intravitreal injection of ranibizumab group(30 eyes)and intravitreal injection of conbercept group(30 eyes). The BCVA, CRT, choroidal neovascularization changes and occurrence of complications were compared between the two groups before treatment and 1, 2 and 3mo after treatment. RESULTS: After 1, 2 and 3mo treatment, the BCVA(LogMAR)of patients in the two groups was better than that before treatment(P<0.05). The CRT was lower than that before treatment(P<0.05), and the CRT at 1, 2 and 3mo after treatment in intravitreal injection of conbercept group was lower than that in intravitreal injection of ranibizumab group(P<0.05). There were no significant differences in the recovery of choroidal neovascularization and the occurrence of complications between the two groups(P>0.05). CONCLUSION: Both intravitreal injection of ranibizumab and conbercept can achieve a good efficacy in the treatment of exudative ARMD, and there was no significant difference in the improvement of visual acuity between them. However, conbercept has obvious advantages in reducing CRT in the treatment of exudative ARMD.

AIM: To explore the application value of serum pigment epithelial derived factors(PEDF), fibroblast growth factor 19(FGF19)and β-endorphin(β-EP)in the diagnosis and severity assessment of primary glaucoma. METHODS: A total of 102 patients with primary glaucoma in the hospital were enrolled as study group between February 2018 and February 2020, while other 102 healthy controls during the same period were enrolled as control group. The levels of peripheral serum PEDF, FGF19 and β-EP were compared between the two groups. And their diagnostic value for primary glaucoma was analyzed. The study group was divided into severe and non-severe groups according to the diagnostic criteria for severe primary glaucoma. The levels of peripheral serum PEDF, FGF19 and β-EP were compared between severe group and non-severe group. And their evaluation value for disease severity was analyzed. The risk factors of disease severity were analyzed by multivariate Logistic regression analysis. RESULTS: The level of serum PEDF in study group was significantly lower than that in control group, while levels of FGF19 and β-EP were significantly higher than those in control group(P<0.001). AUC values of PEDF, FGF19 and β-EP levels in the diagnosis of primary glaucoma were 0.695, 0.754 and 0.768, respectively. The level of serum PEDF in severe group was significantly lower than that in non-severe group(P<0.001), while levels of FGF19 and β-EP were significantly higher than those in non-severe group(P<0.001). AUCvalues of PEDF, FGF19 and β-EP levels in assessing the severity of primary glaucoma were 0.731, 0.709 and 0.685, respectively. PEDF lower than 9.66pg/mL, FGF19 higher than 143.75ng/L and β-EP higher than 106.27ng/L were independent influencing factors of severe primary glaucoma(OR=2.280, 1.570, 1.413, all P<0.05). CONCLUSION: FGF19 and β-EP are of auxiliary diagnostic value in primary glaucoma, while PEDF and FGF19 are of evaluation value in disease severity. PEDF lower than 9.66pg/mL, FGF19 higher than 143.75ng/L and β-EP higher than 106.27ng/L are independent influencing factors of severe primary glaucoma.

目的 探讨LASIK术后再次手术时应用飞秒激光制瓣的可行性及其临床疗效.方法 选择在我院行近视LASIK矫治后再次出现近视并要求手术的患者43例(86眼),根据手术方法不同分为观察组(25例50眼)和对照组(18例36眼).观察组用飞秒激光制瓣,在波前像差引导下行准分子激光切削,对照组掀开原角膜瓣后也同样在波前像差引导下行准分子激光切削.比较术后6个月的裸眼视力、屈光度、高阶像差、对比敏感度等.结果 术后观察组患者角膜反应轻,对照组大部分患者有不同程度的刺激症状,角膜上皮内生发生率较高.术后6个月,观察组的裸眼视力(1.05±0.01)高于对照组(0.92±0.21),差异有统计学意义(P＜0.05);观察组的等效球镜度数为(0.53 ±0.34)D,对照组为(-0.23±0.47)D,差异有统计学意义(P＜0.01);观察组总高阶像差、彗差和球差均较术前明显降低,差异均有统计学意义(均为P＜0.05);对照组总高阶像差、彗差和球差均较术前增加,差异均有统计学意义(均为P＜0.05),两组间像差比较,除三叶草差异无统计学意义外,其余均显示观察组明显低于对照组,差异均有统计学意义(均为P ＜0.05).观察组对比敏感度在1.5c·d-1、3.0c·d-1、6.0 c·d-1、12.0 c·d-1、18.0 c·d-1空间频率下较术前均有改善,差异均有统计学意义(均为P＜0.05),对照组除在6.0 c·d-1空间频率下与术前相比差异无统计学意义外,在其余空间频率下均较术前下降,差异均有统计学意义(均为P＜0.05),观察组在5个空间频率下均显著高于对照组(均为P＜0.05).观察组患者满意率为92.0％,高于对照组的77.8％ (P ＜0.05).结论 LASIK术后再次手术时应用飞秒激光再次制瓣后行波前像差引导LASIK可显著降低高阶像差,改善眩光、暗视力差和夜间驾车困难等.

Objective To evaluate the clinical value and efficacy of gonioscope-guided suturing for traumatic cyclodialysis cleft (detachment of ciliary body).Methods Eighteen eyes of 18 cases with traumatic cyclodialysis cleft accepted the gonioscope guided suturing operation (cyclopexy) and among these eyes 2 eyes received iris suturing simultaneously for iris root detachment.The intraocular pressure (IOP) was 6-7.5 mmHg (1 mmHg =0.133 kPa).The visual acuities of all cases ranged from light perception to 0.25.The follow-up time was 6 months.Results All 18 cases (18 eyes) got reattachments of ciliary body after the surgery with increased intraocular pressure,improved visual acuity and deepened anterior chamber.The IOP increased from 6-7.5 mmHg to 13-22 mmHg.The postoperative best corrected visual acuity were 0.01-0.05 in 2 eyes,0.06-0.1 in 6 eyes,0.1-0.3 in 3 eyes and 0.6-0.8 in 3 eyes.Conclusion Gonioscope-guided suturing for the treatment of traumatic cyclodialysis cleft is effective,simple and suitable for clinical application.

Objective To evaluate the clinical effect of vitrectomy combined with cyclophotocoagulation for traumatic glaucoma.Methods 23 eyes of 23 cases with secondary glaucoma caused by complicated ocular injury underwent vitrectomy combined with cyclophotocoagulation.The intraocular pressure and visual acuity before and after operation were observed.Results The intraocular pressure was controlled in 16 cases after operation.The visual acuities were improved at different degrees in all cases.Conclusion Vitrectomy combined with cyclophotocoagulation is an effective method in the treatment of traumatic glaucoma.

AIM: To investigate the effect of heparin treatment on capsular tension ring(CTR)in the prevention of after-cataract postoperative patients with Marfan syndrome and subluxation of lens.METHODS: Totally 34 cases(56 eyes)were divided randomly into experimental and control groups. Preoperative heparin 12500 units was added to 500mL Ringer's infusion, and CTR was dealt with heparin stock solution soak for 20 minutes in experimental group; there was no any drugs in the control group's solution, and CTR was not dealt with heparin. Postoperative IOP, anterior chamber reaction, corneal edema, IOL position, posterior capsular opacification were observed.RESULTS: There was statistically significant difference in the posterior capsular opacification between the heparin group(13.3%)and the contral group no-heparin(69.2%)(P<0.01). In addition, anterior chamber reaction of the experimental group was significantly lighter than the control group. However, no significant differences were found between the two groups in IOP and corneal edema.CONCLUSION: The present results indicate that there is the preventive effect on posterior capsular opacification by CTR soaked in heparin in postoperative patients with Marfan syndrome and subluxation of lens, thus contributing to the recovery of visual function.