Abstract Purpose To evaluate the advantages and disadvantages of vitrectomy combined with cataract surgery compared with simple vitrectomy without cataract surgery in patients with proliferative diabetic retinopathy. Methods PubMed, EMBASE, CBM, COCHRANE, CNKI, WANFANG and VIP databases were systematically reviewed. Complications include transient ocular hypertension, corneal edema, anterior chamber inflammation, posterior synechia of iris, iris neovascularization, posterior capsular opacification, recurrent vitreous hemorrhage, macular edema and hard exudate of retina. Results Seventeen studies that included 1630 eyes were selected. The proportion of anterior chamber inflammation (OR = 2.15; P= 0.03) was higher in combined group than simple group. The proportions of iris neovascularization (OR = 0.40; P = 0.0002), vitreous hemorrhage (OR = 0.46; P = 0.02), macular edema (OR = 0.28; P = 0.007), hard exudation of retina (OR = 0.26; P = 0.004) and posterior capsular opacification (OR = 0.42; P = 0.006) were lower in combined group than simple group. The proportions of corneal edema, high intraocular pressure and iris synechia between two groups were similar. Conclusion Vitrectomy combined with cataract surgery could reduce retinal ischemia related complications than simple vitrectomy at the cost of increasing anterior chamber inflammation. Combined surgery should be considered first after weighing the advantages and disadvantages.

BACKGROUND:The insulin-like growth factor 1 (IGF1) gene is located within the myopia-associated MYP3 interval, which suggests it may play an important role in the progression of myopia. However, the association between IGF1 SNPs and any myopia is rarely reported. METHODS:A comprehensive literature search was conducted on studies published up to July 22, 2021 in PubMed, EMBASE, CBM, COCHRANE, CNKI, WANFANG and VIP databases. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated for single-nucleotide polymorphisms (SNPs) that have been evaluated in at least three studies. RESULTS:Nine studies involving 4596 subjects with any myopia and 4950 controls examined 25 SNPs in IGF1 gene, among which seven SNPs were included in this meta-analysis. Significant associations were not found in any genetic models between rs6214, rs12423791, rs5742632, rs10860862, rs5742629 and any myopia. Rs2162679 was suggestively associated with any myopia in the codominant model (GA vs. AA: OR = 0.87, 95% CI: 0.76-1.00) and the dominant model (GG+GA vs. AA: OR = 0.88, 95% CI = 0.78-1.00). CONCLUSION:Meta-analysis of updated data reveals that the G allele of the IGF1 rs2162679 SNP is a potential protective factor for any myopia, which is worth further researches.

Background:Intraocular lens (IOL) implantation is required after vitrectomy combined with cataract surgery in diabetic retinopathy patients. However, the question of whether an IOL should be implanted in stage I after vitrectomy or stage II during silicone oil filling has been controversial, and there has been no systematic review of this clinical issue. Methods:WanFang, SinoMed CNKI, VIP, PubMed, Embase, and Cochrane Library databases were systematically searched for relevant studies. The deadline was May 8, 2021. All studies of stage I or II IOL implantation in patients with diabetes who underwent vitrectomy were included. Revman 5.3 software was used for the meta-analysis. Results:Four studies, involving 253 eyes, were included. This study analyzed the literature with a common outcome index by meta-analysis and systematically evaluated the literature without a common outcome index. Four studies compared the efficacy and safety of the 2 sequential surgical methods in patients with diabetic retinopathy. The results of the meta-analysis showed that there was no significant difference in the efficacy and safety of stage II IOL implantation when compared with stage I IOL implantation (P > .05). One study showed that stage II cataract surgery with oil extraction resulted in better postoperative visual acuity and fewer complications than stage I cataract surgery with vitrectomy. One study showed that stage II IOL implantation during oil extraction had better postoperative visual acuity than stage I IOL implantation during vitrectomy without increasing surgical complications. Conclusion:Vitrectomy combined with stage II IOL implantation is safer and more effective than stage I in patients with diabetic retinopathy; however, more clinical studies are needed to verify this.

This paper was originally published in Aging Advance Online Publications on November 29, 2020. In compliance with Aging's withdrawal policy, the paper was withdrawn in its entirety. It will not appear in Aging internal or any external indexes or archives.

Background It has been reported that orthokeratology has the effects of slowing down myopia progression and axial elongation.However,the affecting mechanism of orthokeratology wearing on ocular peripheral refraction is still not elucidated.Objective This study was to observe and compare the changes of ocular peripheral refraction and relative peripheral refraction (RPR) in low to moderate myopic eyes of children after wearing orthokeratology lens and spectacles for 6 months.Methods A randomized controlled clinical trial was carried out after approval of Ethic Committee of Beijing Tongren Hospital and informed consent of guardians of the children.One hundred myopic children aged (ll.0±1.9) years were recruited in Beijing Tongren Hospital from June 2014 to January 2015,with the diopter of-0.50 to-6.00 D.The subjects were randomized into orthokeratology group and spectacles group by the process PLAN PROC of software SAS 9.1.3,50 for each group.The subjects in the orthokeratology group wore orthokeratology lens for 6 months and those in the spectacles group wore spectacles for the same period.An infrared open-field autorefractor was employed to measure the refraction at central 0°,temporal 15°,temporal 30°,nasal 15°and nasal 30° radial lines before and after wearing lens for the assessment and comparison of the changes of peripheral refraction and RPR.Results There was no significant difference in spherical equivalent between the orthokeratology group and the spectacles group before wearing lens ([-3.35±1.31] D versus [-3.01± 1.15] D,P =0.20).The peripheral refraction values in the orthokeratology group were (-2.28 ± 1.60),(-3.28±1.41),(-3.40±1.23),(-3.38±1.12) and (-2.09±1.29)D at nasal 15°and nasal30°,central,temporal 15° and temporal 30°radial lines before wearing lens,and reduced by (0.29±1.67),(0.85±1.66),(0.92±1.76) and (0.66±1.66) D at nasal 30°,nasal 15°,central and temporal 15° after wearing lens,respectively,with significant differences at nasal 15°,central and temporal 15°(all at P＜0.05).The peripheral refraction values in the spectacles group were (-1.88±1.30),(-2.66±1.18),(-2.89±1.27) and (-1.94±1.31)D at nasal 15°,nasal 30°,temporal 15 ° and temporal 30°,radial lines before wearing lens and increased by (-0.25±0.80),(-0.43 ±0.67),(-0.32±0.64) and (-0.22±0.75)D after wearing lens,respectively,with significant differences between before and after wearing lens (all at P＜0.05).The RPR shifted from hyperopia defocus to myopia defocus before and after wearing lens in temporal 15° and 30° radial lines in the orthokeratology group,and at various radial lines in the spectacles group,the RPR showed gradually worsening of hyperopia defocus.Conclusions Long-term wearing of orthokeratology results in a hyperopia shifting in myopic children by exposing the peripheral retina towards relative myopia defocus,whereas wearing spectacles leads to a relative hyperopia defocus on retina.Thus,orthokeratology may slow down the myopia progression.

Myopic foveoschisis (MF) is among the leading causes of visual loss in high myopia. However, it remains controversial whether internal limiting membrane (ILM) peeling or gas tamponade is necessary treatment option for MF.

BACKGROUND:To report the thickness of the peripapillary retinal nerve fibre layer (pRNFL) in Chinese children and examine its association with refractive error, axial length (AL) and optic disc parameters. DESIGN:Population-based cross-sectional study. PARTICIPANTS:A total of 2893 seven-year-old children from 11 randomly selected primary schools in Anyang, central China. METHODS:Participants underwent ophthalmic examinations including optical biometry, cycloplegic autorefraction and spectral-domain ocular coherence tomography. MAIN OUTCOME MEASURES:Retinal nerve fibre layer thickness in 16 radial sections, cycloplegic spherical equivalent, AL. RESULTS:The mean (SD) average RNFL thickness was 102.01(8.02) µm. The average RNFL thickness decreased with smaller disc area (r = 0.18, R2  = 0.03, P < 0.0001), bigger cup area (r = -0.11, R2  = 0.01, P < 0.0001), smaller rim area (r = 0.28, R2  = 0.08, P < 0.0001), smaller nerve head volume (r = 0.27, R2  = 0.07, P < 0.0001), longer AL (r = -0.15, R2  = 0.02, P < 0.0001) and a negative spherical equivalent (r = 0.11, R2  = 0.01, P < 0.0001). Hyperopic children had a thicker RNFL than emmetropic children [102.45(8.13) µm vs. 100.81 (7.18) µm, P < 0.001]. Myopic children had thinner RNFL than emmetropic children [99.17 (7.69) µm vs. 100.81 (7.18) µm, P < 0.05]. CONCLUSION:Retinal nerve fibre layer thickness decreased with increasing AL, higher myopia, bigger cup area, smaller disc and rim area, and a smaller nerve head volume, but the coefficient of determination for all these associations was small. The RNFL in myopes was significantly thinner than emmetropes or hyperopes, but with small absolute differences. The study provides RNFL values for healthy 7-year-old Chinese children. Follow up of this cohort to observe the change of RNFL thickness with myopia and possible change in detected associations with age is planned.

To evaluate the effect of soft contact lens with concentric ring bifocal and peripheral add multifocal designs on controlling myopia progression in school-aged children. We systematically searched MEDLINE, EMBASE, Cochrane Library and reference lists of included trials. Methodological quality of included trials was assessed using Jadad Scale and Newcastle-Ottawa Quality Assessment Scale items. We identified five randomised controlled trials (RCTs) and three cohort studies with a total of 587 myopic children. Compared with the control group, concentric ring bifocal soft contact lenses showed less myopia progression with a weighted mean difference (WMD) of 0.31 D (95

Background Preferred practice pattern (PPP) is an evidence-based documents which can be used for reference to standardize medical practice by ophthalmologists.So far it has been promoted for more than 10 years in China.However,there is no report about the popularization and application of PPP in China.Objective This study was to investigate the cognitions of ophthalmologists to PPP from the view of clinical questions.Methods A questionnaire-based study was conducted.Questionnaires were dispensed during September 17 to 21,2014 to inquiry into the cognitions of ophthalmologists to PPP in the 19th Congress of Chinese Ophthalmological Society.A selfadministered questionnaire was designed and discussed according to the article published in the past by our research group.It included personal basic information and cognitions to PPP,and the latter consisted of self-assessment and cognition scoring.The constituent ratios of aware,quite aware,unaware and fully unaware ophthalmologists were counted.The cognitions were divided into low level (0-4 scores),moderate level (5-8 scores) and high level (9-12 scores) based on the effective answer sheets.The questionnaires were filled out anonymously and incomplete questionnaires were excluded.Results Among the 300 distributed questionnaires,282 were retrieved and 209 were valid,with the effective rate 74.1％.The ophthalmologists of awareness to PPP were 46.4％ (97/209),and 53.6％ (112/209) of respondents did not know PPP very well.A positive correlation was found between the awareness to PPP and the cognition scores to clinical issues (r,=0.143,P ＜ 0.05).The cognition scores to clinical issues were significantly different among different educational backgrounds (F =12.26,P ＜ 0.05),and cognition scores were significantly reduced in the ophthalmologists with lower master degree in comparison with the ophthalmologists with doctoral degree (all at P＜0.05).The coincide ratio between cognitions of ophthalmologists to different clinical issues and suggestions in PPP were evidently different in the ophthalmologists,with the highest coincide ratio 83％ and the lowest coincide ratio 1％.Conclusions The awareness to PPP is not adequate in Chinese eye doctors,which reduces the cognition level to clinical issues.There is a poor coincide ratio between cognitions of Chinese ophthalmologists to clinical issues and suggestions in PPP.This study emphasizes the need for effective awareness programs towards clinical issues based on PPP.

Myopia is a public health problem in the world and its prevalence and incidence are rising in recent years. Studies have shown that myopia is a kind of complex genetic diseases. And sclera-remodeling plays an important role in the development of myopia. The recent research advances in association with both sclera-remodeling relevant gene polymorphisms and myopia are reviewed in this article. (Chin J Ophthalmol, 2016, 52: 876-880).

目的 对美国医学会杂志(The Journal of American Medical Association,JAMA)自2000-2014年收录的眼科方面的文献进行检索和阅读,以了解眼科临床研究的热点问题及研究方向.设计 文献检索分析.研究对象 JAMA杂志2000年1月至2014年2月期间发表的文章.方法 在Pubmed数据库中,MeSH Terms输入“eye”及其所有下位主题词,选择杂志“JAMA”,检索出JAMA收录的眼科相关文献,通过阅读摘要及部分精简全文进一步筛选.主要指标 文献种类.结果 共获得眼科相关文献92篇.按文章类型分类,包括论著26篇(28.3％)、述评38篇(41.3％)、通信6篇(6.5％)、综述10篇(10.9％,其中系统评价1篇)及病例报告12篇(13.0％).按研究内容分类,包括病因及危险因素30篇(32.6％)、治疗14篇(15.2％)、疾病综合评价21篇(22.8％).按研究类型分类,26篇论著中有队列研究8篇、纵向研究6篇、横断面调查5篇、病例对照研究3篇、随机对照试验3篇(其中多中心随机对照试验1篇)及其他1篇.按作者国家和地区分类,美国最多为58篇(63.0％),其次为英国和加拿大各6篇(6.5％),中国大陆1篇述评,中国台湾1篇病例报告.按疾病分类,年龄相关性黄斑变性的文献最多为14篇(15.2％),多为探讨其病因及危险因素(6篇);其次为白内障13篇(14.1％),多关于手术预后(7篇).视网膜脱离和糖尿病视网膜病变的文献分别10篇(10.9％)和9篇(9.8％).结论 JAMA杂志在眼科领域重点关注年龄相关性黄斑变性等眼底病的病因和治疗以及白内障的手术预后等,方法学相应偏重于队列研究、纵向研究和横断面调查,美国发表文献最多,体现出明显的地域特色.

Chinese eye exercises have been implemented in China as an intervention for controlling children’s myopia for over 50 years. This nested case-control study investigated Chinese eye exercises and their association with myopia development in junior middle school children. Outcome measures were the onset and progression of myopia over a two-year period. Cases were defined as 1. Myopia onset (cycloplegic spherical equivalent ≤ −0.5 diopter in non-myopic children). 2. Myopia progression (myopia shift of ≥1.0 diopter in those who were myopic at baseline). Two independent investigators assessed the quality of Chinese eye exercises performance at the end of the follow-up period. Of 260 children at baseline (mean age was 12.7 ± 0.5 years), 201 were eligible for this study. There was no association between eye exercises and the risk of myopia-onset (OR = 0.73, 95%CI: 0.24–2.21), nor myopia progression (OR = 0.79, 95%CI: 0.41–1.53). The group who performed high quality exercises had a slightly lower myopia progression of 0.15 D than the children who did not perform the exercise over a period of 2 years. However, the limited sample size, low dosage and performance quality of Chinese eye exercises in children did not result in statistical significance and require further studies.

To analyze the components of young Chinese eyes with special attention to differences in corneal power, anterior segment length and lens power. Cycloplegic refractions and ocular biometry with LENSTAR were used to calculate lens power with Bennett’s method. Mean refraction and mean values for the ocular components of five different refractive groups were studied with ANOVA and post-hoc Scheffé tests. There were 1889 subjects included with full data of refraction and ocular components. As expected, mean axial length was significantly longer in myopic eyes compared to emmetropes. Girls had steeper corneas, more powerful lenses and shorter eyes than boys. Lens power was lower in boys and also lower in myopic eyes. Lens thickness was the same for both genders but was lower in myopic eyes. Although cornea was steeper in myopic eyes in the whole sample, this was a gender effect (more girls in the myopic group) as this difference disappeared when the analysis was split by gender. Anterior segment length was longer in myopic eyes. In conclusion, myopic eyes have lower lens power and longer anterior segment length, that partially compensate their longer axial length. When analyzed by gender, the corneal power is not greater in low and moderate myopic eyes.

OBJECTIVE The TGFB1 gene is among the most studied genes in high myopia due to its role in scleral remodeling. But reported findings of association on TGFB1 and high myopia are inconsistent. This present study is to evaluate the association of TGFB1 polymorphisms and high myopia. METHODS A comprehensive literature search was conducted on studies published up to April 5, 2015. Summary odds ratios (ORs) and 95% confidence intervals were analyzed. Heterogeneity across studies was evaluated by Cochran Q statistic test and the I(2) index. Sensitivity analyses were conducted by the approach of one-study remove to assess the influence of single study on the combined effect. RESULTS Eight studies were included in this study for meta-analysis. Rs1982073 was associated with high myopia in dominant model (OR=1.64; 95% CI=1.04~2.58; P<0.05), heterozygous model (OR=1.54; 95% CI=1.02~2.33; P<0.05), homozygous model (OR=1.90; 95% CI=1.01~3.55; P=0.05) and allelic model (OR=1.36; 95% CI=1.01~1.84; P=0.05). However, there was no statistical significance when Bonferroni correction was considered. Rs4803455 was associated with high myopia in recessive model (OR=0.40; 95% CI=0.25~0.64; P<0.01) and homozygous model (OR=0.42; 95% CI=0.26~0.68; P<0.01). Rs1800469 was associated with high myopia in allelic model (OR=0.78; 95% CI=0.64~0.96; P<0.05). And the associations can withstand Bonferroni correction in models mentioned above when referring to rs4803455 (P<0.01) and rs1800469 (P<0.05). CONCLUSIONS Meta-analysis of existing data revealed a suggestive association of TGFB1 rs1982073 and rs4803455 with high myopia.

PURPOSE:To develop three-surface paraxial schematic eyes with different ages and sexes based on data for 7- and 14-year-old Chinese children from the Anyang Childhood Eye Study.METHODS:Six sets of paraxial schematic eyes, including 7-year-old eyes, 7-year-old male eyes, 7-year-old female eyes, 14-year-old eyes, 14-year-old male eyes, and 14-year-old female eyes, were developed. Both refraction-dependent and emmetropic eye models were developed, with the former using linear dependence of ocular parameters on refraction.RESULTS:A total of 2059 grade 1 children (boys 58%) and 1536 grade 8 children (boys 49%) were included, with mean age of 7.1 ± 0.4 and 13.7 ± 0.5 years, respectively. Changes in these schematic eyes with aging are increased anterior chamber depth, decreased lens thickness, increased vitreous chamber depth, increased axial length, and decreased lens equivalent power. Male schematic eyes have deeper anterior chamber depth, longer vitreous chamber depth, longer axial length, and lower lens equivalent power than female schematic eyes. Changes in the schematic eyes with positive increase in refraction are decreased anterior chamber depth, increased lens thickness, decreased vitreous chamber depth, decreased axial length, increased corneal radius of curvature, and increased lens power. In general, the emmetropic schematic eyes have biometric parameters similar to those arising from regression fits for the refraction-dependent schematic eyes.CONCLUSIONS:The paraxial schematic eyes of Chinese children may be useful for myopia research and for facilitating comparison with other children with the same or different racial backgrounds and living in different places.

PURPOSE:To test the hypothesis that relative peripheral hyperopia predicts development and progression of myopia. METHODS:Refraction along the horizontal visual field was measured under cycloplegia at visual field angles of 0°, ±15°, and ±30° at baseline, 1 and 2 years in over 1700 initially 7-year-old Chinese children, and at baseline and 1 year in over 1000 initially 14-year olds. One refraction classification for central refraction was "nonmyopia, myopia" (nM, M), consisting of nM greater than -0.50 diopters (D; spherical equivalent) and M less than or equal to -0.50 D. A second classification was "hyperopia, emmetropia, low myopia, and moderate/high myopia" (H, E, LM, MM) with H greater than or equal to +1.00 D, E, -0.49 to +0.99 D, LM, -2.99 to -0.50 D, and MM less than or equal to -3.00 D. Subclassifications were made on the basis of development and progression of myopia over the 2 years. Changes in central refraction over time were determined for different groups, and relative peripheral refraction over time was compared between different subgroups. RESULTS:Simple linear regression of central refraction as a function of relative peripheral refraction did not predict myopia progression as relative peripheral refraction became more hyperopic: relative peripheral hyperopia and relative peripheral myopia predicted significant myopia progression for 0% and 35% of group/visual field angle combinations, respectively. Subgroups who developed myopia did not have more initial relative peripheral hyperopia than subgroups who did not develop myopia. CONCLUSIONS:Relative peripheral hyperopia does not predict development nor progression of myopia in children. This calls into question the efficacy of treatments that aim to slow progression of myopia in children by "treating" relative peripheral hyperopia.

The aim of this study was to investigate the role of the transcription factor, PAX6, in the development of retinoblastoma. The expression of endogenous PAX6 was knocked down using PAX6-specific lentivirus in two human retinoblastoma cell lines, SO-Rb50 and Y79. Cell proliferation functional assays and apoptotic assays were performed on the cells in which PAX6 was knocked down. The results revealed that PAX6 knockdown efficiency was significant (P<0.01, n=3) in the SO-Rb50 and Y79 cells. The inhibition of PAX6 reduced tumor cell apoptosis (P<0.05, n=3), but induced cell cycle S phase arrest (SO-Rb50; P<0.05, n=3) and G2/M phase arrest (Y79; P<0.05, n=3). Western blot analysis indicated that the inhibition of PAX6 increased the levels of the anti-apoptotic proteins, Bcl-2, proliferating cell nuclear antigen (PCNA) and CDK1, but reduced the levels of the pro-apoptotic proteins, BAX and p21. In conclusion, our data demonstrate that the suppression of PAX6 increases proliferation and decreases apoptosis in human retinoblastoma cells by regulating several cell cycle and apoptosis biomarkers.

患者,女,68岁,汉族,右眼视物逐渐模糊5年余,期间偶伴有右眼红、胀痛及头痛,曾于当地诊为"白内障",建议手术.病情加重半年,于2010年3月30日就诊于当地某医院,以"右眼脉络膜黑色素瘤?"收入院.患者自患病以来,神志清,纳佳,大小便正常.于2006年因"宫颈癌"于全身麻醉下行"全子宫切除+盆腔淋巴结清扫术",术后曾行放射治疗、化学治疗;否认高血压及糖尿病史、传染病史、外伤史、药物过敏史、输血史.当地眼科检查:视力右眼数指/眼前,左眼0.8.眼压右眼16 mmHg(1 mmHg=0.133 kPa),左眼18 mmHg.右眼角膜后沉着物(KP)(-),颞上方虹膜与角膜相贴,鼻下方虹膜瞳孔缘后粘连,未见新生血管,双侧晶状体混浊;散瞳眼底检查示右鼻侧玻璃体腔可见棕色瘤样肿物,表面未见新生血管,右眼底窥不清,左眼底未见明显异常.

Background and Objectives A hardcopy or paper cognitive aid has been shown to improve performance during the management of simulated local anesthetic systemic toxicity (LAST) when given to the team leader. However, there remains room for improvement to ensure a system that can achieve perfect adherence to the published guidelines for LAST management. Recent research has shown that implementing a checklist via a designated reader may be of benefit. Accordingly, we sought to investigate the effect of an electronic decision support tool (DST) and designated “Reader” role on team performance during an in situ simulation of LAST. Methods Participants were randomized to Reader + DST (n = 16, rDST) and Control (n = 15, memory alone). The rDST group received the assistance of a dedicated Reader on the response team who was equipped with an electronic DST. The primary outcome measure was adherence to guidelines. Results For overall and critical percent correct scores, the rDST group scored higher than Control (99.3% vs 72.2%, P < 0.0001; 99.5% vs 70%, P < 0.0001, respectively). In the LAST scenario, 0 (0%) of 15 in the control group performed 100% of critical management steps, whereas 15 (93.8%) of 16 in the rDST group did so (P < 0.0001). Conclusions In a prospective, randomized single-blinded study, a designated Reader with an electronic DST improved adherence to guidelines in the management of an in situ simulation of LAST. Such tools are promising in the future of medicine, but further research is needed to ensure the best methods for implementing them in the clinical arena.

Olfactomedin-domain family has been the focus of many recent studies.Although there is little knowledge of its biological functions,more and more evidence show the family members play important roles in the neuro-origin,cell adhesion,modulation of cell cycle and tumor genesis and development.It may also be related with many important signal paths such as Wnt signal path,and so may be associated with eye developments and pathological processes.This article reviews the research advances of this family in ophthalmology these years.