MYCN amplification is a recurrent, high-risk molecular hallmark across diverse tumors, most notably neuroectodermal malignancies. Although MYCN-driven tumors uniformly exhibit robust intrinsic resistance to ferroptosis, the mechanistic link between MYCN and the ferroptotic pathway remains undefined. Here, we charted the genomic and epigenomic landscape of neuroectodermal tumors by combining single-cell RNA-seq, spatial transcriptomics (ST), CUT&Tag, and deep-coverage mass spectrometry proteomics. This integrative atlas identified UBE2C as a spatially resolved, MYCN-controlled driver gene. MYCN occupies the UBE2C promoter and potently transactivates its transcription, thereby accelerating tumor progression in vitro and in vivo. Re-expression of UBE2C fully rescued the proliferative arrest triggered by MYCN depletion, confirming its essential function downstream of MYCN. Proteomic interrogation of the UBE2C interactome further revealed that the tumor suppressor TFRC is a previously unknown ubiquitination substrate of UBE2C. Mechanistically, the polyubiquitination and proteasomal degradation of TFRC by UBE2C reduces iron influx and effectively shields cancer cells from ferroptosis. Clinically, genetic silencing of UBE2C induces ferroptosis and sensitizes tumor cells to the ferroptosis inducer erastin, revealing a therapeutically exploitable vulnerability in MYCN-amplified malignancies. Our study reveals a previously unrecognized MYCN-UBE2C-TFRC-ferroptosis regulatory axis that drives neuroectodermal tumor growth. These findings establish a mechanistic rationale for combining UBE2C silencing and ferroptosis induction as a precision therapeutic strategy against MYCN-amplified tumors.

Introduction Retinoblastoma is divided into two clinical types, sporadic and heritable, and is the most common primary intraocular malignancy in infancy and childhood. It was the first malignancy to demonstrate the genetic etiology of cancer, with the RB1 gene as the only pathological gene present in heritable cases. Although the RB1 mutation p.E125* had been previously reported in other retinoblastoma patients, it lacked functional analysis.Methods In this study, we identified the RB1 p.E125* mutation in a bilateral retinoblastoma patient from China. We investigated the distribution, cell localization, and function of this mutation using molecular biology and structural analysis following the transfection of cells with plasmids encoding the mutant RB1 gene.Results Functional analyses revealed abnormal protein localization, altered cell cycle distribution, and apoptosis in cells transfected with the mutant RB1 plasmids.Discussion Our findings contribute to a better understanding of RB1 mutation hotspots. Furthermore, our results highlight the importance of offering targeted genetic testing and counseling to families with RB1 mutations. The identification of the somatic origin of this mutation was vital in ruling out the heritability of this condition in this specific patient.

Purpose:The regulatory role of N5-methylcytosine (m5C) RNA modification is of vital importance for the metabolism of RNA. As a natural product isolated from Dendrobium chrysotoxum Lindl., erianin shows promising therapeutic efficacy in cancer therapy. Herein, we determined that erianin serves as a naturally occurring NOP2/Sun RNA methyltransferase 2 (NSUN2) inhibitor in malignant vascular formation in uveal melanoma. Methods:Natural product library screening was conducted to explore the effects of natural product monomers on uveal melanoma cells. An intraocular xenografts model was established to examine the effect of erianin. Immunoprecipitation and mass spectrometry (IP-MS) and molecular docking analyses were used to identify NSUN2 as the target of erianin. m5C-methylated RNA immunoprecipitation sequencing (MeRIP-seq) and m5C-MeRIP quantitative PCR (MeRIP-qPCR) analyses were conducted to identify the downstream target of NSUN2. Tube formation assay and CD31/periodic acid-Schiff (PAS) double staining were performed to detect vasculogenic mimicry (VM) capacities. Results:Here, employing Cell Counting Kit-8 (CCK-8), colony-formation, and Transwell assays, we demonstrated that erianin markedly restrains uveal melanoma (UM) proliferation and invasion in vitro. Biotin-linked affinity enrichment coupled to mass spectrometry identified the m5C methyltransferase NSUN2 as a direct molecular target of erianin. Functionally, erianin disrupts NSUN2-mediated m5C modification and thereby abolishes the tube-forming capacity of uveal melanoma cells. Integrated multi-omic profiling further pinpointed glutathione-specific γ-glutamylcyclotransferase-1 (CHAC1) as a critical downstream effector of NSUN2. Erianin inhibits the m5C modification and expression levels of CHAC1 during cancerous progression, thereby curtailing the tube formation of UM cells. Conclusions:Collectively, our data suggest that erianin serves as an inhibitor of vasculogenic mimicry. Our results unveil a novel therapeutic strategy for combating malignant progression by fine-tuning m5C modification with a natural product.

Abstract Purpose To examine the association between tear glucose (TG) and the presence and severity of diabetic retinopathy (DR) in patients with type 2 diabetes mellitus (T2DM). Methods A cross-sectional study. TG was examined by rapid qualitative test strip in 160 patients. The severity of DR was graded as mild DR and severe DR. The presence and severity of DR were compared between patients with positive and negative TG. The association of TG with the presence and the severity of DR was estimated by multivariable regression analysis and spearman’s rank correlation test, respectively. The performance of TG to detect DR was evaluated by the receiver operating characteristic (ROC) curve. Results In this study, 160 patients were included, with a median age of 64.0 years, and 88 (55.0%) patients were males. A total of 91 (56.9%) patients had positive TG, and 69 (43.1%) patients had negative TG. In TG-positive group, 41 (45.1%) patients were diagnosed with DR, among them, 8 (19.5%) patients had mild DR, and 33 (80.5%) patients were afflicted with severe DR. Multivariable logistic regression indicated that the presence of DR positively correlated with the presence of positive TG (odds ratio [OR], 3.62; 95% confidence interval [CI], 1.56–8.40; p < 0.01), longer duration of diabetes (OR, 1.11; 95% CI 1.06–1.17; p < 0.01) and higher HbA1c (OR, 1.25; 95% CI 1.01–1.54; p = 0.03). Moreover, Spearman’s correlation analysis suggested that the grading of TG increased with the severity of DR (rs = 0.28, p < 0.01). The area under the curve (AUC) of the model integrating TG, the duration of diabetes and HbA1c was 0.76 (95% CI 0.69–0.84), indicating a fair discriminative ability of DR. Conclusion TG level was associated with the presence and the severity of DR. TG might be an easy-to-use, non-invasive parameter to the screening and monitoring of DR among patients with diabetes.

Aim This study used swept-source optical coherence tomography (SS-OCT) to investigate subfoveal choroidal thickness (SFCT) in patients with thyroid-associated ophthalmopathy (TAO) who displayed different levels of disease activity and severity. Methods Thirty patients with TAO (60 eyes) and 38 healthy controls (67 eyes) in Shanghai, China, were recruited for this study. Disease activity and severity were graded using European Group on Graves’ Orbitopathy standardised criteria. SFCT values were determined by SS-OCT. Results In total, 129 eyes were included in the final analysis. The mean SFCT was significantly thicker among patients with active disease (276.23±84.01 µm) than among patients with inactive disease (224.68±111.61 µm; p=0.049) or healthy controls (223.56±78.69 µm; p=0.01). There were no differences in SFCT among patients with moderate-to-severe disease, patients with severe disease and healthy controls (p>0.05). Changes in SFCT demonstrated strong predictive ability to distinguish active TAO from inactive TAO (area under the curve=0.659, 95% CI 0.496 to 0.822). Conclusions SFCT was strongly associated with Clinical Activity Score in patients with TAO. Choroidal thickening was observed during active TAO. SS-OCT offers a non-invasive method for follow-up assessment.

This study aims to determine the influence of vitrectomy combined with macular epiretinal membrane dissection and internal limiting membrane (ILM) peeling and phacoemulsification on choroidal vasculature in patients with unilateral idiopathic epiretinal membrane (IERM) and concurrent cataract using optical coherence tomography (OCT). This retrospective study included 26 eyes of 26 patients (8 males and 18 females) with unilateral IERM without vitreomacular traction (VMT) (group 1) and the patients’ fellow eyes (n = 26, group 2). Three-port 25-G pars plana vitrectomy (PPV) combined with macular epiretinal membrane dissection and ILM peeling and phacoemulsification was performed on all patients. The comprehensive ophthalmologic examinations of all patients involved OCT measurements at every visit before and after surgery, and the choroidal thickness (CT), central macular thickness (CMT) and choroidal vascularity index (CVI) were calculated. The mean age of the IERM patients was 66.58 ± 7.06 years. Postoperatively, best corrected visual acuity (BCVA) was significantly greater than baseline (P = 0.023). The CVI of the IERM eyes was significantly lower (P < 0.01) than that of the fellow eyes at baseline. The subfoveal CT in the IERM eyes was lower than that in the fellow eyes (P = 0.023), but there was, no significant difference in the average CT between the two groups at baseline (P = 0.071). In eyes with IERM, the CVI significantly increased at 1 week, 1 month (P < 0.001), and 3 months (P = 0.049) postoperatively, the subfoveal CT was markedly thickened 1 month after surgery (P = 0.001), the temporal 3 mm and nasal CT significantly increased at 1 week and 1 month postoperatively (P = 0.041, P = 0.022 for temporal 3 mm; P < 0.001, P = 0.047 for nasal 1.5 mm; P = 0.01, P = 0.001 for nasal 3 mm), and only the temporal 3 mm CT increased significantly at 3 months postoperatively (P = 0.017). The baseline CMT of the IERM eyes was significantly thicker than that of the fellow eyes (P < 0.001). CMT significantly decreased at 3 months postoperatively in IERM eyes(P = 0.033). The increase in the CVI in the IERM eyes without VMT after combined PPV with ILM peeling and phacoemulsification persists for at least 3 months.

目的:探索翻转课堂联合改良的迷你临床演练评估(mini-clinical evaluation exercise,Mini-CEX)在眼科住院医师规范化培训中的应用可行性及效果.方法:回顾性分析上海交通大学医学院附属第九人民医院眼科在2018—2021年所有参加规范化培训结业考核的住院医师,共计39人.比较翻转课堂教学方法实施前后,包括改良Mini-CEX在内的综合能力考核、毕业合格率、课程出勤率及学员对教学模式的满意度.结果:实验组20人(2020及2021年毕业),对照组19人(2018及2019年毕业).两组间的性别比例、学历或学制构成差异无统计学意义(P>0.05).实验组的毕业合格率明显高于对照组(100.00％vs 68.42％,P=0.008);改良Mini-CEX(P=0.011)及放射诊断(P=0.025)平均成绩也显著高于对照组.两组的理论考核及心电图诊断的平均成绩无统计学差异.4年间的比较发现,学员的改良Mini-CEX平均成绩(P=0.006)及线下课出勤率(P=0.025)出现显著提升.实验组对教学模式的满意度显著高于对照组.结论:翻转课堂联合改良Mini-CEX应用于眼科住院医师规范化培训教学可获得良好效果,提示了积极的深入研究及拓展应用前景.

PURPOSE: To report three-decade changes of clinical characteristics, progress of treatments, and risk factors associated with mortality and enucleation in patients with retinoblastoma in China. DESIGN: Retrospective cohort study. METHODS: This multicenter study included 2552 patients diagnosed with retinoblastoma in 38 medical centers in 31 provinces in China from 1989 to 2017, with follow-up data. Kendall's tau-b value was used to describe correlation coefficients between the three eras (between 1989 and 2008, between 2009 and 2013, and between 2014 and 2017) and clinical or demographic features. Hazard ratios and odds ratios were applied to measure risk factors. RESULTS: A total of 324 (13%) patients died and 1414 (42%) eyes were removed. The 1-year, 3-year, and 5-year overall survival rates were 95%, 86%, and 83%, respectively. Patients were diagnosed at a better stage by International Classification for Retinoblastoma over time (Kendall's tau-b value = -0.084, P < .001). Pathological risk factors were also observed less in recent eras. New conservative therapies were adopted and used in more patients. The eye removal rate gradually decreased (Kendall's tau-b value = -0.167, P < .001). The over all survival rates were 81%, 83%, and 91% in the three eras. By multivariate Cox regression, bilateral tumors and extraocular extension were identified as risk factors for death. Among intraocular disease, Group E indicated higher risk of mortality. By multivariate logistics regression, unilateral tumors, earlier era of diagnosis, and extraocular extension were risk factors for eye salvage failure. Among intraocular retinoblastoma, Groups D and E had higher risk of eye salvage failure. CONCLUSIONS: Patients were diagnosed at an earlier stage in recent eras. Conservative therapies, including intra-arterial chemotherapy, were increasingly being used. The above changes may contribute to the decreasing enucleation rate. Although no significant impact was identified on the mortality by the three eras, a decreasing trend was shown. (C) 2021 Elsevier Inc. All rights reserved.

Very limited progress has been made in the management of advanced melanoma, especially melanoma of uveal origin. Lactamase β (LACTB) is a novel tumor suppressor; however, its biological function in melanoma remains unknown. Herein we demonstrated markedly lower LACTB expression levels in melanoma tissues and cell lines. Overexpression of LACTB suppressed the proliferation, migration and invasion of melanoma cells in vitro. Mechanistically, LACTB inhibited the activity of yes-associated protein (YAP). We showed that the level of phospho-YAP (Serine 127) was increased upon LACTB overexpression, which prevented the translocation of YAP to the nucleus. Further, LACTB could directly bind to PP1A and attenuate the interaction between PP1A and YAP, resulting in decreased YAP dephosphorylation and inactivation in a LATS1-independent manner. Additionally, transfection of phosphorylation-defective YAP mutants reversed LACTB-induced tumor suppression. Upstream, we demonstrated that SOX10 binds to the LACTB promoter and negatively regulates its transcription. Overexpression of LACTB also suppressed the tumorigenicity and lung metastasis of MUM2B uveal melanoma cells in vivo. Taken together, our findings indicate a novel SOX10/LACTB/PP1A signaling cascade that renders YAP inactive and modulates melanoma progression, offering a new therapeutic target for melanoma treatment.

Ocular melanoma, including uveal melanoma (UM) and conjunctival melanoma (CM), is the most common and deadly eye cancer in adults. Both UM and CM originate from melanocytes and exhibit an aggressive growth pattern with high rates of metastasis and mortality. The integral membrane glycoprotein beta-secretase 2 (BACE2), an enzyme that cleaves amyloid precursor protein into amyloid beta peptide, has been reported to play a vital role in vertebrate pigmentation and metastatic melanoma. However, the role of BACE2 in ocular melanoma remains unclear. In this study, we showed that BACE2 was significantly upregulated in ocular melanoma, and inhibition of BACE2 significantly impaired tumor progression both in vitro and in vivo. Notably, we identified that transmembrane protein 38B (TMEM38B), whose expression was highly dependent on BACE2, modulated calcium release from endoplasmic reticulum (ER). Inhibition of the BACE2/TMEM38B axis could trigger exhaustion of intracellular calcium release and inhibit tumor progression. We further demonstrated that BACE2 presented an increased level of N6-methyladenosine (m6A) RNA methylation, which led to the upregulation of BACE2 mRNA. To our knowledge, this study provides a novel pattern of BACE2-mediated intracellular calcium release in ocular melanoma progression, and our findings suggest that m6A/BACE2/TMEM38b could be a potential therapeutic axis for ocular melanoma.

AIM OF THE STUDY:This study was aimed to investigate the growth patterns and the relationship of the eyeball and the orbit using computed tomography (CT)-based three-dimensional (3D) techniques. MATERIALS AND METHODS:A total of 175 Chinese patients who had undergone craniofacial or orbital CT scans were enrolled. This study only included data from the unaffected eye and orbit. Images were processed using 3D reconstruction to obtain the eyeball and the orbit parameters. RESULTS:In early postnatal years, the sizes of eyeball and orbit increased significantly with age (p < 0.001) and reached a turning point at a critical age (8.967 and 12.800 years for the eyeball and orbit volume, respectively). The orbital index and orbital depth index, showing the shape of the orbital aperture and walls, decreased significantly with age (p < 0.001). In all ages, the orbit size was correlated with eyeball size (p < 0.001). The eye-orbit index, equivalent to the ratio of eye volume to orbital volume, declined steadily with age (p < 0.001). CONCLUSIONS:The eyeball and orbit developed rapidly in early postnatal years, and then matured at a critical age. The eyeball size significantly contributed to the orbital growth; this contribution may be reduced as the eye-orbit index decreased with age. To the best of our knowledge, this is the first report on the growth and interrelation of the eyeball and the orbit using CT-based 3D techniques.

AIM: To investigate the changes in choroidal thickness (CT) in high myopic eyes after femtosecond laser-assisted in situ keratomileusis (FS-LASIK) surgery or central hole implantable collamer lens (ICL V4c) implantation using swept-source optical coherence tomography (SS-OCT). METHODS: We examined the right eyes of 116 patients with high myopia who were candidates for FS-LASIK surgery and ICL implantation. Sixty eyes underwent ICL V4c implantation and 56 eyes were subjected to FS-LASIK surgery. The CT was measured with SS-OCT. All data were recorded preoperatively and 2h, 1wk, 1 and 3mo postoperatively. Other demographic information was collected, including age, sex, uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA), spherical equivalent (SE), intraocular pressure (IOP) and axial length (AL). RESULTS: The UCVA improved in both groups and showed no significant differences between groups. There also were no significant differences between the two groups in postoperative BCVA and SE (P=0.581 and 0.203, respectively). The foveal CTs, inner nasal and outer nasal CTs were significantly thicker at 2h postoperatively in both groups (P<0.05) but returned to baseline levels in 1wk; after 1mo, no significant differences were found relative to the preoperative values. At 3mo in each group, nine regions showed variations in the CT as compared with preoperative thickening, but only the foveal and nasal area CTs preoperative differences were statistically significant (P<0.05). In addition, there was no significant difference in 9 regions of CT between the two groups at all follow-up times (P>0.05). CONCLUSION: The CTs after ICL implantation and FS-LASIK surgery are significantly thicker than those before operation, especially in the foveal and nasal areas, but there is no significant difference between the two methods.

The present study aimed to assess the visual and refractive outcomes of an implantable collamer lens with a central hole (ICL V4c) for residual refractive error correction after corneal refractive surgery in individuals with myopia. A total of 16 eyes of eight consecutive patients with myopia undergoing ICL V4c implantation after corneal refractive surgery were investigated. The uncorrected visual acuity (VA) and best-corrected VA were examined prior to surgery and at 1, 3 and 6 months after surgery. The post-operative values of the modulation transfer function (MTF) cutoff frequency, Strehl ratio (SR), objective scattering index (OSI) and Optical Quality Analysis System (OQAS) values (OVs) were quantitatively assessed using an OQAS. At 6 months after surgery, the mean uncorrected LogMAR VA was 0.06±0.10 and the values had improved in 100% of the eyes. The mean MTF cutoff frequency, SR, OSI, OV 100%, OV 20% and OV 9%, were 31.294±4.321 cycles/degree, 0.187±0.039, 1.399±0.274, 1.066±0.261, 0.748±0.287 and 0.509±0.229, respectively. In conclusion, ICL V4c implantation for the correction of residual refractive error after corneal refractive surgery appeared feasible and safe and also had an excellent optical performance. However, long-term changes in visual quality require further investigation.

Purpose To evaluate the ocular pharmacokinetic properties of subretinal conbercept injection in vitrectomized rabbit eyes and to compare them with those by intravitreal injection. Methods The following groups of New Zealand white rabbits received conbercept injections (0.5 mg/0.05 ml): a subretinal group (subretinal injection in vitrectomized eyes), an intravitreal group (intravitreal injection in vitrectomized eyes), and a control group (intravitreal injection in nonvitrectomized eyes). Drug concentrations in the aqueous humor (AH), the vitreous humor (VH), and the retina were measured by the enzyme-linked immunosorbent assay (ELISA), and pharmacokinetic parameters were calculated. Ophthalmic B-ultrasonography, electroretinogram (ERG), and hematoxylin and eosin (H&E) staining were performed to evaluate the safety of subretinal injection. Results On the 28th day after injection, the drug level in the subretinal group was significantly higher than that in the intravitreal group in the AH (0.90 ± 0.25 μg/ml and 0.11 ± 0.07 μg/ml and 0.11 ± 0.07 P < 0.001, respectively) and the VH (5.00 ± 3.86 μg/ml and 0.11 ± 0.07 μg/ml and 0.11 ± 0.07 P < 0.001, respectively) and the VH (5.00 ± 3.86 P < 0.001, respectively) and the VH (5.00 ± 3.86 P < 0.001, respectively) and the VH (5.00 ± 3.86  Conclusions Our study indicates that applying conbercept by subretinal injection can reduce the drug clearance rate and sustain a long maintenance period in ocular tissue, which suggests that subretinal conbercept injection may be a potentially valuable treatment option.

Intraoperative subretinal anti‐vascular endothelial growth factor (VEGF) injections have been used clinically in some case, but the pharmacokinetic characteristics have not yet been determined. In this pilot study, we investigate the pharmacokinetic parameters of anti‐VEGF agents by intraoperative subretinal or intravitreal injection in silicone oil (SiO)‐filled eyes of patients with proliferative diabetic retinopathy (PDR).

The aim of the present study was to investigate the potential changes in the choroidal thickness (CT) after surgical implantation of collamer lens (ICL) and to determine whether the variations in CT were associated with the degree of myopia. In the study, 98 eyes from 98 myopia patients were divided into two groups according to the degree of myopia: High myopia and super-high myopia. All eyes were measured using the swept-source optical coherence tomography (SS-OCT) technique. CT and CT variations were also recorded. The foveal CT increased significantly in high-myopia patients at 2 h after surgery and 3 months after surgery; the same tendency was observed in the inner nasal CT and outer nasal CT at the same time-points. In patients with super-high myopia, the subfoveal CT increased significantly at 2 h and 3 months after surgery compared with the pre-operative values. No statistically significant differences were obtained in any of the nine different choroidal regions evaluated at post-operative week 1 and post-operative month one. Furthermore, the increase in the subfoveal CT in the super-myopia group was significantly higher than that in the high-myopia group at 2 h and at 3 months after ICL. The results of the present study indicated that the CT significantly increased 2 h after the surgery and then reached a peak at 3 months, particularly in the subfoveal and nasal areas. A higher degree of myopia was associated with greater subfoveal choroidal changes.

Background Blepharophimosis-ptosis-epicanthus inversus syndrome (BPES) is a hereditary disease caused by a mutation in the forkhead box L2 ( FOXL2 ) gene. Female patients suffering from premature ovarian failure (POF) were classified as type I, and others were classified as type II. We aimed to clarify a novel FOXL2 indel mutation in Chinese families and to predict the POF risk in the affected patient.Methods Three generations of one Chinese family with BPES were enrolled in this study. Blood samples from patients of this family were collected and then analysed by whole-exome sequencing. Confocal microscopy was performed to observe the subcellular location. Transactivation studies were performed with real-time PCR.Results This novel mutation (c.1068G>C) is located in the downstream of DNA-binding forkhead(FHD) domain, and the mutant protein could also exhibit transactivation capacity of StAR , a key regulator of POF. Conclusively, we discovered a novel FOXL2 mutation and predicted that female patient in this family should be classified as type II BPES.Conclusions Our study revealed a novel missense mutation (c.1068G>C) and expanded the spectrum of FOXL2 gene mutations. Although we were not able to determine the classification from clinical manifestation, we discovered the patient developed type II BPES through subcellular distribution and transactivation analysis.

Purpose . To investigate the impact of disease duration on the ocular surface during the course of type 2 diabetes mellitus compared with nondiabetic controls. Methods . One hundred twenty diabetic patients were divided into three groups according to disease duration: less than 5 years, 5–10 years, and over 10 years. All eyes were imaged using a corneal topographer (Oculus Keratograph 5M). Tear film measurements and meibography were also recorded. Meibomian gland changes were scored from 0 to 6 (meiboscore). Results . The noninvasive breakup time first (NIKBUT-1st) and noninvasive breakup time average (NIKBUT-avg) were significantly shorter in the over 10 years diabetic group compared with the control group (P=0.0056 and P=0.010, resp.). Tear meniscus height (TMH) was significantly lower in the over 10 years diabetic group compared with the control group (P=0.0016) and the 5 years group (P=0.0061). We also found that more patients in the over 10 years diabetic group showed bulbar and limbal hyperemia compared with the control group (bulbar hyperemia: P=0.049; limbal hyperemia: P=0.026). The meiboscore in the over 10 years diabetic group was significantly higher compared with the other three groups (P<0.05). Bulbar hyperemia showed a significant negative correlation with NIKBUT-1st in the over 10 years diabetic group (r=−0.35 and P<0.05). Conclusion . Ocular surface damage in long-term type 2 diabetes is more severe than that in patients with shorter disease duration.

Objective: At present, the effect of the visual electrophysiology and vision field examination in patients with orbital blowout fracture is rarely studied. So, the authors investigate the value of visual electrophysiology and vision field examination in the diagnosis of ocular contusion. Methods: The position and range of fracture of 81 patients were determined by computed tomography (CT) scanning. Visual evoked potential (VEP), electroretinogram (ERG), and mfERG were vision field examination detected in 81 patients and the results were compared with those of contralateral healthy eyes. In addition, visual electrophysiology and vision field examination in diagnosis of eye contusion was analyzed and the correlation of the VEP, ERG, mfERG injury duration, and visual acuity was further analyzed. Results: The visual acuity of orbital fractures was significantly decreased compared with that in the uninjured eyes (t = 2.181, P = 0.032). Compared injured eyes and normal eyes in 54 patients, b wave of Max-ERG and Cone-ERG implied value extension (t = -2.426, P = 0.025; t = -2.942, P = 0.014), P-VEP P100 Peak duration and amplitude significantly extended (t = 3.162, P = 0.007; t = 9.314, P = 0.000), and F-VEP P1 amplitude decreased significantly (t = 3.362, P = 0.004). mfERG showed that the injured eye central reaction was significantly decreased (t = 8.727, P = 0.000). There was a significant correlation between P-VEP P100 amplitude and visual acuity (r = 0.067, P = 0.000). But there was no significant correlation between the P100 peak value, amplitude of P-VEP, mfERG central reaction, and injured days, respectively. There was significant difference between 2 groups with average visual acuity and mean defect value (t = 3.253, 3.461, P = 0.006, 0.003). There was statistical means the difference in P-VEP abnormal group, visual field abnormal group, and combined detection abnormal groups, the abnormal rate increased significantly (chi(2) = 3.931, P<0.01). Conclusion: Orbital floor fracture can lead to optic nerve damage and also may be associated with decreased macular function. The combination analysis of visual electrophysiology and vision field examination is beneficial to early diagnosis of ocular trauma and can improve the positive rate in clinic practice.

Background: Malignant melanoma predominantly occurs in whites, and is potentially fatal. Distant metastases often occur in lung, liver, brain, and could occur without prior regional disease. Conjunctival melanoma metastasis to contralateral orbit has never been reported. Patient Presentation: A 60-year-old man who underwent a left primary conjunctival neoplasm resection 11 months ago presented for the evaluation of a conjunctival dark-colored mass with a bulging left lower eyelid that directly invaded the orbits bilaterally. A histopathologic examination and immunohistochemistry confirmed metastases from conjunctival melanoma. In addition, the contralateral orbit had metastases without local recurrence after surgery within the authors’ department. The patient was given adjuvant therapy (vincristine + nedaplatin + dacarbazine) for 5 cycles, but he died 8 months after surgery. Conclusion: Malignant conjunctival melanoma may metastasize to the contralateral orbit. A histopathologic evaluation should be mandatory in patients with medical histories of malignancy to differentiate new primary tumors, metastases, and benign tumors.