Volume 51 · Issue 11 · 2015

Diabetic retinopathy (DR) is an irreversible blinding eye disease. With the increased number of diabetes patients and aging population, China is now facing both the high prevalence rate and blindness rate of DR. It requires us to change the traditional mode and build a comprehensive, community-based system for DR prevention and treatment. The mainline is " Health Education- Screening- Referral- Treatment- Follow- up- Health Management" . The public health resource and clinical resource should be effectively integrated into this system, so as to control high momentum of DR. (Chin J Ophthalmol, 2015, 51: 801-803)

Anti-VEGF therapy is currently one of the main treatments for neovascular age-related macular degeneration (nAMD). Clinically, patients under standardized anti-VEGF therapy showed different responses, of which recurrences or even insensitivity were found in some patients. However, the specific definitions of these various clinical responses are still unclarified. Therefore, to consolidate and define these concepts are of great importance regarding to future efficacy comparison, treatment response clarification and novel drug switching therapies.(Chin J Ophthalmol, 2015, 51: 804-807)

fundus imaging techniques are commonly used in clinical examination of macular diseases such as age-related macular degeneration (AMD), polypoidal choroidal vasculopathy (PCV), and high myopic macular degeneration, including color fundus photography (FP), fluorescein fundus angiography (FFA), indocyanine green angiography (ICGA) and optical coherence tomography (OCT). In order to further unify the image acquisition and storage operation of color FP, FFA and ICGA in the clinical diagnosis and treatment of macular diseases, and improve the standardization of clinical diagnosis and treatment and research of macular diseases, a standard operating procedure for the acquisition and storage of clinical fundus photography and angiography images of macular diseases is specially formulated (the OCT image acquisition specification of macular diseases will be detailed in the OCT Image Acquisition Specification).

To evaluate diode laser photocoagulation effects in type 1 prethreshold retinopathy of prematurity (ROP) in Peking University People's Hospital.

Retrospective cross-sectional study. Clinical records of the premature infants treated for type 1 prethreshold ROP from the year of 2008 to 2012 were reviewed.

We reviewed 226 infants including 146 male and 80 female. The mean birth weight and the gestational age were 1 386 grams and 30.2 weeks respectively. In all the 384 photocoagulation treated eyes, ROP regressed completely in 381 eyes (99.1%). One eye of zone Ⅰ ROP progressed to stage 4A. Macula kept attaching after vitrectomy. There was no significant difference of regression rate between Zone Ⅰ and Zone Ⅱ of type 1 prethreshold ROP. No severe complications occurred.

Diode laser photocoagulation in type 1 ROP was safe and efficient. (Chin J Ophthalmol, 2015, 51: 814-817)

To observe the efficacy and safety of intravitreal injection of conbercept, a new drugs of VEGFR fusion proteins, on wet age-related macular degeneration(wAMD).

To analyze retrospectively the clinical data of 58 patients with wet wAMD, which was diagnosed by examination of ETDRS charts, color fundus photograph, fluorescein angiography(FFA) and optical coherence tomography (OCT),were underwent intravitreal injection conbercept 0.5 mg(0.05 ml of 10 g/L). Follow-up time was 6 to 12 months.Visual acuity(ETDRS charts letter), retinal thickness, leakage of CNV and operative complications before and after the treatment were analyzed.

Conbercept injection therapeutic times were 3-5, the average therapeutic times were 3.05. At the end of the follow-up period, the mean letter of ETDRS charts was 50.20±12.87, increased 26.20 letters(t=2.936, P<0.01). the ETDRS charts improved 15 or more letters in 33 eyes(53.23%), decreased more than 15 letters in 2 eyes(3.23%); the average foveal thickness on OCT images were (223±74) μm after treatment, decreased significantly( t=3.669, P<0.01) ; FFA showed CNV complete closure in 34 eyes (54.84%), partial closure in 23 eyes(37.10%), no change in 5 eyes (8.06%). IOP increased in 2 eyes after treatment and recovered within one week.

Intravitreal injection of conbercept for wAMD was well tolerated, with an improvement in BCVA, macular edema and leakage of CNV, reduce the risk of rehaemorrhagia.(Chin J Ophthalmol, 2015, 51:818-821)

To observe the retinal vascular development and changes on aggressive posterior retinopathy of prematurity (AP-ROP) by intravitreal ranibizumab , evaluate the therapeutic effect, and provide the basis for clinical treatment.

The total of 38 eyes of 19 premature infants who were diagnosed as AP-ROP from January 2012 to October 2013 in our hospital were performed intravitreal injection of ranibizumab (0.04 ml). It was observed about the regression of plus diseases, ridges, neovascularization on the ridge and the development of peripheral retinal vessel. Laser photocoagulation were performed for 14 eyes of 7 cases whose plus diseases, ridges and neovascularization on the ridge didn't regress completely after intralvitreal injection of ranibizumab.

All infants were found retinopathy regressed and retinal vessels continued to develop peripherally to some degree. Of all infants, 24 eyes of 12 infants were found complete regression of retinopathy, resolution of neovascularization and bleeding and that retinal vessels continued to develop to ora serrata or scarification of peripheral retinopathy. Fourteen eyes of 7 infants were found retinopathy didn't regressed completely and regressed completely after combing intravitreal ranibizumab injection. All 19 infants didn't occure infection, ocular or systemic complications.

The efficacy of intravitreal injection of ranibizumab is good for AP-ROP. It can made ridge, neovascularization on the ridge and plus disease regress, as well as let the retinal vessel continue development. Infants with no regressed retinopathy may need combined laser photocoagulation. (Chin J Ophthalmol, 2015, 51:822-825)

To evaluate the measurement of macular pigment optical density (MPOD) by a novel instrument MPS1000 as compared to that measured by the traditional heterochromatic flicker photometer (HFP).

Method- comparative study. MPOD at 0.5° eccentricity was measured simultaneously by the two different instruments in 111 eyes of the 59 healthy subjects. Test-retest variability was evaluated for each instrument over a 1- week period in 8 subjects.

The mean MPOD levels measured by the MPS1000 and HFP were 0.40±0.18 and 0.47±0.15, respectively, which were statistically significantly different by the paired t-test (t=3.95 , P<0.001). A positive linear correlation was observed for MPOD at 0.5° eccentricity between the two different instruments (r=0.4, P<0.001). The 95% limit of agreement was 0.07±0.35 as shown by Bland-Altman analysis. Inter-sessional repeatability, expressed as a coefficient of repeatability, was 0.26 for HFP and 0.18 for MPS1000.

MPOD levels measured by MPS1000 were significantly higher as compared to that measured by the traditional HFP, suggesting that it is inappropriate to directly compare the MPOD levels measured by these two methodologies. (Chin J Ophthalmol, 2015, 51:826-830)

To investigate the alterations of retinal tissue induced by OAβ(1- 42) subretinal injection in normal C57BL/6N mice.

Experimental study. One hundred and twenty C57BL/6N mice aged 8 weeks participated in this study. Among them, 60 eyes received subretinal injection of OAβ(1- 42); another 60 received double distilled water as control. The concentration of OAβ(1- 42) was 0.312 5 mmol/L. We took fundus photograph and autofluorescence, electroretinogram(ERG), haematoxylineosin staining of retinal paraffin sections, β- galactosidase staining of neural retinal flatmounts, immunofluorescence of senescence marker P16^INK4a of RPE/choroidal flatmounts, Western blot and RT- PCR of senescence relative cytokines IL- 6, TGF- β1 before and after the injection. The data were analyzed by independent sample t-test.

Comparing with controls, 1 week post injection, the experimental group eyes had atrophied area with high autofluorescence site, and showed evident decrease in amplitudes of a wave (39.94±7.75)μV comparing with the controls (225.27±28.94)μV(t=12.45, P<0.001) in scotopia ERG, so did the amplitude of b wave (185.55±4.62)μV comparing with the controls (873.78±43.80)μV(t=27.06, P<0.001), retinal structures appeared significant loss of retinal thickness (t=75.13, P<0.001) along with hypo- or hyperpigmentation; the experimental eyes had high frequency of blue-green deposits in retinal β-gal staining; the green fluorescence sites of RPE/choroidal flatmounts were clear and bright, indicating higher expression of P16 ^INK4a in the nucleus; these results were the same till 8 weeks post operation. Western blot and RT- PCR vertified conspicuous increases in expression of TGF-β1, IL-6 in retinas of experimental eyes compared with the control ones 1 week post injection.

OAβ(1- 42) subretinal injection could induce visual function deficiency and retinal tissue senescence. All the manifestations were AMD-like retinopathy, which implied that Aβ(1-42) might be an essential clue in human AMD pathology. (Chin J Ophthalmol, 2015, 51:831-838)

To investigate the concentrations of vascular endothelial growth factor (VEGF), pigment epithelium-derived factor (PEDF), inositol triphosphate (IP3) and diacylglycerol (DAG) in human retinal pigment epithelium (RPE) cells after exposuring to blue light, and to explore the relationship with Ca²+- PKC signaling pathways, to evaluate the role of Ca²⁺- PKC signaling pathways of blue- light irradiation induced apoptosis in RPE cells.

The fourth generation human RPE cells in vitro were exposured to blue light (2000±500lux) for 6 hours, 24 hours prolongation of post- exposure culture. The concentrations of VEGF, PEDF, IP3 and DAG were assayed by enzyme linked immunosorbent assay (ELISA). Cells were randomly divided into 6 groups, group A(control), group B(exposure to blue light), group C(exposure to blue light + PMA), group D(exposure to blue light+ Calphostin C), group E(exposure to blue light + Nifedipine), group F (exposure to blue light+ Calphostin C+ Nifedipine). Flow cytometry was used to detect the apoptosis rate of human RPE cells in A, B and F group.

Comparing with group A (584.38±10.66) , the concentration of VEGF in group B (700.70±5.88) , groupC (698.21±6.66) and group E (648.30±4.91) was higher, the difference was statistically significant (P=0.002, 0.002, 0.016) . Comparing with group B (700.70±5.88) , the concentration of VEGF in Group D (623.87±3.12) and E (648.30±4.91 ) was lower (P=0.001, 0.002) . Comparing with group A (75.96±1.70) , the concentration of PEDF in Group B(71.82±1.67) and C (72.43±0.58) was lower (P=0.004, 0.011) , but the concentration of PEDF in Group D (86.31±1.35) and E (93.72±1.24) was higher (P=0.000, 0.000) . Comparing with group B (71.82±1.67) , the concentration of PEDF in Group D (86.31±1.35) and E (93.72±1.24) was higher (P=0.000, 0.000) . Comparing with group A (7.70±0.29) , the ratio of VEGF to PEDF in Group B (9.85±0.34) and Croup C(9.64±0.02) was higher (P=0.008, 0.027) Comparing with group B, The ratio of VEGF to PEDF in Group D (7.23±0.08) and E (6.92±0.06) was lower (P=0.016, 0.015) . Comparing with group A (108.42±0.75, 995.47± 13.61) , the concentration of IP3 and DAG in Group B (117.24±1.06, 1070.10±10.07) , C (137.12±2.71, 1046.40±7.90) , D(139.17±1.40, 1041.13±9.76) and E(149.61±0.77, 1273.14±10.89) was higher, the difference was statistically significant (P=0.003, 0.007, 0.000, 0.000, 0.000, 0.000, 0.000, 0.000) . Comparing with group B, the concentration of IP3 in Group C, D and E was higher (P=0.011, 0.000, 0.000) . Comparing with group B, the concentration of DAG in Group C and D was lower (P=0.021, 0.007) . Comparing with group B, the concentration of DAG in Group E was higher (P=0.000) . Comparing with group A (10.27±1.88) , the apoptosis rate of RPE cells in Group B(25.07±2.66) and F(19.37±3.23) was higher, the difference was statistically significant (P=0.001 , 0.009) . Comparing with group B (25.07±2.66) , the apoptosis rate of RPE cells in Group F (19.37±3.23) was lower (P=0.038).

(1) After exposuring to blue light, the concentrations of VEGF,IP3 and DAG are increased and the ratio of VEGF to PEDF is also increased and the concentration of PEDF is decreased in human RPE cells. (2) L- Type Calcium Channels and Ca²⁺-PKC signaling pathways may be regulate the concentrations of VEGF, PEDF, IP3 and DAG in RPE cells after exposuring to blue light by feedback regulation. (3) The application of Calphostin C combined with Nifedipine may be restrain the apoptosis of RPE cells after exposuring to blue light. (Chin J Ophthalmol, 2015, 51:839-843)

To evaluate the efficacy of surgery in the treatment of congenital nystagmus with convergence damping.

Retrospective and comparative case series. Eight patients diagnosed as congenital nystagmus with convergence damping at Beijing Children's Hospital between September 2010 and September 2012 were enrolled in this study. The ages were 9.5 (12, 6) years old, and follow-up was 9 (24, 6) months. All patients received prism induced convergence and the same surgery of bimedial rectus recession and bilateral rectus tenotomy. The best corrected visual acuity, the range of fusion and the nystagmus waveforms were analyzed before and after surgery.

The range of fusion was-3.75±1.83° to + 19.38±3.16° before surgery and- 3.88±1.55° to + 19.00±3.02° after surgery; there was no significant difference (t=0.24, P=0.82). The binocular visual acuity increased from 0.21±0.15 without convergence to 0.28±0.18 using convergence; there was significant difference (t=-4.43, P=0.00). The visual acuity was 0.32±0.20 after surgery, significantly different from that before surgery without convergence (t=-5.29, P= 0.00), but not significantly different from that before surgery using convergence (t=-2.12, P=0.07). Patients had significant improvements in the frequency (t=3.28, 3.02, P<0.05) and intensity of the nystagmus waveforms when using convergence and postoperatively (t=3.27, 3.48; P<0.05), but there was no significant improvement in the amplitude of the waveforms (t=1.31, 1.57, 0.31 , P>0.05).

Surgery for congenital nystagmus with convergence damping can provide expectations for ocular motor and visual results. The range of fusion should be wide enough, and the effect of convergence on the frequency is greater than that on the amplitude. (Chin J Ophthalmol, 2015, 51: 844-849)

The patient was a 68-year-old female. He was admitted to the Department of Nephrology of Peking University First Hospital with foam urine for 5 months and edema of both lower limbs aggravated for 1 month for 1 week. Previous depression for 4 years, oral flupentixol and melitracen tablets; Hyperlipidemia for 2 years, intermittent oral treatment with Xuezhikang and aspirin. A history of hypertension was found for 4 months, blood pressure was controlled at 140/70 mmHg (1 mmHg =0.133 kPa), and oral benazepril was used for antihypertensive therapy. On admission, urine routine showed 4+ urine protein, 24-h urine protein quantitative examination was 17.66 g/L (normal value 0.00~0.15 g/L), biochemical examination albumin was 21 g/L (normal value 35~50 g/L), and abdominal B-ultrasound showed ascites. Combined with the patient's systemic symptoms and laboratory results: 24-h urine protein quantification>3.5 g/d, plasma albumin less than 30 g/L, edema and ascites of both lower limbs, hyperlipidemia, and nephrotic syndrome was diagnosed. One day after admission, the patient suffered from sudden visual loss in both eyes, accompanied by edema of the upper eyelids of both eyes and difficulty in opening eyes. Please consult an ophthalmologist. Check the visual acuity of 0.1 for the right eye and 0.15 for the left eye; Non-contact IOP was 24 mmHg in the right eye and 26 mmHg in the left eye; Upper lid edema and pale skin in both eyes; Edema of the conjunctiva in both eyes, not congested (Figure 1), clear cornea in both eyes, deep anterior chamber, aqueous humor flash (-), plankton (-), transparent lens; Fundus examination shows: the color of the optic papilla edge is normal, the blood vessels run normally, the foveal reflex disappears, retinal edema can be seen in the macular area, and the posterior pole omental edema is irregular and round with clear boundaries (Figure 2）。 Further OCT was performed (Figure 3) and fundus fluorescence angiography (Figure 4), OCT results showed that the retinal neuroepithelial layer in the macular area of both eyes was detached, multiple cystoid edema cavities were seen in the outer nuclear layer, and the hyperreflective band composed of the internal and external ganglion junction band of photoreceptor cells and the outer membrane showed irregular wave-like changes; In the early stage of fluorescein angiography, large irregular near-circular hypofluorescence areas in the posterior poles of both eyes were seen, surrounded by multifocal hyperfluorescence areas; In the late stage of angiography, the low fluorescence area was gradually filled with dye and showed high fluorescence, with clear boundaries. The macular area of both eyes showed typical petal-shaped high fluorescence, and the high fluorescence focus around the optic head gradually leaked and expanded. Therefore, the ophthalmological diagnosis was exudative retinal detachment in both eyes and cystoid macular edema in both eyes.

The patient was a 72-year-old female. Two years ago, a small incision cataract extraction combined with IOL implantation in the left eye was performed due to simple senile cataract in the left eye. One month after the operation, the eye was accidentally bruised, and the vision was blurred and the sensation of foreign body appeared. Recently, due to the continuous aggravation of symptoms, he went to the local hospital for a follow-up visit and was transferred to Hebei Eye Hospital because he could not deal with it. Twenty years of previous history of hypertension. Admission: Visual acuity: right eye 0.4, correction 1.75 DS to 0.6, left eye 0.15, correction 1.003.25 DC x 20° to 0.4; Intraocular pressure: 16 mmHg (1 mmHg =0.133 kPa) in the right eye and 8 mmHg in the left eye. The lens of the right eye was slightly opaque, and there were no abnormalities in the remaining anterior and posterior segments. The conjunctiva of the left eye was slightly congested, and a cystic vesicle with a diameter of about 7 mm was seen outside the upper limbus, with a protuberance of about 3 mm, a thin and translucent wall, pigment membrane tissue was visible inside it, and conjunctival scar wrapped at the margin (Figure 1）。 The cornea is clear, the depth of the anterior chamber axis is normal, the upper iris is embedded in the scleral tunnel incision, no upper pupil margin is seen, the position of the intraocular lens is normal, the vitreous body is slightly flocculate and opaque, the border of the fundus optic papilla is clear, the color is normal, and the C/D is about 0.3. The flow of omental blood vessels is roughly normal, the foveal light reflection disappears, and there is no obvious edema in the macular area. UBM displays (Figure 2): The scleral tunnel incision above the left eye was dehisced, and the pigment membrane tissue prolapsed and imprisoned in the scleral tunnel incision, and partially prolapsed into the upper cystic vesicle. Admission diagnosis: scleral fistula after cataract surgery in left eye with pigment membrane incarceration, intraocular lens eye in left eye, age-related cataract in right eye, hypertension. Surgical treatment was performed 3 days after admission. During the operation, the bulbar conjunctiva was cut from the outer edge of the cystic vesicle, the peripheral adhesive tissue was peeled off, and the cystic vesicle and the prolapsed pigment membrane tissue were removed (Figure 3), the pigment membrane in the tunnel was also incorporated into the anterior chamber, and the tunnel incision was intermittently sutured with two needles to decompress. A 1/2 thick scleral flap with the limbus as the base was made above the tunnel incision, about 8 mm ×3 mm in size. The inverted scleral flap completely covered the original tunnel incision, and 10-0 nylon thread was continuously sutured to a watertight state (Figure 4）。 Radial incision was made from both sides of the conjunctival incision, and the subconjunctival tissue was separated to reduce tension, and the conjunctiva was sealed and sutured (Figure 5）。 The conjunctival sac was applied with tobramycin and dexamethasone eye ointment and pressurized. On the second postoperative day, the conjunctival incision of the left eye was well aligned, the repair site was flat, there was no leakage, the visual acuity was 0.05, and the intraocular pressure was 22 mmHg. On the 5th day, the visual acuity of left eye was 0.2 after discharge, and the correction was 1.001.25 DC ×40° to 0.4, intraocular pressure 14 mmHg, superior conjunctival incision well aligned, suture in place, clear cornea, normal anterior chamber depth, fundus examination as before surgery. UBM showed that the scleral tunnel incision was well closed and there was no pigmented membrane tissue imprisonment.

患者男性，42岁。因双眼间歇性雾视感伴反复右眼不适1年，于2014年5月到厦门大学附属眼科中心就诊。患者1年前曾被诊断为右眼青光眼-睫状体炎综合征，多次发作，表现为右眼不适及眼压升高，双眼视物模糊，每次发作时予局部糖皮质激素抗炎及降眼压治疗，右眼不适感缓解，视力改善，眼压恢复正常。但患者双眼视物模糊感觉未完全消失。本次因青睫综合征复发就诊。既往史：甲状腺机能亢进病史1年，目前病情控制良好，否认高血压、糖尿病等病史。眼部检查：双眼视力均为1.0，右眼眼压39.5 mmHg（1mmHg= 0.133 kPa），左眼19.3 mmHg。右眼眼睑无明显异常，结膜稍充血，角膜透明，角膜上皮荧光染色（-），瞳孔区中下方后表面分布3或4个中等大小角膜后沉着物（keratic precipitate, KP），高倍镜下可见少量透明状小突起；前房无闪光、积脓，房角开放；虹膜纹理清、无虹膜异色素、虹膜位正，未见Koeppe结节和Busacca结节；视网膜平伏，动静脉比约等于2∶3, C/D=0.3，黄斑反光存。左眼眼睑无明显异常，结膜稍充血；角膜中央稍水肿，角膜上皮荧光染色（-），瞳孔区下方后表面分布透明小突起及金箔样反光（图1），余未见明显异常。辅助检查：双眼内皮镜显示右眼细胞密度1 639.6/mm²，六角形细胞占53%，左眼细胞密度1 590.4/mm²，六角形细胞密度占47%。多次角膜激光共聚焦显微镜检查（图2）可见右眼内皮细胞间存在暗区，暗区中央有一高亮点，为典型赘疣表现。少数内皮细胞形态尚未破坏。另一区域右眼角膜内皮散在疣状突起，少量聚集成团，部分内皮细胞间见缺损暗区（图2中A、C）。左眼角膜中央区对应内皮层细胞轮廓不规则，规则六角形细胞比例减少，散在少量疣状突起（箭头标注）及左眼角膜内皮细胞部分可见大量疣状突起（箭头标注）（图2中B、D)；双眼未见炎性细胞浸润。诊断：右眼青光眼睫状体炎综合征；双眼Fuchs角膜内皮营养不良。治疗：右眼局部应用酒石酸溴莫尼定滴眼液2次/d；氯替泼诺混悬滴眼液4次/d；口服醋甲唑胺片0.25 g/次，2次/d。治疗2周后患者复诊，仍诉有双眼雾视感，眼部检查：双眼视力均为1.0，右眼眼压7.9 mmHg，左眼眼压7.6 mmHg。双眼瞳孔区中央角膜后表面透明小突起及金箔样反光无明显变化。复查角膜共聚焦纤维镜示（图2C、D）：右眼角膜内皮细胞散在疣状突起，部分融合，部分角膜内皮细胞缺失；左眼角膜内皮细胞部分可见大量疣状突起，双眼未见炎性细胞浸润。

The patient was a 26-year-old female. Due to the sudden decrease of visual acuity in his right eye for 1 week, he went to the Department of Ophthalmology, Affiliated Hospital of Chengdu University of Traditional Chinese Medicine on August 25, 2014. The patient suddenly developed blurred vision in his right eye after forced defecation 1 week ago, without symptoms such as red eye and eye pain. Deny past history of hypertension, diabetes, etc., and deny history of ocular trauma, surgery and family diseases. General examination: The general condition was good, blood pressure: 128/86 mmHg (1 mmHg =0.133 kPa), routine hematuria examination, liver and kidney function examination and coagulation function examination were no abnormalities. Eye examination: visual acuity was 0.15 for the right eye (uncorrectable) and 0.8 for the left eye; A dark brown round hemorrhagic lesion with a diameter of about 2 PD was visible at the right fundus about 1 PD from the nasal side of the optic papilla and about 0.5 PD below, and an anterior retinal scaphoid hemorrhage connected to it was visible below it (Figure 1A), no obvious abnormalities were observed. FFA examination: the arteriovenous filling time of the right eye was normal, and the anterior retinal occlusion fluorescence with a diameter of about 7 PD was visible on the nasal side of the optic head in the arteriovenous phase (high possibility of bleeding) (Figure 1B), large preretinal occlusion fluorescence (hemorrhage) is visible under the temporal retina and under the nose, and the macular structure is clear (Figure 1C), no obvious abnormalities in the arteriovenous vessels and no obvious fluorescein leakage in the late stage. OCT examination: No obvious abnormalities were found in the macular area of the right eye (Figure 1in D); Hyperreflectivity of a finger-like bulge under the inner limiting membrane of the retina at the lesion, covering its lower retinal structure, sheet-like hyperreflectivity below, and hypo-reflectivity with uniform density above, without abnormality in its pararetinal structure (Figure 1In E, F). Clinical diagnosis: Valsalva retinopathy in the right eye.

The patient was a 25-year-old female. The right eye was blurred for 2 days, and he went to the Department of Ophthalmology of Cangzhou Central Hospital. Eye examination: visual acuity is 1 foot index in the right eye and 1.0 in the left eye; There were no abnormalities in the anterior segment and vitreous body of the right eye, gray-black depression on the temporal side of the fundus papilla, and retinal bulge in the macular area (A in Quintessence Picture 1). No obvious abnormalities were observed in the left eye. Ophthalmic B-ultrasound, FFA and OCT examinations are shown inQuintessence Picture 1In B, C, D. Clinical diagnosis: right eye visual papilla fovea; Retinoschisis and detachment of the right eye.

In order to continuously improve the quality of medical services and reduce the cost of diagnosis and treatment, hospitals at all levels have higher and higher requirements for obtaining health and medical information, and traditional information platforms can no longer meet the requirements. At present, the scale of hospital diagnosis and treatment data is constantly expanding, and the annual retention and growth of business data of general hospitals are constantly increasing. How to effectively analyze and utilize these information becomes increasingly important. Digital hospital management with electronic medical records as the core is the best way to solve these problems^[1,2]It can not only realize the digital operation and management of various hospital's businesses, but also the intelligent characteristics will greatly improve medical efficiency, realize data exchange and information sharing between different departments, help improve the quality of medical services, control and reduce medical expenses, all of which will help the hospital to improve medical and management level^[3]。 With the increasing importance and attention of digital hospital management, governments all over the world attach great importance to the construction of digital hospitals. In recent years, the United States and other countries have launched huge government fund incentive plans to improve the digital development level of hospitals at all levels.

Retinal oximeter is a new machine which has been used in the diagnose, treatment and research of several ophthalmic diseases for recent years. It allows ophthalmologists to gain retinal oxygen saturation directly. Therefore, retinal oximeter might be useful for ophthalmologists to understand ophthalmic diseases more deeper and clarify the impact of ischemia on retinal function. It has been reported in the literatures that retinal oximeter has potentially useful diagnostic and therapeutic indications in various eye diseases such as diabetic retinopathy, central retinal vein and artery occlusion, retinitis pigmentosa, glaucomatous optic neuropathy, et al. In this thesis, the application of retinal oximeter in ophthalmology is reviewed. (Chin J Ophthalmol, 2015, 51:864-868)

Three-dimensional cell culture technology is a kind of technology that cultures the cells in a three-dimensional cultivation by using a kind of scaffold materials in vitro. Its advantage is that the vivo microenvironment simulating degrees of the three-dimensional culture technology is higher than that of the two-dimensional planar cell culture model, and the controllability is also higher than the animal experiment. In recent years, with the development of tissue engineering technology, a varietiy of the stent of biological materials also a fast development, which provided a favorable platform for three-dimensional cell culture technology. In ophthalmology, three-dimensional cell culture has been applied to the cornea, retina and the visual system development and other optic tumor researches. The objective of this paper is to making a review the application status of the three-dimensional cell culture technology in the basic research and clinical treatment in ophthalmology.(Chin J Ophthalmol, 2015, 51: 869-874)

The occurrence and development of myopia and keratoconus is closely related to the changes of scleral and corneal biomechanical properties. The accurate measurement of biomechanical properties for corneoscleral tissure is very important on diagnosis of eye diseases, improvement of ocular operation, ocular biological parameter measurement and invention of ophthalmic instrument. Corneoscleral tissue, composed of bundles of compact and staggered collagen fiber and extracellular matrix, constitute the outer surface of the eyeball. The inhomogeneous distribution of the diameter, gap and amount of collagen fiber, makes its biomechanical characteristics really complex, characterized by nonlinear, viscoelastic, anisotropic, regional variation and age-related variation and etc. With the development of medical diagnostic technology, the importance of the ocular biomechanical property measurement is increasingly recognized. Nevertheless, measuring technology on ocular biomechanics properties are still not well understood by the majority of ophthalmologists. In order to facilitate the researchers to select a suitable measuring platform and method, the development of international corneoscleral biomechanical propertiy measuring technology was reviewed in this article.(Chin J Ophthalmol,2015,51: 875-880)

This issue focuses on the progress of fundus diseases. Professor Xu Xun is the responsible editorial committee responsible for the planning, composition and review of the key contents of this issue.