Volume 51 · Issue 02 · 2015

pigmentary dispersion syndrome (PDS) is characterized by depigmentation in the middle and peripheral part of the iris and pigmentation in the anterior part of the eye, including the trabeculae, which can lead to an increase in intraocular pressure and the appearance of pigmented glaucoma. The disease mostly occurs in young and middle-aged men, and is closely related to myopia. The incidence of PDS was 2.45% among white people^[1]Although the incidence rate has not been reported in China, it is not very rare clinically.

To study the distribution of peak intraocular pressure (IOP) in 24-hour in untreated primary open angle glaucoma (POAG) patients, and to explore the correlation between nocturnal peak IOP and office hour or diurnal IOP level.

A Cross-sectional study. One hundred and twenty-one untreated POAG patients (121 eyes), including 78 normal tension patients (78 eyes) and 43 hyper-tension patients (43 eyes), were enrolled in this study. All the patients underwent 24-hour IOP monitoring with non-contact tonometer. The distribution of peak IOP in 24-hour and the correlation between nocturnal peak IOP and office hour or diurnal mean and peak IOP were evaluated. Categorical variables were described as frequency and constituent ratio, and analyzed by chi-square test. Continuous variables were described as mean, standard deviation, range, and analyzed by independent samples t test, pearson correlation test and linear regression.

In all glaucoma patients, peak IOP occurred mainly from 8: 00 to 10: 00 and 8: 00 to 10: 00. In normal tension group, peak IOP appeared mainly from 8: 00 to 10: 00 and from 0: 00 to 6: 00, the highest frequency showed at 8: 00 (17 eyes 18.48%). In hyper-tension group, the probability of IOP reaching peak was more in night time, mainly from 0: 00 to 6: 00, the highest frequency showed at 2: 00 (10 eyes 21.28%). If only the peak IOP during office hours or diurnal hours were considered, then only 32.55%(14/43) and 44.19%(19/43) patients could be correctly diagnosed. The remaining patients would be missed because of low IOP and/or mild structure and/or functional damages. There were good linear correlations between office hours or diurnal peak and mean IOP and nocturnal peak IOP in glaucoma patients.

More than 50% peak IOP occurred out of office hour in POAG patients. There is a good correlation between peak nocturnal IOP and office hour or diurnal IOP level.(Chin J Ophthalmol, 2015, 51: 103-108)

To evaluate the efficacy and safety of selective laser trabeculoplasty (SLT) as a replacement for medical therapy in primary open-angle glaucoma (POAG).

A prospective, randomized, controlled study. SLT treatment with SOLO® SLT Nd:YAG laser was provided to 45 participants with advanced POAG (67 eyes, IOP ≤21 mmHg, 1 mmHg=0.133 kPa) under anti-glaucomatous medications control). A table of random numbers was created by simple randomization method. Participants were randomly divided into two groups: the standard-energy group (34 eyes), which received a 270°standard-energy SLT treatment and the sub-threshold energy group (33 eyes), which received a 360°sub-threshold energy treatment. The intraocular pressure (IOP) before and after SLT, daytime IOP curve, dosage of anti-glaucoma drugs and treatment complications were observed, which were be followed up for 6-9 months (average6.4 months). Two-tailed t-test or paired t test was used when the continuous variables were normal distribution, such as the basic data, daily fluctuations of IOP, laser energy. Non-parametric Mann-Whitney U test or Wilcoxon rank test was used when data was not distributed normally, such as drug category. Chi-square or Fisher′s exact test was used when count variables such as success rate and complications were analyzed.

The number of anti-glaucomatous drugs used in the standard-energy group and the sub-threshold energy group before SLT was (2.3±0.5) and (2.1±0.4), respectively; whereas, after the last treatment, it reduced to (1.3±0.5) and (1.1±0.3), respectively (Z=-5.477, -5.396; P<0.05). The success rate of the standard-energy group and the sub-threshold energy group was 91.1%, and 87.9%, respectively, which was not significant different (P=0.70). Laser treatment was found to reduce the IOP fluctuation during the daytime. IOP fluctuation decreased from (3.6±1.0) mmHg to (2.3±1.0) mmHg in the standard-energy group, and decreased from (3.9±1.4) mmHg to (2.4±0.9) mmHg in the sub-threshold energy group, which was significant different (t=4.911, 4.679; P<0.05). The total laser energy of the standard-energy group (47.8±6.0) mJ was higher than the sub-threshold energy group (43.2±5.1) mJ (t=12.006, 3.233; P<0.05). However, there was no significant difference in the daily IOP fluctuations, success rate, reduction of medication categories, preoperative and postoperative IOP, and adverse reactions between the two groups.

SLT is a safe and effective replacement for medical therapy in primary open-angle glaucoma treatment. SLT could reduce the applications of anti-glaucoma drugs. There was no significant difference between therapeutic effects of which eyes received 360° sub-threshold energy and 270° standard-energy.(Chin J Ophthalmol, 2015, 51: 109-114)

To evaluate the safety and efficacy of ab interno trabeculectomy (Trabectome) surgery in Chinese open angle glaucoma patients.

Prospective non-comparative case series study. A total of 41 cases (34 primary open angle glaucoma patients, 3 developmental glaucoma patients and 4 pigmentary glaucoma patients) were included in the study. All the cases underwent Trabectome, including 9 cases combined with phacoemulsification cataract extraction. Major outcomes include intraocular pressure (IOP), number of glaucoma medications, secondary glaucoma surgery and postoperative complications. Criteria for successful operation were defined as IOP ≤ 21 mmHg (1 mmHg=0.133 kPa), at least 20% IOP reduction in any two consecutive visits after 3 months with or without IOP-lowering drugs and no additional glaucoma surgery. IOP and number of glaucoma medications were compared to baseline using Wilcoxon signed-rank test with Bonferroni correction. Kaplan-Meier analysis was performed to analyze the success rate of surgery.

In the all 41 patients, 21 cases (51.2%) were followed up for up to 12 months. IOP was reduced from (22.5±8.1) mmHg to (17.6±6.4) mmHg (P=0.02), meanwhile number of glaucoma medications was reduced from 2.0±0.9 to 1.2±0.9 (P=0.02) at 12 months. The success rate at one year was 85% and 4 cases required additional glaucoma surgery.

Trabectome has many advantages, such as shorter surgery time, simple post-operative care, less intraoperative and postoperative complications and clear IOP-lowering effect. But it slong-term efficacy is still need a large sample, long-term follow-up to verify.(Chin J Ophthalmol, 2015, 51: 115-119)

To investigate the dynamic changes and molecular mechanisms of thioredoxin system in lateral geniculate body of chronic intraocular hypertension rats.

Glaucoma model was established by cauterizingrat′s episclera veins. Right eye is the treatment group, while left eye is the sham operation group, vein of which is just isolated not be cauterized. There were 25 rats in high intraocular pressure group, and 4 rats in control group. The expression of Trx, Trx1, Trx2, Sesn2, Srxn1, Txnip was detected by Western blot and RT-PCRat different time points after intraocular pressure rose (1, 3, 7, 14, 28 d), and were grouped according to the time points. Paired t test was used in the data analysis within each time group and one-way ANOVA was used in the comparisons among different time groups.

After 3 days of glaucoma induction, the gray-scale value of thioredoxin (0.83±0.02) was statistically significant decreased (F=4.871, P=0.005), compared with the control group (1.02±0.04). After 14 days, TRX1 related expression level reduced to 0.63±0.04, while the control group level was 0.96±0.03 (t=13.647, P<0.05). The related expression level of SESN2 was 0.53±0.11, but the control group expression was 0.96±0.03 (t=13.812, P<0.05). SRXN1 decreased to 0.71±0.05 and 0.49±0.03 after 7 days and 14 days respectively, while the expression of control group were 0.97±0.02 and 0.96±0.02 respectively.(Group 7 d,t= 9.451, P<0.05; group 14 d,t=13.611, P<0.01). On the contrary, expression of TXINP was upregulated to 1.83±0.04 and 2.37±0.03 respectively, while the expression of control group were 1.00±0.02 and, 0.95±0.03 (Group 7 d,t=7.924, P<0.05; 14 dt=12.637, P<0.01) respectively.

Oxidative stress existed in lateral geniculate body of chronic intraocular hypertension rat model, and the down-regulated expression of Trx, Trx2 of the Trx system in lateral geniculate body was inhibited by multiple pathways when oxidative damage occurs. The inhibitor genes on up-stream increased while promoting genes diminished.(Chin J Ophthalmol, 2015, 51: 120-125)

To evaluate the efficacy of intravitreal carboplatin plus bevacizumab in refractory retinoblastoma.

Perspective study. Eleven patients (11 eyes) with the diagnosis of refractory retinoblastoma were enrolled in Department of Ophthalmology of Peking University People′s Hospital from June 2013 to March 2014. They underwent intravitreal carboplatin plus bevacizumab every 4 weeks, an average of 4.5 times of treatment. Observe for 3 months after the last treatment. Aqueous humor was taken for cytological and VEGF detection and retinal funds were taken photos for observation. Statistical analyses between experimental group and control group and before and after intravitreal injection within experimental group were performed with independent samples t test.

Tumor in vitreous cavity reduced significantly in seven patients, however, poor control in four cases, and three of them were recurrent after first-line treatment. Cytology detection for aqueous humor showed no tumor cells in all of them. Aqueous VEGF of patients with retinoblastoma (60.65±6.20) was significantly higher than the control group (21.98±6.91). The difference was statistically significant (t=13.80, P<0.01). And the aqueous VEGF content decreased significantly after treatment (t=2.12, P<0.05).

Intravitreal carboplatin plus bevacizumab, is a relatively safe, effective treatment for refractory retinoblastoma, however, ineffective for recurrent tumor.(Chin J Ophthalmol, 2015, 51: 126-129)

The aim of the experiment was to investigate the effects of salidroside (Sal) on oxidative damage to human lens epithelial cells (HLEC).

Experimental study. The cultured HLECwas intervened with hydrogen peroxide (H₂O₂) which created oxidative damage model to observe the effect of Sal on HLECs. The cultured cells during the logarithmic phase were interposed by different concentrations Sal (0 μmol/L, 10 μmol/L, 30 μmol/L, 50 μmol/L, 100 μmol/L, 200 μmol/L) for 24 h. Then the viability of cells was detected by cell counting Kit-8 (CCK-8) assay. The cells were divided into 5 groups: control group, H ₂O₂ group, Sal low dose group (30 μmol/L Sal+ H ₂O₂ group), Sal middle dose group (50 μmol/L Sal+ H ₂O₂ group), Sal high dose group (100 μmol/L Sal+ H ₂O₂ group). The effects of Sal on the apoptosis of the HLEC were determined by Hoechst 33258 staining and flow cytometry assay. Reverse transcriptase-polymerase chain reaction (RT-PCR) was used to detect B cell lymphoma-2 associated X protein (Bax), B-cell lymphoma-2 (Bcl-2) and Cysteinyl aspartate specific proteinase 3 (Caspase-3) expression. Data between groups were analyzed using one-way analysis of variance (ANOVA), while LSD-t test was used for further comparison between every two groups.

CCK-8 result showed that when the concentration of H₂O₂ was 200 μmol/L, the survival of HLEC inhibition rate was 49.56%±7.07%, which was close to the half of the cell survival inhibition rate (IC50). So 200 μmol/L was chosen as the concentration of H ₂O₂ in follow-up experiments. Different concentrations of Sal had no inhibitive influence on HLEC viability. After 24 hours cultivated with Sal (10 μmol/L, 30 μmol/L, 50 μmol/L, 100 μmol/L, 200 μmol/L), the survival rate of HLEC were 100.24%±2.07%、101.18%±2.14%, 101.32%±2.48%, 101.76%±1.93% and 99.28%±1.74% correspondingly. There was no significant difference comparing with that of the control group 99.84%±2.21% ( F=1.044, P=0.415; all P>0.05). Hoechst 33258 staining showed that the chromatin of H₂O₂ group aggregated and concentrated obviously. And Sal could reduce the aggregation of chromatin of HLEC obviously. FCM results indicated that the apoptosis rate of HLEC was 2.26%±0.29% in control group and 44.56%±4.28% in H₂O₂ group. After interposal with Sal (30 μmol/L, 50 μmol/L, 100 μmol/L), the apoptosis rate of HLEC reduced to 31.52%±3.05%, 24.06%±4.25% and 17.16%±2.75%. The differences of apoptosis rates had statistical significance between the five groups ( F=117.082, P<0.001). The HLEC apoptosis rate decreased with higher Sal concentreations (F=117.082, P<0.01). The expression of Bax and Caspase-3 in H₂O₂ group were higher and the expression of Bcl-2 were lower than that in the control group (P<0.01). Compared with the control group, the expression of Bcl-2 in three Sal dose groups was higher and the expression of Bax, Caspase-3 was lower, especially the high dose Sal group (Bax:F=493.554, P<0.01; Bcl-2:F=827.820, P<0.01; Caspase-3:F=537.237, P<0.01).

The Sal takes the protective effect on the oxidative damage to HLEC. It could decrease the apoptosis of HLEC.(Chin J Ophthalmol, 2015, 51: 130-135)

To confirm the non-inferiority of the IOP-lowering effect of the 0.0015% Tafluprost ophthalmic solution to the 0.005% Latanoprost ophthalmic solution in patients with primary open-angle glaucoma or ocular hypertension. Safety was also compared between two groups.

This study was conducted from August 2008 to December 2009, at five clinical trial sites in China. Patients of this study population was diagnosed with primary open-angle glaucoma or ocular hypertension in both eyes. Subjects were randomized into 0.0015% Tafluprost group or 0.005% Latanoprost group. Intraocular pressure (IOP) measurement by Goldmann applanation tonometer, slit-lamp microscopy, Gonioscopy, Fundascopy, Visual acuity test, Perimetry, Blood pressure and pulse rate, Subjective symptoms were compered between two groups at Week 0, Week 2 and Week 4. For main effectiveness evaluation index adopt the bad effect evaluation, safety evaluation index by Fisher′s exact test probability method.

The 246 subjects/246 eyes were randomized (Tafluprost group: 122 subjects/122 eyes, Latanoprost group: 124 subjects/124 eyes). Change in the IOP at 17: 00 of Week 2 is (8.8±3.8) mmHg and (8.9±4.4) mmHg (1 mmHg=0.133 kPa) in Tafluprost group and Latanoprost group. Percent change in the IOP at 17: 00 of Week 2 is (33.2±12.8)% and (34.4±14.1)% in Tafluprost group and Latanoprost group. Change in the IOP at 17: 00 at the end of treatment is (9.8±4.0) mmHg and (9.2±4.1) mmHg in Tafluprost group and Latanoprost group. Percent change in the IOP at 17: 00 at the end of treatment is 37.2%±13.4% group and 35.7%±13.0% in Tafluprost and Latanoprost group. In addition, distribution of subjects with percentage decrease of IOP>30% was 72.5% in Tafluprost group higher than 63.8% in Latanoprost group. The major adverse reactions were conjunctival hyperemia, eye irritation, eye pain and foreign body sensation. The incidence of adverse reactions is 31.7% in Tafluprost group and 20.8% in Latanoprost group. The inter-group difference had no statistical significance.

Efficacy and safety of Tafluprost ophthalmic solution are no less than Latanoprost ophthalmic solution in patients with primary open-angle glaucoma or ocular hypertension.(Chin J Ophthalmol, 2015, 51: 95-102)

The patient was a 75-year-old male. On July 16, 2013, he went to the Department of Ophthalmology of Peking University People's Hospital for treatment due to intermittent eye swelling in his right eye for nearly 1 year and poor intraocular pressure control with two intraocular pressure lowering drugs. One year ago, the patient developed intermittent eye swelling in his right eye 1 month after cataract surgery, without nausea and vomiting. The ophthalmology examination of Peking University People's Hospital showed that the intraocular pressure of his right eye was 27 mmHg (1 mmHg =0.133 kPa), the cornea was clear, and there were a few pigmented retrocorneal deposits, but no abnormalities were found. Carteolol hydrochloride eye drops were given to the right eye twice a day, and tobramycin and dexamethasone eye drops (medication after cataract surgery) were stopped. After regular follow-up visits, the intraocular pressure fluctuated between 25 and 30 mmHg, so the patient was treated with selective laser trabeculoplasty in his right eye 10 months ago. After multiple follow-up visits, the intraocular pressure fluctuated between 25 and 40 mmHg, during which 2 or 3 kinds of intraocular pressure lowering drugs (carteolol hydrochloride eye drops, levobunolol hydrochloride eye drops, brinzolamide eye drops) were used. In 2002, the patient underwent YAG laser peripheral iridotomy due to angle-closure glaucoma in both eyes. No intraocular pressure lowering drugs were used in both eyes after operation, and the intraocular pressure was normal after regular reexamination. From December 2010 to May 2012, the intraocular pressure was 19-22 mmHg after multiple reexaminations. The cornea was clear, the anterior chamber was not shallow, the peripheral iris laser incision was unobstructed, the lens was NC2, the fundus optic papilla boundary was clear and positive after mydriasis, the optic cup was shallow, the cup-to-disc ratio was 0.5-0.6, the disc edge was normal, the retina was leopard-shaped, and the visual field examination showed no glaucoma-specific changes. On June 28 and July 12, 2012, phacoemulsification and IOL implantation were performed in the left and right eyes under local anesthesia (AcrySoft IQ IOL, 22.50 D and 22.00 D, respectively). The left eye went smoothly intraoperatively; After implantation of IOL in the right eye, the posterior capsule ruptured when viscoelastic was injected. Continuous annular capsulorhexis of the posterior capsule was performed. IOL was implanted in the ciliary sulcus. The operation was smooth, and no mydriatic drug was used after the operation. After operation, the left eye recovered smoothly, and the intraocular pressure was maintained at about 13 mmHg. The condition of the right eye is described above.

The patient was a 19-year-old female. On March 7, 2008, I came to the Department of Ophthalmology of Jinan Second People's Hospital for treatment due to the protrusion of my left eyeball since childhood, which gradually aggravated for 3 years. General examination: Scattered irregular coffee spot-like changes (>6 places) on the whole body skin with a diameter of 0.5~6.0 cm, and scoliosis deformity (Figure 1), a 1 cm ×1 cm size subcutaneous nodule was seen in the middle of both forearms, which was soft in texture, without tenderness, with clear boundaries and acceptable mobility; The anterolateral radiographs of the chest showed curvature and deformity of the spine, and the heart and lung were roughly normal; MRI scan of the brain showed no obvious abnormalities. Eye examination: visual acuity 1.0 in the right eye, no light sensation in the left eye; No abnormalities were found in the anterior segment and fundus of the right eye; Pulsatile exophthalmos in the left eye, obviously limited movement in all directions of the eyeball, no palpable mass in the eyelid, mixed congestion, corneal edema, several large blisters on the surface, expansion and thinning of the temporal sclera, and transparent pigment membrane above (Figure 2)。 Under the slit lamp microscope, the depth of the anterior chamber was moderate, brown-yellow hamartoma (Lisch nodule) was seen on the surface of the iris, the pigment collar of the iris was everted above the nose, the pupil was not round, and it was displaced to the upper temporal (Figure 3), the rest of the eyes are unclear. IOP: 15 mmHg (1 mmHg =0.133 kPa) in right eye, T +2 in left eye; B-ultrasound of left eye showed scleral staphyloma; Orbital CT scan showed that the left eyeball was about 2.9 cm ×4.4 cm in size, protruding, the left superior and lateral rectus muscles were thickened, the optic nerve was not abnormal, the left sphenoid large wing bone was missing, and the right eye was not abnormal (Figure 4)。 Admission diagnosis: neurofibromatosis type 1 (NF-1). On March 20, 2008, the contents of the left eye were removed under general anesthesia (the anterior sclera was incised 3 mm away from the limbus at 3 o'clock, and a circle was drawn with the diameter of the line connecting the limbus at 9 o'clock, and the corneal tissue and part of the sclera in this circular area were cut off). The tissue was removed and sent for pathological examination after operation. The wound healed well after surgery. Histopathological examination (Figure 5): Conventional paraffin section, HE staining, observation under light microscope, one side of anterior iris adhesion and iris atrophy were seen. On the other side, the pigment epithelium of the pupil margin was everted, the iris atrophy, and the pupil sphincter was cystic lesion, but no neurofibroma lesion was seen; Local chronic inflammation of the cornea, abnormal development of the chamber angle; Choroidal vasodilatation, hyperemia, atrophy of retinal ganglion cell layer and nerve fiber layer.

The patient was a female, 45 years old. On February 22, 2010, he came to Tianjin Medical University Eye Hospital for treatment due to swelling and tearing in his right eye for 3 years, aggravated eyelid swelling, ptosis, and headache on the right side for 4 months. MRI examination showed a tumor above the right orbit. After treatment with 40 mg of prednisone acetate, the appearance of both eyes was consistent. After the dose of prednisone acetate was reduced to 5 mg, the condition recurred, so he was admitted to the hospital with "right orbital mass". The patient denied previous history of ophthalmic disease, systemic disease, and family disease. Admission physical examination: general condition is good. The visual acuity was 0.8 in the right eye and 1.0 in the left eye. The upper eyelid of the right eye is swollen and slightly drooping, the eyelid margin is located above the pupil margin, and the lifting is slightly limited. The cornea was clear, the anterior chamber was clear, the lens was clear, and no obvious abnormalities were found in the fundus. The eyeball is prominent and displaced downward. Exophthalmia: 16 mm in the right eye, 14 mm in the left eye and 105 mm in the orbital distance. Eye movement: Upward rotation was limited, and no abnormalities were observed in the eye movement in all directions. IOP 15.6 mmHg. Palpation: Flat hard mass can be palpable at the upper orbital margin, the surface is not smooth, pushed immobile, orbital pressure (+ +), and no mass is palpable around the orbit. The anterior segment and fundus of the left eye were roughly normal. Cervical lymph nodes were unpalpable. B-mode ultrasound showed that the hypoechoic area above the right external orbit was flat, with clear boundaries and uneven internal echoes. Color Doppler flow imaging showed that the blood flow signal in the tumor was rich, with thick strip-like blood flow signal, staghorn-like bifurcation at the front end, and blue area in the red blood flow signal (Figure 1)。 Color Doppler power imaging showed more obvious bifurcation of blood flow. Orbital CT examination showed irregular high-density mass shadow in the upper part of the right external orbit, with clear and homogeneous boundary, close to the upper wall of the external orbit, and surrounding the upper eye of the external orbit, showing a casting shape, and the relationship with the lateral rectus muscle was not clearly distinguished. There was no obvious bone destruction in the orbital wall, and the inferior eye ball was displaced (Figure 2)。 Orbital MRI examination showed abnormal signal area above the right eyeball, the location, shape and extent were the same as those of CT; The signal intensity showed medium signal in T1WI, but still showed medium signal in T2WI, and the enhancement was not obvious. Clinical diagnosis: right intraorbital mass.

The child was a 3-year-old male. Due to the discovery of left orbital mass since childhood, there was no obvious change in the mass within 3 years, and he went to the Department of Ophthalmology of Peking University Third Hospital on June 2, 2012. The child had no other symptoms of general discomfort. Family history and genetic history are unknown. Ophthalmic examination: Binocular visual acuity examination did not cooperate, and no obvious abnormality was found in the right eye. The left eye is incomplete closure, the left upper eyelid is everted, the bulbar conjunctiva is obviously congested and edema, and an ellipsoidal mass is visible in the eye socket. The mass protrudes from the orbit, is tough to touch, has no adhesion to the surrounding tissues, and the structure of the eyeball is invisible (Figure 1)。 Orbital CT examination: Huge fat-containing space in the left orbit, and the left eyeball compression deformation became small (Figure 2)。 Orbital magnetic resonance imaging examination: lipid space-occupying lesions in the left orbit (Figure 3)。 Preliminary diagnosis: (1) left orbital mass (nature to be investigated); (2) Atrophy of the left eye?

The patient was a 45-year-old male. He went to Tianjin Eye Hospital because his right eye visual acuity decreased for 2 weeks. Eye examination: visual acuity was 0.9 in the right eye and 0.9 in the left eye; There was no obvious abnormality in the anterior segment examination of both eyes; For right fundus examination, seeQuintessence Picture 1In A, see B in Essence Picture 1 for OCT examination. Clinical diagnosis: congenital fovea of the right eye.

The patient was a 48-year-old male. He went to the Department of Ophthalmology of the People's Liberation Army General Hospital because of conscious decline of vision in his right eye. Eye examination: right eye visual acuity 0.7; No obvious abnormalities were observed in the anterior segment of the right eye; For right fundus examination, seeQuintessence Picture 1AndQuintessence Picture 2。 Clinical diagnosis: partial defect of the right eye papilla and choroid.

The patient was a 32-year-old male. Because his right eye had a sense of occlusion for several months, he went to the Department of Ophthalmology, the Second People's Hospital of Yunnan Province. Ophthalmic examination: visual acuity was 0.8 in the right eye and 1.0 in the left eye; The cornea of both eyes was transparent, the depth of the anterior chamber was normal, the pupil was equal size and round, and the direct and indirect response to light was normal. A calcified tumor was seen in front of the retina of the right eye, which was white, turbid and nodular, consisting of a large number of glittering calcium globules and appeared mulberry-like; No obvious abnormalities were observed in the optic papilla, macular area and blood vessels (Quintessence Picture 1)。 Clinical diagnosis: Retinal astrocytic hamartoma of the right eye.

The 20th National Symposium on Eye Trauma and the First Asia-Pacific Eye Trauma Conference were held in Shenzhen, Guangdong Province from October 30 to November 2, 2014. This conference was academically supported by the Ocular Trauma Group of Ophthalmology Branch of Chinese Medical Association and hosted by Shenzhen Eye Hospital. A total of 398 papers were submitted and more than 500 representatives attended. It was the largest grand event in all previous academic symposiums on ocular trauma. As the "First Asia-Pacific Eye Trauma Conference" held at the same time, not only many famous ophthalmologists from all over the country participated, but also invited experts and scholars from India, Singapore, Taiwan Province and Macao to give special lectures.