Volume 41 ·  Issue 01 ·  2005

Thanks to the care and love of the readers and authors of ophthalmology in China, all the editors and reviewers of China Ophthalmology Journal successfully completed the editorial task in 2004. Just as we look back on the past and continue the new chapter, the celebratory day of the 55th anniversary of the founding of China Ophthalmology Journal also comes. On October 1, 1950, China Ophthalmology Journal was founded with the 1st birthday of New China, which is an unforgettable day for fellow ophthalmologists in China. We want to pay tribute to the 55th anniversary of the founding of China Ophthalmology Journal with excellent achievements!

Since the beginning of the new century, great progress has been made in the prevention and treatment of blindness in our country, but there are still some problems to be solved urgently, mainly the small increase of cataract surgery rate, the lack of strong organizational leadership and national planning for prevention and treatment of blindness, and the lack of attention to prevention and treatment of blindness while developing ophthalmology. It is the social responsibility of ophthalmologists in our country to carry out the prevention and treatment of blindness in depth. We should carry forward the good tradition of attaching importance to prevention and treatment of blindness in our country, analyze the actual situation in the new century, and seriously solve the above-mentioned existing problems. Radical cure of cataract blindness is the primary task of prevention and treatment of blindness in our country, and the goal of treating cataract blindness in large quantity, high quality and low price should be realized as soon as possible.

In order to explore the scientificity of logarithmic vision chart and 5-point recording method, a 10 times 4.0-point visual target was made and placed 0.5m in front of the eye, that is, 2.0-point (1000′ =16.67° viewing angle); Moved to 0.05m in front of the eye, that is, 1.0 minutes (10000′ =166.7° viewing angle); Compared with the 5-point recording method, which is 2.0 points for manual recording and 1.0 points for photosensitive recording, it is more scientific and perfects the standard visual target of 5-point recording theoretically. Both the logarithmic eye chart and the 5-point recording method created by China have their own characteristics and advantages.

Objective to investigate the prevalence of age-related macular degeneration (AMD) in people ≥50 years old in Caojiadu Street, Shanghai.Methods The epidemiological investigation of AMD was conducted in the target population of Caojiadu Street, Jing'an District, Shanghai from September 2002 to June 2003.Firstly, stratified quota sampling was adopted; Then, the investigation team conducted external eye, cornea, pupil and lens examinations, and direct ophthalmoscopic fundus examinations under small pupils on the sampled population at the local ophthalmic examination station, and initially screened out patients with confirmed and suspected AMD; The diagnosis of suspicious patients was further confirmed by fundus photography in the First Affiliated People's Hospital of Shanghai Jiaotong University School of Medicine. Results A total of 1063 people were included in this survey, and 1023 people were actually examined, the examination rate was 96.2%. 159 patients (254 eyes) were diagnosed with AMD, accounting for 15.5% of the examined population, and 19 patients (30 eyes) were diagnosed with wet AMD. The detection rates of AMD were 5.7% (12/212 cases), 13.5% (42/311 cases), 20.2% (77/381 cases) and 23.5% (28/119 cases) in all age groups over 50-59, 60-69, 70-79 and 80 years old, respectively (χ 2=27.97, P<0.01). No factors affecting the prevalence of different types of AMD were found. The proportion of blind eyes and low vision eyes caused by AMD was 5.1% and 31.1%, respectively. The proportion of blind eyes and low vision eyes caused by wet AMD (23.3% and 40.0%) was higher than that of blind eyes and low vision eyes caused by dry AMD (2.7% and 7.2%). Conclusion The prevalence of AMD increased significantly with age.

Objective to investigate the normal values of six indexes of orbital distance, pupillary distance, exophthalmos, orbital distance on the ear root, width between the ear root and nasal root angle in different age groups and their growth and development regularities in order to standardize the size of eyeglasses frames for children and adolescents in China. Methods From October 1996 to October 1997, six normal values of orbital distance, pupillary distance, exophthalmos, orbital distance on the ear root, width between the ear root and nasal root angle were measured by vernier caliper and exophthalmometer in 10171 children and adolescents aged 5-17 in Qingdao, Kaifeng, Xiamen and Hohhot. Results The normal values of orbital distance, pupillary distance, orbital distance on the ear root and width between the ear root were positively correlated with age, and the mean values of each age group increased with age. There were statistically significant differences between pupillary distance before 15 years old, orbital distance before 13 years old, exophthalmos before 12 years old, orbital distance on the ear root and width between the ear root before 12 years old (F =1.35, P<There was no significant difference between age groups (F =0.63, P>0.05). The developmental peak ages of pupillary distance, orbital distance, exophthalmos, supraorbital distance and supraorbital width were 10 years old, 11 years old, 5 years old, 7 years old and 11 years old, respectively, and the increase and change of the above parameters were 5~15 years old, 5~13 years old, 5~8 years old, 5~12 years old and 5~15 years old, respectively. The normal values of six indexes were statistically significant (t =3.1, P<0.01). Conclusion The 5-15-year-old age group of 5-17-year-old children and adolescents in China is the development and growth period of orbital distance, pupillary distance, supraorbital distance, supraorbital width and exophthalmos. Although the differences of the above five indexes between male and female sex and six indexes between four regions are statistically significant, they have no practical significance to standardize the specification and size of children's eyeglass frame.

Objective to investigate the effect of adjusting the cutting area according to the pupil center after mydriasis on the curative effect of individualized excimer laser in situ keratomileusis (LASIK). Methods Thirty-two myopic patients (63 eyes) with high-order root mean square aberration (RMS)>0.35 μ m at 6mm pupil diameter were randomly divided into groups A and B and underwent individualized LASIK by Zyoptix. The center of the cutting area in group A was taken as the center of the pupil, while the center of the cutting area in group B was adjusted according to the measured deviation of the pupil center after mydriasis. Results The average deviation of the pupil center after mydriasis was (0.173 ± 0.114) mm, and the maximum was 0.51mm. There was no significant difference in visual acuity and diopter between the two groups at 3 months after operation (P>0.05). The difference of coma aberration before and after operation was (0.025 ± 0.137) and (0.097 ± 0.118) μ m (t =2.131, P =0.037), while the difference in spherical aberration was not statistically significant (P>0.05). The correction effect of coma aberration in group B was better than that in group A. Conclusion

Objective to investigate the clinical effect of bursting ultrasound energy mode in phacoemulsification cataract aspiration.Methods 178 patients (222 eyes) with cataract were randomly divided into three groups: continuous, pulse and bursting.The ultrasound energy, effective ultrasound time and cumulative composite energy parameters (the product of actual ultrasound energy and effective ultrasound time) were recorded and compared in the three groups.The postoperative visual acuity, corneal edema degree and corneal endothelial cell density were examined, and the occurrence of surgical complications were observed. Results The effective ultrasound time [(0.18±0.03), (0.36±0.25) min], actual ultrasound energy [(10.44±2.14) %, (23.63±3.71) %] and cumulative composite energy parameters (2.11±1.40, 6.94±2.66) in the bursting group were significantly lower than those in the continuous group and pulse group, and the differences were statistically significant (P<0.05). The degree of corneal edema in the burst group was significantly lighter than that in the continuous group and the pulse group on 1d and 3d postoperatively, and the differences were statistically significant (P<The loss rate of corneal endothelial cells at 1 week after operation was significantly lower in the burst group than in the continuous group (17.35 13.29) %) (P<Conclusion Blasting ultrasound energy mode can shorten the effective ultrasound time and the total ultrasound energy of phacoemulsification cataract aspiration, thus reducing the intraocular tissue damage and improving the curative effect, which is worthy of popularization.

Objective to observe the histopathological and ultrastructural changes of intraocular silicone oil-related complications after intraocular silicone oil filling, and to explore the mechanisms of their occurrence.Methods 25 pathological specimens were collected from the pathology department of Sun Yat-sen Ophthalmology Center of Sun Yat-sen University, including 8 cases of eyeball, 1 case of ocular contents, 4 cases of epiretinal membrane, 4 cases of cornea and 8 cases of lens. Histopathological observation and immunohistochemical analysis were performed, and 2 cases of fresh epiretinal membrane tissues were observed under electron microscope.Results the main lesions of silicone oil-related keratosis after intraocular silicone oil filling were endothelial cell disappearance (90%) and corneal band degeneration (83%). Typical silicone oil-related retinopathy was observed in 8 cases of eyeball and 1 case of ocular contents, namely, retinal structure was disturbed, proliferative membrane was formed, there were many round silicone oil vesicles of different sizes in them, and the number of neuronal cells was reduced. In 3 cases of eyeball with silicone oil retention time>60 months, the retinal tissue was completely replaced by proliferative membrane, and silicone oil extensively infiltrated into the old wound of corneoscleral margin, trabecula, iris-ciliary body, choroid, optic nerve and its sheath tissue, which suggested that with the prolongation of silicone oil retention time in the eye, the complications of silicone oil were more widespread and serious. Conclusion Long-term intraocular retention of silicone oil after intraocular silicone oil filling may lead to abnormal structure and/or function of ocular tissues. Silicone oil should be removed timely after stable retinal reset to avoid using silicone oil as long-term intraocular filling.

Objective to investigate the effect of binocular form deprivation on γ-aminobutyric acid currents in visual cortex neurons during the critical stage of visual development plasticity in rats. Methods the excitatory postsynaptic currents of normal, binocular form deprivation and deprivation rats were recorded by patch-clamp whole cell recording technique at 14, 21 and 28 days after birth. Then, D, L-2-amino-5-phosphopentanoic acid 50 μ mol/L and cyano-7-nitroquinoline-2,3-dione 20 μ mol/L were added to artificial cerebrospinal fluid simultaneously to separate γ-aminobutyric acid receptor-mediated component currents and analyze their electrical properties. Results The decreasing time and peak value of inhibitory postsynaptic currents in visual cortex neurons of normal rats increased significantly with increasing age (P<0.05); However, there was no significant change in the binocular form deprivation group (P>0.05); The decrease time and peak value of inhibitory postsynaptic current in rats visual cortex neurons increased 1 week after deprivation was removed (compared with binocular deprivation group 4 weeks after birth, P<Conclusion With visual development, inhibitory synaptic transmission mediated by γ-aminobutyric acid receptor in visual cortex neurons of normal rats is enhanced, and binocular form deprivation inhibits this change, which can be reversed after visual input is restored.

Objective to investigate the possible mechanism of amblyopia. Methods Multifocal pattern visual evoked potential (VEP), electroretinogram (ERG) and multifocal flash VEP and ERG were recorded in both eyes of 24 patients with anisometropic amblyopia by using VERISScienceTM4.2 multifocal electrophysiological system, and the results were compared with those of 30 normal controls. Results The amplitude of multifocal pattern VEP and ERG response and multifocal flash VEP and ERG second-order response were decreased in different retinal regions, the characteristic latency of VEP was prolonged, but the latency of ERG was not changed. The response amplitude density of multifocal flash first-order response VEP and ERG were decreased, but the latency time was not changed obviously. The abnormal degree of multifocal pattern VEP waveform was larger in the central area than in the peripheral area, and it was correlated with the abnormal degree of visual acuity in amblyopic eyes. The retinocortical conduction time (RCT) of multifocal pattern and flash second-order response in amblyopic eyes was significantly prolonged, but there was no significant difference in the first-order response RCT in the three groups. Conclusion The mVEP and mERG of amblyopic eyes have obvious characteristic changes, It indicated that there were obvious damage to the retina, visual conduction pathway and visual cortex in amblyopic eyes, and the damage to the central area was more serious than that to the peripheral area, and the damage to the central area was more serious than that to the retina.

Objective to investigate the role of P38 mitogen-activated protein kinase (MAPK) in the expression of heat shock protein 27 (HSP27) in human lens epithelial cells induced by H2O2. Methods the cultured human lens epithelial cell line B3 was stimulated with 100 and 200 μ mol/L H2O2 at different times, respectively. In the blocking experiment, the specific P38MAPK blocker SB203580 was added to block the signal transduction pathway of P38MAPK. The expression of HSP27 mRNA in human lens epithelial cells stimulated at different times was detected by reverse transcription polymerase chain reaction, and the expression of HSP27 and phosphorylated P38MAPK in human lens epithelial cells was detected by Western blotting. Results (1) The expression of HSP27 mRNA and its protein in human lens epithelial cells stimulated by H2O2 was significantly increased; (2) The activity of stress-activated protein kinase (mean gray value) in human lens epithelial cells increased to 8.00 ± 0.81 and 8.25 ± 0.50 after 30 min stimulation with 100 and 200 μ mol/L H2O2, respectively, and returned to baseline level after 6 h (P<0.01); The expression of phosphorylated P38MAPK increased with the increase of H2O2 concentration, reached the peak 15min after H2O2 stimulation, and then gradually decreased; (3) After pretreatment with specific P38MAPK blocker SB203580, the expression of HSP27 in human lens epithelial cells was significantly inhibited from 36.00±0.82 to 8.75±1.26 after 6h stimulation with 200 μ mol/LH2O2 (P<Conclusion P38MAPK signal transduction pathway is involved in H2O2-induced expression of HSP27 in human lens epithelial cells.

Objective to investigate the prevalence of primary angle closure glaucoma (PACG) in rural and urban populations in Beijing and to explore the related influencing factors. Methods From June to October 2001, 4451 people over 40 years old in rural and urban areas of Beijing were screened for glaucoma, including 1980 in rural areas, 2471 in urban areas, 1939 males and 2512 females. The examination items included measurement of peripheral anterior chamber depth and anterior chamber angle by vanHerick method and gonioscopy, routine measurement of visual acuity, intraocular pressure, refractive status, fundus photography and threshold field detection, and standard examination of glaucoma was performed for suspicious glaucoma and glaucoma patients. Results The response rates of rural and urban people over 40 years old were 79.6% (1980/2488) and 87.1% (2471/2836), respectively; The prevalence of PACG in the population was 1.2% [95% confidence interval (CI) was 0.9% ~1.5%], and the prevalence of PACG in rural areas was 1.6% (95% CI was 1.2% ~2.0%), which was higher than that in urban areas 1.1% (95% CI was 0.8% ~1.4%); The prevalence of PACG in females was 1.7% (95% CI 1.3%-2.1%), which was higher than that in males 0.8% (95% CI 0.5%-1.1%); The prevalence of PACG in rural areas (60~69 years) was 10 years earlier than that in urban areas (over 70 years). The rates of monocular low vision (39.3%) and monocular blindness (28.6%) in rural areas were higher than those in urban areas (20.6% and 14.7%, respectively). With the increase of age, the diopter increased and the peripheral anterior chamber depth gradually became shallower. Conclusion The prevalence of PACG in rural areas is higher than that in urban areas, and the prevalence of PACG is related to the peripheral anterior chamber depth, refractive status, sex and age.

Antisense technology is an effective method to inhibit or block the expression of a specific gene in a sequence-specific manner according to the principle of base complementarity. It can be used in the research of functional genomics and the treatment of diseases. In the past 20 years, antisense technology has developed rapidly and has attracted more and more attention. There are many kinds of antisense drugs, which can be mainly divided into three categories: antisense oligonucleotides, antisense RNA and ribozymes. A large number of in vitro experiments and animal experiments have been carried out on many kinds of antisense drugs, which have confirmed that their effects in the treatment of cytomegalovirus retinitis, AIDS, tumor, segmental ileitis, asthma and other diseases are positive. Some drugs have entered the clinical trial stage. With the deepening of research on the mechanism of action, specificity and pharmacological effects of antisense technology, its application scope is constantly expanding, It has broad application prospects in scientific research and clinical treatment in the field of ophthalmology. This paper expounds the mechanism of action of antisense gene therapy, antisense drugs and the application of antisense technology in ophthalmology research.

A 17-year-old female was diagnosed and treated in our hospital on August 3, 2002 due to congenital vertical eyebrow of left eye with partial absence of upper eyelid. The patient's parents were not close relatives, the youngest of 7 siblings, and her mother had no history of viral infection during pregnancy; The other 6 siblings had no similar facial deformity.

A 72-year-old male, due to foreign body sensation in both eyes for 2 days, came to our hospital on February 26, 2002. The patient had no abnormalities in physical examination. Ophthalmological examination: the naked eye visual acuity of both eyes was 1.0, the eyelids of both eyes were not reddened or swollen, and three lacrimal dots were visible on the lower eyelid of the right eye, which were distributed in the shape of plum blossom at the posterior lip of the eyelid margin about 6 mm from the medial canthus angle, with a diameter of 0.2~0.3 mm (Figure 1). After topical anesthesia, the three lacrimal dots were washed with normal saline respectively, and the lacrimal duct probe was performed to find that the three lacrimal dots all opened in the same lacrimal duct. The tears on the upper eyelid of the right eye and the upper and lower eyelids of the left eye were normal; The conjunctiva of both eyelids was slightly congested, the follicles were slightly hyperplasia, the cornea was smooth and transparent, the pupil diameter was 3mm, the shape was normal, and the fundus was not abnormal.

continuous curvilinear capsulorhexis (CCC) is a commonly used method to open the anterior lens capsule in modern phacoemulsification cataract aspiration. It has many advantages [1, 2], but it can also cause new surgical complications, such as capsule contraction syndrome (CCS) [1, 3].

Retinal detachment complicated with retinoschisis is rarely discussed in previous literature. In recent years, due to the clinical application of coherence optical tomography in ophthalmology, this lesion is easier to diagnose. The author treated 6 patients with retinal detachment complicated with retinoschisis from August 2000 to July 2004, and the analysis report is as follows.

A 28-year-old male was admitted to our department on April 28, 2002 due to foreign body sensation in both eyes, redness and swelling, photophobia and visual haze aggravated for 8 months for 4 days. Past history: One year ago, he underwent successful allogeneic bone marrow stem cell transplantation in our hospital due to "severe benzene poisoning and severe aplastic anemia". Eight months ago, he developed dry mouth, dry eyes and rash all over the body.

The proband was a 35-year-old female, Tujia nationality. She had poor vision and photophobia in both eyes since she was a child. She was seen in our hospital on June 8, 2002 due to swelling and pain in both eyes. Physical examination showed that the general vital signs were stable, the root of the nose and cheeks were flat, the nasal wall was wide, the distance between the two sides was far, and the teeth were dysplasia (small teeth). Ocular examination showed that the naked eye visual acuity of both eyes was 0.1, both of which could not be corrected. The corneas of both eyes were transparent, the posterior embryonic ring was visible at 360 degrees at the limbus of the cornea, the iris stroma was dysplasia and thinning, the pigment epithelium was everted and atrophied, and the angle examination showed that the posterior periphery of the cornea was opaque, the Schwalbe line was prominent, the lens and vitreous body were transparent, and the fundus papilla was small and normal in color.

The patient, a 6-year-old male, was seen in the outpatient department of our hospital due to redness, swelling and pain in his right eye for 2 months after trauma, loss of vision, and formation of upper eyelid fistula with pus for more than 1 month. When playing with a cow 2 months ago, the child was unfortunately turned over by a cow's horn, and his right head and face landed on the ground. The skin wound at the upper edge of the right upper eyelid orbit was 1cm long, irregular, active bleeding, and whether or not foreign bodies entered was unknown. He underwent emergency debridement and suture in the local township hospital, and the wound and upper eyelid continued to be red and swollen half a month after operation, with gradual loss of vision in his right eye. 1.5. 5 months ago, he was treated with systemic and local antibiotics in the outpatient department of our hospital for 1 week with "suppurative skin infection of right upper eyelid", and his condition was partially relieved.

A 38-year-old female came to our department in January 2003 because of right eye pain with headache and nasal congestion for more than 7 months, which was aggravated for 1 month. Ocular examination: visual acuity of right eye: front fingers 5cm; Left eye 1.0. Exophthalmos: right eye 23 mm, left eye 14 mm, orbital distance 110mm. Right orbital pressure is high (+ + +). Right eyeball protrudes anterolaterally, eyeball is fixed, and movement is limited; No abnormalities were observed in the anterior segment of the right eye; The pupil was round, 5mm in diameter, and the direct reflection to light disappeared, but the indirect reflection to light was slow; Fundus examination showed no abnormalities.

Malignant lymphoepithelial lesion, also known as undifferentiated carcinoma with lymphoid stroma, most often occurs in the nasopharynx, and its pathogenesis is closely related to Epstein-Barr virus [1-4]. Only one case of malignant lymphoepithelial lesion occurring in the lacrimal sac was reported, and this case was first manifested as lymph node metastasis of undifferentiated carcinoma of the neck [5]. The author once diagnosed and treated a case of malignant lymphoepithelial lesion originating in the lacrimal sac that was first diagnosed in ophthalmology, and the report is as follows.

The macular epiretinal membrane in children is a rare macular disease. The cause of the disease is still unknown, and most of it is related to congenital factors. This disease can not only lead to visual loss and visual deformation in children, but also seriously affect the visual development of children, resulting in amblyopia. There have been many reports on the surgical treatment of macular epiretinal membrane in adults [1,2], but the surgical treatment of macular epiretinal membrane in children has been rarely reported [3,4]. We operated on 4 children with macular epiretinal membrane from 2001 to 2003, and the treatment situation is reported as follows.

Diabetic retinopathy is a serious ocular complication in diabetic patients, and its etiology and pathogenesis have not been elucidated. In recent years, it is believed that chronic hyperglycemia causes excessive deposition of glycosylated proteins in the body and forms glycosylation end products, which leads to chronic diseases and loss of function of various systems. Traditionally, people think that diabetic retinopathy is mainly microvascular diseases, including endothelial cell proliferation, basement membrane thickening, pericyte loss, etc.

Ophthalmology experiment animals (such as rabbits) have large and kyphotic lenses, and the vitreous body is thick and transparent, which adheres to the inner limiting membrane of retina. Therefore, vitrectomy is difficult and long. In the experimental study, we improved the conventional vitrectomy and established an animal model of C3F8 assisted vitrectomy.

In the 1980s, China actively carried out the work of preventing and curing blindness, and made great achievements.With the aging of China's population, age-related eye diseases gradually increased.In order to understand the visual acuity of rural population in our city,from January to March 2003,we investigated the blindness and low vision of people aged 40 and above in Sangzi Village, Jixian County, Tianjin City,analyzed the causes of blindness.Compared with the survey in suburban counties of Tianjin in 1983 [1], the results are reported as follows.

Pterygium is a common disease, belonging to conjunctival tissue proliferation, often ocular congestion, which affects the appearance of patients [1]. When the head of pterygium invades the pupil area, it will cause vision loss [2]. Near the equator and low latitudes, the prevalence of pterygium is higher because of strong sunshine, but relatively less in high latitudes. In order to investigate the prevalence of pterygium and related data in Beijing, we conducted an epidemiological survey in specific areas of Beijing from July to September 2001.

Since Kalman [1] first adopted phacoemulsification technology to remove cataract through 3.0mm incision in 1967, cataract extraction surgery has been continuously developed and perfected. The emergence and improvement of surgical auxiliary instruments have promoted the popularization and improvement of phacoemulsification technology. The nucleus splitting hook combined with appropriate negative pressure can mechanically break the hard nucleus, save ultrasound energy and reduce the loss rate of corneal endothelial cells, so it has been paid more and more attention by cataract surgeons. In order to continuously improve the function of nucleus splitting hook, we designed and developed a new nucleus splitting hook by ourselves, which has achieved good results in clinical application. The results are reported as follows.

Orbital diseases often cause serious clinical problems because of small volume, complex anatomy and fine functions [1]. Imaging examination plays an important role in the diagnosis and differential diagnosis of orbital diseases. High-resolution MRI (HR-MRI) has good resolution of orbital soft tissue and no radiation damage, which has become a widely accepted method for orbital examination. The orbital zoning pattern plays a key role in the differential diagnosis of orbital diseases.

The 9th National Ophthalmology Congress was successfully held in the beautiful city of Wuhan from September 10 to 13, 2004. This conference is another unprecedented grand meeting in China's ophthalmology circle since the 21st century. In order to promote the development of ophthalmology in China in the new century, better and faster reflect the development level of ophthalmology in basic and clinical aspects in China, and smoothly connect with the international standards, the organizing committee of the conference set the goal at the beginning, to make this conference truly a academic grand meeting integrating academic exchange and ophthalmology continuing education, which can reflect the rapid development of ophthalmology in China at present.