Volume 45 ·  Issue 05 ·  2009

Diabetic retinopathy includes retinal microangiopathy and retinal neuronopathy. Most of the clinical research has been primarily focused on the former. The retinal microvascular lesions and its complications has standardized in diagnosis and treatment. However, the emphasis on the latter has not been attached to the importance in clinic, and it has fewer studies on it. In recent years, studies have shown that the functional lesion of the retinal neurons and glial cells often can be detected earlier than microangiopathy in diabetic patients. Therefore, emphasis on the research of the diabetic retinal neurons lesions and retinal neuroprotection is beneficial to understand the essence of diabetic retinopathy rightly, and has great practial significance in preventing and reversing diabetic retinal neuronopathy in the early stage.

Age-related macular degeneration (AMD) is the leading cause of blindness in developed countries. The impact of AMD to the economics, society and the patients are huge. However, the awareness of AMD is alarmingly low. Even in developed countries, the awareness of AMD is below 30%. In terms of the risk factors of AMD, the awareness is also quite low, e. g. , only 32% were aware of the causal link between smoking and AMD. Although cataract is the leading cause of the blindness in China, as the economic and social progress, as the coming of the aging society, as people pursuing higher quality of life, AMD will become a unignoring public health problem. Thus, it is urgent to take action now to increase the public awareness of AMD.

Age-related macular degeneration (AMD) is the leading cause of blindness in the elderly population and threatens the ability of patients to live independendy. Ethnic differences are evident in the prevalence of AMD, its clinical features, as well as treatment responses to photedynamic therapy (PDT), most likely due to the differences in genetic backgrounds, disease susceptibility, living environments and habits. This article reviewed ethnic/racial differences in AMD, paying particular attention to the Chinese population, and highlighted the key findings. Compared to Caucasians, the prevalence of early and late stages of AMD is relatively lower and the polypoidal choroidal vasculopathy (PCV) is more commonly seen in the Chinese population. Regarding genetic susceptibility, the complement factor H (CFH) Y402H variant is not associated with exudative AMD in Chinese although it is strongly associated with AMD in Caucasians. In addition, visual outcome in Chinese patients with AMD seems to be better than that in Caucasian patients after PDT at 1 year follow-up.

Objective To assess the efficacy in patients undergoing pars plans vitrectomy for the treatment of idiopathic macular hole (IMH). Methods Retrospective observational case series. Retrospective analysis of vitrectomy for IMH patients treated between January 2001 and January 2008 was performed. The statistical software SPSS10. 0 were used to analyze the data such as surgical technique, closure rate, BCVA, hole size and stage etc. The variables in normal distribution were compared by independent sample t-tests, the qualitative data were compared by R × C table, and the ordered data were compared by nonpuramatric tests. Results Fifty eight eyes of 57 patients underwent vitrectomy with gas (10% C3F8) injection. Primary closure was achieved in 44 eyes (75.9%) with an average hole size of 0. 20 mm2 (0. 01-0. 85 mm2 ), whereas the size in the remaining 14 eyes was 0. 69 mm2 (0. 08-3. 16 mm2 ). The closure rate of the 36 eyes treated with ILM peeling was 80. 6% (29/36), and decreased visual acuity was not observed in 72. 2% of them (26/36). The closure rate of the 22 eyes without ILM peeling was 68. 2% (15/22), and decreased visual acuity was not observed in 59. 1% of them (13/22). There was a significant difference in the size and the change of BCVA between the closed cases and the unclosed cases, and no other factors had significant effect on the BCVA. Conclusions Vitrectomy was evaluated as an useful treatment for IMH. ILM peeling in vitrectomy could not improve the closure rate and the visual outcomes. Preoperative hole size may be a sensitive predictor for postoperative closure.

Objective To evaluate the effects of scleral buckling combined with intravitreal gas injection for the treatment of retinal detachment in selected eyes which had undergone vitrectomy but without silicon oil tamponade. Methods This was a retrospective observational case series. Including 52 eyes of 52 selected patients. All patients had undergone vitrectomy without silicon oil tamponade as the first surgery for the treatment of various vitroretinal diseases. After the failure of the first surgery, seleral buckling combined with intravitreal gas injection were performed for the treatment of retinal detachment in Xijing Hospital between January 2001 and May 2004. The scleral buckling was used in all surgeries and using radial placement of a silicon sponge or circumferential placement of solid silicon combined with an encircling band. During the surgery, all breaks were carefully marked to ensure they were on the crest or anterior slope of the buckle. Air or C3F8 gas was injected intravitreously. The reattachment rate, visual outcome, and postoperative comlications were investigated. Result After a six-month to three-year follow-up period, the reattachment rate was 69. 2% ( 36/52 cases). Further vitrectomy surgeries were needed for other 16 eyes. The visual acuity was improved in 32 eyes (61.5%), three eyes (23. 1% ) with no change, and 8 eyes (15.4%) decreased. Macular epiretinal membrane happened postoperately in one eye, and cataract was found in another case. There is no serious complications. Conclusions Scleral buckling combined with intravitreal gas injection is an effective procedure for the treatment of retinal detachment in vitrectomized eyes without silicon oil tamponade. The rate of secondary vitrectomy also can be reduced.

Objective To analyze the clinical presentations, and explore the diagnosis, and differential diagnosis of combined hamartomas of the retina and retinal pigment epithelium (CHRRPE). Methods A retrospective review of five patients with suspected CHRRPE presented to Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, from Nov 2001 to July 2008. The clinical presentations, fundus characteristics, fundus fluorescein angiography (FFA), optic coherence tomography (OCT), as well as B ultrasound scan examinations were analyzed. Results The five patients were all male, ranging in age from 6 to 18 years (mean 12 years). The lesion was unilateral ;there were not any associated diseases. Presenting symptoms included painless decrease in vision, metamorphopsia, and discovery of strabismus. Initial visual acuity ranged from 20/333 to 20/50. Locations of the lesion included on optic disk and adjacent retina, and in the macular area. Clinical characteristics were slight elevation on optic disk or in retina, different degree of hyperpigmentation, retinal vascular tortuosity, as well as epiretinal membrane formation. In arterial phase of FFA, there was hypofluorescence of choroid background, retinal vascular was tortuose and telangiectatic, and there was leakage from vessels within the lesion in venous phase and late phase. OCT showed obscuration of the normal retinal layers, elevated lesion with high reflectivity of the inner retina, and hyporeflective shadowing of the underlying tissue. B ultrasound scan showed slightly elevated solid mass involving the disc or adjacent retina in some patients. Conclusions CHRRPE may be confused with other masses of the retina and choroid. Diagnosis of CHRRPE mainly depends on fundus manifestations, FFA and OCT. B ultrasound scan is useful for differential diagnosis.

Objective To provide microanatomical data for optic canal decompression surgery or paranasal sinus surgery through anatomaical study on adjacent structures of the optic canal Methods It was a experimental study. (1)Fifty dry cadaveric adult heads (100 sides) were dissected. The shapes and sizes of ethmoid sinus and sphenoid sinus were observed and measured. (2) The distance between the mid-point of the lateral wall of the sphenoid sinus and the internal carotid artery, the angle between the initial section of the ophthalmic artery and internal carotid artery were observed and measured under both naked eye and microscope. The distance between the medial margin of bilateral optic nerve at the frontal outlet were measured on 15 formalin-fixed wet cadaveric adult heads. The relationships between the optic canal and ethmoid sinus and spbenoid sinus were observed on 6 formalin-fixed cadaveric adult heads by CT scanning;the morphological features and adjacent structures were contrasted and observed on 6 ice-frozen cadaveric head specimens by CT scanning and corresponding applied sectional anatomy. Results The anterior-posterior diameter of total ethmoid sinus was( 39. 02 ± 4. 89 ) mm. The horizontal diameter of anterior ethmoid sinus was ( 12. 26 ± 2. 12)mm. The superior-inferior diameter of anterior ethmoid sinus was ( 11.89 ± 2. 56) mm. The anterior-posterior diameter of sphenoid sinus was ( 24. 08 ± 4. 87 ) mm. The distance between the middle part of the lateral wall of sphcnoid sinus and internal carotid artery was ( 1.23 ± 0. 56 ) mm;the angle between the initial section of ophthalmic artery and internal carotid artery was 54. 33°±7.89°. The distance between the medial margin of bilateral optic nerve at the frontal outlet was ( 14. 26 ± 3.23 ) mm. Conclusions (1)When the medial wail of the optic canal is opened inside the sphenoid sinus, the depth shouldn't exceed 13 mm, otherwise it may damage the internal carotid artery and cause severe bleeding even death. (2)The depth should be less than 15 mm and the superior-inferior diameter should be less than 12 nun inside the anterior ethmoid sinus, otherwise the opposite ethmoid sinus or frontal base may be opened aocidently. (3) The ophthalmic artery should be specifically protceted in order not to cause ocular ischemia and blindness.

Objective To evaluate the efficacy and safety of plasmin or hyaluronidase in the inducing of posterior vitreous detachment in diabetic rats. Methods Forty SD rats were induced diabetes by Streptozotocin (STZ). Four weeks later, these rats were randomized into 4 groups : rats in group A received 5 U hyaluronidase intravitral injection in right eyes;rats in group B received 0. 5 U plsmin intravitral injection in right eyes;rats in group C received 0. 5 U plasmin + 5 U hyaluroniclase intravitral injection in right eyes;rats in group D received BSS (balance salt solution ) 2 μl intravitral injection in right eyes. Clinical examination were performed at 1, 3, 7 days after injection. After 1 week, scanning electron microscope (SEM) was performed to judge whether the PVD was induced. ERG and histology were examined to evaluate the toxicity after the intravitreal injection of these two drugs. Results No PVD was found in SEM disclosed group A and group D. Forty percent eyes were induced complete PVD in groups B, and one hundred percent eyes were induced complete PVD in group C. ERG and histology showed no toxicity changes in any group. Conclusion Intravitreal injection of 0. 5 U plasmin + 5 U hayluronidase can induce complete PVD without obvious toxicity in diabetic rats. Solo usage of plasmin or hayluronidase can not induce complete PVD.

Objective To compare the corneal astigmatism and wavefront aberration differences of patients with cataract coexisting corneal astigmatism after phacoemulsification surgery through traditional superior clear corneal incision or phacoemulsification surgery through clear corneal incision guided by corneal topography and implantation of different spherical aberration intraocular lenses (IOL). Methods In a prospective randomized sample controlled clinical trial, 90 patients (90 eyes) with age-related cataract and corneal astigmatism were randomly divided into 3 groups: (Group A) traditional superior corneal incision phacoemulsification surgery and AcrySof SN60AT IOL implantation, (Group B) corneal topography guiding incision phacoemulsification surgery and AcrySof SN60AT IOL implantation and (Group C ) corneal topography guiding incision phacoemulsification surgery and AcrySof SN60WF IOL implantation. Corneal topography tests were performed at 1 week, 1 month, 3 months and 6 months postoperatively. The Wavefront aberration was measured using a custom built Tschcming wavefront sensor--ALLEGRETTO WAVE Analyze at 90 days postoperatively. Third-, 4th-, 5th-, total and higher-order aberration (HOA) root-mean-square (RMS), spherical aberration and coma aberration were compared at virtual pupil diameters of 6 mm postoperatively. Statistical analyses were performed using the analysis of chi square test, repeated measurement data analysis of variance, one-way analysis of variance (ANOVA), and multiple comparisons Studcnts-Newman-Keuls test. Results Corneal topography tests indicated that no significant difference for corneal astigmatism was found between these three groups preoperatively( F =0. 08 ,P >0. 05). The corneal astigmatism was decomposed into J0, J45 and P with a Vector-based method, and statistically analyzed . When compared with Group B and GroupC, Group A had higher values of corneal J0 ( F = 9.54, P < 0. 01 ) and P( F = 18.69, P < 0. 01 ). For corneal J0 and P, no significant difference was found between Group B and Group C ( P > 0. 05 ). However groups and times had interactions ( F = 13.45,50. 22, P < 0. 01, respectively) . For astigmatic vectors, there were statistical significances between different times in 3 groups ( F = 74. 33,92. 11, P < 0. 01, respectively ). Wavefront aberration test results indicated that the mean values of RMSg (root mean square of general aberration) , coma aberration ,RMSh,RMS3 ,RMS5 and RMS6 of Group A were obviously higher than that of Group B and C ( F = 93.40,471.94,176. 95,216. 99,44. 37, 37. 19,P < 0.01, respectively). And the values of RMS4 and spherical aberration in Group A were significantly higher than that in Group C ( q = 25.30,26. 23, P < 0. 01, respectively). No statistically significant was found between Group A and Group B of RMS4 and spherical aberration ( q = 0. 57,2. 34, P > 0. 05, respectively). The values of RMS4, RMSh, RMSg and spherical aberration in Group B were statistically significantly higher than that in Group C ( q = 24. 73, 7.90, 6. 41,23. 89, P < 0. 01, respectively). Conclusions Corneal topography guiding incision phacoemulsification surgery and the implantation of negative spherical aberration IOL is a more favorable solution for cataract patients coexisting corneal astigmatism, which can correct the corneal astigmatism, decrease the spherical aberration, high-order aberration and general aberration of pseudophakic eyes and therefore improve the visual quality of patients.

Objective To investigate the indications, surgical procedure, clinical efficacy, and the prevention and management of complications of Descemet's stripping with endothelial keratoplasty (DSEK) for bullous keratopathy. Methods In the nourandomized retrospective consecutive case series, 8 patients (8 eyes) with bullous keratopathy at Zhongshan Ophthalmic Center between September 2006 and October 2007 underwent DSEK surgery. During the surgical procedure, the Descemet's membrane and abnormal endothelial layer were stripped from the central recipient posterior surface with 7.75 mm diameter, and then a specially designed scraper was used to roughen the peripheral recipient posterior stroma. Other surgical techniques were the same with routine DSEK surgery. The adherence of the donor lenticule to the recipient posterior stroma and postoperative donor lenticule dislocation were monitored in the early stage after surgery. Best spectacle-corrected visual acuity (BSCVA), graft clearance, corneal astigmatism and endothelial cell density (ECD) were observed over a 3-9 months follow-up period. Results All donor lenticules were well adherent to the recipient posterior stroma and no graft dislocation occurred postoperatively. One patient had papillary block glaucoma at 1-day, and relieved after 48 hours postoperative. All grafts remained transparent, and had improved visual acuity. BSCVA was 0.3-0.7 postoperative. Six patients with preoperative pain had been pain free after DSEK procedure. Mean corneal astigmatism was ( 1.90 ± 0. 70) diopter(D). Mean ECD was (2014 ± 192) cells/mm2. Conclusions Compared with deep lamellar endothelial keratoplasty ( DLEK), DSEK procedure is technically easier and less traumatic to recipient comes and anterior chamber structures. The skill of roughening the peripheral recipient posterior stroma should prevent postoperative graft dislocation effectively.

Objective To evaluate the outcome of embolization via orbital surgical exposure for a series of orbital varices. Methods This study is a retrospective review of 28 patients(28 eyes, 11 men, 17 women)which were diagnosed as orbital varix from March to December in 2007, in the Institute of Orbital Diseases. Patient's age ranged from 11 to 54 years old, mean 32 years old. Right orbit 18 cases, left orbit 10 cases. All patients is under general anesthesia, operative approach included lateral orbitotomy (9 cases), anterior orbitotomy (11 cases), transconjunctiva (7 cases) and percutaneous puncture (1 case). During the operation, venous malformations were dilatated and punctured with an 20-gauge catheter needle, then injected into 33% Glubran 2 with several punctures with different orientations of the needle were required to reach the different lobules of the venous pouch. Results Proptosis, visual acuity and eye movement for pre- and post-treatment were observed. All the patients treated with 100% efficiency, in which 16 cases(57% )were complete resolution of the signs and symptoms, no proptosis with Valsalva and correct completely or partially enophthalmos, 12 cases (43%) marked resolution. Six patients partial resection as lesion was stiffen after glue injection, and can touch in anterior part of the orbit. Complications included the vision acuity loss (1 case), limitation of ocular movement ( 3 cases), and proptosis ( 2 cases). Conclusion The embolization with Glubran 2 after direct surgical exposure is the safe and effective treatment for orbital varix and can correct some enophthalmos.

Objective To report the clinical features of benign lymphcepithelial lesion and to further characterize recommendations for its therapy strategy. Methods It was a retrospective case sires. Retrospective analyze the clinical characteristics, imaging features, pathological manifestation and the treatment effect from the clinical materials of 9 cases of patients with benign lymphoepithelial lesion presenting to Tianjin Eye Hospital from Jan 2006 to Dec 2007. Results The 9 cases, in which 7 cases were female, 7 cases had lesions on beth eyes, demonstrated unpainful swelling of the lacrimal glands and in different degree of salivary glands or had history of tumor resection of salivary glands. Orbital CT scanning showed increased homogeneous density with clear boundary in the lacrimal gland area. Color doppler ultrasonography displayed elliptical space occupying with clear boundary and homogeneous internal eehos of the lacrimal gland area. Six patients received treatment with large dose of glucocorticoid for 1-2 courses, and the symptoms and signs were significantly alleviated. Three patients were operated to excise the lacrimal gland masses due to imperfect treatment effect of medication or in order to make definite diagnosis. The postoperative pathological results supported the diagnosis of benign lymphcepithelial lesion. No recurrence happened in the follow-up. Conclusions A clinical condition with swelling of either or both lacrimal gland and of any salivary gland, and accompanied with systemic relative diseases should be considered benign lymphoepithelial lesion. Imaging examinations are helpful to definite diagnosis. Most patients are sensitive to the glucocorticoid treatment. The dose of glucocorticoid should be large at the beginning of treatment. Surgical excision can be apphed to the cases insensitive to medications or difficult to be diagnosed. The definite diagnosis should be made through pathological examinations.

Objective To investigate the preventative effect of mutant kringle 5 (mK5) eye drops on corneal allograft rejection. Methods It was a experimental study. The outbred strain F344 and Lewis rats were used as donors and recipients respeetively. Sixty Lewis rats were randomly divided into B, C, D and E Group;Group A, F344 rats autograft control;Group B, allograft control (the control groups were given normal sodium only);Group C and D, allograft groups, were treated with 5 mg/L and 10 mg/L mK5 eye drops respectively;Group E, allograft group, was treated with 0. 1% dexamethasone eye drops. The eye drops were applied one drop four times per day for two weeks, the occurrence and development of corneal allograft rejection and corneal neovascularization (CNV) was observed every other day by slit-lamp microscope,the grafts were evaluated clinically by means of Holland's scoring system and the area of CNV was calculated. Nine rats per group were killed on the 14th day, and the corneas were taken for histopathological examinations. Analysis of variance was used to analyze the outcomes. Results The average graft survival time of Group B, C, D and E was (9. 3 ± 2. 1 ) , ( 21.1 ± 7.3 ), ( 23.5 ± 10. 8 ) and ( 28.2 ± 19. 1 )d respectively,Compared with Group B, Group C and D had a statistically significant prolongation of survival time ( q = 10. 24,13.47 ;P < 0. 05 ). Though treated with 0. 1% dexamethnsone eye drops ( Group E) prolonged transplant survival time as compared with inK5 eye drops, but the difference was not statistically significant ( q = 2. 54,1.49;P > 0. 05 ). The occurrence of CNV in Group A was ( 3. 1 ± 0. 8 ) d, Group B ( 2. 6 ± 0. 5 ) d, Group C (6. 4 ± 0. 5 ) d, Group D (7. 8 ± 0. 7 ) d and Group E (5.3 ± 1. 0) d. Significant difference ( q = 31.58,51.21,19. 98 ;P < 0. 05 ) was found between groups C, D, E and Group A. There were also significant difference between groups C, D, E and Group B ( q = 43.87,67. 14,24. 53 ;P < 0. 05 ). The CNV areas of Group C and Group D were also smaller than Group B ( q = 30. 76, 62. 14 ;P < 0. 05 ). The results was similar compared with Group E ( q = 15.20,25.64;P < 0. 05 ). Fewer inflammatory cells and CNV were found in the cornea of the groups treated with mK5 eye drops. Conclusion Topical application of mK5 eye drops can prevent corneal graft rejection and corneal neovascularization in rats.

Acute retinal necrosis is an uncommon but devastating, potentially blinding ophthalmopathy characterized by acute uveitis, vitreitis, retinal arteritis and full-thickness retinal necrosis, frequently complicated by secondary retinal detachment and proliferative vitreoretinopathy in late stages. However, it usually cannot be diagnosed and treated promptly, with unfavorable prognosis for the lesions tend to a rapid circumferential progression in few days. This review summarizes the epidemiology, pathogenesis, clinical features, diagnosis, differential diagnosis and recent situation in the study of treatment of acute retinal necrosis.

Professor Zuo Keming was the director of the Department of Ophthalmology of Beijing Hospital from 1950 to 1980, and a member of the editorial committee of Chinese Journal of Ophthalmology of Chinese Medical Association from 1956 to 1979. He died at the age of 105. Although Mr. Zuo left us for four years, his excellent moral character, earnest and responsible work style, his academic attitude of studying with an open mind and patiently listening to other people's suggestions, especially his deeds of conscientious and silent dedication to Chinese Journal of Ophthalmology, regardless of personal reputation, are still deeply engraved in our minds. 　　

With the extensive application of excimer laser refractive corneal surgery in clinical practice, more and more ophthalmologists and researchers not only pay attention to the evaluation of its clinical effect, but also focus on the research of its basic theory. In recent years, ophthalmologists have gained rich experience in excimer laser treatment of ocular refractive errors. In order to further promote the development of excimer laser treatment technology, the Ministry of Continuing Education of Chinese Medical Association plans to hold the "2009 7th Excimer Laser Refractive Keratophysical Surgery Symposium of Chinese Medical Association" in Guangzhou in early October, 2009. During the conference, a training course on excimer laser certification renewal assessment of large-scale medical equipment will be held. It is hoped that relevant professionals from all hospitals will actively contribute and participate in the conference. The relevant matters are hereby notified as follows.

If the topic involved in the thesis is a national or ministerial or provincial fund or key project, the name of the fund project should be indicated with "Fund Project:" as the logo at the foot of the front page of the article, and the project number should be indicated in parentheses. The name of the fund project shall be filled in according to the official name stipulated by the relevant departments of the state, and a number of funds shall be listed in turn, separated by ";". All fund projects must be accompanied by copies of certificates.

Founded in 1989, Tianjin Medical University Eye Center celebrated her 20th birthday in 2009. To celebrate the 20th anniversary of its founding and the 66th anniversary of Professor Yuan Jiaqin, the founder of the Ophthalmology Center, the 8th International Conference of Tianjin Medical University Ophthalmology Center and China Fundus Disease Forum-Neuroophthalmology Symposium will be held in Tianjin Saixiang Hotel from September 24 to 28, 2009. This conference was jointly sponsored by Tianjin Medical University Ophthalmology Center, Chinese Medical Association Ophthalmology Branch, Chinese Journal of Fundus Diseases and International Retina Foundation.

The First Affiliated People's Hospital of Shanghai Jiaotong University will hold the "National Seminar on Diagnosis and Treatment of Retinal Detachment, Diabetic Retinopathy, Neovascular Ophthalmology and Application of New Ophthalmology Technology and Continuing Medical Education Study Class" in the ever-changing Shanghai from July 10 to 13, 2009.

The First Clinical Medical College of Harbin Medical University will hold the 2009 Harbin International Cataract Forum and National Continuing Education Class on Complex Cataract Surgery and Treatment in Harbin from August 1 to 6, 2009 (Project No. 2009-07-02-034).

According to the latest edition of Xinhua Dictionary and Modern Chinese Dictionary, the use specifications of the words "sticky" and "sticky" are as follows: when pronouncing "nian", the word "sticky" is always used, such as mucosa, mucus, slime mold, adhesive, etc.; When pronouncing "zhan", use the word "sticky", such as intestinal adhesion, paste, etc. Regarding the use of the words "Wei" and "Wei", both words mean only and only, but when used in words such as only, only, only, fear, obedience to orders and profit-seeking, the word "Wei" is always used; When used in words such as materialism, idealism, rationalism, nominalism, etc., use the word "only".

Following the successful "National Symposium on Clinical Rational Drug Use in Ophthalmology" and "National Symposium on Application of New Technologies and New Equipments in Ophthalmology" held by the Editorial Board of Chinese Journal of Ophthalmology of Chinese Medical Association in 2008, at the request of the majority of ophthalmologists, the "First Chinese Ophthalmology Young and Middle-aged Forum (and Organizing Meeting)" sponsored by this journal and co-organized by Ophthalmology Branch of Zhejiang Medical Association will be held in Hangzhou, Zhejiang Province from June 19 to 23, 2009. The content integrates the rational application of ophthalmology drugs and the promotion of new technologies and new equipment, focusing on comprehensively improving the diagnosis and treatment level of ophthalmologists.

The Chinese Journal of Ophthalmology was founded on October 1, 1950. It was sponsored by the Chinese Medical Association and edited by the Editorial Committee of the Chinese Journal of Ophthalmology. The editorial committee is composed of nearly 100 well-known ophthalmologists in China. The current editor-in-chief Zhao Jialiang and the editorial director Huang Yibin. The main readers of this journal are ophthalmologists across the country, and it is publicly distributed at home and abroad. China Standard Issue Number: ISSN0412-4081, CN11-2142/R; Postal Code: 2-60; National map code: M93. The Chinese Journal of Ophthalmology has always implemented the principles and policies of the Party and the state on health work, implemented the principle of combining theory with practice, popularization and improvement, reported the major progress and innovative achievements of clinical and scientific research in ophthalmology in China, and promoted academic exchanges in ophthalmology at home and abroad. This journal is arranged according to international standards, and printed with English copyright pages, contents, abstracts, etc. All the accepted manuscripts are published and distributed in three forms: paper, CD-ROM and online electronic journals. We regularly exchange magazines with more than 30 countries and regions such as the United States, Britain and Japan.

In order to implement the policy of combining popularization and improvement, Chinese Journal of Ophthalmology, while reporting major clinical and basic research results at home and abroad, pays attention to the actual needs of the majority of ophthalmologists and strengthens the practicality of the journal. In 2009, it continued to open the column "Test Questions Analysis". This column invites authoritative ophthalmologists in China to make an accurate and in-depth analysis of all kinds of test questions in the ophthalmology question bank. Readers are welcome to pay attention to this column, actively read, and put forward suggestions and opinions.

In order to comply with the development trend of network and digitalization of journals and provide high-quality services for authors and readers, the Journal of Chinese Medical Association has developed a remote manuscript management system. The system is designed according to the business requirements of manuscript processing process, editing and processing specification, manuscript review system and management specification of Chinese Medical Association series magazines. It adopts advanced database and network technology, and has strong data processing and analysis ability. Manuscript remote management system will assist authors, editors, reviewer experts, editorial board members, finalization meeting experts, editor-in-chief and other related personnel to handle manuscript business in one, solve the needs of editorial department for manuscript networked process management, and realize various functions of inquiry and performance evaluation.

The statutory unit of measurement of this journal implements the "Statutory Unit of Measurement of the People's Republic of China" promulgated by the State Council in February 1984, and is represented by unit symbols. For specific use, refer to the book "Application of Statutory Unit of Measurement in Medicine" edited by the Editorial and Publishing Department of Chinese Medical Association in 1991.

The title should strive to be concise and eye-catching, which can accurately reflect the theme of the article. Chinese titles are generally within 20 Chinese characters, preferably without subtitles, generally without punctuation, and try not to use abbreviations. The meaning of Chinese and English titles should be consistent.

In order to strengthen the overall brand publicity of Chinese Medical Association series magazines, expand the influence of Chinese Medical Association series magazines, do a good job in journal subscription, open up new distribution and subscription channels, and facilitate the subscription of readers, Chinese Medical Association Magazine has set up an "Online Subscription and Online Payment Platform for Chinese Medical Association Series Magazines" on China Medical Network, which has been officially opened. Online subscription not only changes the original single post office subscription channel, but also has greater advantages than the traditional post office subscription: it makes the journal subscription work no longer staged, and can realize the whole year subscription; At the same time, online subscription reduces the subscription link, saves time and cost, and makes magazine subscription more convenient.

According to international practice and the actual situation in China, for papers that meet the following conditions, the Chinese Medical Association series journals allow and accept the republication of relevant papers of the same research in different languages.

In order to strengthen the academic exchange of ophthalmology at home and abroad, expand the international vision of domestic ophthalmologists, and promote the integration of domestic ophthalmology with international standards as soon as possible, the Health Express Training Network (www.lxlearn.com) has been specially established. The training network will serve all domestic ophthalmologists in the form of public welfare.

On October 18, 2001, the National Committee for the Approval of Scientific and Technological Terms and the National Language and Character Working Committee held a "Seminar on the Usage of 'Xiang' and 'Xiang'" at the Chinese Academy of Sciences. The meeting carefully analyzed the reasons for the confusion between the usage of "like" and "like" in the scientific and technological circles. The National Science and Technology Glossary Committee and the State Language Commission considered it necessary to clearly define the usage of this word again. Experts at the meeting believed that: elephant refers to the form and appearance of nature, people or things; Image refers to the image of a person or object made by imitation, comparison, etc., and also includes the image that is the same or similar to the original object formed by reflection and refraction of light.

The "fast track" paper must be innovative, important and scientific, and the early publication of the paper will have a significant impact on clinical and scientific research work. Requirements for submission of "Fast Track" papers: (1) The author should provide written application materials explaining the reasons why the paper needs to be published through "Fast Track". (2) The author provides the "novelty search report" issued by provincial and above libraries or medical information research institutes. (3) The author provides written recommendations from two well-known experts in the industry with senior professional titles (experts in the author's unit and the author's tutor should avoid), which should include the reasons for the academic paper being "latest" and "first" and the application for rapid publication.

With the development of society and economy, visual quality has obviously affected the quality of life of patients, which is increasingly concerned by the society. The rapid development of science and technology has laid the foundation for the continuous renewal of ophthalmic equipment and drugs, and improved the level of clinical diagnosis and treatment.

As a journal with strong academic strength and extensive academic influence in ophthalmology in China, in order to better serve the majority of ophthalmologists in China, strengthen clinicians' cognition of various ophthalmology surgical concepts, surgical standards and surgical effects, and thus promote the development and improvement of clinical surgical skills in China, Chinese Journal of Ophthalmology will hold a series of select activities of Chinese Journal of Ophthalmology for ophthalmologists all over the country. The participating materials are surgical videos, and the evaluation committee of the activity is composed of the editorial board of relevant majors of Chinese Journal of Ophthalmology. Based on the principle of fairness and justice, the academic level is the leading factor, and the participating materials are evaluated according to the standardization of operation, skills, difficulty, excitement and other items. The results of the selection will be announced and awarded at the National Academy of Ophthalmology, and published in Chinese Journal of Ophthalmology in written form. Some or all of the selected surgical videos will be included in the CD-ROM of Chinese Journal of Ophthalmology for distribution.

On November 8, 2008, Professor Xie Lixin, Academician of Chinese Academy of Engineering, Director of Shandong Institute of Ophthalmology, and Deputy Editor-in-Chief of the Editorial Committee of Chinese Journal of Ophthalmology, was awarded the Achievement Award of the American Academy of Ophthalmology. The award is used to recognize individuals who have actively participated in the academic activities of the annual meeting and made outstanding contributions to the development of the Society and ophthalmology.

The main risk factor of glaucoma is the pathological increase of intraocular pressure. At present, the research on the formation of aqueous humor is progressing continuously, but whether and how to regulate intraocular pressure is unknown, which brings confusion to the diagnosis and treatment of glaucoma in clinic. At present, the commonly used intraocular pressure lowering drugs in clinic, such as timolol, α 1 adrenergic receptor stimulant, α 2 adrenergic receptor stimulant clonidine and other vasoactive substances, can cause significant blood pressure changes through local renin-angiotensin system, which indicates that renin-angiotensin system may participate in intraocular pressure regulation through autocrine mode. ``

The patient was a 54-year-old female. She suffered from schizophrenia for 21 years. She took clozapine for 21 years at a dose of 50~600 mg/d. She refused to eat for 1.5 days due to sore throat and fever. She had blurred vision in both eyes for 3 years and gradually worsened for half a year. She was accompanied by her family. Pharyngeal examination showed that the tonsils were congested and swollen, with second degree swelling and white pus spots. Axillary temperature was 38.6℃. Diagnosis: acute tonsillitis. Ocular examination: visual acuity checked by international standard visual acuity chart, naked eye visual acuity: 0.4 in right eye and 0.2 in left eye; corrected visual acuity: 0.6 in right eye and 0.5 in left eye. Intraocular pressure measured by non-contact tonometer: 18 mm Hg (1 mm Hg =0.133 kPa) in right eye and 20 mm Hg in left eye. There was no conjunctiva congestion in both eyes, the cornea was transparent, keratic precipitates (KP) (+ + +), showing diffuse brown-yellow dots (Figure 1), the anterior chamber depth was normal, the aqueous humor was clear, the aqueous humor glow was negative, the iris texture was clear, the color was normal, the pupil was round, the diameter was 3 mm, and it was directly sensitive to light reflection, and the lens was pale yellow 　　

hemophilia is a group of lifelong hemorrhagic coagulation disorders caused by insufficient plasma FVIII and FIX content or functional defects caused by hereditary coagulation factor VIII (FVIII) and IX (FIX) gene defects [1]. Including hemophilia A (HA) and hemophilia B, the former is plasma FVIII deficiency and the latter is plasma FIX deficiency. HA is a rare disease, and phacoemulsification cataract aspiration or vitrectomy are rarely reported in patients with this disease. Recently, the Department of Ophthalmology of Tianjin Medical University General Hospital performed the above operation on a patient with HA, which is summarized as follows...

The patient, a 61-year-old female, was seen on April 16, 2008 due to lacrimal overflow and mass in her left eye. Six months ago, the patient had lacrimal overflow in her left eye, and the lacrimal duct was probed, but the curative effect was not good. In the past 3 months, except for tearing, the mass could be palpable in the lower part of the left orbit without pain. After examination in another hospital, she was diagnosed as "left lacrimal sac tumor". Physical examination: there was no enlargement of superficial lymph nodes in the whole body, and no abnormalities were found. Ocular examination: visual acuity: 1.0 in the right eye and 1.0 in the left eye. There was no restriction in rotation of both eyes. Hard mass could be palpable in the lower part of the left orbit, about 15 mm ×25 mm, no mobility, no tenderness, and unclear boundary. No abnormalities were found in the conjunctiva and anterior segment of the left eyeball, slight opacity of the lens, and no abnormalities in the fundus. Exophthalmos: 13 mm in the right eye and 13 mm in the left eye; The orbital distance was 98 cm. There was no abnormality in laboratory blood routine. 　　

The patient was a 56-year-old female. She had suffered from hypertension and coronary heart disease for more than ten years. Ocular examination showed that the best corrected visual acuity of the right eye was 0.1. The lens was slightly opaque, and there was no obvious abnormality in other examinations of the anterior segment. The color and boundary of the fundus papilla were normal, the macular area was gray-yellow bulge, with a large amount of exudation around it, and the retinal arteriovenous branches extended into the lesion area (Essence Picture 1). The results of fluorescein fundus angiography, indocyanide green choroidal angiography and coherence optical tomography were shown in Essence Pictures 2~4. Diagnosis: angiomatous hyperplasia of the retina in the right eye. 　　

The automatic static perimeter is characterized by adopting modern computer technology and using statistical methods for data processing.Compared with the traditional perimeter with the classic perimeter with the Humphrey and Octopus perimeter, the greatest advantage of the modern perimeter is that it realizes the three-dimensional concept of "visual island" in visual physiology, which originally seems very abstract. Therefore, the principle, method and result expression of visual field examination are obviously different from the traditional perimeter.