Volume 45 ·  Issue 12 ·  2009

The pupillary light reaction represents the functions of either the afferent visual pathway or the pupillary efferent innervations (parasympathetic and sympathetic).Physiologic and pathologic changes of pupil were usually ignored by the physicians.A correct pupil renction testing will be of benefit to catch the abnormal pupil reaction as well as the early diagnosis of neuro-ophthalmologic disorders.A precise pupil reaction test is hardly performed because of the variation of individual,illumination and the instantaneous change of pupil.The proper pharmacologic testing is helpful for ehoosing the right neuro-electrophysiological and neuro-image examinations,and also may be of instuction value on the diagnosis of neuro-ophthalmologic diseases.

Objective To evaluate the demographic,risk factors and clinical characteristics of nonarteritic anterior ischemic optic neuropathy (NAION) and provide clinical guidance for this blindness disease.Methods Retrospective study was used to investigate the data,which consists of 96 NAION consecutive patients in neurology department of our hospital from 2005 to 2008.Results The average age of NAION patients is 50.90±8.88 years (range,34-78 years) and the median is 50 y.About 68.8% of patients are male.The prevalence of hypertension,diabetes mellitus and abnormal lipid level is 34.4% (33/96),29.2% (21/96) and 59.4% (57/93) respectively.The predominant patterns of visual field loss are altitudinal and acurate defects.Visual acuity was improved (change of ≥3 lines) in 44.4% of patients.Conclusions The age of onset in NAION is relatively early in life,compared with cerebral vascular disease,and male seems to have a high incidence.The most common risk factor is metabolic syndrome.Subcortical and periventricular white matter lesions and myocardial ischemia might associate with NAION.Visual acuity showed improvement in some patients,but the long outcome is poor.

Objective To explore the changes of contrast sensitivity (CS) in patients recovered from idiopathic optic neuritis (ION).Methods It was a case-control study.We screened 22 idiopathic optic neuritis patients who underwent treatment and obtained normal visual acuity.No nervous system abnormalities were found in MRI scan.Twenty four healthy individuals were enrolled as the control group.OPTEC 6500 contrast sensitivity tester was used to examine near- and far-distance CS values on 1.5,3.0,6.0,12 and 18 cycles/degree (c/d),separately.T-test or u-test was used to compare the mean of CS values between these two groups.ANOVA or H-test was adopted on CS values at the different frequencies in each group.Simple linear correlation was used to analyze the correlation between CS values and age,duration and gender,separately.Results The maximum CS values in both far- and near-distance appeared in 6.0 c/d in these two groups were 70.27±40.44,53.32±29.50,78.86±36.37 and 109.39±44.98,respectively.The minimum CS values in both far- and near-distance appeared in 18 c/d in these two groups were 8.27±6.11,12.09±8.57,15.67±9.02 and 22.22±14.56,respectively.Far- and near-distance CS values in ION group and control group had very significant differences at these five spatial frequencies (From 1.5 to 18.0 c/d,the test values on far-distance were 4.19,5.59,3.06,2.50,3.13,P values were 0.00,0.00,0.00,0.01,0.00.The test values on near-distance were 3.54,3.98,2.72,3.20,3.39,P values were 0.00,0.00,0.01,0.00,0.00).CS values had no relation to the duration of ION.Significant difference in CS values existed on most frequencies(In far- and near-distance,H values in ION group were 52.38 and 64.96,in control group were 64.77 and 60.53,P values were both less than 0.01).The maximum H value appeared on near-distance in ION group.The maximum H value was 64.96 of neardistance in ION group.Far- and near-distance CS values in ION group itself and control group itself had very significant differences at these 5 spatial frequencies (From low to high frequencies,F values were 6.36,0.03,2.52,1.53.2.90;P values were 0.02,0.87,0.12,0.22,0.10 in ION group.In control sroup,F values were 5.31,5.69,6.06,0.61,3.14;P values were 0.03,0.02,0.02,0.44,0.08 respectively).Conclusions CS values at different frequencies in ION patients with normal visual acuity descend significantly.Contrast sensitivity examination can be an important technique to evaluate vision quality in patients after ION.

Objective To compare static visual field perimetry with Octopus101 and Goldmann perimetry in patients with pituitary adenomas;To identify the factors of visual field defects and visual field prognosis.Methods Retrospective nested case-control study.Visual acuity,fundus,computed tomography (CT) or magnetic resonance imaging (MRI) and visual field were pre-operated assessed in 169 patients (338 eyes) diagnosed pituitary adenoma at the Department of Neurosurgery in Huashan Hospital between Feb.2006 and Feb.2007.334 eyes were underwent Goldmann perimetry,while 323 eyes were underwent static visual field perimetry with Octopus101 perimeter.In the169 patients,28 patients (56 eyes) were followed up post-operatively for 3 to 6 months.Statistical analysis was performed using SPSS 15.0 software.T test and rank sum test were used for continuous variables,and chi-square test and Fisher's exact test were used for categorical variables.We also carry out Logistic regression.Results Of the 169 patients,unilateral or bilateral visual field defects were observed in 133 cases.In these 323 eyes,231 eyes showed visual field defects with static visual field perimetry,while 196 eyes in 334 eyes showed defects with Goldmann perimetry.Earlier age of onset,larger tumors and poor preoperative corrected visual acuity were more frequent in patients with visual field defects than in patients with normal visual fields (t=4.802,7.930;x~2=28.210,P＜0.01).In the 28 followed-up patients (55 eyes),visual acuity was improved in 69.05% eyes and visual field was improved in 85.71% eyes after operation.There were significant differences in age of onset and preoperative visual field defects in upper temporal quadrants between patients with visual field returned to normal after the operation and patients with visual field improvement only (t=2.525,P=0.023;x~2=6.218,P=0.013).Conclusions Static visual field perimetry with Octopus101 perimeter is more sensitive than Goldmann perimetry in the early diagnosis of pituitary adenornas.Patients with visual field abnormalities are significantly with earlier onset age,larger tumors and worse preoperative visual acuity than patients free of visual field defects.The onset age and the degree of impairment in the preoperative visual field in the upper temporal quadrant may be significant factors for visual field prognosis.

Objective To study clinical characteristics of ocular ischemic syndrome (OIS).Methods Retrospective study.Data,including sex,age,systemic diseases,best corrected visual acuity,anterior segment,fundus,fundus fluorescence angiography (FFA),transcranial Doppler (TCD) and digital subtraction angiography (DSA),were collected from 10 patients (12 eyes) with ocular ischemic syndrome from February 2008 to April 2009.Results The mean age was 59 years.There were six males and four females.All patients were combined with heart and/or cerebrovascular diseases.Best corrected visual acuity ranged from hand movement to 1.0.Neovascularization of the iris appeared in 5 eyes.Intraocular pressure over 21 mm Hg (1 mm Hg=0.133 kPa) was present in 3 eyes.Fundus examination showed narrow retinal arteries,dilated but not tortuous veins,fleck-shaped hemorrhage of the retina,cotton-wool exudates,optic disc edema,optic disc neovascularization,and atypical macular cherry-red spots.TCD showed stenosis of internal carotid artery at different degrees.FFA was performed in 9 patients which showed artery front,prolonged arm-retinal circulation time,retinal circulation time and choroid circulation time.All patients accepted vasodilation and microcirculation improving treatments.Visual acuity was improved at different degrees.One patient (2 eyes) with iris neovascularization was treated with retinal photocoagulation and the neovascularization disappeared after the treatment.There were 3 patients (3 eyes) had neovascular glaucoma.One patient was treated by ciliary cryotherapy.One patient was treated by retinal photocoagulation and internal carotid artery stent implantation and one were treated by internal carotid artery stent implantation.Four patients were examined by DSA.Internal carotid artery stent implantation was performed in 3 patients,subclavian artery stent implantation was performed in one patient and internal carotid artery intima decollement was performed in one patient.Conclusions Clinical manifestations of ocular ischemic syndrome patients are complicated which are depended on the different extents of ischemia.The management of ocular ischemic syndrome requires the collaboration of ophthalmologists,neurophysicians and neurosurgeons.

：Objective To evaluatethe visual quality after combined implantation of refractive and diffractive multifocalintraocular lenses (IOL) in both eyes.Methods Prospective,nonrandomized study.Age-relatedcataract patients were divided into multifocal IOL group (MIOL group) and monofocal IOLgroup (SIOL group) and received phacoemulsification.In MIOL group,a ReZoom NXG1 IOL and aTecnis Z M900 IOL were implanted into the dominant eye and the fellow eye,respectively.InSIOL group,Sensar AR40e IOLs were implanted into both eyes.Monocular or binocular test wasperformed one month after surgery,including wavefront aberration,contrast sensitivity withor without glare and near stereoacuity.Results The root mean square of sphericalaberration at pupil diameter of 5 mm was 0.058±0.159 μm in NXG1 eyes and 0.005±0.169μm in ZM900 eyes,both of them were significantly lower than 0.408±0.160 μm achieved in AR40e eyes(F=11.734;P=0.001,0.000).There was no significant difference in the total ocularaberration,contrast sensitivity and high-order aberration among eyes with these differentIOLs.The uncorrected near stereoacuity in MIOL group was (45.60±35.04) seconds ofarc,which was significantly better than (110.00±41.23) seconds of arc achieved in SIOLgroup (F=2.923;P=0.010).Conclusion Combined implantation of muhifocal ReZoom NXG1 IOL andTecnis ZM900 IOL provides a good visual quality with reduced spherical aberration andsatisfactory near stereoacuity.

Objective To investigate the surgical techniques of divided nevus of the eyelids with different locations and sizes.Methods Retrospective observational case series.Thirty cases (30 eyes) of divided nevus of the eyelids in Zhongshan Ophthalmic Center from July 1997 to November 2006 were retrospectively reviewed.There were three different surgical methods.Excision of the nevus and direct suture after excision in 3 cases.Excision of the nevus and free skin graft transplantation in 5 eases.Excision of the nevus and transfer of skin flap,which included a two stages reconstruction,was performed in 22 cases.The upper or lower eyelid was treated first and another eyelid was treated after three months.Lacrimal punctum and lacrimal canaliculus were excised if they were involved in 8 cases among 22 cases.Results The mean follow-up time was 60 months (ranging from 2 years to 11 years).Only one case recurred after two years during follow-up and was excised after five years.Pathologic examination indicated malignant transformation.Excision with histopathological control was performed and the nevus did not recur during follow-up time.Recurrence or malignant transformation did not occur in other cases.Aesthetical results of skin flap transplantation were better than skin graft transplantation.Conclusions The results of two stages reconstruction and transfer of skin flap after excision of the divided nevus are better than free skin graft transplantation.Close observation is required after excision of the divided nevus for early detection of malignant transformation.

Objective To investigate the manifestations and treatment principles of ocular diseases associated with human immunodeficiency virus infection (HIV) and acquired immunodeficiency syndrome (AIDS).Methods It was a retrospective case series.One hundred and ten patients were recruited.Two hundred and twenty eyes underwent ophthalmologic examination that included vision acuity,anterior segment and fundus examinations with papillary dilation and fundus fluorescein angiography.CD_4~+T-lymphocyte was counted in peripheral blood of 110 patients.Intravitreal injection of ganciclovir 400 μg was performed in 4 eyes (2 patients) with cytomegalovirus (CMV) retinitis associated with AIDS.All statistical analyses were performed using SPSS 13.0 software.The association between the age,duration of HIV infection and HIV/AIDS related ocular manifestations was analyzed by Pearson Correlation Analysis.The association between the gender and HIV/AIDS related ocular manifestations was analyzed by Pearson Chi-Square test.For comparison of the CD_4~+T cells counts of the patients with normal fundus,HIV retinopathy,CMV retinitis,Kruskal-Wallis Test for Several Independent Samples was used.Results Baseline visual acuity:no light perception (NLP) 5 eyes;light perception (LP) to 0.04,10 eyes;0.05 to 0.2,14 eyes;0.3 to 0.7,62 eyes and≥0.8,129 eyes.Small grayish keratic precipitates or pigment keratic precipitates were present in 25 eyes,22 eyes had positive aqueous flare,4 eyes had posterior synechia of the iris,28 eyes had cataract.HIV retinopathy was present in 34 eyes.Cotton-wool spots,retinal hemorrhages,and retinal microaneurysms were found in eyes with HIV retinopathy.CMV retinitis was present in 32 eyes.The fundus manifestations of CMV retinitis included retinal vaaculitis;dense,full-thickness,yellow-white lesions along vascular distribution with irregular granules at the border,and hemorrhage on the retinal surface in 26 eyes.Late stage retinopathy was demonstrated in 3 eyes characterized as atrophic retina,sclerotic and attenuated vessels,and optic nerve atrophy.Retinal detachment was found in 3 eyes.The median of CD_4~+T-lymphocyte counts of the patients with normal fundus was 100.0/mm~3.The median of CD_4~+T-lymphocyte counts of the patients with HIV retinopathy was 41.0/mm~3.The median of CD_4~+T-lymphocyte counts of the patients with CMV retinitis was 18.0/mm~3.The difference of CD_4~+T-lymphocyte counts between patients with normal fundus and HIV retinopathy was statistically significant(x~2=4.848,P=0.028).The difference of CD_4~+T-lymphocyte counts between patients with normal fundus and CMV retinitis was statistically signifieant(x~2=15.696,P=0.000).The difference of CD_4~+T-lymphocyte counts between patients with CMV retinitis and HIV retinopathy was statistically significant (x~2=4.860,P=0.027).Four eyes (2 patients) with CMV retinitis underwent intravitreal injection of ganciclovir 400 μg.After intravitreal injection of gancielovir,visual acuity was improved and fundus lesions disappeared in 4 eyes.Conclusions HIV retinopathy is a common intraocular complication in HIV-infeeted patients.CMV retinitis is the severest intraocular complication in patients with AIDS.Highly active anti-retroviral therapy allows immune reconstitution.Intravitreal injection of ganciclovir can effectively control CMV retinitis and save the vision.

Objective To explore the long-term efficacy and safety of laser peripheral iridectomy for primary angle closure glaucoma (PACG).Methods It was a retrospective case series study.Data were collected from those patients who received laser peripheral iridectomy (LPI) for acute or chronic PACG from April 1992 through October 2002 at the Peking Union Medical College Hospital.Ordy patients who were followed for at least 5 years were included in this study.The control of intraocular pressure (IOP),visual acuity and managements after LPI were analyzed.All of the studied eyes were re-classified into three categories according to the status of anterior chamber angle,optic nerve head and visual field before LPI:primary angle closure suspect (PACS),primary angle closure (PAC) and primary angle closure glaucoma (PACG).Satisfactory control of IOP was defined as the IOP was less than 21 mm Hg (1 mm Hg=0.133 kPa) without any medications after LPI.No satisfactory control of IOP was defined as the IOP was greater than 21 mm Hg after LPI,yet could be controlled below 21 mm Hg by anti-glaucoma medications.A failure in IOP control was defined as an acute attack of angle closure developed or filtering surgery was required to control IOP after LPI.Chi-square analysis was used for comparison of IOP control in different groups.Results One hundred and thirty one patients (251 eyes) with PACG were eligible for this study.The mean follow-up period was (9.2±3.7) years.Of the 251 eyes,18 eyes (7.2%) were identified as PACS,98 eyes (39.0%) PAC,129 eyes (51.4%) PACG,and 6 eyes (2.4%) could not be classified owing to the lack of the information on the optic nerve head and visual field before LPI.The rates of satisfactory control of IOP were 27.1% in all eyes,and 88.9% (16/18),38.8% (38/98) and 10.9% (14/129) in PACS,PAC and PACG eyes respectively.The rates of no satisfactory control of IOP were 59.8% in all eyes,and 5.6% (1/18),48.0% (47/98) and 75.2% (97/129) in PACS,PAC and PACG eyes respectively.The rates of failure in IOP control were 13.1% in all eyes,and 5.6% (1/18),13.3% (13/98) and 14.0% (18/129) in PACS,PAC,PACG eyes respectively.The difference in IOP control between PACS,PAC and PACG eyes was statistically significant (x~2=59.08,P=0.000).Only 8 eyes had an acute attack of angle closure after LPI.No long-term complications after LPI were observed in all eyes.Conclusions The IOP control after LPI in PACG eyes is not so good as expected.However,most of PACG eyes after LPI are free of acute attack of angle closure.PACG eyes should be given close and regular follow-up in a long-term to monitor the IOP control and the progression of PACG after LPI.

Objective To determine the effects of Heparin Ⅱ (Hep Ⅱ) domain on cultured human trabecular meshwork (HTM) cells.Methods HTM cells were cultured and treated with Hep Ⅱ domain for 18 and 24 h.The morphological changes in HTM cells were assessed by light and electron microscopy.Changes in cell morphology and the organization of actin cytoskeleton,Vinculin,β-Catenin were assessed by using immunofluorescence.Results Treatment of Hep Ⅱ domains resulted in morphological changes from 10 to 24 h.In light microscopy,cells rounded up,retracted and detached from each other.In high performance liquid chromatography,Hep Ⅱ domains-treated cells showed that actin fibre bundles were highly concentrated at the periphery of the cells with few actin filaments left in this area;decreased vinculin staining was observed toward the cell periphery;decreased β-Catenin staining was also observed around the cell sub-membrane.Transmission electron microscopy showed expended intercellular space.After 24 h,changes of HTM cells were recovered.Conclusions Hep Ⅱ domains reversiblely blocks actin cytoskeleton and cell-junction of HTM cells.Disorganization of actin cytoskeleton and cell-junction in trabecular meshwork through signal transduction may be a useful strategy for the decrease of intraocular pressure.

Objective To investigate the inhibitory effect of small interfering RNA (siRNA) targeting TERT on routine retinal neovascularization and explore the feasibility of potential therapeutic approach in retinal vascular disease.Methods Two recombinant plasmids TERT siRNA (pSIREN-mTERT-1) and negative plasmid (pSIREN-mTERT-N) were constructed and 80 seven-day-old C57BL/6J mice were divided randomly into therapeutic group (A),negative plasmid group (B),oxygen-induced retinopathy group (C) and normal control group (D),20 mice in each group.Group A,B and C were exposed to 75%±2% oxygen for 5 days and then to room air,which induced mice retinal neovascularization.Groups A and B were injected two kinds of the above recombinant plasmid into the murine vitreous on the 12th day.The mice of group D were raised in normal oxygen circumstance.On the 19th day,2% Evens blue angiography was used to observe the pattern of the retinal vascular.Expression of TERT mRNA were confirmed by reverse-transcription polymerase chain reaction (RT-PCR) and Real-time PCR.Histological observation and vascular endothelial cells counting were used to examine the effects of siRNA on the retinal neovascularization.Results Retinal flat after Evans blue angiography indicated that the vessels of group A formed a fined radial branching pattern,which was similar to normal mice.In group A,the retinal neovascularization reduced and the structure of retina were more regular than group B and C.At the same time the large vessels were distorted,neovascular clusters proliferated and fluorescence leaked in the middle and periphery urea in group B and C.RT-PCR and Real-time PCR showed the expression of TERT mRNA was downregulated in group A compared with groups B and C (P＜0.05).Paraffin tissue slice with hematoxylin-eosin staining showed that the average counts of vascular endothelial cells which break through the inner limiting membrane in group A were less than groups B and C,the differences were significant(P＜0.05).Conclusion Pathologic retinal neovascularization can be inhibited by specific TERT siRNA in vivo,which may be a novel efficient strategy against proliferative vasculopathies.

nonarteritic anterior ischemic optic neuropathy (NMON) is a common fundus disease, which mostly occurs in middle-aged and elderly persons. The onset of NAION is mainly due to the circulation disorder of the short posterior ciliary artery supporting the optic disc, transient non-perfusion or hypoperfusion, which leads to acute ischemia in the sieve plate area of the optic disc, resulting in visual impairment and visual field defect.

Langerhans cell-type dendritic cells (DCs) present in the corneal epithelium are capable of taking up,processing,and presenting antigens,leading to the initiation of T-lymphocyte responses.These cells are the professional antigen-presenting cells (APCs) of the corneal epithelium and serves as the critical sentinel cells of the immune system in the ocular surface.A recent study has demonstrated that normal limbal basal epithelium is in fact endowed with a small number of slow-cycling DCs with expression of a limbal stem cell marker,ABCG2.Furthermore,it has been found that central corneal inflammation induces recruitment of major histocompatibility complex (MHC) class Ⅱ~+ DCs from limbal basal epithelium.These findings suggest that limbal basal epithelial DCs play an impoatant role in corneal inflammatory reaction.

Medical nouns should use the nouns published by the National Committee for Approval of Scientific and Technological Nouns. For subject terms that have not yet passed the examination and approval, you can choose the subject words in the latest edition of Medical Thesaurus (MeSH), Medical Thesaurus Annotations and Thesaurus of Traditional Chinese Medicine. For nouns and terms without common translation, the original word should be indicated when it appears for the first time in the text. The names of Chinese and Western medicines are subject to the latest versions of the Pharmacopoeia of the People's Republic of China and the Generic Names of Chinese Medicines (both compiled by the Chinese Pharmacopoeia Commission).

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.

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 Kanxing 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 "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 "fast track" paper submission: (1) When the author submits a manuscript online, he should provide application materials explaining the reasons why the paper needs to be published through the "fast track". (2) The author provides the "novelty search report" issued by provincial and above libraries or medical information research institutes.

Since the copyright law of our country was promulgated, it has been paid widespread attention by all circles of society. As a medical scientific and technological journal, the copyright law must be implemented to the letter. Therefore, the relevant requirements of this journal for author's signature and thanks are reiterated as follows.

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. It is planned to continue to open the column of "Test Questions Analysis" in 2010. 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.

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. Note that the unit name and the unit symbol should not be mixed,

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.

With the development and improvement of clinical diagnosis technology, the role of all kinds of ophthalmology clinical pictures in disease diagnosis has been paid more and more attention. In order to encourage clinical accumulation of relevant data, promote experience exchange, improve clinical diagnosis and treatment technology, provide a new platform for academic exchange for readers, enrich the content and form of this journal, and better serve the majority of ophthalmologists, Chinese Journal of Ophthalmology will continue to open the "Picture Essence" column in 2010.

In order to speed up the processing of manuscripts, this journal adopts online submission at http: / /www.cma.org.cn/ywzx/ywzx.asp, or log on to the website of Chinese Medical Association (http: / /www.cma.org.cn) and click "Business Center". When the author submits a manuscript for the first time, he needs to log in to the website and register. After successful registration and activation of the account, he can submit a manuscript online. This website can also be used for the author to inquire about the handling of the manuscript online.

In order to meet the needs of the information age, the editorial department of Chinese Journal of Medical Aesthetics officially launched the remote manuscript processing system of Chinese Medical Association from January 1, 2010. All paper manuscripts will no longer be accepted. Please cooperate and support the authors. At that time, the majority of authors will be able to know the manuscript processing and the final use information in a short time, which shortens the processing cycle and publication cycle of the manuscript of this journal.

The book "In vivo confocal microscope of ocular surface" (edited by Professor Xu Jianjiang), one of the "Application Series of New Ophthalmology Technologies" edited by Professor Sun Xinghuai of Eye, Ear, Nose and Throat Hospital affiliated to Fudan University, has been published by Fudan University Press. In vivo confocal microscope of ocular surface is a new type of high precision and high magnification microscope which has appeared in recent years. As an auxiliary diagnostic device with strong clinical practicality,

In order to promote the scientific and technological journals sponsored by CAST and its affiliated national societies to better serve the independent innovation of science and technology, strengthen the function of academic exchange, promote the implementation of the strategy of fine scientific and technological journals, improve the core competitiveness of scientific and technological journals, and improve the ability of national societies to serve the strategy of rejuvenating the country through science and education and strengthening the country through talents, CAST has organized and implemented the application and evaluation of projects funded by fine scientific and technological journals since 2006.

Conjunctivalochalasis is a common age-related ocular surface disease in the elderly. With the accelerating aging of the population, the number of people with conjunctiva relaxation will increase day by day. Severe conjunctival relaxation requires surgical treatment. In order to standardize the surgical treatment plan and prevent iatrogenic ocular surface damage, Professor Zhang Xingru combined his more than 10-year research results on surgical treatment of this disease (including key technologies such as indications for surgical treatment, standardized surgical operation, prevention and treatment of surgical complications) with literature and materials to make a CD.

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.lxleam.com) has been specially established. The training network will serve all domestic ophthalmologists in the form of public welfare.

Approved by China Association for Science and Technology, it is co-sponsored by Ophthalmology Branch of Shanghai Medical Association, Ophthalmology Branch of Medical Associations of Six Provinces in East China, Eye, Ear, Nose and Throat Hospital affiliated to Fudan University, Optometry Group of Ophthalmology Branch of Chinese Medical Association, Optometry College of Wenzhou Medical College and China International Science and Technology Conference Center; Eye, Ear, Nose and Throat Hospital of Fudan University,

The 11th National Conference on Corneal and Ocular Surface Diseases and the 2nd National Conference on Corneal Refractive Surgery, sponsored by the Keratology Group of Ophthalmology Branch of Chinese Medical Association and undertaken by Shandong Institute of Service Sciences, will be held in Qingdao, Shandong Province in early June 2010. We sincerely invite domestic and foreign ophthalmologists, colleagues and ophthalmologists to attend the event.

Sponsored by the editorial board of Chinese Journal of Ophthalmology of Chinese Medical Association and co-organized by Ophthalmology Branch of Zhejiang Medical Association, the 2009 "First Chinese Ophthalmology Young and Middle-aged Forum (with Manuscript Meeting)" was successfully held in Hangzhou from June 19 to 23, 2009. The conference opened sections such as thematic lectures, focus arguments and free forums. Nearly 200 academic papers were received, and more than 400 representatives attended the conference, covering nearly 20 provinces and cities in China. At the same time, dozens of domestic and foreign ophthalmology products companies attended the conference.

Optic nerve glioma is a benign tumor that occurs in glial cells of optic nerve, mostly in preschool children, 90% of which occurs before the age of 20. The pathological type is usually grade Ⅰ ~ Ⅱ glioma, and the pathological type is usually grade Ⅲ ~ Ⅳ glioma in adults. From 2004 to 2007, the Institute of Orbitopathy of Armed Police General Hospital treated 3 cases of low-grade optic nerve glioma over 20 years old. The clinical characteristics are reported as follows.

McCune-Albright syndrome is a rare congenital disease. It is mainly manifested as endocrine dysfunction, bone fibrodysplasia and skin milk caffeine pigment spots. Its endocrine dysfunction can be manifested as precocious puberty, hyperthyroidism, Cushing's syndrome, prolactinoma, growth hormone excessive secretion, hypercortisolism, etc. Among them, precocious puberty is the most common. It is rare to report that McCune-Albright syndrome leads to compressive optic neuropathy in China, and its neuroophthalmic and imaging examinations have characteristic changes. We report the situation of one patient admitted to Peking Union Medical College Hospital in December 2008 as follows.

De Morsier syndrome, or Septo-optic dysplasia (SOD), is a congenital central nervous system disease, which is characterized by septum pellucidum defect or malformation, thinning or underdevelopment of corpus callosum, and optic nerve hypoplasia in imaging MRI images [1]. Some children are often diagnosed in ophthalmology for the first time due to low vision. Two cases who will come to our hospital in the future are reported as follows: Case 1: A male, 7 months old, came to our hospital on May 4, 2006 because he was found to be unable to see in both eyes after birth. The child was given birth for the first time in her mother's first pregnancy (i.e. G1P1), delivered naturally at full term, without oxygen inhalation history, without family genetic history, and without similar medical history.

A 57-year-old female was diagnosed and treated at the Department of Ophthalmology of the General Hospital of the People's Liberation Army on October 27, 2008 due to the sudden inability to open and limited rotation of her left eye, and visual acuity decreased with headache and eye pain for 4 days. During the course of the disease, the patient had no significant changes in the degree of blepharoptosis and ocular movement disorder. The history of trauma, hypertension and diabetes were denied. Ocular examination: visual acuity of right eye 1.0, visual acuity of left eye 0.5+1.25DCA ×170° =0.6-1.

The patient was a 52-year-old male. He was admitted to the Department of Ophthalmology of Peking University People's Hospital on September 23, 2008 due to foreign body sensation in his right eye for 17 days. The patient had obvious foreign body sensation in his right eye for 17 days, and he found a small gray-white mass at the edge of the pupil of his right eye, without redness, swelling, pain, and no obvious visual acuity decline. No obvious abnormalities were found in the whole body examination.

Schwannoma is a benign tumor originating from Schwann cells of peripheral nerves, mostly occurring in intracranial and peripheral nerves. The primary ones in the orbit are mostly single, and multiple ones are rare. The author collected a case of multiple orbital schwannoma, and now reports its clinical manifestations, diagnosis and treatment methods as follows.

The patient was an 18-year-old female who was found to have exotropy in her left eye for 5 years. She came to Xiamen Ophthalmology Center affiliated to Xiamen University on August 24, 2009. The patient had poor visual acuity in her left eye since childhood. The visual acuity of the left eye was 30 cm index (uncorrectable), nystagmus, conjunctiva, cornea and anterior chamber were not obviously abnormal, the lens was transparent, there was membrane in front of the optic papilla, and there was no macular structure.

Malignant tumors can directly act on any point on the visual path through distant metastasis or invasion, and can also cause dysfunction of retina and optic nerve through paraneoplastic effects. Radiotherapy and chemotherapy for malignant tumors can also cause visual loss or even visual loss. Ophthalmologists must pay attention to these factors and their clinical manifestations.

1. The correct description of Leber optic neuropathy is A. The offspring of female patients generally do not develop the disease B. The incidence rate of men is lower than that of females C. The visual acuity mostly drops below manual after the onset D. The site mutation of mitochondrial DNA is considered to be a specific symptom of this disease E. Most of this disease is accompanied by systemic diseases Answer: D. Leber optic neuropathy is a hereditary simple optic neuropathy without neurological and systemic diseases, which belongs to a cytoplasmic genetic disease related to maternal inheritance. So far, no male patients have been found to pass this disease to their offspring, all of which are vertically inherited by women.

Domestic ophthalmologists have different understandings on the causes of optic neuritis.Some of them consider infection is the main cause,some believe that so-called idiopathic optic neuritis caused bycentral nervous systemprimary demyelinating disease,such as multiple sclerosis is the most common type of optic neuritis,while others suggest that optic neuritis is attributed to autoimmune disease.Based on the review of literatures,we describe the development of definition and etiology of optic neuritis in Western countries and in China,and then provide some suggestion to a better understanding of etiology of optic neuritis in China.We also expect to have a population-based,multiple-center study to provide more extensive and accurate data on the etiology of optic neuritis in China.