Volume 46 · Issue 09 · 2010

Damage to the limbus by disease or injury would result in corneal epithelium defects,neovascularization and conjunctivalization, which is called limbal stem cells hdeficiency and could be treated by limbal stem cells transplantation. But the outcomes of surgery were much different due to various surgical techniques, different grade damages of recipient site and criteria for clinical evaluation after surgery. This article focused on reasonable evaluation methodology after limbal stem cells trnsplantation.

Great progress has been made on the corneal tissue engineering in the past two decades.Much knowledge has been gained on the seed cells, carrier material, and strategies of corneal tissue reconstruction. However, there are still great challenges regarding the basic research of corneal tissue engineering, such as selection of appropriate carrier and cells, optimization and standardization of the construction method, and evaluation of the clinic outcome. Future studies may address these questions and bring tissue engineered cornea into clinic application.

Objective To investigate the efficacy and complications of limbal allografting from related live donors (RL-LAT) for limbal stem cell deficiency secondary to ocular chemical burn. Methods Retrospective comparative case series. Limbal allografting from related live human leukocyte antigen ( HLA)-matched ( n = 10) and-unmatched donors ( n = 2) was performed in 12 consecutive patients (12 eyes) with limbal stem cell deficiency secondary to ocular chemical burn, including 9 alkali burn and 3 acid burn; whereas allolimbal cadaver transplant was performed in another 15 patients in Zhongshan Ophthalmic Center between April 2006 to December 2007. Systemic cyclosporine A was administered to later eight recipients in living related donor group and all patients in cadaver donor group. Main outcome measures were restoration of corneal epithelium, reduction in corneal vascularization, improved corneal clarity, and visual improvement. Mean follow-up was (11.4 ±3.6) months (from 12 to 27). Results In living related donor group, ten patients (83.3%) achieved initially reepithelialize, and epithelial healing time was (9. 6 ± 3.4 ) d. Nine patients ( 75.0% ) achieved stable ocular surface ( stable corneal epithelium,decreased vascularization of corneal surface, and reduced corneal opacification). However, in seven eyes (77. 8% ) achieved stable ocular surface, gradual recurrence of peripheral corneal vascularization occurred after 5 to 8 months postoperatively. Whereas in cadaver donor group, twelve patients ( 80. 0% ) achieved initially reepithelialize, and epithelial healing time was ( 11.2 ±4. 6) d. Seven patients (46. 7% ) achieved stable ocular surface. However, in all seven eyes achieved stable ocular surface, gradual recurrence of peripheral corneal vascularization occurred after 4 to 10 months postoperatively. The differences of both the rate of initially reepithelialize and epithelial healing time between these two groups showed no statistical significance( χ2 = 1.764, P = 0.117; t = 0.116, P = 0.133, respectively). However, the differences of both the successful rate of ocular surface reconstruction and the recurrent rate of corneal vascularization during the follow-up period between these two groups were statistically significant(χ2=4.158, P =0.015;χ2 = 3. 463, P = 0. 022, respectively). In living related donor group, features of graft rejection developed in two patients with postoperative stable ocular surface, Both rejected recipients had one among HLA-matched and one among-unmatched respectively. Whereas in cadaver donor group, features of graft rejection developed in three patients with postoperative stable ocular surface. None of the donor eyes had any complications. Conclusions Limbal allografting from related live donors is more effective to reconstruct the ocular surface of limbal stem cell deficiency secondary to ocular chemical burn than allolimbal cadaver transplant. HLA-matched limbal allografting could reduce postoperative graft rejection and systemic cyclosporine A is useful in ensuring long-term survival.

Objective To analyze the clinical characterization of ocular cicatricial pemphigoid (OCP). Methods It was a retrospective series case study. Five consecutive patients referred for the evaluation of possible OCP from January 2005 to October 2008 in Departments of Ophthalmology and Dermatology of Peking University First Hospital History and clinical characterization of 5 cases ( 10 eyes) OCP having been misdiagnosed were analyzed to find the causes of misdiagnosis. Results All of cases were diagnosed as chronic conjunctivitis during the early stages of the diseases, one case was diagnosed as Stevens-Johnson syndrome and one as Sj(o)gren syndrome during the later stage. It was two to five years from the first time to see a doctor to definite diagnosis. All of cases have been prescribed antibiotic eye drops for a long times, one case has been undergone three times trichiasis operation and made the disease progression.Among the five patients with OCP, 3 eyes were diagnosed Stage Ⅱ , 5 eyes Stage Ⅲ, 2 eyes Stage Ⅳ. Three cases were positive of bacterial culture. Only in 1 case, there was slight increase of iron protein as tumor mark. Inflammation was controlled by the end of the study, but cicatrization of 2 cases still progressed.Conclusion Manifestation of OCP can mimic chronic conjunctivitis during the early stages, it is important to pay high attention to OCP, misdiagnosis may be stopped.

Objective To investigate tear film alterations in patients with latent herpes stromal keratitis (HSK). Methods Prospective comparative case series study. Twenty-four patients with latent HSK in one eye and 28 age and gender matched healthy individuals were recruited. All subjects were evaluated by subjective symptoms of dry eye, tear film break-up time (BUT) and Schirmer Ⅰ test (S I T).Laser in vivo confocal microscopic investigation was performed in 12 patients with severe tear film instability (BUT≤5 s). Data distribution and homogeneity of variance was analyzed. Statistical comparisons of the mean values between different groups were performed using Kruskal-Wallis test, Mann-Whitney test or student t-test. Results Most of latent HSK patients (n = 22/24, 91.7% ) had symptoms as dryness,burning sensation, redness and foreign body sensation. Both eyes of patients with latent HSK had hyposecretion ( S I T, control eyes ( 16.2 ± 3.2) mm/5 min; affected eyes ( 10. 4 ± 7. 8 ) mm/5 min; lateral eyes ( 11.2 ± 8. 8) mm/5 min; control and affected, U = 135.0, P < 0. 001; control and lateral, U =155.0, P = 0. 001 ) and decreased tear film stability [BUT, control eyes ( 12. 1 ± 0. 7 ) s, affected eyes (4. 3 ±3.3)s,lateral eyes (9.2 ±4. 4)s; control and affected, U =28. 0,P <0. 001; control and lateral,U=114.0, P<0.001] as compared to control group (Kruskal-Wallis nonpararmetric test). The value of BUT showed significant difference between affected eyes and healthy eyes (U =90. 0,P <0. 001 ), whereas no difference of the value ofS I T was found (U =273.0,P =0.757). Abnormal S I T ( ≤10 mm/min)and BUT ( ≤ 10 s) was presented in 14 (58. 3% ) and 23 ( 95.8% ) affected eyes, as well as in 14 (58. 3% ) and 17 (70. 8% ) lateral eyes, respectively. Laser in vivo confocal microscopy investigation in 12 affected corneas with abnormal tear film showed morphological alterations as corneal epithelial metaplasia with polymorphism and enlarged cells, reflective nuclei, and decreased nucleus/cytoplasm ratio; decreased nerve density in subepithelial plexus and obvious branching and beading, which is similar to those changes caused by dry eye. Conclusions Most of latent HSK patients had abnormal tear film. Dry eye related alterations could be found in affected corneas with abnormal tear film by in vivo confocal microscopy.

Objective To analyze the changes of color Doppler flow imaging (CDFI) and hematodynamics of retrobulbar blood vessels in Coats disease. Methods It was a prospective and selfcomparative study in which 18 cases ( 18 eyes) were included. Axial eye length was measured with A scan.Routine CDFI was performed in all cases. We examined ophthalmic arteries (OA), central retinal arteries (CRA) and posterior ciliary arteries (PCA) by CDFI, and recorded the peak systolic velocities (PSV),end diastolic velocities ( EDV), time averaged maximum velocities ( TAMX), pulsatility indexies (PI) and resistance indexes (RI) in all cases. Each hemodynamic parameter in the affected eye(21.36 ± 1.19)mm was compared with those in the contralateral normal eye (controls). T-test was used for the estimation of significance of the difference between the diseased and normal eyes. Results The axial length in diseased eyes was significantly shorter than that of the controls ( 22. 92 ± 1.09 ) mm ( t = 3. 617, P < 0.05 ). The changes of CDFI in diseased eyes included retinal detachment, retinal cyst, subretinal organization, etc.Vitreoretinal traction, intraocular ossification and calcification were uncommon. The PSV (6. 96 ± 1.21 ) cm/s and EDV( 1.99 ± 0. 36)cm/s in the diseased eyes were significantly lower than the PSV (8. 30 ± 1.46)cm/s and EDV (2. 48 ± 0. 47) cm/s in the control eyes ( t = 2. 995,3. 476; P < 0. 05 ). No significance difference was present in other hemodynamic parameters between diseased and normal eyes. Conclusions Coats disease is a congenital disease that may influence the development of the eye. The ultrasonography is helpful for the diagnosis and differential diagnosis in Coats disease. Low perfusion of the central optic artery might exist in Coats disease. The hematodynamics changes in Coats disease require further studies.

Objective To prepare and observe the properties of Folate Receptor-mediated VCR-loaded nanoparticles, which is abbreviated as FA-PLGA (VCR)-NP and to study the inhibitory effect of FA-PLGA (VCR)-NP in ACC-2 cells in vitro and in ACC in BALB/c-nu mice. Methods The mAified W/O/W extraction-evaporation technique was chosen to prepare FA-PLGA (VCR)-NP. Tumor cells were divided into three groups: VCR, PLGA(VCR) -NP and FA-PLGA(VCR) -NP. Seven doses (0. 05, 0. 25, 0. 50, 1.00,5. 00, 10. 00,and 30. 00 mg/L) of VCR were tested in the cell culture mAel. After 1,2, 3, 4 and 5 days,the cell growth inhibition ratio was evaluated by MTT colorimetry. Nude mice mAel of orbital ACC was built by injecting ACC cell suspension and divided into four groups: VCR, PLGA (VCR)-NP, FA-PLGA( VCR)-NP, and control group. After 1 day, 7 days and 14 days, the inhibition ratio of gross tumor volume was observed. Residual concentrations of VCR in tumors were evaluated by HPLC. The feature of histopathology was observed by electron microscopy. The effect of empty nanoparticles on ACC-2 cells was compared with normal control group using t-test to analyze. On account of different drugs, concentration, time and the interaction of them, multivariate analysis of variance was used to analyze their relationship. Inhibition rate and residual volume of drug concentrations were compared using one-factor analysis of variance and LSD method. Results FA-PLGA (VCR)-NP were smooth and spherical with a mean particle size of 249. 2 nm.The drug loading efficiency was 4. 53%. The release of VCR from PLGA nanoparticles can persist for 14 d.After blank particles PLGA-NP and ACC-2 cells were co-cultured for 5 days, cell viability had remained at more than 80 percent(t = 1. 952 ～3.285 ,P = 0. 081 ～ 0. 190). The inhibitory effect of FA-PLGA( VCR)-NP was more effective than VCR alone after a period of time ( F = 4. 798 ～ 563.479, P = 0. 000 ～ 0. 006 ).The effects of the treatment were both in dose-dependent and time-dependent manner. Targeting particles could attach to tumor surface, via folate receptor. FA was competitive inhibitor of this recognization. The volume inhibition ratios of FA-PLGA (VCR)- NP and PLGA (VCR)-NP were significant higher than VCR (P = 0. 016, P = 0. 029 ). The inhibition ratio of FA-PLGA ( VCR ) -NP was higher than that of PLGA (VCR)-NP, but there was no statistical difference (P = 0. 376). There was significant different between residual concentrations of VCR on the 1st, 7th and 14th days. TEM pictures showed a mass of electron-dense microspheres in tumor cells on the 14th day. Tumor necrosis was obvious, while surrounding tissues were normal. Conclusions FA-PLGA(VCR)-NP are stable and have high drug entrapment efficiency and high effect of growth inhibition in vitro. It can be proposed as a potentially controlled and targeted delivery system for the treatment of ACC.

Objective To investigate the protective effect and molecular mechanism of minocycline on toxicity of retinal ganglion cells induced by L-glutamate. Methods Primary mouse retinal ganglion cells (RGC) were isolated from mouse retinalin vitro. RGC were divided into control group, L-glutamate group,and L-glutamate + minocycline group, the cell survival rate and nerve axon growth length were observed. In vivo study, B6 mice was intravitreal injected with 2 μl L-glutamate (2 mmol/L) to construct a toxic damage to retinal ganglion cells animal model. One day before the beginning of the experiment, mice were daily intraperitoneal injected with minocycline (60 mg/kg, saline injected in the control group) till day 7, β3 tubulin positive cells and retinal GFAP protein expression were evaluated by tissue i mmol/L unofluorescence assay. Real-time PCR and Western blot assay were used to detect IFN-γ, IL-1, TNF-α and GFAP and vimentin mRNA and protein expression level in retinal tissues. Results Compared with control group, RGC survival rate in L-glutamate group was significantly reduced with a dose-and time-dependent. In addition,axon growth was inhibited with the treatment of glutamic acid, while these effects were abolished in the minocycline group ( F = 18.87, P < 0. 01 ). Animal study showed that the number of RGC dramatically decreased, however, expression of GFAP in retinal tissue significantly increased in L-glutamate treated mice,compared to control (F = 7.6, P < 0.01 ). Minocycline treatment significantly improved L-glutamate-induced ganglion cell damage and significantly reduced their GFAP expression. Both mRNA and protein expression levels of IFN-γ, IL-1, TNF-α and GFAP and Vimentin in retinal tissue of L-glutamic acid group significantly upregulated compared to control, while the minocycline significantly reduced the expression of these factors.Conclusions L-glutamic acid can induce retinal ganglion cells damage, inhibit axon growth and increase inflammatory and glial-cell related genes and proteins expression. Minocycline could significantly protect retinal ganglion cells from the injury caused by L-glutamate.

Objective To investigate the differential expression of immediate-early genes c-jun and c-fos in primary visual cortex of rat early after acute optic nerve injury and the relationship between immediate-early gene expression and injury degree of optic nerve. Methods This was an factorial design of two factors. 55 male Sprague-Dawley rats were divided into groups randomized. Unilateral optic nerve crush injury or transection was performed in rats to obtain acute partial or complete monocular optic nerve injury models. Frozen sections through visual cortex were cut in normal rats and model rats respectively at 2 h,1 d, 3 d, 1 week and 1 month after operation. Expression of c-Jun and c-Fos was detected in primary visual cortex by means of immunohistochemistry. Statistical comparisons were made using variance analysis of factorial design. Results Statistically significant different of c-Jun expresion existed between optc nerve crash injury and transection models ( F = 50. 344, P = 0. 000 ). Increased expression of c-Jun in primary visual cortex could be observed at 2 h postoperation, and reached peak value at 1 d postoperation. The extent of increased c-Jun expression was much higher in optic nerve transection models than crush injury models. Statistically significant different of c-Fos expresion existed between optc nerve crash injury and transection models ( F = 62. 232,P = 0. 000) Decreased expression of c-Fos in primary visual cortex could be observed at 2 h postoperation in optic nerve crush injury models, and reached bottom at 3 d postoperation.The extent of decrease of c-Fos expression was lower in optic nerve transection models than crush injury models and transient increased expression could be observed at 2 h postoperation. Conclusions The expression of immediate-early genes c-Jun and c-Fos changed shortly after optic nerve injury. They may act in opposite direction in the primary visual cortex.

Objective The research is engaged in developing an improved titanium skirt for keratoprosthesis, the aim of this study was to evaluate biocompatible of keratoprosthesis of novel design.Methods The pure titanium skirt for keratoprosthesis with three hands were first Sandblasted, and then bioactive hydroxyapatite coated on Sandblasted titanium for keratoprosthesis by a acid-alkali chemical treatment. A total of 18 New Zealand white rabbits and 18 alkali burned rabbit corneas were respectively divided into three groups (Group A, B and C;Group E, F and G) with simple random sampling methods.The modified titanium skirt was inserted into the corneal stroma of Group A and E, and then the control skirt was inserted into Group B and F. Group C and H did not insert skirt as surgery control. The interfacial biointegration of skirt/cornea were examined under light microscopy by HE,TEM and SEM. The transparent center was implanted to rabbit corneas with modified titanium skirt after 3 months. Results Dense hydroxyapatite coating was deposited on the Sandblasted specimens by an acid-alkali chemical treatment. The number of corneal fibroblasts increased significantly in Group A compared with Group B, The extracellular matrix deposited on the surface of modified titanium skirt was more dense and tight than that of control skirt.There was a significant difference in the shear force of skirt among groups A and B (t = 3.297, P < 0.05 ), E and F(t =4.237, P <0.05),and taking out the skirt in Group A and E were more difficulty than that in Group B and F after 3 months. The observation of the tissue sections of modified skirt inserted eyes revealed that there were cells and collagen-like fibres perpendicular to or at an angle to the rough interface and the cellular function was extremely active, in accordance with the results of TEM. Compared with healthy host tissue, skirt/cornea healing after alkali burn was impaired. Conclusions Hydroxyapatite modified Sandblasted titanium skirt for keratoprosthesis can promote the interfacial biointegration of skirt and host cornea, no matter in healthy cornea or diseased cornea (alkali burn cornea). Hydroxyapatite coating improved the bioactivity of titanium.

Objective To investigate the expression, contribution and regulation of predominant inflammatory cytokines in the inflammation process of in a mouse model of keratomycosis. Methods It was an exprimental study. Two hundred forty inbred BALB/c mice were randomly divided into four groups (injury control group, F. solani infected group, A. fumigatus infected group and C. albicans infected group) and establishment fungal keratitis was performed. At 1, 3, 5, and 7 days after infection, the photographs of their corneas were taken using the slit lamp and the digital camera system. The presence of inflammatory cells and fungal hyphae were observed by HE and PAS staining. Four inflammatory cytokines in infectious corneas, including MIP-2, KC, IL-1β, and IL-6, were detected respectively for expression of mRNA and protein levels, using RT-PCR and ELISA. One-way ANOVA was used to test the comparisons of the clinical scoring, RT-PCR, and ELISA, and LSD was used to test multiple comparisons. Results The course and inflammatory reaction of corneal tissue in all infected group increased at day 3 and 5 and gradually decreased after day 7 with time. The RT-PCR results showed, the mRNA expression levels of MIP-2 and IL-1β were the highest in A. fumigatus infected group, and the expression levels of KC was the highest in C. albicans infected group. Additionally, the expression levels of IL-6 were found to be the highest in F.solani infected group. The mRNA expression levels of IL-1β and KC in each experimental group were higher than those of IL-6 and MIP-2. The peak expression levels of MIP-2, KC, and IL-1β occurred at day 5, day 1, and day 3 in F. solani infected group, A. fumigatus infected group and C. albicans infected group,respectively. However, the peak expression level of IL-6 occurred at day 1 and 7, day 1 and 7, and day 1 and 5 in the F. solani, A. fumigatus, and C. albicans groups, respectively. The difference of mRNA expression of each cytokine had statistically significant between each groups(MIP-2: F = 1675.339, P <0.01; KC: F=730.267, P<0.01; IL-1β: F =297. 106, P<0.01; IL-6: F=174.513, P<0.01). The protein expression levels of the four cytokines in the infected groups from high to low in turn were IL-1β,MIP-2, KC and IL-6. The trend of protein expression of the four cytokines at each time point was the same as the cytokine mRNA expression in different experimental groups as well as within the same group. The difference of protein expression of each cytokine had statistically significant between each groups ( MIP-2:F=2871.736, P<0.01; KC:F=886.598, P<0.01; IL-Iβ: F=3595.488, P<0.01; IL-6: F=89.225, P < 0.01 ). Conclusions The expression levels of MIP-2, KC and IL-1β are closely related to the performance of the disease severity and inflammatory reaction of FK. The expression of MIP-2 and IL-1β may play important role in the pathogenesis of FK.

Objective To characterize the cytopathology, histopathology, immunohistochemistry and ultrastructural organization features of Mycobacterium abscessus keratitis. Methods This retrospective case report included six cases with the lesions tissues scraped from acute phase of mycobacterium abscessus keratitis after corneal foreign body removal Among the 6 scrapings, 4 were tested for Ziehl-Neelsen acid-fast staining and 3 were examined by transmission electron microscopy (TEM). The corneal tissues of 2 cases in chronic phase of the disease were collected during keratoplasty and were examined by pathological examination including hematoxylin-eosin (HE) staining, acid-fast staining, immunohistostaining and TEM.Results A single or fascicular red bacilli were observed after acid-fast staining in the four cases of corneal scrapings. The smear samples contained a large number of neutrophils and necrotic corneal epithelium and stroma tissue accompanying with a large number of mycobacteria that were positive for acid-fast staining scattered in and out of inflammatory cells. The corneal buttons obtained at keratoplasty in the 2 patientsdemonstrated corneal epithelial hyperplasia, stroma degeneration, necrosis and elcosis, neutrophil and lymphocyte infiltration, neovascularization and fibrous hyperplasia, but no positive mycobacteria by ZiehlNeelsen acid-fast staining. There were no CD4+ or CD8+ cells from immunohistochemistry examination.TEM of the corneal scrapings of the 3 cases showed phagocytosis of mycobacterium abscessus in mononuclear macrophage or neutrophils, inclusion compounds of small vacuoles and metachromatic granules in the thalline. TEM of corneal buttons of 2 cases showed slender rod-shaped mycobacteria with several to dozens of finely ground particles with high electron-dense, but no cell wall (L-form) or inclusion compounds.Conclusions Mycobacterium abscessus keratitis presents acute purulent inflammatory changes in early stage and advances to chronic and non-specificity inflammation changes in late stage. L-formed mycobacterium abscessus make the disease protraction.

Cornea is one of the sites that have many nerve fiber terminals which play critical roles in maintaining normal cornea functions and the wound healing of cornea. SP is one of the neurotransmitters released by cornea nerve fiber and is very important in signal transduction and feedback control of the cornea. The relationship between SP and cornea wound healing has been discussed.

With an increasing number of new cases of tuberculosis every year, the incidence of tuberculous uveitis presents a rising trend. The disease is associated with a wide spectrum of clinical manifestations. The common clinical presentations appear to be anterior uveitis, choroidal tubercles,multifocal choroiditis, rarely serpiginous-like choroiditis, subretinal abscesses or suspected ocular tumors.Macular edema can be the only ocular manifestation of tuberculosis. With absence of proper diagnostic standard, it usually leads to missed diagnosis, misdiagnosis, and delayed diagnosis of tuberculous uveitis which can result in severe consequences such as vision loss, blind, and even eye enucleation. New technology such as PCR and Interferon-Gamma release assays can be helpful for the diagnosis of tuberculous uveitis. The early diagnosis and standard treatment of tuberculous uveitis are in urgent need.

As an important cytokine, interferon has many functions such as antiviral, inhibiting tumor cell growth and immune regulation. Besides its therapeutic effect, interferon can also cause cold-like symptoms and bone marrow suppression, but there are few reports of retinopathy caused by interferon in China.

angiographically occult vascular malformations (AOVM) refer to intracranial vascular malformations confirmed by histopathology or surgery without cerebral angiography [1], which is one of the important causes of spontaneous intracranial hemorrhage.

Orbital bone decompression was born at the beginning of the 20th century for the treatment of compressive optic neuropathy caused by thyroid associated ophthalmopathy (TAO), exposure keratitis or exophthalmos seriously affecting appearance.

The patient was a 50-year-old female who went to the Department of Ophthalmology of Beijing Friendship Hospital affiliated to Capital Medical University on November 17, 2009 due to prolapse of eyeball and loss of vision for 2 h after the left eye was injured by an electric handlebar.

A 41-year-old male was found to have a foreign body in the lens of his left eye under the slit lamp microscope during physical examination. The right eye was injured by a copper detonator in February 1980. One year later, the right eyeball was removed in a hospital of the People's Liberation Army because of eye atrophy. Two fine copper pieces were removed from the ball for pathological examination.

Conjunctiva relaxation is an age-related common eye disease in the elderly [1-2] With the aging of the population, the number of patients with conjunctiva relaxation is increasing day by day. Patients with conjunctiva relaxation often complain of eye dryness, foreign body sensation, lacrimal overflow, and in severe cases, tingling and burning sensation, which affect eye vision and quality of life [3-4].

It is estimated that by 2010, the number of glaucoma patients in the world will exceed 60 million, and the number of blind people will be nearly 10 million. The World Health Organization (WHO) has made the prevention and treatment of primary glaucoma one of the key tasks of blindness prevention. In order to advocate the majority of ophthalmologists to pay attention to the prevention and treatment of glaucoma, Chinese Journal of Ophthalmology of Chinese Medical Association and Alcon (China) Ophthalmic Products Co., Ltd. jointly held the 2010 Alcon "Healthy Intraocular Pressure" Cup prize-winning essay contest.

Ocular Surface Live Confocal Microscope (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 officially 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 a clinically practical auxiliary diagnostic device, ocular surface in vivo confocal microscope can perform non-invasive,

In order to advocate the majority of ophthalmologists to pay attention to "repairing damaged nerves and promoting vision recovery", Chinese Journal of Ophthalmology of Chinese Medical Association and Eisai (China) Pharmaceutical Co., Ltd. jointly held the 2010 Eisai Ophthalmology Award-winning essay contest.

Glaucoma is one of the main eye diseases causing blindness in China. In recent years, the proportion of primary open-angle glaucoma in primary glaucoma has gradually increased. Studies have shown that up to 75% of glaucoma patients need combination medication, and the compliance of combination medication in glaucoma patients is poor, which is one of the important reasons that leads to further impairment of visual function and even poor blindness in glaucoma patients. In order to make more ophthalmologists pay more attention to the hot issues of glaucoma treatment,

In recent years, the concept of cataract refractive surgery has penetrated into the clinical diagnosis and treatment of cataract diseases. It is the higher pursuit of cataract surgeons to restore patients' vision like young people. Multifocal intraocular lens has attracted more and more attention of ophthalmologists because of its good clinical application effect.

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.

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.

Corneal disease is one of the main eye diseases causing blindness at present. According to statistics, there are more than 7 million blind people in China, of which about 8% are caused by corneal disease. The only hope for blindness caused by corneal disease is corneal transplantation. However, due to the lack of donor corneas, only 8,000 corneal transplantations are performed in China every year, and millions of patients can only pray for light in the dark. Therefore, early intervention for corneal diseases is crucial. "Protect the eyes and cherish the cornea" has become the focus of general concern in the society.

The 2010 International Ophthalmic Drug Clinical Trial Standards Training Symposium, jointly sponsored by the State Food and Drug Administration Training Center, Shanghai Food and Drug Administration and the American Academy of Ophthalmology and Vision Research Sciences, and hosted by the First People's Hospital affiliated to Shanghai Jiaotong University, will be held in Shanghai from November 12 to 14, 2010. This conference was organized by authoritative experts from the American Academy of Ophthalmology and Visual Research Sciences and relevant officials of drug clinical research from the State Food and Drug Administration to give special lectures and discussions.

The Ophthalmology Center of Tianjin Medical University will hold a 1-day academic seminar on orbital ocular plastic surgery on October 16, 2010. The conference will invite senior experts in this field in China to conduct academic discussions on the cutting-edge progress, difficult cases, diagnostic skills and surgical experience in the field of orbit and eye plastic surgery. This seminar has been listed in Tianjin Continuing Medical Education Program (credit is 3 points). Registration fee is waived for the conference, and room and board are arranged uniformly at your own expense.

The first National Symposium on Evidence-Based Ophthalmology Research Progress will be held in Kunming, Yunnan Province from November 25 to 28, 2010. This conference was held by Chinese Medical Doctors Association, Evidence-Based Medicine Professional Committee of Chinese Medical Doctors Association, Evidence-Based Ophthalmology Group of Evidence-Based Medicine Professional Committee of Chinese Medical Doctors Association, and Yunnan Second People's Hospital (the Fourth Affiliated Hospital of Kunming Medical College and Yunnan Red Cross Hospital). The theme of this conference is "Evidence-based Ophthalmology, Our Future". Wang Ningli, Zhao Jialiang and Ge Jian, famous experts in the field of evidence-based medicine and ophthalmology in China, will be invited to give wonderful speeches and seminars on the latest evidence-based medicine advances in ocular surface and corneal diseases, refractive surgery, glaucoma, cataract, uveitis, vitreoretinal diseases, optic nerve diseases and other aspects.

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 Ophthalmology, were held in Qingdao, Shandong Province from June 4 to 6, 2010.

The 17th National Conference on Ocular Trauma, Ocular Plastic Surgery and Orbital Diseases and the 5th National Orbital Disease Study Class, sponsored by the Ophthalmology Group of Ophthalmology Branch of Chinese Medical Association and the Institute of Orbital Diseases of Armed Police General Hospital, will be held in Kunming in March 2011. At that time, well-known experts and scholars in the field of ocular trauma, eye plastic surgery and orbital disease in China will gather in Kunming to share successful experiences with fellow ophthalmologists all over the country; At the same time, well-known domestic manufacturers are invited to display related products.

1. Statistical symbols: According to the relevant provisions of GB 3358.1982/ (Statistical Nouns and Symbols ", all statistical symbols are printed in italics. Commonly used: (1) The arithmetic mean of the sample is in English lowercase x (the median is in M);

digita object identifier (DOI) is a tool for identifying digital information including Internet information. In traditional publications, books, magnetic tapes and CD-ROM have international standard numbers (ISBN, ISSN, ISCN) and their barcodes as the unique identification of publications. These logos allow the publication to be effectively managed and easy for readers to find and utilize. Once the document on the Internet has changed the URL, there is no way to retrieve it.

The exclusive strategic cooperation of "Chinese Medical Association Series Journal Database" reached by Chinese Medical Association and Beijing Wanfang Data Co., Ltd. (hereinafter referred to as Wanfang Data) has been successfully operated for 3 years, and a new round of exclusive cooperation agreement has been renewed at the end of June 2010. The right to disseminate digital information network of 123 medical journals in 24 provinces and municipalities directly under the Central Government under the Chinese Medical Association will continue to be exclusively granted to Wanfang Data. Both sides will continue to practice the strategic goal of "inheriting a century-old classics and creating a group of fine Chinese journals; Reproducing the century chapter and building a new aircraft carrier of medical information".

The patient was a 49-year-old male who came to the Department of Ophthalmology of Yantai Yuhuangding Hospital affiliated to Qingdao University School of Medicine on January 8, 2007 due to red right eye and blurred vision for 4 years and aggravated for 1 month. In April 2003, the patient went to the local hospital for a cold, and the specific treatment was unknown. After taking the medication, he developed high fever, systemic erythema and large area of skin exfoliation, and was diagnosed as epidermolysis bullosa drug eruption.

The patient was a 35-year-old female who came to Changchun Yinuo Eye Hospital on October 5, 2009 due to blurred vision and deformation of her left eye for 2 weeks. The patient did not undergo fluorescein fundus angiography due to allergic constitution. Ocular examination: the visual acuity was 1.0 in the right eye and 0.3 in the left eye, and the anterior segment of both eyes was normal. The fundus of the right eye is normal, and the fundus of the left eye is shown in the essence picture 1.

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. This journal was successively awarded the title of Excellent Science and Technology Journals Project Demonstration Project of China Association for Science and Technology from 2006 to 2010.