Volume 47 · Issue 06 · 2011

Vitreoretinal surgery has entered the era of minimally invasive surgery after decades of development. The development of equipments and technology, represented by 25G and 23G vitrectomy, makes the incision smaller and sutureless. However, the"micro-incision"surgery is not the same as"minimally invasive surgery". The key of"minimally invasive surgery"is that the surgeons should have a strong"minimally invasive"consciousness, always follow the "minimally invasive principle",produces minimal trauma to obtain the best outcome. The ideal minimally invasive vitrectomy should be the perfect combination of"minimally invasive technique"and"minimally invasive devices and equipments"under the guidance of"minimally invasive consciousness".

Retinopathy of prematurity (ROP) remains the major cause of childhood blindness in developing countries. Visual prognosis in ROP can be improved if the patients can receive early treatment. Therefore, establishing a perfect prevention and treatment system is the key to reduce blindness rate caused by ROP. The situation of ROP in China is serious and the prevention of ROP remains inadequate. Therefore, the government and medical personnel should pay more attention to its prevention. It is necessary to set-up more prevention centers to screen, diagnose and treat ROP, as well as to afford disease propaganda and follow-up care. These centers can build collaborative relationship by means of professional networks to improve the prevention efficiency of ROP in China.

Objective To observe the clinical results of transvitreal choroidal biopsies in the diagnosis of choroidal tumors. Methods It was a retrospective case series study. Slitlamp, indirect ophthalmoscopy, B scan, CDI, MRI, OCT, FFA and ICGA were performed in all 16 cases. The choroidal biopsy was obtained via an internal approach with a three-port pars plana vitrectomy. Vitreous samples were obtained in patients with vitreous hemorrhage. In choroidal tumor located at or in front of the equator, local excision of tumor were performed. The vitreous specimens, choroidal biopsies and excised tumor specimens were analyzed by the histopathologic studies. Statistical analysis was performed using a commercially available statistical software package (SPSS for Windows, version 13.0, SPSS, Chicago, IL). Results In 4 cases of vitreous hemorrhage, histopathologic studies showed hemorrhage in 2 cases and choroidal melanoma cells in another two cases. In 16 choroidal biopsies, 2 cases had a negative results, 11 cases showed choroidal melanoma, 1 case was melanocytoma and 2 cases were hemorrhage only. The diagnostic rate was 87.5%. In 12 cases that underwent local excision, 9 cases were choroidal melanoma, 1 case was melanocytoma and 2 cases were Schwannoma. High concordance was present between choroidal biopsy and local excision(Kappa=1,P=0.02). Conclusions The results obtained from transvitreal choroidal biopsies were consistent with that from local excision. This procedure can be used in the diagnosis and treatment of choroidal tumors.

Objective To evaluate the efficacy of vitrectomy combined with internal limiting membrane (ILM) peeling in the treatment of diffuse nontractional diabetic macular edema. Methods It was a retrospective case series study. Clinical records of 21 consecutive patients (21 eyes) with diffuse diabetic macular edema without macular traction were reviewed. All patients underwent pars plana vitrectomy with internal limiting membrane peeling. Main outcome measurements included pre- and postoperative optical coherence tomography (OCT) and visual acuity. Results Postoperative follow-up ranged from 12 to 24 months (mean, 16.3 months). Mean preoperative foveal thickness significantly decreased from (406±59) μm to (291±67) μm at 1 months after surgery (t=9.26,P<0.01), and further decreased to (280±77) μm at 12 months (t=9.46,P<0.01). No differences in visual acuity between preoperative and postoperative were found during follow-up periods. The final best-corrected visual acuity improved in 8 (38.1%) of the 21 eyes, remained unchanged in 11 eyes (52.4%), and decreased in 2 eyes (9.5%). Conclusions Pars plana vitrectomy with internal limiting membrane peeling appears to be beneficial in eyes with diffuse nontractional diabetic macular edema in retinal thickness but visual acuity outcomes showed only minimal improvement as compared to the baseline.

Objective To evaluate the efficacy of vitrectomy without internal limiting membrane (ILM) peeling associated with gas tamponade in eyes with myopic foveoschisis. Methods A prospective study was conducted, in which 49 pathological myopia patients (52 eyes) with myopic foveoschisis were enrolled and divided into three groups according to the different therapeutic procedures: 22 patients (24 eyes) underwent vitrectomy without internal limiting membrane (non-gas tamponade group), 15 patients (16 eyes) received vitrectomy without internal limiting membrane peeling but combined with gas tamponade (gas tamponade group) and 12 patients (12 eyes) did not receive surgical treatments (control group) . SAS 9.13 was used for the statistic analysis.Best-corrected visual acuity (BCVA) and optical coherence tomographic (OCT) findings of the foveal thickness before and after the operation (the 3rd, 6th, and 9th month postoperatively) were obtained and compared by the Wilcoxon Rank-Sum test. Non-parameters Wilcoxon symbols test was used to compare the BCVA,the central foveal thickness (CFT) and maximum foveal thickness (MxFT) of each group before and after the surgery.Results Postoperative visual acuity was significantly increased in the two operation groups (t=2.57,P<0.05;t=3.58,P<0.05) but not increased in the control group (t=1.84;P>0.05). The difference of BCVA between these three groups was not significant (χ2 =0.24,P>0.05). OCT showed the mean foveal thickness was significantly decreased postoperatively. Vitrectomy without peeling of the ILM significantly promoted the retinal reattachment in eyes with myopic foveoschisis. No retinal reattachments was found in the control group while 16 and 13 retinal reattachments were found in the non-gas tamponade (66.7%) and gas tamponade group (81.3%), the difference between these two operation groups and the control was statistically significant (χ2=20.50, P<0.05). During the follow-up, two eyes in the control group developed a macular hole and both developed retinal detachment (RD) in the 6 and 8 month, respectively . The remaining 10 eyes did not develop any complications, although the thickness of the macula increased significantly. A transient increase of intraocular pressure occurred in three eyes and had been cured by medications within 2 weeks after gas tamponaded. A macular hole was recognized in one eye 2 months after surgery and the retina was reattached at the fovea 1 month after reoperation. Conclusions Vitrectomy without ILM peeling could be a safe and effective surgical approach for the treatment of foveoschisis in pathologic myopia. In addition, gas tamponade can improve the success rate of the operation.

Objective To evaluate the findings of spectral domain optical coherence tomography (SD-OCT) in patients with idiopathic macular hole (IMH). Methods It was a retrospective case series study. Pre- and post-operative data from patients with IMH during 14 months were analyzed retrospectively. The main outcome data included logarithm of the minimal angle of resolution (logMAR) and SD-OCT findings, including the size of the IMH and the disruption of the boundary line between inner segments (IS) and outer segments (OS) of the photoreceptors. The data were analyzed using the statistical software SPSS14.0. The correlation among various data was analyzed by Bivariate correlation. The pre-and post-operative data were compared by paired-samples t-tests. Results Thirty two eyes of 32 patients were studied. The mean logMAR was 1.16±0.46 (ranged from 0.40 to 2.00), the mean diameter of macular hole was (859.7±292.0) μm (ranged from 332 to 1568 μm).The mean diameter of IS/OS disruption was (1965.1±584.1) μm (ranged from 867 to 3444 μm). In eyes after surgery, the mean logMAR was 0.89±0.46 (ranged from 0.30 to 2.00), the mean diameter of the IS/OS disruption was (1350.4±642.6) μm (ranged from 153 to 2546 μm), both were decreased significantly as compare with the preoperative data(t=3.384,6.360;P<0.05). Preoperative diameter of macular hole(r=0.583) and IS/OS disruption(r=0.416) were correlated significantly with postoperative logMAR(P<0.05). Conclusions Preoperative diameter of macular hole and IS/OS disruption play the main role in vision prognosis. The IS/OS disruption is decreased significantly after the operation.

Objective To describe the pathologic changes of macular in acute central serous chorioretinopathy (CSC) using spectral domain optical coherence tomography (SD-OCT). Methods It was a retrospective case series study. This study included 29 eyes of 29 patients with CSC. The fundus examination was conducted followed by SD-OCT to observe foveal microstructure changes. We evaluated the correlation between the thickness of the outer nuclear layer (ONL), the length of photoreceptors and best-corrected visual acuity (BCVA). Results Serous retinal detachment was found in all 29 eyes with SD-OCT. There was no obvious morphology change in ONL, the thickness of ONL was (96.94±23.72) μm and did not different from that in normal control eyes (104.15±11.90) μm. The thickness of photoreceptors was uniform in 11 eyes (31.9%), uniform but with defects in 6 eyes (20.7%), uneven in 4 eyes (13.8%), protruding of outer segments (OS) was observed in 6 eyes (20.7%) and flaking OS in 2 eyes (6.9%). The length from external limiting membrane to the longest outer segment in CSC eyes was 84 (52 to 148) μm and was not statistically different from that in normal eyes (69 to 82)μm. Morphology changes of retinal pigment epithelium (RPE) were found in 25 eyes, including pigment epithelial detachment of RPE (PED) in 21 eyes (72.4%), small bulge of RPE in 10 eyes (34.5%), granular deposition epi-RPE in 6 eyes (20.7%), defects of RPE in 3 eyes(10.3%). Fluorescein angiography (FA) was performed in 5 eyes and bulging RPE detected by SD-OCT seemed to correspond precisely to the leakage point on FA in 3 eyes. Age, course of disease and thickness of the ONL did not influence BCVA (logMAR). Uneven of thickness of OS was negative prognostic factors for BCVA (r=0.382,P=0.026). Conclusions SD-OCT can demonstrate finer pathologic changes in acute CSC. Furthermore, 3-D image allows localization of these pathologic features to specific site using ELM line as landmark. SD-OCT is a valuable tool for the diagnosis and for predicting visual recovery in CSC.

Objective To screen the mutation in the RPGR gene in a large Chinese family with X-linked recessive retinitis pigmentosa (RP) and to describe the phenotype in affected males and female carriers. Methods Ophthalmic examinations were performed in 77 family members of a RP pedigree to identify affected individuals. Polymerase chain reaction (PCR) and direct sequencing were used for screening of mutations in RPGR gene exon ORF15. Results Mutation screening demonstrated a novel mutation, g.ORF15+577_ 578delAG, which caused an open reading frameshift and resulted in premature truncation of the RPGR protein. This mutation was detected in 8 affected male individuals and 14 obligate female carriers in this family and was found to segregate with the phenotype in this family. This mutation led to a severe RP phenotype in male affected individuals with some variability in the age of onset of night blindness and loss of visual acuity, but was recessive in female carriers without a RP phenotype. However the most striking phenotypic feature in female carriers in this pedigree was moderate to high myopia with refractive error ranging from -5.00 D to -22.00 D in 14 female carriers. Conclusions This novel mutation in RPGR ORF15 causes serious RP phenotype in males and no RP phenotype in female carriers. Moderate to high myopia was a particular feature for female carriers in this pedigree. Our finding expands the spectrum of RPGR mutations causing RP and phenotypic spectrum of the disease in Chinese family, which is useful for further genetic consultation and genetic diagnosis.

Objective To study the cell apoptosis and the expression of connective tissue growth factor (CTGF) in the retina of diabetic rats and to explore their contributions to the changes of microcirculation. Methods It was a experiment study. Fifty-five adult male Wistar rats were divided into two groups, normal control group (CON,10 rats) and diabetes mellitus group (DM, 45 rats). The 30 surviving rats in the DM group were further divided into 3 groups based on the time of observation, 2 month (DM2), 4 month (DM4) and 6 month (DM6) groups, with 10 rats in each group. Cell apoptosis was detected by TdT-mediated dUTP nick end labeling (TUNEL). Expression of CTGF was determined by immunohistochemical study. Retinal vessels were observed by retinal digest stretched periodic acid Schiff (PAS) staining. Results Immunohistochemical staining and TUNEL staining revealed negative results in normal control group. Retinal cell apoptosis index increased gradually from DM2 to DM6, the differences between any two groups were statistically significant (t2-4,2-6,4-6=21.432, 50.843, 29.410;P<0.05). Expression of CTGF in the retina increased from DM2-DM6, the differences between any two groups were statistically significant (t2-4,2-6,4-6=15.345, 26.316, 10.971;P<0.05). PAS staining of retinal blood vessels obtained negative results in the CON and DM2 groups. Part of retinal capillaries were slightly stiff and narrow in DM4 group. Retinal capillaries in DM6 group were trunk stiff and were narrowed obviously. The number of pericytes was reduced in DM4, and progressed following the course of diabetes. The number of pericytes in the DM2 group did not different from that in the CON group (t=0.875,P=0.387). The number of pericytes in the DM4 and DM6 group were significantly decreased as compared to the CON group (t=3.367,6.667;P<0.05). Retinal cellular apoptosis index had a significant positive correlation to the expression of CTGF (r=0.958,P<0.05). Number of pericytes was significantly correlated (negative correlation) with retinal cellular apoptosis index and the expression of CTGF (r=-0.540, -0.595; P<0.05). Conclusions The appearances of cellular apoptosis and fibrosing factor CTGF in the retina of diabetic rats occurred earlier than the changes of microcirculation and the number of capillary pericytes.

Objective To assess the safety and efficiency of posterior scleral reinforcement surgery by analyzing data collected for more than ten years after the surgery. Methods Sixteen patients(32 eyes) with high myopia who underwent scleral reinforcement were followed up for more than ten years(10 to 13 years). Results Best corrected visual acuity was stable(t=0.26,P>0.05).The average axial elongation was 0.056 mm per year postoperation after surgery.The ratio of choroidal neovascularization in the operation group was 3.1%(1/32). Conclusions Posterior scleral reinforcement is a safe and effective.This procedure can prevent the development of choroidal neovascularization in high myopia.A control study with a larger group of cases as well as related basic is still required.

Objective To evaluate the efficacy, safety and stability of three kinds of phakic intraocular lens implantation for the correction of high myopia. Methods This study included 208 eyes of 110 patients with a mean age of 31 years(21-53) from December 2003 to December 2009. Angle-supported lens(Phakic 6H, OII) were inserted into 113 eyes, iris-fixated lens(Artisan, OPHTEC) were inserted into 53 eyes and implantable contact lens(ICL) (V4, STAAR)were inserted into 41eyes. The average follow-up time of the three groups were 54.0 months(3-72 months), 15.7 months(3-24 months)and 7.2 months(3-15 months)respectively. Results At 3 months and 12 months, the efficacy indexes of the three groups were all above 1.00. Only the angle-supported group was followed up to 72 months postoperatively when the efficacy index dropped to 0.85, but still UCVA was 1.0 (20/20) or better in 16% eyes and 0.5 (20/40) or better in 85% eyes. The safety indexes of the three groups were always above 1.00 during the follow up. In the angle-supported group, 46% eyes were within ±0.50 D of the desired refraction and 68% eyes were within ±1.00 D at 5 years postoperatively. In the iris-fixated group, 78% eyes were within ±0.50 D of the desired refraction and 100% eyes were within ±1.00 D at 1 years postoperatively. In the ICL group, 95% eyes were within ±0.50 D of the desired refraction and 100% eyes were within ±1.00 D at 3 months postoperatively. No statistically significant differences were found between preoperative and 3-month postoperative endothelial cell density in the ICL group. Also, there was no statistically significant reduction in endothelial cell density at 1 years in the iris-fixated group. However, when preoperative and 5-year postoperative measurements were compared in the angle-supported group, the total decrease in cell density is statistically significant(t=9.769, P=0.000). 16 eyes developed high IOP within 1 month postoperatively which resolved after intervention. In the three groups(angle-supported, iris-fixated and ICL), the most common complications were pupil ovalization, iris atrophy plus pigment dispersion and lens opacification respectively. Conclusion Although phakic IOL implantation is predictable and safe for treatment of high myopia in short-term, the long-term complications should be concerned and treated well.

Objective To evaluate the effects of protein-free calf blood extract for recovery of corneal nerve after LASEK and LSEIK. Methods A prospective, randomized, control and double-blind study was carried out from January through February 2009 at Department of Ophthalmology, Eye Ear Nose and Throat Hospital of Fudan University. Forty-nine eyes of 25 patients who underwent LASEK were randomly divided into two groups. One group with 16 patients (32 eyes) was treated by protein-free calf blood extract eye gel which was defined as drug treated group and the other group with 9 patients (17 eyes) was not treated by protein-free calf blood extract eye gel which was defined as no drug treated group. Forty-four eyes of 23 patients who underwent LASIK were also randomly divided into two groups. One group with 13 patients (24 eyes) was treated by protein-free calf blood extract eye gel which was defined as drug treated group and the other group with 10 patients (20 eyes) was not treated by protein-free calf blood extract eye gel which was defined as no drug treated group. Protein-free calf blood extract eye gel was delivered in both drug treated groups 3 times per day for three months after surgery. Laser scanning confocal microscopic examinations were performed on 48 eyes in vivo. Central corneal sensitivity and tear break-up time (BUT) were tested on 93 eyes preoperatively and 1,3,6 months, and 1 year after surgery. The obtained dates in the study were analyzed using independent samples t-test, paired t-test and Mann-Whitney Test. Results The morphology oserved by confocal microscope of sub-basal nerve fibers was not different between drug treated group and no drug treated group until the last follow up after LASIK or LASEK(Z=0.0000,P=1.00)and(Z=0.0000,P=1.00). Nerve fibers with interconnections were observed in drug treated group at 3 months after LASEK. The morphology of sub-basal nerve fibers had not recovered completely until 1 year after surgery. The central corneal sensitivity was better in drug treated group than in no drug treated group at 1 month after LASEK [(4.95±0.84)μm,(3.62±1.38) μm;t=4.23,P<0.01] and at 1 and 3 months after LASIK [(3.29±1.40)μm,(2.35±1.51)μm;t=2.10,P<0.05],[(4.31±1.61) μm,(3.18±1.62) μm; t=2.31,P<0.05]. At 6 months postoperatively, the central corneal sensitivity of both drug treated group and no drug treated group which underwent LASEK was not significantly different from pre-operation[(5.81±0.35) μm;t=-1.26,P>0.05],[(5.79±0.36)μm;t=-0.70,P>0.05]. At 6 months postoperatively, the central corneal sensitivity of drug treated group which underwent LASIK was not significantly different from pre-operation[(5.25±0.91)μm;t=-1.87, P>0.05]. No significant difference was seen in BUT between drug treated group and no drug treated group after LASEK or LASIK until 1 year after surgery[(8.13±2.18) μm,(8.76±1.64)μm;t=-0.90,P>0.05],[(7.71±2.14) μm,(7.45±2.37)μm;t=0.30,P>0.05]. Conclusion Protein-free calf blood extract could significantly promote the recovery of corneal nerve in the early period after LASEK and LASIK.

Psoriasis, commonly known as "psoriasis", is a common chronic disease with unclear pathogenesis and easy to relapse. Its pathogenesis is related to environmental factors and genetic factors. Besides common skin and joint damage, it can also be combined with ocular lesions, including abnormalities of conjunctiva, cornea, uvea and lens. In 2009, a patient with psoriasis combined with corneal and conjunctival ulcers was diagnosed and treated in Beijing Tongren Hospital and Beijing Tongren Eye Center affiliated to Capital Medical University.

The patient was a 29-year-old female who felt that the visual acuity of her right eye was gradually decreasing for 5 years. She went to the Department of Ophthalmology of Eye, Ear, Nose and Throat Hospital affiliated to Fudan University in October 2009. The patient denied the accompanying symptoms such as eye pain and vision distortion, and had no history of other ocular and systemic diseases. Ophthalmological examination showed that the best corrected visual acuity in the right eye was only light sensing, and the left eye was 1.0. The intraocular pressure in both eyes was normal, the eyeball was not prominent, and the eye position was normal.

A 73-year-old male was admitted to the Department of Ophthalmology of West China Hospital of Sichuan University on July 30, 2009 due to "left eyeball protrusion with distension and pain, visual acuity decreased for 4 months". Four months before admission, the patient felt that the left eyeball protrusion with eye distension and pain, without photophobia, tearing, fever, headache and other symptoms, and was diagnosed as "left orbital cavernous hemangioma" in another hospital. It was recommended to come to West China Hospital of Sichuan University for treatment.

The patient was a 36-year-old female who came to the doctor with the main complaint of "repeated redness and swelling of the right eye for 5~6 years". The patient had repeated redness and swelling of the right eye without obvious inducement 5 or 6 years ago, and occasionally had mild pain. She went to many hospitals and was relieved after being treated with antibiotics, glucocorticoids and other drugs, but relapsed in a short time after stopping the drug.

A 23-year-old male patient with bilateral chronic maxillary sinusitis was examined by Stryker 70° endoscope before functional endoscopic nasal surgery. The inferior nasolacrimal duct was found in the lower nasal passage and observed in the direction of lacrimal sac, and the whole lumen of nasolacrimal duct was seen (Quintessence Picture 1), which was different from the smaller local surface of lacrimal duct observed by lacrimal duct endoscopy.

Retinopathy of prematurity (ROP) is a proliferative disease that affects prematurely born babies. Despite the progress in management and treatment obtained previously, ROP remains a major cause of childhood blindness in both developed and developing countries. The etiology and pathogenesis of ROP is still unclear despite the fact that some progresses have been obtained. Some factors, such as low birth-weight and short gestational age have been consistently shown to be associated with ROP. Recently, numerous studies indicated that ROP shows genetic susceptibility, which includes sex, ethnicity, gene polymorphisms and gene mutations. Genetic susceptibility will play an important role in the screening and treatment of advanced ROP in the future.

Ciliary neurotrophic factor (CNTF) has been showing neuroprotective effects on photoreceptors in a variety of in vivo and in vitro experiments and clinical trials. CNTF causes morphological and functional alterations in various retinal nerve cells. The neuroprotection mechanism of CNTF involves STAT-dependant, ERK-dependant, and Akt-dependant signaling technology (ECT) device is an efficient administration approach to deliver CNTF into the eyes, which is effective in retarding photoreceptor degeneration in several animal models with retinal degenerative diseases. The safety and efficiency of the device in clinical trials are also being evaluated currently for further clinical use in human eyes as a potential treatment.

With the increasing progress of cataract surgery, the postoperative residual astigmatism has become one of the factors that influences the desirable refractive outcome for patient. Correction of astigmatism has become an important aspect of refractive cataract surgery. There are several options for correcting astigmatism at the time of cataract surgery, which include using the cataract incision or astigmatic keratotomy to counteract pre-existing astigmatism, or using a toric intraocular lens (Toric IOL). All of these choices have their operational indications, inherent advantages and disadvantages. The central concern of astigmatism surgery lies in the preoperative measurement and subsequent surgical planning for its correction. And the correction effect will be influenced by various factors. This paper reviews the recent progress in treating astigmatism at the time of cataract surgery based on the above points.

Following the successful two "Chinese Ophthalmology Youth and Middle-aged Forum" held by the editorial board of Chinese Journal of Ophthalmology of Chinese Medical Association in 2009 and 2010, at the request of the majority of ophthalmologists, the "3rd Chinese Ophthalmology Youth and Middle-aged Forum (with Organizing Meeting)" sponsored by this journal will be held in Xiamen, Fujian Province from July 1 to 4, 2011. The content of this forum integrates the rational application of ophthalmic drugs and the promotion of new technologies and new equipment, focusing on comprehensively improving the diagnosis and treatment level of ophthalmologists. At that time, the academic leaders of ophthalmology in China (the editorial board of this journal) will be invited to give wonderful special speeches, and well-known young and middle-aged experts in ophthalmology will be invited to carry out academic discussions and experience exchanges on hot topics related to ophthalmology. Taking the forum as the main form and academic controversy as the leading thought, we focus on highlighting the development potential of young and middle-aged physicians, and strive to innovate the old and give full play to the academic guiding role of this journal.

The 3rd International Symposium on Uveitis will be held in Chongqing from December 1 to 3, 2011. This conference will be sponsored by Chongqing Medical University and the First Affiliated Hospital of Chongqing Medical University, co-organized by the Ophthalmic Immunology Group of Ophthalmology Branch of Chinese Medical Association, and undertaken by Chongqing Municipal Key Laboratory of Ophthalmology and Chongqing Institute of Ophthalmology. Renowned international and domestic uveitis experts will be invited to give special lectures. Ophthalmology colleagues are welcome to actively contribute and actively participate in the conference.

Sponsored by the Medical Aesthetics and Cosmetology Branch of Chinese Medical Association and co-organized by Beijing Tongren Hospital affiliated to Capital Medical University, the "2nd Symposium on Clinical Skills of Ophthalmoplasty and Cosmetic Surgery and the 2nd Tongren Sino-Korean Symposium on Ophthalmoplasty and Cosmetic Surgery" is scheduled to be held in Beijing Tongren Hospital affiliated to Capital Medical University from July 8 to 10, 2011.

The Chinese Medical Association is scheduled to hold the 16th National Ophthalmology Academic Conference and the 4th Global Chinese Ophthalmology Academic Conference in Guangzhou, Guangdong Province from September 8 to 11, 2011. This conference is another large-scale international event of ophthalmology held in China after the 15th National Ophthalmology Academic Conference of Chinese Medical Association and the 25th Annual Conference of Asia-Pacific Ophthalmology Society (2010APAO) in 2010. It is estimated that there will be 5,000 delegates participating in the conference. At that time, more than 1,000 famous international and domestic ophthalmologists will give special reports on new technologies, new knowledge and new experiences in ophthalmology development. As the 4th Global Chinese Ophthalmology Conference, famous Chinese ophthalmologists from all over the world will gather at this grand event to exchange and share the latest research results in ophthalmology and visual science with domestic colleagues. The conference will also hold a large-scale exhibition of ophthalmic medical devices and drugs. The organizing committee of the conference welcomes ophthalmologists from all over the country to contribute to the conference.

The Ophthalmology Center of Tianjin Medical University will hold a national continuing medical education program on cataract, glaucoma, ocular surface diseases and corneal refractive surgery from July 28 to 31, 2011 in Qinhuangdao, Hebei Province. The conference was co-organized by Qinhuangdao Maternal and Child Health Hospital.

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 an auxiliary diagnostic device with strong clinical practice, ocular surface confocal microscope can observe the corneal and conjunctival tissues in vivo in non-invasive, real-time dynamic and four-dimensional (three-dimensional + time), and can observe the relationship between various layers of tissues. Therefore, it has been widely paid attention by clinicians and scientific researchers.

The Atlas of Corneal Diseases, written by Professor Xie Lixin, academician of Chinese Academy of Engineering, leader of keratology group of Chinese Medical Association Ophthalmology Branch, and deputy editor-in-chief of Chinese Journal of Ophthalmology, was officially published by People's Medical Publishing House in March 2011. The book systematically reflects the clinical characteristics of corneal diseases in the form of images, characteristically reflects the effects of modern corneal imaging examination and modern scientific treatment, and enables readers to "read pictures".

In order to improve the writing level of authors' medical papers, especially English medical papers, the English edition of Chinese Medical Journal of Chinese Medical Association is scheduled to hold two "National Medical Paper Writing Seminars" in Guangzhou in June and Yinchuan in July, 2011. The seminar will invite domestic experts with rich experience in reviewing, submitting and writing in English to give lectures, including: how to write Chinese (English) medical papers that are easily accepted by magazines; How to report clinical randomized controlled trials; Ethical Problems in Essay Writing; Statistical problems in medical research and essay writing; Precautions for submitting articles to English medical journals at home and abroad; Manuscript handling procedures of international first-class medical journals; Clinical trial registration; Selection of scientific research topics in clinical work; A Brief Introduction to the Online Manuscript Processing System of Chinese Medical Journal.

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.

In order to improve the printing quality of the journal, this journal has been changed to CTP plate making since 2011. In order to guarantee the printing quality of the pictures after CTP plate-making, this journal makes the following requirements for the published pictures.

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.

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.

Sponsored by the Chinese Medical Association, this journal was founded on October 1, 1950, and is now a monthly magazine. The editorial committee is composed of more than 100 well-known ophthalmologists across the country. Currently Editor-in-Chief Zhao Kanxing, Deputy Editors-in-Chief Wang Ningli, Sun Xinghuai, Yin Zhengqin, He Shouzhi, Yao Ke, Cui Hao, Hui Yannian, Ge Jian, Xie Lixin (Academician of Chinese Academy of Engineering), Li Xiaoxin, and Director of Editorial Department Huang Yibin. For many years, the circulation, influencing factors, total citation frequency and other indicators of this journal are among the best in this professional journal in China. The papers are included in more than ten important databases at home and abroad, such as IM/MEDLINE, an internationally renowned retrieval system in the United States, and are the core journals of important domestic databases such as China Institute of Scientific and Technological Information. It has won the titles of "100 Outstanding Chinese Academic Journals" and "Demonstration Project of Excellent Scientific and Technological Journals of China Association for Science and Technology" successively. It is a famous brand journal in the domestic ophthalmology community that represents the national level externally and guides academic development internally, and is a good mentor and helpful friend of ophthalmologists in China.

1. Statistical symbols: According to the relevant provisions of GB3358-1982 "Statistical Terms and Symbols", all statistical symbols are printed in italics. Commonly used: (1) The arithmetic mean of the sample is lowercase x in English (the median is M); (2) Standard deviation is lowercase s in English;

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 a logo at the beginning 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.

Chinese Journal of Ophthalmology was founded in 1950. Over the years, India has recorded the development process of ophthalmology in New China, and has become an important part of ophthalmology in China. Up to now, it has become a fine journal that represents the national level externally and guides the academic development internally.

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, and at the same time enrich the content and form of this journal to better serve the majority of ophthalmologists, Chinese Journal of Ophthalmology continued to launch the "Picture Essence" column in 2011. The submitted pictures can be arranged according to the type of case or diagnostic technique, with relevant instructions,