Volume 47 · Issue 12 · 2011

Homonymous visual field defect which is usually caused by stroke,brain tumor and trauma,is common.In spite of partial spontaneous recovery,homonymous hemianopia still causes serious disability.Visual restoration therapy (VRT) based on the residual visual capability and brain plasticity theory was reported effectively enlarged visual field caused by impairment of visual pathway.Controversy still exits on the efficacy of these procedures.However,due to the high prevalence and poor outcome of visual pathway impairment,it is important to initiate multiple disciplinary co-operative study on VRT and other procedures for visual function rehabilitation to improve life quality of patients with retro-chiasmal visual pathway impairment.

Basic knowledge and skills are cornerstone of the diagnosis and treatment of neuroophthalmology diseases in ophthalmology practice. Due to the interdisciplinary features of neuroophthalmology,neuro-anatomy,neuro-physiology related to eyes,neuro-image and neuro-electrodiagnosis,these should be included in the education for the ophthalmologist.Special attention should be paid to training on capability of logically thinking in neuro-ophthalmology.Multiple ways can be used for the education of ophthalmologists and neurologists for the enhancement of basic knowledge and skills of neuro-ophthalmology in China.

Glucocorticosteroid (steroid) therapy is the major treatment for some important neuroophthalmological diseases.However,its efficacy,safety and abuse raise great controversy and debate for a long time,many clinical problems also remain to be solved.This paper discusses the issues relevant to the treatment of idiopathic optic neuritis by steroid and strongly advocate carrying out an evidence-based multicenter randomized clinical trial in China.It is suggested to establish a standard guideline or consensus for the treatment of neuro-ophthalmological diseases with steroid.

Objective To present the ophthalmological characteristics of McCune-Albright syndrome (MAS).Methods Case series study.Best corrected visual acuity (BCVA),visual field,color vision,retinal nerve fiber layer (RNFL) thickness,visual evoked potentials (VEP),fundus examination,computed tomography (CT) imaging of the optic canal,follow up results of multidisciplinary comprehensive treatments were analyzed.Results Of the 6 patients,three were male and three were female.Their age were between 4 to 43 years old (median,16 years old ). Based on CT imaging of the optic canal,encasement of the optic canal was found in all 6 patients (12 eyes ); three patients (6 eyes ) had circumferential encasement of the optic canal ; the remaining 3 patients ( 6 eyes ) had partial encasement of the optic canal. Two patients (3 eyes ) with circumferential encasement of the optic canal had optic neuropathy versus none in the remaining 9 eyes with circumferential or partial optic canal encasement.In addition,lengthening of the optic nerve was found in all 4 patients ( 8 eyes).Conclusion Optic canal encasement and lengthening of the optic nerve are common in MAS patients,which is worthy of attention in clinical practice.

Objective To investigate the clinical features,risk factors,diagnostic methods,treatment regimens and outcomes of Chinese adult patients with radiation optic neuropathy (RON).Methods Retrospective case series.Clinical data with RON admitted to Zhongshan Ophthalmic Center from June 1999 to October 2010 were investigated retrospectively.Results Thirty-five cases (61 eyes) with RON were analyzed. All cases manifested as sudden binocular or monocular painless vision decrease. In 18 cases (51.4％),symptoms occurred within 36 months after the completion of radiation. In 43 eyes (70.5％ ),the visual acuity was less than O.05 and/or with a visual field less than 10 degrees.In 52 eyes which the fundus could be examined,41 eyes (78.8％ ) showed a clear boundary of optic papilla,including 6 eyes (14.6％) with normal appearance of optic papilla,30 eyes (73.2％) with lighter color,5 eyes ( 12.2％ ) with pale optic papilla,and 11 eyes (21.2％) with edematous or hemorrhagic and/or exudative optic papilla.Only 14 eyes showed abnormal visual field examination,mainly manifested as nerve bundle defect scotoma.Seven eyes (50％) manifested as arcuate scotoma,3 eyes (21.4％) manifested as central scotoma and /or paracentral scotoma,2 eyes accompanied by blind spot enlargement,1 eye showed paracentral scotoma and 1 eye with quadrantanopia. Twenty-three eyes received fluorescein angiography (FFA),the major manifestations were low fluorescence at the optic nerve and areas of capillary nonperfusion.Pattern visual evoked potential revealed reduced amplitude and/or extended incubation period in 83.3％ eyes. Treatment regimens including systemic corticosteroids, hyperbaric oxygen therapy,hyperbaric oxygen in combination with corticosteroid and laser photocoagulation,the visual acuity of 10 eyes (16.4％ ) had merely been improved. Conclusions The prognosis of visual function in RON is poor resulting from devastating visual loss and/or visual field defect.The main damage of the fundus is retinal vascular occlusion and optic atrophy at different degrees. No adequately effective therapies are proved currently.The treatment aimed on the complication could only provide a short-term improvement of the vision.(Chin J Ophthalmol,2011,47:1071-1075)

Objective To compare the vascular risk factors between acute ischemic retinopathy (AIR) and nonarteritic anterior ischemic optic neuropathy (NAION).Methods Single center retrospective study.Patients diagnosed of AIR and NAION from Jan 2008 to Jan 2009 in Beijing Tongren hospital were enrolled in this study.The demographical data,the results of blood tests,cardiac examinations,carotid vascular ultrasound and brain MRI were analyzed by Chi-square test.Results Ninety-one AIR patients and 143 NAION patients were enrolled.The mean age of the NAION patients (51.4 ±8.9) was lower than that of the AIR group (55.4 ± 15.8) (t =2.514,P =0.013 ).There was no significant difference in the gender,smoking status,hypertension and fasting blood glucose levels between these two groups (x2 =0.023,2.727,0.217,0.012;all P ＞ 0.05 ).The percentage of hypercholesterolemia ( total cholesterol ＞ 5.17 mmol/L)was 46.2％ (66/143) in the NAION group and 26.4％ (24/91) in the AIR group (x2 =9.193,P =0.002)Prevalence of carotid artery disease and ischemic heart disease was 13.2％ ( 12/91 ) in the AIR group and 4.9％ (7/143) in the NAION group (x2=5.125,P =0.024).Carotid artery stenosis was present in 34.5％ (30/87) patients in the AIR group,whereas none in the NAION group (x2 =44.370,P =0.000).Among 57 AIR patients and 127 NAION patients who finished brain MRI,the percentage of cerebral infarction was 47.4％ (27/57) in the AIR group and 0.8％ (1/127) in the NAION group ( x2 =66.210,P =0.000).Cerebral white matter hyperintensities (WMH) were present in 66.9％ (85/127) of the NAION group and 36.8％ (21/57) in the AIR group ( x2 =66.46,P =0.000).Conclusions The mean age of NAION patients was lower than that of the AIR patients.Carotid artery stenosis and stroke,which might indicate large-middle vessel disease,are common in ischemic retinopathy. WMH with small vascular atherosclerosis,possibly caused by hypercholesterolemia,is more common in the NAION group.

Objective To identify the disease-causing mutation in a family of Leber hereditary optic neuropathy (LHON). Methods Clinical data and family information were collected. Peripheral venous blood was drawn from patients and family members who agreed to donate the blood samples.Genomic DNA was extracted from blood leukocytes.Three primary mitochondrial DNA (mtDNA) mutations,G3460A,G11778A,and T14484C were screened using a method of polymerase chain reaction (PCR) followed by direct sequencing. Results This 3-generation family had 14 members. Seven family members were affected,including 5 female patients and 2 male patients.Pedigree analysis showed maternal inheritance.Mutation analysis in 4 affected and 3 unaffected family members showed G11778A mutation in all 4 affected and 2 of the 3 unaffected individuals.Conclusions G11778A mutation in mtDNA is the disease-causing mutation in this family of LHON.For the mutation carriers,early intervention may prevent or delay the onset of the disease.

Objective To investigate the expression of microglia after optic nerve transection in rats.Method Thirty healthy adult female SD rats were randomly grouped to experimental and control groups according to the random number table.The experimental group received an optic nerve transection (ONT) on their right eyes.ONT was performed 1.5 mm from the eye ball.The control group received a surgery on day 5. Rats were killed 7 days after the first operation. Retinal ganglion cells (RGC) were retrograde labeled by placing fluorogold dye on the stump of the optic nerve. Microglia was immunohistochemically stained in the retinas of normal and 7-day injury groups using ionized calcium adaptive molecular 1 ( Iba-1 ) as the marker.The protein levels of Iba-1 in the retinas were also examined using Western blotting.The number of RGCs was quantified using flatmount of retinas in the two groups.Results There were some resting microglia (Iba-1 positive cells) in the nerve fiber layer and inner plexiform layer in the normal control retina.However,microglia showed a moderately activated morphology with increased Iba-1 immunoreactivity in the stroma and processes up to outer plexiform layer. Western blotting showed that the levels of Iba-1 was lower in the normal retina and increased to 2.3-fold 7 days after injury (t =7.669,P =0.001 ).The number of RGCs after injury was ( 1182 ± 64 ) per mm2,decreased to 51％ in the normal groups (t =23.85,P ＜ 0.0001 ).Conclusions The results implicated that microglia was increased and partially activated after the optic nerve transection.This may be a manifestation of the self-protection mechanism of RGCs against the injury insult.

Objective To investigate the role of endothelial progenitor cells (EPC) in the injury of rat optic nerve.Methods An experimental study.The rat model of optic nerve injury was created by fluid percussion brain injury device (FPI).On hundred and eight rats ( 108 eyes) were divided into 2 groups randomly.Each group was further divided into 9 subgroups by the time of injury (24 h before and 3,12,24,48,72 h,1,2 and 3 weeks after the injury).The number of circulating EPCs was measured,HE staining of the optic nerve,immunohistochemistry study of CD31 (markers of vascular endothelial cells) and flash-visual evoked potential (F-VEP) were observed at every time point.Two independent sample t-test was used for the comparison between the control group and the optic nerve injury groups at the same time point.The correlation between different items was analyzed by Pearson test.P value less than 0.05 was considered significant.Results The number of EPCs in normal rats was 46 - 52/200 000 monocytes.After traumaticoptic nerve injury,the number of EPCs was (34 ±4,34 ±5,69 ±9,76 ±6,107 ±9,69 ±7,58 ±6 and 56 ±4)/200 000 monocytes at 3,12,24,48,72 h,and 1,2 and 3 weeks.The difference of number of EPCs between the experiment and control groups was significant at 3,12,24,48,72 h and 1 and 2 weeks after the injury (t =5.29,2.90,-4.30,-7.61,- 14.17,-5.74 and -2.79;P ＜0.05).The number of CD31 + cell in the optic nerve and surround tissues in normal rats was (7 -9)/5 high magnification field.After the injury,the number of CD31 + cell was 8.36 ± 1.52,7.17 ± 1.10,10.41 ± 1.92,11.43 ± 1.58,14.29 ±2.03,17.33 ± 1.47,17.86 ± 1.22 and 18.13 ± 1.40 at different time points.The difference of number of CD31 + cell between the experiment and control groups was significant at 48,72 h,and 1,2,and 3 weeks after the injury (t =4.31,-7.61,-8.17,- 10.08,and - 10.79;P ＜0.05).The number of microvessels in the optic nerve and surround tissues in normal rats was 6 -9/5 high magnification field.After traumatic optic nerve injury,the number of microvessels was 7.54 ± 2.01,8.52 ± 2.21,11.02 ±1.62,15.40 ± 2.04,18.39 ± 1.96,23.21 ± 1.50,22.78 ± 2.40 and 24.13 ± 2.51 at different time points.The difference of number of microvessels between the experiment and control groups was significant at 48,72h,1,2,and3 weeks after the injury (t=4.25,-7.74,-8.26,-10.28 and -11.49;P＜0.05).The latency period of P waves was decreased at 3 h and increased to above basic level at 24 h,and then tend to be stable.The difference of latency period of P waves between the experiment and control groups was significant at 3,12,24,48,72 h,1,2 and 3 weeks after the injury (t =4.15,3.74,5.84,6.08,6.40,6.52,6.53 and 6.61 ;P ＜0.05).The amplitude of F-VEP was decreased at 3 h and increased to the basic level at 12 h,then decreased to below the basic level gradually.The difference of the amplitude of FVEP between the experiment and control groups was significant at 3,24,48,72 h,1,2 and 3 weeks after the injury (t =3.95,4.14,5.26,5.78,6.49,6.72 and 6.23 ; P ＜ 0.05).The number of EPCs was correlated with the number of CD31 + cell,microvessels and F-VEP ( r =0.43,0.41 and 0.43 ; P ＜ 0.01 ).Conclusions The present study showed that the number of EPCs in the blood increases significantly after traumatic optic nerve injury,and the cells can arrive the traumatic area to repair injured tissue and enhance angiogenesis.

Objective To investigate the incidence and relative factors of Terson syndrome in patients with aneurysmal subarachnoid hemorrhage(SAH).Methods A prospective case series study was conducted in 202 eyes of 101 patients with aneurysmal subarachnoid hemorrhage from November 2009 to May 2010.Fundus examination and color fundus photograph under mydriasis were carried out on every patient diagnosed as Terson syndrome with initial direct ophthalmoscopy after their general state was stable.The incidence of Terson syndrome was analyzed and correlated with gender,consciousness state,Glasgow Coma Scale score (GCS) and Hunt-Hess grade,anatomical locations of the ruptured aneurysms,mortality rate.Results Fifteen (14.8％ ) Terson syndrome patients were diagnosed in a total of 101 aneurysmal subarachnoid hemorrhage patients.Analysis of our data revealed no statistically significant difference between men and women in regard to the incidence of Terson syndrome ( x2 =0.615,P ＞ 0.05 ).A significant relationship was observed between consciousness state ( x2 =17.503,P ＜ 0.05 ),GCS score( x2 =7.673,P ＜0.05),Hunt-Hess grade ( x2 =9.987,P ＜ 0.05 ) and the incidence of Terson syndrome.A higherfrequency of Terson syndrome was demonstrated in patients with consciousness disturbance,lower GCS score and higher Hunt-Hess grade. However,no correlation was found between localization of the ruptured aneurysm( x2 =0.000,P ＞ 0.05 ),mortality rateand the occurrence of Terson syndrome.One case required surgical treatment during follow-up.Conclusions A higher frequency of Terson syndrome was observed in patients with aneurysmal subarachnoid hemorrhage, which had association with clinical conditions significantly.Therefore,the SAH patients with consciousness disturbance,lower GCS score and higher Hunt-Hess grade should be paid attention to ophthalmic conditions and performed fundus examination.The occurrence of Terson syndrome needs to be further explored whether to determine the prognosis in SAH patients.Terson hemorrhage absorbed spontaneously in most patients and required surgical intervention in very few patients.

Objective To evaluate the visual development and prevalence of amblyopia,strabismus among preschool children.Methods A random sample survey was performed in 4 610 preschool children from both urban and rural,aged 3 to 6 years. Participants underwent eye examination including visual acuity,refractive status,eye position,strabismus and amblyopia. Results Percentage of visual acuity above 1.0 was 28.4％,39.3％,46.2％ and 76.5％ in children of 3,4,5 and 6-year-old group,respectively.The mean visual acuity of each group was 0.63 ±0.19 in 3-years old,0.69 ±0.16 in 4-yearold,0.71 ±0.22 in 5-year-old,0.79 ± 0.29 in 6-year-old. Rural children have better vision acuity compared with those from uthan.Hypermetropic was frequent eftactive errors.Manifeststrabismus was found in 2.21％,with exotropia being more prevalence than esotropia; detection rate of recessive strabismus was 33.52％,mainly being exophoria; Based on current diagnostic criteria,the prevalence of amblyopia were 2.93％ in 6 year-old group,4.81％ in 5-year-old group,16.21％ in 4-year-old group,33.33％ in 3-yearold group.Conclusion Vision acutiy is increasing with age in preschool population.A diagnosis standard of amblyopia suitable for each age group should be established to substitute the current one which has a high visual standard for amblyopia.Refractive error,strabismus and amblyopia are the leading causes of visual impairment among preschool-aged children,which represent the focus of prevention of blindness in preschool children.

Objective To investigate the clinical characteristics and surgical treatment of bilateral Duane retraction syndrome.Methods To collect 24 cases with bilateral DRS among 123 cases with DRS from hospital data during 2005.7 to 2009.11. Retrospective study included the clinical types,characteristics,plus diseases and surgical treatments. Results Fourteen male cases (58.3％ )and 10 female cases (41.7％),aging 2 to 23-year-old. 16 cases were type Ⅰ ( 66.7％ ),1 case was type Ⅱ (4.2％ ).7 cases were typeⅢ (29.1％ ),in which patients with esotropia or exotropia were 3 and 4 cases respectively.11 cases had up- or down-shoot pre-operation,which disappeared or improved post-operation in 8 cases (73％). 15 cases had abnormal head posture(AHP) and AHP disappeared or improved in all.Seven cases (29％) were associated with other congenital ocular or systemic anomalies. For horizontal deviation,unilateral medial or lateral rectus weakening procedures were performed in 13 cases and bilateral procedures in 11 cases.Post-operation,horizontal deviation was less than ± 10△ in 21 patients (91％),1 case was under-corrected and 2 cases were overcorrected.Simultaneously,the restriction of ocular motility and global retraction were improved in all the patients.Additional vertical or oblique muscle procedures were performed in 4 patients among 7 with vertical deviation more than 10△ and up- or down-shoot.Conclusions Bilateral DRS has more frequency in male,obviously horizontal deviation in primary position and more cases with vertical deviation which is related with up- or down- shoot phenomenon.The key point for successful surgery are forced duction test pre- and during operation to conform to relieve the mechanical factor and estimating abnormal innervation in horizontal and vertical rectus.

Objective Explored the causation of a case of incomitant vertical strabismus accompanied with elevation deficit and globe retraction by surgery.Methonds Case report.Orbital imaging study of MRI was used to discover the anatomic feature of extraocular muscle.By released the restrictive structure to treat strabismus. Histopathologic inspection was used to confirm the origin of the abnormal structure.Results Abnormal extraocular muscle that located within the cone formed by the four recti muscles was the causation of strabismus.It arose at the annulus of Zinn,passing forwards between the inferior rectus muscle and lateral rectus muscle,and insert directly on the sclera.After Released it from eyeball and recession of inferior rectus muscle the strabismus was improved. Elevation deficit was not improved.Histopathologic inspection confirmed that the structure was muscular in origin.Conclusion The abnormal structure that found by MRI was the cause of elevation deficit and globe retraction. Its histopathologic inspection confirmed the muscular origin. The abnormal structure was an accessory extraocular muscle.For incomitant vertical strabismus accompanied with elevation deficit and globe retraction anomalous orbital structures maybe the causation.Orbital imaging studies should be done to explore the origin of disease.

Optic neuritis (ON) is a common disorder of the neuro-ophthalmology,which harms patients vision seriously.However,there are a lot of controversy and confusion about its etiology.While ON has familial characteristic and the tendency of heredity to some extent. Recently,association studies have made considerable progress with the rapid development of molecular biology techniques and statistical methods.In this article,the latest progresses in genetics of ON are reviewed.

Retina degeneration and neovascularization are present in many common retinal diseases,which can cause vision disability and blindness.Recent studies have demonstrated that the Notch signaling involves in regulating the development and differentiation of various tissues and cells.In this review,we discuss the compositions of the Notch signaling and its effects in the processes of retina development and angiogenesis.The Notch signaling pathway provides us a novel drug target for the treatment of retinal disease.

The patient, 85 years old, came to the Department of Ophthalmology, Shantou Central Hospital, Guangdong Province on May 4, 2011 due to blurred vision in both eyes for 30 years. He had no history of ocular trauma, denied history of uveitis and other diseases, denied history of systemic diseases such as diabetes and hypertension, and denied history of working in high-temperature environment. No abnormalities were found in the systemic physical examination. Eye examination: the visual acuity of both eyes was 0.25, the cornea was transparent, the aqueous humor was clear, and the lens was opaque. Diagnosis: senile cataract in both eyes. Two days after phacoemulsification and cataract aspiration and intraocular lens implantation in the right eye, the visual acuity of the left eye decreased. Eye examination: the visual acuity of the left eye was 0.15, the intraocular pressure was 26.7 mm Hg (1 mm Hg =0.133 kPa), and the anterior lens capsule in the pupil area was attached with a transparent membrane, about 2 mm ×2 mm. Coherence optical tomography of the left eye: lamellar exfoliation of the anterior lens capsule (essence picture 1). Diagnosis: senile cataract in the left eye; Exfoliation of the true lens capsule in the left eye.

The patient was a 12-year-old female with poor visual acuity in both eyes since childhood. She came to the Department of Ophthalmology of Panyu District Central Hospital of Guangzhou on December 5, 2010. No special eye examination and treatment were given in the past, and there was no history of other diseases. Her parents were not intimate married, her mother had no history of infection during pregnancy, and there were no similar patients in her family. General physical examination: general condition was good, normal development, and no digit deformity. Eye examination: visual acuity was 0.05 in the left eye and 0.1 in the right eye, and both eyes could not be corrected. Anterior segment examination of both eyes showed obvious abnormalities; See Essence Picture 1 for fundus examination.

The patient was a 19-year-old male who came to Changchun Yinuo Eye Hospital on May 13, 2011 due to poor visual acuity in his right eye.The eye examination showed that the visual acuity was 0.02 in the right eye and 1.0 in the left eye.The intraocular pressure was 15mm Hg in the right eye (1mm Hg =0.133 kPa) and 14 mm Hg in the left eye; Right eye exotropia 25.; The anterior segment of the right eye was normal, and no iris defect was seen; The fundus condition is shown in the essence pictures 1~3; the left eye is normal. Clinical diagnosis: congenital choroidal defect in the right eye; Useless exotropia of the right eye.

The patient was a 15-year-old female who was admitted to the Department of Neuroophthalmology of the PLA General Hospital for the first time on September 9, 2010 due to the decrease of visual acuity in both eyes for more than 7 months. The patient had suffered from paroxysmal headache for 6 months and decreased visual acuity in his right eye for 1 month. On February 22, 2010, the patient was admitted to the Department of Neurosurgery of the PLA General Hospital. At that time, the visual acuity of his right eye was only light sensing, and the visual acuity of his left eye was 1.0; the visual field of his right eye could not be completed, but the visual field of his left eye was normal; The pupils were normal on both sides, and right papilla edema was visible in the fundus of the eye. After admission, he was diagnosed as right ventricular tumor. On February 25, 2010, he underwent intraventricular tumor resection. Postoperative pathology confirmed that he was right ventricular subependymal giant cell astrocytoma. Ventricular shunt operation was performed 2 weeks after operation, and his visual acuity did not improve at the time of discharge.

The patient was a 66-year-old female who came to the Department of Ophthalmology of Beijing Anzhen Hospital on August 18, 2010 due to dark and blurry vision in her left eye for 1 day. The patient found dark and blurry vision in her left eye when she inadvertently blocked her right eye on August 17, 2010, and did not go to the hospital at that time. After waking up in the morning on the second day, she felt that the symptoms of her left eye were relieved, and came to the doctor in the afternoon. Past history: hypertension, hyperthyroidism, atrial fibrillation after radiofrequency ablation.

A 57-year-old male was admitted to the hospital on January 20, 2010 due to redness, pain and loss of vision for 1 month 4 months after lamellar scleral transplantation of his left eye. More than a year ago, his left eye was scratched by a branch, and he had left eye pain, foreign body sensation and other discomfort. He visited the local hospital many times and was given antibiotic eye drops, but there was no obvious improvement. He was transferred to a superior hospital for examination and found that the nasal sclera of his left eye was thinning, and the inferior uvea was visible. Then, he underwent amniotic membrane transplantation of his left eye in April 2009. After the operation, the patient still felt pain in his left eye, accompanied by redness and swelling, and increased secretion.

Choroidal osteoma is a rare benign tumor. There are many domestic reports on its fundus lesions, but there are few reports on its indocyanine green fundus angiography, and the manifestations are variable. The clinical data of a patient with monocular choroidal osteoma who went to the Department of Ophthalmology of the Second Hospital of Hebei Medical University are reported as follows. The patient, 24 years old, came to the Department of Ophthalmology of the Second Hospital of Hebei Medical University on November 4, 2010 due to a fist injury to his right eye for 1 day.

Takayasu arteritis, also known as pulseless disease or Takayasu arteritis and constrictive Takayasu arteritis, is an inflammatory disease characterized by chronic and progressive occlusion of the aortic arch and its branches. The fundus of patients with Takayasu arteritis clinically shows ischemic retinal vasculopathy. In 2007, we treated a patient with brachiocephalic Takayasu arteritis combined with monocular anterior ischemic optic neuropathy [1]. After two years of follow-up observation, the patient developed refractory retinal branch vein occlusion. The analysis report is as follows.

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. 1. Picture pixels are required to be more than 300 dots per square inch (picture formats are generally JPG, TIF, EPS).

After the editorial board of Chinese Journal of Ophthalmology of Chinese Medical Association successfully held two "Chinese Ophthalmology Youth and Middle-aged Forum" in 2009, at the request of the majority of ophthalmologists, the "Third Chinese Ophthalmology Youth and Middle-aged Forum (and Organizing Meeting)" sponsored by the editorial board of this journal and co-organized by the Institute of Ophthalmology of Xiamen University was successfully held in Xiamen, Fujian Province from July 1 to 4, 2011. This forum continued to open thematic lectures, focus arguments, free forums, outstanding essay awards and other sections, with rich academic contents and diverse forms, and was widely praised. The conference received nearly 200 academic papers, and more than 300 representatives attended the conference, covering nearly 20 provinces and cities across the country. At the same time, more than ten domestic and foreign ophthalmology product companies attended the conference.

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 years' 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.

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. 1. High-quality and influential scientific research papers. 2. The author needs to obtain the consent of the relevant journal, and there is no objection to the journal that publishes the paper for the first time and the journal that is going to be published again. The author is required to provide the republished journal with the consent of the journal for the first publication of the paper, the time of the first publication of the paper and a copy, single volume or original manuscript of the paper.

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 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.

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 and Hunan, Hubei, Henan, Hebei and other provinces, Eye, Otolaryngology Hospital affiliated to Fudan University, School of Optometry of Wenzhou Medical College and China International Science and Technology Conference Center of China Association for Science and Technology; The 12th International Conference on Ophthalmology and Optometry (COOC2012) jointly organized by Eye, Ear, Nose and Throat Hospital affiliated to Fudan University, China International Science and Technology Conference Center and Ophthalmology Branch of Zhejiang Medical Association will be held at Hangzhou Overseas International Convention and Exhibition Center from March 29th to April 1st, 2012.

Congenital cataract is the main eye disease causing blindness in children, and its incidence is about 0.06%, accounting for 5%-20% of children with blindness. Because infants and young children have unique anatomical and physiological characteristics, the treatment of congenital cataract has always been an international problem, and there are still many misunderstandings in the treatment at present. In order to further implement the concept of "patient-centered", adhere to the tenet of "letting the blind people with cataract see the light again", give more humanized care to the majority of children with congenital cataract, and better provide them with individualized, safe and high-quality medical services, the Cataract Department of Sun Yat-sen Ophthalmology Center of Sun Yat-sen University established the "Pediatric Cataract Home" on May 15th, 2011.

1. Statistical symbols: According to the relevant provisions of GB 3358-1982 "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; (3) Standard misuse of English lowercase sx; (4) t test is lowercase t in English; (5) The F test is capitalized F 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 the logo at the foot of the front page of the article, and the project number should be indicated in parentheses. The name of the fund project shall be filled in according to the official name stipulated by the relevant departments of the state, and a number of funds shall be listed in turn, separated by ";". All fund projects must be accompanied by copies of certificates.

The Atlas of Corneal Diseases edited by Professor Xie Lixin 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".

Clinical Pharmacology of Ophthalmology (2nd Edition), edited by researcher Chen Zuji of Henan Institute of Ophthalmology, has been published by Chemical Industry Press. This book is a comprehensive and systematic reference book on ophthalmic pharmacology and ophthalmic pharmacotherapeutics.

The book "Tongren Eye Surgery Techniques and Techniques", edited by Professor Wei Wenbin and Professor Shi Yuying of Beijing Tongren Eye Center, Beijing Tongren Hospital affiliated to Capital Medical University, has been published by People's Medical Publishing House. The book is divided into 9 chapters, 59 chapters, about 600,000 words, and about 500 illustrations. It mainly introduces the common minor surgeries of the external eye, as well as the surgical techniques and skills of cataract, glaucoma, cornea, vitreoretinal surgery, eye trauma surgery, strabismus and eye plastic surgery.