Volume 48 · Issue 01 · 2012

At the beginning of the new year, the editorial committee and editorial department of Chinese Journal of Ophthalmology of Chinese Medical Association extend the most cordial greetings to the ophthalmology colleagues who work in the front line of medicine, teaching and research! In the past year, the world political turmoil, financial, debt crisis plagued the United States and the European Union, lingering, people can't help but ask: What's wrong with the world? At the same time, the "emerging economies" with one-third of the world's population are growing steadily and rapidly, and people are wondering: What is success? What is failure? What is the best development model? How can Yin eat Mao grain continue? Developing economy or "playing with money"? My friend said, those are things that politicians and economists have to think about. What do they have to do with the development of our ophthalmology? What does it have to do with improving the level of running journals? Oh, my friend.

The eyelid and conjunctival sac of healthy individuals inherently supports a small population of bacteria.Alterations in the concentration and type of bacteria present in blepharitis and meibomian gland dysfunction have been reported.The most common sources of the bacteria causing endophthalmitis of postcataract surgery and corneal infections following laser in situ keratomileusis attribute to the eyelids and conjunctiva of the patients,It has become a routine admitting antibiotic eye drops during perioperation and irrigating conjunctival sac before operation,but it is not paid enough attention for dealing with eyelid.So,this article will discuss the impact of eyelid on surgical outcome,and it is helpful for reducing postoperative infection.

Descemet's stripping with automated endothelial keratoplasty (DSAEK) has the advantage of minor surgical injury and fast visual recovery,which has become the optimal surgical choice for endothelial disorders.It has unique complications closely related to surgical maneuver,skill of operation,and proper intervention.The most common complication is graft dislocation.The clinical finding appears corneal edema and whitish.A space is detected between the donor graft and recipient.The risk factors are lens-iris diaphragm defect and vitrectomy eyes.The common situation,rebubbling is a effective method.But viscoelastic maybe needed for abnormal anterior segment structure to reattach the dislocated graft.So DSAEK is a new type of surgery and it is necessary to acknowledge and understand its surgical features and complication.

Objective To report clinical results of non-Descemet stripping automated endothelial keratoplasty(nDSAEK) to treat graft failure after penetrating keratoplasty.Methods It was a retrospective case series study.Five cases of grafts failure after penetrating keratoplasty (PKP) were enrolled in this study.All patients had a cloudy and swollen grafts,which thicker than 620 μm,and had foreign body sensation,vision decrease.Of this 5 cases,4 of them are pseudophacic eye,1 is aphacic eye.One patient had previous vitrectomy,and 3 of them had one time history of PKP,2 of them had twice PKP treatment.All cases were treated by nDSAEK,the nDSAEK grafts were prepared as a 200 μm thickness and 8.00 to 8.75 mm in diameter by using hand or femtosecond laser asisted methods.The graft was inserted by forceps or suture pulling method through a 5.00 mm scleral tunel incision.Results One graft dislocated at lday postoperation,and was reattached by rebuble.All grafts keep clear during 8-28 months follow up period,and no immune rejection episodes were noted.The endothelial density were 865 to 2410/mm2.Postoperative best corrected vision (pBCVA) are better or equal to previous BCVA after pkp.Conclusion nDSAEK appears a good alternative surgical method for patients of grafts failure after pkp,especially for high risk patients of immune rejection.

Objectives To investigate the expression of matrix metalloproteinase-2 (MMP-2) and Tissue inhibior of matrix metalloproteinase-2 (TIMP-2) in rabbit corneas implanted with modified titanium skirt of keratoprosthesis in order to explore the potential roles.Methods A total of 20 New Zealand white rabbits with corneal alkali burn in right eye rabbit corneas were divided into three groups.There were 6 animals in each group.Skirt of hydroxyapatite /Sandblast-Titanium and Sandblast-Titanium were inserted into the corneal stroma of rabbits in group A and group B.The group C did not insert skirt as surgical control.2 rabbits were as normal control D group.A total of 20 New Zealand white rabbits were divided into four groups with the same way.The expression of MMP-2 and TIMP-2 was determined by immunohistochemistry at 1 month,3 months.The expression of MMP-2 and TIMP-2 mRNA level was determined by real time-polymerase chain reaction,and its protein level was determined by western blot.The optical cylinder was implanted to rabbit corneas,which were implanted with modified titanium skirt after 3 months.Results There was one case of corneal dissolution being found in group F.MMP-2 and TIMP-2 immunoreactivities were expressed in the normal comeas,predominantly in the corneal epithelium.After injury,immunoreactivities of both MMP-2 and TIMP-2 were increased notably in the healing corneal epithelium,infiltrating inflammatory cells,stromal fibroblasts and in growing vascular endothelial cells.The expression of MMP-2 was lower in group A and E than that in group B and F after 1 month and 3 months (t =12.05,2.93,12.006,3.781,P ＜ 0.05 ).The Western bolt revealed no significant differences of MMP-2 mRNA between group 3 months and 2 weeks ( t =2.104,P ＞ 0.05 ) ; MMP-2 immunoreactivities were absent or lowly expressed predominantly in the corneal epithelium of normal corneas.The expression of MMP-2,TIMP-2 mRNA level was paralled that of protein level.Conclusions The expression of MMP-2 was lower in the corneal tissue sections of HA/SB-Ti skirt inserted eyes than that in the tissue sections of SB-Ti skirt inserted eyes.The studies of MMP-2,TIMP-2 can provide a new way to prevent the incidence of corneal dissolving after surgery for keratoprosthesis.

Objective Use three different methods of amniotic membrane transplantation for acute alkaline burn of rat cornea,to investigate the difference on operation time,reabsorption time of amniotic membrane,integration patterns of amniotic membrane into the cornea among the three amniotic membrane transplantation methods.Methods SD rats were randomly assigned into five groups.Group A: simply alkaline burn of cornea; Group B: inlay method; Group C: overlay method; Group D: sutureless method;Group E: normal.Prepared the model of corneal alkaline burn of the right eyes of group A-D rats,performed three different methods of amniotic membrane transplantation on Group B-D rats respectively within 24 hours after alkaline burn.The operation time was recorded.Observed the eyes with slit-lamp microscopy after transplantation,recorded the reabsorption time of amniotic membrane.HE staining and immmunohistochemical staining against human collagen Ⅳ were performed for pathological study.The results were analysed with Image-Pro Plus 6.0 software.The integration patterns of amniotic membrane into the cornea after amniotic membrane reabsorbed were observed.Results ( 1 ) Operation time: Group B was ( 35.500 ± 2.878 )minutes ; Group C was ( 33.375 ± 2.973 ) minutes ; Group D was (9.875 ± 1.246 ) minutes.There was statistical significance between group B and group D ( P ＜ 0.001 ),group C and group D ( P ＜ 0.001 ).There was no statistical significance between group B and group C (P =0.102).(2) Reabsorption time of amniotic membrane: Group B was (16.625 ±3.662) days; Group C was (9.250 ±2.188) days; Group D was ( 12.833 ± 2.483) days.There was statistical significance among group B,C,D ( P ＜ 0.001 ).(3)There was significant inflammatory reaction around the suture in Group B and Group C,and there was unconspicuous inflammatory reaction in Group D.(4) There were three integration patterns of amniotic membrane into the cornea after amniotic membrane reabsorption: superficial localization,intraepithelial and intrastromal.We could find one or more integration patterns in same method of amniotic membrane transplantation,there was no statistical significance among group B,C,D ( P =0.86 ).Conclusions Amniotic membrane can integrate into the cornea after amniotic membrane reabsorption.Sutureless amniotic membrane transplantation which has short operation time and unconspicuous inflammatory reaction is better than traditional amniotic membrane transplantation,and it will be used extensively in the ophthalmology field in future.

Objective Randomized controlled experimental study to investigate the therapeutic effect and the possible mechanism of Pranoprofen on the recovery of dry eye induced by topical medication of Benzalkonium Chloride (BAC) in mouse.Methods It was an experimental study.Seventy BALB/c mice were treated with topical administration of 0.25％ BAC to establish the dry eye condition.Based on the consistency of break-up time of tear-film ( BUT ),corneal fluorescein staining scores and inflammation index,the eyes were re-selected and randomly divided into four groups on day (D) 21 after the BAC treatment.Group A was set up as blank control,while group B,C and D were treated respectively with 0.1％ sodium hyaluronate eye drops,0.1％ fluorometholone eye drops plus 0.1％ sodium hyaluronate eye drops,0.1％ pranoprofen eye drops plus 0.1％ sodium hyaluronate eye drops.BUTs,tear volumes,corneal fluorescein staining scores and inflammation index were evaluated in each group on DO,1,3 and 5 after the therapeutic treatment.Global specimens were collected on D6.Sections were stained with hematoxylin and eosin (HE) or by periodic acid-schiff (PAS) assay,and labeled with cytokeratin 10 (K10) antibody.The expression of tumor necrosis factor-α (TNF-α) in the cornea and conjunctiva was quantified by western blot.Results 72 eyes were included in the sequential experiment,18 eyes for each group.On DO,1 and 3,no clinical differences were observed among the groups.On D5,the BUT was (2.933 ± 0.320),(2.900 ±0.280),(3.464 ±0.498) and (3.643 ±0.413)s in group A,B,C and D respectively; the BUTs in group C and D were significant longer than those of group A and B ( F =13.774,P =0.000).The corneal fluorescein staining score was ( 11.640 ± 1.008),( 11.790 ± 1.188),( 10.330 ± 1.371 ) and ( 10.270 ±1.104)s in group A,B,C and D respectively; the scores in group C and D were significant lower than those of group A and B ( F =6.145,P =0.001 ).The corneal inflammatory index was (0.232 ± 0.059),(0.229 ±0.078),(0.151 ±0.055) and (0.154 ±0.056) in group A,B,C and D respectively; the index in group C and D were significant lower than those of group A and B (F =6.703,P =O.001 ).No significant difference was found in tear volume among groups.No significant difference was found between Pranoprofen and Fluorometholone treatment in BUT,corneal fluorescein score or inflammatory index.Corneal morphology showed the feature of thicker corneal epithelial layer in group A and uniformity in group C and D.PAS assay revealed similar goblet cell numbers in group C and D,but less goblet cells in group A and B.Cytokeratin 10 was almost negatively expressed in Pranoprofen or Fluorometholone treated groups,and remained positive in the corneal epithelium with other treatments.The level of TNF-αin the cornea was down-regulated in Pranoprofen or Fluorometholone treated groups.Conclusions Pranoprofen or Fluorometholone combined with sodium hyaluronate treatment presented similar therapeutic effects on BAC-induced mouse dry eye,with the more stable tear film,the better regularity of epithelium recovery,the down-regulation of inflammatory TNF-α,the increased number of goblet cells,and the elimination of squamous metaplasia,when compared with the treatment of sodium hyaluronate eye drops only.Our results showed the great potentialities of Pranoprofen in the clinical treatment of ocular surface inflammation in the mild and severity dry eye.

Objective To explore the change of contrast sensitivity (CS) in diabetic patients without diabetic retinopathy.Methods It was a case-control study.We screened and tested 52 type 2diabetic patients (89 eyes) and 47 healthy persons (68 eyes).OPTEC 6500 contrast sensitivity tester was used to examine near and distance CS values on 1.5,3.0,6.0,12.0,18.0 cycles/degree (c/d)respectively.We kept strict inclusion criteria on subjects,no retinopathy was found and best corrected vision acuity was above 1.0.The difference of CS values between these two groups was investigated,and the influence of gender,age,duration of diabetic mellitus and application time of insulin on CS values,respectively.T-test or u-test was used to compare the means of CS values between these two groups,near and distance CS values in each group.Simple linear correlation and multiple regression analysis were used to analyze the single factor and multiple factors correlation between CS values and age,duration,gender and application time of insulin,respectively.Results The maximum CS values in both distance and near were 112.67 ±43.97,85.85 ±41.83 and 83.68 ±35.91,55.20±24.14,both appeared in 6.0 c/d.The minimum CS values in both distance and near were 26.19 ± 17.69,12.69 ± 7.09 and 18.68 ± 11.81,8.22 ±5.68,respectively,both appeared in 18.0 c/d.Distance and near CS values in diabetic group and control group had very significant differences at these five spatial frequencies (From 1.5 to 18.0 c/d,the test values on distance,t =3.11,3.38,2.77,3.48,3.86 ;P ＜ 0.05 ; the test values on near,u =3.70,3.22;t' =3.69,3.88,4.25 ;P ＜ 0.05).Abnormal rate in diabetic group on high,medium,low and all frequencies were higher than control group,regardless of distance or near CS values ( in near x2 =11.86,8.17,9.14,5.81 ;P ＜ 0.05 ; on 4 combinations in distance x2 =13.27,6.70,4.01,4.50;P ＜ 0.05).In diabetic group,gender related with 3.0 and 6.0 c/d CS values on near-distance ( r =0.26,0.28 ; P ＜0.05 ) ; age related with high-frequencies on near ( r =- 0.45,- 0.28 ; P ＜ 0.05 ) ; duration of diabetic mellitus related with high-frequencies on near( r =-0.25,-0.39;P ＜ 0.05 ),and related with medium,high frequencies on distance ( r =- 0.26,- 0.28,- 0.30,- 0.34 ; P ＜ 0.05 ) ; application time of insulin related with high-frequencies on distance ( r =- 0.30,- 0.31 ; P ＜ 0.05 ).Conclusions There exists important sense of CS value on showing visual function changes accurately in early-stage of diabetes mellitus.The high frequencies on distance is the sensitive index in vision impairment.Duration of diabetes closely relates with changes of retinal function ultimately,can be classified as the most important risk factor of CS values decline in early-stage diabetic patients.

Objective To conclusion the clinical features and image features,the diagnosis and management of orbital hemangiopericytoma,in order to direct clinical diagnosis and differential diagnosis.Methods Seventeen patients with pathologically confirmed orbital hemangiopericytoma were analyzed retrospectively.Results Patients usually complained of exophthalmos.Fourteen patients can be touched the tumor in the orbit.In B-scan ultrasound,a well outlined lesion was revealed.The type of it was often similarly circular or anomaly.The extent of internal echo was associated with histological structure of lesion.Color doppler flow imaging show that the tumor has rich feeding vessels.Some of them is arterial feeding vessels.On CT scan,hemangiopericytoma generally appears to be a uniform high-density mass with obvious enhancement upon injection of contrast material.All cases underwent surgical resection and are proved by pathological examination.Conclusions Orbital hemangiopericytoma is a potentially malignant tumor.The prognosis and clinical behavior can't be predicted on the basis of their histopathologic classification.Medical imaging can help to demonstrate the site,configuration,and characteristics of the tumors and contribute to the treatment.But,there has not characteristic medical features.The final diagnosis must be depend on the pathology.The best management of hemangiopericytoma is complete local excision.All the patients must be observed nearly.

Objective To investigate the influence of vascular endothelial growth factor (VEGF) and transforming growth factor (TGF)-β2 to human retinal pigment epithelium(RPE) cell differentiation,and the mechanism of collagen gel contraction mediated by RPE cells.Methods Experiment study.An in vitro collagen gel contraction assay was performed to evaluate the effect of cultured human RPE in addition of VEGF and TGF-β2 at indicated time points (24 h,48 h and 72 h).Three groups were established in the experiment:control group,50 μg/L VEGF group and 5 μg/L TGF-β2 group.The effects of both cytokines on the collagen gel contraction were analyzed by the reduced diameter of the collagen gel.And the changes of cell morphology and their transdifferentiation were assessed to estimate the possible connection between RPE transdifferentiation and collagen gel contraction.One-way ANOVA was used in conjunction with SNK-q test to assess statistical significance at different time periods within groups.Results There were differences on collagen gel contraction rates among VEGF group [ ( 34.7 ± 3.1 ) ％,( 44.3 ± 6.0 ) ％,( 44.0 ± 7.2 ) ％ ],TGF-β2 group[ (29.3 ±3.1)％,(31.7 ±3.5)％,(29.0 ±3.6)％ ] and control group[ (20.0 ±0.5)％,( 17.3 ± 3.6) ％,( 19.1 ± 0.8 ) ％ ] at 24 h,48 h and 72 h after cultured ( 24 h: F =26.220,P =0.001 ;48 h:F =26.796,P =0.001 ;72 h:F =21.522,P =0.002),and on each time point two two comparison in the three groups ( SNK-q test,P ＜ 0.05 ).There were differences on protein expression level of α-smooth muscle actin (α-SMA) in 50 μg/L VEGF group and 5 μg/L TGF-β2 group at difference time points,respectively ( TGF-β2 group: F =1.134,P =0.000 ; each time point: SNK-q test,P ＜ 0.05 ; VEGF group: F =279.179,P =0.000; each time point: SNK-q test,P ＜ 0.05 ).Moreover,TGF-β2 ( 5 μg/L) demonstrated stronger and more permanent gel contraction than VEGF ( 50 μg/L) ( 6 h: F =3.646,P =0.000 ; 24 h: F =18.706,P =0.003 ;48 h:F =124.195,P =0.000;72 h:F =76.811,P =0.000).RPE cells' form happened fibroblasts sample transformation in both VEGF group and TGF-β2 group.Conclusions Both VEGF and TGF-β2 can induce the collagen gel contraction,partly by means of inducing the expression of α-SMA and RPE contraction,which may thus contribute to the explanations of vitro-retinal diseases.

Objective To study the cellular morphological characteristics and changes of corneal endotheliitis by corneal microstructure in vivo.Methods Forty-eight clinical diagnosed patients of corneal endotheliitis were examined by in vivo confocal microscopy.Confocal images of different layers were collected and observed.Of all the patients,39 were disciform and 9 were diffuse.The history of the 48 patients was from 7 days to 23 years and the duration was from 4 to 180 days.Results Epithelium revealed cellular edema,enlarged intercellular gaps,and bubble between the cells.The density of sub-basal nerve plexus was significantly lower than that of normal,even disappeared in 24 patients.A numerous dendritic cells (Langerhans cells,LCs ) presented in the basal epithelium layer and gradually abated with disease regression,but the density of LCs was significantly higher than that of the contralateral eye.The keratocyte revealed edema and to be activated.Inflammatory cell was found in stroma of the patients with long history and duration disease.Endothelium cells were observed edema,with enlarged intercellular gaps.Inflammatory cells was found to infiltrate into the endothelial layer,most them gathered to be keratic precipitates (KP),which were rounded or elliptic and inserted between the endothelium by pushing the endothelium away,and induced decayed area between the endothelium.Conclusion Corneal endotheliitis was not only the inflammation of endothelium,but also varied pathological changes of all layer of the cornea.Corneal endotheliitis patients with long history and duration presented the mixed type with stromal keratitis.The lower density of sub-basal nerve plexus and the higher density of dendritic LCs were the characteristics of endotheliitis.Impairment of intercellular junction by KP might be another important role of cornea edema.Sufficient and accurate treatment of endotheliitis was important.

The patient was a 29-year-old male who came to our department on February 25, 2009 due to sexual degradation of binocular visual acuity and left eye weight for more than 4 years. The patient had been diagnosed with "binocular keratoconus" in other hospitals. In the past, the visual acuity of the left eye reported obvious decline after bull horn impingement, and there was no surgery or family history. Eye examination: naked eye visual acuity: right eye 0.4, left eye 0.05, corrected visual acuity: right eye wearing rigid gas permeable contact lens (RGP) with curvature of 7.50 degrees-7 25D and diameter of 9.0min, corrected visual acuity was 1.0, left eye frame glasses were not improved, and RGP could no longer be worn. Slit lamp microscopy: right eye conjunctiva and sclera were not abnormal, cornea was spherical swelling (Figure 1), central cornea was still transparent, peripheral posterior elastic layer folds and streaky clouds, The anterior chamber was deep. The spherical bulge of the cornea in the left eye was significantly heavier than that in the right eye, and the posterior elastic layer was folded and streaky cloudy in the central and peripheral parts (Figure 2).

The patient was a 32-year-old male. Four months ago, he showed dryness in both eyes without obvious trigger. He went to our hospital. Physical examination revealed that the ocular surface of both eyes was dry, the tear film rupture time of both eyes was 2 s, and the basic tear secretion was 0.4 mm/min in the right eye, 1 mm/min in the left eye, and reflex secretion was 0.6 mm/min in the right eye and 3 mm/min in the left eye. He was diagnosed as "binocular dry eye syndrome", but there was no obvious improvement after artificial tear spot. One month ago, he went to our hospital for a follow-up examination, and corneal ulcers in both eyes were found. After symptomatic treatment with "ofloxacin eye ointment and calf blood deproteinized extract ophthalmic gel", they were slightly improved. 10 days ago, the above symptoms were aggravated with foreign body sensation in the left eye. He went to our hospital for a follow-up examination, and the corneal ulcers in both eyes were found to be aggravated, but there was no obvious improvement after adding glucocorticoid, antibacterial, antiviral and mydriasis treatment. On December 18, 2009, he went to our hospital for a follow-up examination, and the examination found that "right corneal ulcer and left corneal perforation" was urgently admitted to the hospital.

The patient was a 51-year-old female. On April 27, 2010, she came to Cangzhou Eye Hospital for treatment mainly due to blurred vision in her right eye with eye swelling and pain for 20 days. She was in good health in the past. Ophthalmological examination showed that the visual acuity was 0.5 in the right eye and 0.5 in the left eye. The intraocular pressure was measured by non-contact tonometer. The right eye was 33 mm Hg (1 mm Hg =0.133 kPa), the left eye was 17 mm Hg. The conjunctiva of the right eye was mildly hemorrhagic, corneal edema, retrocorneal deposit (+), the anterior chamber depth was acceptable, and the aqueous humor flashed (+). A flocculate deposit of about 1 mm was visible below the anterior chamber, and a pink mass with clear boundaries was visible at 11 points of the iris. The surface was white plush, about 5 mm ×4 mm in size, and the epiris was scattered with brown nodules, the pupil was round and centered, the light reflection was slow, and the lens was opaque (Figure 1). The fundus of the eye was unclear under the small pupil, and no abnormalities were found in the anterior segment and fundus of the left eye. Auxiliary examination, ultrasound biomicroscopy of the right eye showed that the anterior chamber depth was acceptable, and at 11 o'clock, a round solid light group with medium and high echoes was seen at the pupil margin on the iris surface, with uniform internal echoes and clear boundaries. It was closely connected with the iris tissue. There were accumulated strong echoic spots in the lower chamber angle and the front of the iris, and there was no abnormality in the ciliary body, suggesting that the iris was solid space-occupying lesion (Figure 2). B-ultrasound examination of the right eye showed that the vitreous body was opaque, and there were no abnormal echoes in the retina and choroid.

Terson's syndrome is also known as subarachnoid hemorrhage combined with vitreous hemorrhage syndrome [1]. When a large amount of blood in the retina or before the retina enters the vitreous body, it can cause severe vision loss. Terson's syndrome without intracranial hemorrhage is rare. One case was admitted to our ophthalmology department in 2010. The analysis report is as follows. The patient, a 33-year-old man, was abrased from top to bottom by a 1.5m ×1.5m ×1.0m stone from the head, neck and back on November 21, 2009. He immediately went to the emergency department of the local hospital. X-ray radiographs showed multiple fractures of the 6th and 7th cervical vertebrae, accompanied by intervertebral spondylolisthesis of the 6th and 7th cervical vertebrae, and soft tissue contusion of the head. He underwent neck fracture reduction surgery immediately. After operation, his vision was blurred in both eyes, but no examination and treatment was given. On January 8, 2010, he felt that his vision was obviously aggravated, his vision was deformed, and his vision range was narrowed. After the ophthalmology examination of the local hospital, he was diagnosed as "double fundus hemorrhage and macular degeneration", and no special treatment was given.

The patient was a 51-year-old male who came to the Department of Ophthalmology of the First Affiliated People's Hospital of Shanghai Jiaotong University for more than 1 week due to decreased visual acuity in his left eye with fixed black shadow. He had a history of high myopia, hypertension, no history of trauma and diabetes. Ocular examination: corrected visual acuity in his left eye was 0.3, cornea was transparent, and pupil was round.

The patient was a 28-year-old male. During physical examination, abnormalities in front of the optical papilla of his left eye were found, and he came to the Department of Ophthalmology of Beijing Military Region General Hospital. Eye examination: visual acuity of both eyes was 1.5, the anterior segment of his left eye was normal, and the fundus of his left eye was shown in the essence picture 1. Fluorescein fundus angiography was shown in the essence picture 2. Clinical diagnosis: vessel loop of the anterior vein of the optical papilla of his left eye; Retinal vascular abnormalities in the left eye.

fungal keratitis fungal keratitis is a kind of blinding keratopathy caused by pathogenic fungal infection, which ranks first in the blinding rate of infectious keratopathy in China [1]. The disease is mainly related to plant trauma, and its prevalence has been increasing in recent years. 1. Etiology and pathogenesis The main fungal genera causing corneal infection vary greatly in different regions. The most common pathogenic bacteria in developed countries and cold climate areas is Candida; Fusarium (70% ~80%) and Aspergillus (10%) are the main factors in China [2]. The disease has obvious pathogenic risk factors, which are mostly related to plant-induced ocular trauma, wearing contact lenses, long-term use of immunosuppressants or glucocorticoids and chronic ocular surface injury diseases [2].

In recent years,zebrafish has become ideall animal models of human disease with its unique characteristics,such as small body,fecundity,fast development and growth,embryo transparency,and so on.Furthermore,the structure and gene of zebrafish eye are highly conservative with human eye,which make ophthalmologists to pay close attention to zebrafish.This review focus on the studies and applications on zebrafish embryonic development of anterior segment,including the morphogenesis of cornea,lens and anterior chamber,and diseases of anterior segment (corneal diseases,cataract,glaucoma).

Toll-like receptors (TLRs) were identified as transmembrane signal transduction proteins in recent years.As a group of pattern recognition receptors (PRRs),TLRs play important roles in the innate immunity by recognizing pathogen-associated molecular patterns (PAMPs).Activated innate.immunity subsequently leads to effective adaptive immunity.It,thereby,activites not only innate but ultimately also adaptive immunity.It has been reported that some kinds of TLRs expressed in corneal epithelial cells,stroma cells and endothelial cells.In addition to their recognition function,TLR activation triggers a complex signal transduction cascade that induces the production of inflammatory cytokines and co-stimulatory molecules,thus initiating innate and adaptive immunity.And TLRs play an important role in innate and adaptive immunity of fungal keratitis.In summary,further studies on the regulation of intracellular signaling transduction will contribute significantly to our understanding of immunoregulation of fungal keratitis,eventually provide some way to cure the fungal infection.

Glaucomatous optic neuropathy is a chronic diseaseJ accompanied by visual field loss,cupping of optic nerve head,and apoptosis of retinal ganglion cells (RGCs). The mechanism ofglaucomatous optic neuropathy is unknown but glial cells play an imponant role in glaucomatous optic nervedamage and the repair process.We review the role of glial cells in the remodeling of optic nerve head,apoptosis of RGCs and immune reactions in glaucoma.

Primary angle closure glaucoma is one of the common diseases causing blindness.The Pathogenesis inducing primary angle closure glaucoma has not been entirely clear.Traditionally identified risk factors include shallow anterior chamber,short axial length and thicker lens.Recent studies begin to pay attention to other new risk factors,not only including static anatomical factors,such as anterior chamber volume,iris curvature and lens vault,but also including dynamic changing factors,such as dynamic dilation of iris volume and choroidal effusion.Comprehensive assessment of these risk factors is of great significance for early diagnosis and treatment of angle closure glaucoma.This article briefly reviews research advances in risk factors of primary angle closure glaucoma.

The Institute of Ophthalmology of Tianjin Medical University will hold the "Unveiling Ceremony of the Institute of Ophthalmology of Tianjin Medical University and the Frontier Forum of Ophthalmology" in the Lin Shaoming International Lecture Hall of the Ophthalmology Center from March 2 to 4, 2012 (Friday to 13).

With the approval of Ophthalmology Branch of Chinese Medical Association, the 12th National Academic Conference on Corneal and Ocular Surface Diseases and the 4th National Conference on Corneal Refractive Surgery will be held in Chengdu from May 24 to 26, 2012. The Keratology Group of Ophthalmology Branch of Chinese Medical Association, West China Hospital of Sichuan University and Sichuan Medical Association, the organizers of the conference, and Chinese Journal of Ophthalmology, the cooperative academic media of the conference, jointly invited domestic and foreign ophthalmologists, colleagues and ophthalmology business people to attend.

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.

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.

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 "Choroidal Neovascular Diseases", edited by Professor Wang Yusheng, Department of Ophthalmology, Xijing Hospital, Fourth Military Medical University and Institute of Ophthalmology, written by frontline scientific and technical personnel engaged in clinical and basic research of ophthalmology and visual science in Fourth Military Medical University, reviewed by Professor Yan, West China Ophthalmology Center, Sichuan University, and prefaced by Professor Luo Chengren, has been officially published by People's Medical Publishing House.

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.

The book "Keratology" co-edited by Professor Xie Lixin and Professor Shi Weiyun of Shandong Institute of Ophthalmology has been officially published by People's Medical Publishing House.

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 description format of reference documents in this journal basically implements GB/T7714-2005 (Rules for the Description of Reference Documents after Text). The description is made by sequential coding, which is marked with Arabic numerals according to the order in which it appears in the text, and the serial number is placed in square brackets and arranged at the end of the text. Try to avoid citing abstracts as references. Do not cite internal publications, unpublished materials, personal correspondence, etc. as documents. Quoted documents (including the text and the original meaning expressed) are asked to be checked by the author with the original.

1. Statistical symbols: According to the relevant provisions of GB3358-1982 (Statistical Nouns and Symbols), statistical symbols are typeset in italics. Commonly used: (1) The arithmetic mean of the sample is in English lowercase (median is in M); (2) Standard deviation is in English lowercase s; (3) Standard misuse of English lowercase sx; (4) t test is in English lowercase t; (5) F test is in English capital F; (6) Chi-square test is in Greek lowercase x2; (7) The correlation coefficient is lowercase r in English; (8) Degrees of freedom are lowercase v in Hiven; (9) The probability is capitalized P in English (specific test values should be given before the P value, such as t value, x2 value, q value, etc.).

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, this journal continued to open the "Picture Essence" column in 2012.

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.

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

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.

Chinese Journal of Ophthalmology was founded in 1950. Over the past 60 years, it has recorded the development 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. In order to meet the needs of the development of the information society and raise the awareness of serving the majority of ophthalmology colleagues, this journal has specially opened the "Chinese Ophthalmology Journal Network", the website is http: / /www.cjo-eye.com.

Chinese Journal of Ophthalmology is a professional academic journal of ophthalmology sponsored by Chinese Medical Association. It targets ophthalmologists as the main readers, reporting leading scientific research achievements, clinical diagnosis and treatment experience in the field of ophthalmology, and basic theoretical research that has a guiding role in ophthalmology clinical practice and is closely integrated with ophthalmology clinical practice. The purpose of this journal is to implement the principles and policies of the Party and the state on health work, implement the principle of combining theory with practice, popularization and improvement, reflect the significant progress of clinical and scientific research in ophthalmology in China, and promote academic exchanges in ophthalmology at home and abroad.