Volume 48 · Issue 02 · 2012

Millions of intravitreal injections were performed for the patients with neovascular eye diseases each year.The intravitreal injection has become a routine medical procedure in daily practice of ophthalmologist.Although the risk of post-injection endophthalmitis is low,the prevalence is increasing as more patients received injections.Once occurred,endophthalmitis can lead to irreversible vision loss.To reduce the potential rising risk of post-injection endophthalmitis,establishing guidelines for intravitreal injection is urgent. We reviewed the clinical research evidences on the causes and characters of postinjection endophthalmitis as well as the preventive actions. A standard operation pattern on intravitreal injection is also introduced.

Optical coherence tomography (OCT) is a non-invasive,high-resolution imaging modality to acquire cross-sections and three-dimensional images of the microstructure in biological specimens.Because of rapid improvement of acquisition speed and axial resolution of OCT over recent years,OCT is becoming increasingly used in clinic for diagnosing or analyzing diseases of the eye,especially in the fundus.However,OCT has been used regardless of the location of lesions and the clarity of optical media.This misuse wastes resources and delays diagnosis and treatment of certain ocular diseases.Furthermore,the image of SD-OCT cannot be analyzed completely at present. Therefore,how to apply OCT in clinic appropriately and to analyze its image professionally is crucial,which should attract the attention of ophthalmologists.In addition,comprehensively analyzing ocular diseases combined with other examinations is extremely important to improve the level of diagnosis.

Age-related macular degeneration (AMD) is the leading cause of irreversible visual loss in aged population. As the aging of population,the prevalence of AMD increases gradually.Anti-VEGF medication intravitreal injection,which can obtain good therapeutic efficiency and is relatively safe,becomes the main therapy for neovascular AMD. However, high-frequency repeated treatment increases the intravitreal injections risk,as well as the costs. In clinical practice,to pursue the best-corrected visual acuity,high-frequency repeated injections are implemented and inflict psychological pressure and economic burden on patients.The author believes that to pursue the best corrected visual acuity is the ultimate aim but not the only one for every ophthalmologist and patient.The activity of lesions should be overall evaluated with fundus imaging technologies.Being people-oriented is the principle in clinical medicine.A treatment plan is made according to the patients＇ sickness and economy and to coordinate the relation between the best corrected visual acuity and the numbers of treatment. Based on the stabilized lesion,patient should be benefited at the lowest risk and cost with the best effect.

Objective To evaluate the effect of Spectralis HRA + OCT-guided photodynamic therapy with half-dose verteporfin in the treatment of chronic or recurrent central serous chorioretinopathy.Methods It was a retrospective case series.Twenty eyes of 18 patients with chronic or recurrent central serous chorioretinopathy were included.PDT was applied with half-dose verteporfin (3 mg/m2 ) on the site of active area shown on Spectralis HRA + OCT (defined as focal or diffuse retinal pigment epithelial leakage,choroidal hyperpermeability,or pigment epithelial detachment located within the neurosensory detachment),and patients were observed to determine the anatomic and functional outcomes. Statistical analysis was performed using SAS ( version 9.2).A P value of 0.05 was considered statistically significant.Comparisons of pre- and post-treatment best-corrected visual acuity (BCVA) and central foveal thickness (CFT) were performed using a paired t test.The relationship between BCVA and CFT post-treatment was analyzed by linear correlation analysis.Comparisons of the BCVA of eyes with and without the integrity of photoreceptor IS-OS and/or external limiting membrane at the last follow-up visit were performed using two sample t test.Results The median CSC duration was 4.5 months ( ranged 1 month to 2 years).The median follow-up period after PDT was 8 months (ranged 6 to 20 months).The mean BCVA before PDT was 0.35 ± 0.16 ( ranged 0.05 to 0.6),at 3 months after PDT was 0.72 ± 0.32 ( ranged 0.1 to 1.5 ) and at the last follow-up visit was 0.78 ± 0.29 ( ranged 0.3 to 1.5 ) ( t =6.444,6.883,P ＜ 0.05 ).Fifteen eyes (75.0％) had improved vision,and 5 eyes (25.0％) had stable vision.The mean CFT was reduced from ( 369.0 ± 120.9) μm before PDT to ( 193.3 ± 30.6) μm 1 month after PDT,( 194.9 ± 28.3 ) μm 3 month after PDT and ( 190.6 ±33.7) μm at the last follow-up visit (t =-6.836,-6.826,-7.316;P ＜ 0.05).At the last follow-up visit BCVA was not correlated with CFT (r =0.166,P ＞ 0.05 ),but BCVA of the eyes with the integrity of photoreceptor IS-OS and/or external limiting membrane was better than that of without (t =- 3.53,P ＜ 0.05 ).Subretinal fluid disappeared in all eyes 1 month after PDT and there was no recurrence during the follow-up.Conclusions Spectralis HRA + OCT-guided photodynamic therapy with half-dose of verteporfin seems effective and safe for the treatment of chronic or recurrent central serous chorioretinopathy.

Objective The collection of buccal cells with swabs provides a noninvasive method for obtaining genomic DNA for genetic screening.We aimed to study the feasibility of using buccal swabs for genetic screening in patients with exudative age-related macular degeneration (AMD).Methods Blood and buccal swabs were collected for genetic analysis from 65 patients with exudative AMD.Genomic DNA was isolated from either blood or buccal swabs.The yield of genomic DNA from both sources was determined by spectrophotometer.Genotyping for CFH,LOC387715,and HTRA1 Polymorphisms was performed using a method of polymerase chain reaction (PCR) followed by restriction enzyme digestion.Results using genomic DNA from blood or buccal swabs were compared.Results Three swabs were obtained from each patient,2 from each side of buccal mucosa,and 1 from both upper and inferior gingival mucosa.From swabs with genomic DNA extracted within a week after sample collection,an average of (3.17 ± 1.46) μg genomic DNA was obtained from swab collected from the left or right side buccal mucosa,and ( 3.94 ± 1.04) μg from swab collected from the upper and inferior gingival mucosa,with relatively higher yield of genomic DNA from the upper and inferior gingival mucosa ( t =6.79,P ＜ 0.05 ).From swabs of the left or right side buccal mucosa after being stored at -20 ℃ for 12 months,an average of (3.10 ± 1.17) μg genomic DNA was obtained,which showed no statistically significant difference as compared to the yield of genomic DNA extracted from newly collected swabs (t =0.59,P ＞ 0.05).In all 65 patients,genomic DNA isolated from either buccal swabs or blood samples showed exactly the same results regarding the genotypes of CFH,LOC387715,and HTRA1 Polymorphisms. Conclusions Buccal swab is a simple,noninvasive,and reliable source for obtaining genomic DNA.Swabs stored for 12 months at - 20 ℃ provide similar amount of genomic DNA as the freshly collected swabs.

Objective To compare the thickness and functional changes of the macula after idiopathic macular epiretinal membrane (IEM) surgery. Methods A retrospective study. Thirty-seven patients (37 eyes) received surgical treatment of IEM.All patients received standard three-port vitrectomy as well as epiretinal membrane peeling.The best corrected visual acuity (BCVA,LogMAR) were recorded and optical coherence tomography (OCT) were used to evaluate central foveal thickness (CFT).Microperimetry (MP)-1 was used for the mean sensitivity (MS) of central 10° macula area.SPSS13.0 was used for statistical analysis. Rank and testing methods were used to compare the preoperative and postoperative BCVA,paired t testing method was used to compare the preoperative and postoperative CFT and MS values. Correlation analysis was used to study the BCVA,CFT,and MS. Pearson correlation analysis was applied to analyze measurement data and Spearman rank correlation analysis was used to analyze rating data.Results Postoperatively,the BCVA (0.1-0.7,median 0.4) was significantly better ( Z =- 4.97,P ＜ 0.05 ) than the preoperative one ( 0.3-1.3,median 0.7 ).The CFT ( 246.2 ± 60.4 ) μm was significantly thinner (t =15.86,P ＜ 0.05 ) than the preoperative one (482.2 ± 101.8 ) μm.The MS of central 10° macula area ( 18.6 ± 1.8 ) dB was significantly higher ( t =- 9.20,P ＜ 0.05 ) than the preoperative one ( 14.1 ± 3.4) dB.Thicker preoperative CFT was associated with a lower preoperative BCVA (rs =0.91,P ＜0.05),a lower MS of central 10° macula area (r =-0.82,P ＜0.05) and a lower postoperative BCVA level (rs =0.63,P ＜0.05 ).But with a significant postoperative CFT reduce( r =0.81,P ＜ 0.05 ) and a significant postoperative BCVA increase ( rs =0.71,P ＜ 0.05 ).Conclusions Vitrectomy combined with macular epiretinal membrane removal can effectively promote the recovery of macular thickness and function in patients with IEM.Examinationand analysis of preoperative CFT,BCVA and MS of macula area may help to predict the recovery of CFT and function objectively in patients of IEM.

Objective To evaluate the fundus manifestation and treatment of Takayasu＇s arteritis.Methods Retrospective case series was taken to study the clinical data of 15 patients (30 eyes) diagnosed with Takayasu＇s arteritis at Peking Union Medical College Hospital from 1992 to 2010. Examinations included visual acuity, slit-lamp, fundus, fundus fluorescein angiography (FFA), large vascular ultrasound,digital subtraction angiography (DSA),erythrocyte sedimentation rate (ESR) and reactive protein C (CRP). All patients were given systemic corticosteroids, immunosuppressive agents and anticoagulants.Three patients (4 eyes) received retinal photocoagulation,and 1 patient ( 1 eye) received vitrectomy combined with silicone oil tamponade.Results Fifteen cases aged 13-49 years [ mean(33.6 ±11.1)years]were enrolled,including 2 male and 13 female patients.Two patients recognized by initial presentation of impaired vision prior to the diagnosis of Takayasu＇s arteritis.Visual acuity:light perception0.05,6 eyes; 0.1-0.5,4 eyes; 0.6-1.0,5 eyes; and above 1.0,15 eyes. The fundus examination revealed chronic ischemic retinopathy in 16 eyes characterized by microaneurysms,cotton-wool spots and peripapillary arteriovenous anastomosis,and complicated by vitreous hemorrhage,retinal detachment and proliferative retinopathy at the late stage.There was hypertensive retinopathy in 14 eyes with features of narrow retinal artery,arteriovenous crossing signs and retinal hemorrhage. FFA showed prolonged arm-toretina circulation time and retinal circulation time,microaneurysms and neovasculature. Six cases were classified as brachiocephalic arteritis,and 9 patients belonged to extensive arteritis. ESR increased in 9 patients and CRP elevated in 5 patients. Capillary non-perfusion areas in 4 eyes subsided after retinal photocoagulation,and retina reattached in 1 eye after vitrectomy with visual acuity improved from light perception to count finger. Conclusions Fundus manifestation of Takayasu＇ s arteritis is usually characterized by chronic ischemic retinopathy and hypertensive retinopathy,and complications such as vitreous hemorrhage,retinal detachment and proliferative retinopathy occur at advanced stage. The first symptom in some patients can be impaired vision.The prognosis could be improved if ophthalmologists know fundus characteristics of Takayasu＇s arteritis and give timely and correctdiagnosis and treatment.

Objective To study the clinical characteristics and pathogenesis of intrapapillary hemorrhage with adjacent peripapillary subretinal hemorrhage (IHAPSH).Methods A retrospective review of 8 patients with IHAPSH.The demographical data of the patients,the symptoms,initial and final visual acuities,biomicroscopic findings,fundus photographs,and the results of various special examinations,including fluoresce in angiography,B-scan ultrasonography,optical coherence tomography (OCT) and CT were analyzed.Results Fundus examination of 8 patients showed various changes of optic disc,including:a small and tilted optic disc with elevation and blurring of the nasal or superonasal edge.Hemorrhage of the optic disc was present in the cup and/or on the nasal edge,extended to the surface of the optic disc,the superficial layer of the retina and the subretinal space.Subretinal hemorrhage was located on the nasal,superior and inferior side of the optic disc.OCT examination showed an elevated optic nerve head with an enlarged nasal peripapillary subretinal space.Conclusions In the IHAPSH patient,bleeding may originate from the posterior ciliary artery that traverse the sclera window of the disc,passes through the space between the optic nerve and the scleral canal,reaches the edge of the optic disc and the subretinal space,penetrates into the optic nerve tissues anterior to the lamina cribrosa,reaches the optic cup and extends to the surface of the optic disc,the retina or the vitreous.

Objective To investigate depth of focus (DOF) in spherical and aspheric IOL eye models.Methods Computer numerical simulation experiment was used.IOL eye model based on LiouBrennan eye model was constructed by using ZEMAX optical design software.Different IOL were implanted in this eye model Monochromatic through focus modulation transfer function (MTF) curves were computed.Pupil and aspheric designs＇ effect on DOF were analyzed.Results DOF of eye model increased with pupil shrinkage in 550 nm monochromatic light ( FY60AD 1.20 D at 6 mm pupil,1.35 D at 5 mm pupil,1.70 D at 4 mm pupil,2.46 D at 3 mm pupil; YA60BBR 1.24 D at 6 mm pupil,1.48 D at 5 mm pupil,1.80 D at 4 mm pupil,2.50 D at 3 mm pupil).MTF in spherical IOL eye model was higher with minus defocus,this trend was obvious at larger pupil MTF of aspheric IOL eyes were higher than spherical IOL eyes when well focused at 5 mm pupil,while the DOF was lower in aspheric IOL with negative spherical aberration (Tecnis Z9000 1.31 D,FY60AD 1.35 D,CeeOn911 1.55 D,YA60BBR 1.48 D).DOF decreased less in aspheric IOL with zero spherical aberration ( LI61AO 1.42 D).Conclusions DOF in IOL eye model was higher at smaller pupil. When the pupil was large,well focused aspheric IOL improved optical quality compared with spherical IOL,while DOF and the tolerance to defocus in aspheric IOL were partially lost;this phenomenon was obvious with minus defocus.

Objective To observe the efficacy and safety of 0.5％ Loteprednol Etabonate ophthalmic suspension in the treatment of moderate dry eye.Methods Totally 34 dry eye patients (68 eyes) in grade 2 or grade 3 (DEWS standard) enrolled in our hospital from March 2009 to September 2010 were randomly divided into two groups:the experimental group ( Loteprednol Etabonate Group) and the control group (Cyclosporine A,CsA group).0.5％ Loteprednol Etabonate ophthalmic suspension or 1％ CsA eye drops was applied 2 times a day respectively together with 0.2％ Liposic eye drops (4-6 times/day).Questionnaire was used in these patients before the treatment and repeated every 2 weeks during the treatment till 8 weeks.Slit lamp microscope examination,fluorescent staining,tear break-up time ( BUT),Schirmer Ⅰ test ( S Ⅰ t) and intraocular pressure measurement were carried out at the same time point.The conjunctival impression cytology (IC) was performed before the treatment and 8 weeks after the treatment.The mean of the results were compared by t-tests and x2 test.Results After 2 weeks of the treatment,the mean score of the questionnaire was significantly lower than that before the treatment in each group ( t =5.36,3.63,P ＜0.01 ).After 4 weeks of the treatment,the inflammation of the ocular surface was relieved obviously in both group and the mean score of the corneal fluorescein staining (FL) was lower than that before the treatment in each group.The average density of the goblet cells before the treatment was ( 181.2± 16.1 )/mm2 and (179.4 ± 17.5 )/mm2 in each group respectively.After 8 weeks of the treatment,this increased to (348.6 ± 22.5 )/mm2 and ( 360.4 ± 27.8 )/mm2 significantly ( t =16.9,16.3,P ＜ 0.05 ).BUT was significantly prolonged in each group after the treatment ( P ＜ 0.01 ).There was no significant change in ST Ⅰ or NCT in each group (P ＞ 0.05 ).Conclusions Topical 0.5％ Loteprednol Etabonate ophthalmic suspension is safe and effective for the treatment of moderate dry eye.

Objective To investigate the opsin expression in form-deprived and defocus myopia in guinea pig and to study the relationship between the opsin expression and the experimental myopia.Methods Fifty guinea pigs were randomized into form-deprived group,defocus group ( n =20 in each group) and normal group (n =10).Guinea pigs in form-deprived group wore a diffuser RGP on one eye since one week after birth.Those in defocus group wore - 4.00 D RGP on one eye.The contralateral eyes wore 0 D RGP were used as the control.Refraction,axial length and depth of vitreous cavity were measured after 1 and 2 weeks.Animals were sacrificed and the retina were dissected at 10:00-12:00 AM.The level of opsin and its mRNA were measured by Western-blot and real-time PCR,respectively. Results Two weeks after the experiment,the refraction in form-deprived group and defocus group were ( - 4.00 ± 0.87 ) and ( - 2.00 ± 1.17) D respectively,which were significant different compared with contralateral eyes or normal control group ( F =203.98,88.66,P ＜ 0.05 ).These also accompany with increase of axial length and depth of vitreous cavity in form-deprived group and defocus group.Expression of S-opsin mRNA were increased both in form-deprived and defocus groups and the ratios of S-opsin mRNA/β-actin expression were 0.752 ±0.05and 1.117 ± 0.13 in two weeks treatment,which were significant different from contralateral eyes( the ratios of S-opsin mRNA/β-actin expression were 0.536 ± 0.04 and 0.772 ± 0.10.t =6.10,6.28,P ＜ 0.05 ).Similar findings were also demonstrated in the expression of L-opsin mRNA,which were increased in formdeprived group and defocus group ( the ratios of L-opsin mRNA/β-actin expression were 0.42 ± 0.01 )compared with contralateral eyes ( the ratios were 0.24 ± 0.0 and 0.34 ± 0.04.t =6.30,4.93,P ＜ 0.05 )after two weeks experiment.The western-blot results also indicated the high expression of S-opsin and L-opsin level compared to contralateral eyes in form-deprived and defocus groups.Conclusions Cone might be the detector receiving the signal of form-deprivation and defocus.Changes of opsin expression might play a role in the occurrence of experimental myopia in guinea pig.

Objective To investigate the influence of continuous near-infrared (CNI) laser to potassium ion channels on retinal ganglion cell ( RGC).Methods Experiment study.Porcine RGC was cultured with enzymatic digestion method in vitro by taking off the retina from the piglets.Whole-cell patch clamp mode recordings were obtained from primary cultured porcine RGC.Whole-cell currents of porcine RGC irradiated with a single-mode CNI laser of 845 nm wavelength and 30 mW power were also recorded.The primary cultured porcine RGC were divided into laser irradiation group and control group according to whether they accepted CNI laser of 845 nm wavelength.t test was used to analyze the average peak amplitude between the two groups.Results The cells had the morphological characteristics of typical neurons after one week cultured observed by inverted phase contrast microscope.The body and bumps with yellow-green fluorescence was positive cell which observed by immune cell fluorescence chemical testing.CNI laser had a regulation on outward potassium current of porcine RGC in a voltage-dependent manner.There was significant difference on the average peak amplitude of potassium current between the laser irradiation group [ (634.4 ± 86.8 ) Pa]and the control group [ ( 580.5 ± 116.4 ) Pa ],respectively ( n =30,t =7.923,P =0.000).Conclusions CNI laser can change the properties of outward K + channel.Therefore,formation and releasing of action potential is affected.Further,physiological functions of RGC are regulated,which might contribute to the protection and restoration of injured RGC.It can be provided a new scholar direction for the protection of the RGC,which are injured by glaucoma.

Objective To explore the effects of siRNA-mediated downregulation of integrin-linked kinase (ILK) gene expression on the proliferation and apoptosis in retinoblastoma cells. Methods Experiment study.Human retinoblastoma cells,HXO-Rb44 cells,were divided into four groups:ILK siRNA intervention group,control siRNA intervention group,empty liposome group and blank control group.ILK siRNA was transfected into HXO-Rb44 cells by lipofection.The expression of ILK mRNA and protein was detected at 48 hours after transfection by RT-PCR and Western blot,respectively. Cell proliferation inhibition was measured by Cell Counting Kit-8 assay.The apoptosis was detected by Annexin/PI double immunofluorescence and flow cytometry.Statistical method adopted one-way ANOVA between each group overall comparison.Results The HXO-Rb44 cells were transfected by ILK siRNA successfully with lipofection.RT-PCR analysis showed that the expression of ILK mRNA in the ILK siRNA intervention group was significantly decreased as compared to the control siRNA intervention group,empty liposome group and blank control group (0.12 ± 0.02 vs.0.45 ± 0.04,0.42 ± 0.05 and 0.40 ± 0.04,F =12.781,P =0.000).Similar results were obtained for protein expression as revealed by Western blot analysis (0.10 ±0.03 vs.0.38 ± 0.07,0.40 ± 0.05 and 0.43 ± 0.03,F =18.647,P =0.000).The proliferation inhibition rate in the ILK siRNA intervention group(35.0％ ) was higher than that in the blank control group(0％ ),control siRNA intervention group ( 2.1％ ) and empty liposome group ( 1.8％ ) ( F =23.573,P =0.000).The results of immunofluorescence and flow cytometry showed that ratio of Annexin positive cells was highest in the ILK siRNA intervention group (26.5％ ),which was 5.0％,4.6％,5.3％ in the empty liposome group,blank control group,control siRNA intervention group,respectively (F =65.217,P=0.000).Conclusion ILK siRNA can downregulate the expression of ILK gene in HXO-Rb44 cells inhibited the cell proliferation and induced their apoptosis.

Dry eye is an ocular disease caused by insufficient tear secretion and impaired tear film stability [1-2]. Epidemiological studies have shown that the incidence of dry eye is very high worldwide, which is related to old age, perimenopause of women, wearing contact lenses and autoimmune diseases [3-5]. Among them, the incidence rate is about 17% ~33% in Asian population [6-9], while the incidence rate is relatively low in Caucasians, about 7% ~14.6% [3,10]. At present, the most common treatment for dry eye is artificial tear dropping on the ocular surface. Because dry eye is a chronic disease, most patients need long-term medication, so its long-term efficacy and safety are worthy of attention. This study compared the toxic effects of artificial tear with different components on human corneal and conjunctival epithelial cells cultured in vitro, in order to provide experimental basis for clinical medication.

The patient was a 47-year-old male who came to the Department of Ophthalmology of Yantai Yuhuangding Hospital affiliated to Qingdao University School of Medicine due to poor visual acuity in his left eye for 1 week. The conjunctiva was not congested, the cornea was transparent, the anterior chamber and lens were not abnormal, and the vitreous body was not opacified; The fundus was examined with a Topcon TRC50EX fundus camera. The preretinal hemorrhage with a clear boundary and a size of about 4 PD was observed in the macular area, and tissue proliferation was observed at the interface between the circular boundary and the retina, and blood dissemination was observed around it. Due to the effect of the patient's posture and gravity, the typical hemocyte fluid half-face was presented (Essence Picture 1). Clinical diagnosis: preretinal hemorrhage in the left eye (the cause is to be investigated).

The patient was a 36-year-old male. Fundus abnormalities were found in routine physical examination, and he came to the Department of Ophthalmology of Peking Union Medical College Hospital. The main complaint was that dark adaptation was slightly poor. The limited examination showed that the visual acuity of both eyes was 1.2; the cornea of both eyes was clear, the conjunctiva was not congested, the anterior segment was not inflammatory, the anterior chamber was normal; Dilated pupils to examine the fundus of the eye, see the essence picture 1. Clinical diagnosis: white dot retinitis pigmentosa in both eyes.

The patient was a 39-year-old male whose right eye was injured by a foot, causing swelling and pain and blurred vision for 1h. On March 14, 2010, the patient was kicked in his right eye. At that time, the eye was swollen, painful, teared, and his vision was blurred. radial keratotomy (RK) in both eyes was performed for 15 years. Ophthalmological examination: visual acuity: manual/20 cm in the right eye (no improvement in correction), 1.0 in the left eye. Ten radial gray-white linear surgical scars were seen in the cornea of the right eye, which coincided with each hour, reaching deep stromal layer. Near 10 o'clock and 11 o'clock, the two surgical scars were dehisced in full thickness, and the iris tissue prolapsed outside the corneal rupture. The transparent optical area without incision was about 3 mm in diameter in the central area of the cornea, hyphema, and the lens and fundus were not clear. Ten radial gray-white linear surgical scars were also seen in the cornea of the left eye, which coincided with each hour. Diagnosis: (1) Right eyeball rupture: corneal rupture, hyphema, traumatic aniridism, incomplete lens dislocation: (2) After radial keratotomy in both eyes. After admission, debridement and suture of the right corneal laceration were performed under local anesthesia, and the anterior chamber was washed during operation, see Incomplete dislocation of lens (<1/2 quadrant), partial rupture of temporal suspensory ligament.

Age related macular degeneration (AMD) is the most common cause of irreversible blindness in the aged population in the western world.AMD is considered to be a multifactorial disease with involvement of both genetic and environmental factors. With the development of molecular biology and molecular genetics,numerous susceptibility genes have been identified.Here we review the recent advances in the genetic studies regarding the AMD susceptibility genes.

Retinopathy of prematurity (ROP) is one of the important causes of childhood blindness in China with an increasing trend of affected infants.It gives great burden on both the individuals and the society.With the publishing of guidelines on oxygenation policies by Ministry of Health,the screening of ROP has been gradually performed nation-wide. But the prevalence data of ROP is still confusing. We reviewed literature over the last 20 years about causes of childhood blindness in blind school students and ROP screening.This study could provide preliminary evidence about prevalence of ROP in mainland of China and could be benefit for further prevention and the control of ROP.

Ethambutol is a commonly used first-line anti-tuberculosis agent,and its most important potential side-effect is ethambutol-induced optic neuropathy (EON). Understanding of the incidence,clinical characteristics,risk factors,prognosis and mechanism of EON is of practical significance in the diagnosis and treatment of this disorder.This article reviews the present status of these aspects.

Tuberculosis is a granulomatous clinical disease caused by Mycobacterium tuberculosis infection, and it is still the disease with the highest number of deaths caused by a single infection factor. In the mid-1940s, with the discovery and clinical application of anti-tuberculosis drugs, its prevalence was obviously controlled. However, in the past 20 years, tuberculosis has been revived worldwide. In 2009, the WHO reported that about 2 billion people, or 1/3 of the people in the world, have carried Mycobacterium tuberculosis, and about 9 million people have the disease every year, and 3 million people die of tuberculosis, accounting for 4% of the total deaths in the world, and mainly concentrated in developing countries [1]. China is one of the 22 countries with high burden of tuberculosis in the world. At present, the annual incidence of tuberculosis in China is about 1.3 million, accounting for 14.3% of the global incidence, ranking second in the world. With the rising trend of tuberculosis incidence year by year, ocular tuberculosis patients are also increasing, and tuberculous ocular lesions account for 1.40% ~5.74% of systemic tuberculosis [2]. Choroidal blood vessels are abundant, but the blood flow is relatively slow, and Mycobacterium tuberculosis is easy to retain, However, the diagnosis and treatment of choroidal tuberculosis has always been a difficult problem for ophthalmologists. Because there is still a lack of unified diagnostic standard and specific detection methods, it is impossible to make a quick and definite diagnosis and rational treatment, which leads to misdiagnosis, missed diagnosis and delayed treatment in clinic. Therefore, with the resurgence of tuberculosis today, ophthalmologists should be familiar with the clinical manifestations and treatment plan of choroidal tuberculosis, deepen their cognition of choroidal tuberculosis, and save the visual function of choroidal tuberculosis patients.

According to international practice and the actual situation in China, for papers that meet the following conditions, the Chinese Medical Association series journals allow and accept the republication of relevant papers of the same research in different languages.

With the development and improvement of clinical diagnosis technology, the role of all kinds of ophthalmology clinical pictures in disease diagnosis has been paid more and more attention. In order to encourage clinical accumulation of relevant data, promote experience exchange, improve clinical diagnosis and treatment technology, provide a new platform for academic exchange for readers, 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.

Approved by China Science and Technology Association, the 12th International Conference on Ophthalmology and Optometry (C00C2012), co-sponsored by Shanghai Medical Association Ophthalmology Branch, six provinces in East China and Hunan, Hubei, Henan, Hebei and other provinces, Eye, Ear, Nose and Throat Hospital affiliated to Fudan University, College of Optometry of Wenzhou Medical College, China Science and Technology Association and China International Science and Technology Conference Center, and co-sponsored by Eye, Ear, Nose and Throat Hospital affiliated to Fudan University, China International Science and Technology Conference Center and Zhejiang Medical Association Ophthalmology Branch, will be held at Hangzhou Overseas International Convention and Exhibition Center from March 29th to April 1st, 2012.

The description format of reference documents in this journal basically implements GB/T7714-2005 "Rules for Description of Reference Documents after Text". Sequential encoding is used to make a record, which is marked with Arabic numerals in the order in which it appears in the text, and the serial numbers are placed in square brackets and arranged at the end of the text. Try to avoid citing abstracts as references. Internal publications, unpublished materials, personal correspondence, etc. should not be cited as literature. Quoted documents (including the text and the original meaning expressed) are asked to be checked by the author with the original.

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.

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.

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.

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 Sunday).

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, the organizer of the conference, and the Chinese Journal of Ophthalmology, the academic cooperative media of the conference, jointly invite domestic and foreign ophthalmologists, colleagues and ophthalmology business people to attend.