Volume 48 · Issue 11 · 2012

This article describes the new international classification and routine treatment methods of retinoblastoma,compares the status and gaps between domestic and foreign treatments,summarizes and presents problems to be solved in the treatment process of retinoblastoma domestically,presents suggestions in establishing and promoting a standardized diagnostic methodology and treatment pattern in China,and emphasizes the important guiding role of pathological diagnosis in ophthalmology for retinoblastoma risk factor assessment and subsequent treatment.

Ocular adnexal lymphoma (OAL) is the most common orbital malignant tumor in adults.In contrast with other tumors,the OAL pathological diagnosis and classification,as well as the differential diagnosis with reactive lympoid hyperplasia,is more difficult and complex.Therefore, it is important to emphasize to be familiar the standardized OAL diagnosis and classification from World Health Organization,to adopt the standardized pathological diagnostic technique for pathological diagnosis and classification of OAL,as well as the differential diagnosis with reactive lympoid hyperplasia.

Varies diseases happened in human being were induced by micropathogens.According as the later studies,micropathogens beget not only infective disease,but also contribute to kinds of tumors such as Non-Hodgkin' s lymphoma.Micropathogcns bring on serious ocular disease,infectious corneal ulcer or endophthalmitis will lead to blind.So it will be a important assignment to the medical doctors to prevent infection-related disease.The medical doctor should choose appropriate histopathologic methods to fix on the micropathogen what attributable to infection.We need to pay more attention to the inffectious agents to get more information of the disease.

Melanoma of the uveal tract is most common primary intraocular cancer in adults.Approximately 50％ of patients with uveal melanoma died from metastasis,irrespective of the type of treatment.Enucleation was the primary form of treatment and the best option.Whether the enucleation of the eye containing uveal melanoma accelerates metastatic death has long been a controversial topic.The combination of pathological and some experimental studies in progress concerning this contentious topic is discussed in the current article.

Objectives To analyze the differences and correlation between the ganglion cell complex (GCC),peripapillary retinal nerve fiber laver (pRNFL) and mean deviation (MD),mean sensitivity (MS) of saddle area tumor patients,and to evaluate the feasibility of using OCT to diagnose the visual pathway damage of saddle area tumor patients.Methods It was a case-control study.One hundred and eighty-eight normal persons and 279 saddle area tumor patients treated in Beijing Tiantan hospital,from November 2010 to June 2011,were recruited; the saddle area tumor patients were diagnosed by surgical sample pathological analysis.The recruits were divided into four groups,including the normal group,the pituitary gland tumours group,the meningiomas group and the craniopharynglomas group.All patients received the visual field (VF) test using the Octopus 900 automated perimeter with the central 30 degree program,and the mean thickness measurements of GCC and pRNFL were made by RTVue OCT.The Spearman rank correlation coefficient was used to assess the correlation between GCC,pRNFL and MD,MS.The differences between pRNFL and GCC among the four groups were compared.Results The averagethickness of the pRNFL (rsOD =0.369-0.735,rsOS =0.369-0.691) and GCC (rsOD =0.357-0.797,rsOS =0.375-0.681) were correlated with MD and MS (P ＜0.01),and the measurements from the meningiomas was the most significant.Comparing with the normal group's thickness of pRNFL and GCC [OD:(113.60 ±9.13) μm and (98.04 ± 6.85) μm;OS:(114.06 ± 8.99) μm and (97.70 ±5.83) tm],the pituitary gland tumours group [OD:(101.25 ± 19.95) μm and (91.08 ± 13.19) μm ; OS:(99.96±20.95) μm and (89.82 ± 15.47)μm],meningiomas group[OD:(89.54± 19.19) μm and (80.77 ± 10.43) μm ; OS:(92.79 ± 22.00) μm and (80.43 ± 10.09) μm] and craniopharynglomas group [OD:(94.96 ± 16.59) μm and (86.46 ± 11.65) μm; OS:(94.92 ± 15.77) μm and (86.77 ± 9.56) μm] were thinner.There was statistically significant difference of pRNFL and GCC,among the three tumor groups,and the thickness of pRNFL and GCC of the meningiomas group was the thinnest(P ＜ 0.05).Conclusions The average thickness of the pRNFL and GCC is correlated with vision field damage,which can be used to evaluate optic nerve damage of saddle area tumor patients quantitatively,where the meningiomas was thc most significant.The thickness of the pRNFL and GCC was thinner,and the damage to visual functions was more serious.In the three tumor groups,the meningiomas group was the most serious.In the clinic,visual field test combined with OCT were helpful to find and assess the damage to visual pathway and prognosis.

Objective To evaluate the precision of Intraocular Lens (IOL) power calculation using a new optical low-coherence reflectometry biometer (Lenstar) and compare the results with those obtained with IOLMaster.Methods It was a prospective controlled study.Biometry measurements in 157 eyes of 98 cataract patients were performed by the same examiner with Lenstar and IOLMaster.Axial length (AL),corneal keratometry readings (Km),and anterior chamber depth (ACD) were obtained.Correlation and differences of biometry measurements obtained with two biometers were made.Intraocular Lens power were calculated using 4 formulas and the corresponding IOL constants,the target was emmetropia.Then statistical analysis was proceeded.Results Axial length were (23.65 ± 1.17) mm and (23.65 ± 1.16) mm respectively,Km(44.15 ± 1.58)D and (44.17 ± 1.58)D respectively by Lenstar and IOLMaster and no statistical differences were found (P ＞ 0.05).ACD were (3.09 ± 0.41) mm and (3.05 ± 0.41)mm respectively by Lenstar and IOLMaster and there was statistical difference between them (P =0.001).All biometry measurements showed good linear correlation(r ＞ 0.9,P ＜ 0.001).IOL power calculations with biometry values between Lenstar and IOLMaster using the 4 formulas showed good agreement.The least difference was obtained with formula SRK/T and the most with formula Haigis.Conclusions Lenstar can provide precise and noncontact biometry measurements easily and safely,which are welcome by patients.Providing precise and reliable biometry measurements of cataract patients for Intraocular Lens power calculation,it shows good agreement with IOLMaster and the two biometers can be interchanged.

Objective To invetstigated the feasibility of fibrin glue-assisted sutureless lamellar keratoplasty (LK) in patients with corneal ulcer.Methods Noncomparative interventional case series.In 21 eyes of 21 patients with terriens marginal degeneration (TMD) or corneal ulcer after trauma,sutureless lamellar keratoplasty (LK) using fibrin glue was performed.Postoperatively,the graft status,graft clarity,the visual prognosis and postoperative complications werc recorded.Results There were 16 cases suffered with Terriens marginal degeneration (TMD) and5 cases with corneal ulcer after foreign body removed.All the corneal ulcers were successfully healed after the procedure,the operative complications included corneal perforation during operation in 1 case,recurrence of TMD in 1 case and graft opacity in 2 cases.There was no graft dislocation,hydrops between graft and recipient interface,secondary infection and graft rejection after surgery,19 cases had improved best-corrected visual acuity (BCVA) while 2 cases had poor vison acuity due to graft opacity (t =-2.587,P =0.018).Conclusion Fibrin glue-assisted sutureless LK showed excellent graft stability in all patients.

Objective To observe the effect of simvastatin on the amount and function of endothelial progenitor cells from bone marrow in diabetic rats.Methods Experimental study.Twenty male Wistar rats were induced with streptozotocin (STZ) injection for the establishment of diabetic retinopathy model.Mononuclear cells were collected by density gradient centrifugation from the bone marrow of rats.The isolated cells were cultivated in dishes coated with fibronectin.Cultured cells were divided into normal control (CON) group and the intervention group.Cells in the CON group were cultured with regular culture medium and the intervention group was treated with 0.01,0.1,1 and 10 μmol/L of simvastatin.Immunofluorescence staining and flow cytometry were used to indentify EPC.The colony number of EPC was assayed by CFU counting.Proliferation,migration and adhesion function of EPC were assayed by MTT chromatometry,modified Boyden chamber assay and adhesion activity assay,respectively.All eyeballs were examined by histopathological examination stained by hematoxylin and eosin(HE) and electron microscopic examination.The amount,proliferation,migration and adhesion function of EPC were analyzed by one-way ANOVA and LSD-t methods.Results The cell clusters number of bone marrow-derived EPC was significantly increased in intervention groups [(16.5 ± 1.6),(19.0 ±2.3),(21.9 ±2.0),(13.9 ±2.4) n/200 fields in cultures treated with 0.01,0.1,1 and 10 μmol/L of simvastatin] compared with that in the CON group [(14.0 ± 2.4) n/200 fields].The proliferation ability of EPC was increased in intervention groups (0.105 ± 0.014,0.133 ± 0.024,0.202 ± 0.039 and 0.068 ± 0.011) compared with that in the CON group(0.072 ±0.011).The migration ability of EPC was increased in intervention groups [(10.5±1.6),(12.9±2.2),(15.9 ±2.4),(9.4±1.4)cells/200 fields] compared with that in the CON group [(8.9 ± 1.2) cells/200 fields].The adhesion ability of EPC was increased in intervention groups [(10.6 ± 1.9),(15.1 ± 2.7),(19.0 ± 3.9),(7.9 ± 1.2) cells/200 fields] compared with that in the CON group [(7.5 ± 1.2) cells/200 fields].The thickness of retina was reduced and retinal cells became disorganized in diabetic rats.Transmission electron microscopy showed capillary lumen stenosis and retinal imicroaneurysms with severe local tissue ischemia such as vacuolar degeneration perivascular tissue.Conclusion Simvastatin can enhance the amount and function of EPC from bone marrow in diabetic rats in a dose-dependent manner.

Objective To study the clinicopathological characteristics of orbital solitary fibrous tumor.Methods It was a retrospective case series study.The clinical and pathological characteristics of 8 cases of orbital solitary fibrous tumor that were treated in Tianjin Eye Hospital from January 2003 to December 2011 were reviewed and analyzed.lmmunohistochemical staining was performed,investigating the expression of CD34,vimentin,S-100 and SMA.Results In the 8 cases,5 cases were male and 3 cases were female; 6 cases involved the right orbit.and 2 cases involved the left orbit.Patients' ages ranged from 30 to 60 years,and the mean age was 41 years; duration of symptoms ranged from 2 months to 5 years.The locations of the tumor were in the superior or superotemporal orbit (5 cases),lacrimal sac and medial orbit (2 cases), or inferior orbit (1 case).The clinical features mainly included the swelling of the upper lid,unilateral painless orbital or lacrimal sac mass,proptosis and diplopia.CT scan usually revealed a moderately or intensely enhanced mass that was well-circumscribed.Complete tumor removal was performed in all cases.The tumor sizes ranged from 1.2-3.1 cm and appeared as a round or irregular oval mass with a thin fibrous capsule; incomplete capsule was found in 3 tumors.Microscopic observation revealed that the tumor was composed mainly of spindle or oval cells in a fascicular,storiform,hemangiopericytoma-like or a "patternless" pattern,with numerous thick bands of collagen that showed diffuse positive staining for CD34 and vimentin.Five cases had been followed-up from 6 to 86 months postoperatively,no evidence of local recurrence had been found in these patients.Conclusions Orbital solitary fibrous tumor is a spindle cell tumor with diffuse positive staining for CD34 and vimentin.This tumor usually is well circumscribed and encapsulated.Complete excision is the preferred treatment.The tumor should be distinguished from otherspindle cell tumors in the orbit.

Objective To explore the clinical and pathological features of conjunctival myxoma and angiomyxoma.Methods It was a retrospective case series study.The clinical and pathological features of 3 cases of conjunctival myxoma and 2 cases of conjunctival angiomyxoma were analyzed.These cases were treated from January 2005 to December 2010 at Tianjin Eye Hospital.Routine pathological examinations and immunohistochemical staining were performed,including staining for Vimentin,S-100,SMA and CD34.Results In the 5 patients,2 cases were male and 3 cases were female.The mean age was (55.8 ±14.8) years,ranging from 40 to 74 years.The tumors presented as yellow-pink,translucent,cystic and (or) with solid masses.Regarding the tumor location,2 cases involved the temporal side,1 case involved the nasal side,1 case involved the nasal limbus and invaded the cornea,and 1 case involved the nasal,temporal and inferior parts.The lesions of the 5 cases were excised under local anaesthesia.Histopathological examination revealed that the conjunctival myxomas were composed of abundant mucoid material and relatively small numbers of small,ovoid,spindle and stellate shaped cells with sparse vessels.The histologic features of the conjunctival angiomyxoma were similar to those of myxomas with the exception of the former being characterized by a prominent vascular structure.The immunohistochemical staining showed that tumor cells were positive for Vimentin,but negative for S-100 protein; some tumor cells were positive for CD34 and SMA.The follow-up was performed in 4 cases post-operation.One case experienced recurrence 1 month after surgical excision.Conclusions Most of the conjunctival myxoma and angiomyxoma appear as a local yellow-pink,translucent,cystic and (or) with solid mass,and some of which had multiple tumors.The preferred management route is complete surgical excision.

Objective To study the correlation of EphA2 protein expression with vesculogenic mimicry(VM),clinicopathological characteristics and prognosis in choroidal melanoma(CM).Methods It was a retrospective case series study.Between January 1992 and December 2005,56 cases of human CM with clinicopathologic data from the Second Hospital of Tianjin Medical University were studied.HE stainings were performed to observe the microcirculation patterns in tumor tissue specimens.VM was found in 26 of the 56 cases using CD31/periodic acid-Schiff(PAS) double staining and transelectron microscopy.All cases were divided into two groups:VM-positive and VM-negative.Immunohistochemical staining was performed on paraffin sections of the 56 cases of CM specimens to investigate the expression of EphA2.According to tumor cells positive rate and staining intensity of the results of evaluation,the specimens were divided into low expression and high expression groups.x2-test and t-test were used to analyzed the enumeration data and measurement data,respectively.Survival analysis was used to further elucidate its correlation with clinicopathological characteristics,VM and prognosis.Cox proportional hazard model was used to analyzed the influence factors of prognosis.Results VM channels were found in 26 of the 56 CM cases and VM-negative 30 cases.VM-positivity was related to cell type,tumor size and recurrence and metastasis,and the differences were statistically significant (x2 =4.612,5.346,5.213 ; P =0.036,0.021,0.027).The results showed that EphA2 was up-regulated in the VM-positive group compared with the group of VM-negative group.The positive rates of EphA2 expression in the VM-positive group and VM-negative group were 92.3％(25/26) and 70.0％ (21/30),respectively,with a significant difference between the two groups (t =2.247,P =0.009).The EphA2 protein was expressed in epithelioid (10/12),mixed (11/15) and spindle (41.40％) cell types,with a significant difference among these histological types (x2 =6.513,P =0.010).The expression rate of EphA2 protein were significantly higher in large (54.55％,18/33) than small (45.45％,15/33) tumors,and the expression of EphA2 in metastastic and recurrence patients (10/11) were significantly higher compared with controls (31.11％,14/45) (x2 =4.556,8.211 ; P =0.016,0.005).Kaplan-Meier survival analysis showed the presence of VM resulted in a poor prognosis (t =9.263,P =0.000).The Cox proportional hazards model indicated that the EphA2 overexpression and the presence of VM were independent predictors of a poor prognosis (x2 =12.041,P =0.001).Moreover,there was a significant positive correlation between them (r =0.412,P ＜ 0.05).Conclusion The results of this study demonstrate that EphA2 may play a critical role in the formation process of VM in CM,implicating EphA2 as a valuable marker for the prediction of recurrence,metastasis and prognosis in CM patients.

Objective The purpose of this research lied in studying the structure and function of connective tissue of inferior oblique(IO) in rhesus,rabbit and rat.Methods It was an experimental study.Two adult monkeys(rhesus),five adult rabbits and five adult Wistar rats were involved in this study.The gross anatomy of an orbit in each animal was observed.Meanwhile,the fellow orbit was processed with paraffin imbedding and coronal serial section.Masson trichrome stain was used to distinguish muscle and collagen,and Weigert stain was performed for identification of elastin.Results The connective tissue around IO muscle in rhesus,rabbits and rats all connected with inferior rectus(IR) and lateral rectus(LR),but the arrangements among them were not entirely similar.Only the connective tissue around IO in rhesus consisted of dense collagen,scattered elastic fiber,and connected closely with IR,LR Pulley.The connective tissue circling IO in rabbit and rat were crumbly,and was not connected closely with the connective tissue around IR.Conclusion IR and LR Pulley has some mechanics link with IO in rhesus,and can play roles in covergence in rhesus.

Objective To evaluate the clinical effects of vitreal surgery and the importance of etiological diagnosis in the treatment for bacterial endophthalnitis.Methods Retrospective series case study.20 cases (20 eyes) of bacterial endophthalmitis that were treated in Peking Union Hospital were enrolled.14 eyes were post-traumatic endophthalmitis,and 6 eyes were postoperative endophthalmitis.Twenty cases of aged 3 to 83 years [mean (40.5 ± 23.9) years] were enrolled,including 12 male and 8 female patients.Pre-operative visual acuity:2 cases were able to count fingers,6 cases were able to perform hand movement,11 cases had light perception,light projection were uncertain in all cases,and there was no light perception in 1 case.Hypopyon was seen in 13 eyes.Severe anterior chamber inflammatory reaction was seen in the other 7 eyes.The fundus could not be observed in all 20 eyes.B-Scan ultrasound examination indicated that all 20 eyes displayed moderate to severe vitreous opacity; proliferation and organization were apparent in 12 eyes,and retinal detachment in 2 eyes.Vitrectomy and intravitreal injection of antibiotics were performed in 18 eyes,and only intravitreal injection of antibiotics was administered in the other 2 eyes.At the beginning of operation,vitreous fluids were smeared and Gram stained.To eyes thatshowed a positive result in Gram staining,1 mg of Vancomycin was injected into the vitreous cavity or added in the perfusion fluid (balanced salt solution,BSS) in the eyes.To eyes that showed a negative result in Gram staining,2 mg or 4 mg of Ceftazidime was injected into the vitreous cavity or added in the perfusion fluid (BSS) in the eyes,respectively.Additionally,we examined the vitreous specimens and performed drug susceptibility testing of the bacteria cultured from the specimens.The antibiotics that the bacteria were susceptible to were chosen according to the drug sensitivity tests.The follow-up period is from 1 to 102 months (average 16.6 months).Results Thirteen eyes presented with a positive Gram staining result,and 3 eyes presented a negative result; the other 4 eyes were not infected.Bacteria were cultured in 15 eyes.The detection rate of pathogen was 75％.The result for 11 eyes was consistent with the smear results.The bacteria detected were Staphylococcus aureus in 3 eyes,Staphylococcus epidermidis in 3 eyes,and Bacillus spp in 2 eyes.Streptococcus pneumoniae,Streptococcus mitis,Plesiomnonas,Pseudomonas cepacia,Klebsiella oxytoca,Loffi Acinetobacter and Pseudomonas fluorescens were detected in 1 eye.The remaining 5 eyes did not have bacterial growth.The intraocular infection of all 20 eyes was controlled,and the intraocular inflammation was relieved.The visual acuity was significantly elevated.Postoperative visual acuity achieved were ≥0.3 in 4 eyes,0.1 to 0.2 in 4 eyes,0.02 to 0.09 in 6 eyes,CF in 2 eyes,HM in 3 eyes and LP in 1 eye.The retinas of 17 eyes were normal,but recurrent retinal detachment occurred in the other 3 eyes,postoperatively.Conclusions Vitrectomy combined with antibiotics and intravitreal injection of antibiotics were an effective treatment of bacterial endophthalmitis.We obtained the vitreous fluid smears at the beginning of surgery to quickly and accurately obtain etiological diagnoses by Gram staining.It is crucial to use etiological diagnosis to choose the susceptible antibiotics.

The patient, a 50-year-old man, was admitted to the Department of Ophthalmology of the Third Hospital of Peking University on July 4, 2011 due to progressive visual acuity decrease in his left eye for 4 years and distension and pain for 10 days. The patient went to the local hospital 4 years ago due to blurred vision in his left eye. The ocular MRI results showed space-occupying lesions in the posterior pole of his left eye, with TIWI high signal and T2WI low signal, uniform enhancement (Figure 1). It was considered choroidal melanoma, and left eyeball enucleation was recommended, but the patient refused to operate. Subsequently, the patient's visual acuity in his left eye decreased progressively, and his visual acuity was lost 2 years ago, without diagnosis and treatment. Ocular examination: the visual acuity in the left eye was not light sensing, the intraocular pressure was 5.83 kPa (43.8 mm Hg), the conjunctiva of the left eye was mixed congested, the corneal fog edema, the iris was neovascularized, the pigment of the pupil margin was extropped, the pupil was fixed and dilated, the retina was detached completely, and a large amount of subretinal exudation was obscure.

A 57-year-old male patient went to the Department of Ophthalmology of Peking University Third Hospital on August 10, 2011 because the left upper eyelid mass was found for 4 months and significantly enlarged for 2 months. In April 2011, the patient accidentally found a rice grain-sized mass on the left upper eyelid; Two months ago, the patient felt that the tumor had increased to the size of a mung bean. The patient had no pain, redness, swelling and other discomfort. The patient was in good health before, and denied the history of other ocular diseases and familial ocular genetic history. Ophthalmological examination: a pink mass on the temporal side of the left upper eyelid, with finger-like lobes on the surface, clear boundaries, about 1 cm ×1 cm in size, soft in texture, mobile, and no tenderness. No obvious abnormalities were found in the anterior segment and fundus examination. The patient underwent mass resection in the outpatient clinic on August 16, 2011.

Spinocerebellarataxia (SCA) is a neurological degenerative disease caused by genetic factors. It is often familial, and the inheritance mode is mostly autosomal dominant, with obvious clinical and genetic heterogeneity. The common pathological changes of SCA are mainly cerebellar, brainstem and spinal cord degeneration and atrophy, and the main clinical manifestation is progressive ataxia, which may be accompanied by dysarthria, extraocular muscle paralysis, pyramidal tract sign, extrapyramidal system sign, peripheral neuropathy, intellectual retardation and other clinical manifestations. According to the different location of pathogenic genes, SCA can be further divided into different subtypes. At present, more than 30 pathogenic genes of SCA have been identified. SCA7 is the only subtype of SCA identified with retinal cone and rod degeneration and visual decline, and its incidence rate is about 2% in SCA [1].

The patient, a 25-year-old man, suddenly lost sight in his right eye without obvious trigger on the morning of February 17, 2011, without other ocular or systemic discomfort. He went to a local hospital the next day after the onset and was diagnosed as "central retinal artery occlusion in the right eye". He was given intravenous infusion of salvia miltiorrhiza injection to dilate blood vessels. After 10 days of treatment, his right eye was still lost to sight. Therefore, he went to the Department of Ophthalmology, Wuhan General Hospital, Guangzhou Military Region on March 18, 2011. He had no previous ocular trauma or systemic medical history. No abnormalities were found in the systemic examination. Ocular examination: the right eye had no light sensation, and the left eye was 1.0. IOP: 10 mm Hg (1 mm Hg =0.133 kPa) in the right eye and 12 mm Hg in the left eye. The pupils of both eyes are round, the diameter of the right eye is about 4 mm, and the direct light reflection is slow; The diameter of the pupil of the left eye is about 3 mm, and it is sensitive to light directly. The cornea of both eyes is transparent, the depth of the anterior chamber is normal, the aqueous humor is sparkling (-), the iris texture is clear, and the lens and vitreous body are transparent.

A 35-year-old male came to the Department of Ophthalmology of the 411th Hospital of the People's Liberation Army in November 2010 due to decreased visual acuity in his left eye for 1 year and soreness and discomfort for 2 months. Ocular examination: distant visual acuity: 1.0 in his eye and 0.12 in his left eye (uncorrectable); There was no protrusion of the left eyeball and no obstacle to movement in all directions. The inferior temporal bulbar conjunctiva was slightly congested, and two thickened and filled blood vessels were seen on the corresponding scleral surface. The cornea was transparent, the aqueous humor was clear, the inferior temporal anterior chamber was obviously shallow, the iris was bulged forward, the pupil diameter was 4 mm, and it was oblique oval. After mydriasis, a hemispherical bulging brown-black mass in the ciliary body was seen from 3:00 to 6:00 posterior to the iris, about 10 mm ×8 mm in size, and a white organized membrane was seen at the corresponding iris root. The mass pressed the lens and shifted to the upper side of the nose. The lens capsule in contact with the tumor was slightly opaque (Figure 1). The vitreous body was transparent, the border of the fundus papilla was clear, C/D =0.3, and there were no abnormalities in retina and macula.

A 23-month-old male was found to have a small right eye accompanied by a huge orbital cyst after birth. He came to the Department of Ophthalmology, Suzhou Jiulong Hospital, Shanghai Jiaotong University School of Medicine on April 13, 2011. The child was delivered naturally at the second term, and his mother had no obvious clinical disease history during pregnancy, and there was no special ophthalmology history in his family. 1d after birth, it was found that the right eye of the child could not be opened; On the fourth day, I went to the local hospital and found that the tiny eyeball of my right eye was located above the nose, and the cornea was hidden in the supraconjunctival fornix; One month later, the skin of the lower eyelid of the right eye gradually rose, turned cyan-blue, and pink tissue was exposed outside the palpebral fissure, which was transverse and gradually aggravated, without any treatment. Physical examination: moderate nutrition, normal development and intelligence, except for the eye, no obvious abnormality was found in the whole body.

Filariasis is a group of parasitic diseases transmitted by mosquitoes. There are 8 kinds of filariasis known to be parasitic in human body. Creeping filariasis is a kind of filariasis, and its infection can cause zoonotic diseases. Microfilariasis exists in infected animals such as cats and dogs, and is infected by the bite of vector mosquitoes (mainly Aedes mosquitoes). Because it cannot complete the whole life cycle in human body, removing it from infected tissue is the only effective treatment. The infection mainly manifests as subcutaneous nodules or peripulmonary tissue nodules, which is rare for ocular tissue infections. In 2009, a patient with ocular filariasis was admitted to the Department of Ophthalmology of China-Gabon Friendship and Cooperation Hospital in Libreville, the capital of the Gabonese Republic of Central Africa.

The patient was a 25-year-old male who came to Beijing Tongren Hospital affiliated to Capital Medical University on May 28, 2012 due to iron dust injury in his left eye for 4 days. Ophthalmological examination showed that the visual acuity was 0.6 in the right eye and 0.5 in the left eye; there were penetrating marks in the cornea of the left eye, fine deposits behind the cornea, anterior chamber and intact iris; The anterior capsule of the lens was damaged and partially opaque, with metal foreign bodies visible in it (Quintessential Picture 1); See Essence Picture 2 for the examination of Pentacam anterior segment analyzer in the left eye.

The patient was a 46-year-old female who came to the Department of Ophthalmology of Chengdu Military Region General Hospital due to sudden blurred vision and dark shadow occlusion in her left eye for 3d. There were no abnormalities in the conjunctiva, cornea, anterior chamber, lens and vitreous body. After dilated pupils, photographs were taken with Canon CF-60UD fluorescent fundus camera, which showed that the retinal blood vessels moved normally, and deep dark red and superficial bright red retinal hemorrhage, as well as gushing and scaphoid preretinal hemorrhage were observed in the macular area, respectively (Quintessential Picture 1).

Fungal endophthalmitis is a devastating infectious disease,with a poor visual prognosis and even possibility of eyeball enucleated.In recent years,the incidence of fungal endophthalmitis remarkably increased due to widely use of broad-spectrum antibiotics and corticosteroid hormone.This pose a challenge to ophthalmologists and their capacity of treating fungal endophthalmitis need to be improved.It is necessary to introduce the present status and progress in fungal endophthalmitis treatment focus on medications,surgery and its etiological examination,especially the use of newer antifungal agents,including voriconazole and liposomal amphotericin B.

Neurological damage in glaucoma does not only limit to the eye,but also affects the central nervous system of the visual pathway.Functional magnetic resonance imaging provides a non-invasive method that can help to assess anatomical and functional changes of the central nervous system.This technology has been used in the investigations of nerve fiber damage,metabolic changes in visual cortex,and dysfunction of the visual system in glaucoma.Functional magnetic resonance imaging is introduced,and the progress in its application and prospect in glaucoma diagnosis were summarized in this paper.

As a severe congenital developmental disorder,anophthalmia and microphthalmia are usually accompanied with vision impairment and hypoevolutism of the orbit in the affected side.Many genes are involved in anophthalmia and microphthalmia,in which,SOX2 is an important one.The defect of SOX2 causes multiple system disorders,including anophthalmia and microphthalmia.We describe the relationship between the SOX2 defect and anophthalmia/microphthalmia,in order to offer some proposals for the differential diagnosis,treatment and research of anophthalmia and microphthalmia.

Corneal biomechanical properties will change after laser refractive surgery,which can be evaluated by several biomechanical parameters.The biomechanical stress will decrease remarkably after LASIK,but thin flap is helpful to maintain its stress.Excimer laser surface ablation has biomechanical advantages over LASIK procedure.The femtosecond laser technology can achieve smooth and regular incision and make the angle design.Flap adhesion is stronger when completed by a femtosecond laser.Laser refractive surgery will become safer and achieve more stable outcomes with the emphasis on biomechanical effects.

The Ophthalmology Center of Tianjin Medical University will hold the 2012 International Symposium on High Myopia and the New Technology Study Class in the Anteocular Festival from December 8 to 9, 2012 (Saturday and Sunday). At that time, well-known refractive surgery experts, cataract and glaucoma experts at home and abroad will be invited to give special lectures and surgical comments on high myopia, high myopia, cataract and glaucoma related contents and the latest development trends.

1. Statistical symbols: According to the relevant provisions of GB3358-1982 "Statistical Terms and Symbols", all statistical symbols are printed in italics. Commonly used: (1) The arithmetic mean of the sample is in English lowercase (the median is in M); (2) Standard deviation is lowercase s in English; (3) Standard misuse of English lowercase sx (4) t test with English lowercase t; (5) F test is capitalized F in English; (6) Chi-square test is lowercase x2 in Greek; (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.).

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. Please write Japanese Chinese characters according to Japanese regulations,

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 2013. The submitted pictures can be arranged according to the type of case or diagnostic technique, with relevant instructions,

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 beginning of the article, and the project number should be indicated in parentheses. The name of the fund project shall be filled in according to the official name stipulated by the relevant departments of the state, and a number of funds shall be listed in turn, separated by ";". All fund projects must be accompanied by copies of certificates.

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 all over the country, and it is publicly distributed at home and abroad. China Standard Issue Number: ISSN04124081, CN11-2142/R; Postal Code: 2-60; National map code: M93. "Chinese Journal of Ophthalmology" has always implemented the principles and policies of the Party and the state on health work, implemented the principle of combining theory with practice, popularization and improvement, and reported the major progress and innovative achievements of clinical and scientific research in ophthalmology in China.

The title should strive to be concise and eye-catching, which can accurately reflect 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 Atlas of Fundus Diseases, edited by Professor Zhang Huirong of Peking University Third Hospital, and compiled by many fundus disease experts from Peking University Ophthalmology Center of Peking University Third Hospital, Beijing Tongren Ophthalmology Center of Beijing Tongren Hospital affiliated to Capital Medical University, and Peking Union Medical College Hospital of Chinese Academy of Medical Sciences, has been officially published by People's Medical Publishing House.

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. The contents of this book include basic research and clinical diagnosis and treatment of choroidal neovascular diseases, taking into account both advancement and practicality.

Edited by Professor Zhang Chengfen, Department of Ophthalmology, Peking Union Medical College Hospital, Fundus Diseases (Second Edition) was published by People's Medical Publishing House in September 2010. Fundus Diseases (Second Edition) is supplemented and updated on the basis of the first edition published in 1998. It focuses on the diagnosis and treatment of fundus diseases, incorporates the rich clinical experience of the Department of Ophthalmology of Peking Union Medical College Hospital, and adds recent research results and related literatures, especially supplements the new progress of fundus diseases at home and abroad in recent years,

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 a clinically practical auxiliary diagnostic device, ocular surface in vivo confocal microscope can perform non-invasive, real-time dynamic and four-dimensional (three-dimensional + time) observation of living corneal and conjunctival tissues.

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 "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.

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".

In order to promote international exchanges in the field of ophthalmology and enable domestic doctors to read excellent overseas monographs on ophthalmology, the editorial department of the Overseas Excellent Medical Monographs Introduction Project of China International Medical Exchange Foundation organized and published the book "Pathogenesis and Treatment of Ophthalmic Diseases" in August 2012.

The book "Laser Treatment of Fundus Diseases" edited by Professor Zhang Huirong of Ophthalmology Center of Peking University Third Hospital has been published by People's Medical Publishing House. The book consists of 12 chapters: overview, indications of laser, contraindications of laser, laser treatment of retinal vein occlusion, diabetic retinopathy, retinal vascular inflammation, other retinal vascular diseases, macular and related diseases, peripheral degeneration and hiatus of the retina, benign and malignant tumors of the eye fundus, complications of laser, and methods and effects of photodynamic therapy.

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. Jing Chen Jiaqi,