目的：研究准分子激光原位角膜磨镶术(laser in situkeratomileusis，LASIK)前后角膜滞后量(corneal hysteresis，CH)和角膜阻力因子(corneal resistance factor，CRF)变化量，对其相关因素进行多元线性回归分析。方法：前瞻性研究。纳入行LASIK手术的近视眼及近视散光患者70眼(38例)，术前与术后6个月各项参数分别由眼反应分析仪(ocular response analyzer，ORA)、非接触眼压仪、超声角膜测厚仪及Pentacam眼前节分析仪测量。分析LASIK手术前后△CH，△CRF与术前、手术设计等参数的相关性，并对相关参数进行多元线性回归分析。结果：手术前后CH分别为(10.05±1.36)，(8.15±0.90) mmHg(1 mmHg=0.133 kPa)，CRF分别为(9.91±1.38)，(6.92±0.88) mmHg，差异均有统计学意义(P<0.01)；△CH与△CRF分别为(1.90±1.15)，(2.99±1.23) mmHg。△CH与术前CH，CRF，眼压(intraocular pressure，IOP)，预计切削深度(ablative depth，AD)以及AD/CCT呈正相关；△CRF与术前CH，CRF，IOP，AD，AD/CCT，术前等值球镜(spherical equivalent，SE)以及预计基质床厚度(residual stromal bed’s thickness，RSBT)有相关性。采用多元线性回归对LASIK手术前后△CH，△CRF与术前、手术设计等各相关参数进行分析，回归方程为：△CH=?6.182+0.658CH_术前+8.421AD/CCT (R2=0.639，P<0.01)，△CRF=?0.007+0.725CRF_术前?0.014RSBT (R2=0.689，P<0.01)。结论：LASIK术前后CH与预计AD和角膜厚度比值密切相关，CRF变化量与预计角膜RSBT密切相关，在设计手术时应慎重考虑预计AD与预计RSBT。

Objective: To discuss the change of corneal hysteresis and corneal resistance factor before and after laser in situkeratomileusis (LASIK), and to analyze their related factors by multivariate linear regression. Methods: In this prospective study, 70 eyes (38 patients) with myopia and myopic astigmatism undergoing LASIK were included. Related factors were measured preoperatively and at 6 months postoperatively by ocular response analyzer, noncontact tonometer (NCT), ultrasonic pachymeter, and Pentacam system. TTe correlation was analyzed between △CH, △CRF and preoperative and operative design’s parameters, and correlative factors analyze. △CH and △CRF were analyzed by the multiple linear regression. Results: CH before and after LASIK were (10.05±1.36) and (8.15±0.90) mmHg, and CRF before and affer LASIK were (9.91±1.38) and (6.92±0.88) mmHg. TTere was signiffcant difference between preoperative and postoperative CH and CRF (P<0.01). △CH and △CRF were (1.90±1.15) and (2.99±1.23) mmHg. Preoperative CH, CRF, intraocular pressure (IOP), ablative depth (AD) and AD/CCT were positive correlated with △CH. Preoperative CH, CRF, IOP, AD, AD/CCT, preoperative spherical equivalent (SE) and predicted residual stromal bed’s thickness (RSBT) were correlated with △CRF. TTe regression equation of △CH and △CRF and influencing factors were △CH =?6.182 + 0.658CH_preoperative + 8.421AD/CCT (R2 =0.639, P<0.01), △CRF =?0.007 + 0.725CRF_preoperative ? 0.014RSBT (R2 =0.689, P<0.01). Conclusion: The change of CH before and after LASIK is correlative with AD/CCT. The change of CRF before and after LASIK is correlative with predicted residual stromal bed’s thickness. Ablative depth and predicted residual stromal bed’s thickness should be considered carefully during the surgical design.

目的：探索适合本地实际情况的屈光发育档案管理模式。方法：总结本区屈光发育档案推行数据，采用鱼骨图系统分析影响屈光发育档案在基层医院推行的关键因素。结果：影响屈光发育档案在基层医院推行的关键因素包括家庭因素、个人因素、学校因素、医院因素。建议通过与学校加强合作，进行健康教育，加强与学生、家长的沟通，开发简易技术，加强医院信息化建设，逐步建立适合本地实际情况的屈光发育档案管理模式。结论：在基层医院建立青少年屈光发育档案受多种因素影响，需平衡家庭、学校、医院的关系，加强数字化平台建设。

Objective: To explore an appropriate management model of refractive development archives suitable for local conditions. Methods: The main influencing factors of refractive development archives in primary hospitals were analyzed by using fishbone diagram. Results: The influencing factors included family factors, personal behavior, school and medical factors. It was recommended to improve the cooperation with school and strengthen communication with students and parents. The hospital should develop simple technologies to strengthen the construction of information technology. An appropriate model of refractive development archives was established according to the local situation. Conclusion: The establishment of adolescent refractive development archives in primary hospitals is affected by many factors. It is necessary to balance the relationship among families, schools and hospitals, and strengthen the construction of digital platforms.

目的：研究基质金属蛋白酶-2（Matrix metalloproteinase-2, MMP-2）、基质金属蛋白酶-9（Matrix metalloproteinase-9, MMP-9）和血管内皮生长因子（Vascular endothelial growth factor, VEGF）在视网膜母细胞瘤（Retinoblastoma, RB）中的表达及其与 RB 分化程度和视神经浸润的关系，探讨它们在 RB 浸润、转移过程中的作用和临床意义。

方法：采用免疫组化方法检测 40 例 RB 中 MMP-2、MMP-9 和 VEGF 的表达。

结果：40 例 RB 中 MMP-2、MMP-9 和 VEGF 的阳性表达率分别为 52.5%、57.5% 和 72.5%。未分化型 RB 中 MMP-2、MMP-9 和 VEGF 的阳性表达均高于分化型（P < 0.05）；有视神经浸润的 RB 中 MMP-2、MMP-9 和 VEGF 的阳性水平均高于无视神经浸润的 RB（P < 0.05）。RB 中 MMP-2、MMP-9 和 VEGF 的表达呈正相关关系（P < 0.05）。

结论：RB 中 MMP-2、MMP-9 和 VEGF 高表达与 RB 的浸润和转移相关，且 MMP-2、MMP-9 表达与 VEGF 表达存在相关性。联合检测 MMP-2、MMP-9 和 VEGF 的表达可作为反映 RB 浸润、转移潜能的生物学指标，有助于筛选转移高危病例及评价患者预后。

Purpose: To study the expression of matrix metalloproteinase-2 (MMP-2), matrix metalloproteinase-9 (MMP-9) and vascular endothelial growth factor (VEGF) in retinoblastoma (RB) and its relationship with the differentiation and optic nerve infiltration of RB. And to investigate the role of matrix metalloproteinase-2 (MMP-2), matrix metalloproteinase-9 (MMP-9) and VEGF in the infiltration and metastasis of RB and their clinical significance.

Methods: Immunohistochemical technique was used to detect the protein expression of MMP-2, MMP-9 and VEGF in 40 RB cases.

Results: The MMP-2, MMP-9 protein and VEGF protein expression were detected as positive in 52.5%, 57.5% and 72.5% of 40 RB cases respectively. The expression of MMP-2, MMP-9 and VEGF was significantly higher in the undifferentiated pattern than in the rosetted pattern (p < 0.05); and the expression of MMP-2, MMP-9 and VEGF was significantly higher in tumors with optic nerve invasion than in those without optic nerve invasion (p < 0.05). In RB, the expression of MMP-2, MMP-9 had a positive correlation with the expression of VEGF.

Conclusions: In RB, high expression of MMP-2, MMP-9 and VEGF is related to the invasion and metastasis of RB. The expression of MMP-2, MMP-9 is positively correlated with the expression of VEGF. The expression of MMP-2, MMP-9 and VEGF may act as a biological marker for the invasion and metastasis of RB. The method may help screen and identify the cases with high risk for metastasis and to predict the prognosis of patients. 

Background: The aim of this study was to assess the health literacy of adult Vietnamese population in relation to common eye conditions and identify factors associated with respondents never having had an eye examination.

Methods: Four hundred households from two districts of Ba Ria-Vung Tau (BRVT) province were selected by multistage cluster random sampling. One adult from each household was administered a pre-tested knowledge, attitude and practices toward eye health questionnaire. Chi-square test and logistic regression were used for statistical analysis.

Results: Of the 400 subjects interviewed (mean age: 51.5±14.5 years; range, 30–90 years), 53.5% reported never having had an eye examination and 38.0% had spectacles. Awareness of eye conditions ranged from 7.0% for glaucoma to 52.8% for red eye. Low awareness of these conditions was significantly associated with rural habitation (odds ratio ranged from 1.65 to 2.78), lower educational attainment (odds ratio ranged from 1.78 to 2.59) and non-spectacle wear (odds ratio ranged from 1.88 to 4.55). Significant barriers to eye examination included lower educational attainment, reported absence of eye problems, non-spectacle wear, lack of affordability, and lack of health insurance.

Conclusions: Knowledge of and attitude or practices to eye health is low within the general public in Vietnam, especially among those who have never had an eye examination, are less educated and live in rural areas. Eye health promotion activities are warranted for the population and speciff c factors that influence eye examination visits should be addressed.

Background: The aim of this study was to assess the health literacy of adult Vietnamese population in relation to common eye conditions and identify factors associated with respondents never having had an eye examination.

Methods: Four hundred households from two districts of Ba Ria-Vung Tau (BRVT) province were selected by multistage cluster random sampling. One adult from each household was administered a pre-tested knowledge, attitude and practices toward eye health questionnaire. Chi-square test and logistic regression were used for statistical analysis.

Results: Of the 400 subjects interviewed (mean age: 51.5±14.5 years; range, 30–90 years), 53.5% reported never having had an eye examination and 38.0% had spectacles. Awareness of eye conditions ranged from 7.0% for glaucoma to 52.8% for red eye. Low awareness of these conditions was significantly associated with rural habitation (odds ratio ranged from 1.65 to 2.78), lower educational attainment (odds ratio ranged from 1.78 to 2.59) and non-spectacle wear (odds ratio ranged from 1.88 to 4.55). Significant barriers to eye examination included lower educational attainment, reported absence of eye problems, non-spectacle wear, lack of affordability, and lack of health insurance.

Conclusions: Knowledge of and attitude or practices to eye health is low within the general public in Vietnam, especially among those who have never had an eye examination, are less educated and live in rural areas. Eye health promotion activities are warranted for the population and speciff c factors that influence eye examination visits should be addressed.

Purpose: To investigate the effect of intravitreal injection of basic fibroblast growth factor (bFGF) on activation and proliferation of endogenous retinal progenitor cells in the Royal College of Surgeons (RCS) rat.

Methods: Twenty-four rats were studied after the 30th postnatal day (≥30). Eighteen RCS-p⁺/LAV rats were divided into 3 groups: bFGF-treated, vehicle-treated, and untreated groups randomly, and 6 RCS-ray⁺p⁺/Lav rats were used as normal controls. 6 μl of bFGF (5 μg /10 μl) or vehicle was injected into the vitreous on day 31, 33, and 35 after birth (P31, P33, P35) in the bFGF group and vehicle group respectively, and no injections were administered in the untreated and control groups. All the rats were euthanized, and their eyes were enucleated, hemisected, and fixed at 50 days after birth for immunohistochemistry and measurement of outer nuclear layer thickness.

Results: Nestin and Chx10 were positive in all retinal layers. Intravitreal injection of bFGF in retina-dystrophic RCS (RCS-p⁺/Lav) rats induced intense labeling for the retinal progenitor cell markers Chx10 and Nestin, which were highly colocalized. Fluorescence intensity for both labels was somewhat less in the control rats, and much less in the vehicle-injected rats as well as in the untreated RCS rats. The outer nuclear layer (ONL) was significantly thicker in the bFGF group than that in the vehicle-treated or untreated group (P < 0.01), but thinner than that of the control group (P < 0.01). No significant difference was observed in the ONL thickness between the vehicle group and untreated group (P > 0.05).

Conclusion: bFGF may contribute to the activation of retinal progenitor cells in RCS rats, thus counteracting degeneration by promoting the proliferation of the progenitor cells.

Purpose: To investigate the effect of intravitreal injection of basic fibroblast growth factor (bFGF) on activation and proliferation of endogenous retinal progenitor cells in the Royal College of Surgeons (RCS) rat.

Methods: Twenty-four rats were studied after the 30th postnatal day (≥30). Eighteen RCS-p⁺/LAV rats were divided into 3 groups: bFGF-treated, vehicle-treated, and untreated groups randomly, and 6 RCS-ray⁺p⁺/Lav rats were used as normal controls. 6 μl of bFGF (5 μg /10 μl) or vehicle was injected into the vitreous on day 31, 33, and 35 after birth (P31, P33, P35) in the bFGF group and vehicle group respectively, and no injections were administered in the untreated and control groups. All the rats were euthanized, and their eyes were enucleated, hemisected, and fixed at 50 days after birth for immunohistochemistry and measurement of outer nuclear layer thickness.

Results: Nestin and Chx10 were positive in all retinal layers. Intravitreal injection of bFGF in retina-dystrophic RCS (RCS-p⁺/Lav) rats induced intense labeling for the retinal progenitor cell markers Chx10 and Nestin, which were highly colocalized. Fluorescence intensity for both labels was somewhat less in the control rats, and much less in the vehicle-injected rats as well as in the untreated RCS rats. The outer nuclear layer (ONL) was significantly thicker in the bFGF group than that in the vehicle-treated or untreated group (P < 0.01), but thinner than that of the control group (P < 0.01). No significant difference was observed in the ONL thickness between the vehicle group and untreated group (P > 0.05).

Conclusion: bFGF may contribute to the activation of retinal progenitor cells in RCS rats, thus counteracting degeneration by promoting the proliferation of the progenitor cells.

Background: To explore the difference between the outcomes of correlations between a series of variables and adverse reactions (ARs) to fluorescein from univariate and multivariate analysis and to evaluate the nausea effects in different age groups.

Methods: A retrospective study of patients undergoing consecutive fluorescein angiography between March 2010 and February 2012 was conducted. No patients were excluded on the ground of age, presence of atopy, allergy history, previous procedures without severe allergic ARs, asymptomatic hypertension and kidney failure with serum creatinine levels lower than 250 μmol/L or with renal dialysis.

Results: A total of 829 patients were enrolled and 22.2% of them had ARs. The majority of reactions were nausea (12.1%) which occurred less when age became old (P<0.0001). When the correlations between a series of variables and ARs were assessed separately, age (P<0.0001), prior reactions (P<0.0001) and motion sickness (P=0.0062) were highly and cardio/cerebrovascular disease (P=0.0015), diabetes (P=0.0001) and renal disease (P=0.0219) were lowly related to ARs. However, when the correlations were assessed simultaneously, only age [odd ratio (OR) 0.974; 95% confidence interval (CI), 0.962–0.986], prior reactions (OR 5.596; 95% CI, 2.083–15.029) and motion sickness (OR 4.849; 95% CI, 1.583–14.856) were statistically correlated with ARs.

Conclusions: Fluorescein angiography is a safe procedure for patients who are relatively healthy but with a history of any systemic disease. Young age, prior reactions and motion sickness which are highly related to emetic events should be considered in the evaluation of ARs to fluorescein.

Background: To explore the difference between the outcomes of correlations between a series of variables and adverse reactions (ARs) to fluorescein from univariate and multivariate analysis and to evaluate the nausea effects in different age groups.

Methods: A retrospective study of patients undergoing consecutive fluorescein angiography between March 2010 and February 2012 was conducted. No patients were excluded on the ground of age, presence of atopy, allergy history, previous procedures without severe allergic ARs, asymptomatic hypertension and kidney failure with serum creatinine levels lower than 250 μmol/L or with renal dialysis.

Results: A total of 829 patients were enrolled and 22.2% of them had ARs. The majority of reactions were nausea (12.1%) which occurred less when age became old (P<0.0001). When the correlations between a series of variables and ARs were assessed separately, age (P<0.0001), prior reactions (P<0.0001) and motion sickness (P=0.0062) were highly and cardio/cerebrovascular disease (P=0.0015), diabetes (P=0.0001) and renal disease (P=0.0219) were lowly related to ARs. However, when the correlations were assessed simultaneously, only age [odd ratio (OR) 0.974; 95% confidence interval (CI), 0.962–0.986], prior reactions (OR 5.596; 95% CI, 2.083–15.029) and motion sickness (OR 4.849; 95% CI, 1.583–14.856) were statistically correlated with ARs.

Conclusions: Fluorescein angiography is a safe procedure for patients who are relatively healthy but with a history of any systemic disease. Young age, prior reactions and motion sickness which are highly related to emetic events should be considered in the evaluation of ARs to fluorescein.

The present study reports a case of a patient with choroidal neovascularization (CNV) associated with pseudoxanthoma elasticum (PXE). We observed the functional and anatomical improvement of the patient treated with intravitreal vascular endothelial growth factor (VEGF) inhibitor bevacizumab. The study also systematically searched the database for similar cases to provide a literature review. Data concerning the clinical features, treatment strategies and outcomes were extracted and analyzed. Retrospective interventional case report and systematic literature review. A 56-year-old healthy Chinese woman with CNV secondary to PXE was reported. Examinations included best corrected visual acuity (BCVA), biomicroscopy, optical coherence tomography (OCT), fluorescein and indocyanine green angiography and digital fundus photography. The patient managed with intravitreal anti-vascular endothelial growth factor (anti-VEGF) injections (bevacizumab 1.25 mg/0.05 mL). The Cochrane Library, PubMed, OVID, and UpToDate databases were searched using the term pseudoxanthoma elasticum or Gr?nblad-Strandberg syndrome with the limits English. Articles that predated the databases were gathered from current references. Fundus examination revealed angioid streaks bilaterally and CNV in left eye (LE). After the patient underwent three intravitreal injections of bevacizumab, the LE showed absorption of the subretinal fluid and shrinkage of the CNV. Visual acuity (VA) was improved in her treated LE. Bevacizumab treatment was well tolerated with no adverse events reported. Approximately ten articles about 45 patients (49 eyes) describing CNV secondary to angioid streaks in PXE treated with anti-VEGF were found in the literature search. In the present case, bevacizumab of an initial three injection loading dose, achieved maintenance of visual function in the treatment of CNV associated with angioid streaks in PXE. Literature articles concluded that the intravitreal application of anti-VEGF is highly efficient for improving and stabilizing the lesion as well as the eyesight. So we believe that anti-VEGF therapy can be a great choice of treatment for CNV secondary to angioid streaks related PXE.

The present study reports a case of a patient with choroidal neovascularization (CNV) associated with pseudoxanthoma elasticum (PXE). We observed the functional and anatomical improvement of the patient treated with intravitreal vascular endothelial growth factor (VEGF) inhibitor bevacizumab. The study also systematically searched the database for similar cases to provide a literature review. Data concerning the clinical features, treatment strategies and outcomes were extracted and analyzed. Retrospective interventional case report and systematic literature review. A 56-year-old healthy Chinese woman with CNV secondary to PXE was reported. Examinations included best corrected visual acuity (BCVA), biomicroscopy, optical coherence tomography (OCT), fluorescein and indocyanine green angiography and digital fundus photography. The patient managed with intravitreal anti-vascular endothelial growth factor (anti-VEGF) injections (bevacizumab 1.25 mg/0.05 mL). The Cochrane Library, PubMed, OVID, and UpToDate databases were searched using the term pseudoxanthoma elasticum or Gr?nblad-Strandberg syndrome with the limits English. Articles that predated the databases were gathered from current references. Fundus examination revealed angioid streaks bilaterally and CNV in left eye (LE). After the patient underwent three intravitreal injections of bevacizumab, the LE showed absorption of the subretinal fluid and shrinkage of the CNV. Visual acuity (VA) was improved in her treated LE. Bevacizumab treatment was well tolerated with no adverse events reported. Approximately ten articles about 45 patients (49 eyes) describing CNV secondary to angioid streaks in PXE treated with anti-VEGF were found in the literature search. In the present case, bevacizumab of an initial three injection loading dose, achieved maintenance of visual function in the treatment of CNV associated with angioid streaks in PXE. Literature articles concluded that the intravitreal application of anti-VEGF is highly efficient for improving and stabilizing the lesion as well as the eyesight. So we believe that anti-VEGF therapy can be a great choice of treatment for CNV secondary to angioid streaks related PXE.

目的:研究增殖性糖尿病视网膜病变患者玻璃体基质细胞衍生因子(Strmalcell-derivedfactor-1, SDF-1)和血管内皮生长因子(Vascular endothelial growth factor, VECF)的浓度,及其相互作用关系。

方法:酶联免疫吸附法(Enzyme-linked immunosorbent assay, ELISA)检测玻璃体内 SDF-1 和 VEGF 的含量,每个标本重复3次。实验组为增性糖尿病视网膜病变(Proliferalive diabeticretinopathy, PDR)的住院患者30例,对照组为同期行玻璃体切除术的特发性黄斑裂孔患者12例。

结果: PDR 患者玻璃体 VECF 的平均浓度为(2865.87+387.85) pg/ml,明显高于特发性黄斑裂孔组[(142.42+21.03) pg/ml，P < 0.0001]。增殖性糖尿病视网膜病变患者玻璃体 SDF-1的含量平均为(298.40+24.57) pg/ml,对照组为(86.91+15.89) pg/ml,两组的差异具有统计学意义(P < 0.0001)。在30例PDR患者玻璃体内 VEGF 和 SDF-1 的含量表现为正相关(Peanson相关系数 r=0.62，P < 0.001)。

结论:增殖性糖尿病患者玻璃体 SDF-1 和 VECF 的含量均高于非糖尿病患者,提示 SDF-1 和 VEGF 共同参与了增殖性糖尿病视网膜病变患者病理性新生血管的形成过程。

Purpose: To investigate the levels of stromal cell-derived factor-1(SDF-1) andvascular endothelial growth factor (VEGF) in the vitreous of patients with proliferativediabetic retinopathy.
Methods: The levels of $DF-1 and VEGF in the vitreous of 30 eyes of 30 patients withproliferative diabetic retinopathy(PDR)and 12 eyes of 12 patients with idiopathicmacular hole (MH) were measured by enzyme-linked immunosorbent assay. Vitreousfluid samples were obtained by vitrectomy.
Resuls: The vitreous concentration of VEGF was signifcantly higher in eyes with PDR(2 865.87+387.85 pg/ml) than in eyes with idiopathic macular hole (142.42+21.03 Pgml, P< 0.000 1). The vitreous level of SDF-1 was also significantly higher in eyes withPDR (298.40+24.57 pg/ml ) than in eyes with idiopathic macular hole (86.91+15.89Pg/ml, P<0.000 1 ). The vitreous concentration of SDF-1 correlated significantly with that of VEGF in eyes with PDR( [correlation coefficient]r=0.62,P<0 .001)
Conclution: Vitreous levels of both SDF-1 and VEGF in patients with PDR aresignificantly higher than those of nondiabetic patients. SDF-1 may be correlated withVEGF in angiogenesis in PDR.