Background: This study aimed to explore the best screening measure of myopia and its associated optimal referral criteria for children aged between 6 and 16.

Methods: After informed consent of cycloplegia was obtained, a total of 6,321 children aged between 6 and 16 from 53 primary or junior middle schools in Jiading District of Shanghai were included in our populationbased study. Receiver operating characteristic (ROC) curve was performed to determine the best cutoff points, sensitivities and specifi cities of diff erent screening tests, including uncorrected visual acuity (UCVA), noncycloplegic autorefraction (NCAR) and the combination of these two tests.

Results: There was significant difference in prevalence of myopia between boys and girls (χ² =6.358, P=0.012). Compared with children of low age, the prevalence of older children was significantly higher (χ² =1,386.404, P<0.001). For the combination of UCVA and NCAR, the best cutoff point was UCVA less than or equal to 0.2 logarithm of minimum angle of resolution (MAR) (20/30) and NCAR spherical equivalent refraction (SER) less than or equal to ?0.75 diopters (D), with associated sensitivity and specifi city of 75.0% and 85.0%, respectively, which were higher than those of UCVA and NCAR alone. After stratified by age, the best cutoff points were varied among children. The accuracy for children aged between 9 and 12 was higher than that for other ages.

Conclusions: The best screening measure of myopia was the combination of UCVA and NCAR. The optimal referral criteria of myopia for children should be age-determined.

Background: This study aimed to explore the best screening measure of myopia and its associated optimal referral criteria for children aged between 6 and 16.

Methods: After informed consent of cycloplegia was obtained, a total of 6,321 children aged between 6 and 16 from 53 primary or junior middle schools in Jiading District of Shanghai were included in our populationbased study. Receiver operating characteristic (ROC) curve was performed to determine the best cutoff points, sensitivities and specifi cities of diff erent screening tests, including uncorrected visual acuity (UCVA), noncycloplegic autorefraction (NCAR) and the combination of these two tests.

Results: There was significant difference in prevalence of myopia between boys and girls (χ² =6.358, P=0.012). Compared with children of low age, the prevalence of older children was significantly higher (χ² =1,386.404, P<0.001). For the combination of UCVA and NCAR, the best cutoff point was UCVA less than or equal to 0.2 logarithm of minimum angle of resolution (MAR) (20/30) and NCAR spherical equivalent refraction (SER) less than or equal to ?0.75 diopters (D), with associated sensitivity and specifi city of 75.0% and 85.0%, respectively, which were higher than those of UCVA and NCAR alone. After stratified by age, the best cutoff points were varied among children. The accuracy for children aged between 9 and 12 was higher than that for other ages.

Conclusions: The best screening measure of myopia was the combination of UCVA and NCAR. The optimal referral criteria of myopia for children should be age-determined.

Background: The purpose is to investigate the relationship between full-thickness macular hole (MH) and retinal break (RB) and/or lattice degeneration.

Methods: Patients diagnosed as full-thickness MH and referred to Dr. Lin Lu from January 2009 to December 2013 were evaluated. All patients underwent general ophthalmologic examinations, fundus examination and optical coherence tomography (OCT). The RB and/or lattice degeneration were recorded.

Results: Totally 183 eyes of 167 patients were included. The sex ratio of men to women was 1:2.88. A total of 17 eyes were pseudophakic and 166 eyes were phakic. RB and/or lattice degeneration were found in 62 eyes (33.88%). The prevalence of RB and/or lattice degeneration was similar between men and women (P=0.344>0.05). There was no statistical diff erence between the pseudophakic eyes and phakic eyes (P=0.138>0.05). All of the RB and/or lattice degeneration were located near or anterior to the equator. The inferior quadrants and the vertical meridian were aff ected more often than the superior quadrants and the horizontal meridian.

Conclusions: We identified a high incidence of RB/lattice degeneration in cases of full-thickness MH. Carefully examination of the peripheral retina and prophylactic treatment of RB and/or lattice degeneration are critical.

Background: The purpose is to investigate the relationship between full-thickness macular hole (MH) and retinal break (RB) and/or lattice degeneration.

Methods: Patients diagnosed as full-thickness MH and referred to Dr. Lin Lu from January 2009 to December 2013 were evaluated. All patients underwent general ophthalmologic examinations, fundus examination and optical coherence tomography (OCT). The RB and/or lattice degeneration were recorded.

Results: Totally 183 eyes of 167 patients were included. The sex ratio of men to women was 1:2.88. A total of 17 eyes were pseudophakic and 166 eyes were phakic. RB and/or lattice degeneration were found in 62 eyes (33.88%). The prevalence of RB and/or lattice degeneration was similar between men and women (P=0.344>0.05). There was no statistical diff erence between the pseudophakic eyes and phakic eyes (P=0.138>0.05). All of the RB and/or lattice degeneration were located near or anterior to the equator. The inferior quadrants and the vertical meridian were aff ected more often than the superior quadrants and the horizontal meridian.

Conclusions: We identified a high incidence of RB/lattice degeneration in cases of full-thickness MH. Carefully examination of the peripheral retina and prophylactic treatment of RB and/or lattice degeneration are critical.

Background: Primary chronic angle-closure glaucoma (PCACG) is one of the main types of glaucoma in China. Trabeculectomy is the most commonly used glaucoma filtration surgery for glaucoma in the world. Conventional trabeculectomy is prone to anesthesia-related complications intraoperative and operationrelated complications postoperative in PCACG treatment. Modified minimally invasive trabeculectomy maybe can reduce the incidence of complications.

Methods: We conducted a prospective case series study and performed modified fornix-based trabeculectomy in 27 patients (30 eyes) under topical anesthesia; we then observed intraoperative anesthesia and cooperation effect, intraoperative and postoperative complications, preoperative and postoperative visual acuity, intraocular pressure (IOP), visual field, and the use of ocular hypotensive drugs. The patients were followed up for at least 12 months.

Results: All operations were completed successfully with no intraoperative complications. All 27 patients (30 eyes) were followed up for at least 12 months. No significant decrease in visual acuity was observed at days 1 or 7 and at months 1, 3, 6, and 12 after operation; however, a significant decrease in IOP was observed at days 1 and 7 and at months 1, 3, 6, and 12 after operation. Moreover, no significant progression in visual field mean defect was observed at month 12 after operation, and the number of ocular hypotensive drugs required was significantly reduced at months 6 and 12 after operation. By month 12 after operation, the overall success rate was 93.33% (28/30).

Conclusions: Modified minimally invasive trabeculectomy is safe and effective for the treatment of PCACG.

Background: Primary chronic angle-closure glaucoma (PCACG) is one of the main types of glaucoma in China. Trabeculectomy is the most commonly used glaucoma filtration surgery for glaucoma in the world. Conventional trabeculectomy is prone to anesthesia-related complications intraoperative and operationrelated complications postoperative in PCACG treatment. Modified minimally invasive trabeculectomy maybe can reduce the incidence of complications.

Methods: We conducted a prospective case series study and performed modified fornix-based trabeculectomy in 27 patients (30 eyes) under topical anesthesia; we then observed intraoperative anesthesia and cooperation effect, intraoperative and postoperative complications, preoperative and postoperative visual acuity, intraocular pressure (IOP), visual field, and the use of ocular hypotensive drugs. The patients were followed up for at least 12 months.

Results: All operations were completed successfully with no intraoperative complications. All 27 patients (30 eyes) were followed up for at least 12 months. No significant decrease in visual acuity was observed at days 1 or 7 and at months 1, 3, 6, and 12 after operation; however, a significant decrease in IOP was observed at days 1 and 7 and at months 1, 3, 6, and 12 after operation. Moreover, no significant progression in visual field mean defect was observed at month 12 after operation, and the number of ocular hypotensive drugs required was significantly reduced at months 6 and 12 after operation. By month 12 after operation, the overall success rate was 93.33% (28/30).

Conclusions: Modified minimally invasive trabeculectomy is safe and effective for the treatment of PCACG.

Background: Different visual acuity chart can be targeted to evaluate the visual function of patients with different eye diseases. We conducted a comparative analysis of the digital logarithm of the minimum angle of resolution (LogMAR) vision chart and the standard logarithmic vision chart for the measurement of visual acuity after retinal detachment surgery.

Methods: We used the digital LogMAR vision chart and the standard logarithmic vision chart to measure the visual acuity of 100 patients (100 eyes) who underwent retinal detachment surgery at our hospital using the LogMAR recording method and compared the differences between the mean measurements obtained by both methods for all patients and for different age groups.

Results: When all of the patients were analyzed, the mean visual acuity differed between the digital LogMAR vision chart and the standard logarithmic vision chart by –0.07 LogMAR units. No significant difference was observed in the mean visual acuity between the two vision charts in the 10-20 year and 21-40 year age groups (P>0.05), while a significant difference was observed in post-operative mean visual acuity between the two vision charts for patients aged 41-65 years (P<0.05).

Conclusions: Both the digital LogMAR vision chart and the standard vision chart were effective and reliable for the measurement of visual acuity. The visual acuity measured by the standard vision chart was higher than that measured by the digital LogMAR vision chart. We recommend using the digital LogMAR vision chart as the preferred chart for measuring visual acuity after retinal detachment surgery.

Background: Different visual acuity chart can be targeted to evaluate the visual function of patients with different eye diseases. We conducted a comparative analysis of the digital logarithm of the minimum angle of resolution (LogMAR) vision chart and the standard logarithmic vision chart for the measurement of visual acuity after retinal detachment surgery.

Methods: We used the digital LogMAR vision chart and the standard logarithmic vision chart to measure the visual acuity of 100 patients (100 eyes) who underwent retinal detachment surgery at our hospital using the LogMAR recording method and compared the differences between the mean measurements obtained by both methods for all patients and for different age groups.

Results: When all of the patients were analyzed, the mean visual acuity differed between the digital LogMAR vision chart and the standard logarithmic vision chart by –0.07 LogMAR units. No significant difference was observed in the mean visual acuity between the two vision charts in the 10-20 year and 21-40 year age groups (P>0.05), while a significant difference was observed in post-operative mean visual acuity between the two vision charts for patients aged 41-65 years (P<0.05).

Conclusions: Both the digital LogMAR vision chart and the standard vision chart were effective and reliable for the measurement of visual acuity. The visual acuity measured by the standard vision chart was higher than that measured by the digital LogMAR vision chart. We recommend using the digital LogMAR vision chart as the preferred chart for measuring visual acuity after retinal detachment surgery.

Background: The effect of perioperative injection of Lucentis on intraoperative bleeding in patients with proliferative diabetic retinopathy (PDR) was systematically evaluated using a meta-analysis.

Methods: Reports of surgical eye treatment with and without perioperative intravitreal injection of Lucentis in Medline, the Cochrane Library, PubMed, the Chinese Biomedical Literature Database, and China Academic Journals Full-text Database were included in the study. A meta-analysis was performed on all included literature. A computerized search was performed in the above databases. In addition, relevant books, journals, and conference proceedings and their bibliographies were manually searched. Published literature was screened according to the inclusion and exclusion criteria. Data extraction was performed on included studies. RevMan5.2 software was used for the statistical analyses. Dichotomous variables are presented as odds ratios (ORs) and 95% confidence intervals (CIs). The major indicator was the occurrence of intraoperative retinal hemorrhaging during vitrectomy.

Results: A total of seven studies were included in the analysis. The treatment group included 159 eyes and control group included 149 eyes. The amount of intraoperative bleeding in the treatment group (perioperative Lucentis injection) was significantly lower than that in the control group (OR, 56.93; 95% CI: 21.81-148.57, P<0.01).

Conclusions: Intravitreal Lucentis injection before a vitrectomy significantly reduced intraoperative bleeding in PDR patients.

Background: The effect of perioperative injection of Lucentis on intraoperative bleeding in patients with proliferative diabetic retinopathy (PDR) was systematically evaluated using a meta-analysis.

Methods: Reports of surgical eye treatment with and without perioperative intravitreal injection of Lucentis in Medline, the Cochrane Library, PubMed, the Chinese Biomedical Literature Database, and China Academic Journals Full-text Database were included in the study. A meta-analysis was performed on all included literature. A computerized search was performed in the above databases. In addition, relevant books, journals, and conference proceedings and their bibliographies were manually searched. Published literature was screened according to the inclusion and exclusion criteria. Data extraction was performed on included studies. RevMan5.2 software was used for the statistical analyses. Dichotomous variables are presented as odds ratios (ORs) and 95% confidence intervals (CIs). The major indicator was the occurrence of intraoperative retinal hemorrhaging during vitrectomy.

Results: A total of seven studies were included in the analysis. The treatment group included 159 eyes and control group included 149 eyes. The amount of intraoperative bleeding in the treatment group (perioperative Lucentis injection) was significantly lower than that in the control group (OR, 56.93; 95% CI: 21.81-148.57, P<0.01).

Conclusions: Intravitreal Lucentis injection before a vitrectomy significantly reduced intraoperative bleeding in PDR patients.

目的:探讨胰岛素控制血糖对糖尿病早期大鼠视网膜血管形态改变和血管内皮细胞生长因子(Vascular endothelial growth factor，VEGF)表达的影响。
方法:实验动物 Wisiar 大鼠分正常对照组、糖尿病组、糖尿病血糖严格控制组和糖尿病血糖非严格控制组。链尿佐菌素(Streptozotocin，STZ)诱导糖尿病动物模型，动物成模3周后糖尿病血糖严格控制组及血糖非严格控制组大鼠予胰岛素治疗，20d后处死，行Fluoresceinisothiocyanatedextran(FITC-Dextran)灌注视网膜血管铺片观察大鼠视网膜血管形态变化，并行 VECF 免疫荧光染色观察大鼠视网膜 VEGF 的表达改变。
结果:FITC-Dextran 灌注示糖尿病血糖非严格控制组大鼠视网膜浅层血管多处荧光素聚集，不均匀分布,深层毛细血管局部扩张、迂曲；血糖严格控制组视网膜血管管径较均匀一致，无局部扩张或狭窄。糖尿病血糖非严格控制组VECF高表达，血糖严格控制组较糖尿病组、血糖非严格控制组视网膜 VEGF表达下降，统计学比较具有显著性差异(P <0.05)。
结论:胰岛素治疗严格控制血糖至正常水平可以降低糖尿病早期大鼠视网膜 VEGF的表达、减轻视网膜血管损害；血糖波动会加重糖尿病视网膜病变的发展。

Objective : To observe the role of blood glucose control on morphology changes of retinalvessels and retinal vascular endothelial growth factor ( VEGF) expression in early diabetic rats.

Methods : Diabetes was induced in 8-week-old male wistar rats by a single intraperitone.al injection of Streptozotocin ($TZ). After 3 weeks, the animals were randomly dividedinto four groups:1) normal rats group, 2) diabetic rats group, 3) diabetic rats withglucose controlled group , received intensive insulin therapy for 20 days, and 4) diabeticrats with uncontrolled blood glucose group, received unregular insulin therapy, whichcaused the abrupt fluctuation of glucose. After the treatment period, the animals were perfused with 30mg/ml Fluorescein isothiocyanate-dextran ( FITC-Dextran ). The eyeswere enucleated and fixed in 4% paraformaldehyde immediately. Retinal flat mountsand paraffn sections were prepared. Morphology of impaired retinal vessels and retinalVECF expression were assessed by immunofluorescence stain and image analysis.
Results :The flat-mounted retinas showed more FITC-Dextran aggregated locally at ves-sels and capillary meandered or dilated in $TZ-diabetic rats with uncontrolled blood glu.cose than in $TZ-diabetic rats with controlled blood glucose. Retinal VEGF expressiondecreased in group 3 compared with group 2 or with group 4. The statistical differencewas significant(P <0. 05).
Conclusion : Strict control of blood glucose by insulin could decrease VEGF expressionin retina and protect retinal vessels from impairing in early STZ-diabetic rats. 

Diabetic macular edema (DME) is a major sight-threatening cause in diabetic patients. We review the long-term outcome of four approved pharmacotherapy for treating DME, including intravitreal injections of corticosteroids (dexamethasone implants and fl uocinolone acetonide inserts) and anti-vascular endothelial growth factor (VEGF) (ranibizumab and aflibercept). They all show superior ability to improve vision and reduce macular thickness, comparing with sham injections or macular focal/grid laser treatment. Anti-VEGF agents result in low incidence of severe ocular or systemic adverse effects, but glaucoma and cataract should be aware after intravitreal corticosteroids. Prompt treatment with these agents can lead to a better outcome.

Diabetic macular edema (DME) is a major sight-threatening cause in diabetic patients. We review the long-term outcome of four approved pharmacotherapy for treating DME, including intravitreal injections of corticosteroids (dexamethasone implants and fl uocinolone acetonide inserts) and anti-vascular endothelial growth factor (VEGF) (ranibizumab and aflibercept). They all show superior ability to improve vision and reduce macular thickness, comparing with sham injections or macular focal/grid laser treatment. Anti-VEGF agents result in low incidence of severe ocular or systemic adverse effects, but glaucoma and cataract should be aware after intravitreal corticosteroids. Prompt treatment with these agents can lead to a better outcome.

目的：探讨伴无前房、白内障的葡萄膜炎继发性青光眼的手术治疗方法。

方法：采用经角膜缘的晶状体和前段玻璃体切除或经睫状体平坦部的晶状体和玻璃体切除联合小梁切除术，对7只眼伴有无前房、白内障的葡萄膜炎继发性青光眼进行了手术治疗，观察术前术后眼压和前房深度变化、滤过泡、视力以及并发症情况，随访时间3～48个月。

结果：(1)眼压：7只眼术前平均眼压为(5.18±0.77)kPa，术后1天平均眼压为(0.95±0.29)kPa，术后1周平均眼压为(0.93±0.12)kPa，最后1次随访平均眼压为(1.14 4-0.70)kPa；(2)前房深度：所有患眼术后均形成前房，中央前房深度为3～5CT；(3)滤过泡情况：所有患眼术后均形成功能滤过泡，滤过泡形态为扁平弥散；(4)视力：1患眼术前视力0.01，术后1周视力CF／20am，最后1次随访矫正视力0.06；1患眼术前视力0.05，术后1周0.01，最后1次随访矫正视力0.1；余患者多为幼儿，不能配合视力检查但可追光；(5)术后并发症：所有患眼术后早期均有角膜水肿，瞳孔区均有纤维性渗出，房水闪辉(+～++++)，但均未出现瞳孔和周切口膜闭、视网膜脱离和眼内炎等并发症。

结论：对于葡萄膜炎继发性青光眼同时伴无前房或极浅前房、白内障玻璃体混浊患者，晶状体玻璃体切除联合小梁切除手术能有效降低眼压，形成前房，无严重并发症，是一种治疗伴无前房的葡萄膜炎继发性青光眼安全有效的方法。

Purpose：To evaluate the efficacy of combined trabeculectomy，lensectomy and vitreeto—my for the management of secondary glaucoma in uveitis with extremely shallow anterior chamber and cataract.

Methods: Combined trabeculectomy, lensectomy and vitrectomy were undertaken formedically uncontrolled intraocular pressure (IOP)on 7 eyes (6 patients, aged from 4months to 20 years) with secondary glaucoma in uveitis in a retrospective cohort studybetween 2001 and 2005.

Resuls : The follow-up period ranged from 3 months to 4 years. Deep anterior chamberand functional bleb were observed in all the eyes postoperatively. The average IOP preoperatively, one day postoperatively, one week postoperatively, and the last time of fol-low-up were(5.18±0.77)kPa,(0.95 +0.29)kPa,(0.93 +0.12)kPa, and(1.14±0, 70 ) kPa respectively. No severe complication was observed postoperatively exceptfor the corneal edema and fber exudation.
Conclusions : Combined trabeculectomy, lensectomy and vitrectomy serve as effectiveand safety treatments for secondary glaucomous uveitis accompanied by extremely shal-low anterior chamber, cataract and vitreous opacity. Further intriguing study comparingthis combined surgery with combined phacoemulsification and drainage implant surgeryis warranted.

Widely used in clinical research, the database is a new type of data management automation technology and the most efficient tool for data management. In this article, we first explain some basic concepts, such as the definition, classification, and establishment of databases. Afterward, the workflow for establishing databases, inputting data, verifying data, and managing databases is presented. Meanwhile, by discussing the application of databases in clinical research, we illuminate the important role of databases in clinical research practice. Lastly, we introduce the reanalysis of randomized controlled trials (RCTs) and cloud computing techniques, showing the most recent advancements of databases in clinical research.

Widely used in clinical research, the database is a new type of data management automation technology and the most efficient tool for data management. In this article, we first explain some basic concepts, such as the definition, classification, and establishment of databases. Afterward, the workflow for establishing databases, inputting data, verifying data, and managing databases is presented. Meanwhile, by discussing the application of databases in clinical research, we illuminate the important role of databases in clinical research practice. Lastly, we introduce the reanalysis of randomized controlled trials (RCTs) and cloud computing techniques, showing the most recent advancements of databases in clinical research.

Visual electrophysiology is widely used in clinical ophthalmology. It is also of significant value in the objective assessment of visual function in adult and pediatric cataract patients and for the diagnosis of and research on retinal and visual pathway diseases. This article systematically reviews visual electrophysiology techniques, their applications in the diagnosis and treatment of adult and pediatric cataracts, and factors influencing the application of visual electrophysiology during surgical treatment for cataracts.

Visual electrophysiology is widely used in clinical ophthalmology. It is also of significant value in the objective assessment of visual function in adult and pediatric cataract patients and for the diagnosis of and research on retinal and visual pathway diseases. This article systematically reviews visual electrophysiology techniques, their applications in the diagnosis and treatment of adult and pediatric cataracts, and factors influencing the application of visual electrophysiology during surgical treatment for cataracts.