目的：探讨推广新生儿眼病筛查以及婴儿期定期眼保健的必要性。方法：回顾分析 2014 年 1 月至 2016 年 12 月 20800 例惠州市妇幼保健计划生育服务中心门诊收集的婴儿眼保健资料。结果：共检出致盲性眼病 7 种 158 例，其中满 42 d 内检出 147 例，3 个月内检出 8 例，6 个月内检出 2 例，12 个月内检出 1 例。检出时已合并眼位、眼前节异常、影响视功能者 8 例。不同出生胎龄致盲性眼病检出率：≤ 34 周为 11.64％，34～37 周为 1.24％，≥ 37 周为 1.29％。相对于纸质宣传材料，开展家长学校讲课，利用 PPT 结合实际病例讲解，更有助于普及眼保健。相对于眼底检查，眼前节的方式更容易被接受、被推广。结论：致盲性眼病婴儿期发病在临床中并不少见，并且部分是可以早期筛查、早期治疗以避免视功能损害的。临床中需要大力普及眼保健知识，并可以在具备条件的医院，适当利用新生儿广域成像系统推广新生儿眼病普筛。

Objective: To discuss the necessity of screening for neonatal eye disease and regular eye care in infancy. Methods: A retrospective analysis of 20 800 infants in our hospital from January 2014 to December 2016 was conducted. From January 2014 to December 2016. Results: Seven types of blindness eye diseases were detected in 158 cases, including 147 cases at 42 days, 8 cases at 3 months, 2 cases at 6 months and 1 case at 12 months after birth. Eight cases were supervened with abnormal eye position, anterior segment abnormality and poor visual function. The detection rate of blindness-inducing diseases was 11.64% for infants aged ≤ 34 weeks, 1.24% for 34–37 weeks and 1.29% for ≥ 37 weeks. Compared with the paper propaganda materials, the introduction of parental school lectures and PPT combined with explanation of actual cases was more conducive to popularize eye care. Compared with fundus examination, anterior segment examination was more likely to be accepted and popularized. Conclusion: Eye disease inducing blindness in infancy are commonly encountered in clinical practice, which can be screened and treated early to avoid visual impairment. It is necessary to popularize the knowledge of eye care, and promote the screening of newborn eye disease in qualified hospitals.

目的：探讨两种经巩膜缝线固定法治疗人工晶状体（ intraocular lens，IOL）-囊袋复合物半脱位的方法及效果。方法：回顾性研究2014 年 6 月至 2017 年 12 月 IOL -囊袋复合物半脱位共计 31 例，36 眼。详细检查后分类处理。A 组为更换 IOL 组：对术中未植入囊袋张力环或术后发生脱位时间超过 1 年者，取出原 IOL 并重新行缝襻固定术。B 组为重新固定组：首次 IOL 植入术中植入了囊袋张力环且术后发生脱位时间不超过 1 年者，行囊袋张力环及 IOL 袢缝合固定。A 组 25 只眼，B 组 11 只眼。观察术中、术后并发症情况，术后 1 d 、 1 周、 3 个月的最佳矫正视力，并使用 Image-ProPlus v6.0 软件测量 IOL 偏心情况。结果：患者术后视力均较术前提高，术后 3 个月最佳矫正视力提高者 32 眼（91.7%），不变者 3 眼（8.3%）。术后 1 d ，两组术后视力分布差异有统计学意义；在术后 1 周、术后 3 个月，差异无统计学意义。两组术中未见视网膜脱离等严重并发症。A 组术后一过性眼压高 2 例，玻璃体积血 2 例，经保守治疗恢复。术前图像分析软件测量 IOL 偏心均大于 2 mm ，术后 3 个月 IOL 偏心小于 0.5 mm 者 4 眼（11.1%），偏心 0.5 ~ 1 mm 者 21 眼（58.3%），偏心 1 ~ 2 mm 者 11 眼（30.6%）。两组术后 3 个月 IOL 偏心差异无统计学意义。结论：根据 IOL 半脱位情况来选择不同的经巩膜缝线固定法较为安全有效。采用直接经睫状沟缝线固定复位 IOL 方法的患者术后视力恢复更快。

Objective: To investigate two methods and outcomes of transscleral sutured treatment of the intraocular lens (IOL)-capsular complex dislocation. Methods: A total of 31 cases (36 eyes) of IOL-capsular complex dislocation were studied retrospectively from June 2014 to December 2017. In group A, IOL replacement was performed. New IOL was sutured through the sulcus and the sclera after the original IOL was extracted when the capsular tension ring had not been implanted during the operation, or IOL dislocation happened at least 1 year postoperatively. In group B, IOL refixation was conducted. The original IOL was repositioned directly via transscleral suturing when the capsular tension ring was implanted, and the postoperative dislocation occurred less than 1 year after surgery. There were 25 eyes in group A and 11 eyes in group B. Intra- and post-operative complications were observed. Best corrected visual acuity (BCVA) was analyzed 1 d, 1 week, and 3 months after surgery. IOL decentration was measured using Image-ProPlus v6.0 software. Results: All patients had better visual acuity after the surgery. BCVA was improved in 32 eyes (91.7%), and remained unchanged in 3 eyes (8.3%) at postoperative 3 months. The difference of vision distribution between the two groups was statistically significant 1 d after surgery, and there was no statistical significance between two groups at postoperative 1 week and 3 months. No retinal detachment and other serious complications were observed. In group A, temporary increase in intraocular pressure was noted in 3 eyes and mild vitreous hemorrhage was observed in 2 eyes, which were effectively recovered after medical treatment. The imaging analysis revealed more than 2 mm IOL eccentricity was observed in all cases preoperatively. Postoperative IOL eccentricity were less than 0.5 mm in 4 eyes (11.1%), 0.5 - 1 mm in 21 eyes (58.3%), and 1-2 mm in 11 eyes (30.6%). There was no statistical significance in IOL eccentricity between two groups at 3 months after surgery.  Conclusion: It is safe and effective to choose different scleral suture fixation methods according to IOL-capsular bag dislocation. The visual acuity of patients is faster recovered after IOL fixation via ciliary sulcus suture compared with other approaches.

目的：评价药物治疗无效的开角型青光眼及部分复杂性青光眼行二氧化碳激光辅助下外层Schlemm管消融术(CO2 laser-assisted sclerectomy surgery，CLASS)的短期临床安全性及有效性。方法：收集2015年5月至2016年1月解放军总医院眼科行CLASS手术和小梁切除手术的青光眼患者各23例，共46例46只眼。观察术后1周、1个月和3个月眼压及并发症发生情况。结果：两组术后1周、1个月及3个月眼压较术前均明显下降(P=0.000)。术后1周、1个月及3个月时CLASS手术组眼压平均值均低于小梁切除术组，但无统计学差异(P>0.05)。CLASS手术组23例均无浅前房、脉络膜脱离等并发症出现。小梁切除手术组有4例在术后早期出现浅前房，其中1例出现脉络膜脱离，经治疗后均治愈。结论：CLASS手术在有效降低眼压的同时，能大幅降低患者术后出现浅前房等并发症的概率，但其远期降眼压效果及并发症发生情况有待进一步深入研究。

Objective: To evaluate the short-term of clinical safety and efficiency of CO2 laser-assisted sclerectomy surgery (CLASS) in patient with open-angle glaucoma and complicated glaucoma. Methods: Our study involved 46 eyes of 46 patients with glaucoma that underwent CLASS and trabeculectomy respectively by the same surgeon (Zhaohui Li) from May 2015 to January 2016 at the PLA General Hospital. Intraocular pressure and complications 1 week, 1 month and 3 months after operation was observed separately. Results: The intraocular pressure (IOP) 1 week, 1 month and 3 months after surgery decreased obviously (P=0.000). Compared to the trabeculectomy group 1 week, 1 month and 3 months after surgery, IOP of CLASS group was lower. But there was no statistically significant difference between these two groups (P>0.05). There was no complication occurred in CLASS group. Early postoperative complications occurred in trabeculectomy group included shallow anterior chamber and choroidal detachment, and they were all successfully resolved by pharmacotherapy. Conclusion: CLASS operation could reduce intraocular pressure effectively and decrease the incidence of complications, such as postoperative shallow anterior chamber in patients with glaucoma. However, its long-term effect and complications need to be further studied.

目的：探讨玻璃体手术治疗孔源性视网膜脱离后出现黄斑裂孔的临床表现并分析其原因。方法：回顾 7 例孔源性视网膜脱离患者行玻璃体手术后出现黄斑裂孔的病例资料和检查结果，对其视网膜脱离时裂孔的位置、性质进行归纳，分析术后黄斑部光学相干断层扫描（optical coherence tomography，OCT）特征，进一步推测黄斑裂孔形成的原因。结果：视网膜脱离玻璃体手术后的 OCT 图像提示黄斑区视网膜表面膜与黄斑裂孔形成密切相关。患者均行玻璃体切除联合内界膜剥离，术后黄斑裂孔解剖上闭合，5 例（71.4%）视力较术前提高，6 例（85.7%）术后视力 > 0.1。结论：玻璃体手术治疗视网膜脱离后出现的黄斑裂孔是罕见的并发症，推测视网膜表面膜是视网膜脱离玻璃体手术后黄斑裂孔形成的主要原因。

Objective: To study the clinical characteristics and pathogenesis of macular hole (MH) formation after vitrectomy for rhegmatogenous retinal detachment (RRD).Methods: We reviewed the medical records and optical coherence tomography (OCT) data of patients presenting with MH after RRD repair. Retinal breaks were described and foveal structure was examined by OCT, then the pathogenesis was postulated.Results: OCT images of the vitrectomized eyes showed macular hole with epiretinal membrane (ERM) over the inner layer, which was associated with macular formation. All patients underwent pars plana vitrectomy (PPV) combined with internal limiting membrane peeling and the macula was closed. Visual acuity was improved in 5 eyes (71.4%) and better than 0.1 in 6 eyes (85.7%).Conclusion: MH developing after vitrectomy for RRD is rare. Presence of ERM is considered as the main cause of MH formation after vitrectomy for RRD.

目的：探讨正常成年 SD 大鼠的明视视网膜电图（Electroretinogram，ERG）特征。

方法：选取正常 9～12 周 SD 大鼠 60 只，使用罗兰视觉电生理仪记录大鼠右眼的明视闪光 ERG。使用 SPSS 统计分析 a 波、b 波和明视负波反应（Photopic negative response，PhNR）的隐含期和振幅。比较雄性和雌性 SD 大鼠明视 ERG 特征。

结果：每只 SD 大鼠均能记录到稳定的 a 波、b 波和 PhNR，其中 a 波的隐含期和 PhNR 的隐含期及振幅均符合正态分布，而其余指标均不符合正态分布。PhNR 的隐含期为 124.6±8.5 ms，其变异系数最小（0.07）。PhNR 的振幅为（11.3±4.2）μV，变异系数为 0.37。雄性和雌性 SD 大鼠明视 ERG 的各反应波之间无显著差异。

结论：在正常成年 SD 大鼠，明视闪光 ERG 是一项客观评价大鼠明视状态下视网膜功能的手段，PhNR 可以作为一项稳定的评价内层视网膜功能的指标。

Purpose: To study the characteristics of photopic flash electroretinogram (ERG) in normal adult SD rats.

Methods: Sixty normal adult SD rats aged 9 to 12 weeks old were enrolled in this study. Photopic flash ERG was recorded from these 60 SD rats. The results were analyzed with SPSS.

Results: Stable a, b and PhNR waves could be recorded in each rat. The implicit time of a wave, implicit time and amplitude of PhNR fit normal distribution. The implicit time of PhNR was (124.6 ± 8.5) ms with the smallest coefficient of variation of 0.07. The amplitude of PhNR was (11.3 ± 4.2) μV and the coefficient of variation was 0.37. There was no difference between the results of female and male rats.

Conclusion: Photopic flash ERG is an objective method in evaluating the retinal function in rats and PhNR can be used as a sensitive index of inner retinal function. 

Treatment of the wet form of age-related macular degeneration (wet AMD) has been revolutionized a decade ago with the introduction of vascular endothelial growth factor (VEGF) blockers that reduce neovascularization and macular edema. Two approved drugs are marketed for the treatment of wet AMD—ranibizumab and aflibercept, but there is a third drug, bevacizumab, which is widely used offlabel; a cancer drug that also blocks VEGF but was never tested in pivotal trials and never approved for ophthalmic indications including wet AMD. Similarity of bevacizumab to ranibizumab led to off-label use and even to government-sponsored studies comparison the approved ranibizumab head-to-head to the offlabel cancer drug bevacizumab in wet AMD, like the Comparison of Age-related Macular Degeneration Treatments Trials (CATT) study, discussed in this perspective paper. Recent publication of 5-year follow-up from the initial 2-year CATT study provided the occasion to discuss the similarities and differences between these two drugs and the lessons learned from the last decade of anti-VEGF therapy for wet AMD. Clinical efficacy is comparable, with an advantage for ranibizumab. Likewise, safety finding favor ranibizumab over bevacizumab in some aspects. The latest addition of approved anti-VEGF drugs for wet AMD, aflibercept, may provide even more benefit to patients. In this perspective we discuss results of CATT and other longterm follow-up and comparative studies. While all demonstrate clinical benefit of anti-VEGF, all reveal that most patients’ loose visual acuity (VA) in real-life situations over 5–7 years. This loss is based on—what we believe—significant under-treatment of wet AMD patients, due to economic or practical limitations and overestimation of perceived risks as geographic atrophy. We compare own data that showed more intensive treatment (more than twice the CATT-follow-up injections) with ranibizumab or aflibercept can maintain a sustained gain in VA in wet AMD patients after 6 years. We encourage retina specialists to treat wet AMD patients more aggressively and frequently in order to provide the maximum benefit for their patients.

Treatment of the wet form of age-related macular degeneration (wet AMD) has been revolutionized a decade ago with the introduction of vascular endothelial growth factor (VEGF) blockers that reduce neovascularization and macular edema. Two approved drugs are marketed for the treatment of wet AMD—ranibizumab and aflibercept, but there is a third drug, bevacizumab, which is widely used offlabel; a cancer drug that also blocks VEGF but was never tested in pivotal trials and never approved for ophthalmic indications including wet AMD. Similarity of bevacizumab to ranibizumab led to off-label use and even to government-sponsored studies comparison the approved ranibizumab head-to-head to the offlabel cancer drug bevacizumab in wet AMD, like the Comparison of Age-related Macular Degeneration Treatments Trials (CATT) study, discussed in this perspective paper. Recent publication of 5-year follow-up from the initial 2-year CATT study provided the occasion to discuss the similarities and differences between these two drugs and the lessons learned from the last decade of anti-VEGF therapy for wet AMD. Clinical efficacy is comparable, with an advantage for ranibizumab. Likewise, safety finding favor ranibizumab over bevacizumab in some aspects. The latest addition of approved anti-VEGF drugs for wet AMD, aflibercept, may provide even more benefit to patients. In this perspective we discuss results of CATT and other longterm follow-up and comparative studies. While all demonstrate clinical benefit of anti-VEGF, all reveal that most patients’ loose visual acuity (VA) in real-life situations over 5–7 years. This loss is based on—what we believe—significant under-treatment of wet AMD patients, due to economic or practical limitations and overestimation of perceived risks as geographic atrophy. We compare own data that showed more intensive treatment (more than twice the CATT-follow-up injections) with ranibizumab or aflibercept can maintain a sustained gain in VA in wet AMD patients after 6 years. We encourage retina specialists to treat wet AMD patients more aggressively and frequently in order to provide the maximum benefit for their patients.

Optic nerve damage as a result of trauma, ischemia, glaucoma or other forms of optic neuropathy disease, leads to disconnection between the eye and brain and death of retinal ganglion cells (RGCs), causing permanent loss of vision. Therapeutic options for treating optic neuropathy are limited and represent a significant unmet medical need. Development of a regenerative strategy for replacement of lost RGCs lies at the core of the future cell-based therapy for these conditions. Successful long-term restoration of visual function depends on the type of cells for transplantation. Primary RGCs of neonatal mice are now reported to have the potential for serving such a purpose.

Optic nerve damage as a result of trauma, ischemia, glaucoma or other forms of optic neuropathy disease, leads to disconnection between the eye and brain and death of retinal ganglion cells (RGCs), causing permanent loss of vision. Therapeutic options for treating optic neuropathy are limited and represent a significant unmet medical need. Development of a regenerative strategy for replacement of lost RGCs lies at the core of the future cell-based therapy for these conditions. Successful long-term restoration of visual function depends on the type of cells for transplantation. Primary RGCs of neonatal mice are now reported to have the potential for serving such a purpose.