The 8-A aspects are used to review orthokeratology： awareness， advantage， accuracy， achievement， activity， adjustment， abide and alliance. The present status of orthokeratology reflecting the development of technology at home and abroad， the future， core technology， core personnel， achievements and existing common problems are discussed.

Soft therapeutic contact lenses are widely used in clinical ophthalmology to protect the ocular surface and treat eye diseases or as an adjuvant therapy with the development of materials， design and processing. The purpose of this article is to further normalize the application of therapeutic contact lenses by introducing their indications， contraindications and principles of choice and fitting in detail with the goal of providing better service.

Objective  To investigate the effects of wearing orthokeratology lenses on the magnitude of accommodative microfluctuations and accommodative lag. Methods  In this cross-sectional study， 15 myopic subjects who wore orthokeratology lenses regularly and 15 myopic subjects who wore spectacles regularly were enrolled. Accommodative response （AR） was measured with an open field infrared autorefractor （WAM-5500） using an accommodative stimulus （AS） of 0~4 D. The magnitude of accommodative microfluctuations， accommodative lag， and accommodative error index （AEI） were calculated. The data from the two groups were analyzed by using an independent sample t test. Results  With an AS of 0 D， 1 D， 2 D， 3 D and 4 D， the magnitudes of accommodative microfluctuations of the orthokeratology lens group were all larger than the spectacle group， and the differences were statistically significant （t=3.704， 3.277， 2.365， 2.179， 2.591， P<0.05）. The accommodative lags of the orthokeratology lens group were smaller than the spectacle group. There were statistically significant differences with an AS of 2 D， 3 D and 4 D （t=-2.208， -2.244， -2.098， P<0.05）， while there were no significant differences with an AS of 0 D and 1 D（t=-1.974， -1.758， P＞0.05）. The AEIs of the orthokeratology lens group were also smaller than the spectacle group， and the difference was statistically significant （t=-2.098， P<0.05）. Conclusion  Compared to spectacles， the magnitudes of accommodative microfluctuations were larger after myopes wore orthokeratology lenses， while the accommodative lags were smaller at high accommodative demands. This supports the claim that orthokeratology lenses can slow myopia progression.

Objective  To observe the changes in corneal astigmatism after patients are fitted with different ortho-k contact lens （CL） designs and the influence of these lenses on visual quality. Methods  In a case-control study， corneal astigmatism， corneal topography， wavefront aberrations （Pentacam）， visual acuity and visual disturbance symptoms were observed in three groups （groups A， B， C） before and after CL wear. Group A（30 eyes） had lower corneal astigmatism and wore a general ortho-k contact lens design that fit quite well； group B（30 eyes） had lower corneal astigmatism and wore a general ortho-k contact lens design that did not fit well and was obviously decentered； group C （31 eyes） had higher corneal astigmatism and wore toric ortho-k contact lenses with an acceptable fit. SPSS 16.0 statistical software was used to analyze the data. Results  Changes in corneal astigmatism after fitting with the ortho-k CL： astigmatism increased in group B but was lower in groups A and C. Fourier analysis from corneal topography： increases in asymmetry for all three groups at 3 mm were （-0.393±0.329）D， （-4.050±2.084）D， and （-0.494±0.522）D， respectively， all at P<0.001. Higher order aberrations in the three groups increased at 3 mm and were （-0.011±0.055）D （P>0.05）， （-0.635±0.441）D （P<0.001） and （-0.055±0.082）D （P<0.01）. The three groups at 3 mm regular：differences in the comparison of astigmatism， asymmetry and higher order aberrations were statistically significant， F=79.862， F=83.882， F=54.265， respectively， all at P<0.01. After fitting with ortho-k CLs， the total aberrations and total higher order aberrations for the three groups increased in varying degrees， with group B as the most significant. A comparison of the difference in aberrations： only the anterior surface of the spherical aberration had a statistically significant difference （F=18.048， P<0.01）. After the CLs were removed： in group A 36.7 % achieved a UVA of 1.2， 50.0% achieved 1.0 and 13.3% achieved 0.8； in group B 36.7% achieved 1.0， 46.7% achieved 0.9-0.8， 13.3% achieved 0.6-0.5， and 3.3% achieved 0.4； in group C 9.7% achieved 1.2， 51.6% achieved 1.0， 16.1% achieved 0.9~0.8 and 22.6% achieved 0.6. There were statistically significant differences in UVA between the three groups （χ2=20.252， P<0.01）. Patients reported a variety of visual disturbance symptoms such as ghost， fringe， glare， etc. In group A， 0% reported visual disturbance symptoms， with 16% in group C and 47% in group B. Conclusion  Ortho-k contact lens design and fitting significantly impact corneal astigmatism and visual quality. Appropriate ortho-k CL toric designs can be highly effective for improving the CL fitting and enhancing the corneal reshaping effect for some higher order corneal astigmatisms.

Objective  To evaluate the changes of intraocular pressure （IOP） in myopic children undergoing overnight orthokeratology treatment. Methods  It was a retrospective case-series study. Orthokeratology was performed to correct the refractive errors of 303 eyes of 303 teenagers. The patients were divided into 3 groups： low-myopia， moderate-myopia， and high-myopia， based on the diopters. IOP， corneal curvature and refraction were taken respectively at pre-wear， l day and 7， 30， 90 days after orthokeratology. Data were analyzed by repeated-measures ANOVA tests. LSD corrections were performed to compare the differences in IOP if significant differences were found. Results  The change of IOP became stable after 1-week orthokeratology treatment， and were significant decrease in IOP after treatment （F=51.75， P＜0.01）. Moderate and high myopia had an increase of 1.04 mmHg （t=-4.81， P<0.01） and 0.58 mmHg （t=-2.65， P<0.05） respectively in IOP at 1-day visit， and low myopia only showed a downward trend at the same time （t=0.57， P>0.05）. Furthermore， the changes in diopters were positively correlated with those in IOP （r=0.131， P<0.05） 3 months post-treatment. The changes of IOP resulted by one unit change in diopter were significantly different among different degree of myopic group （F=3.57， P<0.05）. With one unit change in diopter， the low-myopia teenagers showed significantly more reduction in IOP at 0.50 mmHg than moderate-myopia teenagers （t=-2.57， P<0.01）. No significant differences were observed between low- and high-myopia groups （t=-1.86， P>0.05）， moderate- and high-myopia groups （t=0.68， P>0.05）. Conclusion  Orthokeratology results a decrease in IOP measurements. The observed patterns of IOP changes may be caused cooperatively by the changes in corneal morphology and eye accommodation function.

Objective  To analyze the relationship of height， weight， body mass index and other anthropometric parameters to eye refraction， axial length and other biological parameters of the eye in youths. Methods  It was a cross-sectional study. One hundred and one first-year students （12.9±0.7 years of age） were selected from 2 classes in a middle school in Anyang City of Henan Province. A questionnaire survey was conducted that included near work time， family history of myopia， parental income， etc. Biological eye measurements， autorefraction under cycloplegia， retinoscopy， and axial length to corneal curvature radius （AL/CR） were taken and height， weight， waist circumference， and body mass index （BMI） were measured and calculated. Correlations between the parameters were analyzed using bivariate linear correlation analysis and multiple linear regression analysis. Results  The myopia rate of the selected first-year students in junior middle school was 73.3%， with 63.6% for boys and 80.2% for girls. The mild， moderate and high myopia rates were 35.5%， 33.7% and 4.1%， respectively. After adjustment for age， gender， near work time and family history of myopia， the heavier students had longer axial lengths （r=0.269， P＜0.05） and higher degrees of myopia （r=-0.313， P＜0.05）； the more obese students （greater BMI value） had higher degrees of myopia （r=-0.313， P＜0.05）. No associations were found between height or waist circumference and ocular biological parameters or refraction. Conclusion  There were some correlations between weight， body mass index and axial length， and refraction in junior middle school students.

Objective  To observe the change in the number and function of endothelial progenitor cells （EPCs） from bone marrow in rats with diabetic retinopathy （DR）； to discuss the role of EPCs in the pathogenesis of DR. Methods  In an experimental study， 50 male Wistar rats were divided into a control （CON） group （14 rats） and diabetes （DM） group （36 rats）. The rats in the DM were further divided into 3 groups of 12 rats each based on the time periods when analysis was performed： 1 month （DM1）， 3 months （DM3） and 6 months （DM6）. Mononuclear cells were collected by density gradient centrifugation from the bone marrow of the rats. The isolated cells were cultivated in dishes coated with fibronectin. Immunofluorescence staining and flow cytometry were used to identify EPCs. The number of EPCs in the colony was assayed by CFU counting； proliferation， migration and adhesion function of EPCs were assayed by MTT chromatometry， modified Boyden chamber assay and adhesion activity assay. All eyeballs were examined by hematoxylin and eosin （HE） staining and vascular endothelial growth factor （VEGF） by immunity set expression. The correlation between changes in EPCs and DR morphological changes was analyzed. The changes in the number and function of EPCs from bone marrow and expression of VEGF in the retina were analyzed by single factor analysis of variance and LSD-t test. Results  The number of cell clusters in bone marrow-derived EPCs was significantly reduced in the DM1， DM3， DM6 groups （9.6±1.8， 11.5±2.5， 14.0±2.4 n/×200 fields） compared to the CON group （16.6±2.7 n/×200 fields）. The ability of EPCs to proliferate was reduced in the DM1， DM3， DM6 groups （0.133±0.027， 0.106±0.016， 0.072±0.011 OD） compared to the CON group （0.203±0.068 OD）. The ability of EPCs to migrate was reduced in the DM1， DM3， DM6 groups （11.9±2.2， 10.1±1.8， 8.9±1.2 n/×200 fields） compared to the CON group （17.9±4.8 n/×200 fields）. The adhesion ability of EPCs was reduced in the DM1， DM3， DM6 groups （14.8±3.2， 10.5±2.0， 7.5±1.2 n/×200 fields） compared to the CON group （17.9±4.8 n/×200 fields）. Accompanied by responsive pathological changes of retinal structure and vessels， the thickness of the retina was reduced and retinal cells became disorganized in the DM1 and DM3 groups. Endothelial cells expressed edema in the DM6 group. The expression of VEGF in the retina of rats was 0， 18.6%±2.74%， 34.3%±2.21%， 58.73±2.48%， in CON， DM1， DM3， DM6 groups respectively. Conclusion  The number and biological dysfunction of EPCs from bone marrow were reduced in diabetic rats. With the development of DR， the number of EPCs increased gradually.

Objective  To evaluate visual quality and related factors in patients with thyroid-associated ophthalmopathy （TAO）. Methods  This was a prospective case-control study. A total of 38 patients （72 eyes） with TAO and 35 healthy adults （70 eyes） underwent testing with OQASⅡ， which uses a double-pass technique to evaluate the modulation transfer function （MTF）， objective scatter index （OSI） and visual acuity at different contrast sensitivities （100%， 20%， 9%）. Some clinical data was recorded in the patients with TAO， including best corrected visual acuity （BCVA），the disease duration， clinical activity scores （CAS）， NOSPECS， proptosis， smoking habits， etc. Data were statistically analyzed with an independent samples t test， pearson or Spearman correlation analysis and a multiple regression analysis. Results  The visual quality of patients with TAO showed decreases， with lower MTF （TAO 29.35±11.65， controls 42.97±7.38， t=-8.344， P<0.01）， higher OSI （TAO 0.89±0.84； controls 0.33±0.14， t=5.551， P<0.01）， lower VA100% （TAO 0.96±0.40， controls 1.43±0.25， t=-8.522， P<0.01）， lower VA20% （TAO 0.70±0.31， controls 1.05±0.26， t=-7.269， P<0.01）， and lower VA9% （TAO 0.42±0.18， controls 0.64±0.19， t=-6.948， P<0.01）. The MTF in patients with TAO was correlated significantly with age， CAS， NOSPECS， proptosis， palpebral fissure height， intraorbital pressure and smoking （r=-0.281， -0.485， -0.489， -0.277， -0.469， -0.332， -0.502， P<0.05）. OSI in patients with TAO was correlated significantly with age， CAS， NOSPECS， intraorbital pressure and smoking （r=0.368， 0.476， 0.418， 0.268， 0.535， P<0.05）. There were no statistically significant differences in MTF or OSI for BCVA， duration of disease，thyroid function， intraocular pressure，diplopia or average amount of sleep. Multiple regression analysis revealed that CAS， NOSPECS， smoking and palpebral fissure height are risk factors for the MTF （R2=0.497， F=16.567， P<0.01）， while CAS and smoking were risk factors for OSI （R2=0.405， F=23.501， P<0.01）. Conclusion  Visual quality of patients with TAO is reduced， with higher OSI， lower MTF， VA100%， VA20% and VA9%. MTF is negatively correlated with CAS， NOSPECS， proptosis， palpebral fissure height， intraorbital pressure and smoking， while OSI is positively correlated with CAS， NOSPECS， intraorbital pressure and smoking. CAS， NOSPECS， palpebral fissure height and smoking are significant risk factors for the MTF （R2=0.497， F=16.567， P<0.01）； CAS and smoking are significant risk factors for the OSI （R2=0.405， F=23.501， P<0.01）.

Objective  To study the effect of lens induced aniseikonia on stereopsis with size lenses. Methods  A prospective randomized block design was used.  Two percent， 3%， 5%， 8% and 10% of aniseikonia were induced by various lens magnification in front of the right eyes of 45 subjects. Stereopsis was then tested utilizing the Stereo Fly Test and Digital Stereoscopic Test Charts （DSTC） under normal binocular vision and induced aniseikonia. The effect of induced aniseikonia on stereopsis then was analyzed based on the data collected. The data was analyzed by Friedman′s M test， Spearman rank correlation， Wilcoxon rank sum test and Kruskal-Wallis H test. Results  Stereopsis was significantly affected by induced aniseikonia [FLY （x²=210.113， P＜0.01， DSTC （x²=162.237， P＜0.01]； stereopsis was measurably reduced by 2% aniseikonia， and drastically reduced when aniseikonia was more than 5%. The decline in stereoacuity was positively correlated with induced aniseikonia [FLY （rs=0.776， P=0.000）， DSTC （rs=0.626， P=0.000）]. Conclusion  Stereopsis and other aspects of binocular function are impaired if aniseikonia reaches 2%. An aniseikonia test should be performed more frequently in clinical settings.

Objective  To discuss the accuracy and clinical value of Shi′s retinoscopy. Methods  In this cross-sectional study， 100 eyes of 58 patients with ametropia ranging in age from 5 to 38 years were involved in this clinical trial. Shi′s retinoscopy method was used to obtain the predictive value and practical measured value. The astigmatism power and axis were also compared. The subjects were then checked with an autorefracter. Finally， the differences between astigmatism power， axis， the adjustment stability of Shi′s retinoscopy and the measured value obtained from the autorefracter were analyzed using a paired t test. Results  Respective predictive values and practical measured values were compared. The differences were not statistically significant. In addition， the comparison of astigmatism power and axis obtained from Shi′s retinoscopy and the autorefracter did not show a statistically significant difference. However， a comparison of the adjustment stability of the measured values between Shi′s retinoscopy and the autorefracter showed statistically significant differences （t=8.943， 4.066， P<0.01）. Conclusion  Shi′s retinoscopy has the advantages of high accuracy， and quick and simple operation in predicting ametropia. Promotion for wide use in the clinic is merited.

Objective  To study changes in posterior corneal elevation after laser in situ keratomileusis （LASIK） and related factors. Methods  It was a retrospective case series study. One hundred and two eyes of 51 myopic patients undergoing LASIK were examined with a Pentacam preoperatively， and 1 month and 3 months postoperatively. Analysis included posterior corneal elevation of the corneal apex， temporal superior， temporal inferior， nasal superior and nasal inferior quadrants （7 predetermined points in each quadrant） in a 4mm area of the central cornea. Results  The changes in posterior corneal elevation in the corneal apex， temporal superior， temporal inferior， nasal superior and nasal inferior quadrants were -0.12±1.50 μm， 0.18±1.70 μm， -0.16±1.50 μm， 0.15±1.62 μm and 0.01±1.45μm， respectively， at 1 month， and were 0.58±1.49 μm， 0.42±1.85 μm， -0.50±1.99 μm， 0.59±1.67 μm and -0.36±1.70 μm， respectively， at 3 months. Between postoperative 1 month and 3 months， there was a significant difference in changes in the posterior elevation of the corneal apex， but there were no statistically significant differences in the 4 quadrants. At 1 month postoperatively， changes in the posterior corneal elevation in every area did not correlate with central corneal thickness （CCT）， residual bed thickness （RBT）， ablation depth （AD） or spherical equivalent （SE）. At 3 months postoperatively， there was a significant positive correlation between changes in posterior elevation in the corneal apex and SE， but there was no significant correlation between changes in posterior corneal elevation in 4 quadrants and CCT， RBT， AD， SE. Conclusion  LASIK surgery induces tiny changes in posterior corneal elevation in the central 4 mm area. Higher refractive errors may increase the trend of a forward shift of the posterior surface of the corneal apex.

Objective  To evaluate the clinical results of conductive keratoplasty （CK） for correcting residual ametropia after multifocal apodized diffractive intraocular lens （IOL） implantation. Methods  In this retrospective study， seven eyes of six patients underwent CK with CK View Refractec （RCS-200， Refractec， Inc.） for the correction of residual hyperopia after multifocal apodized diffractive IOL implantation. The follow-up period was 12 months and uncorrected distance visual acuity （UCDVA）， uncorrected near visual acuity （UCNVA）， best spectacle-corrected distance visual acuity （BSCDVA）， best distance-corrected near visual acuity （BDCNVA）， best spectacle-corrected near visual acuity （BSCNVA）， manifest refraction and central keratometry were measured and recorded. A nonparametric test was used to analyze the data. Results  The median of UCDVA was 0.4， the median of UCNVA was 0.25， and the mean spherical equivalent （SE） refraction was +1.10±0.3 D （range +0.75 to +1.50 D） after cataract surgery and before CK. One year after CK， all eyes had from a UCDVA and UCNVA of 0.5 or better with a mean median UCDVA of 0.8 and a UCNVA of 0.5. The mean SE refraction was -0.4 D±0.4 （range +0.25 to -1.00 D）. There were statistically significant differences in UCDVA and UCNVA， after CK surgery （Z=-2.226，-2.375， P<0.05）. Conclusion  CK is an effective and safe approach to correct residual hyperopia in pseudophakic eyes with multifocal apodized diffractive IOL implants.

Objective  To study the eye complication situation of patients initially diagnosed with Acquired Immunodeficiency Syndrome （AIDS）； to analyze the main factors that cause damage to eyesight； and to provide a basis for the prevention and control of damage to vision in Shanghai. Methods  This was a cross-sectional investigation. A cohort study of patients initially diagnosed with AIDS was conducted in the Shanghai public health clinic center from March 2011 to February 2012. The patients underwent a full and thorough set of ophthalmology examinations. Natural and best corrected distance vision were tested with a Snellen chart. The anterior segment and fundus were examined by slit lamp microscopy and direct ophthalmoscopy. The data were input in compliance with the WHO visual impairment standard classification， and the causes of blindness and low vision damage were analyzed. The data were collected and measured by percentage， and analyzed with a chi-square test. Results  Among 358 patients initially diagnosed with AIDS， 286 patients （79%） signed an informed consent to allow the eye clinic to examine them. Of the 286 patients， 58.4% had ocular complications. The highest incidence was 36.01% for dry eyes， the second highest was 19.9% for conjunctivitis and the third was 8.39% for cytomegalovirus retinitis （CMVR）. The leading cause of blindness was 40% from CMVR and the second leading causes were 30% from retinal microvascular lesions （HIVM） and glaucoma. The rate of blindness increased with a CD4+T lymphocyte level less than 250 cells/μl. Conclusion  The ocular complications in patients initially diagnosed with AIDS in Shanghai are higher than in the United States and other countries. CMVR was the main reason for damage to eyesight. It is recommended to move more quickly to establish a reliable CMVR screening and treatment network to improve the quality of life of AIDS patients.

Glaucoma is common and is a leading cause of irreversible blindness worldwide. The pathological foundation of visual function damage is the death of retinal ganglion cells and the loss of nerve fibers. Ganglion cell death is mainly through cell apoptosis. Its pathophysiological features are the same as with most of the diseases of the nervous system including oxidative stress and ischemia. The mitochondrion is a vital intracellular organelle for retinal cell function and survival.