Objective: To establish a database of the peripapillary retinal nerve fiber layer (RNFL) thickness in myopic and emmetropic children; to analyze the thickness and distribution of the peripapillary RNFL topographical map in children and adolescents with different degrees of myopia; and to measure regional differences in the thickness of the peripapillary RNFL and the factors that influence it in myopic and emmetropic children. Methods: This was a population-based, cross-sectional study. The average thickness of the peripapillary RNFL in children 6-18 years old was measured by spectral domain-optical coherence tomography. Ophthalmic parameters and systemic parameters, including height, weight, body mass index, head circumference, chest circumference, waist circumference, and blood pressure were measured. The children were divided into different refractive groups based on spherical equivalent (SE). The thickness of the peripapillary RNFL in different quadrants under different refractive conditions and relevant influencing factors were analyzed. The correlation between the average RNFL thickness and all parameters was analyzed by a simple linear regression and multiple stepwise regression. Differences between the groups were analyzed by one-way analysis of variance. Results: The average thickness of the peripapillary RNFL in 1 056 myopic and emmetropic children was 104±10 μm. It was 107±9 μm for emmetropes, and 105±9 μm for mild myopes, 101±10 μm for moderate myopes, and 95±8 μm for high myopes. The RNFL in emmetropes was thicker than in mild myopes (P=0.007) and moderate and high myopes (P<0.001 each). The RNFL thickness was positively correlated with SE (r=0.25, P<0.001) and lens thickness (r=0.10,
P=0.033). It was negatively correlated with axial length (r=-0.18, P<0.001), but not correlated with age,sex, or other parameters. In all subjects, the inferior temporal quadrant was thickest, 162±23 μm, and the nasal quadrant thinnest, 61±10 μm. The topographical distribution for each group was different. The infratemporal sector was the thickest, and the nasal sector was the thinnest. The thickness of the temporal peripapillary RNFL increased with an increase in the degree of myopia. In mild myopes it was 87±14μm, and in high myopes it was 98±21 μm. The thickness in other quadrants changed in the opposite direction, especially the infranasal sector. Conclusions: The average thickness of the peripapillary RNFL was positively correlated with SE and lens thickness, and negatively correlated with axial length. The topographical distribution was different in each myopia group. The thickness of the temporal quadrant gradually increased with increased degree of myopia, while that of the other quadrants decreased.

Objective: To introduce the application of a retinal whole-cell patch clamp combined with a single-cell reverse transcription polymerase chain reaction in retinal single-cell component analysis and to investigate the effects of N-methyl-D-aspartate (NMDA) on G-protein related mRNA expression by ON-type bipolar cells of the retina. Methods: In this experimental study, twenty 3-5 weeks old C57BL/6J mice were randomly and equally divided into two groups. They then received a 3 μl intravitreal injection of 30 nmol/L NMDA for the induced-glaucoma group or 10 nmol/L phosphate-buffered saline (PBS) for the control group.Twenty-four hours later, ON-type bipolar cells were collected by patch clamp electrode, and RT-PCR was used to determine the relative expression of mRNAs for protein kinase C alpha (PKCα), transient receptor potential melastatin 1 (TRPM1), and G-protein alpha subunit (Gαo). The two groups were compared by Mann-Whitney tests. Results: After intravitreal injection of NMDA, the relative mRNA expression in ONtype bipolar cells of PKCα (0.536±0.339), TRPM1 (0.337±0.271), and Gαo (4.36±1.83) were significantly different from the control eyes (U=0, P=0.001; U=0, P=0.002; U=36, P=0.002). Conclusion: NMDAinduced glaucoma model may affect the signal transduction of G protein-coupled channel of retinal ON bipolar cells.

Objective: To compare the visual quality between small incision lenticule extraction (SMILE) and femtosecond laser-assisted laser in situ keratomileusis (FS-LASIK) in treating myopia and astigmatism.Methods: In this prospective non-randomized study, we selected 162 patients (324 eyes) with myopia and astigmatism who wanted refractive surgery in Changsha Aier Hospital from November, 2015 to February,2016. The patients were allocated to either of two groups according to each person's request. The SMILE group had 78 patients (156 eyes) and the FS-LASIK group had 84 patients (168 eyes). All patients were followed up for 6 months. Uncorrected visual acuity (UCVA) and spherical equivalent (SE) were measured 1 day, 1 month, and 6 months after surgery. Corneal higher-order aberrations (HOAs) and decentration were measured 3 months after surgery. A vision quality questionnaire, based on a simplified version of Quality of Vision (QoV) Questionnaire to assess negative symptoms, was administered at 1 month and 6 months after surgery. Repeated measures ANOVA, ANOVA, chi-square test, and the rank-sum test were used to analyze and compare the data for the two groups. Results: One day after surgery, UCVA in the FS-LASIK group was better than in the SMILE group (t=4.555, P<0.001), but there were no significant differences between the two groups in the later periods. The SE in the SMILE group at 1 day after surgery were higher than in the FS-LASIK group (t=-2.952, P=0.003), but at 1 month and 6 months after surgery, there was no significant difference between them. HOA, spherical, coma, and trefoil aberrations were significantly increased in both groups at 3 months after surgery compared with the preoperative values (P<0.05). SMILE induced more spherical and trefoil aberrations compared with FS-LASIK (t=5.633, P<0.001; t=2.586, P=0.010).The cutting decentration with SMILE (0.17 ± 0.09 mm) was similar to FS-LASIK (0.18 ± 0.10 mm) (t=0.594,P=0.553). For SMILE patients, the rates and degrees of haloes at 6 months had declined compared with 1 month (χ2=5.547, P=0.019; Z=-2.283, P=0.022). For FS-LASIK patients, there were no significant changes in postoperative negative visual symptoms between 1 month and 6 months after surgery. There were also no significant differences between the two groups at 1 and 6 months. Conclusions: Vision recovery
was slower with SMILE, and it induced more spherical and trefoil aberrations than FS-LASIK. Cutting decentration and the occurrence of negative visual symptoms were similar in both procedures.

Objective: To study the efficacy, safety, and change in visual quality of a phakic posterior chamber implantable collamer lens with centra FLOW (PPC-ICL V4c) for correcting high myopia. Methods: This was a prospective study of 58 eyes of 32 patients who were candidates for PPC-ICL V4c. The following indicators were compared: preoperative and postoperative uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA), preoperative aberrations and aberrations 6 months postoperatively, contrast sensitivity, and the Quality of Life Impact of Refractive Correction (QIRC). All patients were followed up for more than 6 months. Data were analyzed using paired t-tests. Results: Preoperative UCVA (LogMAR visual acuity) and UCVA 6 months after surgery was 1.54±0.26 and -0.04±0.06, respectively. Visual acuity 6 months after surgery improved compared to preoperative acuity (t=30.94, P<0.001). Compared to preoperative BCVA, 56 eyes had equal or better BCVA 6 months after surgery, which accounted for 97% of the total number of eyes. There was an increase of 1 row or better for 28 eyes, which accounted for 48% of the total number of eyes. Postoperative higher-order wavefront aberrations, spherical aberrations, coma, and trefoil root mean square (RMS) were 0.292±0.093 μm, -0.030±0.050 μm, 0.096±0.090 μm,and 0.224±0.091 μm, respectively. Total higher-order aberrations increased and coma was reduced, but the differences were not statistically significant. Spherical aberrations were reduced (t=3.87, P=0.001) and trefoil increased (t=-5.47, P<0.001). All contrast sensitivities 6 months after surgery were better than preoperative levels for 3.0, 6.0, 12.0, and 18.0 cycles/degree. There were also significant differences between the photopic 3.0 and 6.0 cycles/degree and mesopic 6 cycles/degree (t=-2.12, P=0.047; t=-2.51,P=0.021; t=-3.27, P=0.004). The QIRC score for patients improved (t=-2.41, P=0.039) after surgery.Conclusions: Implants of PPC-ICL V4c are a safe and effective surgical method for correcting high myopia. All patients are satisfied with the surgery, which can improve visual quality and quality of life.

Objective: To investigate the objective and subjective visual quality after a segmental refractive multifocal intraocular lens (IOL) implantation. Methods: This prospective study enrolled cataract patients who underwent phacoemulsification and IOL implantation at our hospital between December 2015 and March
2016. The patients were divided into two groups (each with 14 patients, 22 eyes) based on the IOL type: segmental refractive multifocal IOL (MF30, Oculentis, Holland) as the trial group, and single focal IOL(SN60WF, Alcon, USA) as the control group. Three months after surgery, the spherical equivalent (SE) was measured, and the best-corrected distance visual acuity (BCDVA=5-LogMAR), best-corrected intermediate visual acuity (BCIVA=5-LogMAR), best-corrected near visual acuity (BCNVA=5-LogMAR), and defocus curve were recorded. A double-pass optical quality analysis system (OQAS II, VISIOMETRICS, Spain) was used to
measure the modulation transfer function (MTF), objective scatter index (OSI), Strehl Ratio (SR), and contrast visual acuity. The near spectacle independence, satisfaction, and symptoms of visual disturbance were assessed by a questionnaire. Data were analyzed using independent t test and chi-square test. Results: Three months after surgery, the SE in the trial and control groups were 0.23±0.30 diopter (D) and 0.09±0.51D, respectively (t=1.051, P=0.300); BCDVA was 5.00±0.05 and 4.99±0.03, respectively (t=0.516, P=0.608); BCIVA was 4.83±0.07 and 4.65±0.11, respectively (t=6.610, P<0.001); BCNVA was 4.88±0.04 and 4.51±0.12, respectively (t=14.485, P<0.001); MTF cutoff was 25.23±12.26 and 32.56±8.06 cpd, respectively (t=2.249, P=0.030); OSI was 2.38±0.67 and 1.64±0.84, respectively (t= 3.234, P=0.020). There were no statistical differences between the groups for SR or contrast visual acuity. The defocus curve was smooth within −3.0 D and +1.0 D in the trial group, while only one peak appeared between −0.5 D and +0.5 D in the control group. Near spectacle independence was 91% in the trial group and 12% in the control group (χ2=21.316, P<0.001). Satisfaction was 80% (16/20) and 59% (10/17), respectively (χ2=1.089, P=0.279); Halo/glare was 9% (2/22) and 0% (0/17),respectively (χ2=0.296, P=0.495). Conclusions: The visual quality of the segmental refractive multifocal IOL was clinically acceptable as it offers a full range of visual acuity with few symptoms of visual disturbance.

Objective: The study aims to investigate and discuss the therapeutic effect and the mechanism of topical resveratrol (Res) on rats with uveitis. Methods: In this experimental study, 36 Wistar male rats were randomly divided into six equal groups as follow: control group, model group, 0.25% Res group, 0.5% Res
group, 1% Res group, and 0.1% dexamethasone (Dex) group. The endotoxin lipopolysaccharide (LPS) was dissolved in normal sterile saline (1 mg/ml) and subcutaneously injected (200 μg LPS) into the hind feet of rats to induce uveitis in the model group and in the four treatment groups. Rats from the control group were injected with the equal volume of the normal sterile saline solution. For the 4 treatment groups, 10 μl of Res (0.25, 0.5, or 1%) or Dex (0.1%) solutions were applied topically as drops to both eyes, every 2 hours, 6 times before LPS injection and continued every 2 hours, 6 times after injection. Rats of the control and model groups received the same amount of saline. During the observation phase, the inflammation of the anterior segment was observed, and the clinical scores were evaluated 24 h after LPS injection. Anterior segment photography was performed 24 h after LPS injection. The levels of TNF-α and IL-6 in the aqueous
humor were determined 24 h after LPS injection. At the end of experiment, the rats were sacrificed and the eyeballs were fixed for histopathological examination. The nuclear translocation of p38 mitogen-activated protein kinase (MAPK) and nuclear factor-kappaB (NF-κB) p65 in the iris ciliary body (ICB) were stained by immunohistochemistry. Data analysis was performed using one-way ANOVA and the Mann-Whitney U test. Results: In the model group, iris vasodilatation was observed 4 h after LPS injection, and the inflammatory reaction gradually increased. After 24 h, massive exudation was present in the anterior chamber, and fibrous exudation was present in the pupil area and anterior capsule of the lens. 1% Res group reacted much smaller than the model group. The composite clinical score of the model group was 4.3±1.2,which was significantly greater than for the 1% Res group, 2.0±0.6 (P<0.05). The TNF-α and IL-6 levels in the aqueous humor of the 1% Res group were significantly lower than for the model group (P<0.05).Consistent with these data, the histopathological damage of the ocular tissue treated with 1% Res was less severe than that of model group (P<0.05). Lastly, the expression of p38 MAPK and NF-κB p65 levels in the 1% Res group were lower than in the model group (P<0.05). Conclusions: The topical administration of 1% Res suppressed ocular inflammation due to LPS injection in endotoxin induced uveitis (EIU) rats and decreased the levels of inflammatory cytokines associated with the inhibition of MAPK and NF-κB signaling pathway.

Objective: To analyze the status of occupational burnout of optometrists and ophthalmologists and related factors by using the Maslach Burnout Inventory-General Survey (MBI-GS) questionnaire.Methods: In the questionnaire survey research. A questionnaire survey of 121 optometrists (n=53) and ophthalmologists (n=68) was carried out with the revised MBI-GS questionnaire and the related-factors satisfaction questionnaire. Independent samples t-tests were used to compare measurement data, chisquare tests were used to compare counting data, and relationships between the relevant factors and job burnout were analyzed by Pearson correlation analysis. The influencing factors of job burnout were analyzed by multiple linear regression. Results: There was no significant burnout among the surveyed subjects, the optometrists' emotional exhaustion scores were 2.11±1.08, cynicism scores were 1.84±1.41, reduced personal accomplishment scores were 1.71±1.23. The ophthalmologists' emotional exhaustion scores were 2.51±1.22, cynicism scores were 1.85±1.20, reduced personal accomplishment scores were 1.86±1.19.There was a statistical difference inemotional exhaustionscores between the two groups (P=0.04).And the MBI-GS scores were correlated with various satisfaction indicators (P<0.05). The emotional exhaustion of optometrists was related mainly to income and health (F=10.373, P<0.001), and their
cynicism was related mainly to family and interpersonal situations (F=11.768, P<0.001), reduced personal accomplishment of optometrists was more closely related to family situations (F=6.967, P=0.011). While the emotional exhaustion (F=20.943, P<0.001), the cynicism (F=11.497, P=0.001), the reduced personal
accomplishment (F=16.303, P<0.001) of ophthalmologists were related mainly to interpersonal situations. Conclusions: Working as an optometrist or ophthalmologist is less susceptible to stress and risk, and the doctors had no obvious burnout. Ophthalmologists are more likely to be affected by interpersonal factors than optometrists, and occupational burnout of optometrists is more likely to be affected by health status and family situations.

Objective: To assess the effect of Malyugin rings in phacoemulsification surgery of cataract in eyes with small pupils. Methods: This was a prospective case-control study. Twenty-seven microcoria cataract cases(32 eyes) were enrolled and divided into two groups. In Group I (21 eyes), the pupils were dilated by with two instruments. In Group II (11 eyes), the pupils were dilated by Malyugin ring insertion. Clear corneal incisions of 3.2 mm were used in the phacoemulsifications. All cases were followed up postoperatively at 1 week and at 1, 3, and 6 months. Pre- and postoperative values were compared for best corrected visual acuity (BCVA), intraocular pressure, corneal endothelial cell counts, and pupil size. Independent-samples t-tests were used in the analyses. Results: All surgery was completed successfully by the same doctor. All intraocular lenses were implanted within the capsule, and no complications occurred. Measurements for the following pre- and 6-month postoperative parameters were compared: BCVA (LogMAR): Group I, 1.15±0.75 vs. 0.30±0.21 and Group II, 1.42±1.16 vs. 0.30±0.31; IOP (mmHg): Group I, 14.7±4.6 vs. 14.1±6.4 and Group II, 16.1±5.1 vs. 12.4±2.2; Average corneal curvature (diopter, D): GroupI, 44.55±1.83 vs. 44.94±2.70 and Group II, 44.72±1.55 vs. 45.37±1.25; Corneal endothelial cell density (cells/mm2): Group I, 2 490±498 vs. 1 486±612 and Group II, 2 620±989 vs. 2 089±729; Pupil diameter (mm): Group I,2.0±0.6 vs. 3.3±1.2 and Group II, 2.2±0.8 vs. 3.5±1.2. The parameters of the corneal endothelial cells were statistically different (t=-2.352, P=0.038) after surgery between the two groups, and no statistical difference was found in the other parameters. Conclusions: Use of the Malyugin ring in microcoria cataract phacoemulsification does not affect the 6-month postoperative visual acuity, intraocular pressure, or average corneal curvature. The pupils were enlarged before surgery. Malyugin ring can help reduce the loss of corneal endothelial cells in surgery.

Myopia is one of the most common eye abnormalities worldwide. Form deprivation or lenses can induce experimental myopia. Melatonin, an important neuroendocrine hormone of the eye and a myopicrelated factor, may have an important influence on the development of myopia. This paper elaborates
on the relationship between melatonin and form deprivation myopia by focusing on the distribution and synthetic factors of melatonin in the eye, the relationship between melatonin and eye growth rhythm, and the relationship between melatonin and dopamine.