In 2017, the Chinese government has announced that myopia is the first irreversible blindness in Chinese, and it is based on the eye study in Beijing and Handan. Medical science is entering the era of precision medicine, big data and artificial intelligence. Multi-dimensional, quantitative and standardized measurement of myopia is the basis for the realization of artificial intelligence. The six dimensional evaluation of myopia control is heredity, diopter, increased nearwork, peripapillary atrophy, pathological myopia degree, intervention degree. ①Heredity: mainly evaluate the susceptibility of students to myopia;②Diopter: mainly record the development rate of myopia per year; ③Increased nearwork: using wearable instrument for monitoring; ④Monitoring the change of peripapillary atrophy; ⑤The level of chorioretinal atrophy: refer to Ohno-Matsui's grade; ⑥The level of intervention: it is referenced in the meta-analysis of international myopia intervention clinical trials. In order to prevent of pathological myopia, it should monitor the changes of the peripapillary atrophy in early state. Long-term monitoring of the fundus image from high myopia can see the relationship between the peripapillary atrophy and the chorioretinal atrophy.

Objective: To investigate the effect of intraocular pressure (IOP) on myopia progression in adolescents.Methods: This was a prospective study of 112 myopia subjects (ages 6-18 years old) in Changsha Aier Hospital from July 2014 to December 2015. Depending on the mean IOP at baseline, the subjects were categorized into three groups: High IOP (IOPH, 21 mmHg < mean IOP < 30 mmHg), moderate IOP (IOPM,15 mmHg < mean IOP ≤ 21 mmHg), and low IOP (IOPL, 10 mmHg < mean IOP ≤ 15 mmHg). Regular follow-ups were at 6, 12, and 18 months after baseline. Twenty-four hour IOP, spherical equivalent (SE),axial length (AL), and central corneal thickness were measured at each follow-up visit. Repeated measures analysis of variance and logistic regression analysis were performed to estimate the factors influencing
SE and AL. Results: At last, 103 cases finish the follow-up. The rates of SE progression for each group were determined for the 18-month follow-up period. For the IOPH group, IOPM group, IOPL group, the SE progression rate was -0.87±0.90 diopter (D)/year, -0.59 ± 0.89 D/year, -0.33 ± 0.32 D/year respectively,the rate of change in SE over the study period was significant (F=5.848, P=0.017). The rates of AL change for each group were also determined. For the IOPH group, IOPM group, IOPL group, the rate was 0.40 ± 0.29 mm/year, 0.18 ± 0.31 mm/year, 0.17 ± 0.30 mm/year respectively , the rate of change in AL over the study period was significant (F=5.265, P=0.007). Eyes with higher mean IOPs were likely to have SE progression (OR=0.454, 95%CI=0.317-0.716, P=0.007). Younger subjects were likely to have greater AL
elongation than older subjects (OR=1.433, 95%CI=0.994-1.506, P=0.015). Conclusions: Adolescents with higher mean IOPs are associated with the SE changes that are consistent with the changes in AL elongation.These findings suggest that IOP plays a major role in myopia progression in adolescents.

Objective: To evaluate the clinical effect of controlling myopia and correcting anisometropia by monocular orthokeratology in anisometropic children. Methods: In this retrospective, self-controlled, clinical study, 40 anisometropic children, aged 9 to 15 years, who wore an orthokeratology lens in only one eye were enrolled from January 2014 to December 2016, and followed for about 1 year. The eyes with an orthokeratology lens had a mean spherical equivalent refraction of -2.51 ± 0.95 diopter (D), and
fellow eyes without a lens had a refraction of 0.10 ± 0.52 D. The average level of anisometropia was 2.61 ± 1.04 D, ranging from 1.00 to 4.38 D. During the follow-up period, we measured changes in binocular visual acuity, spherical equivalent refraction, ocular axial length, anterior chamber depth, and corneal topography parameters. The data were analyzed by paired t-tests and Pearson correlation analysis. Results: After 1 year of wearing an orthokeratology lens, the interocular difference in visual acuity (log minimum angle of resolution) between the treated and untreated eyes decreased from 0.77 ± 0.29 to 0.17 ± 0.22 (t=-15.865, P<0.001). Other interocular differences between the treated and untreated fellow eyes included the following: Anisometropia difference decreased from 2.61 ± 1.04 D to 2.07 ± 1.05 D (t=-7.366,
P<0.001), axial length difference decreased from 0.97 ± 0.66 mm to 0.67 ± 0.63 mm (t=-5.995, P<0.001), and anterior chamber depth difference decreased from 0.47 ± 0.11 mm to 0.01 ± 0.13 mm (t=-2.704, P=0.027). Correlation analysis showed that the reduction of anisometropia between the treated and untreated eyes was correlated with only the decreases in interocular difference for axial length and uncorrected visual acuity (r=0.539, 0.418, P<0.001). Conclusions: Monocular orthokeratology is a safe and effective clinical method to control the progression of myopia and to treat anisometropia.

Objective: To estimate the impact of rigid gas-permeable contact lenses (RGPCLs) on the vision-related quality of life (VR-QOL) of keratoconic patients as assessed by the visual function quality of life questionnaire (VF-QOL). Methods: This prospective study recruited 70 keratoconus patients from the Eye Hospital,Wenzhou Medical University who were fitted with RGPCLs between July 2014 and October 2016. Before fitting each patient for RGPCLs, the best spectacle corrected visual acuity (BSCVA) and self-reported results using VF-QOL questionnaire were determined. After wearing the lenses for 1 month, the visual acuity of each patient was measured while wearing the contact lenses (RGPCLVA) and the VR-QOL was again assessed. BSCVA and RGPCLVA were compared, and the VR-QOL, assessed by self-care,
daily-activities, social function, and mental health, were compared by the Wilcoxon signed-ranked test. Results: The median BSCVA of the better eye of each patient before lens fitting was 4.8 (range, 4.0 to 5.0). After one month of lens wear, the RGPCLVA increased to 5.0 (range, 4.8 to 5.1). The median BSVCA of the worse eye of each patient before lens fitting was 4.5 (range, 4.0 to 4.9). After one month of lens wear, the RGPCLVA increased to 4.9 (range, 4.0 to 5.1). The differences in visual acuity before and after one month of RGPCLs wear in the better eyes and in the worse eyes were each significant (Z=5.92, 6.28, respectively, P<0.001 for each). The median of the 12 items in the visual function questionnaire befor fitting RGPCLs was 27 (range, 12 to 48). After one month of RGPCLs wear, the median decreased to 19
(range, 12 to 30). There was a significant difference in visual function from before and after wearing the RGPCLs (Z=6.64, P<0.001). VF-QOL included self-care, daily activities, social function, and mental health. The median scores for abilities were 4, 4, 4, and 5 respectively. After wearing RGPCLs for one month, the median scores were 4, 3, 2, and 4 respectively. The differences of score for each ability from before and after wearing RGPCLs were statistically significant (Z=3.74, 5.18, 5.20, 4.98, P<0.001 for each). Conclusions: RGPCLs not only contribute to increased visual acuity for keratoconic patients, but also improve vision-related quality of life.

Objective: To measure and analyze higher-order aberrations (HOAs) and optical performance in patients with age-related cataract and in normal subjects. Methods: In this case control study, 36 eyes of 27 patients with age-related cataract were recruited from the outpatient clinics of Xiangya Hospital from October 2013 to July 2014. Optical performance was evaluated in terms of the root means square (RMS), Strehl ratio (SR),and modulation transfer function (MTF) for the central 3.0-mm pupil diameter. For comparison, 30 eyes of 17 subjects with no lenticular opacity (control group) were recruited and assessed in an identical manner.Statistical analyses were performed with independent samples t-tests. Results: There were no significant differences between the two groups for spherical equivalent (SE), corneal radius of curvature (CR), and Q-value. The age-related cataract group had significantly greater internal and ocular HOA RMSs than the control group (t=8.073, 7.321, P<0.001) for both, but the differences in corneal HOAs were not significant.The interal and ocular SR for the age-related cataract group were significantly less than for the control group (t=10.635, 9.039, P<0.001), but the differences in corneal SR were not significant. The internal and ocular MTFs for the age-related cataract group were significantly less than for the control group (t=8.325,7.034, P<0.001 for both). The corneal MTFs were not significantly different between the two groups.Conclusions: The internal and ocular SR, and MTF were significantly lower in patients with cataracts than in normal subjects. The internal and ocular HOAs were significantly higher in patients with cataracts than in normal subjects, while differences in corneal HOAs and optical metrics were not significant.

Objective: To analyze and compare differences in macular thickness of pseudoexfoliation glaucoma (PXG),pseudoexfoliation syndrome (PEX), and age-matched control (CON) subjects. Methods: This clinical casecontrol study was conducted from May 2014 to May 2017, and the patients were selected consecutively.The PXG group included 31 eyes of 31 cases, the PEX group included 16 eyes of 16 cases, and the CON group included 34 eyes of 34 subjects that were age and gender-matched. All subjects underwent three-dimensional optical coherence tomography scans to measure macular thickness and macular volume.The data were analyzed by ANOVA. Results: The average macular thicknesses of CON group, PEX group,and PXG group were 305 ± 15 μm, 299 ± 12 μm, and 289 ± 18 μm, respectively. The average macular volume of the three groups were 0.94±0.05 μmm3, 0.92 ± 0.03 μmm3, and 0.89 ± 0.06 μm3 respectively. The overall difference of macular thickness in nasal inner macula (NIM), superior inner macula (SIM), temporal inner macula (TIM), inferior inner macula (IIM), superior outer macula (SOM), temporal outer macula (TOM),and inferior outer macula (IOM) quadrants was significant among the three groups (F=4.887, 8.987, 7.889,9.489, 6.462, 6.464, and 7.964, P<0.05). However, there were no significant differences among the central macular thickness (CMT), central subfield (CSF), and nasal outer macula (NOM) quadrants. The overall
difference of macular volume in NIM, SIM, TIM, IIM, SOM, TOM, and IOM quadrants was significant among the three groups (F=4.352, 8.697, 7.920, 8.513, 6.185, 6.411, 9.095, P<0.05). However, there were no significant differences between the CSF and NOM quadrants. The macular thickness of the PXG group was thinner than in the CON group in the NIM, SIM, TIM, IIM, NOM, SOM, TOM, and IOM quadrants (P<0.05). The macular volumes of the PXG group were smaller than in the CON group in the NIM, SIM,TIM, IIM, NOM, SOM, and IOM quadrants of (P<0.05). The macular thicknesses and macular volumes of the PXG group were thinner or smaller than in the PEX group for the SIM, IIM, and SOM quadrants (P<0.05).Conclusions: The macular thickness and volume becomes thinned in PXG, and monitoring the changes can provide important information for making a diagnosis of PXG.

Objective: To estimate a preliminary reference range for lower tear meniscus parameters that apply to different ages of individuals. Methods: A total of 206 healthy subjects (410 eyes) at Shanxi Eye Hospital and Universities were enrolled in this serial-case study. The subjects were divided into 4 groups at ten-year intervals that included all ages of the participants (21 to 60 years of age). The parameters for the lower tear meniscus, central corneal epithelial thickness and central corneal thickness were measured by anterior segment OCT. A Spearman rank correlation analysis was used to analyze the correlation between traditional dry eye diagnostic methods. The values of the reference range of the lower tear meniscus parameters in normal people at different ages were estimated by using the range of 95% medical reference values. Results: Spearman rank correlation analysis showed that there was no correlation between the central corneal thickness and other indicators, but other indicators were correlated with each other. Among them, there was a positive correlation between the and lower tear meniscus height (LTMH) and lower tear
meniscus area (LTMA) (r=0.981, P<0.001), LTMH and lower tear meniscus depth (LTMD) (r=0.983,P<0.001), LTMA and LTMD (r=0.990, P<0.001), and were significantly higher than that of SIT, NIBUTav and central corneal epithelial thickness (r=2.261-0.409, P<0.05). The LTMH reference values of the 4 age groups were: 21-30 years old: 356-441 μm; 31-40 years old: 323-378 μm; 41-50 years old: 274-332 μm; 51-60 years old: 232-319 μm, respectively. The reference range of LTMD were: 21-30 years old: 161-188 μm; 31-40 years old: 139-166 μm; 41-50 years old: 114-138 μm; 51-60 years old: 85-115 μm. The LTMA reference values were 21-30 years old: 0.031-0.038 mm2; 31-40 years old: 0.027-0.033 mm2; 41-50 years old:0.023-0.028 mm2; 51-60 years old: 0.013-0.018 mm2. Conclusions: There is a certain correlation
between the parameters of SⅠT, NIBUTav and central corneal thickness measured by anterior segment OCT. The reference value range of the lower tear meniscus parameters in different age groups showed a decreasing trend with an increase in age.

Objective: To assess the efficacy of single intravitreal injection of ranibizumab with laser photocoagulation for the treatment of macular edema secondary to branch retinal vein occlusion (BRVO). Methods: In this retrospective study, 52 patients (52 eyes) during June 2014 to December 2016 at Taizhou Municipal Hospital with macular edema secondary to BRVO were diagnosed by fundus fluorescence angiography. The patients were divided into two groups, one receiving laser photocoagulation alone and the other receiving a single intravitreal injection of ranibizumab. The injection group was further divided into two groups,one receiving the injection before laser therapy and one receiving afterwards. The best corrected visual acuity (BCVA) and central macular thickness (CMT) were recorded before the therapy and at one and six
months afterwards. Repeated measurement analysis of variance, one-way analysis of variance, and paired t-tests were used to analyze the data. Results: Before the therapy, and at one and six months after therapy,the total difference of BCVA among the three groups was statistically significant (F=18.28, P=0.011).Objective: To assess the efficacy of single intravitreal injection of ranibizumab with laser photocoagulation for the treatment of macular edema secondary to branch retinal vein occlusion (BRVO). Methods: In this retrospective study, 52 patients (52 eyes) during June 2014 to December 2016 at Taizhou Municipal Hospital with macular edema secondary to BRVO were diagnosed by fundus fluorescence angiography. The patients were divided into two groups, one receiving laser photocoagulation alone and the other receiving a single intravitreal injection of ranibizumab. The injection group was further divided into two groups,one receiving the injection before laser therapy and one receiving afterwards. The best corrected visual acuity (BCVA) and central macular thickness (CMT) were recorded before the therapy and at one and six months afterwards. Repeated measurement analysis of variance, one-way analysis of variance, and paired t-tests were used to analyze the data. Results: Before the therapy, and at one and six months after therapy,the total difference of BCVA among the three groups was statistically significant (F=18.28, P=0.011).

Objective: To assess the effectiveness of the different clinical treatments of traumatic endophthalmitis.Methods: This retrospective study included one eye of 73 patients diagnosed with traumatic endophthalmitis from November 2010 to July 2016 at Cangzhou Municipal Central Hospital. Forty-one patients were treated by vitrectomy and 32 immediately received intravitreal injection. For vitrectomy patients, 21 eyes received silicon oil tamponade, 9 eyes received C3F8 tamonade, and 11 eyes received
no tamponade. At the beginning of each vitrectomy, vitreous purulence was extracted for bacterial and fungal culture and for drug sensitivity. Results: During the following 6-24 months, two victrectomized eyes with silicon oil tamponade and one eye with intravitreal injection atrophied. Endophthalmitis was controlled for the remaining 70 eyes. Sixty-three strains of organisms were isolated from 58 eyes with traumatic endophthalmitis, including five eyes with polymicrobial infection. Among them, 39(62%)
were gram-positive, 13(21%) were fungi, and 11(18%) were gram-negative bacteria. The most common organisms were Staphylococcus epidermidis at 25% of the eyes, Aspergillus at 14%, and Staphylococcus aureus at 11%. Conclusions: For traumatic endophthalmitis, once confirmed, actions should be undertaken immediately. Vitrectomy and antimicrobials are both effective treatments.

Objective: To analyze the incidence and influencing factors of postoperative endophthalmitis after cataract surgery in the Guangming Project, and to recommend precautionary actions. Methods: In this retrospective study of cases from January 2004 to December 2016 in Jinhua Eye Hospital, we collected clinical data of cataract surgery patients who developed postoperative endophthalmitis. Then we analyzed the incidence,clinical features, and possible preventive measures. The effects of different surgical procedures and different perioperative management protocols were analyzed. The Fisher exactness test was used for statistical analysis. Results: Sixteen cases of postoperative endophthalmitis occurred after 20, 131 cataract surgeries during the study period; thus, the cumulative incidence was 0.079%. After 5, 371 cases of small incision extracapsular cataract extraction, there were two cases of postoperative endophthalmitis (0.037%).After 14, 760 cases of phacoemulsification, there were 14 cases of postoperative endophthalmitis (0.095%).There was no significant difference in the incidence of postoperative endophthalmitis between the two
surgical methods (P=0.265). There was also no difference in the incidence of postoperative endophthalmitis between procedures in which the eyelashes were trimmed (incidence 0.121%) or not trimmed (incidence 0.062%, P=0.29). The incidence of postoperative endophthalmitis for patients using 0.5% povidone iodine to wash the conjunctival sac before surgery was 0.059%, while the incidence for patients not using the povidone wash was 0.174%, P=0.04). According to the description of the cause of the disease, we found that 4 cases of male patients have a clear incentive, accounting for 25%, of which one patient shampoo a day before the disease occurring; one patient dismantle the old wall of its own roof collapse one day beforethe disease occurring; One patient covered surgery eye by their own buied gauze; One patient droped the surgery eye only with one of the discharged medicine, and only once a day. There were no obvious causes in the remaining 12 patients. In addition, follow-up intravitreal surgery found that the clear corneal incision was oblique and poorly closed in two patients. Conclusions: The incidence of postoperative
endophthalmitis after cataract surgery is 0.079%. Pre-surgical washing of the conjunctival sac with 0.5% povidone iodine before the operation can reduce the incidence of postoperative endophthalmitis. The incidence of postoperative endophthalmitis can probably be further reduced by providing patients with clear pre- and postoperative medical and behavioral instructions to ensure that medications are taken properly, and that inappropriate activities are avoided.

The levels of hormones in pregnant women usually change markedly during pregnancy, and the organs and tissues of the pregnant women also undergo physiological or pathological changes in response to the hormonal changes. The eye and associated organs are also affected. In this article, we reviewed the researches related to ocular changes in healthy pregnant women.