Objective: We analyzed the incidence of secondary glaucoma, the surgery rate, and the efficacy of intraocular (IOP)-lowering medication following blunt ocular trauma. We also correlated these factors with the ocular trauma score (OTS) system suggested by the International Society of Ocular Trauma and evaluated the applicability of the OTS in predicting the likelihood of secondary glaucoma onset and the optimal treatment of it. Methods: We conducted a retrospective review of 265 patients (267 eyes) with ocular contusion admitted to Xijing Hospital from January 2014 to December 2016. The initial visual acuity (VA), zone of injury, relative afferent papillary defect, and OTS were evaluated to analyze the clinical characteristics and the incidence of secondary glaucoma. Data were analyzed using chi-square tests,linear correlation analysis, t-tests, and analysis of variance. results: Overall, the final VA was better than the initial VA ( χ 2 =65.99, P<0.001). The incidence of secondary glaucoma was 13.1% (35 eyes), and higher OTSs were associated with lower occurrences ( χ 2 = 8.593, P=0.035). All glaucoma patients had eye injury in zones Ⅰ and Ⅱ, and 12 eyes were involved in zone Ⅲ. Glaucoma patients with worse OTSs had higher surgery rates (r =-0.980, P<0.001). All glaucoma patients with an OTS of 2 received surgery graded over level 3. At 6 months after injury, the IOP of glaucoma patients in each OTS group was significantly lower than at the initial visit (t=6.93, 8.21, 8.24, 6.36, P<0.01), but there were no significant differences in IOP between each group. The number of IOP lowering medications taken at 6 months after injury by patients with a score 2, 3, or 4 trauma was significantly reduced compared with the initial treatment (t=13.50, 4.75,3.20, P<0.05). However, there was no statistical difference in the number of medications used between groups with score 3, 4, and 5 at the initial treatment or at 6 months. conclusions: The OTS is of value in predicting secondary glaucoma after blunt trauma. Poorly scoring victims are more likely to develop secondary glaucoma and need surgical intervention. A larger data sample is needed to determine differences in the number of IOP lowering medication needed for patients with different scores.

Objective: To demonstrate that the RCS (rdy-/-, p-/-) rat model for retinitis pigmentosa has a blood stasis and deficiency pathogenesis. Methods: This was an experimental study. Ten RCS (rdy+/+, p+/+) rats were in the control group (5 males and 5 females); 10 RCS (rdy-/-, p-/-) rats were in the model group (5 males and 5 females). The general morphological and behavioral characteristics of the two groups of rats were observed to evaluate the biological differences between them. ELISA was used to determine the indicators of blood stasis and deficiency. The indicators of deficiency included cAMP, cGMP and cAMP/cGMP levels in retinal homogenate tissue, and plasma PG and E2 levels. The indicators of blood stasis were the P-selectin level in plasma, and hemorheology indexes. Tissue sections with HE staining were used to observe the retinal structures of the rats in the two groups. Independent sample t tests were performed on both sets of data. results: The rats in the model group manifested significant weight loss,fatigue, unresponsiveness, slow movements, volumized and dull back hair, vulnerability to fright, low food intake, and slightly loose stools. The plasma E2 content in female rats was significantly lower than that in the control group, and the difference was statistically significant (t=2.67, P=0.03). The plasma PG content in the male rats of the model group was lower than that of the control male rats, and the difference was statistically significant (t=4.12, P=0.003). The levels of cAMP, cGMP, and cAMP/cGMP in retinal tissue homogenates of the control group were higher than levels in the model group, and the difference was statistically significant (t=18.87, 12.63, 11.76, P < 0.001). When the blood flow shear forces were 5/s, 100/s,and 200/s, the blood viscosity of the model group was higher than that of the control group, and the difference was statistically significant (t=5.58, 4.40, 6.80, P < 0.001). The plasma viscosity value, whole blood high incision relative index, whole blood low incisionrelative index, and fibrinogen in the model group were higher than those in the control group, and the difference was statistically significant (t=5.20,8.25, 9.08, 6.15, P < 0.001). The content of P-selectin in the plasma of the model group was significantly higher than that of the control group (t=4.30, P=0.003). The retinal thickness of rats in the model group was significantly thinner than that of the control group, and the structure of each layer of the rat's retina in the model group was disordered and atrophic. The lesions were mainly located in the outer layer of the retina, and the cones and rods were atrophic. conclusions: The RCS (rdy-/-, p-/-) rat model of retinities pigmentosa has pathophysiological characteristics such as body weight loss, deficiency of kidney essence,and blood stasis deficiency.

Objective: To investigate the therapeutic effect of sodium paeonolsilate on experimental immunologic conjunctivitis in mice and to explore the mechanism of action. Methods: This was an experimental study.The Balb/c mice which immunologic conjunctivitis was initiated by intraperitoneal injection with ovalbumin (OVA) were randomly assigned to five treatment groups (Groups B-F, n=6 mice each), and another 6 mice served as uninjected controls (Group A). Both eyes of each mouse were treated with eyedrops 7 days after as follows: Group A, uninjected controls treated with phosphate-buffered saline (PBS); Group B, model group treated with PBS; Group C, treated with 1% sodium paeonolsilate group;Group D, treated with 2% sodium paeonolsilate group; Group E, treated with sodium cromoglicate;Group F, treated with olopatadine. After five days of medication or control treatments, ocular clinical symptoms were evaluated, and blood and conjunctival tissue were taken for analysis. Conjunctival tissue sections were stained with toluidine blue to visualize mast cell degranulation (MCD). Ovalbumin specific immunoglobulin E (OVA-s IgE), interferon-γ (IFN-γ), and interleukin-4 (IL-4) levels were determined in serum by enzyme linked immunosorbent assay. One-way analysis of variance was used for the comparison of data among the groups. results: Symptom scores were significant among all groups (F=38.72,
P<0.001). The symptom scores in Group B, were significantly higher than those in Group A (P<0.001).The symptom scores in each medication group were lower than those in Group B (P<0.05). There were significant differences in the mast cell among the six groups (F=15.28, P<0.001). The number of mast cell higher in Groups B-F than in the group A (all P<0.01). The serum levels of OVA-s IgE were significantly lower in Groups C-F than in the Group B (all P<0.05). The serum IFN-γ levels were significantly higher in Group A and Groups C-F than in Group B (all P<0.05). The serum IL-4 levels were significantly lower in Group A and Groups C-F than in Group B (all P<0.05). conclusions: In mice, sodium paeonolsilate eye drops have a therapeutic effect on experimental immunologic conjunctivitis initiated by OVA injection.It stabilizes mast cells and inhibits activated degranulation. Sodium paeonolsilate down regulated serum levels of OVA-s IgE and IL-4 while upregulating IFN-γ.

Objective: To analyze the changes in corneal higher order aberrations (HOAs) and contrast sensitivity (CS) after orthokeratology (ortho-K) treatment, and their correlation with the magnitude of lens decentration.Methods: This was a prospective study. Thirty-one patients (31 eyes) who had undergone orthokeratology treatment from March to August 2017 in 3rd Affiliated Hospital of Wenzhou Medical University were chosen for the study. Corneal topography, CS and corneal HOAs were measured before and one month after ortho-K lens treatment, in addition, the diameter and decentration of the treatment zone and their inf luence on corneal HOAs and CS were analyzed. CS was expressed as area under log contrast sensitivity function(AULCSF) was a paired-t test, pearson correlation and stepwise multiple linear regression were used to analyze the data. results: The mean TxZ diameter was 3.48±0.49 mm, while the mean decentration of TxZ was 0.64±0.27 mm, mostly toward the inferior temporal quadrant (45%). The root mean squares (RMS) of the total corneal HOAs, corneal spherical aberrations corneal vertical coma aberrations and corneal horizontal coma aberrations increased after one month of treatment (t=10.99, 10.19, -2.21, -3.50,P<0.05). The vertical decentration of TxZ was significantly correlated with the corneal vertical coma aberrations (standard B=0.620, P=0.001), while the horizontal decentration was significantly correlated with the corneal horizontal coma aberrations (standard B=0.422, P=0.049). The photopic and mesopic AULCSF tended to decrease, but there were no significant differences. The change in photopic AULCSF only correlated with the change in diopters (standard B=0.452, P=0.021), while the change in mesopic AULCSF correlated with both the change in diopters (standard B=0.528, P=0.004) and the decentration of TxZ (standard B=0.458, P=0.027). conclusions: Decentered othokeratology lenses increase corneal HOAs but do not affect CS.

Objective: To study the changes in accommodative response and microfluctuations in patients with intermittent exotropia (IXT) before and after surgery. Methods: Twenty-nine patients 8-20 years of age with IXT were recruited for a prospective clinical study at Eye Hospital of Wenzhou Medical University from June to August 2017. A Grand Seiko WAM-5500 auto-refractor was used to measure the accommodative response and microfluctuations at 33 cm before and after strabotomy. Data were analyzed using a paired t-test. results: Before surgery, the accommodative response in IXT patients was higher under binocular conditions (dominant eye: 2.23±0.44 D; nondominant eye: 2.44±0.51 D) compared to monocular conditions (2.03±0.40 D; 2.11±0.40 D)(t=2.481, P=0.019; t=2.786, P=0.009). After surgery, the accommodative response under binocular conditions (after surgery: 2.00±0.37 D; 2.11±0.50 D; t=2.628,P=0.014; t=3.120, P=0.004) decreased and accommodative microfluctuations in IXT patients under binocular conditions also decreased (before surgery: 0.22±0.14 D, 0.22±0.12 D; after surgery: 0.16±0.08 D,0.16±0.07 D; t=2.306, P=0.029; t=2.242, P=0.033). conclusions: After surgery, the accommodative ability of IXT patients improves, more stable accommodative microfluctuations and visual performance improved.

Objective: To observe binocular vision characteristics in the diagnosis and treatment of accommodative dysfunctional vision loss patients. Methods: In this retrospective study, 25 participants with accommodative dysfunctional vision loss were enrolled at the Ophthalmic Center, Wuhan General Hospital of the People's Liberation Army from February 2014 to February 2016. All patients had routine examinations that excluded eye disease, amblyopia risk factors, and systemic disease. Based on binocular vision characteristics, all patients participated in visual function examination and training. Each patient’s binocular vision was checked under cycloplegia to assess the effect of accommodative relaxation on visual acuity and binocular vision. All data were statistically analyzed with paired t-tests and Wilcoxon tests.results: Patients ranged in age from 6 to 24 years. Four patients were misdiagnosed as retrobulbar optic neuritis, one patient's symptom was poor uncorrected visual acuity (UCVA) after orthokeratology, two patients were referred to us because of blurred vision after femtosecond LASIK surgery, eleven patients' vision declined after overuse of eyes, seven patients complained of reduced distance vision only. The patients' baseline (25 cases) uncorrected visual acuity was 4.19±0.34, and the spherical equivalent (SE) was-7.95±3.10 diopter (D), the best corrected visual acuity (BCVA) was 4.28±0.32. After cycloplegia with tropicamide eyedrops (21 cases), the SE was -0.06±0.86 D, the BCVA was 4.43±0.15. After using atropine eye ointment (14 cases), the SE was +1.24±0.84 D, the BCVA was 4.93±0.14. After 3 months' vision training, visual function indexes improved. Negative relative accommodation before and after training was 1.76±0.61 D, 2.49±0.15 D (t=-3.780, P<0.001). Positive relative accommodation was -1.26±0.76 D,-2.43±0.34 D(t=3.977, P<0.001). Accommodative facility was 0 cycle/min (cpm), 10.6 cpm (Z=-4.012,P<0.001). BCVA and SE remained stable. conclusions: Patient functional vision loss was caused by accommodative abnormities. Upon basic treatments combined with visual function examination and training, visual acuity was improved and remained stable.

Objective: We investigated the expression and regulation of microRNA-127 (miR-127) in uveal melanoma cells. We also investigated the effect of epigenetically upregulating miR-127 by altering DNA methylation and histone acetylation. Methods: In this experimental study, we performed real-time reverse transcriptase
quantitative polymerase chain reaction (RT-qPCR) to detect the expression level of miR-127 in both uveal melanoma cells (M23 and SP6.5) and uveal melanocytes (UM95). Lipofectamine RNAiMAX reagent was used to transfect M23 and SP6.5 with either miR-127 or a negative control (NC). The proliferation of uveal melanoma cells was quantified by 3-[4, 5-dimethyl-thiazol-2-yl]-5-[3-carboxymethoxyphenyl]-2-[4-sulfophenyl]-2H-tetrazo-lium, inner salt (MTS) cell proliferation assay. Cell cycle was examined by flow cytometry. The expression of cell cycle-related proteins was analyzed by Western Blot. In addition,RT-qPCR was performed to detect the expression level of miR-127 in M23 and SP6.5 cells after treatment with 5-aza-2-deoxycytidine (5-Aza-dC) and trichostatin A (TSA). These agents modify gene expression through DNA methylation and histone acetylation, respectively. Data were analyzed using independent t-tests. results: miR-127 was dramatically downregulated in M23 and SP6.5 cells as compared to UM95 (t=72.2, 591.5, P<0.001). The MTS assay showed that the relative number of cells transfected with miR-127 [(62.3±4.2)% and (65.4±2.3)%] was significantly lower than transfected with NC (t=12.7,21.6, P<0.001). Flow cytometry showed that the percentage of M23 and SP6.5 cells transfected with miR-127 in G0/G1 phase was significantly higher than for the NC group (t=-6.7, P=0.003; t=-9.9,P<0.001), and the percentage of M23 and SP6.5 cells in the S phase was significantly lower than for the NC group (t=8.6, P=0.001; t=12.7, P<0.001). Furthermore, miR-127 downregulated the level of phosphorylated retinoblastoma protein in uveal melanoma cells. In addition, miR-127 was upregulated after treatment with 5-Aza-dC and/or TSA (P<0.05). conclusions: Our results demonstrated that miR-127 can suppress uveal melanoma cell proliferation by inhibition of cell cycle. Furthermore miR-127 expression was modulated by epigenetic regulation including DNA methylation and histone acetylation.

Objective: To evaluate and verify the correlation between retinopathy of prematurity (ROP) in preterm infant Chinese twins with the NDP/FZD4 gene mutation. Methods: In this case series study, clinical evaluations and gene examinations were done on 12 cases of preterm infant twins (6 couples, aged 4-6 weeks) with ROP which were identified in Shanghai Children's Hospital from January 2017 to December 2017.The mean gestation age was 31 weeks and the mean weight was 1 252 g. Polymerase chain reaction (PCR) amplification and Sanger sequencing were used to extract the human genome DNA from peripheral blood.
results: Twelve premature infants were diagnosed with stage 3 ROP, and 6 infants were diagnosed with threshold ROP disease and treated with photocoagulation combined with an injection of intraocular anti-VEGF medication. Lesions in the other 6 infants subsided during the follow-up period. The longest follow-up period was 7 months after birth. Neither a clear pathogenicity point mutation nor a small insertion/deletion in either a NDP or FZD4 gene was detected in any infants in the study. conclusions: There was no mutation correlation with the NDP or FZD4 gene in ROP in preterm infant twins. We predicate that other genetic or racial factors cause the ROP in preterm infant twins.

Objective: To use anterior segment optical coherence tomography (AS-OCT) for structural imaging and accurate measurements of pinguecula and pterygium in order to understand the structural features of these lesions. Methods: This study was a prospective parallel control study. Lateral bulbar conjunctiva of 25 cases (30 eyes) that included pinguecula (10 eyes of 8 cases), pterygium (10 eyes of 9 cases), and normal eyes (10 eyes of 8 cases), were enrolled from the Department of Ophthalmology of the Fourth Affiliated Hospital of Zhejiang Medical University from January to April 2018. The anterior segment module of an Optovue optical coherence tomography angiography (OCTA) was used for measurements. The thickness of the bulbar conjunctiva epithelium and propria tissues at sites at a distance of 0.0 mm, 0.5 mm, 1.0 mm,1.5 mm, 2.0 mm and 2.5 mm from the scleral process were stratified within the 2.5 mm range, were measured, compared and further analyzed. The data were described by means of mean ± standard deviation.Repeated measurement analysis of variance was used for comparison of each point in the group, one-way analysis of variance was used for comparison between groups. results: Compared with normal eyes and pinguecula eyes, pterygium showed thickened epithelium in 0.5 mm point (P<0.05). In the 2.5 mm range on the nasal side, pterygium and pinguecula showed thickened subepithelium tissues (P<0.05), especially for pterygium, compared to normal eye tissue. conclusions: AS-OCT can image microstructures in benign conjunctival proliferative diseases, resulting in accurate quantitative diagnosis and evaluation. The thickness of subepithelium tissues increases in pinguecula and pterygium.

Objective: To analyze visual function after phacoemulsification in patients with super high myopia with cataract. Methods: Fifty-three patients (81 eyes) underwent cataract surgery by the same surgeon from January 2015 to January 2016 in Xin Hua Hospital Medical College of Shanghai Jiao Tong University. The patients were divided into three groups based on axial length: < 29 mm, 29-31 mm and > 31 mm. Postoperative best corrected distant visual acuity (BCDVA) and uncorrected near visual acuity (UCNVA) was measured and compared at one week, one month, and three months after surgery. Mara (4-2 strategy) were measured and analyzed three months after surgery. Data were analyzed using Kruskal-Wallis test. results: Patients with nuclear cataract classes Ⅲ, Ⅳ and Ⅴ were accounted for 90% (73 eyes), 9% (7 eyes), 1% (1 eye), respectively.The mean value of postoperative BCDVA and UCNVA all declined as axial length (AL) increased but the differences were not statistically significant between groups (P > 0.05). The ratio of normal macular integrity and fixation stability was not correlated with axial length. The ratio of the normal average threshold declined as AL increased. conclusions: In patients with super high myopia with cataract, the BCDVA, UCNVA, and retinal function show a tendency to decline with an increase of axial length.

Molecularly imprinted contact lenses (MI-CL) can provide sustained drug release and improve the efficiency of ophthalmic drug delivery. They can significantly decrease the patients' discomfort caused by eye drops, but can also reload relevant drugs. More importantly, they can load high-molecular drugs. They show great potential application in the ophthalmology clinic. In this review, the principle and development,and the drug-loading model and sustained-release model of the MI-CL are included and discussed. This review can be useful for the design of novel contact lenses for clinical applications and the improvement of drug-loaded contact lenses in the future.