Chinese Journal of Optometry Ophthalmology and Visual science

中华眼视光学与视觉科学杂志

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Chinese Journal of Optometry Ophthalmology and Visual science

	2021 Vol.23 Issue.12 Published 2021-12-25

	Orignal Article Case Report Review

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		2021 Vol. 23 (12): 0- [Abstract] ( 341 ) [HTML 1KB] [ PDF 34585KB] ( 13363 )

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		2021 Vol. 23 (12): 0- [Abstract] ( 298 ) [HTML 1KB] [ PDF 611KB] ( 11505 )

Orignal Article

	881	Changes in Retinal Blood Flow Density after ICL Implantation in High Myopia Using Optical Coherence Tomography Angiography
	Changes in Retinal Blood Flow Density after ICL Implantation in High Myopia Using Optical Coherence Tomography Angiography[J]. Chinese Journal of Optometry Ophthalmology and Visual science, 2021,23(12): 881-886>')" href="#">	Yingnan Xu,Jin Yao,Tan Long,et al
		Objective: To observe the effect of posterior chamber intraocular lens (ICL) implantation on retinal blood flow density and retinal thickness in high myopia using optical coherence tomography angiography (OCTA). Methods: This was a prospective clinical study. Twenty-five patients (43 eyes) who underwent ICL implantation from December 2019 to may 2020 in the Affiliated Eye Hospital of Nanjing Medical University were selected. The spherical equivalent (SE) was >-6.00 D. Visual acuity, intraocular pressure, arch height, macular blood flow density and retinal thickness were measured before the operation and 1 week, 1 month and 3 months after the operation. The data were analyzed with repeated measures ANOVA.visual acuity (BCVA, LogMAR) were statistically significant (F=500.975, P<0.001; F=16.032, P<0.001, respectively), and all improved compared to the preoperative values (P<0.001). The macular foveal retinal thickness (CRT) did not change significantly after surgery, but the area of the avascular zone (FAZ) decreased significantly after surgery (all P<0.001), and difference between preoperative and postoperative were statistically significant (P<0.001), respectively. There was no significant difference in superficial retinal blood flow density in the fovea, parafovea, temporal, superior, nasal or inferior regions before the operation, and 1 week, 1 month and 3 months after the operation. There was no significant difference in the deep retinal blood flow density in the fovea, temporal, superior or inferior regions 1 week, 1 month and 3 months after the operation, but the deep retinal blood flow density in the parafovea and nasal region decreased after the operation (all P<0.05). Conclusions: According to the OCTA, ICL implantation has a significant effect on deep nasal retinal blood flow density, and decreases the area of FAZ, however there is no significant effect on other retinal blood flow and thickness parameters. Results: The postoperative uncorrected visual acuity (UDVA, LogMAR) and postoperative best corrected
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		2021 Vol. 23 (12): 881-886 [Abstract] ( 347 ) [HTML 1KB] [ PDF 767KB] ( 12140 )

	887	A Comparative Study of the Repair of Nerve Fibers after Different Laser Keratomileusi Procedures
	A Comparative Study of the Repair of Nerve Fibers after Different Laser Keratomileusi Procedures[J]. Chinese Journal of Optometry Ophthalmology and Visual science, 2021,23(12): 887-895>')" href="#">	Jiangfeng Li, Hui Li, Jinjian Li,et al
		Objective: To investigate the repair of corneal subepithelial nerve fibers in the early and middle stages after small incision lenticule extraction (SMILE), femtosecond flap excimer laser in situ keratomileusis (FS-LASIK) or laser epithelial keratomileusis (LASEK) in patients with high myopia. Methods: This was a prospective clinical study. Fifty-five patients (110 eyes) with high myopia who were treated in the Department of Ophthalmology at the Affiliated Hospital of Qingdao University were divided into a SMILE group (44 eyes), FS-LASIK group (36 eyes) and LASEK group (30 eyes). The repair of corneal nerve fibers was observed by laser confocal microscopy at 1, 3 and 6 months after the operations. Parameters of nerve fibers at different time periuds after the operations was used one-way ANOVA of random block design. Results: The corneal nerve distribution density, branch density, and length and width of different areas in patients with high myopia were best in the early stage after SMILE compared with the other two groups. The repair speed was also the fastest and reached the preoperative level earlier. Comparisons of corneal nerve repair in different areas, including the corneal flap, showed that the repair rate for FS-LASIK was between SMILE and LASEK. In the early stage after LASEK, especially in the central area, the white scar turbidity was obvious, and the speed and quality of corneal repair in different areas were the worst. The results of image analysis at the different time periods in each group suggested that the levels of corneal nerve fiber density (CNFD), corneal nerve fiber length (CNFL) and corneal nerve fiber total branch density (CTBD) in the center of the SMILE and FS-LASIK groups were significantly better than those in the LASEK group at 1 month after the operation (all P<0.05). The CNBD of SMILE was significantly better than that of both the FS-LASIK and LASEK groups (HSD=4.367, P=0.007; HSD=4.237, P=0.008). Three months after the operation, the CNFD, CNBD, CNFL in the center of the SMILE operation were significantly better than for both the FS-LASIK and LASEK groups (all P<0.05). The CNFW of the LASEK operation was significantly better than that of both the SMILE and FS-LASIK groups (HSD=3.457, P=0.003; HSD=3.668, P=0.004). Six months after the operation, the central CNFD, CNBD and CNFL of the SMILE operation were better than those of both the FS-LASIK and LASEK groups, and the difference was statistically significant (all P<0.05). Conclusions: In the early and middle stages after laser keratomileusis, SMILE is significantly superior to FS-LASIK and LASEK for nerve repair in all regions.
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		2021 Vol. 23 (12): 887-895 [Abstract] ( 359 ) [HTML 1KB] [ PDF 6980KB] ( 12584 )

	896	The Efficacy of Intense Pulsed Light Combined with Meibomian Gland Massage in the Treatment of Meibomian Gland Dysfunction-Related Dry Eyes Using the Meibomian Gland Analysis System
		Pengfei Dai, Ying Li, Yuqian Wang,et al
		Objective: To observe the therapeutic effects of intense pulsed light (IPL) combined with meibomian gland massage on dry eyes associated with meibomian gland dysfunction (MGD) using the meibomiangland analysis system. Methods: This study was a case series study. A total of 37 outpatients (74 eyes) with MGD-related dry eyes were selected from July 2019 to August 2019 at Xi'an Fourth Hospital. Patients underwent IPL treatment combined with meibomian gland massage (once every three weeks, three times in all). Intergroup comparisons of the ocular surface disease index (OSDI), non-invasive tear film rupture time (NITBUT), non-invasive lacrimal river height measurement (NITMH), meibomian gland yielding secretion score (MGYSS), deformation coefficient and photographic value of the meibomian gland analysis system were performed before treatment and after the first, second, and third treatments. A repeated measurement analysis of variance (ANOVA) was used for evaluation. Pearson linear correlation analysis was used to assess the relationships between the deformation coefficient and the photographic value of the meibomian gland and other variables of ocular surface function. The therapeutic effects of IPL combined with meibomian gland massage on dry eyes associated with MGD were further evaluated. Results: Indexes, including OSDI, NITBUT, MGYSS and photographic value, at each time point after treatment were significantly improved compared with those before treatment, and the difference was statistically significant (P<0.001). There was no significant difference in the deformation coefficient after the first and second treatments, while the deformation coefficient significantly decreased after the third treatment (P=0.01). NITMH data showed no significant improvement at each time point after treatment compared with before treatment, and the difference was not statistically significant. As the trends for the indicators changed, OSDI, NITBUT, MGYSS and photographic values continued to improve after the first treatment, and were best after the third treatment. In addition, the deformation coefficient changed gently, with a significant improvement only after the third treatment. The results showed that the deformation coefficient of the meibomian gland was positively correlated with OSDI (r=0.379, P=0.01), negatively correlated with NITBUT (r=-0.427, P=0.01), and had no correlation with NITMH and MGYSS. The photographic value of the meibomian gland had a significant negative correlation with OSDI (r=-0.904, P<0.001), a positive correlation with NITBUT (r=0.947, P<0.001) and MGYSS (r=0.467, P<0.001), and had no correlation with NITMH. In the study, there was no irreversible eyelid skin injury, no anterior segment inflammatory reaction, iris depigmentation, ocular surface or fundus injury, decreased vision, high intraocular pressure or other complications. Conclusions: Both intense pulsed light combined with palpebral gland massage are convenient, safe and effective for MGD-related dry eyes. The meibomian gland analysis system can monitor the secretion capacity of glands to a certain extent, which can be used as a supplementary means to evaluate the therapeutic effect through specific quantitative data such as the photographic value.
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		2021 Vol. 23 (12): 896-902 [Abstract] ( 363 ) [HTML 1KB] [ PDF 2851KB] ( 12638 )

	903	The Prevalence and Risk Factors of Pterygium in Han and Kazak Ethnic Groups in Tacheng, Xinjiang
		Xiao Li, Guoqing Li, Jing Xu, et al
		Objective: To investigate the prevalence and risk factors of pterygium in Han and Kazak ethnic groups aged 50 and older in the Tacheng region of Xinjiang. Methods: This was a cross-sectional study. The prevalence of pterygium in people aged 50 years and older in the Tacheng region was investigated and studied by the Jiu Shi Hospital of Xinjiang Production and Construction Corps from October 2015 to June 2018. The basic sampling units (BSU) were divided by administrative area, with approximately 1 000 people in each BSU, or divided into more than 2 BSUs if the BSU exceeded 1 500 people. The Tacheng region was divided into 240 BSUs. We randomly selected 12 BSUs by using random number table method. Questionnaires were used to collect information such as age, ethnicity, gender, hypertension, diabetes, smoking, age-related cataract, coronary heart disease, duration of UV exposure (summer), and duration of UV exposure (winter). Pterygium was diagnosed and graded clinically by slit-lamp examination. Rank sum test was performed to compare the association between the above factors and the prevalence of pterygium. Then, we entered all significant factors (predefined as P<0.05 in Rank sum test) into a multivariable logistic regression model to identify independent factors correlating with pterygium. Results: A total of 2 114 individuals were included in this study, of which 489 were diagnosed with pterygium (23.13%), including 65(21.04%) in group aged 50-59, 168(24.93%) in group aged 60-69, 219(23.08%) in group aged 70-79, 37(20.33%) in group aged above 80. Rank sum test showed that gender (F=5.560, P=0.018), smoking (F=6.568, P=0.010), duration of UV exposure (summer) (F=8.884, P<0.001), age-related cataract (F=4.397, P=0.036), and refractive error (F=8.273, P=0.004) were associated with pterygium. Further logistic multiple regression analysis revealed that UV exposure (summer) [0-4: OR=2.184, 95%CI: 0.502- 9.175; 4-8: OR=1.651, 95%CI: 1.256-3.295], and refractive error (OR=1.903, 95%CI: 1.425-2.248) were independent risk factors for the presence of pterygium in this region. Conclusions: The prevalence of pterygium in people aged 50 years and older in Tacheng, Xinjiang is 23.13%, There is no significant difference between Han and Kazak ethnic groups. Ultraviolet radiation (summer) is independently associated with pterygium.
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		2021 Vol. 23 (12): 903-909 [Abstract] ( 359 ) [HTML 1KB] [ PDF 831KB] ( 11923 )

	910	Comparative Study of the Progression of Low to Moderate Myopia in Children 6−12 Years of Age in the Xi'an First Hospital before and after the Outbreak of COVID-19
	Comparative Study of the Progression of Low to Moderate Myopia in Children 6−12 Years of Age in the Xi'an First Hospital before and after the Outbreak of COVID-19[J]. Chinese Journal of Optometry Ophthalmology and Visual science, 2021,23(12): 910-917>')" href="#">	Pan Li, Tong Li, Jin Wang, et al
		Objective: To compare the progression of low to moderate myopia in children 6-12 years of age in the Xi'an First Hospital before and after the COVID-19 epidemic. Methods: This was a retrospective cohort study. One hundred cases (200 eyes) of children 6-12 years of age with binocular myopia who were admitted to the Department of Ophthalmology in Xi'an No.1 Hospital before the outbreak of the COVID-19 epidemic (December 2018 to January 2019) and after the outbreak (December 2019 to January 2020) participated in the study. Follow-up records were recorded for 0.5 and 1 year. The mean age of the pre-epidemic group was 9.6±1.2 years, and the mean age of the post-epidemic group was 9.2±2.4 years. Changes in the ocular axis (AL), spherical equivalent (SE) and axial/corneal curvature ratio (AL/CR) at baseline, 0.5 and 1 year were retrospectively analyzed in the 2 groups, and the data were compared by a paired t test. Results: At the 0.5 year follow-up, the pre-epidemic group showed less AL growth than the post-epidemic group (0.27±0.16 mm vs. 0.36±0.19 mm) (t=-6.228, P<0.001), an increase in SE (-0.48± 0.37 D vs. -0.74±0.63 D) (t=-2.375, P<0.001), and an increase in AL/CR ratio (0.017±0.028 vs. 0.029±0.031) (t=-6.052, P<0.001). At the 1 year follow-up, the pre-epidemic group showed less AL growth than the post-epidemic group (0.46±0.31 vs. 0.61±0.24) (t=1.138, P<0.001), an increase in SE (-0.90± 0.41 D vs. -1.25±0.48 D) (t=7.253, P<0.001), and an increase in the AL/CR ratio (0.030±0.051 vs. 0.046±0.036) (t=5.049, P=0.032). Conclusions: After the outbreak of COVID-19, the progression of myopia in 6-12 year-old school-age children in the post-epidemic is faster than in the pre-epidemic, mainly manifested in AL, SE and AL/CR
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		2021 Vol. 23 (12): 910-917 [Abstract] ( 393 ) [HTML 1KB] [ PDF 9615KB] ( 13410 )

	918	The Zigzag Suture Technique for Re-Centering a Dislocated IOL without Using a Scleral Flap
	The Zigzag Suture Technique for Re-Centering a Dislocated IOL without Using a Scleral Flap[J]. Chinese Journal of Optometry Ophthalmology and Visual science, 2021,23(12): 918-924>')" href="#">	Jintao Chen, Lingjie Zhang, Honghui Duan, et al
		Objective: To study the surgical procedure and its clinical effects for an intrascleral zigzag suture technique (ZST) without using a scleral flap or knot to re-center a dislocated intraocular lens (IOL). Methods: This was a retrospective study. Twenty-one patients (21 eyes) with IOL dislocation underwent intrascleral ZST without using a scleral flap or knot to re-center dislocated IOLs at Taizhou Eye Hospital between June 2011 and December 2016. Among them, there were 15 eyes with subluxation of IOLs and 6 eyes with completely dislocated IOLs. Patients were regularly followed up at 2 weeks, 1 month, 3 months and 6 months and then every 12 months after that for a total of 4-8 times. The position of the IOL and its stability, visual acuity, intraocular pressure (IOP) and complications were observed and analyzed postoperatively. Results: Postoperative position of the IOL was in the center, unbiased position with no pupil capture. Visual acuity improved significantly compared to preoperative acuity and IOPs were normal in all operated eyes. During the follow-up period, the position of the IOL was in the center and unbiased position with no tilt. No erosion from exposure of the polypropylene thread end was observed at the scleral ZST fixation point of the IOL. There was no polypropylene suture slippage and no local conjunctive congestion or intraocular infection in any operated eye. Vision was stable and good. There was no high IOP or secondary glaucoma among the patients. Conclusions: Re-centering a dislocated IOL with intrascleral ZST produces good results. The IOL is re-centered firmly after the operation without using a scleral flap or knot. There is no risk of knot erosion from exposure or intraocular infection.
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		2021 Vol. 23 (12): 918-924 [Abstract] ( 364 ) [HTML 1KB] [ PDF 9661KB] ( 12837 )

	925	Dynamic Assessment of Tear Film Optical Quality in Dry Eye Using a Double-Pass Optical Quality Analysis System
	Dynamic Assessment of Tear Film Optical Quality in Dry Eye Using a Double-Pass Optical Quality Analysis System[J]. Chinese Journal of Optometry Ophthalmology and Visual science, 2021,23(12): 925-929>')" href="#">	Yu Chen, Liqing Wei, Nannan Dong,et al
		Objective: To assess the relationship between optical quality dynamic change using a double-pass system (OQAS-II) and tear breakup time (TBUT) in patients with dry eye disease. Methods: Thirty patients (60 eyes) with dry eye disease in Hangzhou Xihu Eye Hospital were included in this serial case study from May 2018 to May 2019. All subjects underwent examinations as follows: TBUT under fluorescein staining, Shirmer Ⅰ test (SⅠT) under topical anesthesia, and corneal fluorescein staining. The basic objective scattering index (basic OSI), the average OSI under natural blinking within 20 s (mean OSI1), and the average OSI under non-blinking within 20 s (mean OSI2) were recorded by the OQAS-II system. The differences between mean OSI1 and basic OSI and mean OSI2 and basic OSI were recorded as ΔOSI1 and ΔOSI2, respectively. Spearman correlation analysis was used to observe the correlation between ΔOSI1, ΔOSI2, basic OSI, mean OSI1, mean OSI2, and BUT. Results: The average BUT was 0.93-7.05(2.56±1.02)s, the average of Shirmer Ⅰ was 11.33±7.93 mm/5 min, and corneal fluorescein staining was positive in 4 out of 60 eyes. The medians of basic OSI, mean OSI1, mean OSI2, ΔOSI1, ΔOSI2 were 0.60(0.40, 1.28), 1.22(0.68, 2.22), 2.18(1.13, 2.85), 0.41(0.25, 1.01), 1.13(0.48, 2.30. Both ΔOSI1 and ΔOSI2 had anegative correlation with BUT (r=-0.276, P=0.033; -0.305, P=0.018), no correlation between the remaining indexex. Conclusions: The OQAS II system has the potential to be a useful method to evaluate the optical quality and tear-film dynamics in patients with dry eye. When using OQAS-II to detect tear film stability, patients should be instructed to blink as little as possible to provide more valuable results.
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		2021 Vol. 23 (12): 925-929 [Abstract] ( 386 ) [HTML 1KB] [ PDF 9309KB] ( 12776 )

	930	Clinical Study of Ocular Accommodation and Convergence in Dyslexic Children
	Clinical Study of Ocular Accommodation and Convergence in Dyslexic Children[J]. Chinese Journal of Optometry Ophthalmology and Visual science, 2021,23(12): 930-934>')" href="#">	Junwei Tan1, Liping Qiao2, Yueshuang Hou1
		Objective: To study the characteristics of the ocular accommodation and convergence functions in dyslexic children, and to provide evidence for the prevention and clinical treatment of dyslexia. Methods: In this case control study, cluster random sampling was used for a questionnaire survey of 2 301 children in grades 3 to 5 in two primary schools in the Dongli district of Tianjin. One hundred and two children with dyslexia were the dyslexic group and 102 children without dyslexia matched for age, gender and grade were the control group. The dyslexic children were identified based on the criteria for dyslexia. Each child in the two groups underwent complete measurements of visual acuity, refractive error, near stereo vision, strabismus angle, accommodative amplitude (with moving near measurement), accommodative response (FCC), relative accommodation, accommodative convergence/accommodation (AC/A) ratio, near point of convergence (NPC), relative convergence and so on. The t test and χ2 test were used to analyze the differences between the two groups. Results: The refractive errors of the children in the control group and the dyslexia group were -2.08±2.18 D and -1.95±2.00 D, and the difference between the two groups was not significant. The dyslexic group's accommodative response was 0.21±0.35 D while the control group's response was 0.02±0.63 D, and there was a statistically significant difference between two groups (t=5.065, P=0.011). The dyslexic group's PRA was -1.88±1.06 D while the control group's was -2.77±1.82 D, and the difference between the two groups was statistically significant (t=-2.153, P=0.040). The dyslexic group's accommodative facility was 5.43±4.25 cpm while the control group's was 8.20±2.26 cpm, and there was a statistically significant difference between two groups (t=2.402, P=0.027). The dyslexic group's AC/A was 3.09±0.84 Δ/D while the control group was 3.81±0.81 Δ/D, and the difference between two groups was statistically significant (t=2.491, P=0.025). Conclusions: These results show that there are differences in ocular accommodation and convergence between dyslexic and normal children, and the main problems are accommodative insufficiency and convergence insufficiency.
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		2021 Vol. 23 (12): 930-934 [Abstract] ( 389 ) [HTML 1KB] [ PDF 9173KB] ( 12963 )

	935	A Visual Bibliometric Analysis of Congenital Cataract-Based on BiblioShiny (2011-2020)
	A Visual Bibliometric Analysis of Congenital Cataract-Based on BiblioShiny (2011-2020)[J]. Chinese Journal of Optometry Ophthalmology and Visual science, 2021,23(12): 935-942>')" href="#">	Hengli Lian, Xiangqing Ke, Jinhai Huang,et al
		Objective: To analyze the current status and developmental trends of global congenital cataract research from 2011 to 2020 using the bibliometric method based on the Web of ScienceTM core collection database and to provide reference information for further research. Methods: This article uses the BiblioShiny program of scientific bibliometrics based on the R language to analyze the congenital cataract research literature included in the Web of Science Core Collection (WoSCC) from 2011 to 2020, based on journals, country and author distribution, keyword co-word analysis, co-citation analysis, collaboration network, etc. The research knowledge base and research frontier hotspots of global congenital cataract were analyzed. Results: ①A total of 1 492 studies were included. China and the United States had the largest number of publications and were in the leading position. ②The publication volume of 《Molecular Vision》 journal ranked first, with 74 published articles, followed by 《PLoS One》 with 66 published articles. Both are American journals. ③Dr. Scott R. Lambert from the Department of Ophthalmology, Stanford University School of Medicine, Palo Alto, California had the most publications. ④The knowledge base in the field of congenital cataracts were congenital cataracts and gene mutations, and the current academic research hotspot was the topic of gene expression. ⑤The direction of research can be divided into three major clusters: The first cluster is the incidence of congenital cataract, risk factors, surgical treatment, etc. The second cluster is mainly molecular genetics, gene mutations, etc. The third cluster is mainly focused on the structure, stability and function of lens protein. Conclusions: In the field of congenital cataracts from 2011 to 2020, China and the United States are the countries with the largest number of publications. However, the collaboration network between countries and institutions in the United States is much larger than that of China. The current mainstream research directions can be divided into clinical treatment and gene and protein levels.
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		2021 Vol. 23 (12): 935-942 [Abstract] ( 392 ) [HTML 1KB] [ PDF 11846KB] ( 12859 )

Case Report

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		2021 Vol. 23 (12): 943-946 [Abstract] ( 343 ) [HTML 1KB] [ PDF 16691KB] ( 12940 )

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		2021 Vol. 23 (12): 947-949 [Abstract] ( 376 ) [HTML 1KB] [ PDF 14247KB] ( 12947 )

Review

	950	Research Progress on Corneal Collagen Cross-Linking and Its Combination with Refractive Surgery for Keratoconus
	Research Progress on Corneal Collagen Cross-Linking and Its Combination with Refractive Surgery for Keratoconus[J]. Chinese Journal of Optometry Ophthalmology and Visual science, 2021,23(12): 950-955>')" href="#">	Yanting Chen, Xiaohan Liu, Ning Ma, et al
		Corneal collagen cross-linking (CXL) has become the preferred modality of treatment for progressive keratoconus since the late 1990s. There has been an increasing appeal for a completely surgical approach by combining CXL with adjuvant refractive procedures both to halt the ectatic process and enhance functional visual outcomes. Several combined protocols have been studied to various degrees in conjunction with CXL, involving photorefractive keratectomy, transepithelial phototherapeutic keratectomy, intrastromal corneal ring segments implantation, and phakic intraocular lens implantation. This review summarizes current CXL protocols, presents the current status of studies involving CXL plus and discusses the future potential of these protocols.
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		2021 Vol. 23 (12): 950-955 [Abstract] ( 386 ) [HTML 1KB] [ PDF 9197KB] ( 13174 )

	956	Progress in the Clinical Application of Astigmatism Detection Devices
	Progress in the Clinical Application of Astigmatism Detection Devices[J]. Chinese Journal of Optometry Ophthalmology and Visual science, 2021,23(12): 956-960>')" href="#">	Bo Liu, Li Yang, Changjun Lan, et al
		Accurate measurement of astigmatism is of great significance for the design of corneal refractive surgery, preoperative planning of cataract surgery, evaluation of postoperative visual quality, diagnosis of ocular diseases and optometry. Therefore, astigmatism has attracted much attention. Clinically, there are many kinds of devices that can be used for corneal curvature and morphology detection, each with different principles and characteristics. There has been a great deal of development in the past few decades. This article reviews the progress of astigmatism detection devices for clinical application in recent years.
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		2021 Vol. 23 (12): 956-960 [Abstract] ( 368 ) [HTML 1KB] [ PDF 9181KB] ( 13027 )

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