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

	2022 Vol.24 Issue.9 Published 2022-09-25

	Orignal Article Case Report Consensus Editorial Review

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		2022 Vol. 24 (9): 0- [Abstract] ( 108 ) [HTML 1KB] [ PDF 683KB] ( 2312 )

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		2022 Vol. 24 (9): 0- [Abstract] ( 116 ) [HTML 1KB] [ PDF 64128KB] ( 1965 )

Consensus

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		Chinese Optometric Association, Chinese Ophthalmological Society; et al

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		2022 Vol. 24 (9): 641-648 [Abstract] ( 148 ) [HTML 1KB] [ PDF 2611KB] ( 5784 )

Editorial

	649	History and Prospect of Endoscopic Minimally Invasive Decompression for Thyroid-Associated Ophthalmology
		Yunhai Tu, Mingna Xu, Wencan Wu
		Thyroid-associated ophthalmology (TAO) is the most common orbital disease in adults. With the development of endoscopic technology, endoscopic orbital decompression has become an important treatment for this disease. This paper will introduce the advances of endoscopic decompression of the medial wall, lateral wall, and inferior wall and the surgical effect, as well as the prevention and treatment of complications such as postoperative diplopia. At the same time, the advances of endoscopic decompression for dysthyroid optic neuropathy were introduced.
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		2022 Vol. 24 (9): 649-654 [Abstract] ( 123 ) [HTML 1KB] [ PDF 1141KB] ( 1698 )

Orignal Article

	655	Density and Morphology of Microglia in Optic Nerve Following Optic Nerve Crush in Mice
		Yuanfei Ji, Chen Yang, Min Wang, et al
		Objective: To investigate the density and morphology of microglia in optic nerve of mice at differenttime points after optic nerve crush. Methods: In this experimental study, thirty-two healthy adult male CX3CR1?/GFP transgenic mice were randomly grouped to normal control group, optic nerve crush (ONC) 1 day group, ONC 7 days group, ONC 14 days group according to the random number table, with 8 mice in each group. ONC models were established in the left eye, while the right eye was not treated, and normal control group without any treatment. Three frozen sections (30 μm) were taken from each optic nerve.Images were taken from each section at 500 μm from optic disk. The density and morphology of microglia in optic nerve were assayed and compared. Data were analyzed by one-way ANOVA. Results: Thenumber of microglia in optic nerve was (438±16) cells/mm2,(323±15) cells /mm2, (1 252±107) cells /mm2, (1 474±113) cells /mm2 in the normal control group, ONC 1 day group, ONC 7 days group, ONC 14 days group. The microglia number significantly increased in ONC 7 days group and ONC 14 days group incomparison with the normal control group and ONC 1 day group (all at P<0.001). In the control group,the nuclei of microglia were small, and the processes were elongated. one day after optic nerve injury,the number of processes decreased, and the change of the nuclear was not obvious. Within 7 days and 14 days after the operation, microglia were largely activated. The number of cells was large, the nucleus was enlarged, and the processing changed from thin to short. Conclusions: Early on, the number of microglia in optic nerve decreased after ONC. Over time, the number of microglia increased greatly, and the morphology changed from ramification to ameoboid.
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		2022 Vol. 24 (9): 655-659 [Abstract] ( 180 ) [HTML 1KB] [ PDF 9531KB] ( 2184 )

	660	Clinical Analysis of 141 Cases of Occupying Lesion of Lacrimal Gland
		Xiaoying Li, Shiwei Huang, et al
		Objective: To investigate the clinicopathologic features of 141 patients suffering from sustained lacrimal gland occupying lesions. Methods: Retrospective series of case studies. The clinical data of 141 patients having sustained lacrimal gland occupying lesions from June 2019 to October 2021 in the Second Hospital of Jilin University were selected, including gender, age, clinical manifestations, imaging examinationand histopathological diagnosis. The clinical and imaging features of lacrimal gland lesions were delved into as per the classification of pathological diagnosis. An independent sample t-test or nonparametric rank-sum test was used for comparison between groups. The classification variables were expressed in terms of case number and percentage, and the Chi-square test and/or Fisher exact probability method were used for comparison between groups. Result: 141 patients, including 50 males and 91 females,were recruited. According to the nature of lesions, 117 cases (83.0%) were benign lesions, and the most common disease was found to be IgG4-related dacryoadenitis, 55 cases. 24 cases (17.0%) were malignant tumours, and the most common disease was lymphoma accounting for 10 cases. The average age of benign lesions (45.8±15.7 years) is younger than that of malignant lesions (56.3±16.2 years) and the difference was statistically significant (Z=-3.23, P=0.001). According to the frequency, there were 72 cases of inflammatory diseases (51.1%), 33 cases of epithelial diseases (23.4%) and 17 cases of lymphatic system diseases (12.1%). Lacrimal occupying lesions were divided into three groups: dacryoadenitis,lymphoproliferative and epithelial tumours. Besides, among the three groups, the gender ratio, clinical manifestations (eyelid swelling, proptosis, limited ocular motility and decreased vision), imaging manifestations (bilateral involvement, orbital bone changes, rhinosinusitis), all of these results possessed statistical significance (P<0.05). However, there was no significant difference in ocular pain, thickened extraocular muscle and enlarged trigeminal nerve among the three groups. Pairwise comparisons were between groups, epithelial tumors compared to dacryoadenitis, the former has affected a lower proportion of females, eyelid swelling, bilateral involvement and rhinosinusitis(χ2=17.01, P<0.001; χ2=32.34, P<0.001; χ2=10.43, P=0.001; χ2=10.12, P=0.001), a higher proportion of proptosis, limited ocular motility, decreased vision and bone destruction were statistically significant (χ2=18.71, P<0.001; χ2=7.64, P=0.006; χ2=7.32, P=0.012); Additionally, epithelial tumours were compared to lymphoproliferative lesions, and it was found that the former has a lower proportion of eyelid swelling and bilateral involvement, but a higher proportion of proptosis, with a statistically significant difference (χ2=15.93, P<0.001; χ2=6.38,P=0.012;χ2=10.14, P=0.001); The difference was statistically significant only in bilateral involvement between the dacryoadenitis and lymphoproliferative lesions groups(χ2=10.43, P=0.001). Besides, there was nosignificant difference in the remaining clinical and imaging manifestations of lymphoproliferative lesions compared with dacryoadenitis and epithelial tumours. No epithelial tumours were found in 7 children with lacrimal gland space occupying lesions. Conclusion: Inflammatory diseases are the most common occupying lesions of the lacrimal gland, followed by epithelial tumours. The average age of benign lesions is less than that of malignant lesions. The distribution of lacrimal gland lesions in children differs from those in adults. The clinical and imaging manifestations of lacrimal gland dacryoadenitis and epithelial tumours contain conspicuous differences which are readily distinguishable.
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		2022 Vol. 24 (9): 660-666 [Abstract] ( 121 ) [HTML 1KB] [ PDF 2047KB] ( 2138 )

	667	Comparation of Visual Acuity and Refractive Status of Primary School Students in Zhuhai and Kashgar
		Jieying Guan1,Aixin Jiang2,Yingting Zhu1,et al
		Objective: The visual acuity (VA) and refractive status of primary school students in Zhuhai and Kashgar were compared and analyzed, so as to provide a reference for the prevention and control of juvenile myopia in different regions of China. Methods: This was a cross-sectional observational study of primary school students of 10 schools in Zhuhai and 6 schools in Kashgar from 2018 to 2019. VA, noncycloplegic autorefraction, and spherical equivalent (SE) were obtained via visual screening. Independent sample t-test,Chi-square test, Mann-Whitney U test, Spearman correlation analysis, and 1:1 propensity score match (PSM) were used for statistical analysis. Results: A total of 12 001 students were recruited in Zhuhai, including 6 528 boys (54.4%), 5 473 girls (45.6%), with an average age of 8.7±1.6 years. And 5 584 students were obtained in Kashgar, including 2 796 boys (50.1%), 2 788 girls (49.3%), with an average age of 8.3 ± 0.9 years. There were statistical differences in sex (χ2=28.60, P<0.001) and age (t=-19.27, P<0.001) between zhuhai and Kashgar. PSM was used to eliminate influences of sex and age. After PSM, 5 478 students in both groups entered the following statistical analysis. The average value of SE in the right eye was -0.25 (-0.88, +0.13) D in Zhuhai and -0.11 (-0.30, +0.11) D in Kashgar (Z=-9.32, P<0.001). The absolute value of SE increased year by year in the two groups, but the increase rate in Zhuhai was bigger than that in Kashgar after 8-year-old. In Zhuhai, the proportion of poor vision was 17.7%, of which pre-myopia was 18.3% and screening myopia was 76.3%. Comparatively, it was 15.2%, 42.9%, and 51.1% respectively in Kashgar. A total of 15 students in Zhuhai encountered high myopia. Conclusion: The incidence rate of screening myopia in Zhuhai is higher than that in Kashgar. The differences in climate, economy, population and education may be the main reasons.
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		2022 Vol. 24 (9): 667-674 [Abstract] ( 159 ) [HTML 1KB] [ PDF 1920KB] ( 2073 )

	675	Evaluation of Effect of Blue-Light Filtering Spectacles on Adults' Color Perception
		Weiwei Lu, Yan Lian, Haixiao Huang, et al
		Objective: To evaluate the effect of two types of blue-light filtering spectacles on adults' color perception. Methods: This was a prospective, randomized and controlled study. One humdred and forty-four normal adults who are used to wearing spectacles were enrolled in Eye Hospital, Wenzhou Medical University from January 2017 to June 2018. The age was ranging from 20 to 39 and the spherical equivalent refraction was ranging from -6.00 D to -0.50 D. The participants were randomly divided into A group (45 participants, using the regular clear spectacles), B group (49 participants, using 15% blue-light filtering spectacles) and C group (50 participants, using 30% blue-light filtering spectacles). All participants underwent FarnsworthMunsell 100 hue and questionnaires about color perception at baseline, 1 month, 3 months and 6 months of using spectacles. The parameters of the square root of total error score (Sqrt TES), the square root of partial error score (Sqrt PES) in four hue zones (red to yellow-green, yellow-green to blue-green, blue-green to blue-violet and blue-violet to red) and the scores of three questionnaires items were compared among three groups. The data were analyzed by repeated-measures analysis of variance. Results: During six months, there were no significant differences in Sqrt TES among the three types of spectacles (F=0.82, P=0.411). No statistical difference was found in Sqrt PES of every hue box among three groups (Fred to yellow-green=0.28, P=0.758; Fyellow-green to blue-green=0.95, P=0.390; Fblue-green to blue-viole=0.62, P=0.539; Fblue-violet to red=0.43, P=0.653). There was no statistical difference in the scores of each item (difficulty in color discrimination, difficulty in clothing matching and overall satisfaction) among three groups (F=0.25, P=0.777; F=0.10, P=0.905; F=0.63, P=0.533). Conclusions: During six months, two types of blue-light filtering spectacles does not affect adults’ color perception compared with the regular clear spectacles. Blue-light filtering spectacles which could filter blue light within 30% had no effect on adults’ color perception.
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		2022 Vol. 24 (9): 675-681 [Abstract] ( 130 ) [HTML 1KB] [ PDF 1191KB] ( 2120 )

	682	Discussion on the Therapeutic Effect of Secondary Glaucoma Characterized by Iris Atrophy
		Xiaowei Yan, Guangxian Tang, Yulei Geng, et al
		Objective: To analyze the therapeutic effect of secondary glaucoma characterized by iris atrophy. Methods: In this case retrospective study, a total of 60 patients (70 eyes) with secondary glaucoma characterized by iris atrophy admitted to Shijiazhuang People's Hospital from July 2013 to January 2020 were collected and followed up for 12 months, including 32 males (36 eyes) and 28 females (34 eyes), aged 26-67 (50.0±10.4) years. The clinical classification and therapeutic effect were analyzed, and the changes of best corrected visual acuity, intraocular lens (IOP) and anti-glaucoma drugs were observed. Repeated measures analysis of variance, Wilcoxon signed-rank test were used to analyze the data. Results: Therewere 70 eyes of patients with secondary glaucoma characterized by iris atrophy, including uveitis in 54 eyes, Fuchs syndrome in 10 eyes and corneal endodermatitis in 6 eyes; There were 44 eyes with diffuse iris atrophy and 26 eyes with localized atrophy; In 30 eyes, 10 eyes were positive for IgG antibody of aqueous humor virus, and 20 eyes were elevated for interleukin-6 (IL-6), interleukin-8 (IL-8), interleukin-10 (IL-10) and vascular cell adhesion molecule (VCAM). After active treatment with inflammation and antiviral therapy, there were 20 eyes treated with anti-glaucoma medications, 12 eyes were treated with YAG laser peripheral iridectomy, and 38 eyes were treated with anti-glaucoma surgery. After 12 months of follow-up, the best corrected visual acuity of 70 eyes before and after treatment had a statistically significant difference (F=24.04, P<0.001). The best visual acuity was found 1 month after treatment and leveled off 3 months after treatment. The IOP before and after treatment had a statistically significant difference (F=445.16, P<0.001), the IOP was the lowest 1 month after treatment, then rose gradually, and leveled off 3 months after treatment. Anti-glaucoma drugs decreased significantly after treatment, the difference was statistically significant (Z=-7.28, P<0.001). Conclusion: Viral uveitis is still the main cause of secondary glaucoma characterized by iris atrophy. Based on active control of intraocular inflammation and anti-viral therapy, anti-glaucoma medications and YAG peripheral iris laser perforation showed significant efficacy in the first attack, and short iris adhesion time. Glaucoma surgery is necessary for recurrent glaucoma and severe glaucoma damage.
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		2022 Vol. 24 (9): 682-688 [Abstract] ( 128 ) [HTML 1KB] [ PDF 1004KB] ( 2130 )

	689	A Comparative Study of the Influence of Atropine and Compound Tropicamide on Astigmatism in School-Age Children
		Guizhen Jia1,Wei Gu2,Na Zhu1,et al
		Objective: To investigate the influence of different cycloplegic agents on astigmatism in school-age children by comparing the vector changes of astigmatism before and after optometry in children aged 6-12 years with atropine and compound tropicamide. Methods: We conducted a retrospective cohort study of 1 262 outpatients (1 262 eyes), aged from 6 to 12 years, who underwent ciliary palsy optometry from January 2019 to September 2020. The patients were divided into two groups according to different cycloplegic agents, the atropine group (530 eyes) and the compound tropicamide group (732 eyes). Data of right eye of each patient was selected. The refractive measurements before and after cycloplegia were measured using an autorefractor (TOPCON KR 800) for all children, and the spherical, cylindrical and axial powers were recorded. The Thibos vector analysis method was used to decompose the astigmatism into J0 and J45. Before and after cycloplegia, data were analyzed by using t-test for the changes in astigmatism; the correlations of J0 and J45 were analyzed by Spearman's correlation coefficient, and the consistencies were described by the Bland-Altman diagram. Results: The J0 values of compound tropicamide group after cycloplegia increased by 0.04卤0.13 (t=8.34, P<0.001). Further grouped according to astigmatism and spherical equivalent, there was no significant difference between the J0 and J45 values between the noncycloplegia and cycloplegia in the atropine group while in the compound tropicamide group, a statistically significant difference in J0 values between noncycloplegica and cycloplegica (all P<0.001), J45 was only significant in the highly astigmatic eyes and myopic eyes (t=-2.18, P=0.031; t=-2.67, P=0.008). Spearman correlation analysis showed that high correlations of J0 and J45 values between noncycloplegia and cycloplegia in both groups. Bland-Altman analysis comparing the two methods showed a good agreement. Conclusions: Compared with atropine, there were significantly changes in astigmatism after cycloplegia refraction with compound tropicamide, especially in school-age children with myopia or high astigmatism.
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		2022 Vol. 24 (9): 689-697 [Abstract] ( 170 ) [HTML 1KB] [ PDF 1189KB] ( 2031 )

	698	Repeatability of Intelligent Visual Acuity Chart Projector and Its Comparison with Traditional Visual Acuity Chart
		Yiran Hao, Silu Wang, Lei Zhu, et al
		Objective: To analyze the repeatability of intelligent visual acuity chart projector in measuring visual acuity, and its comparison with the outcomes of traditional visual acuity chart. Methods: This case series study included 120 eyes of 60 patients with ocular surface diseases who visited Beijing Tongren Hospital, Capital Medical University from 4 to 22 January 2022. At first, the intelligent visual acuity chart projector (LSJ-IVAC-6000A) was used to measure visual acuity three times, and the repeatability of the outcomes was assessed by intraclass correlation coefficient (ICC). And then, standard logarithmic visual acuity chart displayed by the light house was used to measure visual acuity once, and the consistency with intelligent visual acuity chart projector of the outcomes was assessed by ICC and Bland-Altman analysis. Results: The ICCs between the right eye and left eye of each patient by using the intelligent visual acuity chart projector were 0.830 and 0.868, respectively, both ICCs were over 0.8 (all P<0.001). The ICCs between the right eye and left eye of each patient by using intelligent visual acuity chart projector and standard logarithmic visual acuity chart were 0.846 and 0.873, respectively, both ICCs were over 0.8 (all P<0.001). And the Bland-Altman 95% limits of agreement of the difference between the two measurements were -0.25 to 0.20 and -0.24 to 0.17, respectively. Conclusion: Intelligent visual acuity chart projector can improve the efficiency of visual acuity screening with acceptable repeatability and specific consistency with traditional visual acuity.
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		2022 Vol. 24 (9): 698-703 [Abstract] ( 152 ) [HTML 1KB] [ PDF 1083KB] ( 2350 )

	704	Progression of Juvenile Myopia and Its Related Factors
		Meng An2,Xiaoyan Sun1,Chengye Che1,et al
		Objective: To investigate juvenile myopia progression and analyze its related factors. Methods: Longitudinal investigation and research. Six grades from a primary school (grade 3 to grade 6) and a middle school (grade 7 and grade 8) in Huangdao District of Qingdao were selected by random sampling, of which two classes were selected for each grade. A total of 320 myopic students were included in the study. During the winter vacation in January 2018, all the selected students' naked eye far vision, autorefraction, slit-lamp microscope, cycloplegic refraction and best corrected visual acuity examination were completed and baseline data were obtained. One year later, during the winter vacation in January 2019, the above examinations were repeated again to obtain follow-up data, and the relevant information of the affected factors including near work time, outdoor activities time and so on was obtained through on site questionnaire. All the data were statistically analyzed by ANOVA, χ2 test and logistic univariate and multivariate regression analysis. Results: A total of 296 (92.5%) students' complete data were obtained. One year later, the average increase of spherical equivalent (SE) in all students was about (-0.56±0.62)D (t=7.71, P<0.001), and the myopia progression in grade 6 was the fastest (P<0.001). There was no significant difference in the myopia progression between boys and girls. Among the selected myopic students, the proportion of two myopic parent was the highest, followed by one myopic parent, and no myopic parent was the lowest (χ2 =27.92, P<0.001). In univariate analysis, myopia progression was statistically correlated with two myopic parent[odds ratio (OR)=1.68, 95% confidence interval (CI): 1.22-2.13, P=0.042], near work distance <30 cm (OR=1.23, 95% CI: 1.02-1.59, P<0.001), continuous near work ≥ 30 min (OR=1.34, 95% CI: 1.02-1.61, P=0.021). However, in multivariate models, only continuous near work ≥ 30 min was significantly associated with myopia progression (OR=1.28, 95% CI: 1.08-1.68, P=0.042). Conclusions: The SE in all students increased by an average of (-0.56±0.62)D in one year. The progression of myopia in all grades showed a law of fast first and then slow. Among them, the sixth grade (13 years old) might be a turning point for the slow progression of myopia. Continuous near work time was an important risk factor for the progression of myopia.
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		2022 Vol. 24 (9): 704-710 [Abstract] ( 188 ) [HTML 1KB] [ PDF 991KB] ( 2456 )

Case Report

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		2022 Vol. 24 (9): 711-712 [Abstract] ( 113 ) [HTML 1KB] [ PDF 899KB] ( 1838 )

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		2022 Vol. 24 (9): 713-715 [Abstract] ( 132 ) [HTML 1KB] [ PDF 4701KB] ( 1909 )

Review

	716	Advances in the Prevention of Cataract by Caffeine
		Yuan Tan1,Min Zhang2,Yingzhe Pan2,et al
		Caffeine, the common term for 1, 3, 7-trimethylxanthine, is an alkaloid. It is widely studied in the fields of neurology, internal medicine, pediatrics, obstetrics and gynecology. In recent years, there has also been some new understanding of caffeine in the field of ophthalmology. Cataract is the leading cause of blindness in humans, so the prevention and treatment of cataract is extremely significant. Currently, surgery is the only treatmen. Some research has revealed that caffeine can prevent cataract by anti-oxidation and inhibition of apoptosis. Therefore, the relationship between caffeine and cataract is worth discussing. This review puts emphasis on the research progress of the mechanism of caffeine in the prevention of cataract in an effort to provide insights for the therapeutic approach to cataract.
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		2022 Vol. 24 (9): 716-720 [Abstract] ( 143 ) [HTML 1KB] [ PDF 1617KB] ( 2347 )

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