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

	2023 Vol.25 Issue.1 Published 2023-01-25

	Orignal Article Case Report Review

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		2023 Vol. 25 (1): 0- [Abstract] ( 111 ) [HTML 1KB] [ PDF 1992KB] ( 4762 )

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		2023 Vol. 25 (1): 0- [Abstract] ( 108 ) [HTML 1KB] [ PDF 65114KB] ( 5638 )

Orignal Article

	1	Proteomic Analysis of Aqueous Humor Proteins in Patients with Primary Acute Angle-Closure Glaucoma
		Junyi Li, Fujie Yuan, Kelin Liu,et al
		Objective: Explore the differential expression of aqueous protein in patients with primary acute angle-closure glaucoma (PAACG) with different intraocular pressure, find the possible mechanism of glaucomatous optic nerve damage, and provide experimental basis for possible targets for glaucomatous optic nerve protection. Methods: In this case-control study, a total of 88 patients (88 eyes) with primary acute angle-closure glaucoma admitted to the Ophthalmology Center of the Second Hospital of Jilin University from March 2019 to September 2020 were randomly collected. Eighty-eight selected samples were divided into two groups according to the intraocular pressure (IOP) of patients with PAACG: group A (36 samples, IOP 50 mmHg, 1 mmHg=0. 133 kPa) and group B (52 samples, IOP 21 mmHg). The above samples were divided into two cohorts: discovery cohort (group A, 26 samples; group B, 37 samples) and validation cohort (group A, 10 samples; group B, 15 samples). Their aqueous humor proteomes were analyzed by the data-independent acquisition method and by the parallel reaction monitor method (PRM), respectively. Indepenednt t-test was used to compare protein expression. Results: In this study, a total of 636 proteins were detected from 63 aqueous humor samples in groups A and B of the discovery queue, and 506 proteins were obtained for subsequent analysis after the removal of the default protein. Among them, 51 proteins were differentially expressed between the two groups (P=0.020). Moreover, 17 proteins of these 51 differential proteins were up-regulated in group A, and 34 proteins were up-regulated in group B. Besides, APOA2, TIMP1, LRP2, and VASN were randomly selected for PRM validation, and the study results demonstrated that the results in the discovery queue were consistent with those in the validation queue. Conclusions: Our study results revealed that the expression of differentially expressed proteins was associated with inflammatory response, as well as extracellular matrix remodeling in the trabecular meshwork and nerve injury. The above factors would be an essential reason for increased intraocular pressure and optic nerve injury in glaucoma.
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		2023 Vol. 25 (1): 1-9 [Abstract] ( 189 ) [HTML 1KB] [ PDF 7804KB] ( 5625 )

	10	Clinical and Experimental Study of Intraocular Lens Opacity after Pars Plana Vitrectomy
		Shilan Mao, Jin Xie, Ting Liu,et al
		Objective: To investigate the case characteristics and risk factors for intraocular lens(IOL) opacities after pars plana vitrectomy (PPV). Methods: In this retrospective study, two of the retrieved and well preserved IOLs were chosen for experimental studies including in vitro light microscopy, scanning electron microscopy, laser confocal microscopy, and energy dispersive spectrometer analysis to evaluate the case data of 11 patients who developed IOL opacities after PPV surgery at Qingdao Eye Hospital of Shandong First Medical University from February 2007 to February 2022. Results: The age of the 11 patients ranged from 63.3±15.0 (23 to 76) years, and the duration between IOL opacity and PPV was assessed to be 82.2±45.7 (24 to 180) months. Eight patients underwent retinal photocoagulation, five had intraocular silicone oil/gas injection surgery, and one had glaucoma surgery. Six cases of diabetes and five cases of hypertension were identified as systemic diseases. The patients' IOLs and clinical disposition were as follows: hydrophilic acrylates in 9 instances (9/11), including type 860UV (1 case, removed), Akreos Adapt AO (2 cases, 1 removed), and hydrophilic acrylic material with a hydrophobic surface coating L-312 (6 cases, 4 removed); and hydrophobic acrylate MA60MA in the other two cases (2/11, not removed). The study revealed two opacities IOLs: the first was an 860UV type IOL with the opacities component primarily positioned on the optical section's front surface. It was diffuse, uneven, earthworm-shaped, and ridge-shaped under the light microscope and scanning electron microscopy, with no obvious sediment at the loop and around; laser confocal microscopy revealed that the opacities were primarily concentrated in the anterior superficial layer, with a depth of approximately anterior 6.9% of the overall thickness of the IOL. Energy dispersive spectrometer examination showed that carbon, oxygen, calcium, phosphorus, silicon, and magnesium were arranged according to the amount of content; The second was an Akreos Adapt AO type IOL, which had opacities principally in the optical zone, under light microscopy and scanning electron microscopy, coarse, microscopic spherical sand grains, as well as sand grains in the loop and peripheral areas. Laser confocal microscopy showed that the opacities were deeper, at about Anterior 12.5% of the total thickness of the IOL. Energy dispersive spectrometer examination showed that carbon, oxygen, and silicon were arranged according to the amount of content. Conclusion: Opacities can occur with different types of acrylate IOLs following PPV, and the shape and surface deposits of IOL opacities vary.
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		2023 Vol. 25 (1): 10-17 [Abstract] ( 216 ) [HTML 1KB] [ PDF 4075KB] ( 5395 )

	18	Posterior Chamber Phakic Intraocular Lens Implantation for Low-to-Moderate Myopia
		Jin Zhou, Honghui Li, Fangfang Li, et al
		Objective: To investigate the efficacy, safety and stability outcomes of central-hole posterior chamber collamer phakic intraocular lens implantation in the correction of low-to-moderate myopia. Methods: This retrospective cohort study included 707 eyes of 490 consecutive patientes submitted to posterior chamber collamer phakic intraocular lens implantation that completed a 6-month postoperative follow-up. Efficacy, predictability, stability and safety outcomes were demonstrated preoperatively and at 1, 3 and 6 months postoperatively. Results: At 6 months postoperative, uncorrected and best corrected visual acuities were -0.076±0.079 logMAR and -0.079±0.080 logMAR, with an efficacy index of 1.26±0.21 and safety index of 1.13±0.18 respectively; 94.9% eyes were within ±0.50 D of targeted refraction. The spherical equivalent was -0.063±0.135 D at 1 month and -0.071±0.126 D at 6 months postoperatively. The endothelial cells was 3 078±258 /mm2 preopearatively and 2 953±206 /mm2 at 6 months postoperatively; the mean rate of endothelial cell loss was (1.05±0.39)%. The mean vault were 498±143 μm and 474±177 μm at 1 month and 6 months after operation respectively. The rate of the ICL exchange was 1.4%. No vision-threatening complications were reported. Conclusion: The posterior chamber collamer phakic intraocular lens implantation demonstrates high refractive efficacy and an excellent safety profile for the correction of lowto-moderate myopia.
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		2023 Vol. 25 (1): 18-23 [Abstract] ( 174 ) [HTML 1KB] [ PDF 2482KB] ( 5030 )

	24	Clinical Observation on Correction of Corneal Astigmatism by Femtosceond Laser-AssistedArcuate Keratotomy during Cataract Surgery
		Fan Zhang1, Shaowei Li1, Dongmei Huo2,et al
		Objective: To research the clinical effect of femtosceond laser-assisted arcuate keratotomy (FSAK) in the correction of preoperative corneal astigmatism during cataract surgery. Methods:This was a retrospective case control study. Eight-nine patients (89 eyes) with preoperative regular corneal astigmatism of 0.75 -2.00 D who underwent femtosecond laser-assisted cataract surgery from March 2017 to December 2021 in Beijing Aier-Intech Eye Hospital were continuously collected. Femtosecond laser assisted cataract surgery and arcuate keratotomy were performed on Lensx platform. All patients were divided into 3 subgroups according to the axis of preoperative astigmatism, with the rule astigmatism group (90°±30°),against the rule astigmatism group (180°±30°) and the oblique astigmatism group (45°±15° and 135°±15°). Femtosecond laser-assisted cataract surgery and arcuate incisions were performed on Lensx platform.Observe the changes and distribution of corneal astigmatism before and 3 months after surgery in the general and subgroups of with the rule and against the rule subgroups. Paired samples t-test or Wilcoxon signed-rank test were used to compare the preoperative and postoperative astigmatism differences between the whole and each subgroup. Independent samples t-test or Mann-Whitney U test were used to compare the differences between the with-the-rule and the against-the-rule astigmatism groups, astigmatism change analysis usingAlpins vector analysis method.Results: Eighty-nine patients (89 eyes) were included,there were 38 cases in with the rule group, 44 cases in against the rule group and 7 cases in oblique group. The corneal horizontal diameter was 11.48±0.57 mm and the vertical diameter was 10.66±0.60 mm.The post-operative uncorrected distance visual acuity and corrected distance visual acuity of the patients weresignifcantlyimprovedcomparedwithpre-operative.Totalmeancornealastigmatismbeforeoperation was1.28±0.33D,and the residual corneal astigmatism was 0.67±0.37 D at 3 months after operation, the correction magnitudle of astigmatism is 0.61±0.33 D. In with the rule and against the rule groups, the net changes of corneal astigmatism were 0.48±0.27 D, 0.74±0.34 D, respectively. The postoperative fat keratometric of the patients in the overall and with the rule, against the rule groups increased signifcantly, while the steep keratometric decreased significantly. Alpins vector analysis shows that the overall astigmatism correction index is 0.63±0.30, the fatting index is 0.58±0.30, the index of success is 0.51±0.25,and the angle of error is -1.83°±12.59°. Among two subgroups, the against the rule group has the best correction effect (correction index is 0.81±0.25, fatting index is 0.75±0.26, index of success is 0.40±0.24), the with the rule group takes the second place (correction index is 0.42±0.21, fatting index is 0.39±0.21, index of success is 0.63±0.21).Conclusions: FSAK during cataract surgery is effective and safe in the treatment of corneal astigmatism, the same arcuate incision design achieved better curative effect in the against the rule astigmatism group, and corneal diameter maybe an important factor affecting the amount of astigmatism correction.
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		2023 Vol. 25 (1): 24-32 [Abstract] ( 128 ) [HTML 1KB] [ PDF 7096KB] ( 5512 )

	33	Long-Term Clinical Study of Astigmatism Induced by Steep Axis Clean Corneal Incisions during Cataract Surgery
		Haiwei Chen, Dongmei Liu, Hongsheng Bi, et al
		Objective: To observe the long-term changes of surgically induced astigmatism (SIA) in phacoemulsifcation surgery with steep axis clear corneal incision. Methods: Retrospective case analysis was used. The data was gathered from 56 patients (63 eyes, 32 right eyes, and 31 left eyes) who underwent cataract surgery at the Eye Hospital of Shandong University of Traditional Chinese Medicine from January 1 st, 2018, to March 1 st, 2021. In addition to intraocular lens implantation, all patients had their cataracts phacoemulsified. The same doctor conducted the procedure. During the most recent follow-up (follow-up period from October 1 st, 2021, to December 31 st, 2021) and prior, the IOL-Master 700's corneal curvature was assessed. Through the use of vector analysis, axial, SIAis determined. Corneal incisions in different eye types, in different directions (the incision group corresponding to the upper incision group in the compliant astigmatism group, the temporal incision group in the anti-regular astigmatism group,and the oblique axis incision group in the oblique axis astigmatism group) and different periods (from 36 months to 48 months after cataract surgery, 24 months to 36 months after cataract surgery, and 12 months to 24 months after cataract surgery) and SIAusing different calculation methods (vector analysis method and centroid method) were compared. The obtained data was analyzed by one-way homogeneity of variance test and independent-sample t test method. Results:Among 63 eyes, the SIAof different eyes was compared, the right eye was (0.45±0.19) D, the left eye was (0.48±0.34)D, and the difference was statistically signifcant (t=0.43, P=0.045); the incision comparison of SIAwas (0.44±0.36) D, (0.47±0.23) D, (0.50±0.20) D respectively and the difference was not statistically significant (F=0.22, P=0.800); the difference of different periods was not statistically signifcant (F=0.28, P=0.756); there was no signifcant difference between the SIAcalculated by the vector analysis method and the centroid method (t=0.08,P=0.800). Conclusion: The SIAof the incision of the right eye was signifcantly smaller than that of the incision of the left eye by the vector analysis method, but therewas no signifcant change in the SIAof the incision in different steep axial directions, different periods, and different calculation methods in all patients.
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		2023 Vol. 25 (1): 33-37 [Abstract] ( 158 ) [HTML 1KB] [ PDF 7096KB] ( 5662 )

	38	Changes and Analysis of Angle Kappa under Photopic and Mesopic Pupils in Myopia Patients
		Yaqin Nie1, Xi Qiao1, Yaling Ma2
		Objective: To study the changes of horizontal and vertical shifts of angle Kappa in myopic patients from mesopic condition to photopic condition. Methods: In this cross-sectional study. A total of 120 patients (240 eyes) who were diagnosed with myopia at the Outpatient Myopia Center of Ningxia Medical University General Hospital from November 2020 to December 2021 were selected by simple random sampling and examined under mesopic condition and photopic condition using a Bausch & Lomb Orbscan II corneal topographer. Then records the diameter of the photopic and mesopic pupils, the angle of angle kappa under photopic and mesopic pupils, and the horizontal and vertical displacement. Paired t-test was used to compare the pupil diameter and angle Kappa of the left and right eyes under photopic and mesopic conditions; the quadrant distribution of the angle Kappa of both eyes under photopic and mesopic conditions was analyzed by scatter plot. Results: The pupil diameters of both eyes under mesopic condition were signifcantly larger than those under photopic condition, with signifcantdifferences (t=13.67,P<0.001; t=13.48, P<0.001). The angle Kappa of the left eyes were larger than that of the right eyes in both mesopic and photopic conditions, and both were signifcantly different (t=4.15, P=0.021; t=5.27, P=0.008). When shifting from mesopic condition to photopic condition, the distribution of angle Kappa in both eyes showed mirror symmetry, with horizontal displacement mainly deviating to the nasal side and vertical displacement mainly deviating to the superior side. The mean vector displacement of right eyes was 0.168±0.100 mm, 87.5% of the right eyes had a vector displacement of less than 0.3 mm. The mean vector displacementoflefteyeswas0.171±0.069mm, 92.5% of the left eyes had a vector displacement of less than 0.3 mm. The vast majority of myopic patients have a vector displacement of 0.3 mm or less. Conclusion:From mesopic to photopic condition, pupil diameters become small and the angle Kappa distribution in myopic patients mainly shift to nasal and superior direction.
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		2023 Vol. 25 (1): 38-43 [Abstract] ( 135 ) [HTML 1KB] [ PDF 2469KB] ( 5137 )

	44	Research of Corneal Power Distribution andAge-Related Change in Cornea
		Zhongye Wang1, Xiuhua Liu2, Min Zhang2, et al
		Objective: To investigate the distribution characteristics of corneal power of 2 mm, 4 mm and 6 mm diameter zones centered on the pupil and age-related change in cornea. Methods: In this retrospective serial case study, a total of 254 eyes were included by randomly, which were divided into three groups by age, including 20-39 age group (Group A, 102 eyes), 40-59 age group (Group B, 73 eyes) and ≥60 age group (Group C, 79 eyes). Simulated keratometry (Simk), total corneal refractive power (TCRP) were evaluated.Analysis of Variance was used for comparing the difference between Simk and TCRP. Evaluating uniformity of Simk and TCRP was based on Bland-Altman plot. Regression analysis was used for the age-related trend of Simk and TCRP. Paired-samples ttest was used to compare the difference between Simk and TCRP in 2, 4 and 6 mm. Results:The Simk and TCRP of 2, 4 mm diameter zones centered on the pupilwere signifcant differences between them (t=6.30, P=0.002;t=4.44, P=0.001); However, The Simk and TCRPof 6 mm diameter zones centered on the pupil were no statistically signifcant differences between them (P>0.05). In 2 mm diameter zones centered on the pupil, there were statistically signifcant differences between three groups (F=4.66,P=0.010;F=3.87,P=0.022),Among them, groupA was significant different from B and C (P<0.05). In 4 mm diameter zones centered on the pupil,there were statistically significant differences between three groups (F=6.85,P=0.001;F=6.07,P=0.003). Among them, group Awas signifcant different from B and C (P<0.05). In 6 mm diameter zones centered on the pupil, there were statistically significant differences between three groups (F=9.91, P<0.001; F=10.15,P<0.001), both Simk and TCRPof Agroup in all corneal diameter zones showed statistically signifcant differences with B, C group respectively (P<0.001). Conclusion: Simk and TCRP centered on pupil and the age-related change in corneal should be taken seriously in corneal refractive surgery and cataract surgery. Simk and TCRP shows steeper with aging, which may tend to be stable after 40 years old.
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		2023 Vol. 25 (1): 44-49 [Abstract] ( 136 ) [HTML 1KB] [ PDF 2421KB] ( 5042 )

	50	Characteristics and Correlation of Diopter and Eyeball Biological Parameters in Term Neonates
		Xinli Liu, Lihua Wang, Wei Chen
		Objective: To investigate the characteristics of diopter and ocular biological parameters in term neonates, and to analyze the correlation between diopter and ocular biological parameters. Methods: In this cross-sectional study, a total of 71 full-term neonates (142 eyes) born in Haidian Maternal and Child Health Hospital were included and examined within 7 days of birth with the method of simple random sampling. The diopter was obtained by retinoscopy after cycloplegia, the depth of the anterior chamber (ACD), the lens thickness the depth of the vitreous cavity (V) and the axial length (AL) were obtained by measuring the eyeA-type ultrasound, and the keratometric power of the cornea (Km) was obtained by a handheld computer refractometer. The corneal curvature radius (CR) was calculated from Km. The axial ratio (AL/CR) was calculated fromAL and CR. The lens refractive power (LP) were calculated fromAL,ACD,Km, spherical equivalent (SE). Spearman correlation analysis and linear regression were used to analyze the relationship between diopter, axial length, lens diopter and other parameters. Results: SE of these infants was +3.00 (+2.00, +5.25)D, Km was 46.25 (44.63, 47.63)D, AL was (16.99±0.49)mm, LP was (46.10±5.13)D. SE showed a negative correlation with AL and LP (r=-0.52, P<0.001; r=-0.21, P=0.014), but not with Km (r=-0.16, P=0.053). ALwas positively correlated with gestational age (GA) (r=0.24,P=0.005). Regression analysis demonstrated that AL=11.937+0.129×GA(R2=0.07, F=10.75, P=0.001),SE=60.362-2.835×AL-0.190×LP(R2=0.39, F=44.95, P<0.001). Conclusions:The refractive status of full-term neonates is moderate to high hyperopia, with shorter AL and larger LP than adutls. SE is negatively correlated withAL, but not with KM,AL is a key factor affecting SE.
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		2023 Vol. 25 (1): 50-55 [Abstract] ( 153 ) [HTML 1KB] [ PDF 2468KB] ( 5011 )

	56	Exploration of Sensitivity Threshold of Human Eyes to the Change of Spectacle Lens Diopter and Clinical Study of Effect of Using Small Gradient Lenses
		Tingting Yao1, Jihong Wang2
		Objective:To measure the sensitivity threshold of human eyes to the change of spectacle lens diopter, and to study thesignifcanceof smallgradientlenses.Methods:In this self-control study, atotal of 100 patients were selected from the ophthalmic clinic of Affiliated Hospital of Jiangnan University from January to December 2021, and one eye was randomly selected as the test eye.All the test eyes were divided into three groups according to diopter: low hyperopia group (34 eyes), low myopia group (32 eyes) and moderate myopia group (34 eyes). Subjective optometry under non-cycloplegic state was performed in both eyes of the subjects using 0.05 D gradient lenses. Superimpose a piece of 0.05 D lens on the subjects' eyes when the red-green balance was achieved, and the sensitivity threshold was tested by observing the change of the clarity of the red-green visual target. If the red-green balance could not be achieved, the sensitivity threshold was less than 0.05 D. Self comparative study was used to compare the corrected visual acuity,contrast sensitivity, visual function test and the binocular balance of these one hundred subjects' eyes with the 0.25 D and 0.05 D gradient lenses respectively. Wilcoxon signed rank sum test was used to analyze data in each experiment. Results:Ninty-fve percent of the subjects'eyes had a sensitivity threshold of 0.05 D and less to the change of spectacle lens diopter , and there was no correlation between diopter and sensitivity threshold. The 0.05 D gradient prescription had better corrected visual acuity (Z=-7.40, P<0.001) and contrast sensitivity at four spatial frequencies (3, 6, 12, 18 c/d) than the 0.25 D gradient prescription (all P<0.001).There were no signifcant differences in accommodation fexibility, amplitude and accommodative vergence/accommodative between 0.05 D gradient prescription and 0.25 D gradient prescription (P>0.05). Binocular balance was easier to be achieved with the 0.05 D gradient prescription than the 0.25 D gradient prescription (r=0.44, P<0.001). Conclusions:Without affecting visual function,small gradient lenses are more accurate and can provided a better visual experience and same visual clarity between both eyes.
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		2023 Vol. 25 (1): 56-61 [Abstract] ( 175 ) [HTML 1KB] [ PDF 2295KB] ( 4948 )

	62	Effect of Corneal Normal B/FRatio on theAccuracy of Barrett Universal Formula for IOLCalculation
		Wanmin Wu, Feiyan Chai, Jiewei Liu
		Objective: To investigate the effect of corneal normal back-front radius ratio (B/F ratio) on the accuracy of Barrett Universal formula for calculating the refractive power of intraocular lens (IOL). Methods: This retrospective analysis focused on the clinical data of 63 patients (63 eyes)with cataracts and a normal corneal back-front radius ratio (0.780.05). Conclusions: For cataract patients with corneal normal B/F ratio, the prediction error is negatively correlated with the B/F ratio. The larger the B/F ratio, the more the prediction error drifts toward myopia. Conversely, hyperopic drifts. The regression formula of B/F ratio and prediction error is used to optimize the predicted postoperative SE, which could improve the accuracy of Barrett Universal II formula for calculating IOL.
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		2023 Vol. 25 (1): 62-67 [Abstract] ( 175 ) [HTML 1KB] [ PDF 2439KB] ( 4979 )

Case Report

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		2023 Vol. 25 (1): 68-70 [Abstract] ( 126 ) [HTML 1KB] [ PDF 9892KB] ( 5555 )

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		2023 Vol. 25 (1): 71-74 [Abstract] ( 132 ) [HTML 1KB] [ PDF 27227KB] ( 5696 )

Review

	75	Intrinsically Photosensitive Retinal Ganglion Cells and Chromatic Pupillometry
		Shiya Shen, Hui Zhu, Rui Li, et al
		Independently photosensitive retinal ganglion cells (ipRGCs) are the third type of photoreceptor cells besides cones and rod cells, located in the inner retina. They contain melanopsin and have the unique ability to respond to light directly. Pupilary light reflex (PLR) is mainly mediated by ipRGCs. IpRGCs can generate PLR by directly sensing light signals from melanopsin, and can also be activated by signals from rods and cones. Because different photoreceptors play unique roles in PLR, light signals of different intensities and wavelengths can be used to selectively stimulate rods, cones, and melanopsin. Analysis of the generated PLR can indirectly reflect the functions of rods, cones, and ipRGCs containing melanopsin. This method is called chromatic pupillometry. This article reviews the pathways of ipRGCs-mediated PLR, the characteristics of PLR mediated by rod/cone cells and melanopsin, the measurement of chromatic pupillometry and their clinical applications, hoping to provide new ideas for the diagnosis and differential diagnosis of related ophthalmic diseases.
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		2023 Vol. 25 (1): 75-79 [Abstract] ( 134 ) [HTML 1KB] [ PDF 2154KB] ( 2054 )

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