Objective To observe the characteristics of multifocal eletrotetinogram (mfERG) in nonarteritic anterior ischemic optic neuropathy (NAION) and its relationship with visual acuity and macular central retinal thickness (CRT).Methods By means of patients self-contrast analysis.40 patients (40 eyes) with NAION were collected underwent the examinations of best corrected visual acuity, fundus color photography, fundus fluorescein angiography and field of vision.All the disease and normal eyes had underwent the examination of frequency-domain optical coherence tomography (fdOCT) and mfERG.The CRT and retinal thickness about perifovea, parafovea were documented with fdOCT.All patients underwent the retinal macular function exam with mfERG.Centered by macular fovea, the reaction zone were divided into 5 rings from inside to outside by circles, ring 1 0.00°, ring 2 5.44°, ring 3 10.31°, ring 4 16.31°, ring 5 23.42°.Treated ring 1 hexagon as macular center the amplitude densities of P1 wave, the amplitude of P1 and N1 wave, and the latencies of P1and N1 wave at cvcry ring were observed.The relationship between mfERG characteristics and visual acuity or CRT were analyzed by Spearman correlation analysis.Results fdOCT revealed that there was significantly statistical difference in the retinal thickness about perifovea between disease eyes and contralateral eyes (P＜＜0.05).The increase of CRT and retinal thickness about parafovea had no significantly statistical difference between diseases eyes and contralateral eyes (P＞0.05).mfERG revealed that the decrease of amplitude densities about P1 wave at ring 1 to 2 had significantly statistical difference between two groups (P＜0.05);there were no significantly statistical difference in the amplitude densities of P1 wave at ring 3 to 5;the decrease of amplitude about P1 and N1 wave at ring 1 had significantly statistical difference between two groups (P ＜ 0.05).There was no significantly statistical difference in the amplitude of P1 and N1wave at ring 2 to 5, the latencies of P1 and N1 wave at ring 1 to 5 (P＞0.05).The correlation analysis revealed that the amplitude densities and amplitude of P1 wave at ring 1, amplitude of N1 wave at ring 1 had no effect on visual acuity (r=0.087,0.195,-0.134;P＞0.05) and CRT(r=-0.154,0.365, 0.412;P＞0.05).Conclusions Compared with contralateral eyes,the disease eyes were significantly decrease in amplitude densities of P1 wave at ring 1 to 2, amplitude of P1 and N1 wave at ring 1.There are no correlated between the amplitude densities of P1 wave at ring 1,amplitude of P1 and N1 wave at ring 1 and visual acuity or CRT.

Non-arteritic anterior ischemic optic neuropathy (NAION) is one of the most common acute optic neuropathy in adult characterized with impaired visual acuity and visual fields.The pathogenesis of NAION mostly result from the interactions between the systemic risk factors (such as diabetes mellitus,night hypotension, hereditary) and the local ocular risk factors (such as small optic disc and vitreo-papillary traction).A fully promoted diagnosis and treatment of NAION are based on the higher levels of clinical cvidence, as well as the comprehensive assessment of relationship between the systemic and ocular risk factors in the pathogenesis of NAION.Secondary optic neuropathy of NAION and the early diagnosis with effective treatment of the fellow eye would be highly emphasized.

Objective To observe the neuro-ophthalmological features of intracranial aneurysm.Methods 169 patients with intracranial aneurysm were retrospectively studied.45 patients, including 18 men and 27 women, had neuro ophthalmological symptoms or signs.Their average age was (56.21 ± 16.11) years and 32 (71.11％)patients' age was more than 50 years.The onset time ranged from 30 minutes to 20 years.20 (44.44％) patients' onset time was among 24 hours.CT, CT angiography, MRI, MRI angiography and cerebral digital subtraction angiography were performed alone or combined in all 45 patients.Visual acuity, pupil reflex and eye movement were examined.Clinical data including general condition, initial symptoms, neuro-ophthalmological changes, imaging data and treatment effects were recorded.Results 26.63％ of the 169 patients had neuro-ophthalmological symptoms or signs.There were 6 patients (13.33％) with neuro ophthalmological changes as their first manifestation and 39 patients (86.67 ％) with neurologic changes as first manifestation.Neuro-ophthalmological symptoms included vision loss (10 patients, 22.22％), diplopia (4 patients, 8.89％) and ocular pain (2 patients, 4.44％).The most common neuro-ophthalmological sign was pupil abnormality which was found in 31 patients (68.89 ％).The second most common sign was eye movement disorder (16 patients, 35.56％).The other signs included ptosis (8 patients, 17.78％), nystagmus (2 patients, 4.44％), exophthalmos (1 patient, 2.22％) and disappeared corneal reflection (1 patient, 2.22％).Imaging examination indicated that intracranial hemorrhage happened in 29 patients (64.44％).The most common neuro-ophthalmological features were pupil abnormality, eye movement disorder and vision loss in both patients with or without intracranial hemorrhage.The incidence of pupil abnormality was higher in patients with intracranial hemorrhage than that without intracranial hemorrhage, the difference was statistically significant (x2=7.321, P=0.007).Pupil abnormality and vision loss were common in patients with internal carotid artery aneurysm, and eye movement disorder was common in patients with internal carotid artery aneurysm and posterior communicating aneurysms.Conclusions Patients with intracranial aneurysm have different neuroophthalmological features.The most common features are pupil abnormality, eye movement disorder and vision loss.

Objective To predict as well as bioinforrmatically analyze the target genes of has-miR-451.Methods miRBase, miRanda, TargetScan and PicTar were used to predict the target genes of hsa-miRNA-451.The functions of the target genes were demonstrated by Gene Ontology and pathway enrichment analysis.P＜0.05 was set as statistically significant.Results 18 target spots of hsa-miRNA-451 were predicted by 3 databases or prediction software at least.The functions of the target genes were enriched in proliferation and development of epithelial cells and regulation of kinase activity (P＜ 0.05).Pathway analysis showed that transforming growth factor-beta signaling pathway, mitogen-activated protein kinase signaling pathway, epidermal growth factor signaling pathway, Wnt signaling pathway and mammalian target of rapamycin signaling pathway were significantly enriched (P＜0.05).Conclusion hsa-miRNA-451 might be involved in various signaling pathways related to proliferation and development of epithelial cells.

Objective To analyze the concentrations of vascular endothelial growth factor (VEGF) and pigment epithelium-derived factor (PEDF) in aqueous humor of patients with proliferative diabetic retinopathy (PDR) before and after intravitreal injection of ranibizumab.Methods Twenty-five eyes of 20 PDR patients were collected as the PDR group.Twenty-five eyes of 21 senile cataract patients were collected as the control group.There were no statistical significance in gender (x2 =0.223), age (Z=-1.555) and intraocular pressure (Z=0.225) between the two groups (P＞0.05).Samples of aqueous humor (0.1 ml) were collected just before and 7 days after the injection of ranibizumab in PDR group.Samples of aqueous (0.1 ml) humor were collected just before cataract surgery in control group.The concentrations of VEGF and PEDF in the aqueous humor were measured by enzyme-linked immunosorbent assay.Results The VEGF and PEDF concentration in the aqueous humor were reduced significantly after intravitreal injection of ranibizumab in PDR group (Z=-4.072,-4.319;P＜0.05).The concentrations of VEGF and PEDF in the aqueous humor before intravitreal injection of ranibizumab in PDR group were significantly higher than the control group (Z=-5.228, 4.706;P＜0.05).The VEGF concentration in the aqueous humor after intravitreal injection of ranibizumab in PDR group were similar to control group (Z=-1.557,P＞ 0.05).However, the concentration of PEDF in the aqueous humor after intravitreal injection of ranibizumab in PDR group still higher than control group (Z=-2.475, P＜0.05).The ratio of VEGF/PEDF before and after intravitreal injection of ranibizumab was statistically different (Z=-2.058, P＜0.05), but was the same between PDR group and control group (Z=-0.456,-0.844;P＞0.05).The aqueous humor concentrations of VEGF and PEDF were not significantly correlated with each other, neither in PDR group (r=-0.195,-0.174;P＞0.05) nor in control group (r=-0.286, P＞0.05).Conclusions Aqueous humor concentrations of VEGF and PEDF are significantly elevated in eyes with PDR.Intravitreal injection of ranibizumab significantly decreased the VEGF and PEDF in the aqueous humor after 7 days.

Objective To comparatively observe features of choroidal osteoma by multimodal fundus imaging methods.Methods This is a retrospective case study.Sixteen patients (16 eyes) with choroidal osteoma were enrolled in this study.The patients included 6 males (6 eyes) and 10 females (10 eyes),with an average age of (30.5±2.4) years.All patients received examination of best-corrected visual acuity,slit lamp microscope,indirect ophthalmoscopy,fundus color photography,fundus autofluorescence (AF),fundus fluorescein angiography (FFA) and spectral domain optical coherence tomography (SD-OCT).The tumors were classified as fresh lesion (clear boundary and rosy tumor with smooth surface) and obsolete lesions (pale and flat tumor with obvious patches).The tumor features of color fundus photography,AF,FFA and SD-OCT were comparatively observed.Results There were 5 fresh lesions and 11 obsolete lesions.Color fundus photography showed the tumor color was orange-red or yellow-white with clear boundary and retinal blood vessels on the surface of the tumor.The color of fresh lesion was rosy.In general,choroidal osteoma shown weak AF,however AF of fresh tumor was slightly stronger than the obsolete tumor,and retinal detachment region showed relatively stronger AF.FFA of fresh tumor indicated uniform intense fluorescence with clear boundary at late stage,much stronger than obsolete tumor.SD-OCT showed mesh-like reflected signal in the choroidal layer,but different from the surrounding choroidal vascular structures.Conclusions The tumor color is orange-red or yellow-white in color funds photography,which shown weak AF.FFA showed mottled hyperfluorescence in the early stage and tissue staining at the late stage.SD-OCT showed mesh-like reflected signal in the choroidal layer.

Dome-shaped macula (DSM) of high myopia has been described as an inward convexity or bulge of the macular within the concavity of the posterior staphyloma in highly myopic eyes,with the bulge height over than 50 μm,which can be observed by optical coherence tomography.There are three patterns of DSM,including the typical round dome,the horizontally oriented oval-shaped dome and the vertically oriented oval-shaped dome.The pathogenesis of DSM development remains unclear,several hypotheses have been suggested,such as localized choroidal thickening in the macular area,relatively localized thickness variation of the sclera under the macula,resistance to deformation of sclera staphyloma,ocular hypotony and tangential vitreoretinal traction.Vision-threatening macular complications of DSM including serous retinal detachment,choroidal neovascularization,foveoschisis and retinal pigment epithelial atrophy.Clinically,asymptomatic patients with DSM mainly take regular follow-up observation.Appears serous retinal detachment and significant visual impairment,treatment with half-dose photodynamic therapy,supplementary of laser photocoagulation or oral spironolactone may have a beneficial effect.However,more large clinical studies are required to confirm the exact efficacy of these treatments.

Hypertensive retinopathy (HR) often coexist with carotid lesions in hypertensive patients.Carotid lesions are closely associated with cardiovascular and cerebrovascular diseases,as well as end events,offering early important evidence to screening high risk patients.HR has significant value to predict target organ damage (TOD) of hypertension including carotid lesion.In addition,hypertensive retinopathy and carotid lesions-related ischemic ocular diseases will cause serious vision function damage.This article is going to summarize the value and correlation between hypertensive retinopathy and carotid lesions in terms of clinical manifestations,pathological physiological mechanism and target organ damage.

Optogenetics is a novel technique which combines optics with genetics.Using genetic means,a selected opsin protein is ectopically expressed in target neurons,which are then stimulated by light to moderate the neuronal circuit,as a consequence to regulate the animal's behaviors.Retinal degeneration like retinitis pigmentosa and aged macular degeneration causes visual impairment and eventual blindness.Optogenetics techniques have opened the door to creating artificial photoreceptors in the remaining retinal circuits of retinal degeneration retinas via gene therapy.However,there are still limitations in optogenetics technique,for example,potential risk in virus infection,the choice of target cells and the low visual resolution of the experiment animal.It has been reported that vision was successfully restored to a certain extent in animal model using optogenetics technique.With higher photosensitivity of opsin protein,longer activation kinetics and higher transfection efficiency of virus vector,optogenetics techniques' application in ophthalmology will be improved.

Usher syndrome (USH) is an autosomal recessive hereditary disease,characterized as retinitis pigmentosa and deafness.According to the severity of hearing loss,presence or absence of vestibular dysfunction,Usher syndrome is divided into 3 clinical subtypes..USH1,USH2 and USH3.Due to the genetically heterogeneous,it is important and valuable to find out the gene mutations in USH patients,which will be helpful to prenatal diagnosis,early intervention and gene therapy.Till now,the following 13 USH-related chromosomal loci were reported in the literature:USH1B,USH1C,USH1D (CDH23 gene),USH1F (PCDH15 gene),USH1G (SANS gene),USH1E,USH1H,USH1J and USH1K,USH2A,USH2C,USH2D and USH3 (CLRN1 gene).Ten out of all 13 loci have been located and identified.But more mechanisms should be further investigated,such as the relationship between the locus of gene mutations and clinical symptoms,how the modified protein structures and functions trigger clinical symptoms.