Objective:To observe and analyze the changes and correlation of macular mean sensitivity (MS) and the thickness of ganglionic plexiform layer (GCIPL) in patients with non-arteriotic anterior ischemic optic neuropathy (NAION).Methods:A cross-sectional clinical study. From March to August 2023, 37 patients with 38 eyes of NAION (NAION group) diagnosed by ophthalmic examination in the First Affiliated Hospital of Zhengzhou University were included in the study. In the NAION group, 29 patients with contralateral healthy eyes were selected as the contralateral healthy eye group. A total of 31 eyes of 16 healthy subjects matching gender and age were selected as the normal control group. NAION group was divided into acute stage group (disease course ≤3 weeks), subacute stage group (disease course 4-12 weeks) and chronic stage group (disease course>12 weeks), with 16, 10 and 12 eyes, respectively. Best corrected visual acuity (BCVA), optical coherence tomography (OCT), perimetry, and microperimetry were performed. BCVA statistics are converted to logarithm of the minimum angle of resolution (logMAR). The macular region was scanned by Cirrus HD-OCT macular volume 512×128 scanning program. The mean (GCIPLav), minimum (GCIPLmin), and the GCIPL thickness at supranasal, superior, subnasal, supratemporal, inferior, and inferotemporal quadrants were detected. The Humphrey 24-2 automated visual field test was utilized to measure the mean defect (MD) of the visual field. MP-3 microperimetry was used to measure MS (total MS) in the 10° macular region and MS in the supranasal, superior, subnasal, supratemporal, inferior, and inferotemporal quadrants. MS> 21 dB was defined as normal. One-way analysis of variance was used to compare among groups. t test was used to compare GCIPL thickness between MS≤21 dB and> 21 dB regions. Spearman correlation analysis was used to analyze the correlation between GCIPL thickness and MS in corresponding areas. Results:There were statistically significant differences in logMAR BCVA and MS in the NAION group, contralateral healthy eye group, and normal control group ( F=13.595, 83.741; P<0.05). GCIPL thickness in the MS≤21 dB region was significantly lower than that in the> 21 dB region in the NAION group ( t=2.634, P=0.009). The thickness of GCIPL in the inferotemporal quadrant decreased in the NAION group compared with the contralateral healthy eye group and normal control group, but the difference was not statistically significant ( P=0.092, 0.192). The thickness differences of GCIPLav and GCIPLmin and GCIPL in other quadrants were statistically significant ( P<0.05). Compared with the contralateral healthy eye group and normal control group, the thickness of GCIPLmin, superior and supratemporal of GCIPL in the acute stage group were significantly decreased ( P<0.05). The thickness of GCIPLav, GCIPLmin, GCIPL in upranasal, superior and supratemporal quadrants were significantly decreased in the subacute stage group ( P<0.05). The thickness of GCIPLav, GCIPLmin and GCIPL in all quadrants were significantly decreased in the chronic stage group ( P<0.05). Correlation analysis showed that total MS were significantly correlated with logMAR BCVA ( r=0.779, -0.596, P<0.001) in NAION group. The inferior GCIPL thickness was significantly correlated with MS in the corresponding region ( r=0.410, P=0.046), while no correlation was found in the other quadrants ( r=0.220, 0.148, -0.131, 0.296, 0.321; P>0.05) in NAION group. GCIPL thickness in acute and subacute groups was significantly correlated with MS ( r=0.329, 0.400; P=0.007, 0.028). There was no correlation in the chronic phase group ( r=0.238, P=0.103). Conclusions:GCIPL atrophy and thinning and MS decrease in the macular area of NAION. The thickness of GCIPL in the MS decreasing region is significantly lower than that in the MS normal region. GCIPL atrophy and thinning in acute and subacute stages are correlated with MS.

Objective To observe and analyze the incidence ofmacular edema and its related factors after cataract surgery in diabetics with and without diabetic retinopathy.Methods A retrospective study.The data of 90 diabetics including 45 cases with diabetic retinopathy (DR group) and 45 cases without DR (diabetics group) and an equal number of non-diabetic matched controls (control group) who underwent phacoemulcification and intraocular lens implantation were collected.Patients with macular edema before the surgery were excluded.Main outcome measurements included best-corrected visual acuity (BCVA) and central subfield mean thickness (CSMT).Optical coherence tomography (OCT) was used to measure the distance from the inner limiting membrane to the pigment epithelium of the central macular with diameter of 1 mm,which was used as the CSMT.There were no significant differences in BCVA and CSMT among three groups preoperatively (F=1.300,1.329;P=0.280,0.273).The BCVA and CSMT before and after the surgery in all three groups were compared.macular edema was defined as an increase of CSMT on OCT ＞ 30％ from preoperative baseline.The incidence of macular edema of three groups after the surgery were compared and analyzed.The correlation between postoperative BCVA and CSMT,and the correlation between diabetes mellitus,DR and macular edema after surgery were analyzed by Logistic regression analysis.Results After the surgery,compared with control and diabetics group,the BCVA in DR group decreased and the CSMT increased significantly and the differences were statistically significant (P＜ 0.05).However,between control and diabetics group,the differences in BCVA and CSMT after the surgery were not statistically significant (P＞0.05).The incidences ofmacular edema in DR group (15.6％ and 13.3％) 1 month and 3 months postoperatively were significantly more than that in control group (2.2％ and 2.2％) and non-DR diabetics group (4.4％ and 2.2％),and the differences were statistically significant (x2=6.696,6.644;P=0.035,0.036).Logistic regression analysis showed that the postoperative BCVA was correlated with CSMT (r=0.444,P=0.000),diabetics was not correlated with postoperative macular edema (r=7.231,P=0.999) and DR was correlated with macular edema after surgery (r=0.378,P=0.008).The diabetic retinopathy might correlated to macular edema after surgery.Conclusions The incidence of macular edema after cataract surgery in patients with DR was significantly higher than that in patients without DR.There is no correlation between diabetics and postoperative macular edema,and DR is correlated with macular edema after surgery.

·AIM: To observe the effect of two kinds of bandage contact lenses on epithelial erosions and corneal thickness after vitreoretinal surgery for proliferative diabetic retinopathy ( PDR) .· METHODS: In this prospective, nonrandomized, comparative clinical study, 69 eyes of 69 patients with PDR were divided into two groups. They underwent vitreoretinal surgery. Group A, 36 eyes of 36 cases, the bandage contact lens with diameter of 13. 8mm were covered on corneal surface during surgery under noncontact wide-angle viewing systems. Group B, 33 eyes of 33 cases, the bandage contact lens with diameter of 14. 0mm were covered on corneal surface during the same surgery. Visual acuity, intraocular pressure, slit-lamp examination, corneal fluorescein sodium staining, count of corneal endothelium cells, measure of corneal thickness before and after operation were assessed.·RESULTS: Pre-operation, corneal fluorescein sodium staining positive rate was 42% in Group A and 42% in Group B (x2=0. 004, P=0. 949). At 1d after surgery, the positive rate of was 47% in Group A and 45% in Group B (x2=0. 022, P=0. 883). At 2d after surgery, the positive rate of was 44% in Group A and 45% in Group B ( x2 =0. 007, P=0. 933). At 3d after surgery, the positive rate of was 44% in Group A and 42% in Group B (x2=0. 029, P=0. 886). At 7d after surgery, the positive rate of was 42%in Group A and 39% in Group B (x2=0. 037, P=0. 848). Count of corneal endothelium cells showed no significant difference between Group A and Group B(P>0. 05). Count of corneal endothelium cells of Group A before surgery and at 7d after surgery were 2779. 25 ± 329. 55 /mm2 , 2777. 14±331. 17 /mm2, without significant difference (t=0. 551, P=0. 585);those of Group B were 2678. 61±335. 64/mm2 , 2672. 45 ± 336. 25 /mm2 , without significant difference(t = 1. 774, P = 0. 086). Measure of corneal thickness was 519. 25±23. 42μm before surgery and 542. 03± 25.94μm after surgery in Group A (t=-6.854, P<0.001). Measure of corneal thickness was 525. 64 ± 20. 97μm before surgery and 551. 33±27. 87μm after surgery in Group B (t=-7. 204, P<0. 001).·CONCLUSION:Two kinds of bandage contact lenses are used in vitreoretinal surgery in diabetic patients. The corneal epithelial integrity shows no difference before and after surgery. Both the bandage contact lens could protect the corneal epithelium and maintain good corneal transparency during vitreoretinal surgery.

Objective To observe the clinical characteristics of multi-mode images of retinal arterial macroaneurysms and provide reference for the accurate diagnostic.Methods The clinic data of 24 patients (25 eyes) with retinal arterial macroaneurysms who were diagnosed in the First Affiliated Hospital of Zhengzhou University from August 2012 to May 2016 were retrospectively analyzed.All patients received ophthalmologic examinations including visual acuity,fundus photography,and fundus fluorescein angiography (FFA).The patients who could not be diagnosed by fundus photography and FFA underwent indocyanine green angiography (ICGA) and spectral-domain optical coherence tomography (SD-OCT) examinations.The visual acuity of the three types of retinal arterial macroaneurysms and the diameters of retinal arterial macroaneurysms based on FFA images was analyzed.Results A single macroaneurysm appeared in all the 25 eyes.Retinal arterial macroaneurysms of 22 eyes were on temporal artery branches and those of 3 eyes were on the nasal artery branches.Sixteen retinal arterial macroaneurysms were determined as hemorrhagic type,2 were exudative type and the other 7 were quiescent type.The difference of vision acuity in the three types of retinal arterial macroaneurysms was significantly different (x2=15.117,P=0.001).Retinal arterial macroaneurysms of 20 eyes could be clearly exhibited by FFA,and the retinal arterial macroaneurysms in other 5 eyes which were concealed due to bleeding were displayed by ICGA and OCT.The average diameter of retinal arterial macroaneurysms and normal arteries were (330.65±43.09)μm and (134.70±10.74)μm,respectively,showing a significant difference (t =21.034,P =0.000) and a positive correlation between them (r =0.867,P=0.000).Conclusions Most retinal artcrial macroaneurysms can be diagnosed by FFA,moreover,both ICGA and OCT can provide necessary supplement for the concealed retinal arterial macroaneurysms.The larger the diameter of the normal artery is,the larger the diameter of the corresponding retinal arterial macroaneurysms is.The typing of retinal arterial macroaneurysms can offer basis for the evaluation of management.

Objective To investigate the role of leukemia inhibitory factor (LIF) on retinal photoreceptor cells and the underlying mechanism after light damage.Methods Fifty 5-6 weeks old BALB/c mice were randomly divided into normal control group (10 mice),light damage+LIF group (20 mice) and light damage+PBS group (20 mice).Four days before exposing to light,the right eye of each animal in light damage+LIF group and light damage+PBS group was injected with LIF and PBS,respectively;then the mice in the light damage+LIF group and light damage+PBS group were exposed to 4 000 lx intensity of cool white fluorescent light for 4 hours to establish the experimental model of retinal light damage.The function and morphology of retinal photoreceptor cells were detected by flash electroretinogram (fERG) and histopathological examination.Real-time PCR was used to detect the mRNA expression of Jak3,STAT3,and apoptosis-related factor Bcl-2 and Bax.The use of animals is guided by the State Science and Technology Commission's regulations on the management of experimental animals.Results The amplitudes of scotopic ERG a wave of 0.01,1,100,200,400 cd · s/m2 light in the light damage + PBS group were significantly lower than those in the normal control group and light damage + LIF group (all at P ＜ 0.05).The amplitudes of photopic ERG b wave of different color light in the light damage+PBS group were significantly lower than those in the normal control group and light damage+LIF group (all at P＜0.05).The number of photoreceptor nuclei in the light damage+PBS group was significantly lower than that in the normal control group and light damage+ LIF group (both at P＜0.05).Compared with light damage+PBS group,the relative expression of Jak3,STAT3,Bcl-2 mRNA in light damage+LIF group were significantly increased (all at P＜0.05),and the relative expression of Bax mRNA were significantly decreased (P＜0.05).Conclusions LIF can protect retinal photoreceptor cells from light damage,which may result from the activation of Jak3/STAT3 signaling pathway and inhibition of its downstream Bax/Bcl-2 apoptotic pathway.

Objective To investigate the clinical effect of pars plana vitrectomy combined with segmental scleral buckling(PPV-SSB)in the treatment of inferior rhegmatogenous retinal detachment(RRD).Methods Totally 87 eyes of 87 patients with inferior RRD who attended the Ophthalmology Department Ⅱ,the First Affiliated Hospital of Zhengzhou University from October 2020 to April 2022 were retrospectively included.Among them,45 patients(45 eyes)were treated with PPV-SSB(PPV-SSB group),and 42 patients(42 eyes)were treated with PPV(PPV group).The retinal reattachment rate,best corrected visual acuity(BCVA)and complications of patients who underwent single surgery in the two groups were compared.Results After a single surgery,the retinal reattachment rate was 95.56％(43/45)in the PPV-SSB group and 80.95％(34/42)in the PPV group,with a statistically significant difference(P=0.033).At 3 months and 6 months af-ter surgery,there were significant differences in BCVA between the PPV-SSB group and the PPV group(P=0.010,0.004).The incidence of postoperative phacoscotasmus in the PPV-SSB group and the PPV group was 28.89(13/45)and 54.76％(23/42),respectively,with a significant difference(P=0.018),while there were no significant differences in the inci-dence of the remaining few complications(all P＞0.05).Conclusion PPV-SSB has a higher retinal reattachment rate,better visual effect and fewer complications in the treatment of inferior RRD.

The subretinal space is a potential area between the retinal pigment epithelium layer and the photoreceptor layer.Subretinal injection is a way of drug administration to the subretinal space.Compared with intravitreal injection,subretinal injection allowed drugs to take more direct and effective action on retinal photoreceptor cells and retinal pigment epithelial cells.In recent years,thanks to advances in medical technology and surgical instrumentation subretinal injection realizes a gradually expanded clinical application,becoming an important drug delivery method for gene therapy and cell therapy of various fundus oculi diseases and playing an increasingly prominent role in vitreoretinal surgery.This article will explore the indications,techniques,potential risks,and complications of subretinal injection.

Objective:To quantitatively evaluate the changes of choroidal biomarkers in patients with central serous chorioretinopathy (CSC) and preliminarily explore its pathogenesis.Methods:Clinical cross-sectional study. From July 2021 to December 2022, 74 eyes of 65 patients with CSC (CSC group) confirmed by ophthalmic examination at the First Affiliated Hospital of Zhengzhou University were included in the study. Among them, 46 patients (51 eyes) were male, 19 patients (23 eyes) were female. The duration from the onset of symptoms to the time of treatment was less than or equal to 3 months. A control group consisted of 40 healthy volunteers (74 eyes) matched in age and gender. Among them, 26 patients (50 eyes) were male, and 14 patients (24 eyes) were female. Using VG200D from Microimaging (Henan) Technology Co., Ltd., macular scanning source light coherence tomography angiography was performed, with scanning range 6 mm × 6 mm. According to the division of the diabetes retinopathy treatment research group, the choroid within 6 mm of the macular fovea was divided into three concentric circles centered on the macular fovea, namely, the central area with a diameter of 1 mm, the macular area with a diameter of 1-3 mm, and the surrounding area of the fovea with a diameter of 3-6 mm. The device comes with software to record the three-dimensional choroidal vascular index (CVI), choroidal vascular volume (CVV), perfusion area of the choroidal capillary layer (CFA), choroidal thickness (CT), and three-dimensional CVI, CVV, and CT in the upper, temporal, lower, and subnasal quadrants within 6 mm of the fovea. Quantitative data between the two groups were compared using an independent sample t-test. Qualitative data comparison line χ2 inspection. The value of receiver operating curve (ROC) analysis in predicting the occurrence of CSC, including CVI, CVV, CFA, and CT. Results:Compared with the control group, the CVI ( t=3.133, 4.814), CVV ( t=7.504, 9.248), and CT ( t=10.557, 10.760) in the central and macular regions of the affected eyes in the CSC group significantly increased, while the CFA ( t=-8.206, -5.065) significantly decreased, with statistically significant differences ( P<0.05); CVI ( t=7.129), CVV ( t=10.020), and CT ( t=10.488) significantly increased within 6 mm of the central fovea, while CFA ( t=-2.548) significantly decreased, with statistically significant differences ( P<0.05). The CVI ( t=4.980, 4.201, 4.716, 8.491), CVV ( t=9.014, 7.156, 7.719, 10.730), and CT ( t=10.077, 8.700, 8.960, 11.704) in the upper, temporal, lower, and lower nasal quadrants within 6 mm of the central fovea were significantly increased, with statistically significant differences ( P<0.05). In the CSC group, the maximum CVI and CVV were (0.39±0.10)% and (1.09±0.42) mm 3, respectively, on the nasal side of the affected eye. Upper CT was (476.02±100.89) μm. The nasal side CVI, CVV, and CT have the largest changes. The ROC curve analysis results showed that the area under the curve of CT, CVV, and CVI within 6 mm of the central region, macular region, and fovea was over than 0.5. Subcentral CT was the most specific for the diagnosis of CSC. Conclusion:Choroidal biomarkers CVI, CVV, and CT in CSC patients increase, while CFA decreases. Central CT is the most specific for the diagnosis of CSC.

Objective:To observe the changes in the biomechanical properties of the cornea of diabetic retinopathy (DR), and analyze its relationship with the degree of DR.Methods:A retrospective study. From September 2020 to February 2021, 83 patients with type 2 diabetes (T2DM) combined with DR treated in the Department of Ophthalmology, The First Affiliated Hospital of Zhengzhou University, 83 eyes (DR group), 30 patients with T2DM without DR recruited from the outpatient clinic 30 eyes (NDR group) and 30 eyes of non-diabetes patients (NDM group) were included in the study. All left eyes were chose as the study eye. Among the 83 eyes in the DR group, 39 eyes were non-proliferative DR (NPDR) and 44 eyes were proliferative DR (PDR). Based on this, they were divided into NPDR group and PDR group. There was no statistically significant difference in age ( t=1.10) and sex ratio ( χ2=0.46) among patients in the DR group, NDR group, and NDM group ( P>0.05); body mass index ( t=3.74), glycosylated hemoglobin ( t=35.02) and the length of the eye axis ( t=5.51), the difference was statistically significant ( P<0.05). The eye response analyzer (ORA) was used to measure the corneal hysteresis (CH), corneal resistance factor (CRF), Goldman related intraocular pressure (IOPg), and corneal compensatory intraocular pressure (IOPcc). The corneal topography was used to measure the central corneal thickness (CCT) of the examined eye. The differences of CCT, IOPcc, IOPg, CH, CRF among multiple groups were compared by one-way analysis of variance. Multiple linear regression was used to analyze the relationship between CH, CRF and related influencing factors in DR patients. Results:There were statistically significant differences in CCT, IOPcc, IOPg, CH, and CRF among the eyes of the DR group, NDR group, and NDM group ( F=3.71, 5.60, 9.72, 9.02, 21.97; P<0.05). Pairwise comparisons were between groups, CH, CRF: the difference between the DR group and the NDM group and the NDR group was statistically significant ( P<0.05); CCT: the difference between the DR group and the NDM group was statistically significant ( P<0.05), and The difference in the NDR group was not statistically significant ( P>0.05). CCT, CH, CRF: the difference between the NDR group and the NDM group was not statistically significant ( P>0.05). The results of multiple linear regression analysis showed that CCT and IOPcc in DR patients were independent influencing factors of CH [CCT: β=0.01, 95% confidence interval ( CI) 0.01-0.03, P=0.013; IOPcc: β=-0.15, 95% CI -0.25--0.05, P=0.005]; Age, CCT, IOPcc were independent influencing factors of CRF [Age: β=-0.06, 95% CI -0.09--0.03, P<0.001; CCT: β=0.01, 95% CI 0.00-0.02, P=0.049; IOPcc: β=0.16, 95% CI 0.07-0.25, P=0.001]. The comparison of CCT, CH, CRF, adjusted CH, and adjusted CRF of the eyes in the NDR group, NPDR group, and PDR group were statistically significant ( F=3.76, 5.36, 12.61, 6.59, 10.41; P<0.05). Pairwise comparison between groups, CH, CRF, adjusted CH, adjusted CRF: the difference between the NPDR group, the PDR group and the NDR group was statistically significant ( P<0.05), and the difference between the PDR group and the NPDR group was not statistically significant ( P>0.05); CCT: The difference between NPDR group and NDR group, PDR group and NPDR group was not statistically significant ( P>0.05), and the difference between PDR group and NDR group was statistically significant ( P<0.05). Conclusion:The CH and CRF of eyes with T2DM and DR are elevated; CCT and IOPcc are independent influencing factors of CH, and age, CCT and IOPcc are independent influencing factors of CRF.

Objective:To observe the histopathological changes in peripheral retinal lesions under intraoperative optical coherence tomography (iOCT).Methods:A retrospective case series study. Eighty-eight patients (194 eyes) who underwent vitreoretinal surgery in the Department of Ophthalmology at the East Ward of the First Affiliated Hospital of Zhengzhou University from October 2021 to May 2022 in 94 eyes were included in the study. Among them, 49 cases were male and 39 cases were female, with the mean age of (50.93±17.55) years. Ninety-four eyes included 32 eyes with retinal detachment, 6 eyes with proliferative diabetic retinopathy, 28 eyes with vitreous hemorrhage, 8 eyes with ocular trauma, 14 eyes with the macular lesion, 1 eye with uveitis, 1 eye with family exudative vitreoretinopathy (FEVR), 1 eye with acute retinal necrosis (ARN), and 3 eyes with lens dislocation. All affected eyes were examined with iOCT during vitreoretinal surgery. The iOCT scanning of the peripheral retina was performed with the help of episcleral pressure. The pre-equatorial and serrated edge anterior and posterior of retinas were scanned according to the characteristics of different fundus diseases. Various abnormal fundus manifestations were recorded.Results:In 94 eyes, 53 eyes (56.38%, 53/94) have different types of retinopathy in the peripheral retina. Of these, 7 eyes (7.45%) have retinal cystoid degeneration; 19 eyes (20.21%) have lattice degeneration; and 8 eyes (8.51%) have pigment degeneration; 9 eyes (9.57%) have pavement-like degeneration; 7 eyes (7.45%) have small occult holes; 1 eye (1.06%) has familial exudative vitreoretinopathy (FEVR) serrated edge "dyke-like" proliferative degeneration; 4 eyes (4.26%) have vitreous and retinopathy adhesions; and one eye (1.06%) has ARN.Conclusion:With clear refractive media, iOCT can provide clear scans of different peripheral retinal lesions.